EMERALD-1 Post Hoc Analysis: Durvalumab, Bevacizumab, TACE Boosts PFS in HCC

A post hoc analysis of the EMERALD-1 study presented at the American Society of Clinical Oncology 2025 Gastrointestinal Cancers Symposium has revealed the benefits of durvalumab plus bevacizumab and transarterial chemoembolization (TACE) for patients with embolization‑eligible hepatocellular carcinoma (HCC).

In EMERALD-1, investigators analyzed the combination of durvalumab plus bevacizumab and TACE versus placebo with TACE. Patients in this post hoc analysis received durvalumab (1500 mg) or placebo every 4 weeks with conventional or drug-eluting bead TACE. After this, patients were administered either durvalumab (1120 mg) plus bevacizumab (15 mg/kg) or placebo every three weeks.

The radiologic progression patterns at the time of first progression of disease (PD) were assessed by the investigators according to modified Response Evaluation Criteria in Solid Tumors (RECIST). New lesions were classified as new intrahepatic lesions (NIH) or new extrahepatic lesions (NEH).

Tumor growth of existing intrahepatic lesions (defined as an increase of ≥20% of an existing target lesion with at least 5 mm absolute increase or unequivocal PD with a non-target lesion) was classified as intrahepatic growth. Efficacy was assessed by time to progression (TTP).

PD was found in 53.9% of patients in the durvalumab plus bevacizumab and TACE arm and in 79.0% of patients in the placebo plus TACE arm. The most common pattern of disease progression in both treatment arms was NIH, occurring in 73 (35.8%) and 107 (52.2%) patients in the durvalumab plus bevacizumab and TACE arm and in the placebo plus TACE arm, respectively, with 31 (15.2%) and 34 (16.6%) patients exhibiting intrahepatic growth, and 24 (11.8%) and 39 (19.0%) patients exhibiting NEH, respectively.

Although improvements in TTP and rate of progression were noted in patients treated with durvalumab plus bevacizumab and TACE versus placebo plus TACE regardless of progression pattern, the pattern was similar, with NIH being the most common pattern in both treatment arms.

Consistent benefit in TTP was observed in patients treated with durvalumab plus bevacizumab and TACE, and the combination met the trial’s primary endpoint of progression-free survival in this patient population.