By VETTAPHARMA reporter – Derek Roche: AstraZeneca reported that IMFINZI® (durvalumab) plus IMJUDO® (tremelimumab) combined with lenvatinib and transarterial chemoembolization (TACE) significantly improved progression-free survival (PFS) in patients with embolization-eligible unresectable hepatocellular carcinoma (HCC) in the Phase III EMERALD-3 trial. The results were presented in a late-breaking session at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting.
In a planned interim analysis, the STRIDE regimen (Single Tremelimumab Regular Interval Durvalumab) combined with lenvatinib and TACE reduced the risk of disease progression or death by 30% compared with TACE alone (hazard ratio [HR] 0.70; 95% confidence interval [CI] 0.57–0.86; p=0.0007). Median PFS was 13.0 months in the investigational arm versus 9.8 months with TACE alone.
EMERALD-3 is a global Phase III, randomized, open-label, sponsor-blinded study evaluating STRIDE plus lenvatinib and TACE, STRIDE plus TACE, or TACE alone in patients with locoregional HCC not eligible for curative treatment. The trial enrolled 760 patients across 171 centers in 22 countries.
For the key secondary endpoint of overall survival (OS), investigators observed a positive trend favoring the IMFINZI-based regimen. Median OS was 39.5 months in the STRIDE plus lenvatinib and TACE arm compared with 34.7 months in the TACE-alone arm (HR 0.84; 95% CI 0.65–1.09; p=0.1814). The study continues with follow-up for final OS analysis.
Hepatocellular carcinoma is the most common form of liver cancer and remains a leading cause of cancer-related mortality worldwide. Patients with embolization-eligible unresectable disease often receive TACE, but recurrence and disease progression remain common following treatment.
For patients, the findings suggest that integrating dual immunotherapy and targeted therapy with TACE may extend the time patients live without disease progression. The regimen also offers a potential systemic treatment strategy for a population with limited options beyond locoregional therapy.
Commercially, the results further expand AstraZeneca’s IMFINZI franchise in liver cancer and support the company’s strategy of moving immunotherapy combinations into earlier stages of disease. Positive Phase III data may also support future regulatory discussions in embolization-eligible unresectable HCC.
Quick FAQs
What Is the Drug/Product/Asset?
IMFINZI (durvalumab) is a PD-L1 inhibitor and IMJUDO (tremelimumab) is a CTLA-4 inhibitor. In EMERALD-3, the medicines were used as the STRIDE regimen in combination with lenvatinib and TACE for patients with unresectable hepatocellular carcinoma.
What Did AstraZeneca Present at ASCO?
AstraZeneca presented Phase III EMERALD-3 data showing that IMFINZI plus IMJUDO combined with lenvatinib and TACE significantly improved progression-free survival compared with TACE alone in embolization-eligible unresectable HCC.
What Is the Study/Trial?
EMERALD-3 is a global Phase III randomized study evaluating STRIDE plus lenvatinib and TACE, STRIDE plus TACE, or TACE alone in 760 patients with embolization-eligible unresectable hepatocellular carcinoma.
What Is the Disease Condition?
Hepatocellular carcinoma is the most common type of liver cancer. Patients enrolled in EMERALD-3 had unresectable disease that was eligible for embolization but not curative treatment.
What Were the Key Results?
The STRIDE plus lenvatinib and TACE regimen reduced the risk of disease progression or death by 30% versus TACE alone (HR 0.70; p=0.0007). Median PFS was 13.0 months versus 9.8 months, and a positive OS trend was observed with median OS of 39.5 months versus 34.7 months.
Why Is This Important?
The findings demonstrate that combining immunotherapy, targeted therapy, and TACE can significantly delay disease progression in embolization-eligible unresectable HCC. The results may support future treatment strategies and regulatory discussions in earlier-stage liver cancer.
