KOL Pulse · ESMO 2026 · Madrid · Oct 23–27 · Melanoma
ESMO 2026 Melanoma Slides
Melanoma results slides from ESMO 2026 (Madrid, October 23–27), posted since the October 22 embargo lift: 48 slide posts and 18 KOL infographics from 39 accounts, organized by clinical trial — led by INTerpath-001. Each trial links to its KOL Pulse trial page and conference discussion. Physician posts first; every slide carries a verbatim OCR transcription. Updated October 25, 2026. ← Back to the full ESMO 2026 coverage
This page holds the ESMO 2026 Melanoma results slides, part of the ESMO 2026 slide library. Other tumor types have their own pages below; pre-congress previews are in the pre-congress archive →
Slide: Photo/screenshot of presented ESMO 2026 conference slide
#ESMO26 INTerpath-001
8 Grade 5 AEs in the experimental arm, 0 in the control arm.
Of course, it could all be pure coincidence! After all, 6 of the 8 events were not considered TRAE
Perhaps it was just the excitement of being randomized to the experimental arm?
I'm genuinely curious about the independent causality assessment.
[Slide 1]
Recurrence-Free Survival, ITT Population
HR 0.58 (95% CI 0.45–0.75)
P < 0.001 (two sided)a
24-month landmark (dashed line): 82.2% (95% CI 79.3–84.8) [intismeran arm, teal]; 70.0% (95% CI 65.0–74.5) [placebo arm, blue]
N | Events, n (%)
Intismeran + pembrolizumab | 757 | 136 (18.0%)
Placebo + pembrolizumab | 380 | 111 (29.2%)
No. at risk (months 0/6/12/18/24/30/35):
Intismeran + pembrolizumab: 757, 683, 646, 618, 136, 10, 0
Placebo + pembrolizumab: 380, 341, 302, 282, 72, 3, 0
aMultiplicity-adjusted significance level: two-sided 0.024692.
ITT: all randomized patients according to the arm to which they were assigned.
RFS: time from randomization to the first occurrence of any recurrence or death from any cause. Data cutoff date: June 30, 2026 (median study follow-up, 24.6 mo).
Presented by: Georgina V. Long, Melanoma Institute Australia
[ESMO Congress Madrid 2026 logo]
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: Recurrence-free survival (RFS), ITT population
Intismeran + pembrolizumab | 757
Placebo + pembrolizumab | 380
HR: 0.58
HR CI: 0.45–0.75
P: <0.001 (two sided); multiplicity-adjusted significance level two-sided 0.024692
{'timepoint': '24 months', 'arm': 'Intismeran + pembrolizumab', 'value': '82.2%', 'ci': '79.3–84.8'}
{'timepoint': '24 months', 'arm': 'Placebo + pembrolizumab', 'value': '70.0%', 'ci': '65.0–74.5'}
Note: Data cutoff June 30, 2026; median study follow-up 24.6 mo. Presented by Georgina V. Long. Medians not printed.
Yakup Ergün@dr_yakupergun
INTerpath-001
Slide: LBA1 abstract screenshot (Long, ESMO 2026)
#ESMO26 | INTerpath-001: My Personal Perspective Ahead of the Presidential Session
This innovation deserves recognition: a groundbreaking result for personalized cancer vaccines. However, in patients with macroscopic stage III melanoma who are eligible for neoadjuvant IO, this trial does not establish the added value over contemporary perioperative strategies. Neoadjuvant treatment can produce substantial responses while allowing some patients to avoid adjuvant therapy.
The trial design I would prioritize is:
Neoadjuvant IO → surgery → standard adjuvant therapy ± a personalized vaccine in patients without a major pathological response.
Here, “failure to achieve a major pathological response” is a more appropriate selection criterion than “any residual disease.” Patients with minimal residual viable tumor who still achieve a major pathological response should not automatically receive additional treatment.
This approach would direct treatment intensification toward patients at higher risk of recurrence. The key biological uncertainty, however, is that IO-resistant residual disease is not necessarily vaccine-sensitive. Whether vaccination can overcome that resistance needs to be demonstrated.
This criticism should remain specific to that population: INTerpath-001 retains distinct clinical value for patients with stage IIB/IIC disease and those who underwent surgery without neoadjuvant therapy.
[Slide 1]
LBA1 - INTerpath-001: Phase 3 study of the mRNA-based individualized neoantigen therapy (INT) intismeran autogene (intismeran) plus pembrolizumab (pembro) vs pembro alone for adjuvant treatment of resected stage IIB-IV melanoma (MEL)
Speakers Georgina V. Long (Sydney, Australia)
Lecture Time 16:30 - 16:42
Abstract
Background
Many patients (pts) with resected high-risk MEL experience recurrence despite adjuvant therapy. Enhancing immune activation may improve efficacy. Intismeran is an mRNA-based INT designed to expand pre-existing and generate de novo neoantigen-specific antitumor T-cell responses by targeting pt-specific tumor-derived antigens. INTerpath-001 (NCT05933577) is a double-blind phase 3 study of intismeran + pembro as adjuvant therapy for resected stage IIB–IV MEL.
Methods
Eligible adults with surgically resected stage IIB/IIC (pathologic or clinical) or III/IV cutaneous MEL and a tumor sample suitable for next-generation sequencing were randomized 2:1 to pembro 400 mg (9 cycles, IV Q6W) + intismeran 1 mg or placebo (9 doses, IM Q3W). Pembro started at randomization, intismeran or placebo upon availability. Primary endpoint: RFS. Secondary endpoints: DMFS, OS, and safety.
Results
1137 pts were randomized: 757 to intismeran + pembro, 380 to placebo + pembro; 726 (95.9%) received ≥1 dose of intismeran and 365 (96.1%) received ≥1 dose of placebo as planned. Median follow-up as of 30Jun2026 was 24.6 mo. Intismeran + pembro significantly improved RFS and DMFS compared with placebo + pembro (Table). Benefit was similar in stage IIB–IIIB and IIIC–IV MEL and other subgroups. For intismeran + pembro vs placebo + pembro, AEs were grade ≥3 in 23.6% vs 20.3%; 6.5% vs 5.3% discontinued both drugs simultaneously due to an AE. Most common AEs were pyrexia (52.2% vs 8.2%), injection site pain (51.0% vs 9.5%), and fatigue (38.5% vs 29.7%). Table: LBA1
| Intismeran + pembro (N = 757) | Placebo + pembro (N = 380)
Recurrence-free survival (RFS)
24-mo rate, % (95% CI) | 82.2 (79.3–84.8) | 70.0 (65.0–74.5)
HR (95% CI) | 0.58 (0.45–0.75) | —
Two-sided P | <0.001 | —
Distant metastasis-free survival (DMFS)
24-mo rate, % (95% CI) | 88.5 (86.0–90.6) | 80.2 (75.6–84.0)
HR (95% CI) | 0.62 (0.45–0.85) | —
Two-sided P | 0.002 | —
Conclusions
Intismeran + pembro significantly improved RFS and DMFS compared with placebo + pembro and was generally well tolerated when given as adjuvant therapy for stage IIB–IV MEL. These findings set a new benchmark for adjuvant MEL and are a pivotal advance in personalized medicine and cancer treatment.
Yago Garitaonaindía@YGaritaonaindia
INTerpath-001
1) Mechanism of action: Intismeran mechanism of action schematic · 2) Trial design schema: intismeran design, manufacture and exposure · 3) Slide: RFS and DMFS prespecified subgroup forest plots (Long, ESMO 2026) [too blurry]
🔥 #ESMO26 INTerpath-001, full data (now yes)
On top of RFS HR 0.58 and DMFS HR 0.62:
• Manufacturing success >99%
• >90% of patients got the maximum 34 neoantigens
🔍 Practice-changing? For a population, yes. Two things still to prove:
• Can an mRNA strategy rescue patients primary refractory to neoadjuvant ipi-nivo (no pathologic response)?
• Will it move OS in stage II-IIIB too?
Resuls in @NEJM soon
@myESMO @OncoAlert @Larvol @_SEOM
#Melanoma #Immunotherapy
[Slide 1]
Intismeran mechanism of action
• Intismeran is designed to strengthen existing and create new T cell responses1-3
• Pembrolizumab blocks PD-1 to enhance T-cell activity, complementing intismeran's MOA
1 Administer INT
2 mRNA uptake into cells
3 mRNA translated into protein and processed
4 Neoantigen presentation
5 T cell activation and clonal expansion
6 Migration to tumor microenvironment
7 Tumor cell killing
8 Epitopes releaseda
Diagram labels: APC (eg, dendritic cell); [illegible small diagram labels]; T cells; Dying tumor cell; Cytokine release
[footnotes and references illegible]
Presented by: Georgina V. Long, Melanoma Institute Australia [blurred]
[Slide 2]
Intismeran Design, Manufacture,a and Exposure
• 91% of the 1137 randomized patients had the maximum 34 neoantigens identified for intismeran design
• >99% of the 757 patients in the intismeran + pembrolizumab arm had their intismeran successfully manufactured
• Median time to first intismeran dose was 64 days
• Median number of intismeran doses was 9b
No. neoantigens in each intismeran
Median: 34 (range, 7–34)
Pie chart legend: 34 | 30-33 | 25-29 | 20-24 | 15-19 | 10-14 | <10
[footnotes a/b largely illegible: aIntismeran was designed for all randomized patients. The manufacturing workflow was initiated when it was known that a patient was randomized to the intismeran + pembrolizumab arm. bThe median number of placebo administrations and pembrolizumab cycles was also [?]]
Presented by: Georgina V. Long, Melanoma Institute Australia
Balazs Halmos@BalazsHalmosMD
INTerpath-001
1) Slide: Photo of presented ESMO 2026 slide alongside presenter video · 2) Slide: Photo of presented ESMO 2026 slide
I admit i am very much into intismeran…and it seems many others too as it is standing room only here…
Fabulous presentation/data on the Interpath-001 trial demonstrating clear benefit of this space age bespoke neoantigen vaccine along w pembro for pts w resected high risk melanoma as to 40% or so improvement in RFS/distant met free survival
Indeed a landmark trial for precision medicine and hopefully not too Long before we see confirmation in nsclc/other trials!
Interpath- indeed makes us foresee a wonderful path and light ahead for our field!
#ESMO26
[Slide 1]
Intismeran mechanism of action
• Intismeran is designed to strengthen existing and create new T cell responses1-3
1 Administer INT
2 mRNA uptake into cells
APC (eg, dendritic cell)
3 mRNA translated into protein and processed
Endosome | Endoplasmic reticulum | INT mRNA | Polypeptide | Proteasome | Tumor-specific neoantigens | MHC I | MHC II | Endo-lysosomes
CD8 T cell (cytotoxic activity)
CD4 T cell (memory)
4 Neoantigen presentation
5 T cell activation and clonal expansion
T cells
6 Migration to tumor microenvironment
7 Tumor cell killing
CD4+ T cell | CD8+ T cell | Cytokine release | Dying tumor cell
8 Epitopes releaseda
aHypothetical mechanism of action.
1Weber JS et al. Lancet 2024;403:632–44. 2Ojalvo LS et al. JCO Oncol Adv 2026;3:e2500206. 3Gainor JF, et al. Cancer Discov. 2024;14(11):2209-2223
Presented by: Georgina V. Long, Melanoma Institute Australia
[Slide 3]
All-Cause AEs, Incidence ≥10%
Intismeran + Pembrolizumab (N = 755) | Placebo + Pembrolizumab (N = 380)
AE | Intismeran + pembro (%) | Placebo + pembro (%)
Pyrexia | 52.2 | 8.2
Injection site pain | 51.0 | 9.5
Fatigue | 38.5 | 29.7
Influenza-like illness | 25.4 | 9.2
Diarrhea | 23.7 | 23.7
Pruritus | 23.4 | 23.4
Headache | 23.3 | 13.2
Arthralgia | 22.6 | 23.2
Injection site reaction | 21.6 | 1.6
Nausea | 21.2 | 15.3
Myalgia | 20.3 | 10.5
Asthenia | 19.9 | 18.2
Injection site erythema | 19.9 | 0.8
Chills | 16.2 | 3.4
Hypothyroidism | 15.8 | 15.5
Rash | 15.1 | 17.6
Cough | 10.9 | 10.3
Dry mouth | 9.7 | 11.3
~10% greater incidence vs pembrolizumab alone due to intismeran injection
Low grade and transient
Managed per standard practice
Legend: Grade 1–2 | Grade 3–5
Incidence, %
As-treated population: all randomized patients who received at ≥1 dose of study treatment. Data cutoff date: June 30, 2026 (median study follow-up, 24.6 mo).
Presented by: Georgina V. Long, Melanoma Institute Australia
Toni Choueiri, MD@DrChoueiri
INTerpath-001
Slide: title slide (Long, ESMO 2026 Presidential Symposium)
Superb presentation by Georgina Long! INTerpath-001: adding personalized mRNA vaccine intismeran to pembrolizumab reduced recurrence/death risk by 42% in resected stage IIB-IV melanoma (HR 0.58). A major step for cancer vaccines! #ESMO26 @OncoAlert @myESMO #ESMO26 https://t.co/9miRzK7fhb
[Slide 1]
INTerpath-001: Phase 3 Study of the mRNA-Based Individualized Neoantigen Therapy (INT) Intismeran Autogene plus Pembrolizumab vs Pembrolizumab Alone for Adjuvant Treatment of Resected Stage IIB-IV Melanoma
Georgina V. Long; Muhammad A. Khattak; Helen J. Gogas; Dirk Schadendorf; Ana Arance; Matteo S. Carlino; Piotr Rutkowski; Gareth Rivalland; Antoni Ribas; Janice M. Mehnert; Patrick A. Ott; Reinhard Dummer; Paola Queirolo; Christoffer Gebhardt; Laureen S. Ojalvo; Jinchun Zhang; Dmitri O. Grebennik; Mizuho Fukunaga-Kalabis; Paolo A. Ascierto; Michele Del Vecchio on behalf of the INTerpath-001 Investigators
MADRID 2026 ESMO congress
🚨 #ESMO26 | Phase III INTerpath-001 🚨
After an early embargo breach, @myESMO brought the abstract release forward!!!!!!
And yes, it’s clearly positive:
📉 RFS HR 0.58
📉 DMFS HR 0.62
But here’s the uncomfortable part: SWOG S1801 also reported an HR 0.58…simply by moving 3 doses of pembrolizumab BEFORE surgery…
☝🏼Not the same population. Not the same endpoint. Not a cross-trial comparison.
Still, in 2026, should a personalized mRNA vaccine really be benchmarked against adjuvant pembro alone?
Before calling this a new standard, I want to see the vaccine face the NEOADJUVANT era.
Same HR. Different path. And that may be the real INTerpath question 👀
@OncoAlert @OncoReporte @myESMO @_SEOM @GrupoMelanoma
What do you think? @SuyogCancer @OncBrothers @A_May_MD @Dr_R_Kurzrock
[Slide 1]
Results
1137 pts were randomized: 757 to intismeran + pembro, 380 to placebo + pembro; 726 (95.9%) received ≥1 dose of intismeran and 365 (96.1%) received ≥1 dose of placebo as planned. Median follow-up as of 30Jun2026 was 24.6 mo. Intismeran + pembro significantly improved RFS and DMFS compared with placebo + pembro (Table). Benefit was similar in stage IIB–IIIB and IIIC–IV MEL and other subgroups. For intismeran + pembro vs placebo + pembro, AEs were grade ≥3 in 23.6% vs 20.3%; 6.5% vs 5.3% discontinued both drugs simultaneously due to an AE. Most common AEs were pyrexia (52.2% vs 8.2%), injection site pain (51.0% vs 9.5%), and fatigue (38.5% vs 29.7%).
Table: LBA1
| Intismeran + pembro (N = 757) | Placebo + pembro (N = 380)
Recurrence-free survival (RFS)
24-mo rate, % (95% CI) | 82.2 (79.3–84.8) | 70.0 (65.0–74.5)
HR (95% CI) | 0.58 (0.45–0.75) | —
Two-sided P | <0.001 | —
Distant metastasis-free survival (DMFS)
24-mo rate, % (95% CI) | 88.5 (86.0–90.6) | 80.2 (75.6–84.0)
HR (95% CI) | 0.62 (0.45–0.85) | —
Two-sided P | 0.002 | —
Mario Balsa@MarioBalsaMD
INTerpath-001
1) Kaplan-Meier survival data: DMFS primary analysis ITT KM curve (Long, ESMO 2026 LBA1) · 2) Slide: RFS and DMFS prespecified subgroup forest plots (Long, ESMO 2026 LBA1)
👑 Presidential #ESMO26! INTerpath-001: personalized mRNA vaccination reaches phase III in melanoma.
Resected stage IIB–IV melanoma, N=1,137: intismeran + pembrolizumab vs pembrolizumab.
💥 At 24 months:
• RFS: 82.2% vs 70.0% → HR 0.58
• DMFS: 88.5% vs 80.2% → HR 0.62
• Absolute gains: +12.2% RFS / +8.3% DMFS
• Benefit emerges mainly after 6 months
• Grade ≥3 AEs: 23.6% vs 20.3%
• OS still immature
A clinically meaningful new mechanism, but the real question now is positioning 🤔
For macroscopic stage III: adjuvant personalized vaccine after surgery, or neoadjuvant ipi/nivo before it? Biomarkers may ultimately decide.
Congrats to @ProfGLongMIA and all the team! 👏🏼
@OncoAlert
@OncoReporte @myESMO @_SEOM @GrupoMelanoma
A long-awaited breakthrough in cancer vaccines.
One patient. One tumor. One personalized mRNA vaccine.
INTErpath-001 brings this vision closer to clinical reality. Are we ready to deliver it?
@myESMO @OncoAlert @OpenMedicineHQ #ESMO26 @ProfGLongMIA @FAndreMD @curijoey @YJanjigianMD
[Slide 3]
INTerpath-001: Randomized, Double-Blind, Phase 3 Trial
Key Eligibility Criteria
• Age ≥18 years
• Resected cutaneous melanoma
• AJCC 8th ed. Stage IIB/IIC (clinical IIB/IIC permitted), III, or IV
• FFPE tumor sample suitable for NGS and intismeran generation
• No prior systemic therapy
• ECOG PS 0 or 1
R 2:1
Intismeran 1 mg IM Q3W for 9 doses + Pembrolizumab 400 mg IV Q6W for 9 cycles
Placeboa IM Q3W for 9 doses + Pembrolizumab 400 mg IV Q6W for 9 cycles
Stratification factors
• Risk-based stage (IIB/IIC/IIIA/IIIB vs IIIC/IIID/IV)
• Age (<65 years vs ≥65 years)
aNormal saline or dextrose. Placebo was started at random to maintain the blind.
ClinicalTrials.gov identifier: NCT05933577.
Presented by: Georgina V. Long, Melanoma Institute Australia
🔥 Personalized cancer vaccines delivering impressive results at #ESMO26! @ProfGLongMIA
presents the phase III INTerpath-001 trial in resected high-risk melanoma.
Individualized neoantigen mRNA vaccine intismeran autogene + pembrolizumab vs pembrolizumab alone.
Key results:
🔹 DMFS: HR 0.62 (95% CI 0.45–0.85), p=0.002
🔹 24-month DMFS: 88.5% vs 80.2%
🔹 RFS: HR 0.58 (95% CI 0.45–0.75)
A major milestone for personalized cancer vaccines! A promising step towards truly individualized immunotherapy.
#ESMOAmbassador #ESMO26 #Melanoma #CancerVaccines #Immunotherapy
[Slide 1]
Science enables individualized therapeutic cancer vaccines
Neoantigen discovery
• Tumor-specific mutations
• Potential for enhanced immunogenicity
Cancer Cell: Patient A | Patient B | Patient C
Neoantigen selection
• NGS identifies tumor mutations
• Computational prediction of HLA presentation and ranking
The mRNA platform
• Multiple antigens per mRNA
• Robust CD8+ and CD4+ T cell responses
• Rapid, individualized manufacturing
Lipid nanoparticle (LNP) | mRNA
HLA, human leukocyte antigen; mRNA, messenger RNA; NGS, next-generation sequencing.
Ascierto PA, Melero I. J Immunother Cancer 2025;13:e013766. Zaidi N et al. Nat Rev Cancer 2025;25:517–33. Haanen JB et al. Nat Med 2026;32:828-40. Weber JS et al. Lancet 2024;403:632–44. Ojalvo LS et al. JCO Oncol Adv 2026;3:e2500206.
Presented by: Georgina V. Long, Melanoma Institute Australia
[Slide 2]
Standardized intismeran workflow
1 Tissue and blood samples
2 Neoantigen identification
3 mRNA design
4 Manufacture
5 Administer
~6-8 weeks
Presented by: Georgina V. Long, Melanoma Institute Australia
Congratulations to the amazing @ProfGLongMIA presenting Interpath results at #ESMO26 Presidential. Practice changing data. AEs similar, slightly higher in v940 arm. Hoping for similar results in lung study! https://t.co/l5o6Jj1o9p
[Slide 3]
Baseline Characteristics
| Intismeran + pembrolizumab (N = 757) | Placebo + pembrolizumab (N = 380)
Age, median (range) | 61.0 y (18–89) | 61.5 y (18–88)
Male sex, n (%) | 456 (60.2) | 227 (59.7%)
Race, n (%)
Asian | 15 (2.0) | 13 (3.4)
Multiple | 5 (0.7) | 4 (1.1)
White | 696 (91.9) | 337 (88.7)
Other | 10 (1.3)a | 4 (1.1)b
Missing | 31 (4.1) | 22 (5.8)
Geographic region, n (%)
Australia | 89 (11.8) | 39 (10.3)
Europe | 415 (54.8) | 209 (55.0)
Latin America | 45 (5.9) | 22 (5.8)
United States | 84 (11.1) | 35 (9.2)
Rest of world | 124 (16.4) | 75 (19.7)
ECOG PS 0, n (%) | 697 (92.1) | 350 (92.1)
Risk-based disease stage, n (%)
IIB/IIC/IIIA/IIIB | 441 (58.3) | 230 (60.5)
IIIC/IIID/IV | 316 (41.7) | 150 (39.5)
Overall disease stage, n (%)
IIA | 1 (0.1)c | 0
IIB | 155 (20.5) | 73 (19.2)
IIC | 92 (12.2) | 42 (11.1)
IIIA | 50 (6.6) | 32 (8.4)
IIIB | 143 (18.9) | 83 (21.8)
IIIC | 245 (32.4) | 118 (31.1)
IIID | 10 (1.3) | 4 (1.1)
IV | 61 (8.1) | 28 (7.4)
aIncludes American Indian or Alaska Native (n = 5), Black or African American (n = 3), and Native Hawaiian or other Pacific Islander (n = 2). bIncludes American Indian or Alaska Native (n = 3) and Black or African American (n = 1). cProtocol deviation.
ITT population: all randomized patients according to the arm to which they were assigned. Data cutoff date: June 30, 2026 (median study follow-up, 24.6 mo).
Presented by: Georgina V. Long, Melanoma Institute Australia
Shilpa Gupta@shilpaonc
INTerpath-001
Slide: Photo/screenshot of presented ESMO 2026 conference slide
#ESMO26 @myESMO
Presidential session presentation by session @ProfGLongMIA
INTerpath-001: intismeran + pembro vs pembro in resected stage IIB–IV melanoma (n=1,137)
RFS HR 0.58, 2-yr RFS 82% vs 70% DMFS HR 0.62, 2-yr DMFS 89% vs 80%
1st phase 3 win for an individualized cancer vaccine against an active IO control. OS is pending, but the adjuvant melanoma bar just moved!
Moving moment as @ProfGLongMIA paid tribute to Dr. Jeff Weber, who designed this trial and enrolled patients until his passing. Jeff was a dear friend and my colleague at @MoffittNews and today's results are his legacy 💙
Bladder next: INTerpath-005 in MIUC, look forward to seeing the data in future!
[Slide 3]
Summary and Conclusions
• INTerpath-001 met both the primary RFS and key secondary DMFS endpoints
– Intismeran + pembrolizumab reduced the risk of recurrence or death by 42% and the risk of distant metastasis or death by 38% compared with placebo + pembrolizumab
– In a sensitivity analysis, intismeran + pembrolizumab reduced the risk of recurrence or death by 58% after month 6
– Benefit was observed in most prespecified subgroups, including risk-based disease stages
– OS was immature and did not meet prespecified significance boundarya; follow-up is ongoing
aThe hazard ratio for OS was 0.77 (95% CI, 0.45–1.31); two-sided P = 0.33.
Presented by: Georgina V. Long, Melanoma Institute Australia
David H Aggen, MD PhD@Dr_Aggen
INTerpath-001
Trial design schema: study design (Long, ESMO 2026 LBA1)
There is clear additive activity with a personalized mRNA vaccine with intismeran autogene with pembrolizumab in melanoma where dual PD1 failed before.
Presented by @ProfGLongMIA - I hope the same will come in the future for RCC #ESMO26 #Oncoalert https://t.co/Owe1QY5Uuh
[Slide 1]
INTerpath-001: Randomized, Double-Blind, Phase 3 Trial
Key Eligibility Criteria
• Age ≥18 years
• Resected cutaneous melanoma
• AJCC 8th ed. Stage IIB/IIC (clinical IIB/IIC permitted), III, or IV
• FFPE tumor sample suitable for NGS and intismeran generation
• No prior systemic therapy
• ECOG PS 0 or 1
R 2:1
Intismeran 1 mg IM Q3W for 9 doses + Pembrolizumab 400 mg IV Q6W for 9 cycles
Placebo(a) IM Q3W for 9 doses + Pembrolizumab 400 mg IV Q6W for 9 cycles
Pembrolizumab
• Started at randomization, ≤13 weeks after resection
Intismeran
• Started upon availability to site
• Earliest: Cycle 1, day 22
• Latest: Cycle 4, day 1
Stratification factors
• Risk-based stage (IIB/IIC/IIIA/IIIB vs IIIC/IIID/IV)
• Age (<65 years vs ≥65 years)
Primary end point: RFS per investigator
Secondary end points: DMFS per investigator, OS, patient-reported outcomes, safety
(a)Normal saline or dextrose. Placebo was started at random to maintain the blind.
