The ESMO Congress 2026 will feature new prostate cancer data across localized, hormone-sensitive, castration-resistant, and neuroendocrine disease. The program includes phase III treatment readouts, long-term survival analyses, patient-reported outcomes, and studies examining circulating tumor DNA and genomic biomarkers.
Several presentations build on previously reported phase III trials, including TALAPRO-3, CAPItello-281, PROTEUS, and PEACE-1, while DASL-HiCaP will report an interim analysis of treatment intensification with darolutamide and radiotherapy in very high-risk localized disease. Other studies will address neuroendocrine prostate cancer, PSMA radioligand therapy, and the interpretation of liquid-biopsy results for treatment selection. This overview highlights 10 prostate cancer presentations to watch at ESMO 2026.
KEYNOTE-365 Cohort I: Pembrolizumab + Chemotherapy in Neuroendocrine Prostate Cancer
Abstract: 2217RO
Presenter: Gunhild Von Amsberg (Hamburg, Germany)
Trial Type: Phase 1b/2
Session: Rapid Oral session
KEYNOTE-365 cohort I (NCT02861573) is evaluating pembrolizumab plus carboplatin and etoposide versus carboplatin and etoposide alone in patients with metastatic neuroendocrine prostate cancer (NEPC).
As of the data cutoff, 40 patients had been randomized; 19 received at least one dose of pembrolizumab plus chemotherapy and 18 received at least one dose of chemotherapy alone. Among patients with RECIST-measurable disease, the confirmed objective response rate was 33% versus 6%, respectively. In all treated patients, median radiographic progression-free survival was 5.1 versus 4.0 months, while median overall survival was 11.4 versus 7.8 months.
At ESMO 2026, investigators will report updated results from KEYNOTE-365 cohort I.
Liquid Biopsy: Distinguishing Clonal Hematopoiesis From Tumor HRR Alterations
Abstract: 2218RO
Presenter: Emmanuel S. Antonarakis (Minneapolis, United States of America)
Trial Type: Liquid-biopsy biomarker analysis
Session: Rapid Oral session
Circulating cell-free DNA testing can identify homologous recombination repair (HRR) alterations that may inform PARP inhibitor treatment in metastatic castration-resistant prostate cancer (mCRPC). However, variants arising from clonal hematopoiesis (CH) can be detected in plasma and potentially be mistaken for tumor-derived alterations. In a case series published in JAMA Oncology, 69 men with advanced prostate cancer underwent plasma cfDNA testing. CHIP variants were detected in 13 patients (19%), while 7 patients (10%) had CHIP variants in DNA repair genes used for PARP inhibitor selection, including ATM, BRCA2, and CHEK2.
At ESMO 2026, the 2218RO analysis will address distinguishing clonal hematopoiesis from tumor HRR alterations in liquid biopsy and the implications for PARP inhibitor use in mCRPC.
TALAPRO-3: ctDNA Tumor Fraction as a Prognostic Biomarker
Abstract: 2219RO
Presenter: Arun A. Azad (Melbourne, Australia)
Trial Type: Phase III biomarker analysis
Session: Rapid Oral session
TALAPRO-3 (NCT04821622) is a randomized, double-blind phase III study evaluating talazoparib plus enzalutamide versus placebo plus enzalutamide in patients with HRR gene-altered metastatic castration-sensitive prostate cancer (mCSPC).
The primary results were presented at ASCO 2026 and published in The New England Journal of Medicine. Among 599 randomized patients, talazoparib plus enzalutamide significantly improved radiographic progression-free survival compared with placebo plus enzalutamide (HR 0.481; 95% CI, 0.357–0.647; P<0.0001). Median rPFS was not reached versus 45.8 months. Interim overall survival had not reached statistical significance (HR 0.767; 95% CI, 0.564–1.044).
At ESMO 2026, investigators will evaluate the utility of circulating tumor DNA tumor fraction as a prognostic biomarker in TALAPRO-3.
PROMPT: Plasma ctDNA for HRR and PI3K/AKT Genotyping in mCRPC
Abstract: 2220RO
Presenter: Niven Mehra (Nijmegen, Netherlands)
Trial Type: Biomarker analysis
Session: Rapid Oral session
PROMPT (NCT04746300) is a prospective molecular-profiling study in patients with treatment-naive or first-line mCRPC. Previous results from PROMPT were published in the British Journal of Cancer and evaluated next-generation sequencing of tumor tissue and molecular tumor board recommendations for genotype-matched treatment. The analysis included 340 tissue samples from 307 patients. Valid sequencing results were obtained from 84% of samples, and druggable targets were identified in 39% of patients. PI3K-AKT and homologous recombination pathways were affected in 26% and 21% of patients, respectively.
