ESMO Congress 2026

Durvalumab, an anti-PD-L1 antibody, already rests on solid phase 3 evidence: PACIFIC established its consolidation role after chemoradiotherapy in unresectable stage III NSCLC, with gains in progression-free survival ^[1] and overall survival ^[2]; CASPIAN supported durvalumab plus platinum-etoposide in first-line extensive-stage small-cell lung cancer ^[4]; and HIMALAYA showed that a single priming dose of tremelimumab plus durvalumab (STRIDE) improved median overall survival versus sorafenib in unresectable hepatocellular carcinoma (16.43 vs 13.77 months) ^[6], a regimen also captured in reviews of HCC immunotherapy ^[5], while a systematic review of fatal immune checkpoint inhibitor toxicities includes durvalumab data ^[3].

At ESMO26, the densest durvalumab readout came from the phase II POP-DURVA trial (UNLOCK 14, presented by Joana Ribeiro) in stage I (cT1 cN0) TNBC: short-course preoperative durvalumab without chemotherapy raised median sTILs from 10% to 22%; numbers as posted give pCR of 1.7% (n=71, single dose) or 1.4% (2 cycles, n=78), objective response 11.6%, tumor shrinkage 41.3%, and conversion to an inflamed phenotype in 33% of initially immune-negative tumors, with greater stromal TIL increases in paired biopsies associated with lower residual viable tumor. In perioperative muscle-invasive bladder cancer, posts reported improved survival with durvalumab with or without tremelimumab combined with EV (noted in the post as adjuvant only), and 24-month event-free survival of 63.5% with perioperative durvalumab plus neoadjuvant enfortumab vedotin versus 45.1% with surgery alone; exploratory NIAGARA analyses showed 75% pCR in ERCC2-mutated tumors across arms and EFS hazard ratios of 0.44 (TMB-high), 0.51 (TP53-mutated) and 0.24 (FGFR3-mutated). Elsewhere, RAMPART reported that adjuvant durvalumab after renal cell carcinoma surgery worsened overall quality of life at week 16 versus active monitoring with no difference at month 15, and DUO-E showed durvalumab plus olaparib extended median overall survival by 11.5 months versus chemotherapy alone, especially encouraging for pMMR tumors.

The main site news did not independently cover these meeting data; instead it added two pipeline-expansion leads toward earlier settings: in the phase 2 MDT-BRIDGE trial, neoadjuvant durvalumab plus chemotherapy, after multidisciplinary team re-evaluation, allowed most patients with resectable or borderline resectable NSCLC to undergo surgery, with an encouraging pathological complete response rate; and Japan's National Cancer Center registered a phase 2 trial of zolbetuximab plus durvalumab and FLOT as neoadjuvant therapy in CLDN18.2-positive gastric or gastroesophageal junction adenocarcinoma (NCT07872722, 29 planned patients, primary endpoint histologic complete response rate, Grade 3, in surgical specimens).

The step forward lies in pushing durvalumab from advanced and consolidation settings into earlier therapeutic windows while attempting to subtract: POP-DURVA shows that a short chemotherapy-free course can reshape the immune microenvironment yet yields minimal pCR, suggesting chemotherapy partners remain hard to omit in TNBC neoadjuvant therapy; NIAGARA's molecular profiling begins to address who benefits from perioperative immunotherapy; and RAMPART brings patient experience into adjuvant decision-making. Limitations: POP-DURVA is small, live posts diverge on pCR and patient numbers (1.7%/71 vs 1.4%/78), whether immune activation translates into clinical benefit remains unproven, and no efficacy data have yet been reported for the two trials covered in the news.