ESMO 2026 | Liver function and post-progression outcomes in EMERALD-3 for eeHCC

The EMERALD-3 study is a study in patients with intermediate stage HCC and also with limited macrovascular invasion, VP1 and VP2. The study is positive and demonstrated that TACE plus STRIDE plus Lenvatinib, so STRIDE plus immunotherapy plus Tyrosine kinase inhibitors, is superior compared to TACE in terms of progression-free survival. And this study includes also an arm of TACE plus TRI, the tested versus TACE. At ESMO 2026, the investigators presented the data regarding liver function. This is important because liver function is a key point in the management of patients with HCC. And what they’ve shown is that, first, patients with ALBI grade 1 and ALBI grade 2, so the liver function was evaluated according to ALBI grade in this analysis, had similar baseline characteristics. The liver function remained stable over time, regardless of baseline ALBI grade or Child-Pugh score, assessed by Child-Pugh score and ALBI score and also the outcomes, the benefit of STRIDE plus or minus Lenvatinib plus TACE versus TACE was maintained regardless of baseline ALBI grade and in terms of safety, the safety profile is similar in the two groups, even though there are some differences, like a shorter period of duration of treatment or a lower number of TACEs for patients with ALBI grade 2. But overall, the safety profile is similar. And these results are really important because, as I said at the beginning, liver function is a key point in the management of patients with HCC. TACE can deteriorate liver function. Liver decompensation is a competing risk of death for these patients and so having this analysis showing that liver function can be maintained over time and the benefit of the triple combination is maintained regardless of baseline liver function is key for our patients.

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