TARE vs TACE for Hepatocellular Carcinoma and NET patients

TARE vs TACE for Hepatocellular Carcinoma and NET patients

The incidence of Hepatocellular Carcinoma or HCC has been increasing over the past several years and several studies have projected that the incidence of HCC will continue to rise in the coming years.

Transarterial Chemoembolisation or TACE has been the initial treatment modality for HCC and has a huge body of evidence from several studies and clinical trials. Therefore, for long TACE has been a preferred treatment algorithm for unresectable HCC. However, as the experience of Transarterial Radioembolisation or TARE has evolved, it is playing an increasingly important role in the treatment of unresectable HCC. Studies and trials have shown that TARE has many potential advantages over TACE and there is now substantial evidence to favor TARE over TACE.

 tace vs tare

The many potential advantages of TARE when compared with TACE are as below:

  • Several studies have shown a statistically significant overall survival advantage with TARE as compared to TACE.
  • TARE has better health-related quality-of-life metrics and toxicity profile when compared with TACE.
  • TARE as a much wider range of applications, including use in patients with more advanced liver disease, multi-focal disease, vascular invasion and portal vein thrombosis. Actually, TARE is more suitable for patients of HCC with portal vein thrombosis because of the small size of TARE particles when compared with TACE, which tends to induce more ischemia and necrosis.
  • Studies have also shown a much-lower risk of post-embolisation syndrome with TARE as compared with TACE.
  • In terms of side-effects, TARE is overall well-tolerated, whereas post-TACE, there is deterioration of the liver function coupled with pain and fever.
  • In patients with early-stage HCC and preserved liver function who are not candidates for radiofrequency ablation, TARE provides better response rates, tumor control and survival outcomes.
  • In Neuroendocrine Tumor (NET) patients with multiple lesions in both the lobes of the liver, TARE is a preferred modality and TACE is not recommended at all.
  • Also, in NET patients where the tumor does not express somatostatin receptors, TARE is a much better treatment technique as compared to TACE.
  • When it comes to cost, the upfront cost of a single TARE session is much higher (at least two to three times higher) than the cost of a single TACE session. However, considering the cost of hospital admission, pain control, treatment multiplicity and toxicity, the overall cost-effectiveness of TARE is likely to be superior to TACE in patients with unresectable HCC.  

In terms of overall survival and delay of progression in patients with unresectable HCC, TARE is as efficacious as TACE, however TARE has an evolving role to play in the treatment of HCC with more advanced liver disease, multi-focal disease, vascular invasion and portal vein thrombosis. Apart from these reasons, a more favorable side-effects profile and cost are the other potential advantages of TARE as compared to TACE.

 

About The Author

Manav Sadhwani

Head Patient Facilitation
Hi, I am Manav. I have spent over 7 years working in the Healthcare Industry. My experience spans marketing and treatment management of oncology patients from across the globe. .... Read More..

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