AstraZeneca (AZ) has shared positive results from a late-stage study evaluating its immunotherapy Imfinzi (durvalumab) in a subset of patients with hepatocellular carcinoma (HCC), the most common type of liver cancer. 

The phase 3 EMERALD-1 trial has been comparing Imfinzi plus transarterial chemoembolisation (TACE), followed by Imfinzi with or without Genentech’s Avastin (bevacizumab), until progression against TACE alone in more than 600 patients with unresectable HCC eligible for embolisation.

About 75% of all primary liver cancers in adults are HCC and up to 30% of HCC patients are eligible for embolisation, a procedure that blocks blood supply to the tumour and can also deliver chemotherapy or radiation therapy directly to the liver.

Despite being the standard of care in this setting, AZ outlined that most patients who receive embolisation experience rapid disease progression or recurrence.

According to the results from EMERALD-1, which were presented at this year’s American Society of Clinical Oncology Gastrointestinal Cancers Symposium, Imfinzi in combination with TACE and Avastin reduced the risk of disease progression or death by 23% compared to TACE alone.

Median progression-free survival (PFS) was 15 months in patients treated with the Imfinzi combination versus 8.2 months with TACE and the PFS benefit was "generally consistent" across key pre-specified subgroups, AZ said.

Bruno Sangro, MD, PhD, Director of the Liver Unit and Professor of Medicine at Clínica Universidad de Navarra, Pamplona, Spain and a lead investigator in the EMERALD-1 trial, said: “In this earlier liver cancer setting, embolisation alone has been the standard of care for more than 20 years, and rates of disease progression have remained high. Adding durvalumab and bevacizumab to TACE reduced the risk of disease progression or death by twenty-three per cent for patients with liver cancer eligible for embolisation, showing for the first time that combining a systemic treatment with TACE meaningfully improves this clinically relevant outcome in earlier-stage disease.”

Susan Galbraith, Executive Vice President, Oncology R&D, AstraZeneca, said: “With Imfinzi-based treatment, patients with liver cancer eligible for embolisation lived nearly seven additional months before their disease progressed. We are discussing these positive EMERALD-1 data with global regulatory authorities while awaiting the final overall survival results from the trial.”