Magnesium microspheres for enhanced transarterial chemoembolization therapy of hepatocellular carcinoma: From animal models to a pilot clinical study
- Fei Gong
- Liyun Zheng
- Jiachen Xu
- Yumin Wu
- Qiutong Jin
- Jiaqi Lu
- Zifan Pei
- Zhongwei Zhao
- Minjiang Chen
- Jianfei Tu
- Shiji Fang
- Weiqian Chen
- Kailu Wei
- Nailin Yang
- Chuntao Gong
- Fazong Wu
- Yeyu Zhang
- Caifang Ni
- Liang Cheng
- Zhuang Liu
- Jiansong Ji
2025-07-02
Transarterial chemoembolization (TACE) has been extensively used in clinic to treat unresectable hepatocellular carcinoma (HCC). Herein, magnesium microspheres (Mg MSs) were used as embolic devices to enhance lipiodol-mediated TACE. After being dispersed in lipiodol and injected into tumors, Mg MSs would continuously generate hydrogen and magnesium hydroxide, which could neutralize the acidic tumor microenvironment, restore exhausted CD8 + T cells, reverse immunosuppression, and trigger specific T cell–mediated antitumor responses, synergistically resulting in inhibited tumor growth. As demonstrated in a rabbit orthotopic liver cancer model, artery infusion of Mg MS–dispersed lipiodol offered greatly enhanced therapeutic outcome compared to lipiodol-based or polymeric-bead–based TACE. In a pilot clinical study, among 15 eligible patients with HCC, 11 patients achieved complete response and 3 patients achieved partial responses without unexpected treatment-related adverse events during the 1 to 3 months’ follow-up. The objective response rate of Mg-enhanced TACE was ~93.3% in this small-scale trial, much higher than that of current TACE therapies.