The addition of durvalumab and bevacizumab to transarterial chemoembolization (TACE) may improve progression-free survival (PFS) in patients with unresectable hepatocellular carcinoma (HCC) who were eligible for embolization, according to press release from ASCO.

These findings were presented by Lencioni et al at the 2024 ASCO Gastrointestinal Cancers Symposium (Abstract LBA432).

In the double-blind, global, three-arm phase III EMERALD-1 study, researchers randomly assigned 616 patients with embolization-eligible unresectable HCC to receive treatment with durvalumab plus bevacizumab and TACE, durvalumab plus TACE, or TACE alone. 

The patients who received durvalumab, bevacizumab, and TACE demonstrated a significant improvement in PFS vs the patients treated with TACE alone (median PFS = 15.0 vs 8.2 months). There was not a statistically significant difference in PFS in patients treated with durvalumab and TACE vs TACE alone.

Objective response rate and time to progression were also superior in the durvalumab, bevacizumab, and TACE group. Grade 3 or 4 treatment-related side effects and discontinuation of treatment occurred in a respective 32.5% and 8.4% of the patients in the durvalumab, bevacizumab, and TACE group; 15.1% and 4.3% of those in the durvalumab and TACE group; and 13.5% and 3.5% of those in the TACE-alone group.

The study authors concluded: “These results of the EMERALD-1 trial have the potential to establish a new standard of care for the treatment of unresectable HCC … by showing for the first time that adding an immunotherapy-based combination to TACE significantly improved PFS.”