Immunotherapy in hepatocellular carcinoma: Combination strategies

Table 6 Summary of active clinical trials evaluating combination therapy of checkpoint inhibitors plus ablation, trans-arterial chemoembolization, or radiation

Therapy	Comparator	Therapy indication	Phase	Estimated study duration	Estimated patient enrollment	Primary endpoints	Trial identifier
Pembrolizumab plus RFA or MWA	None	First-line	II	May 9, 2019-September 2022	30	ORR	NCT03753659 (IMMULAB)
Durvalumab plus tremelimumab plus RFA	Durvalumab plus tremelimuumab, durvalumab plus tremelimumab plus TACE, or durvalumab plus tremelimumab plus cryoablation	Second-line	II	July 5, 2016, December 31, 2021	90	PFS	NCT02821754
Nivolumab plus TACE	None	First-line	II	June 14, 2018-September 2022	49	ORR	NCT03572582 (IMMUTACE)
Pembrolizumab plus TACE	None	First-line	I/II	January 28, 2018-December 31, 2020	26	Incidence of adverse events	NCT03397654 (PETAL)
Durvalumab plus tremelimumab plus TACE	Durvalumab plus tremelimuumab, durvalumab plus tremelimumab plus RFA, or durvalumab plus tremelimumab plus cryoablation	Second-line	II	July 5, 2016-December 31, 2021	90	PFS	NCT02821754
Durvalumab plus tremelimumab plus DEB-TACE	Durvalumab plus tremelimumab plus DEB-TACE (regimen 1 vs regimen 2)	Not Specified	II	June 12, 2019-November 2020	30	ORR	NCT03638141
Durvalumab plus bevacizumab plus TACE	Durvalumab plus bevacizumab plus TACE (one TACE procedure vs possibility of multiple procedures)	Second-line	II	April 27, 2020-December 31, 2022	22	PFS	NCT03937830
Durvalumab and bevacizumab plus TACE	Durvalumab plus placebo plus TACE vs placebo plus TACE	Not specified	III	November 30, 2018-November 29, 2023	600	PFS	NCT03778957 (EMERALD-1)
Pembrolizumab plus SBRT	None	Second-line	II	February 15, 2018-April 2, 2022	30	ORR	NCT03316872
Durvalumab plus tremelimumab and radiation	None	Second-line	II	May 14, 2018-October 31, 2025	70	ORR	NCT03482102

RFA: Radiofrequency ablation; MWA: Microwave ablation; ORR: Overall response rate; TACE: Transarterial chemoembolization; PFS: Progression-free survival; DEB-TACE: Drug-eluting bead transarterial chemoembolization; SBRT: Stereotactic body radiotherapy.