د.عبدالله علي الشرم @dralsharm

China keeps delivering new assets and studies, now in HER2+ gastric 🇨🇳 KC-WISE updated OS at #ESMO26. Double-blind phase 3 in HER2+ GC/GEJC after progression on trastuzumab: anbenitamab (biparatopic HER2 bispecific) + chemo vs placebo + chemo. • ORR 56 vs 14%
• mPFS 7.1 vs 2.7 mo
• mOS 19.6 vs 9.7 mo, HR Almost 20 months median OS in second line. The control arm is single-agent chemo, so the bar wasn't high. But the OS doubled, and that's hard to argue with. Takeaway: HER2 is still a target after trastuzumab. Sequential HER2 blockade works. The question I can't answer yet: HERIZON just moved zanidatamab to 1L. Once patients get a biparatopic up front, does a second one still work in 2L? Or does that spot go to T-DXd? Also, Should point out 20 months is significantly lower than what we saw on HERIZON which hit 26-27 month. @OncoAlert @TheGutOncLab

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#ESMO26 💊 RAMIRIS | Phase II/III 👥 317 taxane-pretreated GEA 🔀 FOLFIRI+Ram vs Pac+Ram ❌ Co-primary endpoints not met ⏳ OS: 8.7 vs 7.5 mo (HR 0.95) 🎯 ORR: 25.3% vs 22.6% ✅ PFS: 5.5 vs 3.7 mo (HR 0.70; p=.003) ⚠️ G≥3 AEs: 70% vs 68% 💡 PFS benefit without OS improvement @OncoAlert

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The KN905 MIBC trial includes a 3rd, less celebrated arm of single agent pembro. Results show pembro delivers an important contribution to the EVP. The trial is small and EVP performs better, but pCR rates for pembro of 35% are in the same range as neoadjuvant cisplatin chemo while EFS/OS HRs of 0.71/O.76 vs surgery are impressive. Pembro had about half the toxicity of EVP, underlining the relevance of therapy duration. VOLGA (3 cycles of EVD), is a half way between Pembro alone and 9 cycles of EVP. @Annals_Oncology #ESMO26 @Annals_Oncology @OncoAlert

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Encouraging OS results in neuroendocrine prostate cancer at #ESMO26! #KEYNOTE-365 evaluated pembrolizumab + carboplatin/etoposide vs chemotherapy alone. • mOS: 10.2 vs 7.1 months (HR 0.33) • rPFS: 5.1 vs 4.0 months (HR 0.66) • PD-L1 CPS ≥1: mOS 11.0 vs 4.8 months (HR 0.16) No new safety signals observed. @myESMO @oncoalert

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🚨⭐🟠 #ESMO26 GU Oncology Invited Discussion 🎤 Prof. Robert Jones 🇬🇧 @OncoAlert 🔬 Why did NIAGARA succeed while KEYNOTE-866 and ENERGIZE failed to meet their primary efficacy endpoints? 📊 EFS HR: ✅ NIAGARA: 0.68 ❌ KEYNOTE-866: 0.88 ❌ ENERGIZE: 0.94 🧩 Different populations, baseline risks, eligibility criteria and trial designs complicate comparisons. ⭐ MY POINT OF VIEW Different outcomes across trials do not establish superiority of PD-L1 over PD-1 blockade. 💡 In curative-intent MIBC, patient selection, endpoint definitions and absolute clinical benefit matter as much as the HR. Cross-trial comparisons generate hypotheses, not definitive conclusions. 🌍 GU Oncology Community @gbanna74 @ravikanesvaran @urologysummit @tompowles1 @PGrivasMDPhD @apolo_andrea @sonpavde @AndreaNecchi @drenriquegrande @DrYukselUrun @yekeduz_emre @cdanicas @ecancer @UrologyTimes @urotoday @wearemedsir @OpenMedicineHQ @UCSFCancer #BladderCancer #UrothelialCancer #GUOncology #ADC #ClinicalTrials

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Three important aspects worth emphasizing re SANO 5 yr update: (1) Current SOC is neoadj/periop chemo-IO in adeno; though pts whom are not candidates for aggressive chemo or non surgical candidates still need dCRT option. In these typically older pts who may only have 5-10 year life expectancy anyway, these OS results are still helpful in counseling pts. But agree, younger/fit adeno patients, would be highly concerned about this DMFS delta (but is this data even applicable in the MATTERHORN era??) (2) Insightful note here about RT dosing; would be curious to hear your thoughts @KrishanJethwa (3) Where’s the MMR stratification data??

