The Effect of TACE on the Tumor Microenvironment and the Synergistic Effect of TACE Combined with Molecular Target Agent and Immune Checkpoint Inhibitor

Abstract

The tumor microenvironment is composed of multiple cells and structures, including blood vessels, fibroblasts, immune cells and the extracellular matrix. The tumor and its surrounding microenvironment are closely related and constantly interact for growth. The tumor microenvironment is characterized by abnormal tumor neovascularization, intra-tumor hypoxia, acidic environment, and increased number of tumor-associated immune cells, which play different roles in the growth and progression of cancer cells. Therefore, the tumor microenvironment is considered to be of great importance in understanding cancer biology and devising therapeutic strategies.
Recently, it has been reported that local therapies such as TACE and RFA produce adverse reactions that are different from the original therapeutic effect, activating the tumor microenvironment. Based on these findings, a new strategy is needed to control the adverse reactions associated with local treatment and lead to death of the tumor.
In this chapter, we describe the tumor microenvironment and the impact of TACE on hepatocellular carcinoma based on multiple in vitro and in vivo studies. We will also discuss the impact of newly approved tyrosine kinase inhibitors and immune checkpoint inhibitors on the microenvironment and their synergistic and complementary efficacy in combination with local therapies.