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ESMO Congress 2026

October 23–27, 2026 · Madrid · 2749 items

← Floor

pembrolizumab

★★★

48 people · 52 posts · 8 abstracts

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Deep dive

The evidence base for the PD-1 antibody pembrolizumab rests on pivotal phase 3 trials: KEYNOTE-024 compared pembrolizumab with investigator's-choice platinum-based chemotherapy in previously untreated advanced NSCLC with PD-L1 expression on at least 50% of tumor cells, with median PFS of 10.3 vs 6.0 months [1], after which pembrolizumab monotherapy replaced cytotoxic chemotherapy as the first-line treatment of choice in the PD-L1 ≥50% population [5]; KEYNOTE-189 evaluated pemetrexed plus a platinum with pembrolizumab or placebo in metastatic nonsquamous NSCLC without sensitizing mutations, with OS and PFS as primary endpoints [5], extending earlier evidence that the combination produced higher response rates and longer PFS than chemotherapy alone [5]. The two strategies ran in parallel, and the head-to-head comparison of monotherapy versus combination within the PD-L1 ≥50% population is exactly the question PERSEE set out to answer.

At ESMO 26, the GFPC phase 3 PERSEE trial (01-2020) provided a direct answer: 321 patients with previously untreated advanced NSCLC and PD-L1 ≥50% were randomized in an open-label design to pembrolizumab plus platinum-based chemotherapy or pembrolizumab alone, with PFS by blinded central review as the primary endpoint, presented by Chantal Decroisette. Median PFS was 16.1 vs 6.9 months, HR 0.56 (0.43–0.74), p<0.001; ORR 77.5% vs 50.3%; median OS 50.2 vs 29.9 months, HR 0.77 (0.57–1.05) — a notable numerical difference that was not statistically significant, and several commentators on site noted that OS was not the primary endpoint; the trade-off was grade ≥3 treatment-related AEs of 53.8% vs 19.3%.

Relative to existing knowledge, PERSEE shifts the PD-L1 ≥50% population away from a default of monotherapy toward stratified decisions based on tumor burden, pace of disease, comorbidities and biomarkers: adding chemotherapy does deliver deeper and faster disease control, but grade ≥3 toxicity nearly triples, turning the question from whether to add into for whom to add, which is consistent with earlier whole-exome sequencing data linking mutation and neoantigen burden to sensitivity to PD-1 blockade [3]. Note also that the 6.9-month median PFS of PERSEE's monotherapy arm and the 10.3 months in KEYNOTE-024 [1] come from different trials, so cross-trial comparison warrants caution.

Several other pembrolizumab readouts at the same meeting should not be conflated with the PERSEE mainline: the final phase 2 IOV-COM-202 showed lifileucel plus pembrolizumab in checkpoint inhibitor-naïve advanced melanoma with ORR 62.5%, CR 29.2%, median PFS 19.8 months and mDOR not reached, with 13/15 responses lasting ≥12 months, and the phase 3 TILVANCE-301 to advance the signal; neoHIP showed adding pembrolizumab to neoadjuvant THP raised pCR from 48.3% to 67.2% (+18.9%, p=0.03) in early HER2+ breast cancer; another trial found pembrolizumab plus dCRT did not improve EFS or OS in esophageal/GEJ cancer even with PD-L1 CPS ≥10; and data on the personalized mRNA vaccine intismeran autogene plus pembrolizumab reducing melanoma recurrence were also reported. Limitations: PERSEE was open-label, OS was neither the primary endpoint nor statistically significant, and criteria for selecting patients for whom the toxicity is worthwhile remain to be defined.

References
  1. 1.Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer · N Engl J Med 2016
  2. 2.PD-1 Blockade in Tumors with Mismatch-Repair Deficiency · N Engl J Med 2015
  3. 3.Cancer immunology. Mutational landscape determines sensitivity to PD-1 blockade in non-small cell lung cancer · Science 2015
  4. 4.PD-1 blockade induces responses by inhibiting adaptive immune resistance · Nature 2014
  5. 5.Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer · N Engl J Med 2018
  6. 6.Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial · Lancet 2016
Evidence
1239O

