Top 5 Takeaways From ESMO 2026 That Patients Should Know

The European Society for Medical Oncology (ESMO) Congress 2026, one of the world's largest cancer meetings, took place Oct. 23-27 in Madrid. Some of the biggest news came from phase 3 trials, the large studies that compare a new approach with the current standard of care and are often what leads to new approvals. Here are five results that people living with cancer and their caregivers should know about, explained in plain terms, with who each one applies to and what it means for treatment today.

A quick note before you read: most of these treatments are not yet approved by the U.S. Food and Drug Administration (FDA) for the uses tested, and some results have been presented at the meeting but not yet published in a medical journal. You will also see the word "median" below. A median survival of 12 months means half the people in that group lived longer than 12 months and half did not.

1. Small Cell Lung Cancer: Adding Imdelltra Helped Patients Live Longer

Who it's for: People with extensive-stage small cell lung cancer, meaning the cancer has spread beyond one side of the chest, whose cancer did not grow during their first treatment with chemotherapy and Imfinzi (durvalumab). After that first treatment, many patients stay on Imfinzi alone to help keep the cancer in check, which is called maintenance therapy.

What it found: The DeLLphi-305 trial tested whether adding Imdelltra (tarlatamab) to maintenance Imfinzi helps people live longer. Among 563 patients, those who received both drugs lived a median of 21.1 months, compared with 12.7 months with Imfinzi alone, a 58% lower risk of death. After one year, nearly 80% of people on the combination were alive, compared with 53% on Imfinzi alone. For a cancer that often comes back quickly, that is a gain of more than eight months at the median.

Side effects and availability: About half of the people who received Imdelltra had cytokine release syndrome, an immune reaction that can cause fever and low blood pressure. Almost all cases were mild or moderate, and care teams monitor for it, especially after the first doses. Imdelltra is already approved for small cell lung cancer that has grown after platinum chemotherapy, but not yet for this earlier use.

2. Bladder Cancer: Imfinzi and Padcev Around Surgery for People Who Can't Get Cisplatin

Who it's for: People with muscle-invasive bladder cancer, meaning the cancer has grown into the muscle wall of the bladder, who are having surgery to remove the bladder but cannot get, or chose not to get, cisplatin, the chemotherapy usually given before this surgery. Many people can't take cisplatin because of kidney problems, hearing loss or other health issues, which has left them with fewer ways to lower the chance of the cancer coming back.

What it found: In the VOLGA trial, 695 people either had surgery alone or received Imfinzi plus Padcev (enfortumab vedotin-ejfv) before surgery and Imfinzi after it. At two years, 78% of those who received the drugs were alive, compared with 69% of those who had surgery alone, a 42% lower risk of death. Sixty-four percent were alive without the cancer coming back or getting worse, compared with 45%.

Side effects and availability: Serious side effects were more common with the added treatment, affecting 64% of patients vs. 44% with surgery alone, so it is worth talking through what to expect with your care team. The FDA granted the combination Priority Review in September 2026, which means the agency aims to make a decision faster than usual, but it is not yet approved for this use.

3. Prostate Cancer: Nubeqa Added to Hormone Therapy and Radiation

Who it's for: Men with very high-risk prostate cancer that has not spread beyond the prostate area and who are being treated with radiation plus hormone therapy, which lowers the male hormones that fuel prostate cancer.

What it found: In the DASL-HiCaP trial, 1,106 men received radiation and hormone therapy plus either Nubeqa (darolutamide), a pill that blocks those hormones from acting on cancer cells, or a placebo (inactive pill) for about two years. After four years, 95% of men who took Nubeqa were alive without their cancer spreading, compared with 88% of those who took placebo, a 58% lower risk. Put simply, adding Nubeqa kept the cancer from spreading in more men. Survival at four years was 97% vs. 95%, a difference that is not yet conclusive.

Side effects and availability: Serious side effects happened in 43% of men who took Nubeqa and 36% of those who took placebo. Nubeqa is already approved for some types of advanced prostate cancer, but not for this use, and these results have not yet been published in a journal.

4. KRAS G12C Lung Cancer: A Newer Pill Beat Approved Drugs Head to Head

Who it's for: People with non-small cell lung cancer driven by a gene change called KRAS G12C whose cancer grew after earlier treatment. Two pills that target this change, Lumakras (sotorasib) and Krazati (adagrasib), are already approved.

