In-Depth Analysis Why TACE Fails in Treating Liver Cancer?

Transarterial Chemoembolization (TACE) is a treatment for Hepatocellular Carcinoma (HCC) where chemotherapy drugs are injected into the hepatic artery that supplies the tumor, followed by embolization to block the blood flow. This process restricts the tumor’s growth and destroys cancer cells.

Why TACE May Not Be Effective in Some Patients

1. Tumor Characteristics

• Large or Multiple Tumors:
  TACE may be less effective in patients with large or multiple liver tumors, making complete tumor destruction difficult.
• Portal Vein Invasion:
  If cancer has invaded the portal vein, embolization may cause liver failure due to blocked blood flow.

2. Abnormal Liver Blood Flow

• Neoangiogenesis (New Blood Vessel Formation): Tumors may develop new blood vessels, allowing them to receive nutrients despite embolization.
• Abnormal or Venous Connections:
  Abnormal blood vessels can prevent chemotherapy drugs from reaching the tumor effectively.

3. Liver Function Condition

• Severe Cirrhosis (Child-Pugh C):
  Patients with advanced cirrhosis may not tolerate TACE and face higher risks of complications.
• Impaired Liver Recovery:
  Poor liver function can hinder recovery after TACE, leading to poor treatment outcomes.

4. Chemotherapy Resistance

• Drug Resistance:
  Tumors resistant to chemotherapy used in TACE will reduce treatment effectiveness.
• Inappropriate Drug Selection:
  Mismatched chemotherapy drugs or incorrect dosages can lead to ineffective treatment.

5. Frequent TACE Sessions

• Repeated TACE:
  Multiple TACE procedures can damage healthy liver tissue, reducing liver function and limiting future treatment options.

6. Improper Patient Selection

• Advanced Cancer Stage:
  TACE is less beneficial for patients with metastatic cancer or extensive disease.
• Poor Overall Health:
  Weak or multi-disease patients may not tolerate TACE well.