NRG-GY020: Phase III randomized trial of radiation +/- MK-3475 (pembrolizumab) for newly diagnosed early-stage high intermediate risk (HIR) mismatch repair deficient (dMMR) endometrioid endometrial cancer

https://esmocongress.esmo.org
2071O

STARBOARD phase 3: A randomized, double-blind study of first-line (1L) encorafenib (enco), binimetinib (bini), and pembrolizumab (pembro) vs placebo (pbo) and pembro for unresectable locally advanced or metastatic BRAF V600-mutant melanoma

https://esmocongress.esmo.org
2072O

Efficacy and safety of lifileucel and pembrolizumab in patients with immune check point inhibitor-naïve advanced melanoma: Final results from IOV-COM-202 study

https://esmocongress.esmo.org
2217RONCT04746300

Updated results from the phase 1b/2 KEYNOTE-365 cohort I: Pembrolizumab (pembro) + carboplatin and etoposide chemotherapy (chemo) or chemo alone for neuroendocrine prostate cancer (NEPC)

https://esmocongress.esmo.org
2683P

First-line (1L) olomorasib + pembrolizumab in KRAS G12C-mutant NSCLC: Updated results from LOXO-RAS-20001 and SUNRAY-01

https://esmocongress.esmo.org
2875O

Pembrolizumab or placebo plus concurrent definitive chemoradiotherapy in esophageal and gastroesophageal junction (GEJ) cancer: The phase 3 randomized KEYNOTE-975 study

https://esmocongress.esmo.org
3609P

Adjuvant pembrolizumab plus belzutifan versus placebo in clear cell renal cell carcinoma: A reconstructed survival data analysis of the KEYNOTE-564 and the LITESPARK-022 trials

https://esmocongress.esmo.org
Floor
  5. Gil Morgan, MD

    An important negative trial to be presented at #ESMO26

    引用@

    OncoAlert 4Sight Abstracts to be Presented at #ESMO26 2875O: Pembrolizumab or Placebo Plus Concurrent Definitive Chemoradiotherapy in Esophageal and Gastroesophageal Junction (GEJ) Cancer: The Phase 3 Randomized KEYNOTE-975 Study @MDmanishshah @BennounaJaafar @cbcbc1971 🔬 Phase 3, double-blind trial (n=703): pembrolizumab or placebo plus definitive chemoradiotherapy in untreated, unresectable esophageal/GEJ cancer. Dual primary endpoints: EFS and OS. ➡️ CPS ≥10 EFS: median 15.2 vs 14.7 mo; HR 0.97 (0.77–1.23); P=0.3994 ➡️ CPS ≥10 OS: median 32.2 vs 35.0 mo; HR 1.00 (0.77–1.30); nominal P=0.5003 ➡️ Grade 5 AEs 13% vs 10%; discontinuation due to AEs 34% vs 27% ✅ Pembrolizumab + dCRT did not significantly improve EFS in PD-L1 CPS ≥10; no new safety signals observed. 🎙️ Manish Shah 👥 Jaafar Bennouna · Toshihiko Doi · Lin Shen · Ken Kato · Antoine Adenis · Harvey Mamon · Markus Moehler · Xiaolong Fu · Byoung Chul Cho · Sonal Bordia · Pooja Bhagia · Chie-Schin Shih · Anjali Desai · Peter Enzinger (4Sight Made from Abstracts publicly available at the ESMO website) Pinging OncoAlert Faculty @CathyEngMD, @BenWestphalen, @graokane, @NiuSanford, , @GillSharlene, @pashtoonkasi, @DrVilmaPBarcia, @Erman_Akkus, @GIMedOnc, @UOzkerim, @MarioBalsaMD, @p_ciracimd, @DraMartinezLago, @DaisukeKotani, @Aiims1742, @ARosen380, @realbowtiedoc, @KoheiShitara,

    ★★★Same topic pembrolizumab · 48 people1072 views13 likes8 reposts0 replies
  12. Dra. María Natalia Gandur Quiroga

    🫁 PD-L1 ≥50% has long supported pembrolizumab monotherapy — but PERSEE asks whether some of these patients should receive more upfront.

    引用@

    OncoAlert 4Sight Abstracts to be Presented at #ESMO26 Pembrolizumab With or Without Platinum-Based Chemotherapy as First-Line Treatment in Advanced NSCLC With PD-L1 ≥50%: PERSEE Phase 3 Trial (GFPC 01-2020) @decroisette @BenjaminBesseMD @LGreillier @C_Ricordel @FGuisier 🫁 Phase 3, open-label (n=321): pembrolizumab + platinum-based chemotherapy vs pembrolizumab alone, first-line advanced NSCLC with PD-L1 ≥50%. Primary endpoint: PFS by blinded central review. ➡️ Median PFS 16.1 vs 6.9 mo; HR 0.56 (0.43–0.74); p<0.001 ➡️ Median OS 50.2 vs 29.9 mo; HR 0.77 (0.57–1.05); ORR 77.5% vs 50.3% ➡️ Grade ≥3 TRAEs 53.8% vs 19.3% ✅ Pembrolizumab-chemotherapy significantly improved PFS vs pembrolizumab monotherapy and may help refine treatment selection. #NSCLC #LungCancer 🎙️ Chantal Decroisette 👥 Renaud Descourt · Christos Chouaid · Maurice Pérol · Benjamin Besse · Laurent Greillier · Olivier Bylicki · Charles Ricordel · Florian Guisier · Radj Gervais · Roland Schott · Jean-Bernard Auliac · Gilles Robinet (4Sight Made from Abstracts publicly available at the ESMO website) Pinging our OncoAlert Lung Cancer Faculty @christine_lovly, @GlopesMd, @DrSanjayPopat, @StephenVLiu, @jillfeldman4, @UOzkerim, @DrMirallas, @MartinReck2 , @bmassutis @UmbertoMalapel1 , @CharuAggarwalMD @peters_solange, @HenningWillers, @HHorinouchi, @BRicciutiMD, @PercyLeeMD, @bensolomon1, @Latinamd, @DrJNaidoo, @barlesi, @VanitaNoronha, @ChristianRolfo @Tony_Calles @s_couraud @marinagarassino @g_mountzios @BairdAM @barlesi @JFreemanDaily @Piuchagarrido @LeciaSequist @bensolomon1 @VanitaNoronha +@alexdrilon @JordiRemon @caliraf @JulienMazieres @TerriConneran

