EMERALD-1

EMERALD-1, trial NCT03778957 sponsored by AstraZeneca and reported in 2024, was the first trial to show that adding immunotherapy and an anti-VEGF drug to transarterial chemoembolisation delays progression in intermediate-stage hepatocellular carcinoma. It randomised 616 embolisation-eligible patients to TACE with durvalumab, with or without bevacizumab, or TACE with placebo, met its primary progression-free survival endpoint for the three-way combination, and overall survival trended favourably but was not statistically significant at follow-up, as published in the Lancet in 2025. OnCo links it to TACE as a technology and term, durvalumab and the pairing of TACE with immunotherapy and anti-VEGF drugs. Whether delaying progression after TACE translates into longer life is the open question, and LEAP-012 suggests it may not.