ESMO Congress 2026

Liver cancer remains one of the leading causes of cancer mortality, with its burden closely tied to modifiable risk factors such as high BMI, alcohol consumption, and smoking; global DALYs attributable to high BMI are projected to reach 145,100 by 2050 ^[2]. On the therapeutic front, overcoming immunosuppression through immune modulation has been a main line of exploration — for example, a CTLA-4-targeted nanobody enhanced the proliferation, IFN-γ production and cytotoxicity of DC-CIK cells, with anti-tumor effects verified in a mouse xenograft model ^[1]. In intermediate-stage liver cancer, TACE-based combination strategies have been explored in a rabbit VX2 model to improve local tumor response, survival benefit and metastasis control ^[3]. Meanwhile, coagulation parameters are associated with primary liver cancer staging and survival, and monitoring them is considered helpful for disease management ^[4], underscoring the value of liver-function-related measures in treatment follow-up.

Two liver cancer readouts emerged at #ESMO26. First, exploratory analyses of EMERALD-3 asked whether STRIDE-based therapy can preserve liver function in intermediate-stage HCC: ALBI and Child-Pugh scores remained broadly stable during treatment, with no clear signal of deterioration with combination therapy. Second, BGB-B2033, a GPC3 × 4-1BB bispecific antibody, showed promising activity in a Phase I study (n=94) in advanced HCC: in dose optimisation, ORR was 30% at 1,000 mg and 36% at 450 mg; 450 mg Q3W was selected as RP2D; the safety profile was manageable, with grade ≥3 TRAEs in 5% and IRR 8.5%.

Relative to existing knowledge, each readout marks a step forward. The CTLA-4 blocking strategy represented by ^[1] remains at the in vitro and mouse-model level, whereas BGB-B2033 moves the immune activation axis (GPC3 × 4-1BB) into Phase I human data in advanced HCC, with a higher ORR observed at the lower 450 mg dose (36% vs 30%), leading to the RP2D selection. For EMERALD-3, prior evaluations of combination strategies in intermediate-stage liver cancer focused on local tumor response, metastasis and survival ^[3]; this analysis extends attention to liver function dynamics as captured by ALBI/Child-Pugh. Given that coagulation parameters correlate with staging and survival and merit monitoring ^[4], broadly stable liver function during treatment carries clinical meaning for intermediate-stage patients requiring ongoing management.

Limitations to note: the EMERALD-3 results are exploratory analyses, and the primary endpoint and other efficacy data were not disclosed in the post; BGB-B2033 data are Phase I (n=94), with duration of response, survival and other key information not disclosed — confirmatory evidence remains to be confirmed.