The ESMO Congress 2026 is the annual meeting of the European Society for Medical Oncology. It stands as one of the world’s most influential oncology platforms for presenting pioneering cancer research. The event takes place from October 23 to 27, 2026, in Madrid, Spain, at the IFEMA MADRID convention center, utilizing a highly accessible hybrid (in-person and virtual) format.
Julian Chavarriaga, Urologic Oncologist at Penn State Urology, shared on X:
“Exploratory ctDNA findings from phase III KEYNOTE-B15, comparing perioperative EV+pembrolizumab vs cisplatin/gemcitabine.
Key findings:
- Presurgical ctDNA clearance: 82.1% vs 66.7%
- 24-month EFS after ctDNA clearance: 81.1% vs 63.2%
- Persistent ctDNA positivity: 24-month EFS only ~33–35%
- Postsurgical ctDNA positivity: Only 10% event-free at 24 months in either arm
- Presurgical ctDNA-negative patients: pCR 72.4% vs 43.7%
How much does each drug contribute to perioperative EV + pembrolizumab in MIBC?
A 3-arm analysis of KEYNOTE-905/EV-303 (N=255). EV+P vs P alone vs surgery:
- 3-year EFS: 69.5% vs 49.6% vs 37.4%
- pCR: 58.8% vs 25.3% vs 10.3%
- Pathologic downstaging: 65.9% vs 33.7% vs 14.9%
- EFS HR vs surgery: 0.40 with EV+P; 0.71 with P alone
- The efficacy gradient suggests both EV and pembrolizumab contribute to the combination’s activity, with substantially greater benefit from EV+P.
- Important caveat: descriptive, ad hoc analysis without formal statistical testing.
Can two ADCs + IO push response rates even higher in 1L metastatic urothelial cancer?
TROPHY-U-01 Cohort 7, evaluating sacituzumab govitecan + enfortumab vedotin + zimberelimab (N=21).
- ORR 81%, including 14% CR
- Median DOR 16.7 months
- Median PFS 19.3 months
- Median OS not reached
- Grade ≥3 treatment-related AEs: 52%; 33% discontinued ≥1 agent
Impressive early activity from dual ADC targeting Trop-2 + Nectin-4, but the key question is whether the added efficacy justifies the toxicity over EV+pembrolizumab.
Andrea Necchi presented ENERGIZE (CA017-078), comparing perioperative nivolumab + gemcitabine/cisplatin vs GC alone (N=653).
- pCR: 39.1% vs 29.6%, but statistical threshold not met
- EFS: HR 0.94; p=0.67
- OS: HR 0.88 (descriptive)
- Grade ≥3 AEs: 73% vs 56%
- ctDNA clearance was strongly prognostic for EFS and OS, but neither baseline ctDNA status nor clearance identified patients who benefited more from nivolumab.
KEYNOTE-866: The final EFS analysis (N=907) of perioperative pembrolizumab + cisplatin/ gemcitabine vs chemotherapy alone:
- 5-year EFS: 63.5% vs 61.9% (HR 0.88; p=0.137)
- 5-year OS: 70.8% vs 70.9% (HR 1.00)
- pCR: 44.4% vs 35.8%
- Grade 3–5 AEs: 80.2% vs 75.1%
Despite a numerically higher pCR rate, no significant EFS benefit emerged, and OS was virtually identical.
In an evolving perioperative MIBC landscape, KEYNOTE-866 does not support adding pembrolizumab to cisplatin/gemcitabine.”
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