ClinicalTrials.gov identifier: NCT05933577.
Presented by: Georgina V. Long, Melanoma Institute Australia
The First Positive Phase III Trial of a Personalized mRNA Cancer Therapy
Adding individualized mRNA therapy to adjuvant pembrolizumab reduced the risk of recurrence or death by 42% in patients with resected stage IIB–IV melanoma.
#ESMO2026 https://t.co/aSdzLwcxiG
[Slide 1]
RFS Sensitivity Analysis: Piecewise Hazard Ratios, ITT
0-6 months: HR 0.99 (95% CI 0.66–1.49)
>6 months: HR 0.42 (95% CI 0.30–0.58)
| 0-6 months Events (ratea) | >6 months Events (ratea)
Intismeran + pembrolizumab | 68 (0.016) | 68 (0.006)
Placebo + pembrolizumab | 35 (0.016) | 76 (0.015)
Months: 0 | 6 | 12 | 18 | 24 | 30 | 35
No. at risk
757 | 683 | 646 | 618 | 136 | 10 | 0
380 | 341 | 302 | 282 | 72 | 3 | 0
aRate calculated as no. of events divided by person-time in each interval. ITT: all randomized patients according to the arm to which they were assigned.
RFS: time from randomization to the first occurrence of any recurrence or death from any cause. Data cutoff date: June 30, 2026 (median study follow-up, 24.6 mo).
Presented by: Georgina V. Long, Melanoma Institute Australia
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: RFS sensitivity analysis — piecewise hazard ratios (ITT)
Intismeran + pembrolizumab | 757
Placebo + pembrolizumab | 380
HR: 0-6 months: 0.99; >6 months: 0.42
HR CI: 0-6 months: 0.66–1.49; >6 months: 0.30–0.58
Note: Piecewise HRs split at 6 months (dashed line). No p-values, medians or landmark rates printed. Arm N from numbers-at-risk row at time 0. Data cutoff June 30, 2026; median follow-up 24.6 mo.
Daniel Heng@DrDanielHeng
INTerpath-001
Slide: summary and conclusions (Long, ESMO 2026)
#INTerpath001 amazing adjuvant melanoma trial of a personalized vaccine plus pembrolizumab. 17% of patients didn’t have sufficient tumor sample to create the neoantigen vaccine. DFS highly positive and OS immature. @oncoalert #ESMO26 excited to see other tumor data coming soon! https://t.co/VyUKabIWE2
[Slide 3]
Summary and Conclusions
• INTerpath-001 met both the primary RFS and key secondary DMFS endpoints
– Intismeran + pembrolizumab reduced the risk of recurrence or death by 42% and the risk of distant metastasis or death by 38% compared with placebo + pembrolizumab
– In a sensitivity analysis, intismeran + pembrolizumab reduced the risk of recurrence or death by 58% after month 6
– Benefit was observed in most prespecified subgroups, including risk-based disease stages
– OS was immature and did not meet prespecified significance boundarya; follow-up is ongoing
• Safety was generally consistent with previous experience, with no potentiation of pembrolizumab-associated AEs with the combination
• Intismeran was reliably delivered at a global scale
• Ongoing phase 2 and 3 trials are evaluating intismeran for bladder cancer, melanoma, NSCLC, and RCC in the neoadjuvant, adjuvant, or metastatic settings
• INTerpath-001 sets a new benchmark for adjuvant therapy in melanoma and establishes intismeran as a landmark advance in personalized cancer medicine
aThe hazard ratio for OS was 0.77 (95% CI, 0.45–1.31); two-sided P = 0.33
Presented by: Georgina V. Long, Melanoma Institute Australia
Alfredo Addeo MD@Alfdoc2
INTerpath-001
1) Kaplan-Meier survival data: NADINA neoadjuvant ipi/nivo EFS and RFS · 2) Kaplan-Meier survival data: NADINA EFS/RFS plus mixed trial and real-world OS · 3) Slide: take-home messages, open questions and hurdles (Svane discussant, ESMO 2026)
Balanced discussion by prof Svane of the phase III INTerpath-001 trial at #ESMO26.
Personalized cancer vaccines represent a major step forward, but:
🔹 Will the RFS benefit translate into improved OS?
🔹 Where should adjuvant vaccination fit alongside neoadjuvant ipilimumab/nivolumab?
🔹 Who benefits most? Predictive biomarkers remain urgently needed.
🔹 Manufacturing complexity, treatment delays, costs and access are major challenges.
👏 Compelling data and a milestone for personalized oncology, but clinical positioning and real-world feasibility will be crucial!
#ESMOAmbassador #ESMO26 #Melanoma #CancerVaccin
[Slide 2]
Neoadjuvant therapy for macroscopic resectable disease
EFS, RFS according to pathological response, and Real-world OS
NADINA - EFS
neo-adjuvant ipi/nivo versus adj nivo
macroscopic stage III
[KM curve] Neoadjuvant 83.7 | Adjuvant 57.2 (labels at 12 months)
Events/N: Neoadjuvant: 28/212; Adjuvant: 72/211
HR= 0.32 ( 99.9% CI: 0.15 - 0.66 ), p <0.0001
Months since Randomization
NADINA - RFS
neo-adjuvant ipi/nivo versus adj nivo
macroscopic stage III
[KM curve] Major pathological response 95.1 | Partial pathological response 76.1 | Pathological nonresponse 57.0 (labels at 12 months)
Months since Randomization
ESMO Guidelines: Neoadjuvant ipi/nivo is recommended for macroscopic resectable st III and IV melanoma
Neoajduvant ipi/nivo is associated with 30% severe toxicity as compared to 15% for adjuvant anti-PD1
NADINA have not yet presented mature OS data
Inge Marie Svane
Blank et al NEJM 2024, Long et al Nature Med 2026
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: EFS (NADINA, neoadjuvant ipi/nivo vs adjuvant nivo, macroscopic stage III)
Neoadjuvant ipi/nivo | 212
Adjuvant nivo | 211
HR: 0.32
HR CI: 99.9% CI 0.15-0.66
P: <0.0001
{'timepoint': '12 months', 'arm': 'Neoadjuvant ipi/nivo', 'value': '83.7', 'ci': None}
{'timepoint': '12 months', 'arm': 'Adjuvant nivo', 'value': '57.2', 'ci': None}
{'timepoint': '12 months', 'arm': 'RFS - major pathological response', 'value': '95.1', 'ci': None}
{'timepoint': '12 months', 'arm': 'RFS - partial pathological response', 'value': '76.1', 'ci': None}
{'timepoint': '12 months', 'arm': 'RFS - pathological nonresponse', 'value': '57.0', 'ci': None}
Note: Landmark labels printed at the 12-month dashed line. Partial response label 76.1 is faint (yellow). Source cited on slide: Blank et al NEJM 2024, Long et al Nature Med 2026.
[Slide 3]
Neoadjuvant therapy for macroscopic resectable disease
EFS, RFS according to pathological response, and Real-world OS
NADINA - EFS
neo-adjuvant ipi/nivo versus adj nivo
macroscopic stage III
[KM curve] Neoadjuvant 83.7 | Adjuvant 57.2 (labels at 12 months)
Events/N: Neoadjuvant: 28/212; Adjuvant: 72/211
HR= 0.32 ( 99.9% CI: 0.15 - 0.66 ), p <0.0001
Months since Randomization
NADINA - RFS
neo-adjuvant ipi/nivo versus adj nivo
macroscopic stage III
[KM curve] Major pathological response 95.1 | Partial pathological response 76.1 | Pathological nonresponse 57.0 (labels at 12 months)
Months since Randomization
Mixed trial and RW data - OS
neo-adjuvant CPI
resectable stage III/IV
[KM curve, OS (%) vs Time (years)] 89 / 83 (at 3 years); 88 / 83 (at 5 years)
- PD-1 alone
- PD-1 + IO
P = 0.04
ESMO Guidelines: Neoadjuvant ipi/nivo is recommended for macroscopic resectable st III and IV melanoma
Neoajduvant ipi/nivo is associated with 30% severe toxicity as compared to 15% for adjuvant anti-PD1
NADINA have not yet presented mature OS data
Mixed trial and real-world data indicates excellent survival after neoadjuvant CPI
ESMO Guidelines: discussions with the patient should consider the RFS benefits but lack of mature OS data
Inge Marie Svane
Blank et al NEJM 2024, Long et al Nature Med 2026
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: EFS (NADINA, neoadjuvant ipi/nivo vs adjuvant nivo, macroscopic stage III)
Neoadjuvant ipi/nivo | 212
Adjuvant nivo | 211
HR: 0.32
HR CI: 99.9% CI 0.15-0.66
P: <0.0001
{'timepoint': '12 months', 'arm': 'Neoadjuvant ipi/nivo', 'value': '83.7', 'ci': None}
{'timepoint': '12 months', 'arm': 'Adjuvant nivo', 'value': '57.2', 'ci': None}
{'timepoint': '12 months', 'arm': 'RFS - major pathological response', 'value': '95.1', 'ci': None}
{'timepoint': '12 months', 'arm': 'RFS - partial pathological response', 'value': '76.1', 'ci': None}
{'timepoint': '12 months', 'arm': 'RFS - pathological nonresponse', 'value': '57.0', 'ci': None}
{'timepoint': '3 years', 'arm': 'Mixed trial/RW OS - upper curve', 'value': '89', 'ci': None}
{'timepoint': '3 years', 'arm': 'Mixed trial/RW OS - lower curve', 'value': '83', 'ci': None}
{'timepoint': '5 years', 'arm': 'Mixed trial/RW OS - upper curve', 'value': '88', 'ci': None}
{'timepoint': '5 years', 'arm': 'Mixed trial/RW OS - lower curve', 'value': '83', 'ci': None}
Note: Landmark labels printed at the 12-month dashed line. Partial response label 76.1 is faint (yellow). Source cited on slide: Blank et al NEJM 2024, Long et al Nature Med 2026. Third panel (Mixed trial and RW data - OS, neo-adjuvant CPI, resectable stage III/IV): legend PD-1 alone vs PD-1 + IO, P = 0.04; legend colours not distinguishable in photo, so curve-to-arm mapping not assigned.
[Slide 4]
Take-home messages
The INTerpath-001 results are compelling and mark a crucial moment for personalized cancer vaccines
OPEN QUESTIONS
• Will improved RFS translate into improved OS with longer FU and when will data be available ?
• To which extend is the clinical efficacy of Intismeran driven by neoantigen-dependent immune effects ?
• How should adjuvant pembro/intismeran be positioned compared to neoadjuvant ipi/nivo for macroscopic St III/IV ?
– For patients without major pathological response ?
• Further insight into predictive biomarkers and MOA are urgently needed
HURDLES
• Intismeran production process is complex and time-consuming which translate into an expensive drug
• Intismeran is not available for a significant number of patients with tissue samples unsuitable for sequencing
• Health technology assessments have yet to evaluate Intismeran real-world cost-effectiveness and feasibility
Inge Marie Svane
Elad Sharon@EladSharonMD
INTerpath-001
1) Slide: background: science of individualized therapeutic cancer vaccines (Long, ESMO 2026) · 2) Trial design schema: study design slide (rotated, blurry photo)
Watching the intismeran presentation by @ProfGLongMIA here @myESMO here in Madrid #ESMO26 https://t.co/MDuBbMTtsJ
Georgina Long presented INTerpath-001 at #ESMO26: intismeran + pembrolizumab vs placebo + pembrolizumab as adjuvant therapy for resected melanoma. It met the primary RFS endpoint (42% reduction in risk of recurrence or death) and the key secondary DMFS endpoint (38% reduction). OS is still immature, and follow-up is ongoing.
[Slide 2]
RFS Sensitivity Analysis: mITT
HR 0.51 (95% CI 0.39–0.67)
84.2% (95% CI 81.3–86.7)
70.4% (95% CI 65.3–74.9)
| N | Events,a n (%)
Intismeran + pembrolizumab | 726 | 116a (16.0%)
Placebo + pembrolizumab | 365 | 106b (29.0%)
Months: 0 | 6 | 12 | 18 | 24 | 30 | 35
No. at risk
726 | 674 | 638 | 611 | 133 | 9 | 0
365 | 333 | 294 | 275 | 71 | 2 | 0
[a3]1 patients in the intismeran + pembrolizumab arm were excluded from the mITT population due to AEs (n=13), recurrence (n=10), or other reason (n=8). RFS events occurred in 20 (64.5%) of the 31 patients who did not [re]ceive intismeran as planned. b15 patients in the placebo + pembrolizumab arm were excluded from the mITT population due to AEs (n=5), recurrence (n=4), or other reason (n=6). RFS events occurred in and 5 (33.3%) of [the 15] patients who did not receive placebo as planned. mITT: all randomized patients who received intismeran or placebo as assigned. RFS: time from randomization to the first occurrence of any recurrence or death from any [ca]use. Data cutoff date: June 30, 2026 (median study follow-up, 24.6 mo).
[Pre]sented by: Georgina V. Long, Melanoma Institute Australia
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: RFS sensitivity analysis, mITT
Intismeran + pembrolizumab | 726
Placebo + pembrolizumab | 365
HR: 0.51
HR CI: 95% CI 0.39–0.67
{'timepoint': '24 months', 'arm': 'Intismeran + pembrolizumab', 'value': '84.2%', 'ci': '95% CI 81.3–86.7'}
{'timepoint': '24 months', 'arm': 'Placebo + pembrolizumab', 'value': '70.4%', 'ci': '95% CI 65.3–74.9'}
Note: No p-value printed (sensitivity analysis). Medians not printed. Footnote left edge cropped; bracketed text reconstructed only where obvious (e.g. 31 excluded = 13+10+8).
Dr. Antonio Calles 🫁🚭@Tony_Calles
INTerpath-001
Slide: treatment disposition and exposure CONSORT (Long, ESMO 2026)
🧬 Personalized mRNA vaccines work‼️
📈 INTERPATH-001 met its primary endpoint in resected melanoma patients, paving the way to other tumor types and combinations, including lung 🫁 #cancer
🚀 🌓 One small step for a vaccine, one giant leap for personalized medicine. #ESMO26 @myesmo
[Slide 3]
Treatment Disposition and Exposure
1749 patients screened
302 (17.3%) had inadequate tumor sample
125 (7.1%) not disease free
91 (5.2%) did not provide informed consent
94 (5.4%) excluded for other reasons
1137 randomized (2:1 ratio)
757 to intismeran + pembrolizumab | 380 to placebo + pembrolizumab
756 received ≥1 dose of treatment | 379 received ≥1 dose of treatment
756 received ≥1 dose of pembrolizumab | 379 received ≥1 dose of pembrolizumab
726 (96.0%) received ≥1 dose of intismeran | 365 (96.3%) received ≥1 dose of placebo
1 (0.1%) received ≥1 dose of placebo(a) |
228 (30.2%) discontinued treatment | 117 (30.9%) discontinued treatment
114 (15.1%) adverse event | 37 (9.8%) adverse event
82 (10.8%) recurrence/relapse | 68 (17.9%) recurrence/relapse
32 (4.2%) other | 12 (3.2%) other
528 (69.8%) completed treatment | 262 (69.1%) completed treatment
(a)The patient for whom intismeran could not be manufactured received placebo to maintain the blind.
Presented by: Georgina V. Long, Melanoma Institute Australia
INTerpath-001: In macroscopic stage III melanoma, added value beyond neoadjuvant IO remains unclear. Next: target patients without MPR—but can vaccines overcome IO resistance? Value in stage IIB/IIC remains distinct.
#ESMO26 @Larvol @OncoAlert @myESMO https://t.co/E4nKMmpxfy
[Slide 2]
Efficacy in Prespecified Subgroups
RFS and DMFS benefits observed in most subgroups
Recurrence-Free Survival
Subgroup | Intismeran + Pembro Events/Patients | Placebo + Pembro Events/Patients | Hazard Ratio (95% CI)
All patients | 136/757 | 111/380 | 0.58 (0.45-0.75)
Age
<65 yr | 79/458 | 61/230 | 0.65 (0.47-0.91)
>=65 yr | 57/299 | 50/150 | 0.53 (0.36-0.77)
Sex
Female | 57/301 | 40/153 | 0.71 (0.47-1.06)
Male | 79/456 | 71/227 | 0.54 (0.39-0.74)
Geographic region
Australia | 16/89 | 12/39 | 0.54 (0.26-1.15)
Europe | 70/415 | 54/209 | 0.64 (0.45-0.92)
Latin America | 15/45 | 9/22 | 0.85 (0.37-1.95)
United States | 12/84 | 10/35 | 0.50 (0.22-1.16)
Rest of world | 23/124 | 26/75 | 0.50 (0.29-0.89)
ECOG PS
0 | 120/697 | 97/350 | 0.61 (0.47-0.80)
1 | 16/60 | 14/30 | 0.48 (0.24-0.99)
Risk-based disease stage
IIB/IIC/IIIA/IIIB | 59/440 | 50/230 | 0.60 (0.41-0.88)
IIIC/IIID/IV | 77/316 | 61/150 | 0.57 (0.41-0.79)
Axis: 0.2 | 0.5 | 1.0 | 0.5 ; Intismeran + Pembro Better / Placebo + Pembro Better
Distant Metastasis-Free Survival
Subgroup | Intismeran + Pembro Events/Patients | Placebo + Pembro Events/Patients | Hazard Ratio (95% CI)
All patients | 89/757 | 71/380 | 0.62 (0.45-0.85)
Age
<65 yr | 47/458 | 37/230 | 0.65 (0.42-0.99)
>=65 yr | 42/299 | 34/150 | 0.61 (0.39-0.95)
Sex
Female | 31/301 | 27/153 | 0.58 (0.34-0.97)
Male | 58/456 | 44/227 | 0.66 (0.44-0.97)
Geographic region
Australia | 12/89 | 11/39 | 0.42 (0.19-0.96)
Europe | 42/415 | 34/209 | 0.63 (0.40-0.99)
Latin America | 11/45 | 9/22 | 0.62 (0.26-1.49)
United States | 8/84 | 2/35 | 1.77 (0.38-8.35)
Rest of world | 16/124 | 15/75 | 0.63 (0.31-1.28)
ECOG PS
0 | 77/697 | 60/350 | 0.65 (0.46-0.91)
1 | 12/60 | 11/30 | 0.47 (0.21-1.06)
Risk-based disease stage
IIB/IIC/IIIA/IIIB | 41/440 | 33/230 | 0.65 (0.41-1.02)
IIIC/IIID/IV | 48/316 | 38/150 | 0.59 (0.39-0.91)
Axis: 0.2 | 0.5 | 1.0 | 2.0 | 3.0 | 9.0 ; Intismeran + Pembro Better / Placebo + Pembro Better
ITT: all randomized patients according to the arm to which they were assigned. Data cutoff date: June 30, 2026 (median study follow-up, 24.6 mo).
Presented by: Georgina V. Long, Melanoma Institute Australia
Prof. Dr. Ahmet Dirican@dr_dirican
INTerpath-001
Slide: summary/conclusions (Long) and discussant take-home messages (Svane), ESMO 2026
ESMO 2026 | Personalized mRNA Cancer Vaccines Deliver Phase III Success!
INTerpath-001: Intismeran + pembrolizumab in resected high-risk melanoma.
• RFS: HR 0.58 (42% risk reduction)
• 24-month RFS: 82.2% vs 70.0% (+12.2%)
• DMFS: HR 0.62 (38% risk reduction)
3 Key Takeaways:
1. Personalized neoantigen vaccines have demonstrated clinically meaningful Phase III efficacy.
2. No major increase in severe treatment-related toxicity, but overall survival data remain immature.
3. Predictive biomarkers, ctDNA/MRD, and optimal sequencing versus neoadjuvant immunotherapy are the next critical questions.
A major milestone for personalized oncology.
#ESMO26 @myesmo @oncodaily @OncoAlert #CancerVaccines #Melanoma
[Slide 1]
[Left slide]
Summary and Conclusions
• INTerpath-001 met both the primary RFS and key secondary DMFS endpoints
– Intismeran + pembrolizumab reduced the risk of recurrence or death by 42% and the risk of distant metastasis or death by 38% compared with placebo + pembrolizumab
– In a sensitivity analysis, intismeran + pembrolizumab reduced the risk of recurrence or death by 58% after month 6
– Benefit was observed in most prespecified subgroups, including risk-based disease stages
– OS was immature and did not meet prespecified significance boundarya; follow-up is ongoing
• Safety was generally consistent with previous experience, with no potentiation of pembrolizumab-associated AEs with the combination
• Intismeran was reliably delivered at a global scale
• Ongoing phase 2 and 3 trials are evaluating intismeran for bladder cancer, melanoma, NSCLC, and RCC in the neoadjuvant, adjuvant, or metastatic settings
• INTerpath-001 sets a new benchmark for adjuvant therapy in melanoma and establishes intismeran as a landmark advance in personalized cancer medicine
aThe hazard ratio for OS was 0.77 (95% CI, 0.45–1.31); two-sided P = 0.33.
Presented by: Georgina V. Long, Melanoma Institute Australia
[Right slide]
Take-home messages
The INTerpath-001 results are compelling and mark a crucial moment for personalized cancer vaccines
OPEN QUESTIONS
• Will improved RFS translate into improved OS with longer follow-up and when will data be available ?
• To which extent is the clinical efficacy of intismeran driven by neoantigen-dependent immune effects ?
• How should adjuvant pembrolizumab/intismeran be positioned compared to neoadjuvant ipi/nivo for macroscopic stage III/IV ?
– For patients without major pathological response ?
• Further insight into predictive biomarkers and mechanisms of action are urgently needed.
HURDLES
• Intismeran production process is complex and time-consuming which translate into an expensive drug
• Intismeran is not available for a significant number of patients with tissue samples unsuitable for sequencing
• Health technology assessments have yet to evaluate Intismeran real-world cost-effectiveness and feasibility
PERSPECTIVES
• Potential for broader use across other cancer types and disease stages
• Potential for new treatment combinations
Inge Marie Svane
Evelyn Wong@EvelynWongYT
INTerpath-001
1) Trial design schema: Marco Gerlinger: Trial design and patient selection - vs CRC · 2) Slide: Marco Gerlinger: Taking the brakes off immune cells and tackling immunosuppression
Enjoyed @MarcoGerlinger's take on INTerpath & the discontinued BNT-122 CRC study at #ESMO26.
What can each teach us? A reminder: we’re testing a strategy: that includes tumour biology, combination therapy and patient selection and not just a vaccine. #ESMOAmbassadors https://t.co/NfRxtIrsui
[Slide 1]
[Madrid 2026 ESMO congress logo]
Trial design and patient selection
INTerpath-001:
- Melanoma – high mutation load, highly immunogenic
- Pembrolizumab – potent backbone, with vaccine directing T cell response
- High risk population – resected stage IIB – IV melanoma
CRC: BNT-122:
- MSS/MMRp CRC – modest mutation load, low immunogenicity & often immune-excluded
- Vaccine monotherapy – in a tumour type where immunotherapy has so far not succeeded
- Very high risk population:
- ctDNA positive
- Roche Avenio ctDNA test limit of detection ~0.1% vs. Signatera 0.01%1
- Potential under-detection of low-level MRD
1) Chen et al. Mol Diagn Ther 2021
[Slide 2]
[Madrid 2026 ESMO congress logo]
Taking the brakes off immune cells and tackling immunosuppression in CRC
- MMRp CRC: modest immunogenicity, often immune excluded
- In the metastatic setting: negligible response rates and PFS benefit from PD1/PDL1 +/- CTLA4 ICIs1
- Still: omission of trial arm with vaccine + ICI appears like a key mistake now
- Several next-generation ICIs look more promising in CRC:
- Botensilimab/Balstilimab (PD1 + Fc-enhanced CTLA4): 17% RR in 101 MSS CRC (0% in patients with liver metastases)2
- INCA33890 (PD1/TGFBR bispecific AB): 15.2% RR in 105 MSS CRC (12% in patients with liver metastases)3
- We need combination trials with ICIs that overcome immunosuppression in CRC.
1) Chen et al. Jama Onc 2020 2) Bullock et al. Nat Med 2024 3) Moyers GI ASCO 2026
Lung Cancer Europe@LungCancerEu
INTerpath-001
Slide: BBC News article screenshot: 'First personalised cancer vaccine cuts risk of disease
The embargo broke before #ESMO26 even opened.
Leaked results from INTerpath-001 show a personalised mRNA vaccine plus pembrolizumab lowered the risk of melanoma returning, or death, by 42%.
The same vaccine is already in Phase 3 trials for non-small cell #lungcancer. Like the melanoma trial, they're testing it after surgery, when the removed tumour is used to build a vaccine for each person. That's why the lung trials focus on early-stage lung cancer, from high-risk stage I to IIIB.
Melanoma and lung cancer behave differently, so the lung trials need to report their own results. But this is the first Phase 3 evidence the approach can work.
https://t.co/vY3UxmjMcw
[Slide 1]
NEWS [Menu]
First personalised cancer vaccine cuts risk of disease returning in major trial
[Photo: nurse administering an injection to a seated man in a clinic]
The trial also found that the new drug combination reduced the risk of melanoma, a type of skin cancer, spreading by 38% over two years compared to immunotherapy alone.
The drug manufacturers MSD and Moderna say the same approach is already being tested against other tumours, including kidney, bladder and lung cancer.
Free Access · KOL Pulse Intelligence
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My TOP 3 🥉#Melanoma #ESMO26 HBI-8000 + nivolumab in advanced melanoma - phase III vs nivolumab alone.
▪️ mPFS: 11.7 vs 7.4 mo | HR 0.73
💥 ORR: 41.4% vs 32.3% (p=0.0569)
🔴 G3/4 TRAEs: 54.8% vs 17.9%
⚠️ 4 treatment-related deaths with HBI-8000
☝🏼Benefit seemed strongest in lower-burden/normal-LDH disease!
