From 23rd to 27th October, the world’s cancer scientists gathered in Madrid to share their latest findings at the European Society for Medical Oncology (ESMO) annual conference.

They brought news about personalised cancer vaccines, a precise radiotherapy treatment plan for advanced lung cancer, exciting updates on targeted treatments, and much more.

Our experts were also on hand to explain the science behind some of the biggest stories. They picked out lots of encouraging signs, but, as the findings mostly come from ongoing studies, there’s more work to do before we understand how these new treatments could translate to the NHS.

Scroll down for the highlights – and a glimpse of how cancer care might change in years to come.

Personalised cancer vaccine lowers the risk of melanoma coming back 

ESMO weekend kicked off with a bang, with one of the most anticipated stories breaking before the conference had even started. You can see why someone might have jumped the gun; this is the clearest sign yet that personalised vaccines could help shape the future of cancer treatment. 

The Phase 3 INTerpath-001 trial tested whether an mRNA vaccine called intismeran autogene could help treat advanced melanoma skin cancer alongside a standard immunotherapy drug. Over two years, the combination cut the risk of patients dying or seeing their skin cancer return by 42% compared with immunotherapy alone. 

Although it uses the same technology as some COVID-19 vaccines, intismeran is designed as a treatment, rather than a prevention tool. Researchers gave it to people with stage 2, 3 or 4 melanoma that had been surgically removed but had a high risk of coming back. 

“The science that helped protect us against COVID-19 is now showing promise in treating cancer,” said Elliott. “These results are encouraging for people with melanoma, a cancer that can come back aggressively after surgery.” 

Even so, we’re still some way from personalised cancer vaccines becoming a common part of standard care. Making them is difficult, expensive and time-consuming, and success in melanoma, where immunotherapy is already relatively effective, won’t necessarily translate to trials for other cancer types. 

This trial will also need to continue so researchers can see how well the new treatment works over longer periods and if it can improve overall survival. Regulators will then need to review the final results, which may take several years. 

“Cancers differ from person to person, so research into tailored treatments is vital,” said Elliott. “Continued investment will help us understand who benefits most from approaches like this, and how we can make them available to the people who need them.”

NHS radiotherapy helps some people with advanced lung cancer live longer

More traditional cancer treatments are also driving progress. One Cancer Research UK-funded trial at ESMO showed that adding targeted radiotherapy to standard drug treatments could help control some advanced lung cancers for longer.

People with oligometastatic non-small cell lung cancer (NSCLC) have cancer that has spread beyond the lungs, but only to a small number of other areas. Doctors usually treat these patients with therapies that work throughout the body, such as chemotherapy, immunotherapy or a combination of the two, to control tumours and slow further spread.

In the Phase 2 SARON trial, researchers wanted to test whether a more precise form of traditional radiotherapy, called local consolidation radiotherapy, could help improve patient outcomes.

The researchers treated the tumours and affected lymph nodes of 70 patients from 19 hospitals across the UK with the radiotherapy in addition to their other treatments. When the researchers followed up with patients after three years, they found that those who received the radiotherapy went 56% longer without their cancer growing or spreading. On average, their disease remained stable for 13.9 months before progressing, while those who received standard treatment alone were stable for 8.9 months.

Encouragingly, this type of radiotherapy is already available on the NHS, so it could start making a difference quite quickly.

Dr Dani Skirrow, a science engagement manager at Cancer Research UK, said: “Thanks to SARON, we now know that adding targeted radiotherapy to standard treatment helps keep cancer under control for longer, giving people precious time to carry on doing the things that matter to them with their loved ones.

“It’s vital that we support research like this that helps people with cancer to live better lives for longer.”

You can read more about SARON on the Institute of Cancer Research (ICR) website. The trial was funded by Cancer Research UK and sponsored by University College London.

A powerful new treatment for advanced womb cancer

This is where things get hard to pronounce. Sacituzumab tirumotecan (sac-TMT) is a relatively new type of treatment called an antibody-drug conjugate (ADC). It has two names because it’s designed to do two things: track down cancer cells and deliver targeted doses of chemotherapy.

The Phase 3 TroFuse-005 study trialled sac-TMT in women who had already received chemotherapy and immunotherapy for advanced or recurring endometrial cancer, the most common type of womb cancer.

There are currently very few options for endometrial cancers that resist or return after standard treatment, but the results suggest ADCs could offer a new way forward. Over the course of the trial, women who received sac-TMT had a 41% lower risk of their cancer growing and spreading than those who were treated with further rounds of chemotherapy. Their overall risk of death was also 32% lower.

That’s linked to the key differences between sac-TMT and standard chemotherapy. ADCs share chemo’s cancer-killing power, but they direct it with a biological homing device.

In sac-TMT’s case, the homing device, or antibody, locks onto cells with lots of TROP2 molecules, which are common in womb cancers. That can be an effective treatment approach on its own, as antibodies can flag cells to the immune system. But in ADCs, they also carry chemotherapies directly to cancer cells, which helps deliver more powerful doses and can lower the risk of side effects.

In the trial, sac-TMT treatment shrank cancers in more than twice as many women as standard chemotherapy (35% versus 17%). A higher percentage of people who received the new drug experienced difficult adverse events linked to their treatment, but the most frequent side effects were reported as “manageable”. 

