Evolving HCC Treatment: Combining Immunotherapy and TACE

Antonella Cammarota, MD, of Humanitas Research Hospital, spoke with Lorenza Rimassa, MD, of Humanitas University, to discuss the growing data for immunotherapy–based treatment in HCC, including presentations from the 2026 American Society of Clinical Oncology Annual Meeting.

Ongoing trials like phase 3 EMERALD-3 study have shown that combining systemic immunotherapy regimens with standard of care TACE improved progression-free survival for TACE–eligible patients with unresectable HCC. If approved, medical oncologists may need to collaborate more heavily with hepatologists, radiologists, and potentially surgeons to effectively implement these strategies. Incorporating immunotherapy alongside other treatment modalities in earlier lines of treatment may also require more shared management of toxicities amongst multidisciplinary teams.

In addition to novel immunotherapy and TACE combinations, studies are also investigating the use of immunotherapy regimens in patient subgroups with more decompensated liver function. These patients were historically excluded from initial immunotherapy trials in HCC. Safety data from the phase 3b SIERRA study suggested the STRIDE (single tremelimumab regular interval durvalumab) regimen had comparable tolerability for patients with poorer liver function, including Child-Pugh Class B patients. If efficacy data are positive, Child-Pugh Class B patients and other subgroups may have more access to immunotherapy–based treatment options in the future, said Dr. Rimassa.