A PFS win, yes. A new standard? OS?
@OncoAlert
@OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 1]
HBI-8000-303: Study Design
Advanced, unresectable melanoma naïve to anti-PD1/-L1 therapy -> R 1:1
N=203: HBI-8000 30mg BIW + Nivolumab 480mg IV Q4W
N=201: Placebo + Nivolumab 480mg IV Q4W
-> Follow-up
Primary endpoint: PFS by BIRC
Secondary endpoints: -ORR by BIRC -Overall Survival -Safety and Toxicity
Treatment until progression, intolerable toxicity, withdrawal of consent, or completion of 24 months of therapy
Stratification Factors: Serum LDH; Tumor PD-L1 Expression*
• 123 sites in 15 countries
• Accrual from July 2021 to April 2024
• Separate open label cohort (N=45) of asymptomatic brain metastases treated with HBI-8000 + Nivolumab (reported at ESMO 2025; 1630P)
* PD-L1 Positive: ≥ 1% tumor membrane staining in a minimum of 100 evaluable tumor cells
Nikhil I. Khushalani, MD
[ESMO Congress Madrid 2026 logo]
[Slide 2]
Efficacy: Progression-Free Survival, Normal LDH
HBI + NIVO (N=135) | Placebo + NIVO (N=133)
Events: 66 | 89
Median (months): 20.04 | 7.39
[95% CI]: [8.31, 35.61] | [4.63, 13.04]
HR [96% CI]: 0.65 [0.47, 0.90]
P-value: 0.0082
Landmark labels at 24 months: 47.2% (95% CI 37.7-56.1) [HBI-8000 + Nivolumab]; 32.6% (95% CI 24.3-41.2) [Placebo + Nivolumab]
Y-axis: Probability of Progression-Free Survival; X-axis: Time from Randomization (Months)
Legend: HBI-8000 + Nivolumab; Placebo + Nivolumab; Censored
N at Risk (0,6,12,18,24,30,36,42,47 mo):
HBI-8000: 135 77 61 50 37 26 14 2 0
Placebo: 133 67 53 43 28 18 7 3 0
Nikhil I. Khushalani, MD
[ESMO Congress Madrid 2026 logo]
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: PFS (Normal LDH subgroup)
HBI-8000 + Nivolumab | 135 | 20.04 mo | 8.31–35.61
Placebo + Nivolumab | 133 | 7.39 mo | 4.63–13.04
HR: 0.65
HR CI: 0.47–0.90 (96% CI)
P: 0.0082
{'timepoint': '24 mo', 'arm': 'HBI-8000 + Nivolumab', 'value': '47.2%', 'ci': '37.7–56.1'}
{'timepoint': '24 mo', 'arm': 'Placebo + Nivolumab', 'value': '32.6%', 'ci': '24.3–41.2'}
Note: Subgroup (normal LDH), not ITT. Landmark labels small; read at limit of legibility.
[Slide 3]
Efficacy: Objective Response Rate (BIRC)
Response | HBI-8000 + Nivolumab (N=203) | Placebo + Nivolumab (N=201)
CR | 29 (14.3%) | 14 (7.0%)
PR | 55 (27.1%) | 51 (25.4%)
SD | 41 (20.2%) | 49 (24.4%)
PD | 54 (26.6%) | 74 (36.8%)
ORR | 84 (41.4%) | 65 (32.3%)
95% CI – ORR [a] | [34.5, 48.5] | [25.9, 39.3]
OR (96% CI) [b] | 1.50 (0.97, 2.33)
P Value [b] | 0.0569
[a]: Clopper-Pearson exact 95% CIs for ORR
[b]: OR and its 96% CI, and p value are derived using Cochran-Mantel-Haenszel (CMH) stratified by LDH and PD-L1 status.
Nikhil I. Khushalani, MD
[ESMO Congress Madrid 2026 logo]
[Slide 4]
Adverse Events (Clinical; ≥10%)
Columns: HBI-8000 + Nivolumab (N=199) Any Grade | Grade 3-4 || Placebo + Nivolumab (N=201) Any Grade | Grade 3-4
Any AE: 196 (98.5) | 142 (71.4) || 196 (97.5) | 91 (45.3)
TRAE*: 184 (92.5) | 109 (54.8) || 160 (79.6) | 36 (17.9)
Diarrhea: 88 (44.2) | 11 (5.5) || 29 (14.4) | 0 (0)
Nausea: 69 (34.7) | 2 (1.0) || 41 (20.4) | 2 (1.0)
Fatigue: 42 (21.1) | 4 (2.0) || 42 (21.4) | 1 (0.5)
Asthenia: 41 (20.6) | 2 (1.0) || 19 (9.5) | 0 (0)
↓ Appetite: 37 (18.6) | 4 (2.0) || 18 (9.0) | 1 (0.5)
Vomiting: 36 (18.1) | 2 (1.0) || 13 (6.5) | 2 (1.0)
Arthralgia: 26 (13.1) | 2 (1.0) || 16 (8.0) | 0 (0)
↓ Weight: 26 (13.1) | 3 (1.5) || 6 (3.0) | 0 (0)
Hypothyroidism: 24 (12.1) | 1 (0.5) || 18 (9.0) | 0 (0)
Vitiligo: 21 (10.6) | 0 (0) || 19 (9.5) | 0 (0)
Pruritus: 20 (10.1) | 0 (0) || 34 (16.9) | 0 (0)
Rash: 19 (9.5) | 0 (0) || 25 (12.4) | 0 (0)
TRAE leading to discontinuation**: 28 (14.1) | 16 (8.0) || 10 (5.0) | 6 (3.0)
* Causality of adverse events as assessed by investigator
**Study treatment discontinuation of later drug
Nikhil I. Khushalani, MD
[ESMO Congress Madrid 2026 logo]
Other Melanoma slides
23 slide posts · 7 physiciansNot tied to a single tracked trial
Yüksel Ürün@DrYukselUrun
Slide: Why mRNA? Key Advantages for Vaccine Development - Toni K. Choueiri (with speaker video)
Excellent perspective from @DrChoueiri The more personalized the vaccine, the bigger the system it needs.
Melanoma shows promise. Proud our @Ankaratip1945 team is part of a kidney cancer vaccine trial.
@myESMO @OncoAlert @OpenMedicineHQ #ESMO26
@DanaFarber @DanaFarber_GU https://t.co/lR83gEplV0
[Slide 1]
[Screen with speaker video of Toni K. Choueiri at podium; MADRID 2026 ESMO congress logo]
Why mRNA? Key Advantages for Vaccine Development
[Radial diagram centered on: mRNA Cancer Vaccine]
Short research and development cycle
Rapid production
Highly targeted
Lower production costs
Fewer side effects
Lower risk of insertional mutagenesis
Support personalized therapy
Lower risk of viral infection
Induce stronger immune responses
Wang, et al. Front. Immunol. 2023.
Toni K. Choueiri, MD
(c) 2023 Moderna, Inc. All rights reserved.
Mario Balsa@MarioBalsaMD
1) Biomarker data: What determines the immunogenicity of a mutation? · 2) Slide: Functional, diverse, and durable immune responses · 3) Slide: PD-1 inhibition and NeoVax induce distinct sets of circulating TCR clonotypes · 4) Slide: How can we improve vaccines further? (adjuvants, peptide platforms; Kim et al Nat Nanotechnol 2025)
💉#ESMO26 Personalized cancer vaccines: promise meets precision (🗣️ Dr. Patrick Ott, he is simply the BEST!!!!!!!!)
Large-scale personalization is now feasible, with growing clinical evidence in melanoma 💥
-Robust, durable vaccine-induced T-cell responses
-Positive randomized phase II/III development in adjuvant melanoma
-Excellent safety profile
-But immune breadth remains limited
Personalized? Yes. Predictable? Not yet
@OncoAlert @OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 1]
[ESMO Congress Madrid 2026 logo]
What determines the immunogenicity of a mutation?
Variant in DNA
• Is the mutation "real"?
• Clonal vs. subclonal?
• Expression? (RNAseq)
Peptide selection
• Proteosomal processing
• "Foreignness"
• Similarity to Pathogens
Peptide-HLA interaction
• Binding Strength
• Stability of pHLA complex
Peptide T cell interaction
• TCR repertoire – a vast space
• Much harder to model than HLA
• Need experimental TCR-pHLA Datasets!
[Diagram: Tumor cell; DNA mutations; Antigenic precursors; Proteolytic intermediates; MHC; T cell receptor; Anchor residues of peptide; PEPTIDE; T cell contact residues of peptide]
Purroy & Wu
CSH Perspect Med 2017
[Slide 2]
[ESMO Congress logo]
Functional, diverse, and durable immune responses
Generation of memory response
[UMAP plots: Cluster 0 1 2 3; Patient 3 4 5; UMAP_1 / UMAP_2]
[Line plots: Naive, Cytotoxic, AICD, Memory; y-axis % of tetramer+ CD4+ T cells; x-axis Pre 3 8 12 16 20 24 wks; Priming / Boosting]
T cell diversification
Pt. 4
Priming: wk 3, wk 8, wk 12
Boosting: wk 16, wk 20, wk 24
[pie charts]
Persistence of vax-specific T cell responses
Pt. 3
Week 16 | 47 months
CD4+ T cells: DMSO, mut-VPS16, mut-CASP1, mut-CRY1b, mut-CRY1c
CD8+ T cells: DMSO, mut-VPS16, mut-CASP1
[ELISpot well images]
Hu Z & Leet DE Nat. Med., 2021
[Slide 3]
[ESMO Congress logo]
PD-1 inhibition and NeoVax induce distinct sets of circulating TCR clonotypes in all vaccinated patients
[Left plot] Number of significantly expanding clones; After Nivo vs After Vaccine; p = 0.00219
Patients: P101, P103, P104, P105, P106, P108, P109, P110, P111
[Middle plot] Patient 103; Nivolumab; NeoVaxM; Vaccine-expanded?
Frequecny [sic]; Timepoint: Pre-treatment, Post-Nivolumab, Post-vaccine, W48, W72; LOD
Type: Other, Existing, Post-Nivolumab, Post-Vaccine
[Pie chart] Median percent of vaccine expanded post-vaccine clones
Post-vax clones: Not expanded 75.18%; Expanded 24.82%
Blass et al, Cell, 2025
[Slide 4]
[ESMO Congress Madrid 2026 logo]
How can we improve vaccines further?
•Immune Adjuvants
•Vaccine Platform Technology - Peptides
Link peptides and adjuvant to self-assembling nanoparticles
[Diagram: Peptide antigen; CpG adjuvant; DMPC lipid; 22A apoA1 peptide; Lipid nanodisc; Subcutaneous; Lymph node]
Link peptides and adjuvant to an albumin-binding phospholipid tail
[Diagram: Albumin-binding phospholipid; PEG linker; Peptide antigen; CpG DNA; Membrane insertion; Albumin]
Kim et al, Nat Nanotechnol, 2025
[podium: ESMO Congress Madrid Spain 23-27 October 2026]
Mario Balsa@MarioBalsaMD
1) Response data: STARBOARD: ORR per BICR - triplet vs control (room photo, Dirk Schadendorf) · 2) Kaplan-Meier survival data: STARBOARD: PFS per BICR (room photo, Dirk Schadendorf) · 3) Kaplan-Meier survival data: STARBOARD: OS (room photo, Dirk Schadendorf) · 4) Safety data: STARBOARD: Most frequent (>=15%) all-cause TEAEs (room photo, Dirk Schadendorf)
My top 🥈💎 #Melanoma #ESMO26 STARBOARD - Triplet therapy in BRAF V600 melanoma: enco + bini + pembro vs pembro alone in 1L.
💥 ORR: 70% vs 32.7% || mPFS: 33.0 vs 3.4 mo
▪️G3/4 TEAEs: 70% vs 39%
OS: positive trend, but immature after early trial closure.
Impressive PFS! But STARBOARD has not reached the OS shore yet⚓
@OncoAlert @OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 1]
ORR PER BICR
Encorafenib and binimetinib plus pembrolizumab demonstrated clinically meaningful and statistically significant improvement in ORR vs the control arm
Confirmed ORR per BICR, (95% CI)
Odds ratio (90% CI): 4.903 (2.870, 8.125)
P<0.0001^a
[Bar chart] Triplet (n=110): 70.0% (60.9, 77.8); Control (n=110): 32.7% (24.7, 41.9); legend CR / PR
All randomized patients | Triplet (n=110) | Control (n=110)
Confirmed ORR, n (%) [95% CI] | 77 (70.0) [60.9, 77.8] | 36 (32.7) [24.7, 41.9]
Odds ratio (90% CI) | 4.903 (2.870, 8.125)
1-sided P-value | <0.0001
Best overall response, n (%)
CR | 12 (10.9) | 5 (4.5)
PR | 65 (59.1) | 31 (28.2)
SD | 16 (14.5) | 16 (14.5)
Non-CR/non-PD | 4 (3.6) | 1 (0.9)
PD | 5 (4.5) | 47 (42.7)
Not evaluable | 8 (7.3) | 10 (9.1)
Responders | n=77 | n=36
TTR, median (range), weeks | 9.1 (7.7-58.3) | 9.7 (7.1-46.1)
DOR, median (95% CI), months | NE (20.7, NE) | NE (18.8, NE)
Patients with a response >=15 months, n (%) | 43 (55.8) | 25 (69.4)
Data cutoff: January 12, 2026.
^aOne-sided P-value.
BICR, blinded independent central review; CR, complete response; NE, not estimable; PD, progressive disease; PR, partial response; SD, stable disease; TTR, time to response.
Dirk Schadendorf, MD
[ESMO Congress Madrid 2026 logo; presenter at podium]
[Slide 2]
PFS PER BICR
Encorafenib and binimetinib plus pembrolizumab demonstrated statistically significant improvement in PFS over the control arm
| Triplet (n=110) | Control (n=110)
Follow-up, median (95% CI), months | 24.9 (24.6, 27.8) | 30.2 (25.8, 33.1)
Events, n (%) | 44 (40) | 77 (70)
PFS, median (95% CI), months | 33.0 (20.0, NE) | 3.4 (2.2, 8.3)
Hazard ratio (stratified) (90% CI) | 0.33 (0.24, 0.46)
1-sided P-value | <0.0001
12 months: Triplet 70.7%; Control 34.3%
24 months: Triplet 54.8%; Control 26.4%
Median PFS: 3.4 mo (95% CI: 2.2, 8.3); Median PFS: 33.0 mo (95% CI: 20.0, NE)
No. at risk (0,3,...,42 months):
Triplet: 110 95 89 69 62 58 52 46 40 27 19 12 4 0 0
Control: 110 57 44 35 31 31 29 24 21 18 13 10 4 2 0
Data cutoff: January 12, 2026.
BICR, blinded independent central review; NE, not estimable
Dirk Schadendorf, MD
[ESMO Congress Madrid 2026 logo; presenter at podium]
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: PFS per BICR
Encorafenib + binimetinib + pembrolizumab (triplet) | 110 | 33.0 mo | 20.0-NE
Placebo + pembrolizumab (control) | 110 | 3.4 mo | 2.2-8.3
HR: 0.33 (stratified)
HR CI: 0.24-0.46 (90% CI)
P: <0.0001 (1-sided)
{'timepoint': '12 mo', 'arm': 'Triplet', 'value': '70.7%', 'ci': None}
{'timepoint': '12 mo', 'arm': 'Control', 'value': '34.3%', 'ci': None}
{'timepoint': '24 mo', 'arm': 'Triplet', 'value': '54.8%', 'ci': None}
{'timepoint': '24 mo', 'arm': 'Control', 'value': '26.4%', 'ci': None}
Note: Same slide as 2113638289521471984_s2. DCO January 12, 2026.
[Slide 3]
OS
OS showed a positive trend favoring encorafenib and binimetinib plus pembrolizumab vs control but was immature at final analysis
| Triplet (n=110) | Control (n=110)
Follow-up, median (95% CI), months | 30.8 (29.0, 32.6) | 30.9 (28.8, 32.7)
Events, n (%) | 32 (29.1) | 41 (37.3)
OS, median (95% CI), months | NE (NE, NE) | NE (31.8, NE)
Hazard ratio (stratified) (90% CI) | 0.71 (0.48, 1.05)
12 months: Triplet 89.5%; Control 78.7%
24 months: Triplet 76.6%; Control 64.2%
No. at risk (0,6,...,42 months):
Triplet: 110 102 92 84 74 43 11 0
Control: 110 92 77 71 57 37 12 2
Data cutoff: January 12, 2026.
NE, not estimable
Dirk Schadendorf, MD
[ESMO Congress Madrid 2026 logo; presenter video panel]
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: OS
Encorafenib + binimetinib + pembrolizumab (triplet) | 110 | NE | NE-NE
Placebo + pembrolizumab (control) | 110 | NE | 31.8-NE
HR: 0.71 (stratified)
HR CI: 0.48-1.05 (90% CI)
{'timepoint': '12 mo', 'arm': 'Triplet', 'value': '89.5%', 'ci': None}
{'timepoint': '12 mo', 'arm': 'Control', 'value': '78.7%', 'ci': None}
{'timepoint': '24 mo', 'arm': 'Triplet', 'value': '76.6%', 'ci': None}
{'timepoint': '24 mo', 'arm': 'Control', 'value': '64.2%', 'ci': None}
Note: Same slide as 2113638289521471984_s3. OS immature.
[Slide 4]
MOST FREQUENT (>=15%)^a ALL-CAUSE TEAES
AEs were consistent with the known safety profiles of the individual components of encorafenib and binimetinib plus pembrolizumab
Triplet (n=110): Grade 1/2, Grade 3/4 | Control (n=110): Grade 1/2, Grade 3/4
Triplet all-grade frequencies by AE (as listed top to bottom): Nausea 45%; Diarrhea 40%; Alanine aminotransferase increased 33%; Fatigue 33%; Pyrexia 32%; Blood creatine phosphokinase increased 31%; Arthralgia 30%; Lipase increased 29%; Pruritus 26%; Rash 26%; Vomiting 26%; Aspartate aminotransferase increased 25%; Headache 21%; Anemia 20%; Asthenia 18%; Constipation 16%; Blood creatinine increased 15%
[Grade 3/4 and control-arm bar values visible (e.g. 2%, 5%, 14%, 1%, 8%, 3%, 12%, 4%, 11%, 7%; control 17%, 19%, 10%, 17%, 14%, 15%, 21%, 14%, 12%, 15%, 15%, 9%, 15%, 15%, 15%, 10%, 7%) but row alignment cannot be reliably assigned from this angled photo]
Treatment-related (including immune-related)^b AEs of special interest were reported in 46.4% of patients in the triplet arm and 17.3% of patients in the control arm
X-axis: Patients, % (50 - 25 - 0 - 25 - 50)
Data cutoff: January 12, 2026
^aFrequency is based on the triplet arm. ^bIncluding cardiac failure, cytokine release syndrome, diarrhea, hepatic events/hepatitis, myocarditis, pneumonitis/intestinal lung disease, rash, and uveitis (group terms).
AE, adverse event; TEAE, treatment-emergent adverse event
Dirk Schadendorf, MD
[ESMO Congress Madrid 2026 logo]
Mario Balsa@MarioBalsaMD
1) Slide: Which Cancers Should We Target? Autogene cevumeran in resected PDAC phase 1 - Toni K. Choueiri · 2) Slide: Which Cancers Should We Target? Nous-209 neoantigen vaccine in Lynch syndrome carriers · 3) Biomarker data: What about cancers with low TMB? Intismeran + pembrolizumab RFS subgroup forest
💉 #ESMO26 mRNA cancer vaccines: beyond melanoma
Personalized neoantigen vaccines are moving from treatment toward broader (and earlier) disease settings!
💥 Signals in low-TMB tumors
💥 Activity explored in PDAC and RCC
💥 Now even entering cancer prevention in Lynch syndrome
The mRNA “message” getting much broader than melanoma 😏
Congrats @DrChoueiri!! Amazing discussion!!! 👏🏼
@OncoAlert @OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 2]
Which Cancers Should We Target?
...benefit may extend to immunologically "Cold" tumors [emoji]
Autogene Cevumeran in Resected Pancreatic Cancer: Phase 1 trial and 3-year follow-up
[Schema] Resection -> Process and transport tissues -> Sequence tumour and normal DNA; Tumour RNA -> Predict and select neoantigens -> Custom manufacture autogene cevumeran (individualized neoantigen-encoding mRNA-lipoplex)
Custom manufacture autogene cevumeran
Key inclusion criteria
- All surgically resectable PDAC
- No borderline resectable
- No locally advanced or metastatic disease
- No neoadjuvant therapy
- >=5 neoantigens
[Timeline] Screen for eligibility; Week 0 Surgery; 6 Atezolizumab 1 dose; 9-17 Autogene cevumeran Priming doses 1-8; 21-43 mFOLFIRINOX 12 cycles (biweekly); 46 Booster dose 9; Follow-up
Rojas, et al. Nature 2023.
[Bar chart: Number of neoantigens in autogene cevumeran; Responders (n = 8), Non-responders (n = 8); legend Immunogenic / Non-immunogenic / No data; pie 50% / 50%]
[Small KM inset: RFS, Responders (n = 8) vs Non-responders (n = 8); Median RFS: not reached; Median RFS 13.4 months; P = 0.007; HR [illegible]; Median follow-up [illegible] years]
Bethune, et al. Nature 2025.
Toni K. Choueiri, MD
[ESMO Congress Madrid 2026 logo]
[Slide 3]
Which Cancers Should We Target?
...and beyond, to cancer syndromes
Nous-209 Neoantigen Vaccine For Cancer Prevention In Lynch Syndrome Carriers: A Phase Ib/II Trial
[Schema] Population: LS carriers n = 45
GAd (week 0); MVA (week 8); Weeks 0, 4, 8, 12, 24, 28, 48, 52/68
Blood collection and colonoscopy
PBMCs; P1-P16 Peptide pools; IFNγ; T cell
[Charts: SFCs per 10^6 PBMCs Baseline vs Peak; immune response over time n = 27 100%, n = 33, n = 33 [percentages partly illegible]; Negative immune resp / Positive immune resp; No. of adenomas per participant (Baseline vs EoS, LS carriers); Advanced adenomas present]
Toni K. Choueiri, MD
D'Alise, et al. Nature Medicine 2026.
[ESMO Congress Madrid 2026 logo]
[Slide 4]
What about cancers with low TMB?
Subgroup^a | Intismeran plus pembrolizumab (n = 107) Events, % (n/N) | Pembrolizumab (n = 50) Events, % (n/N) | Hazard ratio (95% CI)
Overall (N = 157) | 26.2 (28/107) | 46.0 (23/50) | 0.510 (0.294 to 0.887)
Disease stage: Stage IIIC (n = 131) | 28.1 (25/89) | 45.2 (19/42) | 0.563 (0.310 to 1.024)
Stage IV (n = 22) | 18.8 (3/16) | 33.3 (2/6) | 0.480 (0.080 to 2.898)
PD-L1 status: Positive (n = 98) | 25.7 (18/70) | 50.0 (14/28) | 0.439 (0.218 to 0.885)
Negative (n = 19) | 28.6 (4/14) | 100 (5/5) | 0.143 (0.033 to 0.619)
BRAF status: Mutant^b (n = 61) | 22.0 (9/41) | 55.0 (11/20) | 0.350 (0.145 to 0.847)
Wildtype (n = 96) | 28.8 (19/66) | 40.0 (12/30) | 0.641 (0.311 to 1.324)
TMB status [boxed]: High^c (n = 109) | 22.8 (18/79) | 36.7 (11/30) | 0.579 (0.273 to 1.227) [boxed]
Non-high^d (n = 45) | 38.5 (10/26) | 63.2 (12/19) | 0.515 (0.222 to 1.197) [boxed]
ctDNA status: Positive^e (n = 15) | 76.9 (10/13) | 100 (2/2) | NE
Negative (n = 109) | 15.8 (12/76) | 51.5 (17/33) | 0.241 (0.115 to 0.507)
[Forest plot, Hazard Ratio axis 0.01, 0.1, 1, 5, 10]
^aRFS in the overall population was estimated by a stratified Cox proportional hazards model; an unstratified analysis was used for subgroup analyses. ^bV600K or V600E mutation. ^c>=175 mutations/exome; ^d<175 mutations/exome. ^eHazard ratio for the ctDNA-positive subgroup was NE as all patients in the pembrolizumab had a recurrence event. Subgroups were defined as previously described.^1
1. Weber JS, et al. Lancet. 2024;403(10427):632-644
Carlino et al, ASCO 2026
Mario Balsa@MarioBalsaMD
1) Slide: Selection of antigens for adoptive cellular therapy - Furness · 2) Slide: PRAME-directed TCR therapy in ICI-resistant cutaneous and uveal melanoma (anzu-cel) - Furness · 3) Slide: Advancement of cell-based approaches for solid tumours? - Furness
🔥 #ESMO26 Matchmaking TCRs: from standard fit to bespoke melanoma care
The antigen is as important as the engineered T cell.
