ASCO Reveals the Future of Cancer Care: Less Is More
When people think about ASCO, they often think about breakthrough therapies and the next generation of cancer treatments. Those innovations were certainly on display at this year’s meeting—i.e. Revolution Medicine’s daraxonrasib.
But one of the more interesting themes emerging from ASCO 2026 was that some of the most important progress in precision oncology care is not about adding more/new treatment—it is about determining when less treatment is enough.
Biomarkers Help Make Safer Treatment Decisions
Precision medicine continues to expand across oncology and reinforce how central biomarker-driven care has become. Beyond helping determine which patients are most likely to benefit, there is also growing evidence that it can identify patients who may safely avoid certain therapies altogether.
In breast cancer, the Optima trial led by the University College London found that genomic assays can identify patients who can safely skip chemotherapy without compromising outcomes, reducing toxicity while preserving benefit. ¹
At the same time, RAS-targeted therapies, such as daraxonrasib, generated significant attention at ASCO for their potential to treat pancreatic, colorectal, lung, and other RAS-mutated cancers.² This reflects the broader shift away from empiric treatment toward more precise therapy selection—even in historically difficult-to-treat cancers.
ctDNA Helps Determine Individual Needs for Treatment Intensity
Once viewed mainly as a biomarker, ctDNA is increasingly being studied as a tool for guiding treatment decisions. One of the most notable examples at ASCO came from the CIRCULATE study in stage II colon cancer, where postoperative ctDNA was used to help identify which patients may benefit from chemotherapy and which patients may be able to avoid it—enabling more individualized decisions around treatment intensity. ³
In this way, ctDNA is pushing oncology further toward truly personalized care.
Moving Treatments Upstream
A third trend is the continued movement of effective therapies into earlier stages of disease. The goal is not simply earlier treatment—it is preventing recurrence and reducing long-term treatment burden.
Antibody-drug conjugates (ADCs) illustrate this shift. Agents such as trastuzumab deruxtecan (T-DXd) showed positive results as a first-line treatment in HER2+ metastatic breast cancer and Belamaf showed promise in newly diagnosed patients with Multiple Myeloma. ⁴˒⁵ If successful, this approach may reduce downstream treatment needs and cumulative toxicity by preventing disease progression earlier in its course.
Other Notable Trends from ASCO 2026
While the central theme of ASCO 2026 focused on better treatment selection and reduced unnecessary therapy, several other developments highlighted continued evolution across oncology.
Synthetic and External Control Arms
Synthetic and external control arms continue to gain traction in clinical research, leveraging real-world and historical patient data to reduce the need for large randomized control groups in select settings. Several ASCO presentations highlighted how external control cohorts are being used to contextualize outcomes in biomarker-defined and difficult-to-study patient populations. ⁶˒⁷ These approaches may also be particularly valuable in diseases where the standard of care has remained largely unchanged and a robust body of historical data can serve as a comparator. Synthetic arms have the potential to streamline trial design, accelerate development timelines, and improve feasibility in rare cancers where traditional randomized studies may be challenging.
CAR-T and the Next Evolution of Cell Therapy
Cell therapy was once the dominant conversation at ASCO before ADCs and other drug modalities captured much of the spotlight. Yet CAR-T continues to demonstrate staying power. While initially transforming the treatment of hematologic malignancies, researchers are increasingly exploring CAR-T approaches in solid tumors, signaling continued investment in cellular therapies despite the challenges that remain.
ASCO also highlighted growing interest in in vivo CAR-T approaches, which aim to generate engineered immune cells directly inside the patient rather than through complex ex vivo manufacturing processes. Companies such as Kelonia are pursuing this strategy with the goal of improving scalability, reducing manufacturing burden, and expanding patient access. ⁸ While still early, these approaches represent a potentially important next chapter in the evolution of cell therapy.
Together, these trends reflect broader progress not only in how patients are treated, but also in how therapies are developed and studied.
The Bigger Takeaway
The biggest message from ASCO 2026 may not be that oncology needs more treatments. It may be that oncologists are becoming better at determining when treatment is necessary, when it should be intensified, and when it can safely be avoided.
The result is cancer care that can spare patients unnecessary toxicity while improving the likelihood that the treatments they do receive are the right ones, at the right time.
References
- ASCO Annual Meeting abstract 500. Journal of Clinical Oncology. 2026;44(16_suppl). doi:10.1200/JCO.2026.44.16_suppl.500
- ASCO Annual Meeting abstract LBA5. Journal of Clinical Oncology. 2026;44(17_suppl). doi:10.1200/JCO.2026.44.17_suppl.LBA5
- ASCO Annual Meeting abstract 11125. Journal of Clinical Oncology. 2025;43(16_suppl). doi:10.1200/JCO.2025.43.16_suppl.11125
- ASCO Annual Meeting abstract 1012. Journal of Clinical Oncology. 2026;44(16_suppl). doi:10.1200/JCO.2026.44.16_suppl.1012
- ASCO Annual Meeting abstract 7512. Journal of Clinical Oncology. 2026;44(16_suppl). doi:10.1200/JCO.2026.44.16_suppl.7512
- ASCO Annual Meeting abstract 11521. Journal of Clinical Oncology. 2026;44(16_suppl). doi:10.1200/JCO.2026.44.16_suppl.11521
- ASCO Annual Meeting abstract 4021. Journal of Clinical Oncology. 2026;44(16_suppl). doi:10.1200/JCO.2026.44.16_suppl.4021
- ASCO Annual Meeting abstract 7509. Journal of Clinical Oncology. 2026;44(16_suppl). doi:10.1200/JCO.2026.44.16_suppl.7509
