Reviewing the HIMALAYA Trial of Tremelimumab Plus Durvalumab in Unresectable HCC

Lipika Goyal, MD, presents the HIMALAYA trial on behalf of Team Deep-Dish Pizza, detailing the phase 3 study of tremelimumab plus durvalumab, known as the STRIDE regimen, versus sorafenib in unresectable hepatocellular carcinoma (HCC). Goyal reviews the patient population, including Child-Pugh class A liver function and the exclusion of main portal vein thrombosis, and walks through the survival benefit that established STRIDE as a frontline standard. She emphasizes the HIMALAYA 5-year update, noting that roughly 20% of patients treated with STRIDE were alive at 5 years and highlighting the long-term survivor tail produced by adding a CTLA-4 antibody. Goyal also discusses outcomes by ALBI grade, showing benefit even among patients with grade 2 or 3 liver function, and reviews patient-reported outcomes demonstrating preserved quality of life. The presentation frames tremelimumab plus durvalumab as a durable frontline option for advanced HCC, including patients with poorer liver reserve.