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Review | Open Access

Hepatoma Research

Li et al. Hepatoma Res. 2026;12:36 DOI:10.20517/2394-5079.2025.114

Synergistic era: practice and reflection on TACE
combined with systemic therapy in hepatocellular
carcinoma

Chenghui Li 1,2,# , Li Chen 1,2,# , Hangfei Bao , Yuchen Wang , Jinhe Guo , Guangyu Zhu 1,2
1,2
1,2
1,2
Keywords:
Hepatocellular carcinoma,
transarterial
chemoembolization,
immunotherapy, targeted
therapy, combination
therapy

Citation: Li C, Chen L,
Bao H, Wang Y, Guo J, Zhu G.
Synergistic era: practice and
reflection on TACE
combined with systemic
therapy in hepatocellular
carcinoma. Hepatoma Res.
2026;12:36.
https://dx.doi.org/10.20517
/2394-5079.2025.114
Abstract
Received: 22 Dec 2025
First Decision: 13 Apr The treatment paradigm for hepatocellular carcinoma (HCC) is evolving from traditional
2026 stage-based monotherapy toward a synergistic era characterized by the proactive
Revised: 24 May 2026 integration of locoregional and systemic therapies. Transarterial chemoembolization
Accepted: 25 Jun 2026 (TACE) plus systemic therapy has shown notable synergistic potential, but it also
Published: 10 Jul 2026
complicates clinical decision-making and trial interpretation. This review briefly outlines
Academic Editor: advances in TACE and systemic therapy, summarizes key randomized controlled trials of
Lianxin Liu combination therapy, and analyzes core challenges in treatment timing, TACE
Copy Editor:
Ting-Ting Hu implementation, endpoint design, and patient selection. Although combination regimens
Production Editor: have not consistently demonstrated significant overall survival (OS) benefits in
Ting-Ting Hu intermediate-to-advanced HCC, improvements in progression-free survival, objective
response rate, and other disease-control endpoints have been increasingly reported. Future
prospective trials should look beyond drug selection alone and refine combination timing,
clinically meaningful endpoints, TACE standardization, and subgroup selection. These

1 Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast
University, Nanjing 210009, Jiangsu, China.
2 Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009,
Jiangsu, China.
# These authors contributed equally and share the first authorship.

Correspondence to: Prof. Guangyu Zhu, Prof. Jinhe Guo, Center of Interventional Radiology and Vascular Surgery, Department of
Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, Jiangsu, China. E-mail: njzgy@sina.com;
jinheguo@sina.com

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