Immunologic Response to Transcatheter Arterial Chemoembolization in an Animal Model of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the fifth most common malignancy in the world1 and the fast-rising cause of cancer deaths in the United States2. For the majority of patients presenting beyond resection or transplant eligibility, locoregional therapies (LRT: ablation, TACE, and radioembolization) have demonstrated significant survival benefits3,4. For intermediate stage disease, TACE is the standard of care, with proven survival benefit5-8. However, TACE is limited by tumor revascularization and recurrence, frequently requiring repeated treatments9-11. Therefore, opportunities to optimize treatment of unresectable HCC to improve response rate and survival require exploration. Combining TACE, which has been shown to affect cellular immune function and induce a peripheral immune response12-14, with immunotherapy is appealing mechanism for enhancing anti-tumor response15,16. The objective of this study is to characterize the timeline of immune response to TACE using pre-loaded, radiopaque, drug-eluting beads (DEBs), in an immunocompetent rat model of HCC in order to inform combination therapy with immune checkpoint inhibitors.