{"entity":{"id":"tare-plus-durvalumab-hcc","kind":"pairing","name":"Radioembolisation (TARE) with durvalumab in hepatocellular carcinoma","aka":[],"tldr":"Small early trials are giving liver-directed radiation beads (TARE) together with the immunotherapy drug durvalumab for liver cancer that cannot be operated on. Early results show high tumour shrinkage rates, but these are small studies and it is not yet proven that the combination helps people live longer than either treatment alone.","summary":"A phase I/IIa pilot trial (Aliseda et al., Clinical Cancer Research 2023) treated 24 patients with locally advanced, unresectable hepatocellular carcinoma (Child-Pugh score up to 7, BCLC stage B or non-metastatic BCLC-C) with yttrium-90 radioembolisation followed 7-14 days later by intravenous durvalumab 1500 mg every 4 weeks. At a median follow-up of 19 months, median time to progression was 15.2 months, 18-month overall survival was 58.3%, and the objective response rate by modified RECIST was 83.3% (29.2% complete response, 54.2% partial response). Toxicity was modest: 47.8% of patients had any-grade treatment-related adverse events and only 8.7% had grade 3 events (neutropenia, fever), with no treatment-related serious adverse events.\n\nThis single-arm signal has prompted larger prospective studies of TARE plus durvalumab-based regimens, including the phase II ROWAN study (NCT05063565, Boston Scientific-sponsored, TheraSphere followed by durvalumab plus a single dose of tremelimumab, the STRIDE regimen; enrolment of 100 patients completed August 2025, results expected 2027) and EMERALD-Y90 (NCT06040099, AstraZeneca-sponsored, TARE followed by durvalumab and bevacizumab, 58 patients enrolled). A retrospective National Cancer Database analysis of 1,664 patients cited by Boston Scientific also associated TARE plus immunotherapy with improved survival compared with immunotherapy alone, though retrospective comparisons of this kind cannot rule out selection bias.\n\nAs of September 2026 none of the randomised, adequately powered trials of TARE plus systemic immunotherapy in HCC has reported a definitive survival readout; the evidence base is early-phase and registry-level. Clinicians should treat the high response rates from the pilot study as hypothesis-generating rather than practice-changing pending ROWAN and EMERALD-Y90 results.","asOf":"2026-09-22","links":[{"label":"Aliseda et al., Y90-radioembolisation plus durvalumab phase I/IIa trial, Clin Cancer Res 2023;29:3650-3658","url":"https://pubmed.ncbi.nlm.nih.gov/37459133/"},{"label":"Boston Scientific TheraSphere systemic therapy combination evidence brochure","url":"https://www.bostonscientific.com/content/dam/bsc/us/pi/ir/ioe/therasphere/downloads/TheraSphere-Systemic-Brochure.pdf"},{"label":"ROWAN study (NCT05063565) enrolment-complete summary","url":"https://oncodaily.com/oncolibrary/immune-oncology/rowan-study-enrol-complet"},{"label":"ClinicalTrials.gov: NCT06040099 (EMERALD-Y90, TARE + durvalumab + bevacizumab)","url":"https://clinicaltrials.gov/study/NCT06040099"}],"tags":["hepatocellular carcinoma","radioembolisation","immunotherapy"],"related":["hcc","sirtex","boston-scientific","astrazeneca","nct05063565","nct06040099","y-90"],"indications":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"radioembolisation-tare","b":"durvalumab","rationale":"Radiation from TARE can release tumour antigens and prime an immune response, providing a rationale for combining it with checkpoint blockade in unresectable hepatocellular carcinoma where systemic options are limited.","evidence":"Phase I/IIa pilot trial (n=24): objective response rate 83.3% by modified RECIST (29.2% complete response), 18-month overall survival 58.3%, low grade 3 toxicity (8.7%) (Aliseda et al., Clin Cancer Res 2023); larger randomised readouts (ROWAN, NCT05063565; EMERALD-Y90, NCT06040099) are pending as of September 2026.","pairingType":"combination"},"route":"/pairings/tare-plus-durvalumab-hcc/","neighbours":{"indication":[{"id":"hcc","kind":"indication","name":"Hepatocellular carcinoma","route":"/indications/hcc/"}],"company":[{"id":"astrazeneca","kind":"company","name":"AstraZeneca","route":"/companies/astrazeneca/"},{"id":"boston-scientific","kind":"company","name":"Boston Scientific","route":"/companies/boston-scientific/"},{"id":"sirtex","kind":"company","name":"Sirtex Medical","route":"/companies/sirtex/"}],"trial":[{"id":"nct06040099","kind":"trial","name":"A US Study to Evaluate Transarterial Radioembolization (TARE) in Combination With Durvalumab and Bevacizumab Therapy in People With Unresectable Hepat","route":"/trials/nct06040099/"},{"id":"nct05063565","kind":"trial","name":"TheraSphere With Durvalumab and Tremelimumab for HCC","route":"/trials/nct05063565/"}],"isotope":[{"id":"y-90","kind":"isotope","name":"Yttrium-90","route":"/isotopes/y-90/"}],"technology":[{"id":"radioembolisation-tare","kind":"technology","name":"Radioembolisation (TARE / SIRT, yttrium-90)","route":"/technologies/radioembolisation-tare/"}],"drug":[{"id":"durvalumab","kind":"drug","name":"Durvalumab","route":"/drugs/durvalumab/"}]}}