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Editorial | Open Access

Hepatoma Research

Zhong. Hepatoma Res. 2026;12:54 DOI:10.20517/2394-5079.2026.95

Combining locoregional and systemic therapies in
liver cancer: from strategy to survival

Bin-Yan Zhong

Citation: Zhong BY. Hepatocellular carcinoma (HCC) remains a major global health challenge and
Combining locoregional and accounts for the majority of primary liver cancers. Despite remarkable advances in
systemic therapies in liver
cancer: from strategy to surveillance, surgical techniques, locoregional interventions, and systemic therapies,
survival. Hepatoma Res. the prognosis of many patients with HCC remains unsatisfactory because of frequent
2026;12:54. recurrence, treatment resistance, and the complex interplay between tumor
https://dx.doi.org/10.20517
/2394-5079.2026.95 progression and underlying liver disease. These challenges have driven a
fundamental transformation in the therapeutic paradigm of HCC, moving beyond
Received: 13 Aug 2026 single-modality treatment toward multidisciplinary and integrated therapeutic
Accepted: 19 Aug 2026
[1]
Published: 2 Sep 2026 strategies .
Academic Editor:
Huiguo Ding Historically, locoregional therapies and systemic therapies have developed as
Copy Editor: relatively independent treatment approaches. Locoregional modalities, including
Ting-Ting Hu transarterial chemoembolization (TACE), thermal ablation, and selective internal
Production Editor:
Ting-Ting Hu radiation therapy (SIRT) with yttrium-90 (Y-90) microspheres, have primarily
focused on achieving local tumor control. In contrast, systemic therapies, particularly
immune checkpoint inhibitors (ICIs) and targeted therapies, have aimed to control
tumor progression at a systemic level. However, advances in tumor biology have
increasingly revealed that these two therapeutic domains are not mutually exclusive.
Instead, they may complement each other through modulation of tumor immunity,
angiogenesis, and the tumor microenvironment .
[2]

The concept of combining locoregional and systemic therapies has therefore evolved
from empirical clinical practice toward biologically rational treatment strategies.
Locoregional therapies can induce tumor necrosis, promote the release of tumor-
associated antigens, and reshape the immune microenvironment. Meanwhile,
treatment-induced hypoxia, angiogenic activation, and immunosuppressive changes
may contribute to tumor recurrence and resistance. Systemic therapies, including
immune checkpoint blockade and anti-angiogenic agents, may counteract these
adaptive mechanisms and enhance the durability of local treatment effects. The
emerging clinical evidence supporting TACE combined with systemic therapies
illustrates this transition, while also highlighting unresolved questions regarding
patient selection, treatment sequencing, and clinically meaningful endpoints.

Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences,
Hangzhou 310022, Zhejiang, China.

Correspondence to: Dr. Bin-Yan Zhong, Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of
Medicine (HIM), Chinese Academy of Sciences, Hangzhou 310022, Zhejiang, China. E-mail: byzhongir@sina.com

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