ESMO 2026: four Presidential Symposium trials to know
For healthcare professionals. Educational summaries of published literature; not patient-specific medical advice. Always consult the original publication. All four trials below were presented as late-breaking abstracts in the ESMO 2026 Presidential Symposia and published simultaneously; figures are taken from the published abstracts only — full text was not accessed. Session and LBA numbers are from post-congress news coverage, linked under each entry.
DeLLphi-305: tarlatamab plus durvalumab as first-line maintenance in extensive-stage SCLC
563 patients without progression after first-line chemoimmunotherapy were randomized to maintenance tarlatamab (DLL3×CD3 bispecific T-cell engager) plus durvalumab or durvalumab alone. At the interim analysis, median overall survival was 21.1 versus 12.7 months (HR 0.42, 95% CI 0.32–0.54; P<0.001) and median PFS 7.4 versus 1.9 months (HR 0.34). Grade ≥3 adverse events: 46.8% versus 40.6%; cytokine release syndrome, mostly grade 1–2, in nearly half of tarlatamab-treated patients.
OS HR 0.42 (95% CI 0.32–0.54), P<0.001 · n=563
Why it stood out: one of the largest overall-survival gains reported in extensive-stage SCLC maintenance. Open-label interim data; CRS monitoring will shape implementation. Full landmark-trial entry →
Pérol M, et al. N Engl J Med. Published online 2026 Oct 24. PubMed · DOI 10.1056/NEJMoa2609482 · Session: Targeted Oncology recap
KRAScendo 1: divarasib versus sotorasib or adagrasib in previously treated KRAS G12C-mutated NSCLC
338 patients were randomized to the next-generation KRAS G12C inhibitor divarasib or a first-generation inhibitor (156 of 171 control patients received sotorasib, 15 adagrasib). Median PFS was 9.8 versus 5.7 months (HR 0.58, 95% CI 0.44–0.76) and median overall survival 17.7 versus 12.0 months (HR 0.56, 95% CI 0.41–0.78), both P<0.001. Confirmed response rate 58.4% versus 32.3%; grade 3–4 treatment-related adverse events 24.6% versus 34.5%.
PFS HR 0.58 · OS HR 0.56, both P<0.001 · n=338
Why it stood out: a head-to-head win over an active, approved targeted-therapy comparator, including overall survival, with less high-grade toxicity. The adagrasib comparison rests on only 15 patients.
Skoulidis F, et al. N Engl J Med. Published online 2026 Oct 25. PubMed · DOI 10.1056/NEJMoa2605703 · Session: news coverage (LBA5, Oct 25)
TroFuse-005/ENGOT-en23/GOG-3095: sacituzumab tirumotecan versus physician's choice in previously treated endometrial cancer
776 patients with advanced or recurrent endometrial carcinoma or carcinosarcoma, previously treated with platinum-based chemotherapy and anti-PD-(L)1 therapy (up to three prior lines), were randomized at 242 centres in 31 countries to the TROP2-directed antibody–drug conjugate sacituzumab tirumotecan or doxorubicin/paclitaxel. Median PFS was 7.2 versus 3.9 months (HR 0.59, 95% CI 0.50–0.70; p<0.0001) and median overall survival 19.0 versus 12.1 months (HR 0.68, 95% CI 0.55–0.84; p=0.0001). Grade ≥3 adverse events: 69% versus 57%; treatment-related deaths <1% in each arm.
PFS HR 0.59 · OS HR 0.68 (95% CI 0.55–0.84) · n=776
Why it stood out: both dual primary endpoints met after chemotherapy and immunotherapy, a setting with few effective options; the authors propose it as a new standard of care. More grade ≥3 toxicity than chemotherapy; open-label with median follow-up 14 months.
Lorusso D, et al. The Lancet. Published online 2026 Oct 26. PubMed · DOI 10.1016/S0140-6736(26)02099-4 · Session: Targeted Oncology recap
KEYNOTE-C93/GOG-3064/ENGOT-en15: first-line pembrolizumab versus carboplatin–paclitaxel in dMMR endometrial cancer
299 patients with advanced or recurrent mismatch repair-deficient endometrial cancer were randomized to pembrolizumab monotherapy or carboplatin plus paclitaxel. Median PFS was 38.2 versus 8.4 months (HR 0.57, 95% CI 0.42–0.79; p=0.0002); overall survival did not meet its significance threshold at this interim (HR 0.77, 95% CI 0.52–1.15; p=0.10). Grade ≥3 treatment-related adverse events: 18% versus 51%.
PFS HR 0.57, p=0.0002 · OS HR 0.77, not significant at interim · n=299
Why it stood out: a chemotherapy-free first-line option with far less toxicity. The comparator was chemotherapy alone, not today's standard chemo-immunotherapy — the presenter stressed the trial does not show equivalence to that combination. Longer summary in this week's research digest →
Slomovitz BM, et al. The Lancet. Published online 2026 Oct 26. PubMed · DOI 10.1016/S0140-6736(26)02095-7 · Session: Targeted Oncology recap
Last reviewed: November 1, 2026
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Independent summaries of published abstracts. Not affiliated with or endorsed by the authors or journals. Data as published; verify against the original article before clinical use.