ESMO Congress 2026

The therapeutic landscape of non-small cell lung cancer rests on fairly solid evidence: ALK rearrangement accounts for 3-7% of NSCLC, and three generations of ALK inhibitors—crizotinib, ceritinib, alectinib and lorlatinib—have been used clinically, although room for improvement in drug resistance remains at the initiation of each treatment, with point mutations being the most important resistance mechanism ^[3]. In the combination direction, a systematic review and meta-analysis of 13 studies and 1558 participants showed that compound Kushen injection plus radiotherapy significantly improved the effective rate versus radiotherapy alone (OR=1.92, 95% CI 1.42-2.60) and reduced adverse events, though most included trials were of low quality ^[2]. On the biomarker side, an eight-gene ubiquitin-proteasome signature built on 703 lung adenocarcinoma patients showed good performance in predicting overall and relapse-free survival in training and validation sets ^[5]. This paradigm of targets, combinations and biomarkers frames the new information from this meeting, whereas the cited background literature contains no corresponding treatment-landscape data for small cell lung cancer.

The #ESMO26 posts touch on two separate matters. One is the RESONANCE study, to be presented at the congress by @nicogirardcurie: 623 people with extensive-stage SCLC in France, Germany, Italy, Spain and the UK, where once the cancer returned, treatment varied widely; the authors point to a likely reason—there are too few effective options. The post also stresses that this reflects Western Europe only—home to some of the best-resourced health systems on the continent—and that far less is known about people with SCLC across Central and Eastern Europe. The other is an interview at #ESMO26 with Matthew Lee of City of Hope by VJOncology, discussing the development of BG-C477, a CEA-targeting ADC, and its early results in NSCLC, how CEA compares with established NSCLC ADC targets, and whether its expression and internalisation support efficient payload delivery; the content is coming soon to VJOncology.com, and no efficacy figures were disclosed in the post. Separately, Pilar Garrido received the ESMO26 Women for Oncology Award for her contributions to lung cancer research and her commitment to gender equity in cancer treatment and in the oncology profession.

The two items advance existing knowledge differently. RESONANCE turns the lack of an agreed post-relapse treatment for extensive-stage SCLC from a clinical impression into multinational evidence covering five countries and 623 patients, situated within high-resource systems, in direct contrast with NSCLC, where a sequential landscape of three generations of ALK inhibitors has been established yet remains constrained by resistance at each step ^[3], underscoring the scarcity of options after SCLC recurrence. BG-C477 pushes the ADC target discussion in NSCLC toward CEA; its question of whether expression and internalisation suffice for payload delivery is in line with the broader biomarker-driven research direction in NSCLC ^[5]. For now, however, it remains an early-stage description at the interview level, and no efficacy comparison can be drawn with the radiotherapy-combination regimens ^[2] or ALK inhibitors ^[3] in the background literature.

The limitations are clear: RESONANCE covers only five Western European countries, with Central and Eastern European data missing; no dosing, efficacy or safety figures for BG-C477 have been disclosed, and its comparison with established ADC targets remains at the mechanistic level of expression and internalisation, pending formal data release before any assessment.