# EMERALD-1: durvalumab with or without bevacizumab added to transarterial chemoembolisation for embolisation-eligible hepatocellular carcinoma

Source: https://onco.cc/key-papers/paper-emerald-1-lancet-2025/  
OnCo record `paper-emerald-1-lancet-2025` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding durvalumab and bevacizumab to chemoembolisation lengthened the time to progression by about seven months in liver cancer suitable for embolisation, the first systemic combination to improve on chemoembolisation alone.

## Summary

Phase 3 placebo-controlled trial of 616 patients with unresectable hepatocellular carcinoma eligible for embolisation randomised to transarterial chemoembolisation with durvalumab plus bevacizumab, durvalumab alone, or placebo.

Median progression-free survival was 15.0 months with durvalumab plus bevacizumab against 8.2 months with placebo (hazard ratio 0.77), while durvalumab alone did not significantly improve progression-free survival; grade 3 to 4 adverse events were more frequent with the combination.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2025
- DOI: 10.1016/S0140-6736(24)02551-0
- Authors: Sangro B, Kudo M, Erinjeri JP, et al.
- Findings: Median progression-free survival 15.0 vs 8.2 months; hazard ratio 0.77.; Durvalumab alone with chemoembolisation: 10.0 months (not significant).
- What it means: Chemoembolisation combined with durvalumab and bevacizumab is a new option for intermediate-stage hepatocellular carcinoma where approved, though overall survival benefit is not yet shown.
- Caveats: Overall survival data immature.; Bleeding risk with bevacizumab requires endoscopic assessment.

## Sources

- Lancet 2025: https://doi.org/10.1016/S0140-6736(24)02551-0
- PubMed: https://pubmed.ncbi.nlm.nih.gov/39798579/

## Connected records

- cancers: [Intermediate hepatocellular carcinoma (BCLC B)](https://onco.cc/cancers/hcc-intermediate/)
- drugs: [Bevacizumab](https://onco.cc/drugs/bevacizumab/), [Durvalumab](https://onco.cc/drugs/durvalumab/)
- trials: [EMERALD-1](https://onco.cc/trials/emerald-1/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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