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ESMO 2025 | HIMALAYA: 5-year survival data of tremelimumab and durvalumab vs sorafenib in uHCC

Ghassan Abou-Alfa, MD, Memorial Sloan Kettering Cancer Center, New York, NY, discusses the long-term outcomes and clinical significance of the Phase III HIMALAYA trial (NCT03298451), which evaluated the combination of the anti-CTLA-4 antibody tremelimumab with the anti-PD-L1 antibody durvalumab in unresectable hepatocellular carcinoma (uHCC). Durable survival benefits were observed, representing a major step forward in immunotherapy for hepatocellular carcinoma. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.

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Transcript

“I love how much we continue to be asked here at ESMO 2025 in Berlin about the HIMALAYA study. It’s a great study we’re very proud of. And if anything, this was the add-on of the anti-CTLA-4-tremelimumab plus the anti-PD-L1-durvalumab. And great benefit. Improvement in survival by the median was about 16.43 months versus 13 for sorafenib as a standard of care therapy...

“I love how much we continue to be asked here at ESMO 2025 in Berlin about the HIMALAYA study. It’s a great study we’re very proud of. And if anything, this was the add-on of the anti-CTLA-4-tremelimumab plus the anti-PD-L1-durvalumab. And great benefit. Improvement in survival by the median was about 16.43 months versus 13 for sorafenib as a standard of care therapy. But as we all know, there’s a time for priming of the T cells, and that priming will actually lead to those kind of what we call long tails on the curves, and that continued separation with the Kaplan-Meier curves. It’s really wonderful, and we really continue to celebrate the recent publication that we have, and colleagues and co-authors from the HIMALAYA study in the Journal of Hepatology about the five-year survival. Numbers that, admittedly, I still can’t really fathom in my mind about advanced liver cancer with five-year survival. And guess what? Patients will receive only a single dose of tremelimumab, one single dose of tremelimumab, and continue to repeat the therapy of durvalumab once a month, they have 20% survival at five years, at five years. So in other words, one in five patients will be alive at five years. And this was compared to about like close to about 10% or so for the sorafenib. So clearly that dose, remember, we give it only once, that was given five years ago, it still has an impact to really benefit patients. And to that matter, we know very well durvalumab itself, probably a tad closer to the sorafenib, about 13 or so, but definitely the standout of the anti-CTLA-4 plus anti-PD1, really fascinated, we were fascinated by it when we looked at the five-year survival for the HIMALAYA study, which is a great standard-of-care therapy now for a patient with liver cancer.

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