TACE Plus Ablation Improves Survival in Unresectable HCC Compared With TACE Alone
Key Clinical Summary
- The phase 3 TORCH trial randomized 241 patients in China with liver-confined, BCLC stage B hepatocellular carcinoma (HCC) to transarterial chemoembolization (TACE) plus thermal ablation or TACE alone.
- Median progression-free survival was 17.7 vs 7.3 months, respectively.
- Median overall survival was 88.6 vs 35.1 months, favoring combination treatment.
Introduction
Adding selective radiofrequency ablation after transarterial chemoembolization (TACE) significantly improved survival outcomes among patients with liver-confined, unresectable hepatocellular carcinoma (HCC), according to the phase 3 TORCH randomized clinical trial. The study, led by Ning Lyu, MD, and colleagues, was published online on July 30, 2026, in JAMA Oncology.1
Study Findings
The open-label trial enrolled patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC at 2 tertiary medical centers in China. Investigators randomized 241 patients 1:1 to TACE followed by selective radiofrequency ablation or TACE alone. The primary endpoint was progression-free survival (PFS) according to RECIST 1.1.
Median PFS was 17.7 months with TACE-ablation vs 7.3 months with TACE alone. Untreatable PFS was also longer with combination treatment: 35.1 vs 12.3 months.
Median overall survival reached 88.6 months with TACE-ablation vs 35.1 months with TACE alone. In addition, 23 (23.2%) patients in the combination group experienced treatment-related adverse events (grade 3 or 4), while 24 (18.3%) met this criteria in the TACE-alone group.
Clinical Implications
The investigators concluded that TACE followed by thermal ablation produced superior survival outcomes compared with TACE alone and could represent a feasible treatment option for patients with liver-confined, unresectable HCC.
In a separate accompanying editorial, Cynthia Yeung, MD, of The University of Texas MD Anderson Cancer Center, and Howard Lim, MD, PhD, of the University of British Columbia, discuss the place of TORCH in the current therapy landscape for intermediate-stage HCC. They acknowledge that while treatment with TACE alone has advanced to its limits and combination strategies represent the next frontier for this patient group, supporting data are lagging far behind the rapid pace at which clinicians are adopting these new modalities.2
References
- Lyu N, Yi JZ, Wu XT, et al. Transarterial chemoembolization plus thermal ablation in unresectable hepatocellular carcinoma: the phase 3 TORCH randomized clinical trial. JAMA Oncol. 2026:e262366. doi:10.1001/jamaoncol.2026.2366
- Yeung C, Lim H. Refining combination locoregional therapy for intermediate-stage hepatocellular carcinoma—lessons from the TORCH trial. JAMA Oncol. 2026. doi:10.1001/jamaoncol.2026.1884