Jeff Ryckman @jryckman3

a day ago

🚨SANO 5y: surveillance vs surgery after cCR OS 50% vs 54% (NS) Distant mets 46% vs 29% (P<.01) Reminder: only 41.4 Gy/23 fx, a pre-op, arguably non-definitive dose, especially with/ ~75% adenocarcinoma. Nonsignificant OS doesn't establish noninferiority. #ESMO26 #RadOnc

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#ESMO26 🚀 RASolute 302 | Phase III 👥 500 pts | Previously treated mPDAC 💊 Daraxonrasib (RAS(ON) inhibitor) vs chemo 📈 OS: 13.2 vs 6.7 mo (HR 0.40) 🧬 OS benefit by RAS genotype: 🔹 G12D: HR 0.49 🔹 G12V: HR 0.32 🔹 G12R: HR 0.61 📊 PFS: HR 0.55 (BICR) 🎯 ORR: 32% vs 11% 💡 new SOC! @OncoAlert

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#ESMO26 HERIZON-GEA-01 @myESMO @OncoAlert

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Daisuke Kotani, MD, Ph.D 小谷 大輔 @DaisukeKotani

23 hours ago

#ESMO26 | LBA79 Second interim analysis from Ph3 HERIZON-GEA-01 Overall survival ▪️Zani + chemo vs Tra + chemo: 22.9 vs 19.6 mo, HR 0.76, p=0.0088 ▪️Zani + Tis + chemo vs Zani + chemo: 27.0 vs 22.9 mo, HR 0.81, p=0.0502 @myESMO @OncoAler

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It hard to explain why 1 trial with gem/cis +/-PD(L)1 (NIAGARA) is +ve for EFS/OS and 2 very similar trials (presented today) are negative in MIBC. Potentially NIAGARA has the highest risk population, not all respond to IO and the maintenance phase the most effect- but the OS of gem/cis pembro HR of 1 is concerning. This reflects what we saw in metastatic disease with contradictory results for the big combination trials. Overall EVP looks better and more consistent #ESMO26 @myESMO @Annals_Oncology @OncoAlert

#ESMO26 G-HOPE-001 @myESMO @OncoAlert

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Daisuke Kotani, MD, Ph.D 小谷 大輔 @DaisukeKotani

23 hours ago

#ESMO26 | LBA77 G-HOPE-001: Ph3 Arcotatug tavatecan (CLDN-ADC) vs SoC in 3L+ CLDN18.2+ GEA ▪️PFS: 5.5 vs 2.9 mo, HR 0.47, p<0.0001 ▪️OS: 9.9 vs 7.4 mo, HR 0.63 ▪️ORR: 23.6% vs 5.3% @myESMO @OncoAlert

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KEYNOTE-975 phs-3 study: Pembrolizumab or placebo plus concurrent definitive chemoradiotherapy in E/GEJ cancer #ESMO26 #ESMOAmbassadors 👉 mEFS: 15.2 vs 14.7 mo 👉 mOS: 32 vs 35 mo 🧐disappointing, no benefit in all & CPS>10 pts @myESMO @ASCO

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#ESMO26 | LBA77 G-HOPE-001: Ph3 Arcotatug tavatecan (CLDN-ADC) vs SoC in 3L+ CLDN18.2+ GEA ▪️PFS: 5.5 vs 2.9 mo, HR 0.47, p<0.0001 ▪️OS: 9.9 vs 7.4 mo, HR 0.63 ▪️ORR: 23.6% vs 5.3% @myESMO @OncoAlert

