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World J Hepatol. Dec 27, 2023; 15(12): 1284-1293
Published online Dec 27, 2023. doi: 10.4254/wjh.v15.i12.1284
Any role for transarterial radioembolization in unresectable intrahepatic cholangiocarcinoma in the era of advanced systemic therapies?
Alessandra Elvevi, Alice Laffusa, Federica Elisei, Sabrina Morzenti, Luca Guerra, Antonio Rovere, Pietro Invernizzi, Sara Massironi
Alessandra Elvevi, Alice Laffusa, Pietro Invernizzi, Sara Massironi, Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza 20900, Italy
Federica Elisei, Luca Guerra, Department of Nuclear Medicine, Fondazione IRCCS San Gerardo dei Tintori University of Milano Bicocca, Monza 20900, Italy
Sabrina Morzenti, Medical Physics, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
Antonio Rovere, Department of Radiology and Interventional Radiology, Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza 20900, Italy
Author contributions: Elvevi A and Morzenti S conceptualization, review, and editing; Laffusa A literature searcher and wrote the original draft; Elisei F wrote the original draft and expert opinion; Massironi S wrote the original draft and expert opinion; Guerra L, Rovere A, and Invernizzi P expert opinion and supervision.
Conflict-of-interest statement: All authors declare that they are bound by confidentiality agreements that prevent them from disclosing their conflicts of interest in this work.
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: Sara Massironi, MD, PhD, Chief Physician, Doctor, Medical Assistant, Research Scientist, Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori Hospital, Via Pergolesi 33, Monza 20900, Italy. sara.massironi@libero.it
Received: August 1, 2023
Peer-review started: August 1, 2023
First decision: October 9, 2023
Revised: November 27, 2023
Accepted: December 5, 2023
Article in press: December 5, 2023
Published online: December 27, 2023
Processing time: 145 Days and 22.2 Hours
Core Tip

Core Tip: Intrahepatic cholangiocarcinoma (iCCA), the second most common type of liver cancer, is frequently diagnosed at an advanced stage due to limited diagnostic tools and undefined risk factors. Surgery, the potential cure, is often infeasible. Ongoing investigations into unresectable iCCA treatment include chemotherapy, targeted therapy, immunotherapy, and locoregional treatments. Transarterial radioembolization (TARE) demonstrates safety and effectiveness, with a median response rates (34%-86%) and OS (12-16 mo) varying due to patient heterogeneity. Key prognostic factors include tumor burden, portal vein involvement, and patient performance status. The median overall survival reported after TARE is of 22 mo with 22% of tumor down-staging. TARE is a viable unresectable iCCA treatment, especially when combined with systemic chemotherapy. Nonetheless, further research is needed to optimize treatment combinations and identify predictive factors for favorable responses in iCCA patients.