What it found: The Krascendo 1 trial compared a newer investigational pill, divarasib, directly with those approved drugs in 338 people. Those who took divarasib lived a median of 17.7 months, compared with 12.0 months, a 44% lower risk of death, and their cancer was kept from growing for a median of 9.8 months vs. 5.7 months. Because divarasib was tested against drugs patients can already get, the results give a clear picture of how it compares. CURE has more on what the new KRAS data mean for patients.

Side effects and availability: Serious treatment-related side effects were less common with divarasib (7.8% vs. 15.2%). The most common side effects were diarrhea, nausea, vomiting and liver changes seen on blood tests. Divarasib is not approved and is available only in clinical trials.

5. Stomach Cancer: A New CLDN18.2-Targeted Drug After Earlier Treatment

Who it's for: People with advanced stomach, gastroesophageal junction (where the esophagus meets the stomach) or esophageal cancer whose cancer grew after earlier treatment and whose tumors carry a protein called claudin 18.2 (CLDN18.2). A test on a tumor sample shows whether a cancer has this protein.

What it found: The CLARITY-Gastric01 trial tested sonesitatug vedotin, an investigational drug that works like a delivery system: an antibody finds cancer cells carrying CLDN18.2 and brings chemotherapy straight to them. In the main comparison, 532 patients received the new drug or the treatment their doctor would usually choose. People who received the new drug lived a median of 10.6 months vs. 6.4 months, a 42% lower risk of death, and 42.6% vs. 27.8% were alive at one year. That matters for a group of patients who have had few options once their first treatments stop working.

Side effects and availability: Serious treatment-related side effects happened in 36.4% of patients who received the new drug and 44.8% of those who received standard treatment. The drug is investigational, and the full results have not yet been published in a journal.

What's Still Unknown

Several of these results come from early (interim) looks at the data, and longer follow-up will show how lasting the benefits are and whether new side effects appear over time. Some results, including those from DASL-HiCaP and CLARITY-Gastric01, have been presented at the meeting but not yet published in a medical journal, where other experts review the full data. In the prostate cancer trial, it is also too early to say whether adding Nubeqa helps men live longer, since survival has been similar in both groups so far.

Most of these treatments still need FDA review for these uses, and it is not yet known when, or whether, they will be approved. Divarasib and sonesitatug vedotin are available only in clinical trials, while Imdelltra, Imfinzi plus Padcev and Nubeqa are approved for other uses but not yet for the ones tested here. Researchers also still need to learn how these options fit alongside other newer treatments and which patients benefit most.

What It Means for You

Many of these results apply to people whose tumors have specific gene changes or proteins, such as KRAS G12C or CLDN18.2. Biomarker testing, done on a tumor or blood sample, shows whether your cancer has one of these markers. If you are not sure whether your tumor has been tested, it is a good question to bring to your next appointment, because the answer can help you and your care team see which treatments and clinical trials may fit you.

Other results, like the bladder and prostate cancer findings, apply to people at a specific point in their treatment, such as before surgery or alongside radiation. If one of these results sounds like your situation, ask your oncologist whether it applies to you, whether the treatment is available yet, and whether a clinical trial might be an option. Even when a new treatment isn't approved yet, knowing about it can help you plan ahead with your care team.

References

1. "Imdelltra in Combination With Imfinzi Reduced Risk of Death by an Unprecedented 58% in First-Line Extensive Stage Small Cell Lung Cancer." Amgen. Oct. 24, 2026.
2. "Perioperative IMFINZI (durvalumab) plus neoadjuvant enfortumab vedotin reduced risk of recurrence by 49% and risk of death by 42% in muscle-invasive bladder cancer." AstraZeneca. Oct. 24, 2026.
3. "Darolutamide plus ADT and radiation therapy reduces risk of metastasis or death by 58% in prostate cancer patients at high risk of recurrence." Orion Corporation. Oct. 24, 2026.
4. "Roche's divarasib demonstrated best-in-class efficacy, advancing the standard of care in previously treated KRAS G12C-mutated lung cancer." Roche. Oct. 25, 2026.
5. "Sonesitatug vedotin reduced the risk of death by 42% in 2nd and later-line CLDN18.2-positive advanced gastric/GEJ cancers in CLARITY-Gastric01." AstraZeneca. Oct. 25, 2026.