ESMO 2026 Conference Intelligence

1/4 🔥 #ESMO26 Lung Cancer Presidential Highlights 🇪🇸 Madrid | October 24–25, 2026 Three major Phase 3 lung cancer LBAs, each with potential to reshape treatment paradigms: 🎙️ LBA3 | DeLLphi-305 🎙️ LBA5 | KRASCENDO 1 🎙️ LBA6 | SAFFRON Three Phase 3 readouts to watch closely at #ESMO26 👀 @myESMO @OncoAlert @Larvol

Three lung cancer phase 3 trials selected for presidential sessions at #ESMO26 ! I have been honoured to chair the metastatic lung track this year w 2 proffered paper & 2 rapid oral sessions & even more phase 3 trial results in EGFR lung cancer, radiation, & IO! #lcsm @myESMO https://t.co/h2sHUZf4td

Small cell carcinoma of the bladder: why ADC targets from conventional UC do not simply carry over, and what may work instead 🧵 New in @Histo_Journal: 88 SmCCB from Milan and Erlangen, 79 fully profiled by IHC for ASCL1, NEUROD1, POU2F3, YAP1, HNF4α, NE and tuft cell markers, plus 7 therapeutic targets and NECTIN4 FISH. 🔬 Two phenotypes 🟢 High-NE (57/79): ASCL1-driven, NEUROD1-driven or mixed, diffuse synaptophysin, chromogranin and CD56 🟠 Low-NE (22/79): POU2F3-driven, YAP1-driven or TF-negative, weak or absent NE markers, significantly associated with admixed urothelial, glandular or squamous histology 🎯 ADC and BiTE targets, one by one Nectin-4 (membranous) • Completely negative in 75% (60/80) • Median H-score 0, mean 11.6, max 220 • Higher in Low-NE than High-NE (median 1.5 vs 0, P<0.001), consistent with retained urothelial differentiation NECTIN4 amplification (FISH) • 16/73 (21.9%), a frequency comparable to conventional UC • No difference between High-NE and Low-NE (P=0.835) • No association with membranous protein (P=0.099) TROP2 • Completely negative across the cohort HER2, FOLR1, Claudin 18.2 • Rare and weak expression only DLL3 • Positive in 35/43 evaluable High-NE cases (81%) • Nearly absent in Low-NE (P<0.001) • Relevant for DLL3-directed BiTEs such as tarlatamab and for DLL3 ADCs in development SLFN11 • Median H-score 125, significantly higher in High-NE (P=0.006) • Supports testing DNA-damaging strategies in this group 💡 Key takeaways 1️⃣ High-NE SmCCB is largely Nectin-4 protein negative, yet carries NECTIN4 amplifications at rates similar to conventional UC. The amplification is present, the protein is not. 2️⃣ Our hypothesis: this points to NE transdifferentiation from a urothelial precursor that already harboured the amplification. The gene status is retained, while the urothelial protein program, including Nectin-4, is switched off during lineage change. The equal amplification rate in both phenotypes fits this model. It needs confirmation in paired and clonal analyses. 3️⃣ Practical consequence: NECTIN4 FISH alone should not be read as a surrogate for target presence in SmCCB. Gene status and membranous protein both need to be assessed. 4️⃣ Enfortumab vedotin benefit cannot be assumed in High-NE SmCCB. Low-NE tumours with residual urothelial features remain the more plausible candidates for UC-type ADCs. 5️⃣ High-NE SmCCB behaves biologically like SCLC: DLL3-high, SLFN11-high. This makes it a rational population for SCLC-directed strategies. 6️⃣ A tuft cell-like subset exists: POU2F3-driven tumours co-express POU2AF2 (11/16) and ChAT (13/16), with preclinical mSWI/SNF vulnerabilities. 7️⃣ A simple workflow (NE markers ± TF panel) can stratify SmCCB in routine diagnostics today. ⚠️ Limits: retrospective, TMA-based, no treatment or outcome annotation. Treatment-annotated and paired pre/post-therapy cohorts are the next step. Big shout out to Nazario Tenace from San Raffaele he drove this work as fellow. Bright future for this talented pathologist. Shout out also at great collaborators from Sann Raffaele @AndreaNecchi @Albert0Briganti @F_Montorsi and @mauriziocollechia @maurilioponzoni @claudiodoglioni and @UroMoschini Great collaboration between San Raffaele Milan and UK Erlangen, led by Nazario Tenace, with @andreanecchi 🔗 https://t.co/JEgkOU7a24

