According to the TALENTACE trial, on-demand transarterial chemoembolization (TACE) plus atezolizumab and bevacizumab significantly improved the time to progression that was untreatable with TACE, failure or refractoriness to TACE, or death (TACE-PFS) among treatment-naïve patients with unresectable hepatocellular carcinoma with intermediate-to-high tumor burden. 

These data were first presented by Guohong Han, MD, Xi’an International Medical Center Hospital, China, at the 2025 European Society for Medical Oncology (ESMO) Gastrointestinal Cancers Annual Congress in Barcelona, Spain.

This open-label phase 3 trial randomized 342 patients who had not received systemic therapy and were eligible for TACE with hepatocellular carcinoma, with a sum of maximum tumor diameter plus the number of lesions ≥ 6. Patients were randomized on a 1-to-1 basis to receive either TACE followed by atezolizumab plus bevacizumab within 14 days to 8 weeks after TACE (n = 171), or TACE alone (n = 171). TACE was administered on-demand, at the discretion of the investigator. The co-primary end points of this study were investigator-assessed TACE-PFS, and overall survival. Secondary end points included investigator-assessed PFS and safety.

With a median follow-up duration of 26.3 months, the median TACE-PFS was 11.30 months in the TACE plus arm compared to 7.03 months in the TACE alone arm (hazard ratio [HR], 0.71; 2-sided P = .001), representing a statistically significant improvement with TACE plus atezolizumab and bevacizumab. This benefit was generally consistent across all pre-specified subgroups. There was also a clinically meaningful improvement of PFS, with a median PFS of 10.32 in the TACE plus arm and 6.37 months in the TACE alone arm (HR, 0.64; P < .001). At the time of analysis, OS data was immature. The incidence of grade 3 to 5 treatment-related adverse events was 63.8% in the TACE plus arm and 42.4% in the TACE alone arm. 

The study authors concluded that these results establish “a potential new therapeutic paradigm” with on-demand TACE plus atezolizumab and bevacizumab for this patient population.

Source:

Dong J, Han G, Ogasawara S, et al. TALENTACE: A phase III, open-label randomized study of on-demand transarterial chemoembolization (TACE) combined with atezolizumab + bevacizumab (atezo+bev) or on-gemand TACE alone in patients with systemically untreated, intermediate-to-high burden unresectable hepatocellular carcinoma (uHCC). Presented at 2025 ESMO GI Cancers Annual Congress. July 2-5, 2025; Barcelona, Spain. Abstract: LBA2.