Two antibody-drug conjugates in platinum-resistant ovarian cancer drew the most physician discussion of the gynecologic cancer readouts in Madrid. Both showed responses across levels of their target antigen. Breast and gynecologic oncologist Mali Barbi wrote: “With TOPO1 payloads, the gate is falling.” Gynecologic oncologist Kathleen Moore asked: “So do we need a biomarker at all here?” In endometrial cancer, NRG-GY020 was negative and DUO-E’s overall survival update did not reach significance; physicians were still discussing DUO-E on October 25. Below are seven trials ranked by physician posts, each with a presented slide and physician posts quoted in full, then the sessions still ahead on October 25–27, including TroFuse-005 and KEYNOTE-C93.
Physician posts on X, October 23–25.
| # | Trial | Physician posts | Physicians posting |
|---|---|---|---|
| 1 | BEHOLD-1 (mocertatug rezetecan) | 5 | 3 |
| 1 | DUO-E | 5 | 3 |
| 3 | NRG-GY020 | 5 | 2 |
| 4 | INCB123667 + bevacizumab | 3 | 2 |
| 5 | FONTANA (torvutatug samrotecan) | 2 | 2 |
| 6 | DENALI (GOG-3066) | 2 | 1 |
| 7 | KEYNOTE-B21 ctDNA analysis | 1 | 1 |
Physician discussion of gynecologic cancer data on X has been concentrated: Kathleen Moore wrote about half of the posts above, in threads on each readout. Two of the highest-profile endometrial trials, TroFuse-005 and KEYNOTE-C93, have not been presented yet (see What’s yet to come). Two other October 24 readouts, both presented by Ana Oaknin, drew little physician discussion on X: REJOICE-Ovarian02, raludotatug deruxtecan plus bevacizumab (posts), and the BEATcc final overall survival analysis in cervical cancer (posts).
Mocertatug rezetecan (Mo-Rez, GSK) is a B7-H4-directed antibody-drug conjugate with a topoisomerase I payload. Updated BEHOLD-1 results with longer follow-up (LBA41, Vanda Salutari) and a translational biomarker analysis (1248RO, Stephanie Lheureux) were presented on October 24; Camilla Nero was the discussant. Mo-Rez is investigational; the Phase 3 BEHOLD-Ovarian01 trial is enrolling.
Physicians agreed that responses were seen across B7-H4 expression levels. The discussion was about what predicts response instead: linker cleavage and payload sensitivity rather than antigen level. Kathleen Moore also flagged the neutropenia that comes with the higher dose.
Torvutatug samrotecan (Torvu-Sam, AZD5335, AstraZeneca) is a folate receptor alpha (FRα)-directed ADC with a topoisomerase I payload. Funda Meric-Bernstam presented updated FONTANA results on October 24 (1245RO); Philipp Harter was the discussant. The conclusions slide lists three Phase 3 ovarian cancer trials: TREVI-OC-01, TREVI-OC-02 and TREVI-OC-03. Torvu-Sam is investigational.
Both physicians who posted noted activity across FRα expression levels. They read it differently: one asked whether a biomarker is needed at all; the other concluded that all patients with platinum-resistant disease can benefit.
INCB123667 (Incyte) is an oral selective CDK2 inhibitor, tested with bevacizumab in recurrent ovarian cancer. Domenica Lorusso presented the platinum-resistant cohort (1241RO, October 23); Iain McNeish discussed it with DENALI. INCB123667 is investigational.
Physicians noted the single-arm design and asked how patients should be selected: by cyclin E1 overexpression on IHC or by CCNE1 amplification.
DENALI Part 1b tested azenosertib, an oral WEE1 inhibitor, in platinum-resistant ovarian cancer and reported overall survival by cyclin E1 status (1242RO, Fiona Simpkins, October 23). Azenosertib is investigational. One physician posted about it: Kathleen Moore, in the same thread as INCB123667.
Kathleen Moore’s thread weighed the overall survival result against how cyclin E1 status was assigned, then turned to tolerability: dose interruptions, reductions and discontinuations.
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NRG-GY020 (1239O, NRG Oncology/NCI) is a Phase 3 trial of adjuvant radiotherapy with or without pembrolizumab in stage I–II, high-intermediate-risk dMMR endometrioid endometrial cancer. It did not meet its primary endpoint. A ctDNA analysis of KEYNOTE-B21 (pembrolizumab with adjuvant chemotherapy in high-risk dMMR disease) was presented in the same session. Vicky Makker was the invited discussant for both and for DUO-E. Adjuvant pembrolizumab is investigational in these settings.
Physicians agreed the primary endpoint was negative. They disagreed on what that means: one kept radiotherapy alone as his default; another questioned whether the trial was designed to detect a realistic effect. On KEYNOTE-B21, the question was whether postoperative ctDNA can select patients, and whether a negative test is reliable enough to drive de-escalation.
