Transarterial embolization microspheres for liver cancer: current applications and advances

Transarterial chemoembolization (TACE) is a minimally invasive interventional technique developed specifically for hypervascular tumours, including intermediate-to-advanced hepatocellular carcinoma (HCC). This procedure achieves dual therapeutic mechanisms through catheter-based delivery of chemotherapeutic agents using embolic materials directly into tumor-feeding arteries, thereby inducing both localized chemotherapy and ischemic necrosis. TACE demonstrates distinct advantages, including precise tumor targeting, minimal invasiveness, and procedural repeatability, and has been established as a standard treatment modality for unresectable intermediate-to-advanced HCC. This review systematically summarizes recent advances in embolic microspheres and their applications in TACE procedures for HCC. The dual functional roles of embolic microspheres in inducing tumor ischemia while delivering chemotherapeutics were comprehensively analyzed. A systematic analysis of current research progress was provided regarding embolic microsphere development from 3 critical perspectives: material physical properties, radiographic visibility characteristics, and manufacturing methodologies. The challenges in standardizing embolization protocols, optimizing drug release kinetics, translating novel biomaterials into clinical practice, and establishing robust efficacy evaluation metrics were discussed with a brief analysis of future directions for studies of embolic microspheres.