Phase 1b study of transarterial chemoembolization followed by pembrolizumab for hepatocellular carcinoma

Transarterial chemoembolization (TACE) may prime adaptive immunity and enhance immunotherapy efficacy in patients with hepatocellular carcinoma (HCC). The phase 1b PETAL study at Imperial College London (UK) evaluated TACE followed by pembrolizumab every three weeks for liver-confined HCC. Pembrolizumab after TACE yielded no synergistic toxicity nor dose-limiting toxicities. The objective response rate 12 weeks after TACE was 53%. Progression-free survival rate at 12 weeks was 93% and median PFS was 8.95 months (95% CI 7.30-NE), median duration of response was 7.3 months (6.3-8.3), and median overall survival was 33.5 months (11.6-NE). The authors conclude that TACE plus pembrolizumab for liver-confined HCC was tolerable and had promising efficacy.