# EMERALD-1

Source: https://onco.cc/trials/emerald-1/  
OnCo record `emerald-1` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The first trial to show that adding immunotherapy and an anti-VEGF drug to TACE delays progression in intermediate-stage liver cancer.

## Summary

EMERALD-1, trial NCT03778957 sponsored by AstraZeneca and reported in 2024, was the first trial to show that adding immunotherapy and an anti-VEGF drug to transarterial chemoembolisation delays progression in intermediate-stage hepatocellular carcinoma. It randomised 616 embolisation-eligible patients to TACE with durvalumab, with or without bevacizumab, or TACE with placebo, met its primary progression-free survival endpoint for the three-way combination, and overall survival trended favourably but was not statistically significant at follow-up, as published in the Lancet in 2025. OnCo links it to TACE as a technology and term, durvalumab and the pairing of TACE with immunotherapy and anti-VEGF drugs. Whether delaying progression after TACE translates into longer life is the open question, and LEAP-012 suggests it may not.

## Fields

- Kind: Trial
- Status: mixed
- Last checked: 2026-09-07
- Registry id: NCT03778957
- Phase: 3
- Setting: Embolisation-eligible unresectable HCC: TACE + durvalumab ± bevacizumab vs TACE + placebo
- Sponsor: AstraZeneca
- Enrolled: 616
- Result: PFS HR 0.77; OS HR 0.80, not significant.
- Outcomes: Progression-free survival: TACE + durvalumab + bevacizumab 15 months vs TACE + placebo 8.2 months, HR 0.77; Overall survival: TACE + durvalumab + bevacizumab vs TACE + placebo, HR 0.8

## Sources

- ClinicalTrials.gov NCT03778957: https://clinicaltrials.gov/study/NCT03778957
- Lancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02551-0/abstract

## Connected records

- cancers: [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Intermediate hepatocellular carcinoma (BCLC B)](https://onco.cc/cancers/hcc-intermediate/)
- technologies: [Transarterial chemoembolisation (TACE)](https://onco.cc/technologies/tace/)
- drugs: [Durvalumab](https://onco.cc/drugs/durvalumab/)
- companies: [AstraZeneca](https://onco.cc/companies/astrazeneca/)
- terms: [TACE (transarterial chemoembolisation)](https://onco.cc/terms/tace-term/)
- pairings: [TACE + immunotherapy/anti-VEGF](https://onco.cc/pairings/tace-plus-systemic/)
- key papers: [EMERALD-1: durvalumab with or without bevacizumab added to transarterial chemoembolisation for embolisation-eligible hepatocellular carcinoma](https://onco.cc/key-papers/paper-emerald-1-lancet-2025/)
- roadmaps: [Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work](https://onco.cc/roadmaps/surgery-roadmap/)

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JSON: https://onco.cc/api/v1/entities/emerald-1.json