Researchers at The University of Texas MD Anderson Cancer Center presented a slate of new findings at the European Society for Medical Oncology (ESMO) Congress 2026 in Madrid, outlining emerging strategies to monitor how patients respond to treatment, to prevent cancer from developing in people at high genetic risk, and to improve outcomes with targeted and immune-based therapies. The work spans several distinct disease settings, including lung cancer, triple-negative breast cancer, skin cancer and Lynch syndrome, and it reflects a broader shift in oncology toward detecting molecular signals of response earlier than conventional measures allow.
Among the most closely watched presentations were late-breaking abstracts reporting improved survival with divarasib in KRAS-mutant lung cancer and with an immunotherapy-based regimen in advanced endometrial cancer. Those survival results, presented as late-breaking data, add to a portfolio that also includes detailed biomarker analyses and long-term follow-up from earlier-phase trials. All of the center’s ESMO content was made available through its institutional congress hub, and the findings were delivered across abstracts 3438O, 4244RO, 540RO and 2490P between October 23 and October 25.
One of the prevention-focused studies examined a cancer interception vaccine in people with Lynch syndrome, a hereditary condition that substantially increases the risk of colorectal, endometrial and other cancers. The investigational vaccine, called Nous-209, is a neoantigen-based vaccine designed to intercept cancer development before it begins in this high-risk population. In a cohort expansion of the Phase I trial, researchers evaluated safety and outcomes following re-vaccination, assessing two different re-vaccination strategies, each administered one year after an initial vaccine series.
The results offered an early but encouraging signal for the interception concept. Both re-vaccination approaches were well tolerated, with no severe side effects reported, and investigators documented enhanced T cell immune responses following re-vaccination. The strongest immune boost was seen in patients who received a single neoantigen booster dose. Importantly for a prevention trial, no advanced colorectal cancers were detected in follow-up colonoscopies among study participants. Eduardo Vilar-Sanchez, M.D., Ph.D., chair ad-interim of Clinical Cancer Prevention, presented the findings on October 25.
“Cancer interception seeks to prevent cancer before it develops, fundamentally changing how we approach care for individuals at highest risk,” Vilar-Sanchez said. “These findings show that re-vaccination can safely strengthen and sustain immune responses, supporting continued development of vaccine-based prevention strategies for people in this population.” Because the trial is an early-phase safety and immunogenicity study, the cancer-prevention benefit will require further testing in larger, longer studies before the approach can be considered established care.
A second presentation turned to localized lung cancer and the question of which patients are most likely to benefit from treatment before and after surgery. In the Phase 2 NeoCOAST-2 trial, researchers evaluated whether changes in circulating tumor DNA, or ctDNA, could identify patients with resectable non-small cell lung cancer who respond best to novel perioperative combination regimens. They found that patients whose ctDNA was cleared from the bloodstream early in treatment had better outcomes and a lower risk of recurrence. Patients who achieved both ctDNA clearance and a pathologic complete response at surgery experienced the most favorable outcomes of all.
The findings suggest ctDNA may serve as an early biomarker of treatment effectiveness and could help inform future treatment decisions in the perioperative setting. Tina Cascone, M.D., Ph.D., professor of Thoracic/Head & Neck Medical Oncology, presented the data on October 25, and the results were published concurrently in Nature. “While pathologic response has become an important measure of treatment benefit, ctDNA can provide an earlier view of how a patient’s cancer is responding,” Cascone said. “These findings suggest ctDNA clearance may help identify patients most likely to achieve long-term benefits and could play an important role in guiding future perioperative treatment strategies.”
In the B-STRONGER-I study, researchers evaluated an ultrasensitive, tumor-informed ctDNA assay in patients with stage 1-3 triple-negative breast cancer receiving pre-surgery treatment. The assay detected ctDNA in 96% of patients at baseline and revealed rapid molecular responses after treatment initiation, with more than 80% of patients achieving ctDNA clearance by the first assessment. Early molecular clearance was associated with an increased likelihood of achieving a pathologic complete response, suggesting that ultrasensitive ctDNA monitoring may provide an early indication of treatment effectiveness.
Carlos Barcenas, M.D., professor of Breast Medical Oncology, presented the findings on October 23. “These results demonstrate the potential of ultrasensitive ctDNA monitoring to provide a real-time view of how patients are responding to treatment,” Barcenas said. “Earlier insights into treatment effectiveness could ultimately help physicians personalize treatment strategies and improve outcomes for these patients.”
The longest follow-up came from a Phase 2 study of neoadjuvant immunotherapy in high-risk skin cancer. Researchers reported final results evaluating cemiplimab, an immune checkpoint inhibitor, given before surgery in patients with resectable stage 2-4 cutaneous squamous cell carcinoma, the second most common form of skin cancer. After more than four years of follow-up, no new cancer recurrences were observed since the one-year analysis, and more than 75% of patients remained free of disease-related events at 4.5 years, or 54 months. The strongest outcomes were seen in patients whose tumors completely responded to treatment before surgery, and no new safety concerns were identified. Neil Gross, M.D., professor of Head and Neck Surgery, presented the findings on October 24, and the data were published concurrently in the Journal of Clinical Oncology. “These long-term results demonstrate that many patients can achieve durable disease control with immunotherapy given before surgery,” Gross said. “The absence of new recurrences after the first year of follow-up reinforces the potential of this approach to improve outcomes for patients with high-risk cutaneous squamous cell carcinoma.” Together, the studies give some of the longest follow-up to date supporting immunotherapy before surgery in this cancer type, and they sketch a coherent agenda: earlier molecular signals of response, vaccine-based interception for genetically high-risk individuals, and pre-surgical immune priming for durable disease control.
Subject of Research: Biomarker-guided cancer monitoring, prevention vaccination and perioperative immunotherapy studies presented at ESMO 2026
Article Title: ESMO 2026: UT MD Anderson highlights innovative approaches to monitor, prevent and treat cancer
Article References: ESMO 2026: UT MD Anderson highlights innovative approaches to monitor, prevent and treat cancer. Original publication (Bibliographic details unavailable.)
Image Credits: AI Generated
DOI: Not provided
Keywords: ESMO 2026, MD Anderson Cancer Center, ctDNA, Lynch syndrome, triple-negative breast cancer, non-small cell lung cancer, cutaneous squamous cell carcinoma, cancer interception vaccine, neoadjuvant immunotherapy, cemiplimab, NeoCOAST-2, divarasib
News Source: Nathaniel Bowman. (October 29, 2026). MD Anderson Studies Point to Blood Tests, Vaccines and Pre-Surgery Immunotherapy at ESMO 2026. Scienmag.
