Six oncology papers from the past week
For healthcare professionals. Educational summaries of published literature; not patient-specific medical advice. Always consult the original publication. All six summaries below were written from the published abstract only — full text was not accessed.
First-line pembrolizumab versus carboplatin–paclitaxel in dMMR advanced or recurrent endometrial cancer (KEYNOTE-C93/GOG-3064/ENGOT-en15)
This open-label phase 3 trial at 122 centres in 24 countries randomized 299 adults with inoperable stage III/IV, persistent, advanced or recurrent mismatch repair-deficient (dMMR) endometrial cancer 1:1 to pembrolizumab 400 mg every 6 weeks (up to 18 cycles) or carboplatin plus paclitaxel (six 3-weekly cycles). Progression-free survival (blinded central review) and overall survival were dual primary endpoints. At the prespecified interim analysis, median PFS was 38.2 months (95% CI 17.9–not reached) with pembrolizumab versus 8.4 months (6.8–10.4) with chemotherapy — HR 0.57 (95% CI 0.42–0.79), p=0.0002. PFS was similar at 6 months (75% vs. 76%) before the curves separated (67% vs. 40% at 12 months; 53% vs. 30% at 36 months). 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 occurred in 18% versus 51%.
PFS HR 0.57 (95% CI 0.42–0.79), p=0.0002 · OS HR 0.77, not significant at interim · n=299
Limitation: interim analysis with immature overall survival, open-label design, and — as the authors note — the comparator was chemotherapy alone, not the current standard of immunotherapy plus chemotherapy.
Takeaway: supports single-agent pembrolizumab as a chemotherapy-free first-line option in dMMR endometrial cancer with substantially less toxicity; it has not been compared head-to-head with chemo-immunotherapy.
Slomovitz BM, et al. The Lancet. Published online 2026 Oct 26. Abstract only. PubMed · DOI 10.1016/S0140-6736(26)02095-7
Divarasib versus sotorasib or adagrasib in previously treated KRAS G12C-mutated NSCLC (Krascendo 1)
This international, open-label phase 3 trial compared divarasib, a next-generation oral KRAS G12C inhibitor (400 mg once daily), with a first-generation inhibitor (sotorasib 960 mg daily or adagrasib 600 mg twice daily) in previously treated KRAS G12C-mutated advanced NSCLC. 338 patients were randomized (167 divarasib; 171 control, of whom 156 received sotorasib and 15 adagrasib). At a median follow-up of 14.3 months, median PFS (blinded central review, primary endpoint) was 9.8 versus 5.7 months — HR 0.58 (95% CI 0.44–0.76), P<0.001. Median overall survival was 17.7 versus 12.0 months — HR 0.56 (95% CI 0.41–0.78), P<0.001. Confirmed response rate was 58.4% versus 32.3%, and grade 3–4 treatment-related adverse events were less frequent with divarasib (24.6% vs. 34.5%).
PFS HR 0.58 (95% CI 0.44–0.76) · OS HR 0.56 (95% CI 0.41–0.78), both P<0.001 · n=338
Limitation: open-label; the control arm was almost entirely sotorasib, so the comparison against adagrasib rests on only 15 patients; follow-up is relatively short.
Takeaway: the first phase 3 evidence that a next-generation KRAS G12C inhibitor improves both PFS and overall survival over first-generation agents, with less high-grade toxicity.
Skoulidis F, et al. N Engl J Med. Published online 2026 Oct 25. Abstract only. PubMed · DOI 10.1056/NEJMoa2605703
Tarlatamab plus durvalumab as first-line maintenance in extensive-stage small-cell lung cancer (DeLLphi-305)
This international, open-label phase 3 trial randomized 563 patients with extensive-stage SCLC without progression after initial chemoimmunotherapy to maintenance tarlatamab (a DLL3×CD3 bispecific T-cell engager) plus durvalumab (n=282) or durvalumab alone (n=281). Overall survival, measured from randomization at the start of maintenance, was the primary endpoint. At the prespecified interim analysis (median follow-up ~16 months), median OS was 21.1 months (95% CI 20.8–not estimable) versus 12.7 months (11.2–14.8) — HR 0.42 (95% CI 0.32–0.54), P<0.001. Median PFS was 7.4 versus 1.9 months (HR 0.34, 95% CI 0.28–0.42). Grade ≥3 adverse events occurred in 46.8% versus 40.6%; cytokine release syndrome, mainly grade 1–2, occurred in nearly half of patients receiving tarlatamab.
OS HR 0.42 (95% CI 0.32–0.54), P<0.001 · n=563
Limitation: open-label interim analysis with modest follow-up; applies only to patients who had not progressed after induction; cytokine release syndrome carries monitoring and logistic implications.
Takeaway: a large overall-survival gain for adding tarlatamab to maintenance durvalumab — potentially practice-changing in extensive-stage SCLC, pending longer follow-up and regulatory and guideline review.
