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.
All quotes are reproduced word for word from public posts on X; follow each link to read the original in context.
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
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
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
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
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
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
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
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
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
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
These 10 debates are just a slice. KOL Pulse has full ESMO26 tumor blogs and the complete conference dataset of oncologist reactions.
See the KOL Pulse ESMO26 conference hub →