    Same topic pembrolizumab · 48 people#NSCLC#LUNGCANCER#PDL1#PRECISIONONCOLOGY192 views6 likes4 reposts0 replies
  14. Gil Morgan, MD

    🔁 Important findings from the PERSEE Phase 3 trial to watch at #ESMO26!

    引用@

    OncoAlert 4Sight Abstracts to be Presented at #ESMO26 Pembrolizumab With or Without Platinum-Based Chemotherapy as First-Line Treatment in Advanced NSCLC With PD-L1 ≥50%: PERSEE Phase 3 Trial (GFPC 01-2020) @decroisette @BenjaminBesseMD @LGreillier @C_Ricordel @FGuisier 🫁 Phase 3, open-label (n=321): pembrolizumab + platinum-based chemotherapy vs pembrolizumab alone, first-line advanced NSCLC with PD-L1 ≥50%. Primary endpoint: PFS by blinded central review. ➡️ Median PFS 16.1 vs 6.9 mo; HR 0.56 (0.43–0.74); p<0.001 ➡️ Median OS 50.2 vs 29.9 mo; HR 0.77 (0.57–1.05); ORR 77.5% vs 50.3% ➡️ Grade ≥3 TRAEs 53.8% vs 19.3% ✅ Pembrolizumab-chemotherapy significantly improved PFS vs pembrolizumab monotherapy and may help refine treatment selection. #NSCLC #LungCancer 🎙️ Chantal Decroisette 👥 Renaud Descourt · Christos Chouaid · Maurice Pérol · Benjamin Besse · Laurent Greillier · Olivier Bylicki · Charles Ricordel · Florian Guisier · Radj Gervais · Roland Schott · Jean-Bernard Auliac · Gilles Robinet (4Sight Made from Abstracts publicly available at the ESMO website) Pinging our OncoAlert Lung Cancer Faculty @christine_lovly, @GlopesMd, @DrSanjayPopat, @StephenVLiu, @jillfeldman4, @UOzkerim, @DrMirallas, @MartinReck2 , @bmassutis @UmbertoMalapel1 , @CharuAggarwalMD @peters_solange, @HenningWillers, @HHorinouchi, @BRicciutiMD, @PercyLeeMD, @bensolomon1, @Latinamd, @DrJNaidoo, @barlesi, @VanitaNoronha, @ChristianRolfo @Tony_Calles @s_couraud @marinagarassino @g_mountzios @BairdAM @barlesi @JFreemanDaily @Piuchagarrido @LeciaSequist @bensolomon1 @VanitaNoronha +@alexdrilon @JordiRemon @caliraf @JulienMazieres @TerriConneran

    Same topic pembrolizumab · 48 people#NSCLC535 views7 likes2 reposts0 replies
  21. Dr Amol Akhade

    The benifit is same as if you give neo adjuvant pembrolizumab? - cross trial comparisons-

    引用@

    🚨 ESMO 2026 | INTErpath-001 (LBA1) - as data is released by Esmo 🔹 24-month RFS: 82.2% vs 70.0% HR 0.58 (95% CI 0.45–0.75); P<0.001 🔹 24-month DMFS: 88.5% vs 80.2% HR 0.62 (95% CI 0.45–0.85); P=0.002 🔹 Grade ≥3 adverse events: 23.6% vs 20.3% The trial randomized 1,137 patients with resected stage IIB–IV melanoma. Both arms received pembrolizumab; the experimental arm added an individualized mRNA neoantigen therapy. The key question now: will better recurrence control translate into an overall survival benefit? Looking forward to full dataset on day 2 . #ESMO26 @myESMO

    Same topic pembrolizumab · 48 people1451 views3 likes2 reposts1 reply
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