ESMO 2026 Poll: Which New Data Will Change Your Practice First?

Late-breaking data presented at the 2026 European Society for Medical Oncology (ESMO) Congress, held October 23 to 27 in Madrid, Spain, spanned an oral RAS inhibitor, a bispecific T-cell engager combination, an individualized mRNA therapy and a PD-1/VEGF bispecific antibody, each with distinct implications for patient education and toxicity management.

Oncology Nursing News is asking readers which of these findings they expect to apply first.

What did ESMO 2026 show for daraxonrasib in pancreatic cancer?

Subgroup analyses of the phase 3 RASolute 302 trial (NCT06625320) showed that overall survival (OS) favored daraxonrasib (Rasonque) over chemotherapy across every RAS genotype subgroup among 500 patients with previously treated metastatic pancreatic ductal adenocarcinoma (overall HR, 0.42; 95% CI, 0.32-0.55). The objective response rate was 32% vs 11%.¹ The primary analysis showed a median OS of 13.2 vs 6.7 months,² and the FDA approved the once-daily oral agent on August 26, 2026.³

"These improvements across the board reinforce daraxonrasib as a new standard of care for all patients with previously treated metastatic pancreatic cancer," said presenting author Zev A. Wainberg, MD, MSc, of the University of California, Los Angeles.¹ Prior ONN coverage outlines rash prophylaxis and adherence counseling for the drug.⁴

How did tarlatamab maintenance perform in small cell lung cancer?

In the phase 3 DeLLphi-305 trial (NCT06211036), first-line maintenance tarlatamab (Imdelltra) plus durvalumab (Imfinzi) produced a median OS of 21.1 vs 12.7 months with durvalumab alone in 563 patients with extensive-stage small cell lung cancer (HR, 0.42; 95% CI, 0.32-0.54). Cytokine release syndrome (CRS) occurred in 49.6% vs 1.4% of patients, and no grade 3 or higher immune effector cell–associated neurotoxicity syndrome was reported.⁵

What did INTerpath-001 show in resected melanoma?

Adding the individualized mRNA therapy intismeran autogene to pembrolizumab (Keytruda) reduced the risk of recurrence or death by 42% in 1137 patients with resected stage IIB to IV melanoma (HR, 0.58; 95% CI, 0.45-0.75; P < .001). Grade 3 or higher adverse events occurred in 23.6% vs 20.3% of patients, and OS data were immature.⁶

How did ivonescimab compare with durvalumab in biliary tract cancer?

In the China-based HARMONi-GI1 trial (NCT06591520; N = 682), first-line ivonescimab plus gemcitabine/cisplatin yielded a median OS of 14.9 vs 12.1 months with durvalumab plus the same chemotherapy (HR, 0.75; 95% CI, 0.61-0.92). Grade 3 or 4 treatment-emergent adverse events occurred in 82.0% vs 72.3% of patients.⁷

What are the key takeaways for oncology nurses?

• Reinforce rash and stomatitis prevention and once-daily adherence with every patient starting daraxonrasib.⁴
• Plan CRS monitoring and caregiver education before tarlatamab-based maintenance begins.⁵
• Prepare patients receiving intismeran for pyrexia (52.2%), injection site pain (51.0%) and influenza-like illness (25.4%), which were largely low grade and transient.⁶
• Track blood counts, blood pressure and urine protein with ivonescimab-based regimens.⁷

Which ESMO 2026 data are most actionable in your practice?

Poll: Which data and insights presented at ESMO 2026 are most immediately actionable in your daily practice?

References

1. Wainberg ZA, Wolpin BM, Hendifar AE, et al. Daraxonrasib, a RAS(ON) multi-selective inhibitor vs chemotherapy in previously treated metastatic pancreatic adenocarcinoma (mPDAC): additional subgroup analyses from the phase 3 RASolute 302 study. Presented at: 2026 European Society for Medical Oncology Congress; October 23-27, 2026; Madrid, Spain. Abstract LBA82.
2. O'Reilly EM, Wainberg ZA, Hendifar AE, et al; RASolute 302 Trial Investigators. Daraxonrasib or chemotherapy in previously treated metastatic pancreatic cancer. N Engl J Med. 2026;395(4):325-337. doi:10.1056/NEJMoa2605555
3. FDA approves first in class targeted therapy for metastatic pancreatic cancer. News release. FDA. August 26, 2026. Accessed October 27, 2026. https://www.fda.gov/news-events/press-announcements/fda-approves-first-class-targeted-therapy-metastatic-pancreatic-cancer
4. Biese A. Managing daraxonrasib: key takeaways and efficacy insights for oncology nurses. Oncology Nursing News. September 2, 2026. Accessed October 27, 2026. https://www.oncnursingnews.com/view/managing-daraxonrasib-key-takeaways-and-efficacy-insights-for-oncology-nurses
5. Sands J, Yoshida T, Ahn MJ, et al. Tarlatamab plus durvalumab vs durvalumab as first-line maintenance therapy following first-line durvalumab, platinum, and etoposide in extensive-stage small cell lung cancer: primary analysis of the phase 3 DeLLphi-305 trial. Presented at: 2026 European Society for Medical Oncology Congress; October 23-27, 2026; Madrid, Spain. Abstract LBA3.
6. Long GV, Khattak MA, Gogas HJ, et al. INTerpath-001: phase 3 study of the mRNA-based individualized neoantigen therapy (INT) intismeran autogene plus pembrolizumab vs pembrolizumab alone for adjuvant treatment of resected stage IIB-IV melanoma. Presented at: 2026 European Society for Medical Oncology Congress; October 23-27, 2026; Madrid, Spain. Abstract LBA1.
7. Zhou J, Zheng T, Fan J, et al. Ivonescimab plus chemotherapy versus durvalumab plus chemotherapy as first-line treatment for advanced biliary tract cancer: a randomized, controlled, double-blinded, phase 3 trial (HARMONi-GI1). Presented at: 2026 European Society for Medical Oncology Congress; October 23-27, 2026; Madrid, Spain. Abstract LBA8.