Can advances in antibody-drug conjugate design translate into meaningful survival benefits across more tumor types and earlier treatment settings, without unacceptable toxicity?
Ahead of the European Society for Medical Oncology (ESMO) Congress 2026, antibody-drug conjugates (ADCs) are generating much excitement as a significant breakthrough across solid tumours and hematological malignancies. Having transformed treatment for HER2-positive breast cancer, ADCs are now taking center stage in Madrid, featuring in one-third of the Presidential Symposium late-breaking abstracts across genitourinary, gastrointestinal, gynecological cancers and osteosarcoma. These studies illustrate a shift from established HER2-directed approaches, toward a broader landscape of targets, payloads and clinical applications. In this article, we examine the key trials to watch and the clinical questions they aim to address.
Dr Ken Kato, National Cancer Center Hospital, Tokyo, Japan
Trials to watch
| Trial (abstract) | Agent and target | Setting |
| VOLGA (LBA2) | Enfortumab vedotin (Nectin-4) + durvalumab ± tremelimumab | Perioperative, cisplatin-ineligible muscle-invasive bladder cancer |
| CLARITY-Gastric 01 (LBA7) | Sonesitatug vedotin (CLDN18.2) | Second-line or later CLDN18.2-positive gastroesophageal cancer |
| ARTEMIS-011 (LBA9) | Risvutatug rezetecan | Relapsed or refractory osteosarcoma |
| TroFuse-005 (LBA11) | Sacituzumab tirumotecan (TROP2) | Previously treated endometrial cancer |
| PANKU-Lung01 (LBA71) | Izalontamab brengitecan (EGFR×HER3 bispecific) | EGFR-mutant non-small cell lung cancer after third-generation tyrosine kinase inhibitor therapy |
| PANKU-Breast01 (LBA50) | Izalontamab brengitecan | Pretreated hormone receptor-positive, HER2-negative breast cancer |
Explore the sessions and speaker profiles
VOLGA (LBA2)
VOLGA is evaluating perioperative enfortumab vedotin with durvalumab, with or without tremelimumab, in cisplatin-ineligible muscle-invasive bladder cancer. ESMO 2026 will present Phase III results, helping clarify whether this combination-based approach can improve outcomes in earlier-stage disease and whether adding CTLA-4 inhibition offers further benefit.
CLARITY-Gastric 01 (LBA7)
CLARITY-Gastric 01 has already reported positive topline results, demonstrating a statistically significant overall survival benefit with the CLDN18.2-directed ADC sonesitatug vedotin versus investigator’s choice of therapy. ESMO will provide detailed Phase III findings, helping establish the magnitude of benefit, safety profile and potential role in previously treated CLDN18.2-positive disease.
ARTEMIS-011 (LBA9)
ARTEMIS-011 met its primary endpoint, with risvutatug rezetecan significantly improving progression-free survival versus gemcitabine plus docetaxel in heavily pretreated relapsed or refractory osteosarcoma. ESMO will reveal the detailed efficacy and safety data, including the extent of benefit across secondary endpoints, helping clarify the potential role of B7-H3 targeting in this rare cancer.
TroFuse-005 (LBA11)
TroFuse-005 is investigating the TROP2-directed ADC sacituzumab tirumotecan in previously treated endometrial cancer, where additional treatment options are needed. The ESMO presentation will provide further evidence of its antitumor activity and tolerability in this setting, helping assess whether TROP2 targeting could offer a clinically meaningful option for patients whose disease has progressed after prior therapy.
PANKU-Lung01 (LBA71)
PANKU-Lung01 is evaluating the EGFR×HER3 bispecific ADC izalontamab brengitecan after progression on third-generation EGFR tyrosine kinase inhibitors. Earlier Phase III studies of the agent have reported positive topline findings in other cancers. ESMO will provide pivotal data in EGFR-mutant non-small cell lung cancer, clarifying its efficacy and safety relative to the study comparator.
PANKU-Breast01 (LBA50)
PANKU-Breast01 is investigating izalontamab brengitecan in previously treated hormone receptor-positive, HER2-negative advanced breast cancer. The agent’s dual EGFR×HER3 targeting and topoisomerase I inhibitor payload offer a distinct approach to ADC design. ESMO’s Phase III findings will help determine whether this strategy improves outcomes and how its efficacy and tolerability compare with the trial’s control treatment.
This content has been developed independently by Touch Medical Media for touchONCOLOGY. It is not affiliated with the European Society for Medical Oncology (ESMO). Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media. This article was created by the editorial team utilizing AI as an editorial tool (Claude.AI and ChatGPT 5.5). The content was developed and edited by human editors. No funding was received in the publication of this article.
Cite: ESMO 2026 preview: Can ADCs deliver greater clinical benefit? touchONCOLOGY. 21st October 2026.
Editor: Sophie Nickelson
