Cancer Expert MD

The European Society for Medical Oncology congress, known as ESMO, is one of the two most important cancer meetings in the world. In 2026 it was held in Madrid from October 23 to 27, and the most important results were presented in three sessions called Presidential Symposia. This article explains, in plain language, the major results and what they mean for patients. These are new results presented at a congress, and approval of new treatments can take time.

Melanoma: A Personalized mRNA Vaccine

In the INTerpath-001 trial of 1,137 people whose melanoma had been removed by surgery, a vaccine made individually for each patient from the mutations in their own tumor was added to the immunotherapy drug pembrolizumab. It reduced the risk of the melanoma returning or death by 42 percent. At two years, 82.2 percent were free of recurrence, compared with 70.0 percent with pembrolizumab alone, and spread to distant organs was also reduced. It is too early to know whether it extends survival. Side effects from the vaccine were mainly short-lived fever, injection site pain and flu-like symptoms.¹ It is the first personalized cancer vaccine to succeed in a large phase 3 trial. See our article on melanoma.

Bladder Cancer: The VOLGA Trial

For people with muscle-invasive bladder cancer who cannot receive cisplatin, giving durvalumab with enfortumab vedotin before surgery, and durvalumab after, reduced the risk of death by 42 percent compared with surgery alone. At two years, 78 percent were alive, compared with 69 percent, and no cancer was left at surgery in 45 percent, compared with 10 percent. The trial was presented by Thomas Powles of Barts Cancer Institute in London.² See our article on bladder cancer.

Lung Cancer: Three Advances

Small cell lung cancer. In the DeLLphi-305 trial, adding tarlatamab, an immune therapy that links T cells to small cell lung cancer cells, to durvalumab maintenance after first treatment extended median survival to 21.1 months, from 12.7 months. At one year, 79 percent were alive, compared with 53 percent.³

KRAS G12C lung cancer. In the Krascendo 1 trial, the newer drug divarasib extended median survival to 17.7 months, compared with 12.0 months with the older drugs sotorasib or adagrasib, with tumors shrinking in 58 percent compared with 32 percent, and fewer serious side effects.⁴

EGFR lung cancer with MET changes, from China. In the SAFFRON trial, led by Shun Lu of Shanghai Chest Hospital, adding savolitinib to osimertinib after osimertinib stopped working extended median survival to 17.8 months, compared with 12.9 months with chemotherapy.⁵ See our article on lung cancer.

Prostate Cancer: The DASL-HiCaP Trial

For men with very high-risk prostate cancer treated with radiation and hormone therapy, adding darolutamide reduced the risk of the cancer spreading or death by 58 percent. At four years, 95 percent were free of spread, compared with 88 percent. It is too early to know whether it extends survival.⁶ See our article on prostate cancer.

Stomach Cancer, From China

In the CLARITY-Gastric01 trial, led by Rui-Hua Xu of Sun Yat-sen University Cancer Center in Guangzhou, sonesitatug vedotin, an antibody that carries chemotherapy to cancer cells with a protein called Claudin 18.2, doubled median survival in people receiving third-line or later treatment, to 10.0 months from 5.0 months.⁷ See our article on stomach cancer.

Bile Duct Cancer, From China

In the HARMONi-GI1 trial, led by Jian Zhou of Zhongshan Hospital in Shanghai, ivonescimab, a Chinese antibody that blocks both the PD-1 immune brake and the VEGF blood-vessel signal, was compared with the current standard, durvalumab, each given with chemotherapy. Ivonescimab extended median survival to 14.9 months, from 12.1 months, and tumors shrank in 53.8 percent, compared with 32.5 percent.⁸ See our article on bile duct and gallbladder cancer.

What This Means for Patients

Several of these advances depend on tumor testing, for KRAS G12C, EGFR, MET or Claudin 18.2, which is one more reason comprehensive testing matters. Some new treatments may be available through clinical trials or in other countries before they are approved in the United States. Also in October 2026, the FDA approved dostarlimab for mismatch repair-deficient rectal cancer, the immunotherapy that made the cancer disappear in every patient in the Memorial Sloan Kettering trial. See our articles on tumor DNA and RNA sequencing and rectal cancer.

Whether any of these new results may apply to your situation depends on your type of cancer, your tumor testing and your treatment so far. In a consultation, Dr. Silver, MD, educates you on the newest research and what it may mean for you. Request a consultation.

How Cancer Expert MD Helps

Cancer Expert MD provides education and consultation for people with every type and stage of cancer, and specializes in Stage IV and metastatic cancer. We follow the major cancer meetings and the newest research from around the world, and our book, The New Reality of Cancer, covers testing and treatment across all cancers.

Frequently Asked Questions

What is ESMO?

The European Society for Medical Oncology. Its yearly congress is one of the two most important cancer meetings in the world, where many major trial results are first presented.

What was the biggest news at ESMO 2026?

A personalized mRNA vaccine that reduced melanoma recurrence by 42 percent, along with major survival improvements in bladder, small cell lung, KRAS G12C and EGFR lung, stomach and bile duct cancer.

Are these new treatments available now?

Not all of them. Approval can take months or longer, and some may first be available through clinical trials or in other countries.

What is a personalized cancer vaccine?

A vaccine made individually for each patient from the mutations in their own tumor, which trains the immune system to recognize and attack that patient’s cancer.

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References

1. Long GV, et al. INTerpath-001: phase 3 study of intismeran autogene plus pembrolizumab vs pembrolizumab alone for adjuvant treatment of resected stage IIB–IV melanoma. ESMO Congress 2026, Madrid. Abstract LBA1.
2. Powles T, et al. Perioperative durvalumab with or without tremelimumab plus neoadjuvant enfortumab vedotin in muscle-invasive bladder cancer (VOLGA). ESMO Congress 2026, Madrid. Abstract LBA2.
3. Sands J, et al. Tarlatamab plus durvalumab as first-line maintenance therapy in extensive-stage small cell lung cancer (DeLLphi-305). ESMO Congress 2026, Madrid. Abstract LBA3.
4. Skoulidis F, et al. Krascendo 1: divarasib vs sotorasib or adagrasib in previously treated KRAS G12C-mutated NSCLC. ESMO Congress 2026, Madrid. Abstract LBA5.
5. Lu S, et al. Osimertinib plus savolitinib vs platinum-pemetrexed in EGFR-mutated, MET-overexpressed and/or amplified advanced NSCLC after osimertinib (SAFFRON). ESMO Congress 2026, Madrid. Abstract LBA6. Published simultaneously in the New England Journal of Medicine, 2026.
6. Niazi T, et al. Darolutamide with androgen deprivation therapy and radiation therapy for very high-risk prostate cancer (DASL-HiCaP). ESMO Congress 2026, Madrid. Abstract LBA4.
7. Xu RH, et al. Sonesitatug vedotin in previously treated Claudin 18.2-positive gastroesophageal carcinoma (CLARITY-Gastric01). ESMO Congress 2026, Madrid. Abstract LBA7.
8. Zhou J, et al. Ivonescimab plus chemotherapy versus durvalumab plus chemotherapy as first-line treatment for advanced biliary tract cancer (HARMONi-GI1). ESMO Congress 2026, Madrid. Abstract LBA8.

This article is for education only. It is not medical advice and does not diagnose or treat any condition. Cancer Expert MD has no financial relationship with any laboratory, drug maker, supplement company, clinic or hospital.