2026 年 10 月 23–27 日 · Madrid · 共 3154 条
54 人 · 72 条 · 2 篇摘要
当前热度 27·可比范围峰值 30（10月25日 03:00）·近 24 小时可比范围变化 –·当前参与者 37
切除后 IIB–IV 期黑色素瘤，辅助帕博利珠单抗已经是标准之一。KEYNOTE-942 是随机 IIb 期：个体化新抗原 mRNA（当时代号 mRNA-4157 / V940）加帕博利珠单抗对比单药，Lancet 2024 报的是无复发生存，不是总生存。[1] 2026 年 JCO 有五年更新。[2] 那些是 II 期数字，不是这次 III 期。
INTerpath-001（NCT05933577）是它的 III 期后续，不是同一项试验：intismeran autogene 加帕博利珠单抗对比单用帕博利珠单抗。会场 LBA1（Presidential I）报 n=1137，无复发生存风险比 0.58，2 年无复发生存 82.2% 对 70.0%；远处无转移生存同步达到；总生存随访未成熟。现场写无新的安全性信号。完整置信区间、分期和 BRAF 分层以幻灯为准。
它相对 942 推进的是把同一组合做到 1137 人的 III 期，并且无复发生存和远处无转移生存都达到。总生存未成熟，不能把风险比 0.58 写成已经改写辅助黑色素瘤标准治疗。个体化 mRNA 的可及性、周转时间和费用，现场帖没有给。会上数字与 942 的期刊数字分开读，不叠成一条。
INTerpath-001: Phase 3 study of the mRNA-based individualized neoantigen therapy (INT) intismeran autogene (intismeran) plus pembrolizumab (pembro) vs pembro alone for adjuvant treatment of resected stage IIB-IV melanoma (MEL)
https://esmocongress.esmo.orgINTerpath-001
https://esmocongress.esmo.orgINTerpath-001提出了令人兴奋的问题： 改善的RFS/DMFS能否转化为OS获益？ 与新辅助免疫治疗相比如何？ 个性化疫苗能否快速、低成本地规模化生产？ 创新还必须能够落地。 #ESMO26
#ESMO26 | INTerpath-001: My Personal Perspective Ahead of the Presidential Session This innovation deserves recognition: a groundbreaking result for personalized cancer vaccines. However, in patients with macroscopic stage III melanoma who are eligible for neoadjuvant IO, this trial does not establish the added value over contemporary perioperative strategies. Neoadjuvant treatment can produce substantial responses while allowing some patients to avoid adjuvant therapy. The trial design I would prioritize is: Neoadjuvant IO → surgery → standard adjuvant therapy ± a personalized vaccine in patients without a major pathological response. Here, “failure to achieve a major pathological response” is a more appropriate selection criterion than “any residual disease.” Patients with minimal residual viable tumor who still achieve a major pathological response should not automatically receive additional treatment. This approach would direct treatment intensification toward patients at higher risk of recurrence. The key biological uncertainty, however, is that IO-resistant residual disease is not necessarily vaccine-sensitive. Whether vaccination can overcome that resistance needs to be demonstrated. This criticism should remain specific to that population: INTerpath-001 retains distinct clinical value for patients with stage IIB/IIC disease and those who underwent surgery without neoadjuvant therapy.
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