Acetazolamide enhanced drug-eluting beads: manipulating the hepatocellular carcinoma microenvironment

Abstract

Hepatocellular carcinoma (HCC) is the most common type of primary liver malignancy. Intra-arterial therapies such as drug-eluting bead transarterial chemoembolization (DEB-TACE) can be effective forms of locoregional treatment for HCC. Solid liver tumors such as HCC promote a biochemical tumor microenvironment (TME) that allows tumor recurrence. The TME creates an environmental acidic pH, which induces chemotherapy resistance and immunosuppression. To address TME acidity, pharmacological agents like acetazolamide could be combined with primary transarterial therapies to optimize HCC treatment. We present a case of a 51-year-old male with a history of alcoholic cirrhosis and recently diagnosed HCC who underwent DEB-TACE with acetazolamide, resulting in complete tumor response on 1.5, 4.5, and 7.5 months follow-up.

Keywords:

• Hepatocellular carcinoma
• drug eluting beads
• chemoembolization
• carbonic anhydrase
• tumor microenvironment

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.