On the other hand, it has been shown that chemotherapeutics can exhibit several beneficial effects on the immune system in spite of its myelosuppressive effects. For example, gemcitabine increases the antigen cross-presentation, T lymphocyte expansion, and the T-cell infiltration of tumors [37] and 5-FU has been described to upregulate tumor antigen expression on colorectal cancer cells [38]. In fact, some pilot clinical trials in cancer patients indicate that the efficacy of anticancer vaccines may be enhanced by chemotherapy [39]. Beside

our results and published data #Vemurafenib cell line keyword# from other groups showing the advantage of DSM in TACE, a high-class randomized clinical study with respect to a prolongation of the overall survival is still lacking. Those randomized prospective clinical trials choosing the overall survival as primary endpoint will give the chance to discover whether there is a statistically significant survival benefit as well as

an improvement of the Inhibitors,research,lifescience,medical quality of life for cancer patients receiving regional drug therapy with DSM. Moreover, the stimulatory effect Inhibitors,research,lifescience,medical of chemotherapy on tumor immunogenicity without impairing the immune effector cell function may provide a strong rationale to combine TACE using DSM with dendritic cell vaccination procedures. 5. Conclusion Taken together, the investigations show Inhibitors,research,lifescience,medical that DSM is a very effective embolization material leading to effective and enhanced accumulation of

5-FU especially within the liver tumor tissue. The selective increased accumulation of the drug in the tumor tissue is supposed to be partly due to portal washout, which occurs only in healthy liver parenchyma. Interestingly, the degradation processes of DSM lead to temporally blood flow shiftings caused by a negative pressure in the occluded blood vessels. This mechanism may also lead to increased contact frequency of the drug with the tumor tissue. By using DMS in transarterial chemoembolization (TACE), severe adverse side effects like post-embolization syndrome are Idoxuridine rarely observed when compared Inhibitors,research,lifescience,medical to other embolization materials like Lipiodol or permanent embolization materials. Several of these materials lead to a permanent vascular occlusion and thus limit repeated treatments. The complete degradation of DSM causes only a short-lasting temporary vascular occlusion, which allows a repeat application of DSM in TACE. Meanwhile, it is known that some chemotherapeutics can exhibit several beneficial effects on the immune system in spite of its myelosuppressive effects. For example, 5-FU has been described to upregulate tumor antigen expression on cancer cells. Thus, the use of DSM in TACE can be probably combined with immune therapeutic treatment approaches not having the same myelosuppressive effect as when the drug is administered systemically.