ADJUVANT MELANOMA | ESMO 2026 INTerpath-001: How Much Benefit Are We Actually Adding? Adding a personalised mRNA vaccine to pembrolizumab improved 2-year RFS from 70.0% to 82.2%. Absolute gain: +12.2 percentage points | HR 0.58 Unlike earlier adjuvant trials against placebo or ipilimumab, this benefit was demonstrated on top of pembrolizumab. ⚠️ Cross-trial comparisons are not valid: populations, comparators and follow-up differ. OS benefit remains unproven. The key question: Will this RFS advantage translate into improved long-term survival? #MVOnco #ESMO2026 #INTerpath001 #Melanoma #CancerVaccine #Immunotherapy

ARION adds to the negative IO+CRT story in esophageal cancer. Durvalumab + FOLFOX/50 Gy in 25 fx: PFS HR 0.91 (95% CI 0.55-1.49), OS HR 0.99. Only 112 pts, mostly SCC. No demonstrated benefit from adding durva here. #ESMO26 #radonc cslide.ctimeetingtech.com/esmo2026/atten…

🚨SANO 5y: surveillance vs surgery after cCR OS 50% vs 54% (NS) Distant mets 46% vs 29% (P<.01) Reminder: only 41.4 Gy/23 fx, a pre-op, arguably non-definitive dose, especially with/ ~75% adenocarcinoma. Nonsignificant OS doesn't establish noninferiority. #ESMO26 #RadOnc #OncTwitter

#ESMO26 | LBA78 Long-term results from SANO: Active surveillance vs standard surgery after nCRT in EC ▪️5y-OS: 50% vs 54%, HR 1.17 (95% CI 0.77-1.77) ▪️DFS: HR 1.39 (95%CI 0.94-2.06) ▪️5y-distant mets: 46% vs 29%, p<0.01 👉Despite no significant OS or DFS differences, the wide CIs and significantly higher distant mets rate highlight important challenges for implementing active surveillance in clinical practice. Looking forward to the presentation! @myESMO @OncoAlert

🚨UNION Trial🚨 Locally advanced rectal cancer N=231 🔍Randomized 🔵Chemoradiation➡️2c CAPOX➡️TME➡️6c CAPOX 🟢SCRT➡️2c CAPOX + camrelizumab ➡️TME➡️6c CAPOX+ cam 🔥SCRT + chemo-IO demonstrated a whopping difference in EFS, 91% vs. 77%!!! #ESMO26

🚨 ESMO 2026 | SANO Trial (LBA78): 5-Year Result Active surveillance vs surgery (N=309) 🔹 5-year OS: 50% vs 54% (HR 1.17; 95% CI 0.77–1.77) 🔹 DFS: HR 1.39 (95% CI 0.94–2.06) 🔹 5-year distant metastases: 46% vs 29% (p<0.01) 🔹 43% in the surveillance arm were spared a non-beneficial oesophagectomy. An important organ-preservation strategy, but the higher distant metastasis rate is concerning. Would you recommend active surveillance over surgery for a patient achieving complete clinical response? #ESMO26 #EsophagealCancer #SANO @myESMO @NiuSanford @OncoAlert @OncBrothers

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🧬 NICHE-2 | Phase II | dMMR colon cancer 🇳🇱 👥 111 pts | Nivo + ipi → surgery 🎯 3-y DFS 100% 📈 5-y OS 100% 🩸 ctDNA clearance 82% pre-op ✅ All ctDNA− post-op ⚠️ Single-arm trial 💡 Remarkable long-term outcomes! 🔗 doi.org/10.1016/S0140-… @OncoAlert

🔥AGITG MASTERPLAN🔥 Borderline resectable or Locally advanced PDAC n=75 🔍Randomized 3m mFOLFIRINOX or Gem+nab-Paclitaxel alone +/- SBRT (40 Gy/5 fx) Primary endpoint: locoregional recurrence 🚨SBRT had improved: ✅12 m LRR: 20% vs. 50% ✅mOS 22m vs. 14 m #ESMO26