Haitham Shaheen, Lecturer of Clinical Oncology at Suez Canal University Egypt, shared a post on LinkedIn:
“HCC at ESMOGI26: Beyond PFS, towards the full patient journey
One of the most interesting discussions at ESMO GI 2026 focused on combining immunotherapy with TACE in intermediate-stage HCC.
EMERALD-1
- Evaluated TACE + durvalumab followed by durvalumab ± bevacizumab versus TACE alone.
- The study improved PFS but did not demonstrate an OS benefit in the final analysis.
EMERALD-3
- Evaluated STRIDE ± lenvatinib combined with TACE versus TACE alone.
- The study met its primary endpoint with significant PFS improvement and showed an encouraging OS signal with STRIDE + TACE, with longer follow-up awaited.
My key takeaways:
- Not every PFS benefit translates into an OS benefit in HCC.
- Treatment sequencing matters. The timing of immunotherapy may be just as important as the treatment itself.
- Patient selection remains critical, particularly for patients beyond the Up-to-7 criteria.
- Toxicity and preservation of liver function remain essential when evaluating combination strategies.
Perhaps the most important message from the session was that intermediate-stage HCC should be viewed as a patient journey, not a single treatment decision.
With survival often extending beyond 30 months, subsequent therapies and treatment sequencing may influence outcomes as much as the initial TACE-based strategy itself.
‘PFS is a surrogate for OS benefit that does not always perform.’
My biggest takeaway:
- The question is no longer whether to combine systemic therapy with TACE, but which patients benefit, with which regimen, and at what point in their treatment journey.”
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