Esmo 2026: personalised melanoma vaccine cuts recurrence 42%, lung cancer combo cuts death risk 58%

Melanoma vaccine trial

Phase 3 results from the INTerpath-001 study, presented at the Esmo 2026 congress in Madrid, tested an individualised mRNA vaccine, intismeran autogene, given alongside the standard immunotherapy pembrolizumab. The trial enrolled 1,137 patients with high-risk melanoma who had their tumours surgically removed. After two years, the combination lowered the risk of recurrence by 42% and the risk of distant metastasis by 38% compared with pembrolizumab alone. Michele Del Vecchio, head of melanoma medical oncology at the Istituto nazionale dei tumori in Milan, whose centre enrolled more patients than any other site in the world, presented the findings.

For the first time a personalised neoantigen therapy has shown benefits in a phase 3 study.

The vaccine uses the same mRNA technology as some Covid-19 vaccines and is built from information about each patient's own tumour. The study was randomised and double-blind, and it covered patients with stage IIB to IV melanoma. Researchers said the vaccine is not designed to prevent melanoma, but to stop it returning in people who had already undergone surgery.

Lung cancer combination

Amgen reported interim results from the phase 3 DeLLphi-305 study, in which tarlatamab was combined with durvalumab, AstraZeneca's immunotherapy, as first-line maintenance for extensive-stage small cell lung cancer. The hazard ratio was 0.42, which the company translated into a 58% lower risk of death. Median overall survival reached 21.1 months, compared with 12.7 months on durvalumab alone, a gain of more than eight months. The study data show about 80% of patients alive at one year, against 53% on durvalumab alone. Marcello Tiseo, who directs medical oncology at the University Hospital of Parma, said that before this combination, median survival for extensive-stage disease was generally about 12 months from diagnosis.

It is a great step forward for patients with such a challenging disease.

The results were presented at the Esmo presidential symposium and published at the same time in the New England Journal of Medicine. The presentation was greeted with a standing ovation from the audience.

Bladder cancer study

The Volga study, also presented at Esmo, tested perioperative durvalumab combined with enfortumab vedotin in muscle-invasive bladder cancer, in patients who cannot receive cisplatin chemotherapy. According to the results cited by Rossana Berardi, the combination reduced the risk of recurrence by 49% and the risk of death by 42%. Emiliano Tamburini of the Cardinale Panico hospital in Tricase said the regimen opened treatment options for patients who previously had few, especially elderly and frail patients whose only option had been surgery. Berardi, president-elect of Aiom, said blood in the urine is the most frequent symptom of the disease and warned that it is often delayed.

It is a signal that must not be underestimated, because it can sometimes be attributed to other causes.

Italy records about 29,000 new bladder cancer diagnoses a year, around 23,000 of them in men, according to Aiom-Airtum 2025 data. Berardi noted there is no screening programme for the general population, so prevention and early diagnosis are essential, along with a multidisciplinary approach involving urologists, oncologists and radiotherapists.

Comparing the three results

The risk reductions reported across the three studies range from 38% to 58%.

The largest reduction is the 58% lower risk of death in lung cancer. The melanoma and bladder results each include a 42% figure, but the melanoma number measures recurrence while the bladder number measures death. Amgen said it is working quickly to share its data with regulators around the world.