{"entity":{"id":"paper-emerald-1-lancet-2025","kind":"paper","name":"EMERALD-1: durvalumab with or without bevacizumab added to transarterial chemoembolisation for embolisation-eligible hepatocellular carcinoma","aka":[],"tldr":"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.\n\nMedian 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.","asOf":"2026-09-17","links":[{"label":"Lancet 2025","url":"https://doi.org/10.1016/S0140-6736(24)02551-0"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/39798579/"}],"tags":[],"related":[],"cancers":["hcc-intermediate"],"sections":[],"technologies":[],"targets":[],"drugs":["bevacizumab","durvalumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["emerald-1"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2025,"doi":"10.1016/S0140-6736(24)02551-0","pmid":"39798579","authors":"Sangro B, Kudo M, Erinjeri JP, et al.","paperType":"rct","findings":["Median progression-free survival 15.0 vs 8.2 months; hazard ratio 0.77.","Durvalumab alone with chemoembolisation: 10.0 months (not significant)."],"whatItMeans":"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."],"changedPractice":true,"participants":616},"route":"/key-papers/paper-emerald-1-lancet-2025/","neighbours":{"cancer":[{"id":"hcc-intermediate","kind":"cancer","name":"Intermediate hepatocellular carcinoma (BCLC B)","route":"/cancers/hcc-intermediate/"}],"drug":[{"id":"bevacizumab","kind":"drug","name":"Bevacizumab","route":"/drugs/bevacizumab/"},{"id":"durvalumab","kind":"drug","name":"Durvalumab","route":"/drugs/durvalumab/"}],"trial":[{"id":"emerald-1","kind":"trial","name":"EMERALD-1","route":"/trials/emerald-1/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}