EMERALD-3 — STRIDE (Durvalumab plus Tremelimumab) With or Without Lenvatinib Combined With Transarterial Chemoembolization (TACE) in Embolization-Eligible Hepatocellular Carcinoma

Phase 3 · 2026 · Hepatocellular Carcinoma

Design

Global phase 3 trial randomizing embolization-eligible HCC patients to TACE plus STRIDE (durvalumab plus a single priming dose of tremelimumab) with or without oral lenvatinib, versus TACE alone.

Population

Adults with unresectable, embolization-eligible (locoregional/intermediate-stage) hepatocellular carcinoma with preserved liver function.

Primary Endpoint

progression-free survival (PFS)

Key Result

Both experimental arms significantly improved progression-free survival versus TACE alone. STRIDE (durvalumab + tremelimumab) plus lenvatinib added to TACE: median PFS 13.0 vs 9.8 months (HR 0.70, 95% CI 0.57–0.86; P=.0007). STRIDE plus TACE without lenvatinib: median PFS 12.9 vs 8.1 months (HR 0.71, 95% CI 0.56–0.91). This is the first systemic-therapy combination to delay progression in the embolization-eligible setting. Presented at ASCO 2026 (LBA4000).

Guideline Impact

Systemic therapy added to TACE in embolization-eligible (intermediate-stage) HCC