Guerbet China Hosts Online Roundtable on Interventional Oncology: Experts Highlight c-TACE as a Validated Approach in HCC and the Emerging Blue Ocean Market

This session features a dialogue with industry leaders—Professor Li Xiao, Chief Physician at the Cancer Hospital of the Chinese Academy of Medical Sciences; Professor Jin Yong, Chief Physician at the Second Affiliated Hospital of Soochow University; and Cui Bin, General Manager of Guerbet China—on the management of hepatocellular carcinoma (HCC), transarterial chemoembolization (TACE) treatment strategies, and recent market developments.

VCBeat attended the conference and conducted interviews with Professor Li Xiao and Cui Bin, General Manager of Guerbet China.

Primary Liver Cancer (hereinafter referred to as liver cancer) is one of the most common malignant tumors worldwide. China is a high-incidence region for liver cancer globally, with annual deaths from this disease accounting for more than half of the global total. Among these cases, hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver.

Curative treatments for liver cancer include surgical resection, liver transplantation, and local ablation therapy. However, due to the insidious onset, rapid progression, and high malignancy of liver cancer, it is often diagnosed at an intermediate or advanced stage, thereby missing the window for curative intervention. Transarterial chemoembolization (TACE) has become the preferred treatment modality for patients with intermediate-to-advanced stage liver cancer.

Normal liver tissue receives 75%–80% of its blood supply from the portal vein, whereas more than 90% of the blood supply to hepatocellular carcinoma (HCC) tissue comes from the hepatic artery. This constitutes the theoretical basis for the effective treatment of HCC with transarterial chemoembolization (TACE), which inhibits tumor growth by blocking arterial blood flow, thereby causing tumor cells to “starve to death.”

c-TACE Treatment: Under the guidance of DSA (Digital Subtraction Angiography), a microcatheter is inserted into the tumor-feeding arteries to inject an emulsion mixture of iodized oil and chemotherapeutic agents. The iodized oil blocks the nutrient supply required for tumor growth, while the chemotherapeutic drugs inactivate the tumor tissue, thereby inhibiting tumor progression and leading to gradual tumor shrinkage or necrosis.

Lipiodol® Iodized Oil is a pale yellow/amber, radiopaque oily iodinated contrast agent manufactured by Guerbet, organically bound to ethyl esters of poppy seed oil fatty acids. In c-TACE, Lipiodol® serves as a contrast agent, a drug delivery vehicle, and provides dual embolization (arterial and portal venous vessels).

In June 2020, China’s National Medical Products Administration (NMPA) approved Lipiodol® for use in conventional transarterial chemoembolization (c-TACE) in adult patients with intermediate-stage hepatocellular carcinoma. Prior to this, Lipiodol® had been approved in China in 1993 for radiodiagnostic applications, such as lymphography and hysterosalpingography.

At this conference, Professor Li Xiao presented on “The Formation and Development of the Interventional Therapy Specialty in China.”

Conventional transarterial chemoembolization (c-TACE) was introduced in 1978, and interventional radiology entered China in 1979; both have since been in practice for over 40 years. In addition to conventional transarterial chemoembolization (c-TACE), two major new techniques have emerged: drug-eluting bead transarterial chemoembolization (D-TACE) and transarterial radioembolization (TARE).

Professor Li Xiao further stated, “Interventional medicine is one of the most dynamic and fastest-growing disciplines in the current medical field, with the rapid advancement of interventional therapy for liver cancer serving as a prime example. In general hospitals, interventional medicine has been recognized as the third major diagnostic and therapeutic system, following internal medicine and surgery. In oncology hospitals, its status is becoming increasingly prominent. While the three traditional pillars of cancer treatment are internal medicine, surgery, and radiotherapy, interventional medicine has emerged as the fourth pillar.”

Professor Jin Yong shared his insights on “guideline-based refined c-TACE technique.” “In the past, how embolization was performed varied considerably among practitioners, with no consensus. However, as clinical applications have expanded, there is now a need to refine procedural details. The 2018 Clinical Practice Guidelines for Transarterial Chemoembolization (TACE) in the Treatment of Hepatocellular Carcinoma in China, under the guidance of Professor Teng Gaojun, represents an important guideline in this field.”

In addition, Professor Jin Yong introduced the indications for TACE and superselective catheterization into the tumor-feeding vessels for treatment. He recommended using CBCT functionality for intraoperative navigation and postoperative verification during TACE, which can enable more accurate embolization and protect the patient’s liver parenchyma.

The conference also discussed the relationship between interventional therapy and the traditional “three pillars” of oncology: surgery, chemotherapy, and radiotherapy. Professor Li Xiao believes that, from the perspectives of both historical development and clinical application, interventional therapy is not contradictory to the “three pillars,” nor can it replace them.

Professor Jin Yong believes that there is currently a low level of patient awareness regarding interventional oncology. In cancer hospitals, after diagnosis, patients are aware that they need to take medication or undergo surgery, but few request interventional therapy. However, as awareness increases in the future, the penetration rate of interventional therapy will continue to rise. “After all, once you have taken the high-speed rail, your preferred mode of transportation will certainly not be a horse-drawn carriage.”

Guerbet is a French pharmaceutical company founded in 1926 that provides a range of pharmaceuticals, medical devices, and digital AI solutions for diagnostic and interventional imaging, including contrast media and high-pressure injectors. Listed on the Euronext Paris exchange (Segment B – mid-cap), Guerbet reported annual revenue of €732 million in 2021. The company employs more than 2,600 people worldwide, operates four R&D centers in France, Israel, and the United States, and invests over 10% of its annual revenue in research and development.

Gaber China was established in Shanghai in 2013 and has over 50 employees.

In 1901, Lipiodol® (iodized oil) was first discovered and used for therapeutic purposes by the French pharmacist Marcel Guerbet. In 1921, Lipiodol® was first applied in radiology. In China, Lipiodol® is used to treat a variety of diseases, particularly liver cancer and related liver diseases that pose significant health risks to many citizens.

Two years ago, Lipiodol® Iodized Oil Injection received domestic approval for its c-TACE indication, marking the beginning of Guerbet’s development in China’s interventional imaging field. Moving forward, the company will continue to increase its R&D investment, dedicated to obtaining innovative and potent interventional oncology treatments.

Cui Bin, General Manager of Guerbet China, stated, “Iodized oil plays a significant role in the development of hepatocellular carcinoma (HCC) treatment in China. For many years, Guerbet has remained committed to addressing local customer needs, supporting healthcare professionals in clinical decision-making across all stages with high-quality products and advanced solutions, thereby effectively improving patient outcomes and enhancing public health and well-being. Looking ahead, Guerbet will continue to deepen its roots in the Chinese market, increase investment, benefit Chinese patients, and fully support the achievement of the strategic goals outlined in ‘Healthy China 2030.’”