There are four million Italians alive after a cancer diagnosis. It is the most updated data provided by AIOM - Italian Association of Medical Oncology and reported in the XVIII FAVO Report on the welfare condition of cancer patients, the annual document created by the Italian Federation of Volunteer Associations in Oncology. It is AIOM, again, on the occasion of the ESMO Congress underway in Madrid, who announced that approximately 2.7 million new cancer diagnoses are recorded in Europe every year: 5 new diagnoses every minute. Numbers that tell of an enormous health challenge, but also the progress of research that in recent years has made it possible to increase survival, quality of life and possibilities of treatment. Thanks to prevention and increasingly effective treatments, approximately 7.3 million cancer deaths have been avoided in the European Union since 1988.
It is in this scenario that ESMO 2026, the Congress of the European Society for Medical Oncology, which brought together the world's leading oncology experts in the Spanish capital, takes place. An appointment which, this year more than ever, seems to mark a historic transition: from precision oncology to personalized oncology. Those who experience the Congress closely realize one fundamental thing: we are no longer just talking about finding the right drug for a specific disease, the goal is to build treatments that are increasingly adapted to the biological, genetic and clinical profile of each individual patient.
From personalized vaccines to tailor-made medicine
The symbolic news of the congress comes from personalized mRNA therapeutic vaccines. Unlike traditional vaccines, used to prevent a disease, these treatments are developed after diagnosis and are designed based on the genetic characteristics of the patient's tumor. The goal is to train the immune system to recognize and destroy remaining cancer cells, reducing the risk of recurrence. It is a perspective that until a few years ago seemed to belong to the medicine of the future and which today, thanks to the results presented in Madrid, appears increasingly closer to clinical practice.
Melanoma, the personalized vaccine that changes oncology
Among the news that attracted the most attention at the ESMO 2026 Congress is what many experts consider a true milestone of modern oncology. For the first time, a personalized therapeutic mRNA vaccine has demonstrated in a phase 3 study that it can significantly reduce the risk of tumor recurrence. The results come from high-risk melanoma and represent one of the most advanced applications of tailored medicine. The vaccine is constructed starting directly from the tumor removed from the patient: through genetic analysis of the tumor cells, the unique characteristics of the disease are identified and, within about six weeks, a personalized treatment is created capable of training the immune system to recognize and target any residual tumor cells.
In the international phase 3 INTerpath-001 study, which involved over a thousand patients in 157 centers around the world, the association between the personalized vaccine and immunotherapy reduced the risk of relapse or death by 42% and the risk of distant metastases by 38% compared to immunotherapy alone. Two years after treatment, over 82% of patients were alive and free of disease.
More than a single clinical result, it is a concrete demonstration of what is happening in oncology today: not developing a therapy valid for everyone, but building treatments designed on the biological characteristics of each individual person. A vision that until a few years ago seemed futuristic and which today is starting to translate into real benefits for patients.
Professor Giuseppe Curigliano, President Elect of ESMO, will lead the European Society for Medical Oncology from 2027, underlines how oncology is experiencing an unprecedented phase of transformation: "Oncology is experiencing a phase of important progress, thanks to increasingly innovative and personalized therapies, thanks to molecular analysis we can identify subgroups of patients and choose the most suitable treatments for each one".
ADC, the intelligent missiles against cancer
Among the protagonists of ESMO 2026 there are also ADCs, drug-conjugated antibodies, considered by many specialists to be one of the most important innovations of recent years. The principle is as simple as it is revolutionary: an antibody recognizes specific characteristics of the tumor cell and transports a powerful anti-tumor drug directly inside it. Like a guided missile, the therapy hits the target while reducing the exposure of healthy tissue as much as possible. These drugs are already changing the treatment of many cancers, from breast cancer to lung cancer, up to some forms of gastric and gynecological cancer. The results presented in Madrid suggest that their use is destined to expand further in the coming years.
Bispecific antibodies, the new frontier of immunotherapy
Another line of research that is attracting great attention is that of bispecific antibodies. These are molecules designed to bind simultaneously to the tumor cell and to the cells of the immune system, promoting direct contact between the two targets. In this way the body is helped to recognize and attack the tumor more effectively. A strategy that is offering promising results in various cancers and which could represent a new generation of immunotherapies.
Professor Massimo Di Maio, President of AIOM, highlights that immunotherapy continues to evolve and today we have increasingly sophisticated tools to activate the immune system against tumors and to identify which patients can obtain the maximum benefit from treatments.
Artificial intelligence enters the heart of oncology research
There was also a lot of talk in Madrid about artificial intelligence. AI is already being used to analyze radiological images, interpret molecular data, identify biomarkers and support the design of clinical trials. The goal is not to replace the doctor, but to increase the ability to read and interpret enormous quantities of information that research today produces every day. The more data becomes available, the more essential it becomes to have tools capable of transforming them into useful clinical decisions for the patient.
Research is underway, Europe must accelerate
Alongside scientific innovations, ESMO 2026 also turned the spotlight on the competitiveness of European research. The United States and China are investing heavily in the development of new oncology therapies and translational research. For many experts, the risk is that Europe will lose ground if regulatory processes are not simplified and access to innovation is speeded up. A particularly sensitive issue for the European scientific community, which is calling for more streamlined procedures and greater support for independent clinical research. Professor Giuseppe Curigliano drew attention to the risk of a reduction in clinical trials in Europe and the need to simplify regulatory procedures to keep the continent competitive in oncology research. However, an encouraging sign comes from Italy. This year too, our country confirms its third place in the world in terms of number of abstracts presented and accepted at the ESMO Congress, behind only the United States and China. A result that testifies to the quality of Italian oncology research and the increasingly important role of our centers in the production of scientific evidence capable of influencing international clinical practice.
