Annals of Oncology 'Under Review': What Each Status Means

Before the paper reaches external reviewers, an ESMO handling editor at Annals of Oncology evaluates whether the clinical-oncology significance warrants Annals of Oncology's selective editorial slots. Roughly 75 to 80 percent of submissions are rejected at this stage with insufficient-priority returns sent within 3 weeks per ESMO editorial guidance. A desk rejection most often means the handling editor concluded that the work would fit better at a sister ESMO title (ESMO Open, ESMO Annals of Oncology subseries) or that the European-oncology audience appeal is uncertain.

The ESMO editorial office confirms files are complete: manuscript with figures embedded, supplementary information separate, reporting checklists where applicable (CONSORT for clinical trials, STROBE for observational oncology studies, REMARK for tumor-marker prognostic studies, PRISMA for systematic reviews), cover letter directed to the editor, conflict-of-interest declarations, ethics-statement documentation, IRB approvals, trial-registration documentation, and statistical analysis plan for clinical-trial submissions.

The handling editor reads the paper and evaluates clinical-oncology significance, novelty, ESMO scope fit, and European-oncology relevance. The editorial office returns within 3 weeks, whenever possible, all papers found to be of insufficient priority.

In parallel with the handling editor's primary read, ambiguous-fit papers are discussed at the ESMO editor meeting where peer handling editors at sister ESMO titles weigh in on whether the paper would fit better at Annals of Oncology, ESMO Open, or specialty ESMO titles. This editorial-team discussion runs alongside the desk-screen and adds 3 to 5 days to the timeline that is invisible to the author in the portal.

ESMO handling editors at Annals of Oncology typically invite 2 to 3 external reviewers. The recruitment window can take 7 to 14 days because European-oncology reviewers with topic-matched expertise are scarce. Fast-track manuscripts compress this window to 3 to 5 days.

Once reviewers agree to review, reviewers return their reports within 10 days of receipt per ESMO editorial guidance. Fast-track manuscripts maintain the same 10-day reviewer target. Reviewers are asked to evaluate clinical-oncology significance, methodological rigor, and European-oncology relevance. Reviewer reports for Annals of Oncology tend to be focused; 1500 to 3000 word reports are typical given the 10-day return target.

After both reports return, the handling editor synthesizes them. Total submission-to-acceptance averages 28 days for accepted papers per historical ESMO data. Fast-track submission-to-acceptance can be less than 28 days.

• Rejection within 1 to 5 days: Administrative issue or immediate scope mismatch.
• Rejection within 3 weeks (insufficient priority): Handling editor desk rejection per ESMO editorial guidance.
• Still Under Review after 4 weeks: Strong signal. Paper passed the steepest ESMO filter.
• Still Under Review after 8 weeks: Reviewer-recruitment or reviewer-report delay. A polite inquiry via the submission portal is appropriate.
• Status changes to "Reports Received": Reports are in; expect a decision within 1 to 2 weeks.

This is the most common anxiety we hear from Annals of Oncology authors during the active editorial window. The honest answer: no, 4 weeks at Under Review puts you in the normal middle of ESMO's 6-week standard window. Reports may already be in editorial synthesis with the handling editor preparing a recommendation. Most reviewer-driven delays come from reviewer-recruitment timing for European-oncology specialists rather than slow reviews. The 10-day reviewer target keeps active review fast. If the portal still says Under Review at the 6-week mark, the most likely explanation is that one of the assigned reviewers asked for an extension and the handling editor granted it. This is normal practice at ESMO even with the tight 10-day target.

What you should NOT do during the 4-to-6-week window is email the editorial office. ESMO handling editors at Annals of Oncology are managing 40+ active papers; an inquiry at 4 weeks adds friction without accelerating the timeline.

If your Annals of Oncology paper is rejected after review, the natural cascade depends on what the reviewers and handling editor cited:

ESMO Open is the most natural ESMO cascade because ESMO supports manuscript-transfer where the receiving editor can request reviewer reports from Annals of Oncology, preserving substantial peer-review work. ESMO Open has a broader scope and an open-access publishing model. The transfer process takes 5 to 10 days.

JAMA Oncology is a JAMA Network cascade option for clinical-oncology papers where the JAMA Network reach is preferred. JAMA Network operates independently from ESMO; reports do not transfer.

Lancet Oncology is a Lancet cascade option for papers with global-oncology framing stronger than European-specific. Lancet Oncology operates independently with its own reviewer pool.

JCO is the ASCO cascade option for clinical-trial papers where ASCO treatment-guideline relevance fits.

ESMO asks reviewers at Annals of Oncology to evaluate four things specifically. The table below maps each to actionable preparation.

Three patterns generate the most consistent reviewer concerns we see at Annals of Oncology.

Narrow national framing flagged for European-oncology fit. When the introduction frames the work around one country's treatment patterns or single-center cohort without European-oncology generalization, ESMO reviewers consistently flag generalizability concerns. The strongest manuscripts frame around European-oncology guidelines and treatment patterns.

CONSORT/REMARK-compliance gaps surface as reviewer requests for clarification. When reporting-checklist items are incomplete, ESMO reviewers consistently flag for revision. The 10-day reviewer target means initial reports often request quick compliance fixes rather than extensive new analyses.

ESMO venue mismatch flagged by handling editor. When the handling editor concludes the work is sound but the European-oncology audience appeal is uncertain, transfer offers to ESMO Open are common. ESMO editors take these transfers seriously.

This page was created from ESMO's public author guidance, Elsevier Editorial Manager documentation, ESMO editorial-speed guidance (6-week standard, 14-day fast-track, 10-day reviewer target, 15-day historical mean to first decision), and Manusights pre-submission review experience with Annals of Oncology-targeted manuscripts.

For the ESMO oncology landscape beyond Annals of Oncology, see ESMO Open (broader open-access ESMO), and sister oncology titles (JAMA Oncology, Lancet Oncology, JCO, Cancer Discovery). The choice across these titles depends on whether the central contribution is European-clinical-oncology (Annals of Oncology), broader-clinical-medicine (JAMA Oncology), global-health-oncology (Lancet Oncology), ASCO-treatment-guideline (JCO), or top-tier-translational (Cancer Discovery).

Reviewers at Annals of Oncology typically draw from one clinical oncologist and one methodologist or statistician. The 10-day reviewer target rewards papers reviewers can quickly contextualize against European-oncology guidelines.

For a pre-upload check of your manuscript against the Annals of Oncology clinical-oncology-plus-European-relevance bar before submission, our Annals of Oncology pre-submission diagnostic flags the framing weaknesses and reporting-checklist gaps most likely to surface in reviewer reports.