Dr Teng on the Implications of Data From the CARES-005 Trial of TACE Plus Camrelizumab/Rivoceranib in HCC

“Our study provided very strong evidence. Many radiologists may feel strange, because we only reported 3.2 months [with TACE alone], and the median PFS is usually like 10 months [with this approach]. [This may be attributed to our greater] use of RECICL criteria, physicians’ decisions, and… [the fact that] more than 40 patients had tumor thrombosis…”

Gao-Jun Teng, MD, of Zhongda Hospital, Medical School, Southeast University, discusses the clinical implications of, and provides context for, efficacy data from the phase 2 CARES-005 trial (NCT04559607) evaluating transarterial chemoembolization (TACE) plus camrelizumab and rivoceranib vs TACE alone in patients with unresectable hepatocellular carcinoma (HCC).

Findings reported at the 2025 Gastrointestinal Cancers Symposium showed that the investigational combination regimen (n = 100) significantly improved median progression-free survival (PFS) to 10.8 months (95% CI, 8.8-13.7) compared with 3.2 months (95% CI, 2.4-4.2) with TACE alone (n = 100; HR, 0.34; 95% CI, 0.24-0.50; P < .0001).

Teng notes that the median PFS of 3.2 months with TACE alone may seem surprising given that the median PFS with TACE in other studies is typically approximately 10 months. This outcome is partially attributed to the study design and patient characteristics, he states. Many patients were already experiencing disease progression prior to study inclusion, leading to a shorter effective treatment time, Teng explains. Additionally, the use of the Response Evaluation Criteria in Cancer of the Liver (RECICL) for assessment influenced the reported PFS, he notes.

Moreover, the study population included a substantial number of patients with advanced disease, such as those with tumor thrombosis, larger tumors over 7 cm in diameter, and poor prognosis, Teng says. This underscores the importance of early intervention with combination therapies for patients with late-stage disease, as they are more likely to benefit from the regimen, Teng asserts. The data suggest that for patients with advanced disease, particularly those with alcohol-related liver disease or those with later-stage disease, combined treatment regimens could be a critical approach to improve outcomes, he notes.

Based on these findings, future investigations will likely aim to better define the benefits of combining TACE with immunotherapy and antiangiogenic therapy in patients with advanced-stage disease, particularly those with more severe disease, Teng concludes.