Finding the right cell may start with finding the right match
@OncoAlert @OncoReporte @myESMO @_SEOM @GrupoMelanoma https://t.co/YvXoySJxyo
[Slide 2]
Selection of antigens for adoptive cellular therapy
TIL therapy (intra- and extracellular antigens)
TCR therapy (intracellular antigens)
CAR-T therapy (surface antigens)
Private (patient-specific) neoantigens
Tumour (patient)-specific mutations
Low risk of off-target toxicity
HLA-restricted
Clonal/subclonal - subject to immune editing
Public (shared) neoantigens
Shared across patients (mutant KRAS, TP53)
Evolutionary constraint
HLA-restricted
Potential for pre-manufactured therapies
TAAs: over-expressed, cancer-testis, differentiation antigens
Expressed across multiple tumour subtypes (NY-ESO-1, Claudin(s))
Restricted normal tissue expression
Intra- and extracellular
Potential for pre-manufactured therapies
[ESMO Congress Madrid 2026 logo]
[Slide 3]
PRAME-directed TCR therapy in ICI-resistant cutaneous and uveal melanoma (anzu-cel)
[Embedded ASCO 2026 slide:] Anzu-cel Induced Rapid and Deep Responses in Metastatic PD-1-Relapsed Melanoma and Metastatic Uveal Melanoma
| Cutaneous Melanoma n=14 | Uveal Melanoma n=16 | Melanoma (other) n=3 | All Melanoma n=33
cORR | 50% (7/14) | 67% (10/15) | 1/3 | 56% (18/32)
ORR | 57% (8/14) | 69% (11/16) | 2/3 | 64% (21/33)
DCR | 93% (13/14) | 88% (14/16) | 3/3 | 91% (30/33)
[Waterfall plot: Best % Change in Sum of Longest Diameter of Target Lesions from Baseline and BOR (RECIST 1.1); BOR legend PD/SD/PR/CR/Ongoing; per-patient values small]
• Median time to BOR was 1.4 months (1.2-2.8)
• Most responders exhibit shrinkage of >=1 lesion by first scan
• Responses observed in target and non-target lesions
[Footnotes: small, largely illegible]
Data cutoff Sep 24, 2025
2026 ASCO ANNUAL MEETING #ASCO26; PRESENTED BY: Diwakar Davar M.D., Abstract #95[illegible]
Andrew J.S. Furness
[ESMO Congress Madrid 2026 logo]
[Slide 4]
Advancement of cell-based approaches for solid tumours?
• Proof-of-principle in terms of objective response and clear room for optimism
• Antigen selection - successful targeting should evoke effective induction of epitope spreading
• Potential benefit to enrich for neoantigen-reactivity in TIL therapy?
• Earlier introduction of therapy to mitigate potential for neoantigen editing and development of resistance to all cell-based approaches reliant upon HLA-TCR engagement (e.g. defects in antigen presentation machinery)
• Combination therapies to promote endogenous immunity e.g. immune checkpoint blockade and simultaneously address immune regulation of immune effector cell therapies
• Combination therapies to maximise potential for epitope spreading e.g. TCR T (or CAR-T and stromal targeting) + neoantigen vaccination + immune checkpoint blockade
Andrew J.S. Furness
[ESMO Congress Madrid 2026 logo]
[Slide 1]
[ESMO Congress Madrid 2026 logo]
Efficacy
Lifileucel with Pembrolizumab results in 62.5% ORR and CR rate of 29.2%
Best Percentage Change from Baseline in Target Lesion SOD
Best Overall Response: PD / SD / PR / CR
[Waterfall plot, Change from Baseline (%), patients 1A-25 ... 1A-22; n=2 above zero, n=21 below]
Investigator-Assessed Response (RECIST v1.1) (n=24)(a)
Objective Response Rate, n (%) | 15 (62.5)
(95% CI) | (40.6, 81.2)
Disease Control Rate, n (%) | 20 (83.3)
(95% CI) | (62.6, 95.3)
Best Overall Response, n (%)
CR | 7 (29.2)
PR | 8 (33.3)
SD | 5 (20.8)
PD | 3 (12.5)
NE | 1 (4.2)(b)
95% CI was calculated using the Clopper-Pearson Exact test.
aIOV-COM-202 Cohort 1A Full Analysis Set included all patients who received TIL ≥5.58 billion that met the manufacturing product specifications.
bPatient 1A-10 is included as NE and did not have a post-dose tumor response assessment.
CI, confidence interval; CR, complete response; NE, not evaluable; ORR, objective response rate; PD, progressive disease; PR, partial response; RECIST, Response Evaluation Criteria in Solid Tumors; SD, stable disease; SOD, sum of diameters; TIL, tumor-infiltrating lymphocyte.
[Slide 2]
[ESMO Congress Madrid 2026 logo]
Efficacy
Lifileucel with Pembrolizumab demonstrates durable and deepening responses
[Swimmer plot by patient 1A-05, 1A-07, 1A-06, 1A-03, 1A-17, 1A-18, 1A-22, 1A-12, 1A-14, 1A-01, 1A-15, 1A-20, 1A-23, 1A-11, 1A-04; X-axis Time (Months) Since TIL Infusion 0–60]
Legend: CR Start; PR Start; Ongoing on Study; Completed without PD or Death; Progression; Pembrolizumab Infusion
• mDOR not reached(a) (min, max: 4.3 mo, 57.7+ mo)
• Median f/u for DOR(b): 26.9 mo
• 3 of 15 responders completed 5-year response assessment w/o PD or death (DOR range, 57+ to 57.7+ mo)
• In addition, 3 of 15 responders still ongoing at data cut (DOR range, 25.3+ to 26.9+ mo)
[Footnotes, partially cropped/legible:] ...V-COM-202 Cohort 1A Full Analysis Set includes all patients who received ≥5.58 billion TILs meeting manufacturing product specifications. ...ch bar is presented for each patient starting from date of TIL infusion up to date of new anti-cancer therapy, end of assessment, death, or data cutoff date, whichever occurs earlier. Patient 1A-14 was in response during assessment phase while still in response. Patient 1A-12 discontinued from study while still in response to continue pembrolizumab off-study. ...tients 1A-03 and 1A-11 withdrew consent during assessment phase ... before moving to long-term follow-up phase due to relocation from the investigative site. ...ased on Kaplan-Meier product-limit estimates. bBased on reverse Kaplan-Meier method. ...complete response; DOR, duration of response; mDOR, median duration of response; Pembro, pembrolizumab; PD, progressive disease; PR, partial response; TIL, tumor-infiltrating lymphocyte.
8
[Speaker video panel; MADRID 2026 ESMO logo]
[Slide 3]
[ESMO Congress Madrid 2026 logo]
Efficacy
Lifileucel with Pembrolizumab results in median PFS of 19.8 months and median PFS2 of 34.3 months
Y-axis: Progression-free Survival (%); X-axis: Time (Months) Since Pembrolizumab Infusion (0–78)
+ Censored
Median PFS (95% CI): 19.8 (3.6-NR)
Median PFS2 (95%CI): 34.3 (6.8-NR)
PFS2 suggests feasibility of systemic therapies in later lines with frontline use of lifileucel
Patients at risk (0,3,6,...,78 months):
PFS 24 20 16 15 15 14 14 11 9 7 6 6 5 4 4 4 3 3 3 3 1 0
PFS2 24 23 18 17 16 16 15 14 12 10 9 8 7 5 5 5 5 5 4 4 2 1 1 1 1 1 1 0
...COM-202 Cohort 1A Full Analysis Set includes all patients who received ≥5.58 billion TILs meeting manufacturing product specifications.
...nfidence interval; NR, not reached; PFS, progression-free survival; PFS2, progression-free survival 2; TIL, tumor-infiltrating lymphocyte.
10
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: PFS and PFS2 (single arm)
Lifileucel + pembrolizumab - PFS | 24 | 19.8 mo | 3.6-NR
Lifileucel + pembrolizumab - PFS2 | 24 | 34.3 mo | 6.8-NR
Note: Single-arm cohort; no comparator. Time measured from pembrolizumab infusion. Number-at-risk rows partially small/blurry; transcribed as read.
[Slide 4]
[ESMO Congress Madrid 2026 logo]
Safety: Treatment-Emergent Adverse Events in ≥30% of Patients(a)
Safety of lifileucel with pembrolizumab consistent with disease and safety profiles of study regimen
N=27 | Any grade | Grade 3/4
Preferred Terms, n (%)
Thrombocytopenia | 24 (88.9) | 18 (66.7)
Pyrexia | 22 (81.5) | 4 (14.8)
Chills | 21 (77.8) | 3 (11.1)
Nausea | 21 (77.8) | 0
Anemia | 19 (70.4) | 13 (48.1)
Vomiting | 17 (63.0) | 0
Neutropenia | 15 (55.6) | 15 (55.6)
Fatigue | 14 (51.9) | 1 (3.7)
Headache | 13 (48.1) | 0
Cough | 12 (44.4) | 0
Decreased appetite | 12 (44.4) | 0
Diarrhea | 12 (44.4) | 2 (7.4)
Febrile neutropenia | 11 (40.7) | 10 (37.0)
Rash (maculopapular) | 11 (40.7) | 5 (18.5)
Alopecia | 10 (37.0) | 0
Dyspnea | 10 (37.0) | 2 (7.4)
Hypokalemia | 9 (33.3) | 0
Safety was consistent with the underlying disease and known safety profiles of pembrolizumab, NMA-LD, lifileucel, and IL-2
• AEs consistent with the lifileucel regimen occurred and resolved early
• AEs occurring later than 30 days after lifileucel infusion were generally consistent with the safety profile of pembrolizumab monotherapy
N=27 (safety analysis set includes all patients who received lifileucel). One patient had a grade 5 TEAE of sepsis.
aTEAEs refer to adverse events that occurred from the first dose of pembrolizumab or lifileucel infusion (whichever occurred first) up to 30 days after the last dose of pembrolizumab or lifileucel infusion (whichever occurred later) or up to the start of a new anti-cancer therapy.
AE, adverse event; IL-2, interleukin-2; NMA-LD, non-myeloablative lymphodepletion; TEAE, treatment-emergent adverse event.
12
1) Slide: How does an mRNA personalized vaccine work? - Toni K. · 2) Slide: Accelerated research and development timeline for COVID-19 · 3) Slide: Introduction: Evolution [of cancer vaccines] - From Early
@tonichoueiri with med onc pearls for neoantigen mRNA vaccines. The future is happening now — esp w readout of INTERPATH-001 trial this #ESMO26 @myESMO @oncoalert https://t.co/EhNz2A40yG
[Slide 1]
[Screen with speaker video of Toni K. Choueiri; MADRID ESMO congress logo]
How does an mRNA personalized vaccine wo[rk] [cropped]
5 Vaccination
6 Vaccine Uptake by Antigen-Presenting Cells
7 mRNA Translation and Neoantigen Presentation
8 Priming and Expansion of Neoantigen-Sp[ecific ...] [cropped]
Toni K. Choueiri, MD
Created with BioRender.com
[Podium sign: MADRID SPAIN 23-27 OCTOBER 2026]
[Slide 3]
[Screen with speaker video of Toni K. Choueiri; MADRID 2026 ESMO congress logo]
[Left edge, cropped: Moderna COVID-19 Vaccine vial; mRNA-1273; 7 JAN 2021; photo of vaccination]
Accelerated research and development timeline for COVID-19 SARS-CoV-2 (mRNA-1273)
Isolation/Sequencing: Viral sequence isolated from infected patient
2 DAYS
Antigen design: Spike protein designed to elicit robust immune response
mRNA design
42 DAYS
Vaccine manufacturing + Quality testing
9 MONTHS
Clinical trials
FDA Emergency use authorization
Total Time: 11 MONTHS
[Podium sign: MADRID SPAIN 23-27 OCTOBER 2026]
[Slide 4]
[Screen with speaker video of Toni K. Choueiri; MADRID 2026 ESMO congress logo]
Introduction: Evolutio[n ...] [cropped]
From Early Concepts to Personali[zed ...] [cropped]
1893: The concept of immunotherapy inspired by observations of spontaneous cancer regressions after infections by William Coley
1968: Lloyd Old discovered that Bacillus Calmette-Guerin prolongs the survival of mice with cancer, ushering in the era of immunotherapy
1984: Hoover's pioneering use of a vaccine made from tumor cell lysates increased responses to autologous tumor cells in patients with colorectal cancer
1991: The first tumor-associated antigen (TAA) MAGE-1 were identified and clinical trials of TAA-based cancer vaccine were conducted since then
1999: Melacine was the first approved-to-market tum[or] lysate vaccine against melanoma
[Next item cropped: Pepti[de] vacci[ne] strat[egies] ...]
Toni K. Choueiri, MD
Yago Garitaonaindía@YGaritaonaindia
1) Trial design schema: STARBOARD phase 3 study design - encorafenib + binimetinib + · 2) Slide: STARBOARD: Safety summary - triplet vs control (Dirk Schadendorf)
🔥 STARBOARD at #ESMO26: enco + bini + pembro vs placebo + pembro, 1L BRAF V600 melanoma (n=220)
🖋️ Dirk Schadendorf
➡️ ORR 70% vs 33% | mPFS 33.0 vs 3.4 mo, HR 0.33 | OS HR 0.71 (90% CI 0.48-1.05)
☣️ G3-4 TEAEs 70% vs 39% | enco/bini discontinuation 43%
My two issues: ⚠️ Was pembro mono the right control? Fit BRAF-mutant pts get ipi-nivo
⚠️ Too few events for OS at 31 mo FU, though the trend favours the triplet
@myESMO @_SEOM @OncoAlert @LARVOL
[Slide 1]
STARBOARD PHASE 3 STUDY DESIGN
A randomized, double-blind, placebo-controlled, phase 3 study evaluating encorafenib and binimetinib plus pembrolizumab vs placebo plus pembrolizumab in patients with previously untreated metastatic or unresectable locally advanced BRAF V600E/K melanoma
Patient population
- Documented evidence of BRAF V600E/K mutation
- Unresectable or metastatic cutaneous melanoma
- No prior systemic treatment for metastatic or locally advanced disease
- Measurable disease (RECIST 1.1)
- ECOG PS <=1
R^a 1:1 N~216
Triplet^b (n~108): Encorafenib 450 mg QD + binimetinib 45 mg BID + pembrolizumab 200 mg Q3W
Control^c (n~108): Placebo + pembrolizumab 200 mg Q3W
Primary endpoint: ORR by BICR^d
Key secondary endpoint: PFS by BICR^e
Other secondary endpoints: OS, PFS and ORR by investigator, DOR, TTR, QoL, Safety, and PK
Stratification:
- Prior systemic adjuvant therapy
- CPI or BRAF/MEKi: yes vs no
- Disease stage
- IIIB, IIIC, IIID, IV M1a[0], IV M1b[0] vs IV M1a[1], IV M1b[1], IV M1c[0], IV M1c [1], IV M1d [0] and IV M1d [1]
We present here the final analysis of both ORR and PFS by BICR, as well as OS, and safety from the phase 3 portion of STARBOARD
NCT04657991
^aRepresents planned sample size. Patients were randomized between June 21, 2022, and January 16, 2024. The study design was amended due to recruitment issues, resulting in a reduction in the planned sample size and a revision of primary and key secondary endpoints. ^bStudy treatment was administered in 21-day cycles until patient had disease progression or met any of the other protocol-defined criteria for discontinuation. ^cPatients received a maximum of 35 administrations of pembrolizumab 200 mg every 3 weeks with placebos for both encorafenib and binimetinib. ^dORR was calculated with corresponding 2-sided Wilson score 95% CI; the treatment effect was tested at a 1-sided significance level of 0.05. ^eThe difference in PFS was estimated using a stratified Cox proportional hazards model to calculate the hazard ratio, along with the corresponding 2-sided 90% CI; the treatment effect was tested at a 1-sided significance level of 0.05. The Kaplan-Meier method was used to estimate median PFS for each arm, with the corresponding 95% CIs calculated using the Brookmeyer-Crowley method. Pembrolizumab was limited to a maximum of 35 administrations and treatment with triplet therapy continued until disease progression [footnote order approximate; small angled print]
BICR, blinded independent central review; BID, twice daily; CPI, immune checkpoint inhibitor; DOR, duration of response; ECOG PS, Eastern Cooperative Oncology Group performance status; MEKi, mitogen-activated protein kinase kinase inhibitor; PK, pharmacokinetics; QD, once daily; Q3W, every 3 weeks; QoL, quality of life; RECIST, Response Evaluation Criteria in Solid Tumors; TTR, time to response
Dirk Schadendorf, MD
[ESMO Congress Madrid 2026 logo]
[Slide 4]
SAFETY SUMMARY
No new safety signals and no grade 5 treatment-related TEAEs were observed
Patients, n (%) | Triplet (n=110) | Control (n=110)
TEAE | 110 (100.0) | 104 (94.5)
Treatment related | 106 (96.4) | 81 (73.6)
Maximum grade 3 or 4 TEAE | 77 (70.0) | 43 (39.1)
Treatment related | 63 (57.3) | 24 (21.8)
Grade 5 TEAE | 5 (4.5) | 10 (9.1)
Treatment related | 0 | 0
Serious TEAE | 58 (52.7) | 35 (31.8)
Treatment related | 35 (31.8) | 11 (10.0)
TEAE leading to pembrolizumab interruption | 76 (69.1) | 42 (38.2)
TEAE leading to pembrolizumab discontinuation | 35 (31.8) | 15 (13.6)
TEAE leading to encorafenib/placebo dose reduction or interruption | 91 (82.7) | 51 (46.4)
TEAE leading to encorafenib/placebo discontinuation | 47 (42.7) | 16 (14.5)
TEAE event leading to binimetinib/placebo dose reduction or interruption | 92 (83.6) | 49 (44.5)
TEAE leading to binimetinib/placebo discontinuation | 47 (42.7) | 16 (14.5)
[A] larger proportion of grade 3 or 4 TEAEs and discontinuations due to TEAEs were observed in the triplet arm than in the control arm
[Data cut]off: January 12, 2026. [TEAE, treat]ment-emergent adverse event
[Dirk Scha]dendorf, MD
🔥 IOV-COM-202 1A at #ESMO26: lifileucel + pembro, 1L melanoma (n=24)
🖋️ Andrew Furness
➡️ ORR 62.5% | CR 29% | mPFS 19.8 mo | mDOR NR (26.9 mo FU)
My key points: ⚠️ Known toxicity limiting generalizability ⚠️ Phase 3 vs pembro mono, not ipi-nivo. This toxicity has to pay off ⚠️ IL-2-sparing, low-intensity lymphodepletion approaches (e.g. OBX-115) coming from behind 💡 Resection after 1st pembro dose?
@myESMO @_SEOM @OncoAlert @LARVOL
[Slide 1]
[ESMO Congress Madrid 2026 logo]
IOV-COM-202: Phase 2, Multicohort, Multicenter Study of Lifileucel + Pembrolizumab in Patients with Solid Tumors
Cohort 1A of IOV-COM-202 (NCT03645928) assesses the efficacy and safety of lifileucel + pembrolizumab in patients with ICI-naïve unresectable or metastatic melanoma
• Patients may have received BRAF/MEK inhibitor treatment if they are BRAF mutation positive
• Patients may have received no prior therapies
Eligible patients must have:
• ≥1 resectable lesion (≥1.5 cm diameter) and
• ≥1 measurable lesion for response assessment per RECIST v1.1
Trial was designed as a proof-of-concept study to support a registrational study in the frontline treatment setting
STUDY SCHEMA
GMP Manufacturing
1 Enrollment/ Surgical Resection
2 Pembrolizumab(a) 1st dose
3 NMA-LD Day -7 to -6: CY Day -5 to -1: FLU
4 Lifileucel Infusion 1 dose Day 0
5 IL-2 ≤6 doses Day 0 or 1 to Day 3 or 4
6 Pembrolizumab Q3W or Q6W(a)
7 Efficacy Follow up
(a)First administration of single-dose pembrolizumab IV 200 mg or 400 mg, followed by pembrolizumab IV 200 mg Q3W or 400 mg Q6W for 24 months or until disease progression or unacceptable toxicity.
BRAF, B-Raf proto-oncogene; CY, cyclophosphamide; FLU, fludarabine; GMP, Good Manufacturing Practice; ICI, immune checkpoint inhibitor; IL-2, interleukin-2; IV, intravenous; MEK, mitogen-activated extracellular signal-regulated kinase; NMA-LD, non-myeloablative lymphodepletion; Q3W, every 3 weeks; Q6W, every 6 weeks; RECIST, Response Evaluation Criteria in Solid Tumors.
4
Mario Balsa@MarioBalsaMD
1) Trial design schema: Phase 1 Multicenter Trial of IMA203CD8 in PRAME+ Solid Tumors – design · 2) Safety data: IMA203CD8 – Tolerability in Advanced Solid Tumors (TEAEs, AESI, late N-ICAHT) (Busse ) · 3) Response data: IMA203CD8 – Tumor Reduction Across Dose Levels and Indications (waterfall; ORR 51%) · 4) Slide: IMA203CD8 – Tumor Reduction by Indication (gyn, melanoma, synovial sarcoma, other) (Busse )
🔥 #ESMO26 IMA203CD8: PRAME-directed TCR therapy
Phase I in heavily pretreated HLA-A*02:01+, PRAME+ solid tumors.
💥ORR 51% | cORR 41%
-Melanoma: ORR 52%
-Synovial sarcoma: 67%
-Higher-dose gynecologic tumors: ORR 60%, cORR 55%
Responses ongoing beyond 2.5 years 👀
Is PRAME ready for PRIME time?
@OncoAlert @OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 1]
Phase 1 Multicenter Trial of IMA203CD8 in PRAME+ Solid Tumors
Patient Journey
SCREENING/MANUFACTURING | TREATMENT/OBSERVATION | FOLLOW UP
HLA-A*02:01 Testing (blood)
PRAME Testing – Biopsy or archived tissue – No longer required for indications with high PRAME prevalence, including ovarian and uterine cancer, melanoma, and synovial sarcoma
Leukapheresis
IMA203CD8 Manufacturing (~2 weeks)
Lymphodepletion: Fludarabine 30 mg/m² Cyclophosphamide 500 mg/m² days -6 to -3
IMA203CD8 one-time infusion
± Low Dose IL-2ª: 1M IU SUBQ QD, days 3-5, then 1M IU SUBQ BID, days 6-10
Key Objectives
Primary: • Tolerability • Determination of RP2D
Secondary: • Efficacy • Pharmacokinetics
Key Eligibility Criteria
• Advanced or metastatic solid tumors
• Age ≥18 years
• ECOG PS 0-1
• HLA-A*02:01 positive
• PRAME positive
• No available SOC treatment options
• Measurable disease (RECIST 1.1)
• Adequate organ function
Dose Escalation Scheme ± Low Dose IL-2ª
DL3 (n=7) 0.44-1.00×10⁹ total TCR T cells
DL4a (n=38) 0.93-1.86×10⁹ total TCR T cells
DL4b (n=4) 1.49-2.05×10⁹ total TCR T cells
DL4c (n=9) 1.15-3.06×10⁹ total TCR T cells
DL5 (n=7) 1.95-4.30×10⁹ total TCR T cells
DL6 (n=15) 3.55-8.22×10⁹ total TCR T cells
DL7 (n=17) 4.26-12.50×10⁹ total TCR T cells
Dose escalation completed
Enrichment at relevant DLs (≥DL4c): ~1.2–12.5 billion total TCR T cells
Data cutoff: August 7, 2026
[Footnotes small/partly illegible: IMA203-101: NCT03686124; ... ªDose level ≥DL4c is evaluated ±IL-2 ...; anzu-cel, anzutresgene autoleucel ... [illegible]]
Prof. Dr. med. Antonia Busse, abstract #7231
[ESMO Congress Madrid 2026 logo] 4
[Slide 2]
Tolerability in Advanced Solid Tumors
TEAEs in ≥20% of Patients (N=98ª)
Preferred term, n (%) | Any grade | Grade ≥3
Patients with any adverse event | 98 (100) | 97 (99)
Neutropenia | 88 (90) | 87 (89)
Anemia | 78 (80) | 54 (55)
Thrombocytopenia | 71 (72) | 36 (37)
Nausea | 64 (65) | 2 (2)
Lymphopenia | 45 (46) | 45 (46)
Rash | 39 (40) | 5 (5)
Fatigue | 37 (38) | 6 (6)
Transaminase elevation | 37 (38) | 12 (12)
Hypokalemia | 34 (35) | 2 (2)
Constipation | 33 (34) | 0
Vomiting | 28 (29) | 0
Abdominal pain | 26 (27) | 3 (3)
Leukopenia | 25 (26) | 23 (23)
Hyponatremia | 23 (23) | 2 (2)
Pyrexia | 23 (23) | 0
Hypophosphatemia | 21 (21) | 3 (3)
Diarrhea | 20 (20) | 3 (3)
Headache | 20 (20) | 1 (1)
All TEAEs occurring in at least 20 patients (≥20%) are presented. Grades were determined according to National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0. Grades for CRS and ICANS were determined according to CARTOX criteria (Neelapu et al, 2018 before protocol v11.0; Neelapu et al, from protocol v11.0 onward)
Adverse Events of Special Interest (N=98ª)
CRS, any grade, n (%) | 94 (96)
Grade 1 | 38 (39)
Grade 2 | 47 (48)
Grade 3 | 8 (8)
Grade 4 | 1 (1)
HLH, any grade, n (%) | 7 (7)
Grade 1 | 0
Grade 2 | 4 (4)
Grade 3 | 2 (2)
Grade 4 | 1 (1)
ICANS, any grade, n (%) | 8 (8)
Grade 1 | 5 (5)
Grade 2 | 1 (1)
Grade 3 | 2 (2)
Late N- ICAHT Beyond Day 28* (N=87)
ICAHT, any grade, n (%) | 20 (23)
Grade 1-2 | 15 (17)
Grade 3-4 | 5 (6)
Late neutropenia-based Immune Effector Cell-Associated Hematotoxicity (N-ICAHT) grade was based on the second-lowest absolute neutrophil count between days 28-100 postinfusion and required ≥2 neutropenic measurements during this period, including ≥1 between days 35-60. Measurements before the day 28 visit were not used for late ICAHT grading but were considered when determining neutropenia onset and duration. Day 28 visits could have occurred ±3 days before or after day 28. Assessments were available for n=87 patients.