2 wks to #ESMO26! Here’s a📝of🔑studies for GeneralOnc that could change/reinforce SoC: - #INTerpath001 - #VOLGA - #ANZUP1801 - #LITESPARK011 - #DeLLphi305 - #SAFFRON - #CLARITYGastric01 - #MOIO - #TroFuse005 - Breast Ca Updates #OncTwitter @myESMO @OncoAlert https://t.co/9uGw605Q0W

My Top 10 Lung Cancer Abstracts #ESMO26 👇 https://t.co/lbGT7HzRNN

OptiTROP-Lung05: 🫁 A strong phase 3 signal for ADC + immunotherapy in 1L PD-L1+ advanced NSCLC. Sac-TMT + pembrolizumab vs pembrolizumab: • PFS: NR vs 5.7 months; HR 0.35 • ORR: 70.2% vs 42.0% https://t.co/XDvBtfRXXA @OncoAlert #lcsm #LungCancer https://t.co/heBozvKuxF

As per tradition, here are my hand picked top 10 breast cancer abstracts to keep an eye on at #ESMO26. Key words: ADCs, CDK4, IO, and impactful updates of practice-changing phase 3 trials. See you in Madrid! 🇪🇸 #ESMOAmbassadors https://t.co/ik7DY3WXva

There is no breast cancer or colorectal cancer study in the ESMO 2026 Presidential Symposia🧐 I also struggle to see why DASL-HiCaP and VOLGA were given Presidential slots. In high-risk nonmetastatic prostate cancer, STAMPEDE already showed an overall survival benefit from adding abiraterone to androgen deprivation therapy. DASL-HiCaP may provide useful data for patients receiving salvage radiotherapy, but it does not compare darolutamide with abiraterone. In cisplatin-ineligible muscle-invasive bladder cancer, VOLGA tests perioperative enfortumab vedotin plus durvalumab against cystectomy-based standard care. Enfortumab vedotin plus pembrolizumab has since shown a survival benefit and received FDA approval, yet VOLGA does not compare the two regimens. Both trials addressed real gaps when they were designed. Today, the lack of a comparison with the relevant active treatment makes their impact on treatment choice much less clear. I don’t feel particularly qualified to comment on genitourinary cancers, but I genuinely don’t understand why these two studies were selected for Presidential Symposia.

The @OncoAlert🚨Newsletter brings you the latest in oncology 📰 Giredestrant + everolimus in ER+/HER2− ABC FDA: belzutifan + lenvatinib approved in ccRCC; Priority Review for durva + EV in MIBC (VOLGA) MCED screening RCT Subscribe👉https://t.co/Q2y6eL3OIq and stay informed! https://t.co/SeHfVHGL2W

Following #ESMO26 from afar this year, but following closely. Three questions I'm bringing to it in gyn onc: Endometrial: are we starting to treat it like breast cancer? #TroFuse005 (sac-TMT, TROP2 ADC, Presidential Symposium, Oct 26) after platinum and IO, OS and PFS met. Plus sac-TMT + pembro in post-platinum pMMR EC (phase 2). Molecular groups driving treatment, ADCs. We are slowly getting there. Ovarian: Here ADCs are everywhere, and still no answer for ADC after ADC. The PROC readout I'm watching is #DENALI (azenosertib, WEE1i, OS, Oct 23), with phase 3 ASPENOVA in cyclin E1+ disease behind it. Not an ADC. Maybe that's the most clinically relevant point. Cervical: did we find a better way to prevent it? My biggest agenda, and I haven't seen a prevention abstract on the program yet. We have the vaccine and screening. What we don't have is reach. Going to be a busy October. Follow along. #gyncsm

