Innovative Triplet Therapy Shows Promise for Advanced Liver Cancer

In a significant advancement in the treatment of advanced hepatocellular carcinoma (HCC), Dr. Richard Finn, MD, a professor of medicine at the Geffen School of Medicine at UCLA, presented promising findings regarding the combination of tiragolumab, atezolizumab, and bevacizumab. This triplet regimen was discussed during the 2025 ESMO Gastrointestinal Cancers Congress, revealing a median overall survival of 26.6 months, a notable improvement compared to the 16.0 months observed in patients receiving only the doublet of atezolizumab and bevacizumab.

The study, known as the MORPHEUS-Liver trial (NCT04524871), evaluated 40 patients treated with the triplet therapy and 18 patients receiving the doublet. The results indicated an objective response rate of 42.5% for the triplet compared to only 11.1% for the doublet. Additionally, progression-free survival was significantly extended to 12.3 months for the triplet regimen versus 4.2 months for the doublet (HR, 0.63; 95% CI, 0.35-1.15).

Dr. Finn remarked, “The most striking aspect of this updated dataset is the overall survival rate which is now at 26.6 months for the triplet.” This data highlights the potential integration of tiragolumab, a novel anti-TIGIT antibody, into standard treatment practices for advanced HCC. The ongoing IMbrave-152/SKYSCRAPER-14 trial (NCT05904886) aims to confirm these findings in a larger population, comparing the triplet therapy against the doublet with a placebo.

The implications of these findings are substantial, particularly in light of the evolving landscape of systemic therapies available for patients with advanced liver cancer. The combination of checkpoint inhibitors like atezolizumab with anti-angiogenic agents such as bevacizumab has already transformed therapeutic strategies. The addition of tiragolumab represents a further refinement in this treatment paradigm.

As the field of oncology increasingly embraces immunotherapy, the MORPHEUS-Liver study stands out as one of the first robust datasets assessing a triplet regimen built on a bevacizumab-containing backbone in advanced HCC. This research not only adds to the body of evidence supporting triplet therapies but also raises expectations for future studies and their potential impact on patient outcomes in this challenging disease context.

Furthermore, the findings underscore the necessity for ongoing clinical trials to fully elucidate the benefits and risks associated with more complex therapeutic regimens. Dr. Finn concluded that the results from the MORPHEUS-Liver trial serve as a critical foundation for future research aimed at optimizing treatment pathways for patients suffering from unresectable locally advanced or metastatic HCC.