• Most frequent TEAEs were cytopenias associated with lymphodepletion
• CRS was mostly grade 1-2
• DLTs in 4 of 98 patients:
1. DL4b: grade 4 neurotoxicity/CRS with grade 3 HLH
2. DL4b: grade 3 CRS
3. DL5: grade 3 ICANSᵇ
4. DL7: grade 4 skin infectionᵇ
• Late grade 3-4 N-ICAHT in 5 patients was manageable with supportive treatment; all improved to grade ≤2 at a median of 69 days postinfusion (range, 42–121)
• No IMA203CD8-related grade 5 eventᶜ
• MTD not reached with doses up to 12.5 billion IMA203CD8 cells
ª All patients who started lymphodepletion, including 1 patient who did not receive IMA203CD8 cells. ᵇ 2 events met DLT criteria but did not limit dose escalation: 1 in an enrichment cohort at DL5 and 1 at highest dose, DL7 (1/6 patients), both within protocol-defined dose-finding rules). ᶜ Possibly related grade 5 event as previously reported was determined by the PI to be unlikely related to IMA203CD8 after complete assessment. Patient died from sepsis that was aggravated by immunosuppression from fludarabine/cyclophosphamide (possibly related), a grade 4 HLH event, the toxicity management, and rapidly progressing disease. CARTOX, CAR T-cell therapy–associated toxicity; CRS, cytokine release syndrome; DL, dose level; DLT, dose-limiting toxicity; ICAHT, immune effector cell–associated hematotoxicity; HLH, hemophagocytic lymphohistiocytosis; ICANS, immune effector cell–associated neurotoxicity syndrome; PI, principal investigator; MTD, maximum tolerated dose; TEAE, treatment-emergent adverse event.
Data cutoff: August 7, 2026
Prof. Dr. med. Antonia Busse, abstract #7231
[ESMO Congress Madrid 2026 logo]
[Slide 3]
Tumor Reduction Across Dose Levels and Indications During Dose Escalation
Objective responses across all dose levels and biologically distinct tumor types, including ovarian and uterine cancer, melanoma, and synovial sarcoma
[Waterfall plot: Best % Change in Sum of Longest Diameter of Target Lesions from Baseline (RECIST 1.1); per-patient tumor-type labels on x-axis (ovarian, uterine, melanoma, uveal melanoma, synovial sarcoma, NSCLC, breast, etc.) - too small to transcribe individually]
N | 90
ORR | 51% (46/90)
cORR | 41% (36/87)
DCR (at week 6) | 82% (74/90)
Tumor shrinkage | 83% (71/86)
BOR (RECIST 1.1): PD, SD, PR, cPR, CR, cCR
▶ Ongoing response/disease control
* Confirmed response based on prior PR that deepened to CR
Data cutoff: August 7, 2026
[Footnotes small, partly illegible]
Prof. Dr. med. Antonia Busse, abstract #7231
[ESMO Congress Madrid 2026 logo]
[Slide 4]
Tumor Reduction Across Dose Levels During Dose Escalation by Indication
| | Gynecologic Indications (N=27) | Melanoma (N=44) | Synovial Sarcoma (N=12) | Other (N=7) |
| Median dose [×10⁹ total TCR T cells] | 3.55 | 1.67 | 1.59 | 1.95 |
| ORR | 48% (13/27) | 52% (23/44) | 67% (8/12) | 29% (2/7) |
| cORR | 41% (11/27) | 41% (17/42) | 67% (8/12) | 0% (0/6) |
| DCR | 70% (19/27) | 82% (36/44) | 100% (12/12) | 100% (7/7) |
| Tumor shrinkage | 68% (17/25) | 88% (37/42) | 92% (11/12) | 86% (6/7) |
[Waterfall plots by indication: Best % Change in Sum of Longest Diameter of Target Lesions from Baseline (RECIST 1.1)]
BOR (RECIST 1.1): PD, SD, PR, cPR, CR, cCR
▶ Ongoing response/disease control
* Confirmed response based on prior PR that deepened to CR
Data cutoff: August 7, 2026
[Footnotes small, partly illegible]
Prof. Dr. med. Antonia Busse, abstract #7231
[ESMO Congress Madrid 2026 logo] 11
Yago Garitaonaindía@YGaritaonaindia
1) Trial design schema: MIZAR-003 study design / treatment schema - GC101 TIL vs ICC · 2) Slide: MIZAR-003 baseline characteristics - GC101 TIL vs ICC · 3) Kaplan-Meier survival data: MIZAR-003 GC101 TIL vs ICC - PFS (primary and sensitivity)
🔥 MIZAR-003 update at #ESMO26: GC101 TIL (no IL-2, low-intensity lymphodepletion) + sintilimab vs chemo, anti-PD-1 refractory melanoma (n=101, randomized phase 2)
🖋️ Lu Si
➡️ mPFS 4.4 vs 1.6 mo, HR 0.44 | ORR 44% vs 8% | G≥3 TRAEs 42% vs 31% Benefit holds in acral and mucosal
🔍TIL tackling its toxicity problem, plus impressive recruitment and execution in China 🇨🇳 (101 pts randomized in ~15 months)
⚠️ But: open-label, chemo is a soft comparator, mPFS still short
@myESMO @_SEOM @OncoAlert @LARVOL
[Slide 1]
Study Design: MIZAR-003 Treatment Schema
5
Key Eligibility Criteria:
• Aged 18 to 75 years;
• Histologically confirmed unresectable or metastatic melanoma;
• ≥2 prior systemic therapy, anti-PD-1 failure;
• Feasible tumor tissue for resection (≥150mm3);
• At least one remaining measurable target lesion.
N=98, 1:1
GC101 TIL arm: D0 Tumor Resection → D2-D10 Bridging Therapy (As Needed) → Radiological assessment → Preconditioning: D37-39: CTX 20mg/kg/d, D37: HCQ 600mg/d → D42 GC101 TIL infusion → Sintilimab, 100mg, q6w (up to 5 doses) → D84 Radiological assessment q6w → PD
PFS (Primary Analysis) from D0; PFS (Sensitive Analysis) from D37-39
ICC arm: Investigator's Choice of Chemotherapy: every 3 weeks - Dacarbazine, temozolomide, paclitaxel, cisplatin, carboplatin → D42 Radiological assessment → D84 → PD
PFS (Primary Analysis / Sensitive Analysis)
Eligible patients cross over to GC101 TIL therapy after IRC-verified initial PD
Study Endpoints
Primary endpoint:
• PFS (Primary analysis) by IRC (RECIST v1.1)
Secondary endpoints:
• PFS by Investigator (primary and sensitivity analyses)
• ORR, DCR, DOR assessed by both IRC and Investigator (primary and sensitivity analyses)
• OS
• Safety
CTX, cyclophosphamide; DCR, disease control rate; DOR, duration of response; HCQ, hydroxychloroquine; ICC, investigator's choice of chemotherapy; IRC, independent review committee; ORR, objective response rate; OS, overall survival; PD, progressive disease; PFS, progression-free survival; RECIST, Response Evaluation Criteria in Solid Tumors; TIL, Tumor-Infiltrating Lymphocytes.
[ESMO Congress Madrid 2026 logo]
[Slide 2]
Results: Baseline Characteristics
7
• A total of 99 pts were enrolled, over 70% were acral or mucosal melanomas.
• As data cutoff, 43 pts in Primary analysis of the GC101 TIL group received TIL infusion (ASCO 2026: 35 pts).
• The median infused cell dose was 42.90×10^9 (range, 4.62-53.92×10^9).
Characteristic | GC101 TIL (N=50) | ICC (N=49) | Total (N=99)
Age (years, median, range) | 58 (29~73) | 59 (28~73) | 58 (28~73)
Sex, n (Female, %) | 28(56.0) | 25(51.0) | 53(53.5)
Melanoma subtype, n (%)
Acral | 31(62.0) | 25(51.0) | 56(56.6)
Cutaneous | 12(24.0) | 12(24.5) | 24(24.2)
Mucosal | 6(12.0) | 10(20.4) | 16(16.2)
Unknown primary | 1(2.0) | 2(4.1) | 3(3.0)
Visceral metastasis, n (%)
Lung | 27(54.0) | 31(63.3) | 58(58.6)
Liver | 9(18.0) | 8(16.3) | 17(17.2)
Lymph node | 37(74.0) | 37(75.5) | 74(74.7)
Bone | 8(16.0) | 6(12.2) | 14(14.1)
Characteristic | GC101 TIL (N=50) | ICC (N=49) | Total (N=99)
ECOG performance status, n (%)
1 | 27(54.0) | 37(75.5) | 64(64.6)
0 | 23(46.0) | 12(24.5) | 35(35.4)
Gene mutation, n (%)
BRAF mutated | 5(10.0) | 2(4.1) | 7(7.1)
NRAS mutated | 6(12.0) | 5(10.2) | 11(11.1)
Target Lesions Sum of Diameter (mm, Mean ± SD) | 54.92±26.326 | 63.99±29.852 | 59.60±28.418
Number of prior systemic therapy lines (n, median, range) | 2(2,5) | 2(2,5) | 2(2,5)
Lactate dehydrogenase (LDH), n (%)
≤ ULN | 37(74.0) | 36(73.5) | 73(73.7)
> ULN | 13(26.0) | 13(26.5) | 26(26.3)
ECOG, eastern cooperative oncology group; ICC, investigator's choice of chemotherapy; LDH, lactate dehydrogenase; SD, standard deviation; TIL, tumor-infiltrating lymphocytes; ULN, upper limit of normal.
Updated Data cutoff date: July 2, 2026 (ASCO 2026 Data cutoff date: May 12, 2026)
[ESMO Congress Madrid 2026 logo]
[Slide 3]
Results: GC101 TIL Survival vs. ICC
8
• During extended follow-up, PFS benefit maintained with longer follow-up.
• Median PFS*: 4.37 vs. 1.61 months, HR = 0.44, p = 0.0004 (ASCO 2026: 4.30 vs. 1.58 months, HR=0.43, p=0.0002).
• Even with 59% (ASCO 2026: 57%) chemo cross-over, a survival benefit trend showed in the TIL group.
PFS - Primary analysis (GC101-TIL VS ICC): Event/N: 32/50 43/49; mPFS(95%CI): 4.37(2.99-5.55) 1.61(1.28-2.76); HR(95%CI): 0.44(0.28-0.70); P value: 0.0004. PFS Rate(%) at 6 month 34.48 VS 10.24
No. at Risk (months 0,2,4,6,8,10,12,14): GC101-TIL 50 35 26 9 5 3 3 0; ICC 49 21 12 4 3 1 1 0
PFS - Sensitive analysis (GC101-TIL VS ICC): Event/N: 22/37 42/47; mPFS(95%CI): 4.31(2.79-5.72) 1.54(1.28-2.66); HR(95%CI): 0.44(0.26-0.74); P value: 0.0013. PFS Rate(%) at 6 month 29.73 VS 10.05
No. at Risk (0,2,4,6,8,10,12,14): GC101-TIL 37 28 15 4 4 3 2 0; ICC 47 19 12 4 3 1 1 0
OS§ - Primary analysis (GC101-TIL VS ICC): Event/N: 9/50 15/49; mOS(95%CI): NE(9.49-NE) 12.65(8.74-NE); HR(95%CI): 0.6?(0.26-1.41) [second digit illegible]; P value: 0.2571
No. at Risk (0,2,4,6,8,10,12,14,16): GC101-TIL 50 47 38 28 20 11 7 1 0; ICC 49 49 41 30 21 16 12 7 0
*IRC-assessed; §Not yet mature
CI, confidence interval; HR, hazard ratio; ICC, investigator's choice of chemotherapy; OS, overall survival; PFS, progression-free survival; TIL, tumor-infiltrating lymphocytes.
Updated Data cutoff date: July 2, 2026 (ASCO 2026 Data cutoff date: May 12, 2026)
[ESMO Congress Madrid 2026 logo]
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: PFS (IRC, primary analysis); also sensitivity PFS and OS
GC101 TIL | 50 | 4.37 mo | 2.99-5.55
ICC | 49 | 1.61 mo | 1.28-2.76
HR: 0.44
HR CI: 0.28-0.70
P: 0.0004
{'timepoint': '6 months PFS', 'arm': 'GC101 TIL', 'value': '34.48%', 'ci': None}
{'timepoint': '6 months PFS', 'arm': 'ICC', 'value': '10.24%', 'ci': None}
{'timepoint': '6 months PFS (sensitivity analysis)', 'arm': 'GC101 TIL', 'value': '29.73%', 'ci': None}
{'timepoint': '6 months PFS (sensitivity analysis)', 'arm': 'ICC', 'value': '10.05%', 'ci': None}
Note: Sensitivity PFS: 4.31 (2.79-5.72) vs 1.54 (1.28-2.66), HR 0.44 (0.26-0.74), p=0.0013, events 22/37 vs 42/47. OS not mature: mOS NE (9.49-NE) vs 12.65 (8.74-NE), events 9/50 vs 15/49, HR 0.6? (0.26-1.41) second digit illegible, p=0.2571. Updated DCO July 2, 2026; prior ASCO 2026 DCO May 12, 2026 gave 4.30 vs 1.58, HR 0.43, p=0.0002. 59% chemo crossover.
Mario Balsa@MarioBalsaMD
1) Slide: Th17 cells are more effective than other helpers (preclinical, Cole/Knochelmann Cancer Cell 2025) · 2) Slide: Th17 therapy induces PC, GC and memory B cell proliferation (preclinical) · 3) Slide: Th17 cells activate plasma cells and class switching (preclinical) · 4) Slide: Schematic: Th17 (CD26+) cells drive B-cell, antibody and tissue-resident memory responses
🦠 #ESMO26 Autologous cell therapy: getting the T-cell fit right
▪️Th17-polarized T cells:
1. Enhance B-cell, plasma-cell & memory responses
2. Promote class switching
3. Support tissue-resident CD4/CD8 immunity
4. Show potent antitumor activity in preclinical melanoma models
Not all helpers are equally helpful 👀
Congrats to @Chrystal_Paulos and all the team! 👏🏼
@OncoAlert @OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 2]
Th17 therapy induces PC, GC and memory B cell proliferation
[Schema] C57BL/6 — B16F10 (day -7) — 4 Gy (day -1) — Th17 ACT (day 0) — Tissue analysis (day 12)
C [Histograms, % Max vs Ki67] Th17 ACT; No Treatment
Total B cells (CD19+B220+); Plasma Cell; GC B cell; Memory B Cell
D [Bar plots, % Ki67+, NT vs Th17]
Total B cells (CD19+B220+) ****
Plasma Cell ****
GC B cell ****
Memory B Cell ****
Cole A.C, Knochelmann H.M., et. al., Cancer Cell 2025
[Slide 4]
↑ B cell proliferation/differentiation
↑ GC Formation
↑ MHC-II CD40
B
Th17 (CD26+)
↑ IL-21
↑ Inflammatory cytokines
Tumor-specific antibody secretion
Ab-mediated tumor destruction
Sustained Tumor Killing
TRM CD8 — Tissue-resident memory CD8 (TRM CD8) — Direct tumor killing
TRM CD4 (Th17) — Tissue-resident memory CD4 (Th17) (TRM CD4) — Local cytokine production & tumor control
Mario Balsa@MarioBalsaMD
1) Slide: Melanoma in pregnancy: ICI clinical data, mothers (Borgers, ESMO 2026) · 2) Slide: Melanoma in pregnancy: ICI clinical data, children (Borgers, ESMO 2026) · 3) Safety data: Melanoma in pregnancy: immune-related adverse events, mother and fetus · 4) Slide: Melanoma in pregnancy: targeted therapy (BRAF/MEK) case data (Borgers, ESMO 2026)
🤰🏼#ESMO26 How do we treat melanoma when we are treating for two?
Excellent practical session by Jessica Borgers on melanoma & pregnancy
💥 Key takeaways:
• Evidence remains scarce
• ICI may disrupt fetal-maternal tolerance: prematurity/IUGR concern
• Anti-LAG3 pregnancy data: essentially none
• BRAF/MEK: very limited evidence; consider only case by case
• After high-risk adjuvant therapy: ideally wait ~3 years
• After neoadjuvant ICI+MPR? Maybe shorter
Personalized oncology means treating not one patient, but two timelines at once!
@OncoAlert 🗣️
@OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 1]
ICI – Clinical data, mothers
• Eleven case reports1,2 & thirteen database cases3
o Fifteen conceived while on ICI treatment
o Nine initiated treatment during pregnancy (between week 9 and 26)
o Two twin pregnancies
• Initiated during pregnancy
o Some responses during pregnancy, however majority progresses during pregnancy or shortly after delivery
• Conceived on therapy
o Not recommended during and for at least 5 months after last dose of ICI4
o Generally better prognosis; majority already in complete remission or NED after completion of therapy
o Possibility to discontinue ICI treatment in certain cases with good outcomes
• All current information from anti-PD-1 and anti-CLTA-4; no information on anti-LAG-3
[Figure: Borgers & Heimovaara et al. Lancet Oncol. 2021 — bar chart of treatment by weeks of gestation (0-40)]
Legend: No treatment | Ipilimumab plus IL-2 | Nivolumab | Ipilimumab plus nivolumab | Pembrolizumab | No congenital abnormalities child | Minor congenital abnormalities child
Rows: Menzer et al (2018) | Mehta et al (2018) | Burotto et al (2018) | Xu et al (2019) | Bucheit et al (2020) | Haiduk and Ziemer (2021) | Polnaszek et al (2021)
X axis: Weeks of gestation
Jessica S.W. Borgers, MD
References (partially cropped): ...m J Hematol (2022); 2 Baarslag, Heimovaara, Borgers et al. NEJM (2023); 3 Borgers et al. ECM (2025); 4 Prescribing information
[Slide 2]
ICI – Clinical data, children
• >50% of cases C-sections because of intrauterine growth restriction and/or placental insufficiency
o Majority born prematurely
• (Potential) ir-toxicities
o First trimester exposure: two children with congenital hypothyroidism, spontaneously recovered within 6 months
o Second and third trimester exposure: pembrolizumab-induced immune-related gastro-enterocolitis (presented at 15w), 1mg/kg prednisolone and infliximab for first [partially obscured: 2 years of life]1
• At most recent follow-up (6 weeks to 2.75 years)
o Healthy
o Normal developmental milestones
o No evidence of disease
[Figure: Borgers & Heimovaara et al. Lancet Oncol. 2021 — same gestation-week bar chart as previous slide: Menzer et al (2018), Mehta et al (2018), Burotto et al (2018), Xu et al (2019), Bucheit et al (2020), Haiduk and Ziemer (2021), Polnaszek et al (2021); Weeks of gestation 0-40]
Jessica S.W. Borgers, MD
1 Baarslag, Heimovaara, Borgers et al. NEJM (2023)
[Slide 3]
Immune-related adverse events (irAEs)
Mother
• irAEs events are common, especially when receiving combination therapy1
• irAEs often treated with steroids
o Up to 20 mg/day considered safe during pregnancy
o 1-2 mg/kg associated with an increased risk of gestational diabetes, fetal oral–facial clefts (first trimester exposure), and hypothalamic-pituitary-adrenal axis dysfunction2
o Most 2nd or 3rd line immunosuppressive agents other than infliximab (category B) are classified as pregnancy category C or D3
Fetus
• Weight of ICI exceeds the limit for simple diffusion -> active transport using neonatal Fc receptors
o Most effective for IgG1, closely followed by IgG4 isotypes4
o Not present during the first 14 weeks: protected during organogenesis
o Highest rate of transplacental transmission occurs in late second and third trimesters4
[Figure: Martins et al. Nat Rev Clin Onc (2019) — body diagram of irAEs by organ]
Jessica S.W. Borgers, MD
1 Martins et al. Nat Rev Clin Onc (2019); 2 Ponticelli et al. J Clin Med (2018); 3 Ponticelli. J Clin Med (2018); 4 Pentsuk et al. Birth Defects Res B Dev Reprod Toxicol (2009)
[Slide 4]
Targeted therapy
• Four published case reports1-4, seven cases in our database
• Mothers:
o Two women conceived while receiving dabrafenib/trametinib and vemurafenib (abortions)
o Nine women initiated treatment during second trimester (week 17, 18, 20, 22, 26)
o Six women received vemurafenib, three received dabrafenib
o Most women SD/PR during pregnancy, then progressed after delivery
o One severe side effect: toxic epidermal necrolysis (ICU admission with intubation)2
• Children:
o All born prematurely (week 26, 30, 32, 34, 36)
o Fetal growth restriction
o Cardiac toxicity?
❖ Neonatal paroxysmal supraventricular tachycardia (treated with beta-blocker)
❖ Atrial septal defect, patent ductus arteriosus, and Wolff-Parkinson-White syndrome
o Normal growth and development
Jessica S.W. Borgers, MD
1 Maleka et al. (2019); 2 De Haan et al. (2018); 3 Marce et al. (2019); 4 Pagan et al. (2019)
Dr Sophia Wong@sophiawongyn
1) Slide: IMA203CD8 PRAME-directed TCR T-cell therapy phase 1 — title slide, Prof. Dr. med. Antonia Busse · 2) Response data: IMA203CD8 waterfall: tumor reduction across dose levels and indications during · 3) Slide: IMA203CD8 tumor reduction by indication (gynecologic, melanoma, synovial sarcoma, other) — Busse · 4) Slide: IMA203CD8 spider plot: changes in tumor size over time (mFU for mPFS 12.8 months) — Busse
💉IMA203CD8, a co-transduces a CD8αβ co-receptor alongside the PRAME TCR showing impressive ORR 51% in 90 and durability in heavily pre-treated patients of >3L including melanoma, gynaecological, sarcomas. Well tolerated with CRS mostly G1-2.
Many congratulations to Antonia Busse, investigators and Immatics 👏🏼
#ESMO26
#TCRTherapy
#CellTherapy
@myESMO
[Slide 1]
[MADRID 2026 ESMO congress logo]
Targeting PRAME+ Tumors with IMA203CD8, a PRAME-directed TCR T-cell Therapy: Results from a Phase 1 Study
Antonia Busse1, Dejka M. Araujo2, Winfried Alsdorf3, Oladapo Yeku4, Tobias A.W. Holderried5,6, Leonel F. Hernandez-Aya7, Sarah Taylor8, Dirk Jaeger9, Manik Chatterjee10, Anthony J. Olszanski11, Eva M. Wagner-Drouet12, Peter Herhaus13, Katrin Wetzko14, Apostolia M. Tsimberidou2, Friederike Schmitz8, Diwakar Davar15, Karine Pozo16, Liane Preussner17, Cedrik M. Britten17, Martin Wermke18
1Charité Medical University Hospital, Berlin, Germany;
2The University of Texas MD Anderson Cancer Center, Houston, TX, USA;
3Department of Hematology and Oncology, University Hospital Hamburg Eppendorf, Hamburg, Germany;
4Massachusetts General Hospital, Boston, MA, USA;
5University of Bonn, University Hospital Bonn, Medical Clinic and Polyclinic III Internal Medicine with a focus on Oncology, Hematology, and Rheumatology, Bonn, Germany;
6Clinical Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
7University of Miami, Miami, FL, USA;
8University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA;
9University Hospital Heidelberg, Heidelberg, Germany and Translational Oncology/Early Clinical Trial Unit (ECTU);
10Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany;
11Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA;
12University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany;
13TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, Germany;
14University Hospital Dresden, Dresden, Germany;
15University of Pittsburgh Medical Center (UPMC), Hillman Cancer Center, Pittsburgh, PA, USA;
16Immatics US, Houston, TX, USA;
17Immatics Biotechnologies GmbH, Tuebingen, Germany;
18TU Dresden, Carl-Gustav-Carus Faculty of Medicine, NCT/UCC Early Clinical Trial Unit, Dresden, Germany.
Prof. Dr. med. Antonia Busse
Proffered paper presentation, abstract #7231
[QR code] [Madrid skyline graphic] [ESMO logo]
[Stage photo: presenter at ESMO podium (MADRID SPAIN 23-27 OCTOBER 2026), two chairs seated]
[Slide 2]
Tumor Reduction Across Dose Levels and Indications During Dose Escalation
Objective responses across all dose levels and biologically distinct tumor types, including ovarian and uterine cancer, melanoma, and synovial sarcoma
N 90
ORR 51% (46/90)
cORR 41% (36/87)
DCR (at week 6) 82% (74/90)
Tumor shrinkage 83% (71/86)
[Waterfall plot; y-axis: Best % Change in Sum of Longest Diameter of Target Lesions from Baseline (RECIST 1.1), 25 to -100; per-patient bars labelled with % change from +24 to -100; x-axis labels = tumor types per patient (uterine cancer, acral melanoma, ovarian cancer, uveal melanoma, synovial sarcoma, lung cancer (NSCLC), cutaneous melanoma, breast cancer, mucosal melanoma, melanoma (UNK), etc.)]
BOR (RECIST 1.1): PD; SD; PR; cPR; CR; cCR
▶ Ongoing response/disease control * Confirmed response based on prior PR that deepened to CR
Data cutoff: August 7, 2026
n=2 patients with ovarian cancer and n=1 patient with melanoma died before first postbaseline scan and n=1 additional patient with melanoma had a non-evaluable target lesion; these patients are not depicted in the plot but were included in the ORR, cORR and DCR calculation. ORR: according to RECIST 1.1 at any postbaseline scan, PD or death at any prior timepoint; Confirmed ORR for patients with ≥2 postbaseline scans per RECIST 1.1, PD or death at any prior timepoint, those with ongoing unconfirmed PR/CR were excluded. For patients achieving a (c)CR with <100% change from baseline, target lesions were lymph nodes that resolved to <10 mm per RECIST 1.1. BOR, best overall response; (c)CR, (confirmed) complete response; DCR, disease control rate; NSCLC, non-small cell lung cancer; (c)ORR, (confirmed) objective response rate; PD, progressive disease; (c)PR, (confirmed) partial response; SD, stable disease; UNK, unknown.