The #EC approved #Enhertu + pertuzumab as 1L therapy for HER2+ metastatic #breastcancer, the first new 1L regimen in the EU in a decade. https://t.co/aD4lffkpY8 #Oncology #Cancer #ESMO26 #OncoAlert

This week’s OncoAlert 🚨 Newsletter is OUT! Packed with the latest updates in oncology. subscribe here 👉 https://t.co/NhtuRoIyO3 This week's must-reads: 🔸 Spotlight: Giredestrant + everolimus in ER+/HER2− ABC, PFS HR 0.38 in ESR1m (NEJM) 🔸 FDA: belzutifan + lenvatinib approved in ccRCC; Priority Review for durva + EV in MIBC (VOLGA) 🔸 MCED screening RCT in 142K adults: no drop in stage III/IV (NEJM) 🔸 Plus Lung, GU, GI, Breast Pinging: @OncoAlert @Uromigos @matteolambe @aftimosp @E_de_Azambuja @DrSGraff @ErikaHamilton9 @double_whammied @maryam_lustberg @raalbany @hoperugo @stolaney1 @LoiSher @JaniceTNBCmets @montypal @DrDanielHeng @apolo_andrea @DrChoueiri @PGrivasMDPhD @TiansterZhang @neerajaiims @amerseburger @sonpavde @drenriquegrande @tompowles1 @cdanicas @nataliagandur @realbowtiedoc @Onco_Cifu88 @scocmem @FernandoOnco @ElisaAgostinett @to_be_elizabeth @Erman_Akkus @MarioBalsaMD @DrMirallas @GIMedOnc @UOzkerim @DrRishabhOnco @PaulJiL @DaisukeKotani @DraMartinezLago @p_ciracimd @BenWestphalen @CentralParkWMD @graokane @amanda

🚀Upper GI oral abstracts of #ESMO26 👇 ✅Gastric/esophageal ✅Pancreatic ✅Hepatobiliary ✅NET/NEC #cancer #oncology #MedX #GI #pancreatic #biliary #cholangiocarcinoma #liver #hepatocellular #gastric #esophageal #neuroendocrine @OncoAlert https://t.co/VF3ifn5SPD

🚨 Great news from the @myESMO Scientific Committee! 👉 #6777 Our Phase 1 study of BGB-B2033 (#GPC3 x 4-1BB bispecific) in advanced #HCC has been selected for a Proffered Paper oral presentation at #ESMO26. Join us for the unveiling of our dose optimization and escalation data. #LiverX 🗓️ Sat, Oct 24 | 10:15-11:45 📌 FPN: 1679O

Proud and honored to be an #ESMOAmbassador! Please follow me during #ESMO26 in Madrid for novel data on #HCC #CCA #BTC #PDAC #livercancers #HPBcancers @myESMO @HUNIMED @HumanitasMilano https://t.co/gOVp2EznVE

My picks for #CRC and #PDAC sessions at #ESMO26 Madrid. Some interesting posters as well. Full abstracts will be released soon. Looking forward to meeting with colleagues and discussing these data. @myESMO #colorectal #pancreas #colon #rectum @OncoAlert https://t.co/5LiMCi7L3c

#ESMO26 @myESMO @Incyte Incyte brings an oral KRAS G12D inhibitor to colorectal + pancreatic cancer, plus CDK2/bevacizumab data in Cyclin E1-high ovarian cancer. Akeso's cadonilimab spans 15 presentations across 10+ tumor types. Madrid, Oct 23-27. Watch: https://t.co/7CBpziLZue

PRIME-ROSE community will showcase at #ESMO26 how cross-border collaboration can accelerate evidence generation for patients with limited treatment options Poster 827 on Sun 25 Oct 12-13 Pertuzumab and Trastuzumab in HER2/ERBB2 amp treatment-refractory met colorectal cancer https://t.co/I6s8ARzYcv

TROFUSE-055 is a randomized phase 3 non-muscle invasive bladder cancer trial. It’s another trial exploring bladder surgery sparing approaches. This study tests the combination of SAC-TMT with Pembro (68% RR in advanced disease) followed by chemoradiation. The control is ChemoRT (+/- NAC). This study is distinct from EV309 where no chemoRT is given in the study arm. We will need many trials to identify the optimal approach. The role of chemoRT in ADC driven cCR is unknown. @OncoAlert

