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KOL Reactions: Practice Changing…Or NOT — 10 ESMO26 Controversies Oncologists Debated on X

Brian Shields : Oct 29, 2026, 2:23:31 PM

At #ESMO26, oncologists didn’t just react to the big readouts — they argued, in public on X, about which trials actually change practice. In the spirit of Ripley’s Believe It or Not, KOL Pulse mapped 10 of those controversies: for each trial, the verbatim posts calling it a new standard of care… and the ones saying or NOT.

Infographic: Practice Changing…Or NOT at ESMO 2026. Verbatim physician posts on X for and against calling 10 trials a new standard of care: PERSEE, DeLLphi-305, TroFuse-005, VOLGA, INTerpath-001, KRASCENDO-1, PANKU-Lung01, HERON-Lung01, OptiTROP-Lung04 and FONTANA — Practice Changing…Or NOT: 10 ESMO 2026 trials, with verbatim physician posts on X calling each one a new standard of care, and the posts pushing back. Each quote below links to the original post.

All quotes are reproduced word for word from public posts on X; follow each link to read the original in context.

PERSEE Lung

Oncologists called PERSEE practice changing; others flagged the toxicity trade-off and urged individualization.

✅ New SOC — Julien Mazières (@JulienMazieres)

“Practise changing trial.”
— Julien Mazières (@JulienMazieres) · View post on X

✅ New SOC — Tom Newsom-Davis (@tnewsomdavis)

“Another practice changing result for lung oncology at #ESMO26: PERSEE trial”
— Tom Newsom-Davis (@tnewsomdavis) · View post on X

❌ …Or NOT — Gilberto Lopes (@GlopesMd)

“Better disease control, more toxicity. Individualize.”
— Gilberto Lopes (@GlopesMd) · View post on X

DeLLphi-305 Lung · ES-SCLC

Headshots of Christine Lovly, MD, Clive Peedell, MD and Julien Mazières, MD, the physicians quoted on DeLLphi-305 (extensive-stage small cell lung cancer) at ESMO 2026 — DeLLphi-305 (extensive-stage small cell lung cancer): physicians quoted in this discussion, Christine Lovly, MD, Clive Peedell, MD and Julien Mazières, MD.

Tarlatamab plus durvalumab maintenance drew "new SoC" calls, while the maintenance-vs-second-line question remained open.

✅ New SOC — Christine Lovly (@christine_lovly)

“Median OS almost 2 years in ES-SCLC with Tarlatamab+Durvalumab maintenance = practice changing!”
— Christine Lovly (@christine_lovly) · View post on X

✅ New SOC — Clive Peedell (@cpeedell)

“Tarlatamab + durvalumab as first-line maintenance in SCLC. New SoC.”
— Clive Peedell (@cpeedell) · View post on X

❌ …Or NOT — Julien Mazières (@JulienMazieres)

“Maintenance vs 2L tarlatamab will be discussed and we wait for data in frontline. Anyway DLL3 drugs are definitely changing thepronostic of SCLC.”
— Julien Mazières (@JulienMazieres) · View post on X

TroFuse-005 GYN · Endometrial

Headshots of Kathleen Moore, MD and Mali Barbi, MD, the physicians quoted on TroFuse-005 (endometrial cancer) at ESMO 2026 — TroFuse-005 (endometrial cancer): physicians quoted in this discussion, Kathleen Moore, MD and Mali Barbi, MD.

The same KOL post called the benefit meaningful and flagged toxicity as a concern.

✅ New SOC — Kathleen Moore (@DrKatyMoore)

“That is clinically meaningful and warrants use.”
— Kathleen Moore (@DrKatyMoore) · View post on X

✅ New SOC — Mali Barbi (@DrBarbiOnc)

“sac-TMT should become our second line after chemo-IO.”
— Mali Barbi (@DrBarbiOnc) · View post on X

❌ …Or NOT — Kathleen Moore (@DrKatyMoore) (same post)

“The tox is a concern. Stomatitis 57% (mostly low grade, needs prophylactic steroid mouthwash), ocular 31%, anemia 71%. Requires aggressive counseling and mitigation.”
— Kathleen Moore (@DrKatyMoore) · View post on X

VOLGA GU · Bladder

Headshots of Tom Powles, MD, Petros Grivas, MD and Niklas Klümper, MD, the physicians quoted on VOLGA (bladder cancer) at ESMO 2026 — VOLGA (bladder cancer): physicians quoted in this discussion, Tom Powles, MD, Petros Grivas, MD and Niklas Klümper, MD.

