ESMO 2026: Survival takes center stage

ESMO 2026 showed that newer oncology drug classes are producing meaningful survival gains and moving into earlier treatment lines, creating a broad set of potential growth drivers for biopharma.

• The Madrid congress drew approximately 37,000 participants from more than 170 countries, and 7 of the 12 late-breaking Presidential Symposium trials reported a statistically significant overall-survival benefit.
• Amgen’s Phase III DeLLphi-305 trial added Imdelltra to AstraZeneca’s Imfinzi in first-line maintenance small-cell lung cancer, extending median overall survival to 21.1 months from 12.7 months and reducing the risk of death by 58%.
• Moderna and Merck’s Phase III INTerpath-001 trial combined personalised mRNA therapy with Keytruda after melanoma surgery, reducing recurrence or death risk by 42%; 82% of patients were recurrence-free after two years versus 70% with Keytruda alone, although manufacturing complexity and immature survival data remain concerns.
• In lung cancer, Merck and Kelun’s sacituzumab tirumotecan plus Keytruda more than doubled median progression-free survival in PD-L1-negative patients, to 15.0 months from 5.7 months; AstraZeneca also reported that a claudin 18.2-directed ADC doubled median survival in later-line gastric cancer.
• RAS inhibition is moving rapidly into practice after FDA approval of Revolution Medicines’ daraxonrasib as the first RAS inhibitor for pancreatic cancer, while physicians reported rapid uptake and some off-label use in lung cancer ahead of Phase III data.

Takeaway: Bellevue sees a healthy long-term outlook for oncology and biopharma as T-cell engagers, ADCs, RAS inhibitors and personalised mRNA therapies extend survival and help offset upcoming patent expiries, although some approaches still face manufacturing, maturity-of-data and broader-indication risks.