Our NECTIN4 scoring system for predicting enfortumab vedotin response in urothelial carcinoma is just published. 🔬 The short version: NECTIN4 is not a failed biomarker. It has been measured in the wrong compartment. 📊 179 EV-treated mUC patients, multicenter, FISH plus IHC, benchmarked against EV-301 EPAR data. Why the field thought NECTIN4 was ubiquitous 🧠 In EV-301 the median H-score was 250, with 82.6% ≥150. That near-universal expression underpinned the biomarker-unselected label. In our cohort, membranous H-score alone was 160. Cytoplasmic was 200. Combined, 260, with 78.2% ≥150, almost exactly mirroring EV-301. So the trial numbers most likely reflect membranous plus cytoplasmic staining. That single methodological choice is why NECTIN4 looked like it was everywhere. 🎯 And it matters, because only one compartment predicts anything: ✅ Membranous 2+/3+ vs 0/1+: ORR 55.1% vs 25.5% (p<0.001), mPFS 7.1 vs 2.9 months (HR 0.45), mOS 12.3 vs 6.9 months (HR 0.57). ❌ Cytoplasmic: ORR 49.6% vs 39.5% (p=0.4). No PFS or OS signal. ❌ Bulk NECTIN4 mRNA, which cannot resolve localisation: no association either. Adding cytoplasmic staining inflates positivity and dilutes prediction. Negativity rate drops from 12% to 3.4%. More positives, less information. 📉 The scoring system 🔬 Four tiers (0, 1+, 2+, 3+) adapted from the ASCO/CAP HER2 gastric algorithm, chosen deliberately because it accounts for incomplete membranous staining, the same framework that carried T-DXd to tumour-agnostic approval. Blinded interobserver testing, 44 cases, three raters, two with no prior NECTIN4 experience: 📈 Fleiss' κ 0.749 across all four tiers. 📈 Fleiss' κ 0.874 for the clinically relevant 0/1+ vs 2+/3+ cutoff. Almost perfect agreement. Reproducible, teachable in a short training session, deployable in routine practice. Genomics on top 🧬 NECTIN4 amplification in 25.1% (45/179). ORR 76.2% vs 36.6%. mPFS 12.2 vs 3.9 months (HR 0.40). mOS 30.1 vs 8.5 months (HR 0.33). At 24 months, 58.8% of amplified patients were alive versus 19.0%. And IHC prescreens for it: 80% of amplified tumours are 3+, under 5% of 0/1+ tumours carry an amplification. Restricting FISH to 2+/3+ captures 97.8% of amplified cases while sparing 29.1% of patients any molecular testing. ⚡ The integrated three-tier model: 1️⃣ Amplified: ORR 76.2%, mOS 30.1 mo 2️⃣ Non-amplified, membranous high: ORR 42.9%, mOS 8.8 mo 3️⃣ Non-amplified, membranous low: ORR 26.1%, mOS 6.9 mo Both remained independent in multivariable models. C-index for OS improves from 0.557 to 0.621 when amplification and membranous expression are combined. Neither marker alone does what the two do together. Where I think this lands 🎯 I do not (!) read this as an argument for testing every patient . With EV+P as first-line standard and few alternatives, a negative result rarely changes what you do today and shouldn't change it right now given the high EVP efficacy. But that is an argument about the therapeutic landscape, not about the biology. And the landscape is changing fast: HER2 ADCs, TROP2, HER3/EGFR, NECTIN4 radioligands and T-cell engagers. The moment two viable options compete for the same patient, the question stops being "does the target matter" and becomes "which target first." Notably, unlike the HER2-low paradigm, EV-301 showed an attenuated treatment effect in NECTIN4-low disease, PFS HR around 0.9 with confidence intervals crossing 1 (check out Figure 1 of the paper). ⚠️Prospective validation is running: EVOKE (DRKS00034745). Immense thanks to @niklas_kluemper and Jonas Saal, to Thomas Büttner, Sebastian Rauch and Fabienne Lange, and to every centre and biobank that contributed. This was a genuinely collaborative effort within the fantastic GUARDIANS and BRIDGE Consortium. 🙏 🔗 https://t.co/CuQR9LJe6k @Uroweb @AmerUrological @ASCO @PathSoc @OncoAlert @Histo_Journal @andreanecchi @emanuele_crupi @danieleraggi83 @raffcolo @Dr_Aggen @DrRosenbergMSK @h_alahmadie @PGrivasMDPhD @shilpaonc @drenriquegrande @amerseburger @brookmans76 @DrYukselUrun @onkowissen @imedverse @UroDocAsh @urotoday @EUplatinum @JCO_ASCO @CCR_AACR @niklas_kluemper @DrRosenbergMSK @Dr_Aggen @Uromigos @tompowles1 @shilpaonc @PGrivasMDPhD #Uropathology #urothelial #BladderCancer #NECTIN4 #pathtwitter

