WILMINGTON, Del. — AstraZeneca said a combination of its immunotherapy drugs IMFINZI (durvalumab) and IMJUDO (tremelimumab-actl), alongside lenvatinib and transarterial chemoembolization (TACE), significantly improved progression-free survival in patients with unresectable liver cancer, according to results from the Phase III EMERALD-3 trial.
The study met its primary endpoint, showing a statistically significant and clinically meaningful improvement in progression-free survival compared with TACE alone in patients with hepatocellular carcinoma eligible for embolization. The combination also showed a trend toward improved overall survival, a key secondary endpoint, at the interim analysis.
Patients in the investigational arms received the STRIDE regimen — a combination of tremelimumab-actl and durvalumab — with or without lenvatinib before undergoing TACE, and continued treatment alongside the procedure. The trial is ongoing to further evaluate overall survival and other secondary endpoints.
Hepatocellular carcinoma is the most common form of liver cancer, and more than 200,000 patients globally are expected to be eligible for embolization in 2026. While TACE is a standard treatment, most patients experience disease progression or recurrence within six to 10 months.
Dr. Ghassan Abou-Alfa, a physician and professor of medicine at Memorial Sloan Kettering Cancer Center and a principal investigator in the trial, said the findings represent a meaningful step forward.
“Dual immunotherapy with durvalumab and tremelimumab-actl in the STRIDE regimen represents a meaningful advance for patients with embolization-eligible liver cancer, who currently lack systemic treatment options to keep their cancer from progressing or recurring, with a trend of improving survival. EMERALD-3 shows we can now significantly reduce the risk of disease progression with STRIDE as the immunotherapy backbone alongside lenvatinib and TACE,” Abou-Alfa said.
Susan Galbraith, executive vice president of oncology hematology research and development at AstraZeneca, said the results build on earlier clinical data.
“EMERALD-3 now shows that bringing the dual immunotherapy STRIDE regimen earlier, alongside TACE and lenvatinib, can further improve outcomes in earlier-stage liver cancer. This builds on the HIMALAYA Phase III trial data in patients with advanced, unresectable disease, where the STRIDE regimen has already demonstrated durable overall survival benefit. We are discussing these positive data with global regulatory authorities while awaiting the final results from the key secondary endpoints,” Galbraith said.
AstraZeneca said the safety profile of the combination therapy was consistent with the known profiles of the individual treatments, with no new safety concerns identified.
The company plans to present the data at an upcoming medical meeting and share the results with regulatory authorities worldwide.
