WILMINGTON, Del. — AstraZeneca said Monday that a regimen combining Imfinzi, Imjudo, lenvatinib and transarterial chemoembolization reduced the risk of disease progression or death by 30% compared with TACE alone in patients with unresectable hepatocellular carcinoma eligible for embolization.
The results came from the Phase 3 EMERALD-3 trial and were presented at the 2026 American Society of Clinical Oncology Annual Meeting in Chicago.
In a planned interim analysis, the STRIDE regimen, which includes a single dose of tremelimumab-actl followed by regular interval durvalumab, combined with lenvatinib and TACE showed a statistically significant and clinically meaningful improvement in progression-free survival. Median progression-free survival was 13 months for the combination compared with 9.8 months for TACE alone.
The regimen showed a progression-free survival hazard ratio of 0.70, with a 95% confidence interval of 0.57 to 0.86 and a p-value of 0.0007. AstraZeneca said the benefit was broadly consistent across key prespecified patient subgroups.
The company also reported a positive trend in overall survival for the STRIDE regimen with lenvatinib and TACE compared with TACE alone. The overall survival hazard ratio was 0.84, with a 95% confidence interval of 0.65 to 1.09 and a p-value of 0.1814.
A second investigational arm evaluating the STRIDE regimen plus TACE, without lenvatinib, also showed clinically meaningful improvement compared with TACE alone, though the results were not formally tested at this analysis. Median progression-free survival was 12.9 months for STRIDE plus TACE compared with 8.1 months for TACE alone. The arm also showed an overall survival hazard ratio of 0.70, with a 95% confidence interval of 0.51 to 0.95.
The trial will continue to assess overall survival and other key secondary endpoints in both investigational arms.
“Patients with embolization-eligible liver cancer face the burden of repeated localized therapy and are in urgent need of new systemic treatment options to delay disease progression and recurrence. The EMERALD-3 trial represents a meaningful advance for patients, with nearly one in three alive and progression-free at two years when treated with this dual immunotherapy regimen with or without lenvatinib, with a trend toward improved survival,” said Ghassan Abou-Alfa, MD, JD, MBA, PhD(hc), attending physician and professor of medicine at Memorial Sloan Kettering Cancer Center and principal investigator in the trial.
Susan Galbraith, executive vice president of oncology haematology R&D at AstraZeneca, said the results build on findings from the company’s earlier HIMALAYA Phase 3 trial.
“Building on practice-changing results from the HIMALAYA Phase III trial, these progression-free survival results and the early overall survival trend in the EMERALD-3 trial highlight the meaningful impact of bringing the STRIDE regimen into an earlier setting. These results advance our strategy to move novel immunotherapy regimens into earlier stages of cancer and underscore the opportunity to bring new treatment options for patients into this challenging liver cancer setting,” Galbraith said.
AstraZeneca said the safety profile for each combination was consistent with the known profiles of the individual medicines. Grade 3 or higher adverse events from all causes occurred in 71.4% of patients receiving STRIDE plus lenvatinib and TACE, 64% of patients receiving STRIDE plus TACE, and 28.6% of patients receiving TACE alone.