At ESMO 2026, PROMPT will examine plasma ctDNA as a standalone approach or as an adjunct to tumor tissue for HRR and PI3K/AKT genotyping in mCRPC.
CAPItello-281: Updated Overall Survival With Capivasertib + Abiraterone
Abstract: LBA56
Presenter: Karim Fizazi (Lille, France)
Trial Type: Phase III
Session: Rapid Oral session
CAPItello-281 (NCT04493853) is a randomized, double-blind, placebo-controlled phase III trial evaluating capivasertib plus abiraterone, prednisone/prednisolone, and androgen deprivation therapy versus placebo plus abiraterone, prednisone/prednisolone, and ADT in patients with newly diagnosed PTEN-deficient metastatic hormone-sensitive prostate cancer.
The primary analysis was published in Annals of Oncology. Among 1,012 randomized patients, median investigator-assessed radiographic progression-free survival was 33.2 months with capivasertib plus abiraterone versus 25.7 months with placebo plus abiraterone (HR 0.81; 95% CI, 0.66–0.98; P=0.034). At 26.4% maturity, the overall survival HR was 0.90 (95% CI, 0.71–1.15; P=0.401), and overall survival had not reached statistical significance at that data cutoff.
On June 12, 2026, the FDA approved capivasertib in combination with abiraterone and prednisone for adults with PTEN-deficient metastatic androgen pathway modulation-naive or -sensitive prostate cancer, as detected by an FDA-authorized test.
At ESMO 2026, CAPItello-281 will report an updated overall survival analysis.
TALAPRO-3: Patient-Reported Outcomes
Abstract: 2222RO
Presenter: Arun A. Azad (Melbourne, Australia)
Trial Type: Phase III patient-reported outcomes analysis
Session: Rapid Oral session
TALAPRO-3 randomized 599 patients with HRR gene-altered mCSPC to talazoparib plus enzalutamide or placebo plus enzalutamide. The primary analysis demonstrated a significant improvement in radiographic progression-free survival with the talazoparib combination, while interim overall survival had not reached statistical significance.
At ESMO 2026, investigators will report patient-reported outcomes from TALAPRO-3, comparing talazoparib plus enzalutamide with placebo plus enzalutamide.
PROTEUS Substudy: Perioperative Apalutamide + ADT Versus Surgery Alone
Abstract: LBA53
Presenter: Alberto Briganti (Milan, Italy)
Trial Type: PROTEUS substudy
Session: Proffered Paper session
The phase III PROTEUS trial (NCT03767244) evaluated perioperative apalutamide plus androgen deprivation therapy versus placebo plus ADT in patients with high-risk localized or locally advanced prostate cancer undergoing radical prostatectomy with pelvic lymph node dissection. The final phase III PROTEUS analysis was presented at the 2026 ASCO Annual Meeting and was also published in The New England Journal of Medicine. In the ASCO analysis, among 2,109 randomized patients, apalutamide plus ADT increased the pathological complete response/minimal residual disease rate to 8.9% versus 1.0% (OR 10.17; 95% CI, 5.27–19.64; P<0.0001). Metastasis-free survival was also improved (HR 0.80; 95% CI, 0.67–0.96; P=0.0169), with 5-year MFS rates of 78.2% versus 73.5%.
The ESMO 2026 substudy addresses a different comparison from the parent trial: perioperative apalutamide plus ADT with radical prostatectomy and pelvic lymph node dissection versus radical prostatectomy and pelvic lymph node dissection alone in high-risk localized or locally advanced prostate cancer.
DASL-HiCaP: Darolutamide + ADT + Radiotherapy in Very High-Risk Localized Prostate Cancer
Abstract: LBA4
Presenter: Tamim Niazi (Montreal, Canada)
Trial Type: Phase III
Session: Proffered Paper session
DASL-HiCaP (ANZUP1801; NCT04136353) is an international, randomized, double-blind, placebo-controlled phase III trial evaluating darolutamide in addition to androgen deprivation therapy and definitive radiotherapy in patients with very high-risk localized prostate cancer, or salvage radiotherapy in patients with very high-risk features and PSA persistence or rise after radical prostatectomy.