What great news!!!!! 👏👏👏👏👏👏👏 Perioperative Durvalumab plus EV showed statistically significant and clinically meaningful improvements in event-free survival and overall survival in muscle-invasive bladder cancer in the Phase III VOLGA trial. @OncoAlert @seom @CANVES_ES @GUOncologyNow @OncBrothers @myESMO https://t.co/uOS52u6l7V

Looking forward to @tompowles1 presenting the VOLGA trial at @myESMO Presidential Session on Sat, Oct 24! Congrats Tom, on yet another practice changing work in urothelial cancer! This trial will address several important questions about optimal dosing of EV-IO and need for adjuvant EV. @Uromigos @LosUromigos @uromigosjapan @brian_rini @QMBCI @scocmem @OncoAlert @DrChoueiri @montypal @PGrivasMDPhD @apolo_andrea @MattGalsky @UroDocAsh @IBCG_BladderCA @AstraZeneca @drenriquegrande @Annals_Oncology @TomFlaigMD @DrRosenbergMSK @AndreaNecchi @FAndreMD

New #bladdercancer #clinicaltrial opening now: Bladder-preservation for muscle-invasive #bladdercancer (MIBC) - #TroFuse055 is a Phase III clinical trial that evaluates the value of neoadjuvant sacituzumab tirumotecan (Sac-TMT) + MK3475A followed by consolidation MK3475A when combined with conventional chemoradiotherapy - this trial builds upon the value that chemoradiation brings to patients with MIBC who have elected to avoid radical cystectomy surgery - 1) Sac-TMT is a Trop2 binding antibody drug conjugate (ADC) conjugated to a potent topoisomerase-1 inhibitor payload (belotecan) and 2) MK3475A is subcutaneous pembrolizumab - Trial is opening globally and sponsored by @Merck - we are pleased to offer at our institution @AdventHealthCFL Cancer Institute Orlando, #Florida - Please note @BladderCancerUS @FLASCO_ORG @tompowles1 @DrYukselUrun @drenriquegrande @AndreaNecchi @shilpaonc - https://t.co/Y3Ie8osa7V

🌄 Monday Morning Mention! ✍ BRIEF REPORT: Gemcitabine-Cisplatin Chemotherapy Induces Nectin-4 Downregulation and Enfortumab Vedotin Resistance in Bladder Cancer by Christoph Nössing...Bernhard Englinger et al 💡 Link to full article: https://t.co/FsSsPVIoaM 👏 Thank you to the authors for trusting EUO to publish your work! @uroweb @mroupret @GPloussard @jteoh_hk @Ric_Campi @CaPsurvivorship @LauraMarandino @DaveDandrea @RenuEapen @Ecastromarcos @OncoAlert @Sciencedirect

Here is the company’s description of the mRNA Melanoma cancer therapy. “Along with our partners at Merck, we announced positive results from the Phase 3 INTerpath-001 study of intismeran autogene, our investigational individualized neoantigen therapy” https://t.co/4r0zHw4Fqa

