Liver cancer remains one of the most formidable challenges in global oncology. In China, it accounts for nearly half of the world's new cases and deaths annually. Over 70% of patients in China are diagnosed at intermediate or advanced stages, leaving fewer than 25% eligible for surgical removal.

The challenge is further complicated by regional differences in the disease. While liver cancer in many Western countries is often linked to alcoholic cirrhosis, cases in China are primarily driven by viral hepatitis.

"Treatment strategies require standardization and precision," noted Professor Xiang Hua, president of Hunan Cancer Hospital. "For a long time, we relied on clinical evidence from abroad that did not always align with the specific characteristics of Chinese patients."

To bridge this gap, a multi-center collaborative effort led by Professor Teng Gaojun, an academician of the Chinese Academy of Sciences and director of the Department of Medicine and Life Sciences at Southeast University, has developed a comprehensive treatment strategy for intermediate and advanced liver cancer. This strategy integrates interventional therapy with innovative technology to address one of the most challenging forms of malignancy.

Evidence-based breakthroughs

The foundation of this progress lies in the China Liver Cancer Clinical Research Alliance (CHANCE), established in 2021. By connecting 156 top-tier hospitals, this network has built the world's largest database for interventional-based liver cancer care, tracking over 10,000 patients.

A study from this cohort, recently published in the Journal of Clinical Oncology, confirms that combining Transarterial Chemoembolization (TACE) – a procedure that delivers chemotherapy directly to the tumor's blood supply – with targeted therapy and immunotherapy significantly reduces the risk of disease progression.

This approach has now been elevated to a primary recommendation in national diagnostic guidelines, showing remarkable efficacy in complex cases. For instance, clinical results have documented a 68-year-old patient with a 13-centimeter tumor and multiple metastases who achieved effective disease control under this combined regimen. The patient has maintained a high quality of life for eight years while living with cancer.

Integrating technology and global collaboration

Beyond pharmacological gains, the research team employs a "bench-to-bedside" model that integrates medical engineering with clinical practice. This has led to the world's first iodine-125 radioactive stent system for treating tumor-induced biliary and vascular obstructions, along with Yttrium-90 carbon microspheres developed in partnership with domestic enterprises – yielding tumor remission rates of up to 40%. The team has also introduced multimodal AI-assisted robotic systems to enhance the precision and safety of tumor ablation and seed implantation.

To make these advancements reach a broader population, the International Society of Multidisciplinary Interventional Oncology (ISMIO) is currently working to upgrade the CHANCE cohort into an international research platform. By conducting multi-center studies with experts from the US and Singapore, the team aims to share these clinical insights with the global medical community.

China is now working to standardize these treatments across 500 hospitals. This initiative ensures that patients in remote areas can access the same high-quality care as those in major metropolitan centers, effectively narrowing the gap in cancer survival rates.

(Cover image designed by Pei Zihan)