Shi SM, Zhou QQ, Ren YM, Liu TF. Breaking through the transarterial chemoembolization resistance barrier: Reshaping the treatment path for advanced liver cancer with triple therapy. World J Clin Oncol 2025; 16(11): 112404 [DOI: 10.5306/wjco.v16.i11.112404]
Corresponding Author of This Article
Teng-Fei Liu, PhD, Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No. 241 Huaihai West Road, Shanghai 200030, China. liutfei@alumni.sjtu.edu.cn
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Oncology
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Editorial
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 24, 2025 (publication date) through Nov 21, 2025
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World Journal of Clinical Oncology
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2218-4333
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Shi SM, Zhou QQ, Ren YM, Liu TF. Breaking through the transarterial chemoembolization resistance barrier: Reshaping the treatment path for advanced liver cancer with triple therapy. World J Clin Oncol 2025; 16(11): 112404 [DOI: 10.5306/wjco.v16.i11.112404]
World J Clin Oncol. Nov 24, 2025; 16(11): 112404 Published online Nov 24, 2025. doi: 10.5306/wjco.v16.i11.112404
Breaking through the transarterial chemoembolization resistance barrier: Reshaping the treatment path for advanced liver cancer with triple therapy
Su-Ming Shi, Qing-Qing Zhou, Yi-Meng Ren, Teng-Fei Liu
Su-Ming Shi, ENT Institute, Department of Otorhinolaryngology, Eye and ENT Hospital, NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
Qing-Qing Zhou, Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
Yi-Meng Ren, Department of Endoscopy Center and Endoscopy Research Institute, Shanghai Collaborative Innovation Center of Endoscopy, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Teng-Fei Liu, Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
Co-first authors: Su-Ming Shi and Qing-Qing Zhou.
Co-corresponding authors: Yi-Meng Ren and Teng-Fei Liu.
Author contributions: Shi SM and Zhou QQ contributed to the conception and design of the study, acquisition of data, analysis and interpretation of data, and drafting the article; they contributed equally to this article, and they are the co-first authors of this manuscript; Ren YM and Liu TF contributed to conceiving and drafting the initial article and were responsible for the critical revision and final approval of the manuscript; they contributed equally to this article, and they are the co-corresponding authors of this manuscript; All authors read and approved the final version to be published.
Supported by the National Natural Science Foundation of China, No. 82404058; Shanghai Municipal Commission of Health and Family Planning, No. 2024ZZ2049; and Beijing Xisike Clinical Oncology Research Foundation, No. Y-HS202401-0011.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Teng-Fei Liu, PhD, Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, No. 241 Huaihai West Road, Shanghai 200030, China. liutfei@alumni.sjtu.edu.cn
Received: July 28, 2025 Revised: August 29, 2025 Accepted: October 21, 2025 Published online: November 24, 2025 Processing time: 118 Days and 17.5 Hours
Abstract
In this article we commented on an article published recently by Jiao et al. This retrospective study confirmed that the triple therapy of transarterial chemoembolization (TACE) combined with programmed death protein ligand 1 inhibitors and molecular targeted therapy can significantly reverse TACE resistance in advanced hepatocellular carcinoma. Compared with TACE alone, the triple therapy reduced the resistance rate from 38.8% to 9.7% and increased the median progression-free survival and median overall survival by 92.3% and 26.8%, respectively. TACE induces tumor antigen release and upregulates programmed death protein ligand 1, activating the effect of immune checkpoint inhibitors while molecular targeted therapy inhibits postembolization vascular regeneration, forming a dynamic synergistic network of embolization-immune activation-vascular inhibition. The maximum tumor diameter, capsule loss, and bilateral distribution were identified as independent predictors. This study provided level I evidence and promoted the transformation of advanced hepatocellular carcinoma treatment from single local intervention to an integrated model of local control-systemic treatment. In the future it will be necessary to analyze the dynamic evolution rules of the tumor microenvironment through cross-omics strategies, further explore biomarkers, optimize treatment sequences, and conduct multicenter prospective trials to verify long-term survival benefits and guide the optimization of individualized sequential treatment.
Core Tip: This article discussed a research article published recently focusing on the synergistic value of triple therapy of transarterial chemoembolization combined with programmed death protein ligand 1 inhibitors and molecular targeted therapy to overcome transarterial chemoembolization resistance in advanced liver cancer. The article covered relevant topics and provided insights into the application of the triple therapy in clinical practice.
