ESMO 2026: Four Results You Can Act On Today

ESMO, the European Society for Medical Oncology, held its annual congress in Madrid on October 23-27, 2026. It is Europe's biggest cancer conference.

Most of what is announced there does not change anything for a patient today. This year is different.

Four results in lung cancer and melanoma each come with something concrete a patient or family member can do right now.

1. Small cell lung cancer: tarlatamab maintenance cut the risk of death by 58%

In the phase 3 DeLLphi-305 trial (563 patients), adding tarlatamab (Imdelltra) to durvalumab as maintenance after first-line treatment in extensive-stage small cell lung cancer extended median overall survival from 12.7 to 21.1 months (HR 0.42; 95% CI 0.32-0.54; p<0.001). Nearly 80% of patients on the combination were alive at one year, versus 53% on durvalumab alone. The benefit held in patients with brain metastases. Results were presented in the Presidential Symposium and published simultaneously in The New England Journal of Medicine (Amgen; trial record NCT06211036).

What you can do now: tarlatamab is already FDA-approved for small cell lung cancer that came back after earlier treatment, so it is a real drug your oncologist already knows. The first-line maintenance use is not approved yet - Amgen says it is engaging regulators - but trials in the DeLLphi program are still enrolling. You can search open studies on TrialFinder's lung cancer page.

Worth knowing: serious treatment-related side effects (grade 3 or higher) were more common with the combination (20.9% vs 10.8%). About half of patients had cytokine release syndrome, nearly all of it mild, with monitoring built into the protocol.

2. Melanoma: the first personalized mRNA vaccine to succeed in phase 3

In INTerpath-001 (1,137 patients with completely resected stage IIB-IV melanoma), adding the individualized mRNA vaccine intismeran (Moderna/Merck) to pembrolizumab reduced the risk of recurrence or death by 42% versus pembrolizumab alone (HR 0.58; 95% CI 0.45-0.75; p<0.001). Two-year recurrence-free survival: 82.2% vs 70.0% (Moderna; ESMO; trial record NCT05933577).

What you can do now: the vaccine is not approved anywhere. If you or a family member has had high-risk melanoma removed, ask the treating oncologist about individualized neoantigen vaccine trials, and search open studies on TrialFinder's melanoma page. Our full write-up of this result is here.

Worth knowing: in a prespecified sensitivity analysis, there was no benefit in the first six months (HR 0.99); the effect appeared after the vaccination series finished (HR 0.42). Overall survival data are not mature yet (HR 0.77, not significant). Moderna's reference to a possible 2027 approval is company forward-looking language, not a commitment.

3. KRAS-mutant lung cancer: a next-generation drug beat the approved ones head-to-head

In Krascendo 1 (338 patients with previously treated KRAS G12C-mutant NSCLC), divarasib beat the two currently approved KRAS inhibitors, sotorasib and adagrasib: median overall survival 17.7 vs 12.0 months (HR 0.56; 95% CI 0.41-0.78; p=0.0005), progression-free survival 9.8 vs 5.7 months, response rate 58.4% vs 32.3%, with fewer severe treatment-related side effects (24.6% vs 34.5%). Presented at ESMO and published simultaneously in The New England Journal of Medicine (MD Anderson; trial record NCT06497556).

What you can do now: divarasib itself is only available in clinical trials. Two things are actionable today: make sure the tumor has had full biomarker testing (KRAS G12C appears in roughly 14% of NSCLC, per MD Anderson), and if it carries KRAS G12C, ask the oncologist which option fits - the approved drugs exist now, and next-generation trials are open on TrialFinder's lung cancer page.

Worth knowing: this is a trial result, not an approval. Roche says it is engaging health authorities, but today the approved KRAS G12C inhibitors remain sotorasib and adagrasib.

4. After osimertinib stops working: a biomarker-defined next step

In the SAFFRON trial (338 patients), when EGFR-mutant lung cancer progressed on osimertinib and the tumor showed MET overexpression or amplification, adding the MET inhibitor savolitinib to osimertinib beat chemotherapy: median overall survival 17.8 vs 12.9 months (HR 0.68; 95% CI 0.50-0.91), progression-free survival 7.6 vs 5.4 months (ESMO presentation coverage). About 35% of patients whose tumors were tested for MET met the criteria.

What you can do now: this combination is not approved. The actionable step exists today: if EGFR-mutant lung cancer progresses on osimertinib, ask about re-biopsy and MET testing - that result is what opens the door to MET-directed trials, searchable on TrialFinder's lung cancer page.

Worth knowing: fatal adverse events occurred in 12 patients (7%) on the combination versus none on chemotherapy; one was judged treatment-related, and 9 of the 12 had documented disease progression. Grade 3 or higher treatment-related side effects were actually less common with the combination than with chemotherapy (40% vs 52%).

The pattern behind all four

None of these drugs reached patients through a headline. They reached them through a trial someone joined, and in three of the four cases the door to the relevant trial is a biomarker test: KRAS, MET, or a tumor sample for a personalized vaccine. If you take one thing from ESMO 2026: ask what testing has been done on the tumor, and what trials match the answers.