Prof. Dr. med. Antonia Busse, abstract #7231
[MADRID 2026 ESMO congress logo] 10
[Slide 3]
Tumor Reduction Across Dose Levels During Dose Escalation by Indication
| Gynecologic Indications (N=27) | Melanoma (N=44) | Synovial Sarcoma (N=12) | Other (N=7)
Median dose [×10^9 total TCR T cells]: 3.55 | 1.67 | 1.59 | 1.95
ORR: 48% (13/27) | 52% (23/44) | 67% (8/12) | 29% (2/7)
cORR: 41% (11/27) | 41% (17/42) | 67% (8/12) | 0% (0/6)
DCR: 70% (19/27) | 82% (36/44) | 100% (12/12) | 100% (7/7)
Tumor shrinkage: 68% (17/25) | 88% (37/42) | 92% (11/12) | 86% (6/7)
[Waterfall plots per indication; y-axis: Best % Change in Sum of Longest Diameter of Target Lesions from Baseline (RECIST 1.1), 25 to -100; Baseline line]
BOR (RECIST 1.1): PD; SD; PR; cPR; CR; cCR
▶ Ongoing response/disease control
* Confirmed response based on prior PR that deepened to CR
Data cutoff: August 7, 2026
n=2 patients with ovarian cancer and n=1 patient with melanoma died before first postbaseline scan and n=1 additional patient with melanoma had a non-evaluable target lesion; these patients are not depicted in the plot but were included in the ORR, cORR and DCR calculation. ORR: according to RECIST 1.1 at any postbaseline scan, PD or death at any prior timepoint; Confirmed ORR for patients with ≥2 postbaseline scans per RECIST 1.1, PD or death at any prior timepoint, those with ongoing unconfirmed PR/CR were excluded. For patients achieving a (c)CR with <100% change from baseline, target lesions were lymph nodes that resolved to <10 mm per RECIST 1.1.
BOR, best overall response; (c)CR, (confirmed) complete response; DCR, disease control rate; (c)ORR, (confirmed) objective response rate; PD, progressive disease; (c)PR, (confirmed) partial response; SD, stable disease.
Prof. Dr. med. Antonia Busse, abstract #7231
[MADRID 2026 ESMO congress logo] 11
[Slide 4]
Changes in Tumor Size Over Time
All dose levels: Deep and durable responses observed across all indications with ongoing responses beyond 2.5 years (mFU time of mPFS: 12.8 months)
[Spider plot; y-axis: Change in Sum of Longest Diameter of Target Lesions from Baseline [%], 100 to -100; x-axis: Months post T-cell infusion 0-45 (axis break between 15 and 24); reference lines PD, Baseline, PR]
BOR (RECIST 1.1): PD; SD; PR; cPR; CR; cCR
▶ Ongoing response/disease control
▶ Ongoing
Data cutoff: August 7, 2026
BOR, best overall response; (c)CR, (confirmed) complete response; mFU, median follow-up; PD, progressive disease; (c)PR, (confirmed) partial response; SD, stable disease
Prof. Dr. med. Antonia Busse, abstract #7231
[MADRID 2026 ESMO congress logo] 12
Mario Balsa@MarioBalsaMD
1) Slide: cSCC prognosis in immunosuppressed patients (Lebbe, ESMO 2026 educational session) · 2) Slide: Prevention of cSCC in solid organ transplant recipients (Lebbe, ESMO 2026 educational session) · 3) Slide: JAK inhibitors and cSCC risk: cohort table (Lebbe, ESMO 2026 educational session) · 4) Slide: Merkel cell carcinoma in transplant recipients (Lebbe, ESMO 2026 educational session)
🚨#ESMO26 Skin cancer in immunocompromised patients! 🚨
Key pearls from Celeste Lebbé: @celeste
▪️SOTR: more cSCC risk ~46-fold…treat every cSCC as high-risk
▪️Ruxolitinib: ~2–3× excess cSCC risk, but may still synergise with anti–PD-1
▪️Post-transplant MCC: often MCPyV-negative and more lethal
▪️ICI: rejection ≈1 in 3; mTOR-based immunosuppression may mitigate risk
▪️HIV-associated KS: restoring immunity with ART remains fundamental
Amazing discussion!!! 👏🏼
@OncoAlert @OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 1]
CHAIRS: CELESTE LEBBE, VERNON SONDAK
cSCC PROGNOSIS | Scenario 1 of 4 · Transplant and cSCC
Immunosuppression predicts cSCC death and the next cSCC, beyond transplantation
Solid organ transplant recipients
• Metastasis at 2 years: 6.2% in the prospective SCOPE-ITSCC cohort (no control arm)1
• For comparison, about 1 to 4% in immunocompetent cohorts2,3
All IS patients, 3,994 tumours
• DSD HR 1.7 vs IC; metastasis HR 1.2 (NS)4
• Transplantation predicts recurrence, metastasis and death; CLL predicts recurrence and death4
• Meta-analysis, all hosts: immunosuppression and tumour size predict death5
Haematology
• CLL: cSCC 5-year metastasis 18%, death 11%6
• PWH: no outcome cohort; one series of 10 patients with recurrent and metastatic cSCC8
5-year risk of another cSCC after a first one (%), upper bound of published ranges7
Organ transplant | 92
Haematological malignancy | 64
General population | 67
Full ranges: general population 28 to 67%, haematological malignancy 41 to 64%, organ transplant 74 to 92%
Abbreviations: IS, immunosuppressed; IC, immunocompetent; HR, hazard ratio (multivariable); DSD, disease-specific death; CLL, chronic lymphocytic leukaemia; PWH, people with HIV
References: 1. Eggermont C, JAAD 2024;90:530-6 (SCOPE-ITSCC) 2. Brantsch KD, Lancet Oncol 2008;9:713-20 3. Venables ZC, JAMA Dermatol 2019;155:298-306 4. Klein JC, JAAD 2026;94:151-60 (18,760 tumours) 5. Dessinioti C, Dermatology 2022;238:1026-35 6. Brewer JD, Clin Adv Hematol Oncol 2012 7. Hollestein LM, JEADV 2026 8. Nguyen P, Arch Dermatol 2002;138:758-63
8
[Speaker panel] Celeste Lebbe — Immunocompromised patients, including transplant and HIV
[Slide 2]
CHAIRS: CELESTE LEBBE, VERNON SONDAK
PREVENTION OF cSCC IN SOTR | Scenario 1 of 4 · Transplant and cSCC
Photoprotection, mTOR inhibitors and retinoids; nicotinamide fails in SOTR
Sun protection first
• Daily broad-spectrum sunscreen in OTR: fewer AK and invasive cSCC at 24 months1
• Education at listing and at every visit; clothing, hats, UV avoidance (expert opinion)
mTOR inhibitors
• TUMORAPA (randomised): sirolimus after a first cSCC, fewer new cSCC (p < 0.001); no benefit after multiple cSCC2,3
• 1,055 SOTR, 2011-2021: mTORi + reduced CNI, cSCC HR 0.63; everolimus HR 0.384
Retinoids (acitretin)
• 3 small RCTs in RTR, 1995 to 2003: new cSCC 11% vs 47% at 6 months5; fewer cSCC in crossover6; two doses alike7
• 32 OTR: about 2 fewer cSCC per year; rebound on stopping8; teratogenic, poorly tolerated
• EADO 2026: consider after one or more cSCC9; NCCN: effective in some high-risk patients10
Nicotinamide
• IC (ONTRAC, n = 386): 23% fewer keratinocyte cancers at 12 months11
• SOTR (ONTRANS, n = 158): no effect, RR 1.0 (0.8 to 1.3)12
• Not a substitute for IS modification
At the first cSCC: switch to an mTOR inhibitor and consider acitretin; nicotinamide is not a substitute
Abbreviations: OTR/SOTR, (solid) organ transplant recipients; RTR, renal transplant recipients; AK, actinic keratosis; mTORi, mTOR inhibitor; CNI, calcineurin inhibitor; HR, hazard ratio; RCT, randomised controlled trial; RR, rate ratio; IC, immunocompetent; IS, immunosuppression
References: 1. Ulrich C, BJD 2009;161(Suppl 3):78-84 2. Euvrard S, NEJM 2012;367:329-39 3. Dantal J, JCO 2018;36:2612-20 4. Gomez-Tomas A, BJD 2026;194:747-57 5. Bavinck JN, JCO 1995;13:1933-8 6. George R, Australas J Dermatol 2002;43:269-73 7. de Sevaux RG, JAAD 2003;49:407-12 8. Harwood CA, Arch Dermatol 2005;141:456-64 9. Stratigos AJ, EADO cSCC guideline part 1, 2026 update 10. NCCN SCC skin cancer v1.2024 11. Chen AC, NEJM 2015;373:1618-26 12. Allen NC, NEJM 2023;388:804-12
10
[Speaker panel] Celeste Lebbe — Immunocompromised patients, including transplant and HIV
[Slide 3]
CHAIRS: CELESTE LEBBE, VERNON SONDAK
JAK INHIBITORS AND cSCC: THE OTHER COHORTS | Scenario 2 of 4 · JAK inhibitor
A consistent two- to three-fold excess of cSCC under ruxolitinib, from trials to registries
Study | Design and population | cSCC or NMSC finding
COMFORT-II, 5 years1 | RCT, myelofibrosis: ruxolitinib 146 vs best available therapy 73 | NMSC 17.1% vs 2.7%; 6.1 vs 3.0 per 100 patient-years
RESPONSE, 80 weeks2 | RCT, polycythaemia vera: ruxolitinib 110 vs best available therapy 111 | NMSC 4.4 vs 2.7 per 100 patient-years, mostly with a prior NMSC
Lin, JAAD 20223 | Retrospective cohort, 564 PV or MF, 188 exposed, 10 years, Stanford | cSCC adjusted HR 3.24 (1.45 to 7.22); NMSC HR 2.69 (1.03 to 7.02)
Polverelli, BJH 20214 | 700 ruxolitinib-treated MF, 20 European centres | NMSC = 51% of second cancers; ruxolitinib > 5 years, HR 2.93 (1.39 to 6.17)
MPN-K, Leukemia 20195 | Nested case-control, 647 second cancers vs 1,234 MPN controls | NMSC with ruxolitinib: OR 3.87 (1.18 to 12.75)
ORAL Surveillance, NEJM 20226 | RCT, rheumatoid arthritis, 4,362: tofacitinib vs TNF inhibitor | NMSC HR 1.90 (5 mg) and 2.16 (10 mg) vs TNF inhibitor
Pasquer, ASH 2024 (our data)7 | Pharmacovigilance (VigiBase) and single-centre MPN cohort, n = 1,004 | cSCC disproportionality PRR 4.88; JAKi independently associated with cSCC, HR 6.52
Abbreviations: NMSC, non-melanoma skin cancer; cSCC, cutaneous squamous cell carcinoma; MF, myelofibrosis; PV, polycythaemia vera; MPN, myeloproliferative neoplasm; HR, hazard ratio; OR, odds ratio; PRR, proportional reporting ratio; JAKi, JAK inhibitor
References: 1. Harrison CN, Leukemia 2016;30:1701-7 2. Verstovsek S, Haematologica 2016;101:821-9 3. Lin JQ, JAAD 2022;86:339-44 4. Polverelli N, Br J Haematol 2021;193:356-68 5. Barbui T, Leukemia 2019;33:1996-2005 6. Ytterberg SR, NEJM 2022;386:316-26 7. Pasquer H, ASH 2024, abstract 4513
15
[Speaker panel] Celeste Lebbe — Immunocompromised patients, including transplant and HIV
[Slide 4]
CHAIRS: CELESTE LEBBE, VERNON SONDAK
MERKEL CELL CARCINOMA | Scenario 3 of 4 · Merkel after transplant
In transplant recipients, MCC is mostly virus-negative and more lethal
EUROPEAN multicentre cohort: 30 SOTR vs 44 IC1
MCPyV-positive tumours (%)
Immunocompetent (n = 44) | 91
SOTR (n = 30) | 33
• Virus-negative, UV-driven MCC predominates in SOTR (p = 0.001); SOTR younger at diagnosis (69 vs 78 years)
• Worse outcomes than IC: progression SHR 3.35, MCC-specific death SHR 2.55, OS HR 3.26; mTORi switch after diagnosis did not reduce progression
FRANCE, kidney transplant recipients2
• Same virus-negative predominance; MCC often arising with cSCC or its precursors in a field of cancerisation
USA, Seattle: 37 SOTR vs immunocompetent, 8 on anti-PD-(L)1 3
• Stage III or more at diagnosis: 76% vs 51%; death within 1 year: 24% vs 4%
• Anti-PD-(L)1 in 8 kidney transplant recipients: 5 of 8 responded, 2 irreversible graft failures
FRANCE, 13 SOTR on anti-PD-(L)1 (9 kidney, 2 liver, 2 heart)4
• 1 complete response, 12 progressions; median PFS 1.6 months; no graft rejection
Abbreviations: MCPyV, Merkel cell polyomavirus; SOTR, solid organ transplant recipients; IC, immunocompetent; SHR, subdistribution hazard ratio; HR, hazard ratio; OS, overall survival; mTORi, mTOR inhibitor
References: 1. Ferrandiz-Pulido C, JEADV 2022 (European multicentre cohort, 30 SOTR vs 44 IC) 2. Pacaud A, JEADV 2023 (French kidney transplant recipients) 3. Akaike T, Br J Dermatol 2025;193:1221 (Seattle, 37 SOTR) 4. Idoudi, JDP 2026 (French series, 13 SOTR)
24
[Speaker panel] Celeste Lebbe — Immunocompromised patients, including transplant and HIV
Yago Garitaonaindía@YGaritaonaindia
1) Trial design schema: MSLT-3 (S2601, EORTC-2519) study design: ILN-only vs TLND after · 2) Trial design schema: OMIT study (Netherlands) design: neoadjuvant nivolumab + ipilimumab · 3) Slide: Practice variation in index lymph node (ILN) approach after neoadjuvant IO in melanoma
🔥 #ESMO26 TLND omission after neoadjuvant IO in stage III #melanoma
🎙️ van Akkooi
Many centres already omit TLND with local, non evidence-based strategies outside PRADO.
Two trials will give the answer:
➡️ OMIT (NL): nivo+ipi, ILN MPR → omit TLND ➡️ MSLT-3: randomised ILN-only vs TLND, response-adapted, n≈1,574
@_SEOM @myESMO @oncodaily
#IO
[Slide 1]
Multicenter Selective Lymphadenectomy Trial – 3 (MSLT-3) – S2601, EORTC-2519
Resectable Stage III[B-D?] Melanoma N = ~1,574 [?]
RANDO 1:1 • Continent • AJCC N Stage • NAT Regimen
TLND Arm n = 787 [?]
ILN Arm n = 787 [?]
Neoadjuvant Immunotx 6 weeks
TLND Path Response (ILN + TLND*)
-> MPR n = 248 [?] -> 2 year RFS
-> Non-MPR n = 539 [?] -> SoC Adjuvant Rx
ILN Resection Path Response (ILN only*)
-> MPR n = 248 [?] -> Salvage TLND (for recurrence) -> 2 year RFS
-> Non-MPR n = 539 [?] -> TLND <3 wks + Path Response -> SoC Adjuvant Rx
10 year OS
Index Lymph Node Marker Insertion
Key: ILN - index lymph node; MPR - major pathological response (complete + near complete); NAT - neoadjuvant therapy; OS - overall survival; RFS - relapse-free survival; SoC Rx - standard of care treatment; TLND - therapeutic lymph node dissection; * and any additional nodes [key text small/angled, partly illegible]
NCT07049276
Alexander C.J. van Akkooi
[Slide 2]
NCT06754904
OMIT Study
The Netherlands
Informed Consent: IC
Weeks: -3 | 0 | 3 | 7 | 10
Patients with macroscopic resectable stage III melanoma
1. with at least 1 LN metastasis
A. RECIST 1.1 measurable OR
B. PA proven
2. eligible for neoadjuvant treatment
3. additional in-transit (max 3) allowed
-> ILN marking placing -> Neoadjuvant immunotherapy nivolumab + ipilimumab -> ILN removal
Yes -> MPR = pCR/npCR -> OMIT TLND -> Follow-up
No -> No MPR pPR/pNR -> SoC* -> Follow-up
[Slide 3]
Practice Variation
Currently, some centers started offering ILN
- Not experienced in ILN delivery
- Do not follow PRADO protocol
- Local interpretations = non-evidence based
- Postcode variation = non-desired
Dr Sophia Wong@sophiawongyn
1) Slide: Title slide: Lifileucel + pembrolizumab in ICI-naive advanced melanoma, final results · 2) Trial design schema: Title slide LBA55: GC101 TIL in advanced melanoma, extended follow-up
Great 2 final abstracts presented on #TIL
@ajsfurness showed an ORR 62.5% in treatment naive melanoma with 1L Lifileucel + Pembro IOV-COM-202 @IovanceBio with interesting translational data while Lu Si showed an ORR 44% with GC101 TIL with IL-2 free infusion post cells in heavily pretreated mostly mucosal/acral melanoma with low dose LD chemo.
But devil is in the details and questions - what exactly is GC101 TIL compared to Lifileucel? How does doses of TIL, IL-2 free, low dose LD impact?
#ESMO26
@myESMO
[Slide 1]
[ESMO Congress Madrid 2026 logo]
Efficacy and Safety of Lifileucel and Pembrolizumab in Patients with Immune Checkpoint Inhibitor-Naïve Advanced Melanoma: Final Results from IOV-COM-202 Study
Andrew J.S. Furness, Helen Gogas, Bernard Doger de Speville Uribe, Donald Lawrence, Gino K. In, Sajeve Thomas, Young Ki Hong, Juan Martin-Liberal, Kai He, Marta Sotelo Garcia, Simon Häfliger, Sylvia Lee, Theresa Medina, Friedrich Graf Finckenstein, Morganna Vance, Rana Fiaz, Melissa Catlett, Siyu Zhu, Rongsu Qi, Brian Thompson, Joe Dean, Brian Gastman, Frederick G. Vogt, Patrick Terheyden
Andrew Furness
The Royal Marsden Hospital
London, UK
October 23, 2026
[Live video of presenter at podium on left of screen]
[Slide 3]
[ESMO Congress Madrid 2026 logo]
LBA55:
Autologous Tumor-Infiltrating Lymphocytes (GC101 TIL) in Advanced Melanoma: Extended Follow-up of a Randomized, Open-Label, Pivotal Phase II Trial
Lu Si, Yu Chen, Weizhen Zhang, Jing Chen, Zhengyun Zou, Dongyuan Zhu, Xingxiang Pu, Xianan Li, Xiaoshi Zhang, Jiyan Liu, Quanli Gao, Zhenchao Yuan, Hong Cen, Meiyu Fang, Lingjun Zhu, Ke Li, Huijing Feng, Tongyu Lin, Huajun Jin, Jun Guo
Presented By Lu Si, MD
Peking University Cancer Hospital
[Live video of presenter at podium on right of screen]
Ahmad Tarhini@ATarhiniMDPhD
Slide: Poster 2080P: Host inherited genetic variation and risk of hepatitis after ICI in melanoma (E1609; Tarhini)
#Madrid #ESMO26 Presenting Live | Host #InheritedGeneticVariation & the risk of #Hepatitis following #ImmuneCheckpoint #Immunotherapy (ICI) of #Melanoma | Proud of this original collaborative effort & this team at @MoffittNews @eaonc & @theNCI https://t.co/dwdatNauBN
[Slide 1]
[ESMO Congress logo] Abstract 2080P
[Moffitt Cancer Center logo] [ECOG-ACRIN cancer research group logo] [NCI National Clinical Trials Network logo]
Host inherited genetic variation and the risk of hepatitis following immune checkpoint immunotherapy of melanoma
Ahmad A. Tarhini, MD, PhD; Zhihua Chen, MS; Mohammad Ali Khaksar, MD; Sandra J. Lee, ScD; F. Stephen Hodi, MD; Tingyi Li, MS; Howard Streicher, MD; Vernon K. Sondak, MD; John M. Kirkwood, MD; Xuefeng Wang, PhD; Peter A. Kanetsky, PhD
U.S. Intergroup E1609: Study Design and Accrual
Patients with resected IIIB, IIIC, M1a, M1b Melanoma (AJCC7) -> RANDOMIZED ->
Ipi3 INDUCTION Ipilimumab 3 mg/kg Q 3 week x 4 -> Ipi3 MAINTENANCE Ipilimumab 3 mg/kg Q 3 month x 4
HD-IFN INDUCTION IFN-α2b 20 MU/m2/d IV x1 month -> HD-IFN MAINTENANCE 10 MU/m2 SC TIW x11 months
Ipi10 INDUCTION Ipilimumab 10 mg/kg Q 3 week x 4 -> Ipi10 MAINTENANCE Ipilimumab 10 mg/kg Q 3 month x 4
-> FOLLOW UP
Stratified by: IIIB, IIIC, M1a, M1b N = 1673
E1609 (NCT01274338) tested ipilimumab at 3 mg/kg (ipi3) and 10 mg/kg (ipi10) vs. high-dose interferon-α (HDI). It demonstrated significant improvement in overall survival (OS) with ipi3 versus HDI. Ipi3 was significantly less toxic than ipi10 and at least as effective.
INTRODUCTION
- ICIs are part of the standard of care for patients with advanced melanoma.
- Immune-mediated hepatitis (IMH) is a common toxicity following ICI and can be life-threatening.
- From E1609, 25.4% of pts treated with ipilimumab experienced IMH, including 5.5% Gr3/4.
- Predicting the risk of IMH may inform the treatment plan and clinical follow-up.
- We hypothesize that inherited genetic variations contribute to susceptibility to IMH.
METHODS
- We conducted genome-wide genotyping on biospecimens from 744 consenting patients enrolled in E1609.
- Illumina Infinium Global Screening Array v.3.0 + Multi-Disease BeadChip with 730059 designed loci was used.
- Genotypes were called using Illumina Genome Studio 2.0 and IAAP CLI v1.1.0, quality controlled, and harmonized with the 1000 Genomes Phase 3 (1KGP3) references.
- Michigan Imputation Server 2, pipeline v2.0.6 was used to impute the genotypes against the hrc-r1.1 reference panel.
- Logistic regression implemented in plink (v2.00a4LM glm with firth fallback) was used to estimate associations between inherited genetic markers and the occurrence of IMH, adjusting for genetic ancestry.
- We calculated relevant PRS listed in PGS-Catalog v20240318 containing variant information and weights for existing polygenic scores (PGSs) and examined 17 distinct PRS previously reported to be associated with inflammatory liver disease and generated from non-melanoma patient populations that were not exposed to immunotherapy.
- We treated IMH grades as categorical (Kruskal-Wallis test) and as dichotomous (Wilcoxon rank-sum test) variables.
- IMH was graded using CTCAE v.4, the adopted version at the time of conduct of the E1609.
RESULTS
- Following QC screening, 738 patients were included in the final analysis.
- Mean age 52.2 years, 66% (n = 489) male, 98% White, 94% non-Hispanic.
- IMH of any grade occurred in 28% of patients in this cohort. See Table 1
[Table 1. Baseline characteristics - small, largely illegible]
[Figure 1. Examination of PGS-Catalog PRSs & custom PRS & association with grade - box plots]
- There was no significant difference in the distribution of the PRS across the grades of IMH (Kruskal-Wallis) with any of the 17 previously reported inflammatory liver disease PRSs. See Figure 1
- From our GWAS analysis, we identified 10 independent SNPs significantly associated with IMH incidence following ipilimumab.
- When combined using log(OR) as weights to construct our custom PRS, these SNPs were significantly associated with the severity of IMH grades, both across irAE grades (Kruskal-Wallis p=3.03e-35) and when dichotomized as any IMH vs. none (Wilcoxon p=2.93e-38). See Figures 1, 2
- ROC analyses were performed to evaluate discriminatory performance for our custom PRS (0 vs. all IMH grades; AUC=0.81). See Figure 3
- Figure 4 shows the Manhattan plot of SNPs associated with IMH in this cohort.
- In multivariable survival analysis adjusting for primary tumor status (Known, Unknown) and sex, any grade IMH is associated with improved clinical outcomes for both RFS (HR 0.84, 95% CI 0.67-1.07; p=0.16) and OS (HR 0.71, 95% CI 0.52-0.99; p=0.04). See Figure 5
- In multivariable survival analysis adjusting for primary tumor (Known, Unk) and sex, the combination of 10 SNPs trended towards an association with RFS (HR 0.55, 95% CIO 0.09-3.23; p=0.51) & OS (HR 0.36, 0.04-3.65; p=0.39) likely limited by sample size & number of events. See Figure 5
Figure 2. Novel generated PRS & association with IMH by grade [box plots]
Figure 3. ROC analyses showing AUC for custom PRS (0 vs. all grades) [ROC curve, AUC 0.81]
Figure 4. Manhattan plot of SNPs associated with IMH (X-axis is SNP chromosomal position; Y-axis is the SNP P-value on a -log10 scale)
Figure 5. KM plots & multivariable survival analysis [KM Plot of RFS by Grade 0 vs all IMH; KM Plot of OS by Grade 0 vs all IMH; KM Plot of RFS by Tertiles of PGS Score; KM Plot of OS by Tertiles of PGS Score - details illegible]
CONCLUSIONS
- Our results support an association between inherited genetic variation and the risk of IMH following ICI
- We developed a germline-based PRS that predicts susceptibility to ipilimumab-induced hepatitis with meaningful discrimination (AUC = 0.81)
- The generated 10-SNP novel PRS may have implications in better informing patient risk and follow-up in clinic
[REFERENCES, funding and acknowledgements - illegible]
Presented by Ahmad A. Tarhini, MD, PhD at the European Society for Medical Oncology (ESMO) Annual Meeting, Madrid, Spain, October 23-27, 2026
JAVIER PRATO VARELA, MD@PRATOVARELA1608
Slide: Family planning after melanoma: recurrence-risk-based recommendations (Borgers, ESMO 2026)
At #ESMO2026, an important message on family planning after melanoma:
Pregnancy decisions should be guided by recurrence risk, not diagnosis alone.
