ESMO 2026: three pancreatic cancer results worth reading closely
ESMO 2026 has wrapped up in Madrid. Our Head of Research and Evidence Generation, Amber Johns, shares her take on the pancreatic cancer results from the congress.
For pancreatic cancer, three presentations stood out. One extends a result we already knew. One is Australian and changes how we think about local control. One missed its primary endpoint and still has something to teach us.
None of them is a finished story. All of them are worth reading closely.
1. RASolute 302: daraxonrasib holds up across RAS subgroups (LBA82)
Daraxonrasib has been one of the most talked-about drugs in pancreatic cancer this year. In May, the phase 3 RASolute 302 trial showed it nearly doubled median overall survival in previously treated metastatic disease (13.2 vs 6.7 months), and in August the US FDA approved it. ESMO gave us a closer look at who benefits.
Exploratory analyses from RASolute 302 showed overall survival favoured daraxonrasib over chemotherapy in every RAS genotype analysed, including G12D and G12V. The benefit also held across all comparator chemotherapy regimens, and in patients with no identified RAS mutation.
The caveat matters. These are exploratory analyses and the subgroups are small. Still, the direction is consistent everywhere they looked. That consistency is what makes it interesting.
2. AGITG MASTERPLAN: adding radiation to chemotherapy (Rapid Oral 3136RO)
This one is close to home. MASTERPLAN is an Australian randomised phase 2 trial in 75 patients with high-risk borderline resectable or locally advanced pancreatic ductal adenocarcinoma. It tested adding stereotactic body radiotherapy (SBRT) to mFOLFIRINOX.
The results:
- 12-month locoregional recurrence fell from 52.0% to 20.2%
- Median overall survival was 22.0 vs 14.0 months
- Median progression-free survival was 11.9 vs 6.3 months (P=0.002)
- Grade 3 or higher toxicity did not rise significantly (70.2% vs 64.0%)
The study is small and heterogeneous. Only 39 of the 49 patients assigned to SBRT started it. The locoregional benefit was not significant in the inoperable subgroup.
Congratulations to Andrew Oar and the AGITG team, who presented the work at ESMO and have reportedly published it in Lancet Oncology. Australian investigator-led trials asking practical questions about how we combine existing treatments are exactly the kind of research our patients need more of.
3. AMPLIFY-7P: an adjuvant KRAS vaccine misses its primary endpoint (LBA83)
Dr Eileen O’Reilly presented phase 2 results for ELI-002 7P, a vaccine targeting KRAS mutations. KRAS mutations are found in more than 90% of pancreatic cancers.
The randomised trial enrolled 144 patients with resected mKRAS pancreatic cancer and compared the vaccine with observation. It did not meet its disease-free survival endpoint in the intent-to-treat population.
The immune data tell a more nuanced story. 99% of patients receiving the vaccine developed cancer-fighting T cells, and patients with the strongest immune responses had the lowest recurrence rates. The sponsor is pointing to pre-specified subgroup and biomarker analyses to shape a refined phase 3.
Dr O’Reilly, who co-led the trial, said: “Having a vaccine that’s ‘off-the-shelf’ would make it easier, faster, and less expensive to treat a larger number of patients. This gives hope for people with pancreatic cancer who have been out of effective treatments when their disease returns.”
What happens next with the biomarker work will matter.
What Amber is taking away
It’s remarkable to see so many targets under investigation in pancreatic cancer, and more trials underway than ever before. The task now is to make sure Australia doesn’t miss out.
We can do better for patients. This week showed some of how.