Tom Powles presented VOLGA and gave two takes: attractive for patients, but the tremelimumab add-on arm showed more is not always better. Petros Grivas called the benefit practice changing; Niklas Klümper cautioned against reading too much into cross-trial comparisons with KEYNOTE-905.

✅ New SOC — Tom Powles (@tompowles1)

“It’s likely to be attractive for patients.”
— Tom Powles (@tompowles1) · View post on X

✅ New SOC — Petros Grivas (@PGrivasMDPhD)

“Fantastic presentation by @tompowles1 @Uromigos on VOLGA trial showing practice changing EFS/OS benefit with neoadjuvant EV/durva ->RC ->durva vs no peri-op Tx in cisplatin-unfit pts with MIBC! Addition of treme (anti-CTLA4) with no extra benefit”
— Petros Grivas (@PGrivasMDPhD) · View post on X

❌ …Or NOT — Tom Powles (@tompowles1) (tremelimumab add-on arm)

“More is not always better.”
— Tom Powles (@tompowles1) · View post on X

❌ …Or NOT — Niklas Klümper (@niklas_kluemper) (cross-trial caution)

“Numerically lower EFS and pCR in VOLGA. Why? Different patient populations and tumor characteristics? Different study designs? It seems premature to attribute these differences to pembrolizumab vs durvalumab.”
— Niklas Klümper (@niklas_kluemper) · View post on X

INTerpath-001 Melanoma

The vaccine readout sparked "foundational shift" talk, while others questioned cross-trial comparisons and pointed to NADINA as the neoadjuvant bar.

✅ New SOC — Georgina Long (@ProfGLongMIA) (investigator COI)

“Having succeeded in melanoma, this proof of concept could mark the beginning of a foundational shift in how we treat cancer.”
— Georgina Long (@ProfGLongMIA) · View post on X

Disclosure: Georgina Long is an investigator on INTerpath-001.

✅ New SOC — Mario Balsa (@MarioBalsaMD)

“A clinically meaningful new mechanism, but the real question now is positioning”
— Mario Balsa (@MarioBalsaMD) · View post on X

❌ …Or NOT — Eric Whitman (@Melanoma_doctor) (participant COI)

“It is difficult to compare results between an adjuvant study and a neoadjuvant study (ie, S1801) in any cancer, including #melanoma.”
— Eric Whitman (@Melanoma_doctor) · View post on X

Disclosure: Eric Whitman is a participant on INTerpath-001.

⚖️ NADINA context (same card — positioning counterweight) — Eric Whitman (@Melanoma_doctor)

“Actually, neoadjuvant pembro is not necessarily the standard for resectable Stage III; based on the NADINA study and on clinical judgement, ipi/nivo combo neoadjuvant therapy is often used instead of single agent pembro.”
— positioning counterweight) — Eric Whitman (@Melanoma_doctor) · View post on X

Disclosure: Eric Whitman is a participant on INTerpath-001.

⚖️ NADINA context (also) — Yago Garitaonaindía (@YGaritaonaindia)

“🔥🎯 #ESMO26 NADINA, 3y update … 3y EFS 72.9% vs 50.0% | HR 0.42 … Read it next to the INTerpath-001 hype: in macroscopic stage III, adjuvant PD-1 alone is no longer the bar.”
— Yago Garitaonaindía (@YGaritaonaindia) · View post on X

KRASCENDO-1 Lung

Hailed as a new standard of care, with caution raised about the control arm and differences among KRAS G12C inhibitors.