🚀 WHEN ONCOLOGY MOVES WALL STREET! Can a personalized cancer vaccine transform cancer care—and move the stock market? Moderna shares jumped 9.27% in a September 2026 snapshot amid excitement around intismeran autogene (V940) and ESMO 2026. 01 | The Stock-Market Surprise Why did Moderna stock surge? 02 | The Science How does a personalized mRNA vaccine activate tumor-specific T cells? 03 | The First Evidence KEYNOTE-942 Phase IIb: RFS HR 0.51 | DMFS HR 0.41 04 | The Phase III Moment INTerpath-001: RFS and DMFS endpoints met. Detailed results at ESMO 2026, October 24. 💡 The science moved Wall Street. Will the full data justify the excitement? References: Moderna–Merck announcements (2026); KEYNOTE-942; ESMO 2026 programme; MarketChameleon. #MVOnco #ESMO2026 #INTerpath001 #IntismeranAutogene #mRNAVaccine #CancerVaccine #Melanoma #Moderna #Merck #Immunotherapy #Oncology

ESMO 2026 is 2 weeks away - Madrid, 23–27 October. Our predicted ESMO 2026 Top 10 Trials includes: 🧬 INTerpath-001: mRNA vaccine + pembro, melanoma ⏱ MOIO: 3-monthly immunotherapy 🎯 HARMONi-GI1: PD-1 × VEGF, biliary Which new data will change practice? #ESMO26 #Oncology https://t.co/OnOU7ZB8p3

Vaccines 💉 are coming soon to #melanoma #lcsm #pcsm @OncoAlert @oncodaily @larvol @myESMO #ESMO26 https://t.co/KhdWJtdgkS

#ESMO26 @myESMO @Merck Moderna & Merck melanoma vaccine (intismeran autogene + Keytruda) hits RFS/DMFS in Phase 3 INTerpath-001 — first positive Phase 3 for an individualized neoantigen therapy. Presidential Symposium, Madrid Oct 23-27. Watch: https://t.co/Etvx0ea1Vn

@unusual_whales "Moderna and its partner Merck announced positive Phase 3 results for their personalized mRNA cancer vaccine (intismeran autogene / mRNA-4157) combined with Keytruda in treating resected melanoma, meeting key survival and recurrence-free endpoints."

ESMO 2026 cervical cancer guidelines The INTERLACE is not positioned as routine intensification . It may be considered particularly when access to modern radiotherapy and high-quality IGBT not available @AmericanBrachy @ARRO_org @ASTRO_org @ACROsident @KamravaMD

Thread 2: Cervix and Ovarian 1/5 Part 2 of my #ESMO26 gyn preview: cervical and ovarian cancer, where ADCs keep multiplying and new pathways are emerging 🧵 #gyncsm

90+ abstracts. 20+ cancer types. @Merck heads to ESMO 2026 with new Phase 3 data on mRNA cancer therapy, ADCs, and immunotherapy, including INTerpath-001, TroFuse-005, and KEYNOTE-C93. https://t.co/Nqm4CV41jy https://t.co/KdM9YjPxJd

We’re heading into a busy fall conference season, with Zymeworks researchers presenting new clinical and preclinical data across multiple medical conferences. At #ESMO26 on October 24, we’ll share new clinical results from our Phase 1 randomized dose optimization study of ZW191 in heavily pretreated patients with platinum-resistant ovarian cancer. At #SITC26, we’ll present new preclinical data on a novel approach designed to target IL-7 to tumor-specific T cells. At #PEGSEurope, we’ll showcase work across our next-generation multispecific programs and cytokine engineering. Learn more here: https://t.co/uzYwtNUht0

Sarcoma takes center stage in Madrid. Join OncoDaily Grand Rounds at ESMO 2026: Sarcoma Edition for expert perspectives on diagnosis, treatment and multidisciplinary care. 🔗 Register: https://t.co/Mf3i5HzZBV 🔗 Read more on OncoDaily: https://t.co/H5PR2w2Wpn https://t.co/c2Z2nB8JJ5

SynOx Therapeutics to present primary results from the Phase 3 TANGENT trial as a Late-Breaking Abstract at ESMO Congress 2026. #ESMO26 #TGCT #Sarcoma #Oncology #ClinicalTrials #RareDisease #SynOxTherapeutics https://t.co/sw7GIvjcOV