The European Society for Medical Oncology (ESMO) 2025 congress brought over 100 late-breaking abstracts, 250 sessions, 600 expert speakers and 33,800 delegates to Berlin in October. The meeting highlighted innovations ranging from novel agents to real-world evidence and patient-centred care. In this article, hear from the experts on the key breakthroughs and clinical insights set to shape the future of oncology practice.

Ovarian cancer: Nicoletta Colombo on ENGOT-ov65/KEYNOTE-B96

Platinum-resistant recurrent ovarian cancer remains one of the most challenging areas in gynecologic oncology, with limited treatment options and poor survival outcomes. ENGOT-ov65/KEYNOTE-B96 evaluated pembrolizumab combined with weekly paclitaxel, with or without bevacizumab. We observed one of the longest overall survival durations ever reported in this setting, suggesting this regimen could represent a new standard of care for patients with platinum-resistant disease.

Read the full interview: ENGOT-ov65/KEYNOTE-B96 shows survival benefit in platinum-resistant ovarian cancer

Ovarian cancer: Antonio González-Martín on ANITA and NAPISTAR-101

Median overall survival for patients with platinum-resistant ovarian cancer is around one year, and new strategies are urgently needed. The NAPISTAR phase 1 dose escalation study investigated TUB-040, a novel NaPi2b-targeting exatecan antibody-drug conjugate in patients with platinum-resistant ovarian high grade serous carcinoma; and the phase 3 ANITA study investigated baseline multiplex cytokine profiling identifies prognostic signatures in recurrent ovarian cancer.

Read the full interview: ANITA and NAPISTAR-101 trials, immunotherapy and antibody–drug conjugates in ovarian cancer

Ovarian cancer: Domenica Lorusso on ROSELLA (GOG3073, ENGOT-ov72, APGOT-OV10)

The latest data from the ROSELLA trial (GOG3073, ENGOT-ov72, APGOT-OV10), evaluated relacorilant plus nab-paclitaxel in patients with platinum-resistant ovarian cancer, previously exposed to a PARP inhibitor. We are awaiting the final OS data, which will mature in Q1 2026 and be presented next year. If the current trend is confirmed, this combination could offer an important new option for platinum-resistant ovarian cancer

Read the full interview: Relacorilant plus nab-paclitaxel shows promise in platinum-resistant ovarian cancer

Bladder cancer: Christof Vulsteke on KEYNOTE-905

Upfront surgery alone leaves most cisplatin-ineligible patients at high risk of recurrence – KEYNOTE-905 provides a new path forward. We tested perioperative enfortumab vedotin plus pembrolizumab in a randomized three-arm design, demonstrating significant event-free and overall survival benefits, with a notable proportion of patients achieving complete pathological response. These results may reshape future treatment algorithms and enable surgery-free approaches for eligible patients.

Read the full interview: KEYNOTE-905 delivers breakthrough results in cisplatin-ineligible MIBC 

Bladder cancer: Nicholas D. James on BladderPath

Traditionally, patients with muscle-invasive bladder cancer face lengthy diagnostic-to-treatment timelines exceeding 130 days. The late-breaking BladderPath trial introduced pre-treatment MRI, reducing this to 95 days while halving relapse risk and lowering overall costs. By integrating MRI before TURBT, we cut the time to definitive treatment by six weeks and halved relapse risk. This offers both patients and healthcare systems a more efficient and effective pathway for bladder cancer management.

Read the full interview: Early MRI cuts time-to-treatment and relapse risk in muscle-invasive bladder cancer

Bladder cancer: Morgan Rouprêt on ALBAN

Although adding systemic immunotherapy to BCG didn’t improve event-free survival, it offers key lessons for patient selection. The ALBAN study offers valuable insights into treatment sequencing, toxicity and molecular stratification – moving the field closer to personalized immunotherapy for NMIBC.

Read the full interview: ALBAN – Can systemic immunotherapy boost BCG response in NMIBC?

Breast cancer: Sara A. Hurvitz on VIKTORIA-1

VIKTORIA-1 evaluated gedatolisib in a triplet and doublet combination in HR+/HER2–, PIK3CA wild-type advanced breast cancer. Both combinations significantly improved progression-free survival, with encouraging response rates and a manageable safety profile. Results may inform regulatory review and sequencing after CDK4/6 inhibitors.

Read the full interview: VIKTORIA-1 triplet and doublet combinations improve PFS in HR+/HER2– PIK3CA wild-type breast cancer

Breast cancer: Atul Batra on the efficacy of pembrolizumab at low dose

Could a fraction of the standard pembrolizumab dose still boost outcomes in triple-negative breast cancer? Even at a fraction of the standard dose, pembrolizumab can stimulate the immune system and improve pathological complete response. This new data challenge current dosing and could potentially expand critical access to immunotherapy in low- and middle-income countries.

Read the full interview: Pembrolizumab at low dose: could less be more in triple-negative breast cancer?

Breast cancer: John Crown on NATALEE

The late-breaking five-year outcomes from the phase III NATALEE trial confirmed the sustained benefit of adding adjuvant ribociclib to a nonsteroidal aromatase inhibitor in hormone receptor-positive, HER2-negative early breast cancer. We now have, I believe, the option of offering our patients with higher-risk or even node-negative HR+/HER2− early breast cancer a treatment that can substantially reduce their risk of relapse.

Read the full interview: Five-year NATALEE trial data confirm lasting benefit with adjuvant ribociclib in HR+/HER2− early breast cancer

Renal cell carcinoma: Andrew W Hahn on LenCabo

The LenCabo trial conducted the first head-to-head comparison of second-line treatments for metastatic clear cell renal cell carcinoma. The randomized phase II LenCabo trial compared lenvatinib plus everolimus to cabozantinib after PD-1 checkpoint inhibitor therapy. Lenvatinib plus everolimus reduced the risk of disease progression by nearly half compared with cabozantinib, offering a potential strategy for aggressive disease.

Read the full interview: LenCabo head-to-head highlights lenvatinib-everolimus benefit after immunotherapy in metastatic ccRCC

Diagnostics: Nima Nabavizadeh on PATHFINDER 2

The PATHFINDER 2 study centred on the Galleri multi-cancer early detection (MCED) test, which uses DNA methylation profiling, next-generation sequencing and machine learning to predict cancer signals and their tissue of origin. The Galleri test detected over seven times more screen-detectable cancers than current US screening methods – reinforcing MCED testing’s complementary role alongside established cancer screening programs.

Read the full interview: Galleri MCED test detects early-stage cancers beyond standard screening

Oesophageal cancer: Michael K Gibson on MATTERHORN and SKYSCRAPER‑07

Oesophageal cancer is entering a new era of innovation, as emerging data from ESMO25 congress shows meaningful advances in both adenocarcinoma and squamous-cell subtypes. For the first time in two decades, curative-intent treatment of oesophageal cancer shows substantive incremental gains. Dr Gibson reviews two pivotal phase III trials – the MATTERHORN and SKYSCRAPER‑07 – outlining the key challenges, the current standpoint and where the field is heading next.

Read the full interview: MATTERHORN and SKYSCRAPER-07 mark new era for oesophageal cancer