Transarterial chemoembolization (TACE) is a type of treatment for liver cancer. It works by delivering chemotherapy drugs directly to the tumor and blocking its blood supply.

Liver cancer occurs when cells of the liver begin growing and dividing uncontrollably. The American Cancer Society estimates that 42,240 new diagnoses of liver cancer will be made in the United States in 2025.

The treatment of liver cancer depends on several factors. These include:

  • its stage
  • whether it can be removed with surgery
  • if you’re eligible for a liver transplant

TACE is a potential treatment for liver cancer. Doctors typically use it when the cancer is contained in the liver but cannot be removed with surgery.

Keep reading to learn more about TACE for liver cancer, including how it works, ideal candidates, and potential risks.

TACE is a treatment used for hepatocellular carcinoma, the most common type of liver cancer. Experts estimate that 90% or more of liver cancers are hepatocellular carcinomas.

While most of your healthy liver cells get their blood from the hepatic portal vein, liver cancers often receive their blood supply through the hepatic artery.

Embolization uses substances that block blood flow in the part of the hepatic artery that’s supplying the tumor. When the tumor doesn’t have an adequate blood supply, it will begin to die.

In TACE, chemotherapy drugs are used with embolization. Because the artery is blocked off during the procedure, it allows the chemotherapy to stay close to the tumor.

You may be eligible for TACE if the following are true:

There are several reasons surgery may not be feasible. For example, a tumor could be large or in an area of the liver that cannot be removed safely. There may also be several tumors instead of just one, making surgery more challenging.

Some people will also have TACE to help shrink their tumor(s) while they wait for a liver transplant. This is referred to as bridge therapy.

TACE may also be combined with other liver cancer treatments, such as:

Is transarterial chemoembolization used for other types of cancer?

TACE may also be used for other types of cancers that have spread to the liver. This is called liver metastasis.

A few examples of cancers that commonly spread to the liver include:

TACE can be an effective treatment option for colorectal, breast, and pancreatic cancers when they spread to the liver.

While embolization treatments like TACE can be helpful for treating liver cancer, they cannot cure this type of cancer. The only two possibilities for cure are liver resection (surgery) or liver transplantation.

While it can’t cure liver cancer, TACE has several benefits. According to a 2024 review, TACE can help:

  • improve survival, especially when used with other treatments
  • maintain your eligibility for a liver transplant
  • reduce liver cancer symptoms
  • boost liver function

Before your TACE procedure, your care team will give instructions on how and when to take any existing medications before your procedure. You will need to fast for at least 4 to 6 hours beforehand.

You typically undergo TACE under conscious sedation. This means you’re awake but are given medications that make you feel relaxed and drowsy. Healthcare professionals also administer a local anesthetic so you don’t feel pain during the procedure.

A catheter is typically inserted into an artery in your groin. Once inserted, it’s threaded up to the hepatic artery. Imaging and a special dye are used to help find the blood vessels supplying the tumor.

TACE can be delivered in two ways:

  • In conventional TACE, the chemotherapy drugs are given into the artery. Then, the artery is plugged (embolized).
  • In drug-eluting bead chemoembolization (DEB-TACE), tiny beads with an attached chemotherapy drug are given into the artery, and then the artery is embolized. The beads release the chemotherapy drugs slowly over a longer period of time.

Cisplatin and doxorubicin are two types of chemotherapy drugs that are commonly used for TACE.

After the procedure is complete, the catheter is withdrawn and your incision is closed. TACE can take up to 1.5 hours. You may need to stay in the hospital for 1 or 2 nights afterward.

It’s normal to have some side effects after TACE. These may include flu-like symptoms, like nausea, body aches, and generally feeling unwell. You may also have bruising or discomfort in the area where the catheter was inserted.

TACE is generally a very safe procedure. However, complications can occur. The rate of complications related to TACE is still low, less than 5%.

Examples of potential complications of TACE include:

Your care team will discuss the potential complications associated with TACE before your procedure. Be sure to ask any questions you may have during this time.

TACE can be quite effective at improving the outlook for people with liver cancer.

A 2023 study including 97 people treated with TACE for early stage hepatocellular carcinoma found that 86.6% of study participants had a complete response to treatment. The 3-year survival rate after TACE was 75.4%.

Some research suggests that using DEB-TACE may lead to a better treatment response than using conventional TACE, although researchers also note that DEB-TACE was associated with more side effects.

Researchers have also found that combining TACE with other liver cancer treatments increases its effectiveness.

For example, combining TACE with the targeted therapy drug sorafenib (Nexavar) can improve overall survival than TACE treatment alone. Adding immunotherapy to TACE with targeted therapy may have further benefits.

Other treatments may be used instead of TACE, such as treatment with external beam radiation therapy. Some research suggests that, compared with TACE, radiation therapy leads to improved local control of the cancer and boosted progression-free survival.

Other treatments that may be used instead of TACE include systemic treatments like chemotherapy, targeted therapy, or immunotherapy.

While TACE is an effective treatment for liver cancer, there are several factors that may influence its outlook. These may include but aren’t limited to:

  • tumor size and number
  • tumor location
  • level of liver function
  • amount of alpha-fetoprotein (AFP), a marker of liver cancer
  • whether or not TACE was combined with other treatments

Sometimes a cancer may not respond well to TACE treatment. In some situations, repeated TACE procedures may be done to try to achieve a response.

TACE refractoriness is when there’s no response after repeated TACE treatments. In this scenario, doctors may use other types of treatments instead.

TACE is a procedure doctors may use in the treatment of liver cancer. It works by delivering chemotherapy drugs to the tumor and then closing off the blood flow to the tumor.

Ideal candidates for TACE are people who cannot have surgery for their liver cancer, who have cancer that’s still localized to the liver, and who have good liver function. TACE may also be used as a bridge therapy before a liver transplant.

TACE may help improve liver cancer survival and is often more effective when combined with other treatments. If you’ve recently received a diagnosis of liver cancer that cannot be treated with surgery, talk with your care team about the benefits and risks of TACE.