✅ New SOC — Tom Newsom-Davis (@tnewsomdavis)

“A new standard of care arrives in advanced KRAS G12C NSCLC: Divarasib (Krascendo-1)”
— Tom Newsom-Davis (@tnewsomdavis) · View post on X

❌ …Or NOT — Narjust Florez (@NarjustFlorezMD)

“Not all KRAS G12C inhibitors are equal. … Cautiously optimistic, as most control patients received sotorasib.”
— Narjust Florez (@NarjustFlorezMD) · View post on X

PANKU-Lung01 Lung

Called a new SOC by some; others stressed the need for global validation of a China-only study.

✅ New SOC — Riyaz Shah (@DrRiyazShah)

“This looks like a new SOC I’d like to use in clinic.”
— Riyaz Shah (@DrRiyazShah) · View post on X

❌ …Or NOT — Tom Newsom-Davis (@tnewsomdavis)

“China-only studies needs global validation, as EGFR population different to rest of world”
— Tom Newsom-Davis (@tnewsomdavis) · View post on X

❌ …Or NOT — Gilberto Lopes (@GlopesMd)

“OS immature. China-only trial; global validation and optimal sequencing remain important.”
— Gilberto Lopes (@GlopesMd) · View post on X

HERON-Lung01 Lung

A potential new standard in EGFR-TKI resistant NSCLC, or not yet given toxicities.

✅ New SOC — Young Kwang Chae (@youngkwangchae)

“Positioning ruzaltatug rezetecan as a strong potential new standard of care in EGFR-TKI resistant NSCLC!”
— Young Kwang Chae (@youngkwangchae) · View post on X

❌ …Or NOT — Antonio Calles (@Tony_Calles)

“Significant toxicities. Not a SoC yet to me.”
— Antonio Calles (@Tony_Calles) · View post on X

OptiTROP-Lung04 Lung

Final OS results were called impressive; global validation and sequencing questions were raised.

✅ New SOC — Alfredo Addeo (@Alfdoc2)

“Impressive FINAL OS results from OptiTROP-Lung04 at #ESMO26!”
— Alfredo Addeo (@Alfdoc2) · View post on X

❌ …Or NOT — Estela Rodriguez (@Latinamd)

“Global validation and treatment-sequencing questions remain.”
— Estela Rodriguez (@Latinamd) · View post on X

❌ …Or NOT — Gilberto Lopes (@GlopesMd)

“Two important TROP2 ADC trials at #ESMO26 — but both conducted in China.”
— Gilberto Lopes (@GlopesMd) · View post on X

FONTANA GYN · Ovarian / PROC

Headshots of Kathleen Moore, MD and Mali Barbi, MD, the physicians quoted on FONTANA (platinum-resistant ovarian cancer) at ESMO 2026 — FONTANA (platinum-resistant ovarian cancer): physicians quoted in this discussion, Kathleen Moore, MD and Mali Barbi, MD.

Does the FRα biomarker matter at all? KOLs debated the signal versus current PROC standard of care and the exploratory design.

✅ New SOC — Kathleen Moore (@DrKatyMoore)

“ORR 48.1% in FRα ultralow/null, 57.1% low, 61.7% high. A gradient, yes. But the confidence intervals overlap , and nearly half of FRα-null tumors responded. So do we need a biomarker at all here?”
— Kathleen Moore (@DrKatyMoore) · View post on X

✅ New SOC / signal — Mali Barbi (@DrBarbiOnc) (2nd KOL)

“Torvutatug samrotecan (FRα, TOPO1 payload): ORR 48% in FRα ultralow/null, 57% low, 62% high, with overlapping CIs.”
“With TOPO1 payloads, the gate is falling. Nearly half of FRα-null tumors respond.”
— Mali Barbi (@DrBarbiOnc) · View post on X

❌ …Or NOT — Kathleen Moore (@DrKatyMoore)

“well we would say that right now optimal SOC for PROC is weekly taxane plus something (bev, bev + pembro if CPS>1, or relacorilant) and/or MIRV if FR alpha high.”
— Kathleen Moore (@DrKatyMoore) · View post on X

❌ …Or NOT — Mali Barbi (@DrBarbiOnc) (same post as YES)

“Exploratory and single arm. But the direction is consistent, and it is where the field should look next.”
— Mali Barbi (@DrBarbiOnc) · View post on X