Major pathological response after neoadjuvant immunotherapy may offer new opportunities for earlier family planning https://t.co/2E3kS9TUqk
[Slide 1]
Family planning
• Recommendations should be made on an individual bases
o Tumor characteristics & maternal age1
• Early-stage melanoma with low recurrence risk -> pregnancy likely not affected by melanoma
• High risk melanoma after adjuvant Tx -> ideally wait three years after completion of adjuvant Tx1
o Most recurrences occur within the first three years2
• High risk melanoma after neoadjuvant ICI Tx -> potentially shorter interval for major pathological respo[nse — cut off at image edge]
o Major pathological response is excellent surrogate for relapse-free survival3
Jessica S.W. Borgers, MD
[...]2017); 2 Pérez-Morales. Ann Surg Oncol (2023); 3 Lucas. Ann Oncol (2024)
Dana-Farber@DanaFarber
Slide: Summary slide - personalized cancer vaccines (Patrick Ott, Special Symposium on Melanoma)
Patrick Ott, MD, PhD, presents emerging approaches using peptides, DNA, mRNA and more at the Special Symposium on Melanoma: From Standard Fit to Bespoke Care. #ESMO26 https://t.co/g1iSCAuSup
[Slide 1]
[ESMO Congress Madrid 2026 logo]
Summary
- Personalized cancer vaccines are feasible at a large scale
- Increasing evidence of clinical activity, positive randomized phase 2 and 3 studies in adjuvant melanoma
- The excellent safety profile gives room for combinations
- Robust vaccine-induced immunity, but breadth is limited
- A reliable marker tying vaccine-induced immunity to clinical response is elusive (TCR-clonotype expansion, epitope spreading?)
- Major [illegible - obscured by camera]tunities for improved/novel delivery approaches and tumor antigen [illegible - obscured]covery
[Photo: speaker at ESMO podium, audience in foreground]
@adamfeuerstein @A_May_MD subject of the valuation is another topic, there is a hype effect, and you won't fight that by bringing any clinical data imo
https://t.co/XXDqd8ezq4 https://t.co/3kOHzvZnaR
[Slide 1]
HIGHLIGHTS OF PRESCRIBING INFORMATION
These highlights do not include all the information needed to use KEYTRUDA safely and effectively. See full prescribing information for KEYTRUDA.
KEYTRUDA® (pembrolizumab) injection, for intravenous use
Initial U.S. Approval: 2014
----------RECENT MAJOR CHANGES----------
Indications and Usage (1) 02/2026
Dosage and Administration (2) 02/2026
----------INDICATIONS AND USAGE----------
KEYTRUDA is a programmed death receptor-1 (PD-1)-blocking antibody indicated:
Melanoma
• for the treatment of patients with unresectable or metastatic melanoma. (1.1)
• for the adjuvant treatment of adult and pediatric (12 years and older) patients with Stage IIB, IIC, or III melanoma following complete resection. (1.1)
[illegible - cropped line]
[Slide 2]
Probability of Event-free Survival
Neoadjuvant–adjuvant group
Adjuvant-only group
P=0.004 by log-rank test
Months since Randomization
No. at Risk
Neoadjuvant–adjuvant group 154 96 69 46 25 17 1
Adjuvant-only group 159 98 67 40 22 10 2
(time points 0, 6, 12, 18, 24, 30, 36)
Figure 1. Kaplan–Meier Estimates of Event-free Survival, as Assessed by the Local Investigators.
The log-rank test was stratified according to disease stage and lactate dehydrogenase level at randomization. In the intention-to-treat analysis of event-free survival, there were 105 events (38 in the neoadjuvant–adjuvant group and 67 in the adjuvant-only group). All events that occurred before the start of adjuvant therapy were assigned an event date of 84 days. Tick marks indicate censored data.
[Survival data captured as a table — no point estimates read from the curve]
Endpoint: Event-free survival (local investigator assessment, ITT)
Neoadjuvant–adjuvant group | 154
Adjuvant-only group | 159
P: 0.004 (stratified log-rank)
Note: N taken from number-at-risk at time 0. No HR, medians or landmark rates printed in this figure crop.
[Slide 3]
CLINICAL/PATHOLOGIC STAGE | WORKUP | PRIMARY TREATMENT | ADJUVANT TREATMENT
Stage III (clinically positive node[s])ff
Workup:
• Core biopsy preferred or fine-needle aspiration (FNA). If needle biopsy is not possible, excisional biopsy is acceptable.
• Imagingp for baseline staging and to evaluate specific signs or symptoms
• BRAF mutation testinggg
Resectable nodal disease → Wide excision of primary tumort (category 1) + therapeutic lymph node dissection (TLND) or Neoadjuvant therapy, preferably in the context of a clinical trialtt,uu
→ Systemic therapy options:ll
• Preferred regimens
▸ Nivolumabnn (category 1)
▸ Pembrolizumabnn (category 1)
▸ Dabrafenib/trametinibss for patients with BRAF V600-activating mutation (category 1)
and/or
Locoregional therapy option:
• Consider RT to nodal basin in selected high-risk patients based on location, size, and number of involved nodes, gross and/or histologic extracapsular extensionww,xx (category 2B)
or
Observationll
→ See Follow-up (ME-10)
Unresectable/borderline resectable → See Unresectable pathway on ME-15uu,vv
[Slide 4]
CLINICAL STAGE | WORKUPgg | INITIAL TREATMENT | RESPONSE ASSESSMENT | SUBSEQUENT TREATMENT | ADJUVANT TREATMENT
Stage III (clinical satellite/in-transit)zz
Workup:
• Core biopsy preferred or FNA. If needle biopsy is not possible, excisional biopsy is acceptable.
• Imagingp for baseline staging and to evaluate specific signs or symptoms
• BRAF mutation testinggg
Limited resectable disease →
Neoadjuvant systemic therapyss,aaa,bbb,ccc (for regimens, see ME-6) → Complete excision to clear margins →
or
Complete excision to clear marginsddd → No evidence of disease (NED) → / Less than complete resection → See Initial Treatment for Unresectable/borderline resectable disease (ME-8)
Optionsll
• Systemic therapy optionsggg
▸ Preferred regimens
◊ Nivolumab (category 1)hhh
◊ Pembrolizumabhhh
◊ Dabrafenib/trametinibdd if BRAF V600 mutation positive
• Observation (ME-11)
or
Talimogene laherparepvec (T-VEC)/intralesional therapyeee
or
Systemic therapybbb (First-Line Therapy, MELSYS-1)ccc
→ Clinical assessment ± imagingfff to determine treatment response or progression →
Residual/progressive unresectable disease
Residual resectable disease → See Initial Treatment for Limited Resectable Disease (ME-7)
NED after local or regional therapy → Consider adjuvant systemic therapy options listed above (category 2B) or Observation (ME-11)
NED after systemic therapy → Observation (ME-11), (ME-J 2 of 4)
Unresectable/borderline resectable disease → ME-8
Note: All recommendations are category 2A unless otherwise indicated.
Clinical Trials: NCCN believes that the best management of any patient with cancer is in a clinical trial. Participation in clinical trials is especially encouraged.
Footnotes on ME-7A
ME-7
Melanoma
Cancer Immunology Research@CIR_AACR
Response data: LM103 TIL therapy in advanced melanoma: best change from baseline waterfall
Read this recently published research article, "LM103, an autologous tumor-infiltrating lymphocyte monotherapy, in patients with advanced melanoma resistant to standard therapy," by Chuanliang Cui, who is presenting a poster on this topic at #ESMO26. https://t.co/jFeso9yPhG https://t.co/u5DueufcCd
[Slide 1]
A
Percentage of the best change from baseline(%)
[Waterfall plot, y-axis -100 to 100, dashed lines at +20 and -30]
Patients (left to right) with best response labels:
H01006ME | PD
H01002ME | SD
H01012ME | SD
H01005ME | PD
H01015ME | SD
H01003ME | SD
H01010ME | SD
H01009ME | PR
H01004ME | PR
H01011ME | SD
H01008ME | SD
H01014ME | SD
H01013ME | SD
H01001ME | PR
Legend: Cutaneous | Acral | Mucosal | Unknown primary
爱母Q@Q34566201
1) Slide: Poster FPN2079P: multi-omic profiling of LM103 autologous TIL therapy in advanced melanoma (Cui, ESMO 2026) · 2) Slide: Poster FPN2079P LM103 TIL melanoma with presenter Chuanliang Cui (ESMO 2026)
🔥 Proud to see LM103 data at #ESMO26! Poster 2079P by Dr. Chuanliang Cui presents multi-omic profiling of our autologous #TIL therapy (LM103, BlueHorse) in advanced melanoma (n=14): bORR 57.1%, DCR 85.7%, mPFS 4.6mo, mOS 19.12mo.🧬✨
#TILtherapy #celltherapy #immunotherapy https://t.co/GdSQNYgBM6
[Slide 1]
Multi-omic profiling identifies determinants of clinical benefit in autologous TIL therapy (LM103) for advanced melanoma
Chuanliang Cui(1), Li Zhou(1), Xiaojun Cai(1), Haizhen Du(1), Xuan Wang(1), Yue Yang(1), Jiayong Liu(1), Zhichao Tan(1), Yongming Xue(2), Jun Guo(1), Yan Kong(1)
(1)Peking University Cancer Hospital & Institute, Beijing, China; (2) Suzhou BlueHorse Therapeutics Co., Ltd
FPN2079P
01 BACKGROUND
• Advanced melanoma in Asian populations has distinct biological features and limited benefit from standard therapies.
• LM103 is an autologous TIL therapy evaluated in patients with refractory disease.
Clinical cohort
n = 14
57.1% bORR | DCR 85.7%
4.6 mo MEDIAN PFS
19.12 mo MEDIAN OS
Data updated on 2026.09.30
QUESTION: Which intrinsic features of the infused TIL product are associated with longer PFS?
02 METHODS
• LM103 products from patients stratified by PFS (> median vs ≤ median)
• RNA-seq and ATAC-seq; differential testing with DESeq2
• Pathway interrogation by KEGG/GO GSEA and GSVA
03 MULTI-OMIC SEPARATION OF TIL PRODUCTS BY PFS
LONGER PFS IS ASSOCIATED WITH A DISTINCT TIL PRODUCT STATE.
[Panels A-D: PCA plots and volcano plots, PFS>median vs PFS<=median]
PFS>median open peaks | PFS<=median open peaks [ATAC-seq signal profiles]
ATAC-seq average profiles and heatmap centered on differential peaks, showing group specific chromatin accessibility patterns
Key multi-omic findings
9 genes upregulated / 7 downregulated in PFS > median TILs
Several hundred differentially accessible chromatin regions distinguish PFS groups
Interpretation: clinical benefit is linked to a product state consistent with enhanced tumour re-infiltration potential, rather than to baseline tumour features.
05 WORKING MODEL AND CLINICAL IMPLICATION
PFS > median TIL product -> CXCR6 / CCR6 + open chromatin -> Putative re-infiltration / persistence -> Clinical benefit
Trial registration: CTR20233999 | Funding: Study sponsored by Suzhou BlueHorse Therapeutics Co., Ltd.
Disclosure: Y. Xue are employees of Blue Horse Medical Technology
Correspondence: k-yan08@163.com
04 PATHWAY-LEVEL CONVERGENCE
CXCR6 / CCR6 expression and accessibility are higher in PFS> median group
[Panels F, G: GSEA-KEGG enrichment based on RNA-seq; GSEA-GO enrichment based on ATAC-seq — small print]
PFS > median
Cytokine–cytokine receptor interaction NES = 2.11, FDR = 0.000399
Cytokine Wilcoxon p = 0.0152
Cytokine / chemokine pathways are enriched in PFS>median group
PFS ≤ median
Glycolysis / Gluconeogenesis NES = -2.07, FDR = 0.0564
Glycolysis Wilcoxon p = 0.002
Glycolytic RNA program is enriched in PFS ≤ median TILs.
TAKE-HOME MESSAGE
• Autologous TIL therapy with LM103 showed manageable safety and encouraging antitumor activity.
• Clinical benefit was associated with sustained in vivo clonal persistence and upregulated genes favoring tumor re-infiltration of infused TILs.
[Slide 2]
Multi-omic profiling identifies determinants of clinical benefit in autologous TIL therapy (LM103) for advanced melanoma
Chuanliang Cui(1), Li Zhou(1), Xiaojun Cai(1), Haizhen Du(1), Xuan Wang(1), Yue Yang(1), Jiayong Liu(1), Zhichao Tan(1), Yongming Xue(2), Jun Guo(1), Yan Kong(1)
(1)Peking University Cancer Hospital & Institute, Beijing, China; (2) Suzhou BlueHorse Therapeutics Co., Ltd
FPN2079P
01 BACKGROUND
• Advanced melanoma in Asian populations has distinct biological features and limited benefit from standard therapies.
• LM103 is an autologous TIL therapy evaluated in patients with refractory disease.
Clinical cohort
n = 14
57.1% bORR | DCR 85.7%
4.6 mo MEDIAN PFS
19.12 mo MEDIAN OS
Data updated on 2026.09.30
QUESTION: Which intrinsic features of the infused TIL product are associated with longer PFS?
02 METHODS
• LM103 products from patients stratified by PFS (> median vs ≤ median)
• RNA-seq and ATAC-seq; differential testing with DESeq2
• Pathway interrogation by KEGG/GO GSEA and GSVA
03 MULTI-OMIC SEPARATION OF TIL PRODUCTS BY PFS
LONGER PFS IS ASSOCIATED WITH A DISTINCT TIL PRODUCT STATE.
[Panels A-D: PCA plots and volcano plots, PFS>median vs PFS<=median]
PFS>median open peaks | PFS<=median open peaks [ATAC-seq signal profiles]
ATAC-seq average profiles and heatmap centered on differential peaks, showing group specific chromatin accessibility patterns
Key multi-omic findings
9 genes upregulated / 7 downregulated in PFS > median TILs
Several hundred differentially accessible chromatin regions distinguish PFS groups
Interpretation: clinical benefit is linked to a product state consistent with enhanced tumour re-infiltration potential, rather than to baseline tumour features.
05 WORKING MODEL AND CLINICAL IMPLICATION
PFS > median TIL product -> CXCR6 / CCR6 + open chromatin -> Putative re-infiltration / persistence -> Clinical benefit
Trial registration: CTR20233999 | Funding: Study sponsored by Suzhou BlueHorse Therapeutics Co., Ltd.
Disclosure: Y. Xue are employees of Blue Horse Medical Technology
Correspondence: k-yan08@163.com
[Section 04 PATHWAY-LEVEL CONVERGENCE and Take-home message largely obscured by presenter standing in front of poster]
Secondary commentary
KOL infographics 18
Summary graphics that physicians, media and companies designed themselves (branded cards, redraws, watchlists and top-10 lists). They are commentary, not the presented data, so they sit here in compact form. Click a thumbnail to enlarge it on this page.
Melanoma 18
KOL infographic: Chart: hazard ratios for landmark adjuvant therapy trials incl. DFS HR 0.58
Mark Yarchoan@MarkYarchoan
INTerpath-001
Post text
Topline ESMO data from INTerpath-001 (#Moderna’s personalized cancer vaccine) reportedly leaked elsewhere: DFS HR 0.58
This hazard ratio puts it in the company of the most paradigm-changing adjuvant trials in oncology history: https://t.co/MPruTftgJO
[Slide 1]
Hazard ratios for landmark adjuvant therapy trials
Melanoma – INTerpath-001 (Pembro + Intismeran Autogene vs pembro) DFS — 0.58
Pancreatic – PRODIGE 24 (mFOLFIRINOX vs gemcitabine) DFS — 0.58
Colon – MOSAIC (FOLFOX vs 5-FU/LV) DFS — 0.77
Melanoma – KEYNOTE-054 (pembrolizumab vs placebo) RFS — 0.57
HER2+ breast – HERA (1 year trastuzumab after adjuvant chemotherapy vs observation) DFS — 0.54
[dot plot; x-axis: Hazard ratio, 0.5–1.0, dashed reference line at 1.0]
KOL infographic: Arabic AI-style graphic: personalized mRNA vaccine reduces melanoma
BASEM BAHRANI باسم البحراني@basemstat
INTerpath-001
Post text
💉لقاح mRNA شخصي يقلل خطر عودة سرطان الجلد أو الوفاة بنسبة 42%
📉 أعلنت شركتا Moderna و Merck نتائج تجربة INTerpath-001 من المرحلة الثالثة
📉 اختبرت التجربة لقاح Intismeran autogene المصمم خصيصاً وفق الطفرات الجينية لورم كل مريض بشكل شخصي بالإضافة إلى العلاج المناعي Pembrolizumab بعد الاستئصال الجراحي لسرطان الجلد الميلانيني عالي الخطورة
📉 شملت التجربة أكثر من 1,100 مريض
📉 النتيجة
🔹انخفاض الخطر النسبي Relative Hazard Reduction لعودة السرطان أو الوفاة 42%
🔹انخفاض الخطر النسبي للانتشار البعيد أو الوفاة
38%
🔹البقاء دون عودة السرطان مع العلاج المركب 82.2% و تمثل نسبة المرضى الذين بقوا دون عودة السرطان أو الوفاة خلال عامين
Recurrence-Free Survival
🔹البقاء دون عودة السرطان مع Pembrolizumab وحده 70%
📉 الأهمية السريرية:
يمثل هذا أول دليل من المرحلة الثالثة على فائدة سريرية للقاح سرطاني شخصي قائم على تقنية mRNA عند إضافته إلى العلاج المناعي
❗️النتائج مشجعة
انخفاض الخطر النسبي بنسبة 42% لا يعني انخفاض الوفيات وحدها بهذه النسبة
بيانات البقاء الكلي غير مكتملة و لم يحصل اللقاح بعد على الموافقات التنظيمية
https://t.co/Znw4S3Pl7Z
https://t.co/wGMx1VeKui
https://t.co/FXD240UPQd
[Slide 1]
لقاح mRNA شخصي
يقلل خطر عودة سرطان الجلد أو الوفاة بنسبة 42%
[vial label] mRNA Personalized Cancer Vaccine
[shield] ↓42%
[image of vial, syringe and pigmented skin lesion]
KOL infographic: Dr Mario Balsa / OncoAlert: Eight skin cancer trials to watch at ESMO 2026
Mario Balsa@MarioBalsaMD
INTerpath-001
Post text
🚨‼️ Saved this one for the start of #ESMO26!
If melanoma/skin cancer is your field, these are the 8 trials I think you really cannot miss in Madrid 💥
The studies, the timing, and why each one matters: all in one picture!
Your melanoma map for Madrid starts here🗺️ @OncoAlert
@OncoReporte @myESMO @_SEOM @GrupoMelanoma
[Slide 1]
ESMO CONGRESS 2026 · MADRID · 23–27 OCTOBER
MELANOMA & SKIN CANCER
Eight skin cancer trials to watch
Melanoma, cutaneous SCC and Merkel cell carcinoma: a personal shortlist of the studies most likely to change practice in Madrid.
[photo] Dr Mario Balsa
Skin Cancer Unit
Clínic Comprehensive Cancer Center Barcelona
NO. | TRIAL | SETTING | WHY IT MATTERS
01 | INTerpath-001 | LBA1 · Presidential Symposium | Sat 24 Oct, 16:30 · Long et al. | MELANOMA | Resected melanoma, stage IIB–IV (adjuvant) | Intismeran autogene (mRNA) + pembrolizumab vs pembrolizumab | Positive topline for RFS and DMFS (1,137 patients): the first phase III of an individualised neoantigen therapy. Watch the HR, the stage II subgroup and OS maturity.
02 | STARBOARD | 2071O | Fri 23 Oct, 16:15 · Schadendorf et al. | MELANOMA | First-line BRAF V600-mutant advanced melanoma | Encorafenib + binimetinib + pembrolizumab vs pembrolizumab | Phase III triplet, still under embargo. Can targeted therapy plus anti-PD-1 upfront finally beat anti-PD-1 alone? Toxicity will weigh as much as PFS.
03 | HBI-8000-303 | LBA54 | Fri 23 Oct, 16:25 · Khushalani et al. | MELANOMA | Advanced melanoma | Oral HDAC inhibitor + nivolumab vs nivolumab | Significant PFS gain (404 patients) with epigenetic priming of anti-PD-1. Watch the size of the gain, OS, and how it compares with LAG-3 and CTLA-4 combinations.
04 | TIL earlier | 2072O + LBA55 | Fri 23 Oct, 17:00 · Furness; Si et al. | MELANOMA | ICI-naïve advanced melanoma | Lifileucel + pembrolizumab (final) · GC101 TIL (randomised) | Cell therapy before anti-PD-1 failure. Can TIL earn a first-line role, and does the randomised signal hold with longer follow-up?
05 | NADINA | 2076RO | Sun 25 Oct, 11:14 · Witteveen et al. | MELANOMA | Stage III melanoma | Neoadjuvant ipilimumab + nivolumab vs adjuvant nivolumab | Three-year DMFS. After the EFS win, does the neoadjuvant advantage become fewer distant relapses? The bridge to an OS benefit.
06 | C-POST | LBA59 | Sun 25 Oct, 10:42 · Rischin et al. | CUTANEOUS SCC | High-risk cutaneous SCC (adjuvant) | Cemiplimab vs placebo | DFS benefit already published; now updated OS and ctDNA. Can ctDNA tell us who really needs adjuvant therapy?
07 | ADMEC-O | LBA60 | Sun 25 Oct, 10:47 · Becker et al. | MERKEL CELL | Merkel cell carcinoma (adjuvant) | Nivolumab · mature survival + biomarkers | After ADAM and STAMP missed their endpoints at ASCO26: is there a subgroup where adjuvant anti-PD-1 in Merkel still makes sense?
08 | MATISSE 2 | 2486RO | Sun 25 Oct, 10:52 · Van Dijk et al. | CUTANEOUS SCC | Cutaneous SCC facing extensive surgery | Neoadjuvant immunotherapy for organ preservation | Cure without mutilating surgery? Watch pathological response and how many patients avoid the operation.
OncoAlert360
MELANOMA 5 | CUTANEOUS SCC 2 | MERKEL CELL 1 · All times CEST
KOL infographic: / MADRID
Mustafa Özdoğan, MD@ozdogan_md
INTerpath-001KEYNOTE-975
Post text
I’m in Madrid, and #ESMO26 is underway!
Today’s watchlist, Madrid time: opening at 11:30, ESMO-MCBS and KEYNOTE-975 at 13:30, mRNA vaccines at 15:15.
INTerpath-001 is tomorrow. Which result will truly change practice? I’ll report from the congress. What are you watching? https://t.co/wzhxRhmqZ9
[Slide 1]
ESMO 2026 / MADRID
REPORTING FROM MADRID
ESMO 2026 / DAY ONE
LIVE CONGRESS NOTES
[MADRID 2026 ESMO congress logo]
MADRID • CONGRESS NOTES
MUSTAFA ÖZDOĞAN
MD · MADRID 2026
FRIDAY 23 OCTOBER MADRID TIME · CEST (UTC+2)
WHAT I'M FOLLOWING TODAY
11:30 OPENING SESSION
The scientific programme begins
13:30 //
ESMO-MCBS
How large must a benefit be to matter?
UPPER GI ORAL ABSTRACTS
KEYNOTE-975 on the agenda
15:15 mRNA VACCINES
Context ahead of Saturday's INTerpath-001 (LBA1)
I'M HERE IN THE HALLS
I'll share the results, absolute gains and clinical implications.
ESMO 2026 • Madrid • 23–27 October 2026 | drozdogan.com
ADJUVANT MELANOMA | ESMO 2026
INTerpath-001: How Much Benefit Are We Actually Adding?
Adding a personalised mRNA vaccine to pembrolizumab improved 2-year RFS from 70.0% to 82.2%.
Absolute gain: +12.2 percentage points | HR 0.58
Unlike earlier adjuvant trials against placebo or ipilimumab, this benefit was demonstrated on top of pembrolizumab.
⚠️ Cross-trial comparisons are not valid: populations, comparators and follow-up differ. OS benefit remains unproven.
The key question: Will this RFS advantage translate into improved long-term survival?
#MVOnco #ESMO2026 #INTerpath001 #Melanoma #CancerVaccine #Immunotherapy
[Slide 1]
INTerpath-001 | ESMO 2026
Personalised Vaccine. Fewer Recurrences.
MV Onco
01 THE TRIAL
[illustration: excised melanoma on arm]
Original melanoma
before excision
Completely resected
stage IIB-IV
cutaneous melanoma
1,137 patients
Phase III • Double-blind • Randomised 2:1
757 → Intismeran + pembrolizumab
380 → Placebo + pembrolizumab
02 WHAT & HOW OFTEN?
BOTH GROUPS
Pembrolizumab 400 mg IV
Every 6 weeks × 9 cycles
[IV bag label: IV Pembrolizumab 400 mg]
ADD-ON
Intismeran 1 mg or
matching placebo
INTRAMUSCULAR
Every 3 weeks × 9 doses
Pembrolizumab started at randomisation; vaccine/placebo began when available.
03 THE BENEFIT AT 2 YEARS
Intismeran + pembrolizumab vs placebo + pembrolizumab
RECURRENCE-FREE SURVIVAL
82.2% vs 70.0%
HR 0.58
+12.2 percentage points
DISTANT METASTASIS-FREE SURVIVAL
88.5% vs 80.2%
HR 0.62
+8.3 percentage points
Median follow-up: 24.6 months
04 THE MAIN ADDED SIDE EFFECTS
Intismeran + pembrolizumab vs placebo + pembrolizumab
FEVER
52.2% vs 8.2%
INJECTION-SITE PAIN
51.0% vs 9.5%
TAKE-HOME
✓ Better RFS and DMFS.
✓ More fever and injection-site pain.
✓ OS results not reported in this abstract.
[Slide 2]
INTerpath-001 | ESMO 2026
A PERSONALISED VACCINE.
FEWER RECURRENCES.
MV Onco
Original melanoma
— before excision
Melanoma completely removed
Stage IIB-IV • After surgery
[illustration: syringe labelled Intismeran + IV bag labelled Pembrolizumab → T cells attacking residual tumour cells]
Build tumour-specific immunity
T cells
Possible microscopic residual disease
Intismeran
Personalised mRNA vaccine
Pembrolizumab
RECURRENCE-FREE AT 2 YEARS
82.2% vs 70.0%
Intismeran + pembrolizumab Placebo + pembrolizumab
+12.2 percentage points
RFS HR 0.58
TAKE-HOME
• Better RFS and DMFS.
• OS benefit not yet established.