Pérol M, et al. N Engl J Med. Published online 2026 Oct 24. Abstract only. PubMed · DOI 10.1056/NEJMoa2609482
Adjuvant mFOLFIRINOX versus mFOLFOX6 in high-risk stage III colon cancer (IROCAS)
This international academic phase 3 trial (PRODIGE, CCTG, GONO) randomized 795 patients with R0-resected stage III colon adenocarcinoma at high risk (pT4 and/or pN2) to 12 cycles of mFOLFIRINOX (n=398) or mFOLFOX6 (n=397). 52.8% had pT4 and 72.2% pN2 disease. At a median follow-up of 55 months, 3-year disease-free survival — the primary endpoint — was 65.6% versus 66.3% (HR 1.07, 95% CI 0.84–1.36; P=0.61). Overall survival is immature (3-year OS 91.2% vs. 86.7%; HR 0.85, 95% CI 0.61–1.21; P=0.37). Overall grade ≥3 adverse events were similar (62.2% vs. 62.1%), but the triplet caused more grade ≥3 diarrhoea (15.6% vs. 3.8%) and fatigue (7.3% vs. 1.8%) and required more G-CSF (37.8% vs. 19.1%).
3-year DFS HR 1.07 (95% CI 0.84–1.36), P=0.61 (not significant) · n=795
Limitation: overall survival data remain immature.
Takeaway: intensifying adjuvant chemotherapy to a triplet does not improve disease-free survival in high-risk stage III colon cancer; oxaliplatin-based doublets remain the standard.
Bennouna J, et al. Ann Oncol. Published online 2026 Oct 25. Abstract only. PubMed · DOI 10.1016/j.annonc.2026.10.104
Adjuvant cisplatin–gemcitabine versus capecitabine after resection of biliary tract cancer (ACTICCA-1/AIO-HEP-0112)
This investigator-initiated phase 3 trial at 67 sites in 8 countries randomized 591 patients after curative-intent resection of cholangiocarcinoma (intrahepatic, perihilar or distal) or muscle-invasive gallbladder carcinoma to 24 weeks of cisplatin plus gemcitabine (CisGem) or capecitabine. 47.9% were node-positive. At a median follow-up of 4.8 years, median disease-free survival (primary endpoint) was 25.7 months with CisGem versus 17.9 months with capecitabine, log-rank p=0.097. Because the proportional-hazards assumption was violated, the prespecified analysis used restricted mean survival time (RMST): CisGem gave on average 2.6 additional DFS months over 3 years (95% CI 0.6–4.68; p=0.011), with no significant overall-survival improvement (RMST p=0.076; median 58.1 vs. 48.2 months). Serious adverse events were more frequent with CisGem (130 vs. 113).
Median DFS 25.7 vs. 17.9 months, log-rank p=0.097 · RMST DFS gain 2.6 months (95% CI 0.6–4.68) · n=591
Limitation: non-proportional hazards make a single hazard ratio unavailable, and the log-rank and RMST analyses point in different directions; a heterogeneous mix of primary tumour sites.
Takeaway: the authors conclude CisGem should not replace capecitabine as adjuvant standard of care after resection of biliary tract cancer.
Stein A, et al. Ann Oncol. Published online 2026 Oct 24. Abstract only. PubMed · DOI 10.1016/j.annonc.2026.10.1278
Enzalutamide with ADT and radiotherapy in high-risk localized or locally advanced prostate cancer (ENZARAD, ANZUP 1303)
This open-label phase 3 trial randomized 802 men receiving definitive prostate radiotherapy plus 24 months of androgen deprivation therapy to enzalutamide 160 mg daily for 24 months or an older nonsteroidal antiandrogen (NSAA) for 6 months. Pelvic nodal radiotherapy was required for cN1 disease and optional for cN0. The primary endpoint was metastasis-free survival on conventional imaging (CT and/or bone scintigraphy). After a median follow-up of 92 months, 8-year MFS was 74% versus 72% — HR 0.88 (95% CI 0.67–1.15), P=0.34 — with no overall-survival improvement. In a prespecified subgroup receiving planned pelvic nodal radiotherapy (n=324), enzalutamide was associated with a possible MFS benefit (HR 0.47, 95% CI 0.29–0.76; adjusted P=0.004). Grade 3–5 adverse events were reported in 185 participants in each arm.
8-year MFS HR 0.88 (95% CI 0.67–1.15), P=0.34 (not significant) · n=802
Limitation: metastases assessed by conventional imaging only, not PSMA PET; the pelvic-nodal-radiotherapy subgroup finding is hypothesis-generating.
Takeaway: two years of enzalutamide in place of a short-course older antiandrogen does not improve metastasis-free or overall survival at 8 years when added to radiotherapy and 24 months of ADT.
Williams S, et al. J Clin Oncol. Published online 2026 Oct 24. Abstract only. PubMed · DOI 10.1200/JCO-26-01794
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.