ASCO 2026 Day 4 Highlights
Monday 1st June
ASCO 2026 Day 4 highlighted important advances across oncology, with new data clarifying the role of combination strategies, adjuvant immunotherapy, and treatment intensification across disease settings.
Advancing Combination Strategies in Hepatocellular Carcinoma
Results of EMERALD-3 (LBA4000): A phase 3 trial evaluating STRIDE ± lenvatinib in combination with TACE in unresectable hepatocellular carcinoma
EMERALD-3 investigated the impact of combining systemic immunotherapy and targeted therapy with locoregional treatment in patients with unresectable hepatocellular carcinoma eligible for TACE.
- STRIDE + lenvatinib + TACE significantly improved progression-free survival vs TACE alone (HR ~0.70)
- A positive trend toward improved overall survival was observed (HR ~0.84)
- STRIDE + TACE also improved progression-free survival (HR ~0.71) and overall survival (HR ~0.70) vs TACE
- Improved outcomes were observed across both experimental arms compared with TACE alone
These findings support the further integration of systemic and locoregional therapies in intermediate-stage disease, suggesting that combination approaches may deliver superior outcomes compared with current standard approaches.
Reassessing Adjuvant Immunotherapy in Early-Stage NSCLC
Results of ALCHEMIST (Abstract 8000): A phase 3 randomized trial of adjuvant nivolumab in resected NSCLC
The ALCHEMIST trial evaluated whether adjuvant nivolumab improves outcomes following surgery and chemotherapy in patients with resected NSCLC without EGFR or ALK alterations.
- No significant improvement in disease-free survival (DFS) was observed
- Median DFS: 71 months vs 68.8 months (HR 0.97)
- No benefit observed even in PD-L1 high populations (≥50%)
These findings suggest that adjuvant nivolumab does not provide additional benefit in this setting, reinforcing the need to more precisely define which patient populations derive value from immunotherapy in early-stage disease.
Exploring Adjuvant Immunotherapy in Merkel Cell Carcinoma
Results of STAMP (LBA9505): A phase 3 trial of adjuvant pembrolizumab in resected Merkel cell carcinoma
The STAMP study represents the first randomized phase 3 trial evaluating adjuvant immunotherapy in this rare and aggressive cancer.
- Numerical improvement in recurrence-free survival with pembrolizumab, though not statistically significant
- Improvement observed in distant metastasis-free survival (p ~0.05)
- Merkel cell carcinoma–specific outcomes improved (HR ~0.66)
- Exploratory analyses suggested outcomes may have differed according to radiotherapy sequencing, highlighting an area for further investigation.
While results were impacted by study limitations, including the COVID-19 pandemic, these findings suggest a potential role for pembrolizumab in improving disease-specific outcomes, but also highlight the importance of treatment sequencing and the need for further data to define its optimal use in clinical practice.
Across these studies, a consistent theme emerges: the need to balance treatment intensification with clear evidence of clinical benefit, particularly in earlier-stage disease where precise patient selection is critical to maximizing impact.
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References
- Results of EMERALD-3 (LBA4000): A phase 3 trial evaluating STRIDE ± lenvatinib in combination with TACE in unresectable hepatocellular carcinoma: Efficacy and safety results from EMERALD-3: A phase 3, randomized study of tremelimumab plus durvalumab with or without lenvatinib combined with transarterial chemoembolization (TACE) in participants (pts) with unresectable embolization-eligible hepatocellular carcinoma (eeHCC). - ASCO
- Results of ALCHEMIST (Abstract 8000): A phase 3 randomized trial of adjuvant nivolumab in resected NSCLC: https://www.asco.org/abstracts-presentations/259315
- Results of STAMP (LBA9505): A phase 3 trial of adjuvant pembrolizumab in resected Merkel cell carcinoma: https://www.asco.org/abstracts-presentations/260533
