{"entity":{"id":"tace-plus-systemic","kind":"pairing","name":"TACE + immunotherapy/anti-VEGF","aka":[],"tldr":"Adding drugs to the catheter procedure keeps intermediate-stage liver cancer under control for longer, though a survival gain is still unproven.","summary":"This combination adds immune checkpoint inhibitors, with or without anti-VEGF therapy, to transarterial chemoembolisation for intermediate-stage hepatocellular carcinoma. TACE releases tumour antigen and induces hypoxia-driven VEGF; PD-1 or PD-L1 blockade exploits the former and anti-angiogenic therapy counters the latter. Three phase 3 trials, EMERALD-1, LEAP-012 and EMERALD-3, all improved progression-free survival, but LEAP-012's final overall survival analysis and EMERALD-1's non-significant trend leave the survival question open. Toxicity roughly doubles with the added drugs, so the trade-off is longer disease control against more side effects without a proven gain in survival.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03778957: EMERALD-1","url":"https://clinicaltrials.gov/study/NCT03778957"},{"label":"ClinicalTrials.gov NCT04246177: LEAP-012","url":"https://clinicaltrials.gov/study/NCT04246177"}],"tags":[],"related":[],"cancers":["hcc"],"sections":[],"technologies":["tace","antiangiogenic"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["emerald-1","leap-012","emerald-3"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"tace","b":"checkpoint-inhibitor","rationale":"TACE releases antigen and induces hypoxia-driven VEGF; PD-(L)1 blockade exploits the former and anti-VEGF counters the latter.","evidence":"Three positive phase 3 trials for PFS; no OS benefit shown.","pairingType":"combination"},"route":"/pairings/tace-plus-systemic/","neighbours":{"cancer":[{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"},{"id":"hcc-intermediate","kind":"cancer","name":"Intermediate hepatocellular carcinoma (BCLC B)","route":"/cancers/hcc-intermediate/"}],"technology":[{"id":"antiangiogenic","kind":"technology","name":"Anti-angiogenic therapy","route":"/technologies/antiangiogenic/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"tace","kind":"technology","name":"Transarterial chemoembolisation (TACE)","route":"/technologies/tace/"}],"trial":[{"id":"emerald-1","kind":"trial","name":"EMERALD-1","route":"/trials/emerald-1/"},{"id":"emerald-3","kind":"trial","name":"EMERALD-3","route":"/trials/emerald-3/"},{"id":"leap-012","kind":"trial","name":"LEAP-012","route":"/trials/leap-012/"}]}}