The trial was designed to enroll 1,100 participants randomized 1:1 to darolutamide 600 mg twice daily or placebo for 96 weeks. Both groups receive androgen deprivation therapy for 96 weeks and definitive or salvage radiotherapy. The primary endpoint is metastasis-free survival.
At ESMO 2026, investigators will present the interim analysis of DASL-HiCaP.
CCTG PR21: Quality of Life With 177Lu-PSMA-617 Versus Docetaxel
Abstract: 2221RO
Presenter: Daniel J. Khalaf (Toronto, Canada)
Trial Type: Randomized Phase II quality-of-life analysis
Session: Rapid Oral session
CCTG PR21, also known as PLUDO (NCT04663997), is a randomized phase II trial comparing 177Lu-PSMA-617 with docetaxel in chemotherapy-naïve, PSMA-PET-positive mCRPC progressing after androgen receptor pathway inhibitor therapy; prior docetaxel in the mCSPC setting at least 1 year before enrollment was permitted.
The primary results were presented at the ESMO Congress 2025 as LBA89 and published as a meeting abstract in Annals of Oncology. Among 199 randomized patients, median radiographic progression-free survival was 8.6 months with 177Lu-PSMA-617 versus 10.7 months with docetaxel (HR 1.02; 90% CI, 0.77–1.35; one-sided P=0.54). Median overall survival was 14.3 versus 18.2 months, respectively (HR 1.64; 90% CI, 1.14–2.35; P=0.02).
A prespecified secondary analysis of outcomes after crossover was subsequently presented at the 2026 ASCO Annual Meeting and published as a meeting abstract in the Journal of Clinical Oncology. Among 104 patients who received crossover therapy, there were no differences between treatment sequences in second-line radiographic progression-free survival, rPFS2, overall survival, or second-line overall survival. The investigators concluded that an imbalance in crossover from ¹⁷⁷Lu-PSMA-617 to docetaxel likely contributed to the overall survival difference observed in the intention-to-treat population.
At ESMO 2026, PR21 will report patient-reported quality-of-life outcomes comparing docetaxel with 177Lu-PSMA-617.
PEACE-1: Long-Term Overall Survival With Abiraterone + Prednisone
Abstract: 2215O
Presenter: Karim Fizazi (Lille, France)
Trial Type: Phase III
Session: Proffered Paper session
PEACE-1 (NCT01957436) is a multicenter, open-label, randomized phase III study with a 2 × 2 factorial design evaluating the addition of abiraterone plus prednisone and prostate radiotherapy, separately and in combination, to standard of care in patients with de novo metastatic castration-sensitive prostate cancer.
The primary abiraterone analysis was published in The Lancet in April 2022. Among 1,172 randomized patients, adding abiraterone plus prednisone to standard of care improved overall survival (HR 0.82; 95.1% CI, 0.69–0.98; P=0.030) and radiographic progression-free survival (HR 0.54; 99.9% CI, 0.41–0.71; P<0.0001). Among patients receiving ADT plus docetaxel, the overall survival HR with abiraterone was 0.75 (95.1% CI, 0.59–0.95; P=0.017).
At ESMO 2026, PEACE-1 will report long-term overall survival with abiraterone acetate plus prednisone in de novo mCSPC.
The Bottom Line
The prostate cancer program at ESMO 2026 spans multiple disease states and treatment strategies. DASL-HiCaP will provide an interim phase III analysis of darolutamide added to ADT and radiotherapy in very high-risk localized disease, while the PROTEUS substudy will compare perioperative apalutamide plus ADT and surgery with surgery alone.
In metastatic hormone-sensitive disease, CAPItello-281 will provide updated overall survival data for capivasertib plus abiraterone in PTEN-deficient disease, and PEACE-1 will report long-term survival with abiraterone plus prednisone. TALAPRO-3 will contribute complementary ctDNA tumor-fraction and patient-reported outcome analyses following its previously reported rPFS benefit.
In mCRPC, PROMPT and the clonal hematopoiesis analysis will address the interpretation of liquid biopsy for molecular treatment selection, while PR21 will report quality-of-life outcomes for 177Lu-PSMA-617 versus docetaxel. KEYNOTE-365 cohort I will provide updated data for pembrolizumab plus carboplatin-etoposide chemotherapy in neuroendocrine prostate cancer.
Together, these 10 presentations will provide new clinical, biomarker, and patient-reported evidence across localized, hormone-sensitive, castration-resistant, and neuroendocrine prostate cancer.
Presentation details are available in the official ESMO programme.
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