Alfredo Addeo, Head of the Oncology Department at University Hospitals of Geneva, shared on X:
“3rd Presidential Session at ESMO26!
Can we safely reduce the frequency of immunotherapy in advanced solid cancers?
The phase III MOIO trial tested 12-weekly versus standard immune checkpoint inhibitor administration in responding patients.
- Unexpected and concerning results!
- PFS: HR 1.35 (96.16% CI 0.90–2.04)
- OS: HR 2.04 (95% CI 1.08–3.85), favoring standard treatment!
The trial stopped enrolment early following an unexpected OS imbalance.
A superb and thought-provoking discussion by Dr. Jarushka Naidoo.
Her key messages:
- Statistically inconclusive , but clinically reassuring? Certainly not!
- Non-inferiority margins matter! Would we really be comfortable accepting a potential 30% increase in the hazard of progression simply to reduce treatment frequency?
- One size does not fit all! Different tumour types, different immunotherapy regimens, different biology. Can a pan-tumour de-escalation strategy really work?
- Pragmatic does not mean compromising scientific rigour.
The take-home message: De-escalation remains an important goal, but it must be biologically justified, clinically meaningful and supported by robust evidence.
Doing less is only progress if we can demonstrate that patients are not paying the price in efficacy or survival.
Congratulations to Dr. Jarushka Naidoo for an outstanding discussion!”
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