DSM-TACE Versus Conventional Approaches in HCC: A Systematic Review and Meta-Analysis.

In 30 seconds

This systematic review and meta-analysis compared degradable starch microsphere transarterial chemoembolization (DSM-TACE) with conventional TACE or drug-eluting bead TACE in patients with hepatocellular carcinoma. Six comparative studies met inclusion criteria: one randomized controlled trial and five observational studies. Pooled analyses found no significant difference in tumor response or overall survival; the overall-survival hazard ratio was 1.04 (95% CI: 0.73-1.49; p = 0.690). Post-procedural liver enzyme results suggested, but did not establish, lower elevations with DSM-TACE. Adverse events could not be quantitatively pooled because the data were insufficiently homogeneous.

Key findings

• Tumor response was comparable between DSM-TACE and conventional-treatment groups, with no significant pooled difference.
• Overall survival did not significantly differ (HR = 1.04; 95% CI: 0.73-1.49; p = 0.690).
• ALT and AST analyses suggested lower post-procedural elevations with DSM-TACE, but differences were not statistically significant (ALT: β=30.3, p=0.163; AST: β=44.3, p=0.141).
• Adverse events were assessed narratively because data were insufficiently homogeneous for pooled quantitative analysis.

Why it matters

The findings suggest DSM-TACE may achieve radiological response and overall survival comparable to conventional approaches, while a possible difference in liver enzyme elevations remains uncertain. This helps frame DSM-TACE as an option under investigation rather than an established superior approach. The limited and mixed evidence base makes further well-designed comparative trials important for clarifying its efficacy and safety.

What to keep in mind

Only six studies were included, comprising one randomized trial and five observational studies. Adverse events could not be pooled quantitatively because of insufficiently homogeneous data.