DUO-E (LBA37, Shannon Westin; AstraZeneca) is a Phase 3 trial of carboplatin-paclitaxel plus durvalumab, followed by durvalumab with or without olaparib maintenance, in advanced or recurrent endometrial cancer. The trial met its PFS endpoints earlier. At this interim analysis, the overall survival difference did not reach statistical significance. In the US, durvalumab with chemotherapy followed by durvalumab is FDA approved for dMMR disease. In the EU, the olaparib combination is approved for pMMR disease and durvalumab alone for dMMR disease.
Physicians agreed the OS difference was not statistically significant at this analysis. They split on the olaparib question: one pointed to a numerical benefit in pMMR disease, another concluded the approach belongs only in dMMR disease, and a third asked whether added PFS justifies added toxicity.
On October 25, discussion continued with a comparison of the overall survival results from three first-line endometrial cancer trials: NRG-GY018, RUBY and DUO-E.
The top physicians in the gynecologic cancer tab of the ESMO 2026 KOL leaderboard, with one line each in their own words and the trial it is about.
Gynecologic cancer sessions still ahead. Times are Madrid time.
| When | Session | Trial or talk | Speaker |
|---|---|---|---|
| Sun Oct 25, 14:45–16:15 | Educational session: Cervical cancer: From prevention to optimal therapy (Bilbao Auditorium, Hall 3) | Challenges of prevention and screening (14:45); locally advanced disease: current and future options for improving survival (15:05); optimal systemic therapy for persistent, recurrent or metastatic disease (15:25); new developments in systemic therapy beyond CPIs (15:45) | Angelica N. Rodrigues; Domenica Lorusso; Ana Oaknin; Jung-Yun Lee; chairs Ana Oaknin, Christian Marth |
| Mon Oct 26, 08:30–10:00 | Special symposium: Navigating the wave of new therapies in gynaecologic cancers (Barcelona Auditorium, Hall 9) | DNA damage repair inhibition in ovarian cancer (08:30); new immunotherapy treatments and combinations (08:50); ADCs in gynaecological cancers (09:10); monitoring tumour response (09:30) | Charlie Gourley; Kathleen N. Moore; Toon Van Gorp; Pierre Laurent-Puig |
| Mon Oct 26, 10:15–11:30 | Multidisciplinary session: Optimal management of high-grade serous ovarian cancer with BRCA mutation (Cadiz Auditorium) | Surgery and first-line systemic therapy (10:20); oligoprogression (10:40); systemic therapy for recurrence during PARPi (11:00) | Sven Mahner; Remi Nout; Ilaria Colombo |
| Mon Oct 26, 17:18–17:42 | Presidential Symposium III (Alicante Auditorium, Hall 6) | LBA11 TroFuse-005: sacituzumab tirumotecan in previously treated advanced or recurrent endometrial cancer (posts) | Domenica Lorusso; discussant Joyce F. Liu |
| Mon Oct 26, 17:42–18:06 | Presidential Symposium III (Alicante Auditorium, Hall 6) | LBA12 KEYNOTE-C93: first-line pembrolizumab vs carboplatin-paclitaxel in dMMR advanced or recurrent endometrial carcinoma (posts) | Brian M. Slomovitz; discussant Christian Marth |
| Tue Oct 27, 10:20–10:40 | Scientific Congress Highlights 2 (Barcelona Auditorium, Hall 9) | Gynaecological cancers highlights | Antonio González-Martín |
Physician reactions to TroFuse-005 and KEYNOTE-C93 will appear on the ESMO 2026 trials page as they are posted.
Which gynecologic cancer trials did physicians discuss most at ESMO 2026?
By physician posts on X on October 23-25, the most discussed were BEHOLD-1 (mocertatug rezetecan), DUO-E and NRG-GY020, followed by INCB123667 plus bevacizumab, FONTANA (torvutatug samrotecan), DENALI (azenosertib) and the KEYNOTE-B21 ctDNA analysis.
Are mocertatug rezetecan and torvutatug samrotecan approved?
No. Both antibody-drug conjugates are investigational. Phase 3 trials are under way or planned: BEHOLD-Ovarian01 for mocertatug rezetecan and the TREVI-OC trials for torvutatug samrotecan.
What did DUO-E show at ESMO 2026?
The updated overall survival analysis did not reach statistical significance at this interim analysis. Durvalumab with chemotherapy followed by durvalumab is FDA approved for dMMR advanced or recurrent endometrial cancer; the olaparib combination is approved in the EU for pMMR disease.
Did NRG-GY020 show a benefit for adjuvant pembrolizumab?
No. Adding pembrolizumab to adjuvant radiotherapy in stage I-II high-intermediate-risk dMMR endometrial cancer did not meet the primary endpoint. Physicians on X debated whether the trial was designed to detect a realistic effect.
When are TroFuse-005 and KEYNOTE-C93 presented?
Both are in Presidential Symposium III on Monday, October 26, in Madrid: TroFuse-005 (LBA11, Domenica Lorusso) at 17:18 and KEYNOTE-C93 (LBA12, Brian M. Slomovitz) at 17:42.
KOL Pulse tracks what oncologists post on X. Posts quoted here are shown in full, verbatim, and link to their source.
Brian Shields
