Patient Pamphlet

Drug Eluting Transarterial

Chemoembolization (deTACE)
of Liver Tumors:
A minimally invasive option for
treating liver tumors
Diagnosis of Liver Cancer
Most people do not realize that primary liver cancer is
the fifth most common cancer in the world. Like many
forms of cancer, early detection is important for treating
cancer of the liver. While some patients do not exhibit
symptoms until the disease is in its later stages, others
have their cancer detected early enough for potentially
curative therapies.

Liver tumors come in a variety of sizes, and patients

sometimes have more than one tumor. The location, size
and type of tumor(s) as well as an assessment of your
underlying liver disease helps your doctor determine
the appropriate type of treatment and the associated
prognosis.

Treatment Therapies
There are various methods to treating liver cancer
depending on the stage of the cancer.

One treatment therapy is called drug eluting

Transarterial Chemoembolization (deTACE). This
minimally invasive therapy uses embolics (small spheres)
delivered into the tumor to block the blood supply
and inhibit the tumor’s growth, and to deliver cancer-
fighting chemotherapy. deTACE is one of the most
common methods for treating liver cancer and may be
done with HepaSphere Microspheres. Many physicians
think deTACE is preferable to systemic chemotherapy
because it causes fewer side effects and concentrates the
chemotherapy in the liver.
Treatment Options
Systemic Chemotherapy
With this therapy the drug circulates
throughout the entire body rather than
just to the tumor where it is needed.
Pros:
• Does not require a procedure
Cons:
• Drug circulates throughout body
• Many side effects
• Can damage other organs
Drug is red.
Conventional
Chemoembolization
With this therapy the drug is injected
into the tumor and an embolic is then
used to block the blood supply to the
tumor. This is a procedure that has been
used for many years.
Pros:
• More targeted treatment than
systemic chemotherapy
• Blocks blood supply to tumor
Cons:
• Drug often escapes from tumor
• Side effects
Drug is red.
 HepaSphere Microspheres (deTACE)

With this therapy, the drug eluting embolic (HepaSphere Microspheres) is loaded
with chemotherapy (cancer drugs) and delivered directly to the tumor. This is a newer
therapy that blocks the blood supply to the tumor and also delivers cancer-fighting
drugs from within the tumor over time, thus minimizing drug exposure to the rest of
the body.

Pros:
• Targeted treatment
• Minimizes exposure of drug to rest of body
• Blocks blood supply to tumor
• Reduced side effects
• Fewer adverse events

Cons:
• Side effects

Drug is red.
 About HepaSphere Microspheres
Drug eluting transarterial chemoembolization has been used to treat
liver cancer since 2006. HepaSphere Microspheres are embolics that
are used for this procedure.

Benefits of HepaSphere Microspheres (deTACE)

With conventional chemoembolization, patients often experience
side effects, such as hair loss. The data below shows how using
HepaSphere Microspheres offers a reduction in side effects.

In a published randomized clinical study1 comparing treatment by

conventional chemoembolization to deTACE using HepaSphere
Microspheres, the results show that with HepaSphere Microspheres
less of the drug escapes into circulation. This significantly reduces side
effects such as hair loss as well as serious and life-threatening adverse
events.

• Less Hair Loss

HepaSphere Conventional
Microspheres (deTACE) Chemoembolization

Hair Loss 0% (0 of 16 patients) 71% (10 of 14 patients)

• Fewer Adverse Events

70 - 70 -
60 - 60 -
50 - 50 -
% OF PATIENTS
% OF PATIENTS

40 - 40 -
30 - Conventional 30 -
Chemoembolization
20 - 20 - Conventional
Chemoembolization
10 - 10 -
0%
0- 0-
PATIENTS WITH PATIENTS WITH POTENTIALLY
SERIOUS ADVERSE EVENTS LIFE-THREATENING EVENTS
Who Performs the Procedure?
HepaSphere Microsphere (deTACE) procedures are performed by
physicians trained to perform minimally invasive procedures through
the body’s vascular system. Typically, this type of physician is an
interventional radiologist. Oncologists (cancer specialists) and other
physicians are often consulted prior to the procedure to recommend the
best treatment option for you.
The Procedure
Pre-Procedure
Before undergoing the procedure, patients will have a series of
tests performed to assess their condition. This can include blood tests
and imaging.

The Procedure
A small nick is made at the top of your inner thigh and a thin tube
(catheter) is inserted. Using x-ray imaging, the catheter is guided to the
liver (hepatic) artery which feeds the tumor. You may feel slight pressure
but no serious discomfort.

X-ray dye is injected through the catheter and x-ray images will be
taken to check that the catheter is in the right place. As contrast media
passes through your body, you may experience a warm sensation.

Once the catheter is in place, HepaSphere Microspheres that are

loaded with the chemotherapy drug are injected through the catheter.
X-ray images are taken during the procedure to ensure HepaSphere
Microspheres are delivered to the target area. HepaSphere
Microspheres will begin blocking the flow of blood and releasing
chemotherapy drug to the liver tumor.

The procedure usually takes about one to two hours. At the end of the
procedure, the catheter will be removed and pressure will be applied
to the puncture site for a short period of time.
After the Procedure
When Can I Go Home?
Most patients are able to leave the hospital within one to two days
after the procedure.

Side Effects
During the first two weeks after the procedure, you may have to limit
your normal activities due to the side effects of embolization, referred
to as postembolization syndrome (PES). The most common symptom of
PES is abdominal pain because the blood supply to the tumor is cut off.
You may also feel tired, nauseated, have a fever and experience loss
of appetite. You may be given medicine to minimize these symptoms.

Follow up
During the first month after the procedure, remember to follow- up as
directed with your physician to let him/her know how your recovery is
going. You will need to get follow up imaging. The imaging will be
reviewed by your doctor to determine how your tumor responded to
the treatment.

Depending on the response of the tumor and on your general health,

more sessions may be arranged and/or other treatments may be
offered. Repeating the procedure can be a normal part of managing
your cancer.
 Procedure/Anatomy Overview

Tumor

Liver

Aorta
Hepatic Artery

Vena Cava

Iliac Artery

Catheter
 Delivery of Embolic

Embolic Loaded
Tumor with Chemotherapy

Liver

Catheter

Tumor Response to Procedure

Non-Viable Shrunken Tumor

Questions to Ask Your Doctor
• How effective is drug eluting transarterial
chemoembolization (deTACE) as a cancer treatment?

• What are the risks associated with drug eluting

transarterial chemoembolization (deTACE)?

• How long will I be in the hospital?

• What are the side effects or complications?

• What type of care will I need after the procedure?

• When will I be able to resume normal activity?

NOTES
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 This pamphlet was created, printed and distributed as an educational service from Merit Medical Systems, Inc. While every reasonable care has
been taken to ensure accuracy in compiling the content of this pamphlet, it is for informational purposes only and is not intended to provide
medical advice. Always consult a doctor regarding the diagnosis and treatment of any medical condition.

Reference:
1
van Malenstein, et al. “A Randomized Phase II Study of Drug-Eluting Beads Versus Transarterial Chemoembolization for Unresectable
Hepatocellular Carcinoma.” Onkologie 2011; 34(7): 368-76.

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