HIMALAYA
A single dose of a CTLA-4 antibody added to PD-L1 blockade doubled five-year survival in liver cancer without needing an anti-VEGF drug.
OS 16.4 vs 13.8 months (HR 0.78); five-year OS 19.6% vs 9.4% (ESMO 2024 / 2025 publication), the longest follow-up of any phase 3 in HCC. No bleeding risk from anti-VEGF, so usable in patients with varices. Durvalumab monotherapy was non-inferior to sorafenib.
Setting
First-line unresectable HCC: STRIDE (single priming dose tremelimumab + durvalumab) vs sorafenib
Phase
Phase 3
Sponsor
AstraZeneca
Registry
Headline result
OS HR 0.78; 5-year OS 19.6% vs 9.4%.
Reported
2022
Enrolled
1171
Replication
Five-year follow-up of the same trial; the STRIDE + TACE strategy is being tested in EMERALD-3.
In plain words
What these results mean for people, not percentages
Overall survivalprimarysurvival endpoint
- Median 16.4 vs 13.8 months with STRIDE compared with Sorafenib; about 2.6 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 22 percent lower chance of the event at any given time (hazard ratio 0.78, likely range 0.66 to 0.92).
5-year overall survivalsurvival endpoint
- 19.6 vs 9.4 out of 100 alive at 5 years with STRIDE compared with Sorafenib; 10.2 more per 100.
- Roughly one extra person helped for every 10 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- Put another way, the treated group had about 24 percent lower chance of the event at any given time (hazard ratio 0.76).
Be careful
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: First-line unresectable HCC: STRIDE (single priming dose tremelimumab + durvalumab) vs sorafenib. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
1,171 participants enrolled.
Overall survivalprimary
HR 0.78 (0.66–0.92)
STRIDE
16.4 mo
Sorafenib
13.8 mo
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survivalprimary | STRIDE | 393 | 16.4 months | 0.78 (0.66–0.92) | — | — |
| Sorafenib | 389 | 13.8 months | ||||
| 5-year overall survival | STRIDE | — | 19.6% | 0.76 | — | link |
| Sorafenib | — | 9.4% |
Replication
Five-year follow-up of the same trial; the STRIDE + TACE strategy is being tested in EMERALD-3.