Editor’s Note: From December 5 to 7, 2025, the highly anticipated European Society for Medical Oncology Asia Congress (ESMO Asia 2025) was grandly held in Singapore. During the Mini Oral Session: Gastrointestinal Tumours, Professor George Lau, Chairman of the Hong Kong Humanity Medical Group and Director of the Humanity Medical Clinical Research CenterSenior Consultant in Gastroenterology and Hepatology, Humanity and Health Medical Center, Principal Investigator of the Humanity and Health Clinical Trial Center, as well as a physician Honorary Professor and Senior Consultant at Zhongshan Hospital Affiliated to Fudan University, was invited to deliver an oral presentation. For the first time, he shared the research data on the treatment of Asian patients with unresectable hepatocellular carcinoma (HCC) using Tremelimumab in combination with Durvalumab. This study is based on a sample that more closely reflects the epidemiological characteristics and disease spectrum of Asian patients, providing high-quality evidence-based medical evidence with targeted relevance. It lays a solid foundation for optimizing and advancing the individualization and precision of liver cancer treatment strategies in this region. 

During the conference, our reporter had the opportunity to conduct an in-depth exclusive interview with Professor George Lau on-site, discussing the core findings, data highlights, and clinical significance of this study. This provides readers with insight into the scientific thinking and practical value behind this cutting-edge advancement.

Oncology Frontier: At this year’s ESMO Asia Congress, you presented the efficacy and safety pooled analysis results of the HIMALAYA study in the Chinese population. Could you please briefly introduce the main findings of this latest analysis?

Professor George Lau: I am truly hnored to report on this research achievement at this ESMO Asia Congress. This study primarily focuses on the Chinese population. Given the high incidence of hepatocellular carcinoma in China and the large patient base, it holds significant research value and clinical importance. The original HIMALAYA study was limited by its enrollment time window and did not include patients from Mainland China. Therefore, this analysis specifically integrates data from all Chinese patients in Mainland China, Hong Kong, and Macao (China), as well as Taiwan (China), aiming to re-evaluate the clinical effects of the STRIDE regimen (i.e., the strategy of using a single high-dose Tremelimumab induction combined with Durvalumab, followed by maintenance therapy with Durvalumab). This “dual immunotherapy combination” strategy has demonstrated clear and significant efficacy for patients with unresectable advanced hepatocellular carcinoma, and the research results are encouraging.

In terms of survival benefits, the data from this study show that the hazard ratio (HR) of patients is better than that of the global Phase III trial data: the global study reported an HR of 0.78, while the Chinese population saw a reduction to 0.6, suggesting that Chinese patients may achieve even greater survival advantages under this treatment regimen. By synthesizing data from the Chinese patient population, the results strongly support the inclusion of “dual immunotherapy combination” as one of the priority treatment options for patients with advanced hepatocellular carcinoma, and provide important evidence for its future clinical application in the Chinese population.

Oncology Frontier: Do you think the enhanced benefits of the STRIDE regimen in the Chinese patient population are associated with specific baseline characteristics?

Professor George Lau: Yes, we have long held this view, and the existing data also supports it. In the global HIMALAYA study, patients from Hong Kong, Macao, and Taiwan (China) accounted for approximately 40% of the total enrolled population. However, a notable characteristic of that study is the significant difference between it and the Asian and Chinese populations analyzed in this report. The most prominent difference lies in the proportion of hepatocellular carcinoma cases related to HBV infection: in the Chinese population of this study, nearly 80% of liver cancer cases were caused by HBV infection, whereas in the global study, this proportion was below 40%. Therefore, the high incidence of HBV-related liver cancer may be an important factor influencing the results of this study, and this characteristic is entirely consistent with the epidemiological reality in China—where the vast majority of liver cancers are indeed caused by chronic HBV infection.

Previous studies have shown that patients with liver cancer caused by HBV generally respond more favorably to immunotherapy across multiple dimensions, with significantly better efficacy compared to liver cancer caused by other etiologies. This is positive news for the Chinese patient population. Whether from Mainland China, Hong Kong, Macao, or Taiwan (China), the Chinese population shares a high degree of consistency in race and ethnicity, as well as similar cultural backgrounds and other social factors. Therefore, the results of this study are of significant reference value for all Chinese liver cancer patients.

