Liver-Directed Therapy Combined with Systemic Therapy: Current Status and Future Directions

Shamar Young, Jack Hannallah, Dan Goldberg, Mohammad Khreiss, Rachna Shroff, Junaid Arshad, Aaron Scott, Gregory Woodhead

Research output: Contribution to journalArticlepeer-review


In the past several decades, major advances in both systemic and locoregional therapies have been made for many cancer patients. This has led to modern cancer treatment algorithms frequently calling for active interventions by multiple subspecialists at the same time. One of the areas where this can be clearly seen is the concomitant use of locoregional and systemic therapies in patients with primary or secondary cancers of the liver. These combined algorithms have gained favor over the last decade and are largely focused on the allure of the combined ability to control systemic disease while at the same time addressing refractory/resistant clonal populations. While the general concept has gained favor and is likely to only increase in popularity with the continued establishment of viable immunotherapy treatments, for many patients questions remain. Lingering concerns over the increase in toxicity when combining treatment methods, patient selection, and sequencing remain for multiple cancer patient populations. While further work remains, some of these questions have been addressed in the literature. This article reviews the available data on three commonly treated primary and secondary cancers of the liver, namely, hepatocellular carcinoma, cholangiocarcinoma, and metastatic colorectal cancer. Furthermore, strengths and weaknesses are reviewed and future directions are discussed.

Original languageEnglish (US)
Pages (from-to)515-523
Number of pages9
JournalSeminars in Interventional Radiology
Issue number6
StatePublished - 2024


  • hepatocellular carcinoma
  • immunotherapy
  • interventional radiology
  • intrahepatic cholangiocarcinoma
  • metastatic colorectal cancer
  • thermal ablation
  • transarterial chemoembolization
  • transarterial radioembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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