KOL infographic: evidence-notes summary card by (ESMO26 LBA1)
Mustafa Özdoğan, MD@ozdogan_md
INTerpath-001KEYNOTE-942
Post text
Twelve more patients in a hundred stay recurrence-free at 2 years — on top of pembrolizumab alone. INTerpath-001 (LBA1, #ESMO26): resected stage IIB–IV melanoma; intismeran autogene + pembrolizumab vs pembrolizumab (n=1,137).
Early release after embargo breach — confirm at PS I (Long). @ProfGLongMIA
[Slide 1]
drozdogan.com · Evidence Notes | #ESMO26 · LBA1
INTerpath-001
Resected stage IIB–IV melanoma · adjuvant setting
intismeran autogene + pembrolizumab versus pembrolizumab alone
⚠ Early release after embargo breach · confirm at Presidential Symposium I (Long)
STUDY DESIGN
Patients: 1,137 | Randomization: 2 : 1 | Median follow-up: 24.6 months | Presenter: Long
TREATMENT ARMS
Randomize
Investigational: Intismeran + pembrolizumab — Personalized mRNA neoantigen therapy
Control: Pembrolizumab alone — Standard adjuvant anti–PD-1 therapy
PRIMARY ENDPOINT · 24-month recurrence-free survival
Combination: 82.2%
Pembrolizumab: 70.0%
ABSOLUTE DIFFERENCE: +12.2 percentage points at 24 m[o — cut off]
RELATIVE EFFECT: Hazard ratio 0.58 · recurrence risk ↓ 42%
KEY SECONDARY · 24-month distant metastasis-free survival
88.5% versus 80.2% — +8.3 percentage points absolute
Hazard ratio 0.62 — 95% CI 0.45–0.85 · risk ↓ 38%
HAZARD RATIO · recurrence-free survival (intention-to-treat)
0.58 (95% CI 0.45–0.75)
[forest axis 0.4 0.6 0.8 1] ← favours intismeran + pembrolizumab
CONTEXT
First 6 months: Hazard ratio ≈ 1.0 — Then piecewise 0.42
Grade ≥3 events: 23.6% vs 20.3% — No new safety signal
Versus phase 2: Phase 3 ratio 0.58 — KEYNOTE-942 was ~0.51
HOW TO READ THIS
Relative recurrence risk ↓42% · absolute 24-month gain +12.2 points · treat ~8 to prevent 1 recurrence
Overall survival still immature · benefit appears after the immunization window.
Independent commentary · International Nonproprietary Names only · Confirm on presentation slides
@ozdogan_md
KOL infographic: KOL-made AI-style branded summary graphic
Mustafa Özdoğan, MD@ozdogan_md
Post text
🔥 THE RESULT IS IMPRESSIVE. THE COMPARATOR IS THE REAL QUESTION.
In BRAF V600 melanoma, upfront BRAF/MEK + anti–PD-1 delivered striking disease control.
But does beating anti–PD-1 monotherapy answer today’s first-line question?
Presented by Dirk Schadendorf.
#ESMO26 #Melanoma
[Slide 1]
ESMO 2026 | ABSTRACT 2071O | STARBOARD
THE TRIPLET LOOKS HUGE — BUT DID IT BEAT THE RIGHT CONTROL?
Can speed + immune durability coexist in BRAF V600 melanoma?
[Labels: Anti-PD-1 (pembrolizumab); BRAF inhibitor (encorafenib); MEK inhibitor (binimetinib)]
STUDY DESIGN
Untreated unresectable locally advanced or metastatic BRAF V600-mutant melanoma
Phase 3 | Double-blind | Placebo-controlled | n = 220 (110 per arm)
Pembrolizumab + Encorafenib + Binimetinib, n = 110 ← R → Pembrolizumab + Placebo, n = 110
KEY RESULTS
OBJECTIVE RESPONSE RATE: 70.0% vs 32.7%
MEDIAN PFS: 33.0 months vs 3.4 months; HR 0.33 (90% CI 0.24–0.46)
GRADE 3–4 ADVERSE EVENTS: 70.0% vs 39.1%
OVERALL SURVIVAL: Still immature. No OS benefit has been established.
HOW MIGHT THE TRIPLET WORK?
Fast tumor shrinkage with BRAF/MEK inhibition — Inhibition of MAPK pathway drive rapid tumor regression.
Durable anti-tumor immune response with anti-PD-1 — Anti-PD-1 may enhance and prolong immune-mediated control.
TWO STRATEGIES, ONE QUESTION
Sequential strategy: • Start with immunotherapy • Add targeted therapy at progression
Upfront triplet: • Target tumor and immune system together • Potential for deeper and faster responses
Which approach provides the best balance of efficacy, safety and long-term benefit?
EXPERT PERSPECTIVE
• Impressive improvement in PFS and response rate with the triplet.
• Comparator was anti-PD-1 monotherapy, not dual checkpoint inhibition.
• Control arm PFS was shorter than expected.
• The triplet is not yet standard of care.
• Mature OS data and longer follow-up are needed.
OVERALL SURVIVAL IS STILL IMMATURE — NO OS BENEFIT HAS BEEN ESTABLISHED.
drozdogan.com Source: ESMO 2026 • STARBOARD • Abstract 2071O
1) KOL infographic: MV Onco infographic: ESMO 2026 summary (RFS, DMFS, safety) · 2) KOL infographic: MV Onco infographic: Part 1 – question, mechanism, population · 3) KOL infographic: MV Onco infographic: Part 2 – 24-month RFS and DMFS results · 4) KOL infographic: MV Onco infographic: Part 3 – safety and clinical meaning
MV Chandrakanth@ChandrakanthMv
INTerpath-001
Post text
INTerpath-001 | ESMO 2026
Personalised vaccine. Fewer melanoma recurrences.
Four visuals covering the concept, trial design, efficacy and clinical meaning.
• WHO? 1,137 patients with completely resected stage IIB–IV cutaneous melanoma.
• WHAT? Personalised mRNA vaccine intismeran + pembrolizumab versus placebo + pembrolizumab.
• FEWER RECURRENCES: 2-year RFS 82.2% vs 70.0%—an absolute improvement of 12.2 percentage points. HR 0.58.
• LESS DISTANT SPREAD: 2-year DMFS 88.5% vs 80.2%. HR 0.62.
• SAFETY: More fever and injection-site pain. Grade ≥3 adverse events: 23.6% vs 20.3%.
• TAKE-HOME: Strong phase III evidence for personalised cancer vaccination. RFS and DMFS improved; OS results were not reported in this abstract.
Reference: Long GV et al. INTerpath-001. ESMO Congress 2026; Abstract LBA1. NCT05933577.
#MVOnco #ESMO2026 #Melanoma #CancerVaccines #Immunotherapy
[Slide 1]
INTerpath-001 | ESMO 2026
Personalised Vaccine. Fewer Melanoma Recurrences.
MV Onco
Original melanoma
— before excision
[illustration: excised melanoma lesion on forearm with surgical scar]
Completely resected
stage IIB-IV melanoma
1,137 patients
Randomised phase III
[illustration: IV bag (left arm); IV bag + syringe (right arm)]
Tumour sequencing
[illustration: DNA helix and sequence readout]
Personalised mRNA vaccine
Targets this patient's
tumour neoantigens
Pembrolizumab
+ placebo
Pembrolizumab
+ intismeran
70.0%
recurrence-free
at 2 years
+12.2
percentage points
in RFS
82.2%
recurrence-free
at 2 years
RFS HR 0.58
42% lower hazard
of recurrence or death
2-year DMFS:
88.5% vs 80.2%
Intismeran combination
vs control
More fever and
injection-site pain
Grade ≥3 AEs:
23.6% vs 20.3%
TAKE-HOME
• Better RFS and DMFS.
• Overall survival benefit not yet established.
Median follow-up: 24.6 months
[Slide 2]
INTerpath-001 | ESMO 2026
Part 1 – A Personalised Vaccine After Surgery?
MV Onco
01 — THE QUESTION
After complete melanoma surgery:
Can a personalised mRNA vaccine
reduce recurrence beyond pembrolizumab alone?
02 — HOW DOES IT WORK?
• Intismeran autogene
Personalised mRNA vaccine.
• Targets neoantigens unique to
each patient's tumour.
• Vaccine → builds tumour-specific T-cell responses.
• Pembrolizumab → releases the PD-1 brake.
03 — WHO WAS STUDIED?
• 1,137 adults
• Completely resected
stage IIB-IV cutaneous melanoma.
• Tumour tissue suitable for sequencing.
• Randomised 2:1 • Double-blind • Phase III
• 757 → Intismeran + pembrolizumab
• 380 → Placebo + pembrolizumab
04 — TREATMENT & ENDPOINTS
• BOTH GROUPS
Pembrolizumab 400 mg IV
every 6 weeks × 9 cycles.
• ADD-ON
Intismeran 1 mg IM or placebo
every 3 weeks × 9 doses.
• Pembrolizumab started first;
vaccine/placebo began when available.
• PRIMARY: Recurrence-free survival – RFS
• SECONDARY: DMFS • OS • Safety
[Slide 3]
INTerpath-001 | ESMO 2026
Part 2 – What Was the Benefit?
MV Onco
01 — THE ANALYSIS
• 1,137 randomised patients
• Median follow-up: 24.6 months
• Data cutoff: 30 June 2026
02 — FEWER RECURRENCES
24-month recurrence-free survival – RFS
Intismeran + pembrolizumab Placebo + pembrolizumab
82.2% 70.0%
HR 0.58 | 95% CI 0.45–0.75 p <0.001
42% lower hazard of recurrence or death.
03 — FEWER DISTANT METASTASES
24-month distant metastasis-free survival – DMFS
Intismeran + pembrolizumab Placebo + pembrolizumab
88.5% 80.2%
HR 0.62 | 95% CI 0.45–0.85 p =0.002
38% lower hazard of distant metastasis or death.
04 — TAKE-HOME
At 2 years, adding intismeran gave:
• +12.2 percentage points in RFS
• +8.3 percentage points in DMFS
• Both endpoints significantly improved.
• Overall survival results
were not reported in this abstract.
[Slide 4]
INTerpath-001 | ESMO 2026
Part 3 – Safety & Clinical Meaning
MV Onco
01 — COMMON SIDE EFFECTS
Intismeran + pembrolizumab vs placebo + pembrolizumab
• Fever: 52.2% vs 8.2%
• Injection-site pain: 51.0% vs 9.5%
• Fatigue: 38.5% vs 29.7%
02 — SEVERE EVENTS & STOPPING
Same treatment order as above.
• Grade ≥3 adverse events
23.6% vs 20.3%
• Both treatments stopped simultaneously
because of an adverse event
6.5% vs 5.3%
03 — WHAT REMAINS UNANSWERED?
• Overall survival results
not reported in this abstract.
• Long-term durability
needs longer follow-up.
• Personalised manufacturing,
turnaround and cost need consideration.
04 — TAKE-HOME
• Personalised vaccine + PD-1 blockade.
• Significantly better RFS and DMFS.
• More fever and injection-site pain.
• Strong phase III evidence
with potential to change practice.
KOL infographic: summary infographic (KOL-made): RFS, DMFS, safety, embargo
Mustafa Özdoğan, MD@ozdogan_md
INTerpath-001KEYNOTE-942
Post text
INTerpath-001 is one of those studies where the headline is only half the story.
The phase 3 result is clearly positive and reinforces the potential of personalized cancer vaccination in high-risk melanoma.
But the most interesting part may be what sits beneath the headline: the delayed separation of the curves, a less striking distant-metastasis signal than many expected, immature survival data and an unusual embargo breach that pushed the results into the public domain earlier than planned.
The market reaction was sharp, but that seems to say as much about inflated expectations as it does about the study itself.
A major step forward for personalized cancer vaccines but not a simple story.
#ESMO26 #Melanoma
[Slide 1]
INTerpath-001
Strong RFS, softer-than-hoped DMFS — and an embargo leak
Phase 3 adjuvant trial in resected high-risk cutaneous melanoma
ESMO Congress 2026 #ESMO26
1 What happened?
21:28 TRT — CNBC reports partial data before embargo.
21:37 TRT — Endpoints publishes follow-up coverage.
21:59 TRT — Companies release the official press statement.
ESMO response — Because the data became public, ESMO posted the abstract and lifted the full-dataset embargo. The oral presentation still goes ahead as LBA1 on Saturday, 17:30 TRT.
pharmaphorum reports an investigation; no formal sanction has been announced.
2 Study design
Phase 3, double-blind, placebo-controlled
Resected high-risk stage IIB–IV cutaneous melanoma
n=1,137 | 2:1 randomization
Arms: intismeran autogene + pembrolizumab vs placebo + pembrolizumab
Median follow-up: 24.6 months
Data cut-off: 30 June 2026
3 Key efficacy results (ITT)
RFS: HR 0.58 (95% CI 0.45–0.75) | p<0.001
24-month RFS: 82.2% vs 70.0%
Absolute gain: +12.2 points | NNT ≈ 9
DMFS: HR 0.62 (95% CI 0.45–0.85) | p=0.002
24-month DMFS: 88.5% vs 80.2%
Absolute gain: +8.3 points | NNT ≈ 13
24-month rates were reported in conference/news coverage; NNT is a rough estimate from Kaplan–Meier point differences.
4 Critical read
• No separation during the first 6 months of vaccination: RFS HR 0.99; DMFS HR 1.01
• After month 6, RFS HR 0.42 (0.30–0.58)
• A delayed effect is biologically plausible for a vaccine
• DMFS appears less impressive than in phase 2b KEYNOTE-942
• OS is immature. Merck says there is a positive trend.
• An OS HR 0.77, p=0.33 has been reported by ApexOnco, but this remains unconfirmed.
5 Safety
✓ Grade 3–5 TRAEs: 14.2% vs 13.4%
✓ No major excess severe toxicity
✓ Vaccine-related reactogenicity was common: fever 52% vs 8%; injection-site pain 51% vs 10%
Fever and injection-site pain rates were reported by KOL Pulse.
6 Market reaction
• Moderna fell as much as 25% intraday and closed -17.6%
• Merck fell about -1%
• Analysts suggest the selloff reflects inflated expectations more than a failed study
Bottom line: Phase 3 confirms a meaningful RFS benefit, but the lack of early separation and the softer-than-expected DMFS signal may temper enthusiasm.
Caution: Cross-trial comparisons with KEYNOTE-942 are limited by differences in population and follow-up.
Sources: Merck press release; ESMO Congress 2026 coverage; CNBC; Endpoints; pharmaphorum; KOL Pulse; ApexOnco (unconfirmed OS detail).
KOL infographic: MV Onco infographic: personalised mRNA vaccines – why adjuvant before metastatic
MV Chandrakanth@ChandrakanthMv
INTerpath-001
Post text
PERSONALISED mRNA VACCINES: Why Adjuvant Before Metastatic?
Generating neoantigen-specific T cells is only half the battle.
🟢 Adjuvant: Lower tumour burden, potentially favourable effector-to-target ratio.
🔴 Metastatic: Abnormal vasculature, stromal exclusion, immune suppression and antigen/HLA loss may limit tumour clearance.
The key: T-cell priming ≠ Tumour elimination.
INTerpath-001 explores the adjuvant approach. Biological rationale—not proof of superiority over metastatic vaccination.
Reference: Weber JS et al. Lancet. 2024;403:632–644. doi:10.1016/S0140-6736(23)02268-7.
#MVOnco #ESMO2026 #Melanoma #mRNAVaccine #Immunotherapy
[Slide 1]
PERSONALISED mRNA VACCINES
Why Adjuvant Before Metastatic?
The biological rationale behind INTerpath-001
MV Onco
[illustration: syringe → T cells]
Personalised mRNA vaccine
Vaccine → Neoantigen-specific T cells
Generating T cells is only the first step.
MICROSCOPIC DISEASE
[illustration: T cells attacking small tumour clusters]
Lower tumour burden
Potentially favourable effector-to-target ratio
Control disease before macroscopic outgrowth
GOAL: PREVENT RECURRENCE
ESTABLISHED TUMOUR
[illustration: tumour with vessels, stroma, MDSC, TAM labelled]
MDSC
TAM
Abnormal vessels + stroma can restrict T-cell entry
Suppressive microenvironment can impair T-cell function
Antigen / HLA loss can prevent recognition
PRIMING ALONE MAY BE INSUFFICIENT
TAKE-HOME
A vaccine can generate the response.
Tumour biology determines whether it succeeds.
Rationale—not proof of greater efficacy in adjuvant disease.
INTerpath-012 is investigating a personalised mRNA vaccine in metastatic melanoma.
KOL infographic: 'operation is step one of the drug' explainer graphic
Kevin Tay@KVTay316
INTerpath-001
Post text
Merck and Moderna's personalised mRNA melanoma vaccine (intismeran) plus pembrolizumab cut recurrence or death by 42% vs pembrolizumab alone in INTerpath-001: 1,137 patients, completely resected stage IIB–IV. 2-year recurrence-free 82.2% vs 70.0%. Overall survival not mature yet.
The detail surgeons should notice: each vaccine is built from that patient's own resected tumour, coding up to 34 neoantigens.
So the operation is no longer just the end of the cancer pathway. It's the first step in making the drug. How we handle the specimen, whether there's enough tissue, how fast it reaches sequencing: all of that now sits inside the treatment.
[Slide 1]
The operation is now step one of the drug
Tumour resected in theatre → Tissue sequenced → Personalised mRNA built (up to 34 neoantigens) → Given with immunotherapy after surgery
Phase 3 INTerpath-001, resected melanoma: 2-yr recurrence-free 82.2% vs 70.0%.
KOL infographic: MIZAR-003 GC101 TIL vs chemotherapy in PD-1-refractory melanoma — MedJ infographic
MedJ@MedJ0401
Post text
GC101 TIL cut the risk of progression or death by 56% versus chemotherapy in PD-1-refractory advanced melanoma, while OS remains immature.
At the European Society for Medical Oncology @myESMO Congress 2026, Prof. Lu Si of Peking University Cancer Hospital, directly affiliated with Peking University @PKU1898, reported extended MIZAR-003 follow-up (n=101).
📊 Median PFS: 4.4 vs 1.6 months (HR 0.44)
• ORR: 44.0% vs 8.2%; DCR: 68.0% vs 40.8%
• Benefit extended to acral and mucosal melanoma
• Grade ≥3 TRAEs: 42.0% vs 30.6%; no treatment-related deaths
The IL-2-free regimen offers a clinically meaningful option after PD-1 failure, but higher severe toxicity and immature OS make phase 3 confirmation essential.
🔗 Read the full article via the link in the comments below.
#MedJ #ESMO26 #Melanoma #TILTherapy #Immunotherapy #CellTherapy
[Slide 1]
MEDJ | ESMO 2026 HIGHLIGHTS PROF. LU SI
GC101 TIL Extends PFS in PD-1-Refractory Advanced Melanoma
Key Points:
1. Randomized pivotal phase 2 MIZAR-003 enrolled 101 patients across 25 Chinese centers.
2. IRC-assessed median PFS was 4.4 versus 1.6 months with chemotherapy (HR 0.44).
3. GC101 TIL achieved a 44.0% ORR, compared with 8.2% for chemotherapy.
4. PFS benefit extended to acral and mucosal melanoma, two difficult-to-treat subtypes.
5. Grade ≥3 TRAEs were 42.0% versus 30.6%; OS data remain immature.
MedJ ESMO
KOL infographic: Cancer Therapy Advisor key takeaways: HBI-8000 + nivolumab phase 3 in unresectable
CancerTherapyAdvisor@CancerTherAdvsr
Post text
The phase 3 HBI-8000-303 study presented at #ESMO26 by @DrKhushalani from @MoffittNews found HBI-8000 + nivolumab significantly improves PFS in unresectable advanced #Melanoma
Presented at @myESMO Congress 2026. Read more about this novel study🔽
https://t.co/rK3TS61leo https://t.co/pDcHPIDyxZ
[Slide 2]
ESMO Oct 23-27
1 HBI-8000 plus nivolumab significantly improves PFS in unresectable advanced melanoma, especially with normal LDH levels.
2 At 37 months median follow-up, median PFS was 11.66 months for HBI-8000 versus 7.36 months for placebo
3 ORR 41.4% compared to 32.3% with placebo
KEY TAKEAWAYS
Cancer Therapy Advisor
KOL infographic: Third-party infographic : Moderna x Merck personalized mRNA vaccine
XIT - Xcession Institute of Technology@theXITorg
Post text
🧬 DO CANCER VACCINES WORK?
Moderna + Merck's Landmark Phase 3 Trial Selected for ESMO's Presidential Symposium
1,137 Patients | Results Released October 22, 2026
Moderna and Merck have announced results from a large, randomized Phase 3 clinical trial investigating whether personalized mRNA cancer vaccines can help prevent cancer from returning.
🔬 THE TECHNOLOGY
The investigational vaccine, intismeran autogene (V940/mRNA-4157), is designed using the unique genetic mutations found in each patient’s tumor.
The goal? Teach the immune system to recognize and destroy cancer cells.
Researchers combined the personalized vaccine with Merck’s immunotherapy, pembrolizumab (Keytruda).
📊 THE HUMAN RESULTS
The study enrolled 1,137 adults with high-risk melanoma following surgery.
At two years:
🧬 82.2% estimated recurrence-free survival with the personalized vaccine + immunotherapy.
🧬 70.0% with immunotherapy alone.
🧬 12.2 percentage-point improvement in estimated recurrence-free survival.
The vaccine combination was also associated with a 42% lower relative hazard of recurrence or death during follow-up.
🧬How it works:
Tumor sequencing: Researchers analyze the patient's tumor to identify cancer-specific mutations.
Target selection: They select up to 34 neoantigens—abnormal protein fragments that may help the immune system recognize the cancer.
Personalized manufacturing: A unique mRNA vaccine is produced for that patient.
🤍 BUT WHAT ABOUT CHILDREN?
These results are from adults, not pediatric cancer patients.
However, personalized genetic vaccines are now being investigated in childhood cancers.
This technology introduces an important possibility: developing treatments around the specific genetic characteristics of each child’s cancer rather than relying solely on conventional treatment approaches.
At XIT, we believe breakthroughs in genetic medicine should not stop with adult cancers.
Children deserve access to the same innovation and scientific urgency.
Children deserve cures. 🧬🤍
https://t.co/RWPiH9aOnj
Links:
https://t.co/JUM80VsMjG
Clinical Trial:
https://t.co/53gnxqG2LH
#ChildhoodCancer #PediatricCancer #CancerVaccines #mRNAVaccine #Moderna #Merck #PrecisionOncology #Immunotherapy #PersonalizedMedicine #CancerResearch #GeneBasedTherapy #ChildrenDeserveCures #XITFoundation
[Slide 1]
PHASE 3 HUMAN RESULTS
RELEASED OCTOBER 22, 2026
Do Cancer Vaccines Work?
1,137 PATIENTS | PHASE 3 RANDOMIZED CONTROLLED TRIAL | HIGH-RISK MELANOMA
ESTIMATED 2-YEAR RECURRENCE-FREE SURVIVAL
% OF PATIENTS ALIVE WITHOUT CANCER RECURRENCE
[Bar chart, y-axis 0%-100%]
Personalized mRNA vaccine (intismeran autogene) + pembrolizumab: 82.2%
Pembrolizumab alone: 70.0%
12.2 PERCENTAGE POINT IMPROVEMENT AT 2 YEARS
42% LOWER HAZARD OF RECURRENCE OR DEATH
[Vial graphic] moderna × MERCK
Personalized mRNA Cancer Vaccine (intismeran autogene) + pembrolizumab
FAQ
About this page
What is on the ESMO 2026 Melanoma slides page?
The 48 Melanoma slide photos, abstract screenshots and data graphics plus 18 KOL-made infographics that oncologists, societies, media and companies posted on X from the ESMO 2026 embargo lift (October 22) through the congress in Madrid (October 23–27), compiled by KOL Pulse. Each card links to the original post and keeps the author's full text. It is one tumor-type page of the ESMO 2026 slide library: https://kolpulse.com/kol-pulse-esmo26-slides
Which Melanoma trials are covered?
Trials with their own slide groups, by number of slide posts: INTerpath-001 (23). Slides that compare several trials sit in a Cross-trial group, and slides not tied to a tracked trial come last. Physician posts come first in every group.
How do I filter by trial or KOL?
Use the trial chips in each section, the Trial menu (which also finds cross-trial slides that name that trial) and the KOL menu or the Built by avatars. Filters combine; counts only offer combinations that have results, and Clear filters or the Escape key resets. Every state has a shareable link, for example #tag=interpath001.
What are the OCR text and the source notes?
View OCR Text opens a verbatim transcription of the slide image; survival curves are captured as the printed numbers only, never read off the curve. Where it helps, a short context note gives the figures printed on the presented slide or abstract (for example, a different data cut or analysis). The author's caption is never edited.
Where are the other tumor types and the pre-congress archive?
Breast Cancer: https://kolpulse.com/kol-pulse-esmo26-slides-breast; Lung Cancer: https://kolpulse.com/kol-pulse-esmo26-slides-lung; GU Cancer: https://kolpulse.com/kol-pulse-esmo26-slides-gu; GI Cancer: https://kolpulse.com/kol-pulse-esmo26-slides-gi; Gyn Cancer: https://kolpulse.com/kol-pulse-esmo26-slides-gyn; Heme & Other: https://kolpulse.com/kol-pulse-esmo26-slides-other. Pre-congress previews, watchlists and top-10 lists: https://kolpulse.com/kol-pulse-esmo26-slides-archive
Can I use this page with my own AI assistant (NotebookLM, Perplexity, Claude, ChatGPT)?
Yes. Paste the page URL, or a filtered link, into your assistant and ask questions against it. Example prompt: "From the slide transcriptions on this page, list each trial's primary endpoint result with the hazard ratio and data cut exactly as printed on the slide, and the physician who posted it."
Compiled and reviewed by the KOL Pulse research team, led by Brian Shields, Founder, KOL Pulse. Last updated October 25, 2026. Every card links to its original post; slide text is a verbatim transcription.
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