It is worth adding that, overall, the HR for the Chinese population is 0.6; however, the data for the Hong Kong and Taiwan (China) subgroups are even more outstanding, with an HR of 0.44. Statistical analysis suggests that patients with liver cancer caused by HBV infection may experience greater survival benefits from “dual immunotherapy combination” than those with liver cancer caused by non-viral factors. This finding not only confirms the potential advantages of the Chinese population under this treatment regimen but also provides empirical evidence for formulating precise treatment strategies in China in the future.

Oncology Frontier: In your report, you also presented long-term follow-up data from patients in Hong Kong and Taiwan (China). What new insights and guidance do these long-term survival results offer for the selection of current first-line treatment strategies for unresectable liver cancer?

Professor George Lau: Currently, “dual immunotherapy combination” has significantly improved the survival status of patients with unresectable liver cancer. Historically, targeted therapies represented by Sorafenib have not been as effective in the Chinese population as the global average. In this study, we also simultaneously announced the five-year survival rate data for the Hong Kong and Taiwan (China) subgroups, which showed significantly better outcomes than the Sorafenib treatment group. Specifically, the five-year survival rate of the Sorafenib group was only about 3%, whereas even the use of Durvalumab alone under the “dual immunotherapy combination” regimen demonstrated a trend of better survival benefits than Sorafenib in the Chinese population.

Combining the data from Mainland China with those from Hong Kong and Taiwan (China), the three key survival indicators for the Chinese population also performed ideally, significantly outperforming historical Sorafenib data. Meanwhile, the recently published CheckMate 9DW study also showed that such “dual immunotherapy combination” regimens can significantly and comprehensively extend the overall survival of patients with unresectable liver cancer compared to control groups treated with Sorafenib or Lenvatinib.

Notably, about 10% of patients in this study achieved complete remission, a proportion that is encouraging. The objective response rate has also significantly increased. In real-world practice, some patients who achieved complete remission have successfully undergone liver transplantation and maintained good survival status over the long term. These advancements are gradually changing the clinical perception and response strategies for previously difficult-to-treat, unresectable liver cancer.

Looking back thirty years ago, unresectable liver cancer basically meant a lack of effective intervention, and patients often could only passively wait for the disease to progress. If interventional therapy was not possible, survival was extremely limited. Today, with the emergence of new treatment regimens, this situation is being rewritten. This is particularly significant for China—where liver cancer remains a major public health issue, with over 350,000 deaths annually, the vast majority of which are caused by chronic HBV infection. The new therapies bring tangible hope and better survival prospects for patients.

Oncology Frontier: Do you think these data from your report could facilitate the approval process of this treatment regimen in Mainland China? Can the STRIDE regimen be considered a first-line preferred treatment option for Chinese liver cancer patients?

Professor George Lau: From the data perspective, the conclusion is clear. This analysis specifically includes data from Mainland China, whereas the original global study was limited in its enrollment scope and did not include such a large number of Chinese cases. In fact, whether from Mainland China, Hong Kong, Macao, or Taiwan (China), the Chinese population shares homologous origins in race and ethnicity, so the study design and result interpretation can be considered as a unified whole. By incorporating the Mainland China expansion cohort, the sample size of Chinese patients in this study has nearly doubled, thereby providing a more solid data foundation and allowing for re-validation of the efficacy and safety conclusions of the global study. This is undoubtedly of positive significance for liver cancer treatment in the Chinese population.

As hepatologists, in clinical practice, we often encounter patients with end-stage unresectable liver cancer who are relatively young. In the past, such patients, lacking effective treatment options, could only passively await disease progression or death; even without the possibility of interventional therapy, the prognosis was extremely poor. Now, with the emergence of new treatment regimens, we at least have available strategies, and we are gradually entering a stage where liver cancer can be effectively controlled. Some patients, after receiving treatment, have even achieved complete remission, which is undoubtedly a welcome development.

Looking ahead, we still need to continuously explore several scientific issues, such as how to better manage treatment-related adverse reactions, how to further improve efficacy, and in what clinical scenarios to prioritize targeted combination immunotherapy or “dual immunotherapy combination.” Decisions in all these aspects must rely on the systematic integration and in-depth analysis of large-scale data, and artificial intelligence technology will play an important role in data mining and model construction, helping to formulate more precise treatment strategies.

ReferenceOriginal link: George Lau, et al. Pooled efficacy and safety with tremelimumab plus durvalumab in participants(pts) with unresectable hepatocellular carcinoma(uHCC) from the mainland China extension cohort, and Hong Kong(HK) and Taiwan(TW) subgroups from the global cohort in the phase III HIMALAYA study. ESMO 2025 Mini Oral Presentation#274MO