Mali Barbi, Medical Oncologist at Northwell Health, shared on X:
“ESMO2026, my read. What changes my practice, and what doesn’t yet.
Breast Cancer
- OptiTROP-Breast01: OS HR 0.60, and the gap held despite crossover to TROP2 ADCs. In TNBC, the ADC goes early.
- BRIDGET: Isolated brain progression in HER2+, local therapy plus tucatinib, keep the backbone. Single arm, historical control, but I’d use it.
- NATALEE OS: HR 0.81, nominal. iDFS remains the proven benefit.
- Paired biopsies after T-DXd: HER2 rarely lost, efflux and uptake change instead. A repeat biopsy that only re-checks HER2 explains little.
Endometrial Cancer
- TroFuse-005: Sac-TMT beat doxorubicin or weekly paclitaxel after chemo-IO, PFS HR 0.59, with an OS benefit reported. First ADC with survival in endometrial cancer. I want the subgroups before I call it for everyone.
- KEYNOTE-C93: Pembro alone vs chemo in dMMR, PFS HR 0.57, OS not significant. Real option for patients avoiding chemo. But about 20% progress early, and we can’t identify them upfront.
- GY020: Pegative and underpowered. Radiation alone stays my standard in early-stage dMMR.
- DUO-E: In pMMR, durvalumab OS HR 0.95. Olaparib bought PFS with twice the grade ≥3 toxicity. Never tested against durvalumab alone.
Ovarian Cancer
RAINFOL-02: Rina-S OS HR 0.43 without FRα selection. Press release only so far. If it holds, FRα stops being the gate. The next question is whether it works earlier. I am bringing the first-line maintenance trial of rina-S to Northwell Health, for newly diagnosed non-HRD ovarian cancer, where PARP inhibitors help least.
BEHOLD-1: Response tracked with linker cleavage and TOP1, not B7-H4 level. Exploratory, but it changes what the next biomarker should measure.
Circulating tumor DNA (ctDNA) – Positive means risk. One negative draw means little.
Most of what we saw improves PFS. Fewer trials improved survival, and almost none told us who benefits. That’s the work now.”
Other articles from Mali Barbi and ESMO26 on OncoDaily.