Dr Catherine Elliot, Cancer Research UK’s director of research, called the results “promising”.

“This innovative drug can reduce the risk of death by nearly a third for some patients, stopping the disease in its tracks for longer than standard treatment,” she said.

“If it’s approved for NHS use, this could be a vital new treatment option in the future to give those with womb cancer the chance for longer and healthier lives.”

A promising new drug for people with advanced stomach cancer

Researchers from China and Japan showed that another antibody-drug conjugate could slow down some advanced stomach (gastric) and gastro-oesophageal cancers when standard options stop working. 

Interim analysis of the Phase 3 G-HOPE-001 trial found that arcotatug tavatecan helped patients with these hard-to-treat cancers live an average of three months longer than other approved drugs. It also shrank tumours in almost 4 in 10 people whose previous treatments were no longer effective and extended the average time until they started growing again. By contrast, the other drugs on the trial shrank tumours in fewer than 1 in 10 people.

“People with advanced stomach cancer can feel they’ve run out of road when treatments stop working,” said Dr Graham Cadwallader, Cancer Research UK’s head of clinical research. “These results point towards another treatment option that could give people more precious time with the ones they love.”

Arcotatug tavatecan delivers its chemotherapy payload to cells with lots of Claudin 18.2 molecules, which are especially prevalent in cancers affecting the stomach.

Overall, the researchers reported a slightly lower rate of severe side effects from arcotatug tavatecan than the other drugs on the trial.

“We must keep pushing to improve the treatments we offer at every stage of someone’s cancer and developments like this could become the new standard of care,” Cadwallader added.

“We now need to understand whether these benefits last and extend to a wider range of people beyond China and Japan. This will help establish where this treatment could fit into UK care.”

New combination treatment could help tackle drug-resistant lung cancer 

New findings from the Phase 3 SAFFRON clinical trial suggest that combining targeted drugs could help keep advanced NSCLC under control for longer. 

The research builds on decades of progress in understanding how lung cancer works. In the 1980s, Cancer Research UK-funded scientists helped uncover a key protein that drives cancer growth called EGFR. The discovery paved the way for today’s targeted cancer growth blockers, giving many people precious extra years of life. 

However, over time, NSCLCs can begin to resist drugs that block EGFR. One common escape route involves cells relying on a protein called MET to help them grow instead. 

That’s why researchers wanted to see if targeting both EGFR and MET at the same time could stop more NSCLCs from growing. SAFFRON tested the EGFR-targeting drug osimertinib and the new MET-blocker savolitinib in patients with advanced NSCLC that showed signs it was using MET to resist osimertinib on its own. 

By blocking both proteins at once, the two drugs were able to stop some patients’ tumours from growing for longer than chemotherapy. People who received the new treatment combination had an average of two more months before their cancer grew again, and five extra months overall. They were also less likely to experience severe side effects. 

The results show that genetic testing can be make a difference throughout cancer treatment, and not just at the start.  

Rethinking head and neck cancer to improve treatment 

In some cases, one drug can target cancer cells from multiple angles at once. In a trial led by UK researchers, amivantamab, an antibody that blocks EGFR and MET while stimulating the immune system, helped shrink tumours in almost 8 out of 10 patients with a hard-to-treat type of head and neck cancer. 

The NHS already offers amivantamab, which is given as an injection, as a treatment for NSCLC. This study, part of the early-phase OrigAMI-4 trial, tested it in a small group of people with head and neck cancers that had returned or spread and aren’t linked to high-risk HPV infections.

Traditionally, all head and neck cancers have been treated the same way, but people with cancers that aren’t linked to HPV tend to have worse outcomes. There’s now evidence that more targeted treatments could change that. In OrigAMI-4, adding amivantamab to immunotherapy and chemotherapy more than doubled the proportion of people with these cancers whose tumours shrank as a result of their treatment. 

Thanks to these positive results, the Phase 3 OrigAMI-5 trial will now test the treatment in a larger group of people to better understand how effective it can be. 

Researchers from the ICR and the Royal Marsden NHS Trust took part in this study in the UK, and you can hear from someone who took part in the trial on the ICR website.

An alternative to chemotherapy for people with muscle-invasive bladder cancer

Finally, another major study at ESMO added more evidence that another treatment combination – immunotherapies and ADCs – could help treat people with muscle-invasive bladder cancer (MIBC).

When possible, before MIBC patients undergo surgery, doctors give them cisplatin-based chemotherapy to help make sure their cancer doesn’t come back.

But for almost 1 in 2 patients, this isn’t an option because of age, poor kidney function, or other complicating health conditions. And without the treatment, they face a higher risk of their cancer returning.

Researchers have been looking for an alternative, and the results of the Phase 3 VOLGA trial suggest that they might have found one. They tested the immunotherapy drug durvalumab along with an ADC called enfortumab vedotin in patients who were going to have surgery but were ineligible for or refused to take cisplatin. Patients received three cycles of both drugs before surgery, followed by nine cycles of durvalumab after surgery.

Those who were given the treatment lived longer and had an overall higher survival rate than those who had surgery alone (78% compared to 69%). They were also half as likely to have certain complications or health events like cancer returning.

Together with the results of other trials from earlier this year, the findings suggest that more treatment options may soon be available to those with muscle-invasive bladder cancer.