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ASCO 2026 Preview: Precision Medicine, MRD, and the Next Wave of Care
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Released: May 27, 2026

John Marshall
John Marshall, MD
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ASCO 2026 Preview: Precision Medicine, MRD, and the Next Wave of Care

John Marshall, MD: John Marshall, Oncology Unscripted, getting you ready for ASCO. Whether you're going or not, you're going to need to know what's being presented up there.

And one of the things that I like about ASCO is, of course, seeing everybody in person. No AI allowed up there—although there'll be a session about AI—but we're going to be really there.

I think there will be no robots. Who knows what they'll have? There probably will be some robots up there. But going to be with other people, getting to see people you haven't seen in a while, is my favorite part.

My least favorite part is this sort of waiting on the data to be presented. The late-breaking abstract kind of irritates me a little bit. They tease you with the title. They tell you it's going to be in these big sessions, which usually means that the trial is positive or the data that we're going to see are going to be impactful. But we can't tell in advance where the best data are going to be or what room we should be in until after they've been presented. That's probably the thing that irritates me the most.

But what I want to feature really quickly is some of the highest-level data that's going to be presented, which usually are preserved for what we call the plenary session Sunday afternoon. Everybody crams into these huge, tractor pull-sized arenas, and we all sit around and watch slides be presented. They have some really interesting papers being presented at the plenary this year. It is about precision medicine. It is about immunotherapy and how those two are combining nicely to improve outcomes. But it is also about the right patient and the right drug, with smaller and smaller patient subsets. Let me kind of give you a high-level overview of what we're expecting to see at ASCO during the plenary and other sessions.

So, there's the CDK4/CDK6 drug abemaciclib. It's a breast cancer drug that you know already. It looks like it's going to be positive in liposarcoma. Who's ever seen a liposarcoma plenary session paper? We are going to in Chicago in 2026.

Selpercatinib is being studied in a RET fusion-positive non–small cell lung cancer trial, and it's obviously positive; otherwise, it wouldn't be in the plenary. But let's face it: that's really a 1% positivity rate for RET fusions in non–small cell lung cancer. And so, this is actually a stage I all the way to stage IIIA clinical trial, so it must be positive as well.

Ivonescimab with chemotherapy versus tislelizumab plus chemotherapy. Who makes these names up? Non–small cell, but squamous cell lung cancer. It looks like ivonescimab will be positive, and it's the first medicine at this level that combines PD-1 and VEGF in one bispecific antibody.

Lots of those are coming, with lots of positive data being seen in that combination, so there's going to be one more. So, two of these studies are in non–small cell lung cancer.

Then, there's one in my category. This drug is called daraxonrasib. Believe it or not, I really didn't know how to say that drug, even though I've been playing with it and coaching it. So, I actually looked up the phonetic spelling and pronunciation. So, daraxonrasib. We're going to have to learn how to say it. We'll probably just call it “Durak” or something like that. This is a RAS(ON) nonselective inhibitor, a kind of drug we thought could never happen. We said this was untargetable, and not only is it positive and going to be presented at the plenary at ASCO, it's already been on the front page of most newspapers around the country for its impact on patients with pancreatic cancer.

So, in my world, every one of my patients is very aware of this. And, of course, as you know, the FDA did grant it breakthrough status, and we'll talk a little bit about the FDA through this session as well. But, how are patients going to get access to these drugs? Who's going to pay for it? So, even though it's out there and accessible, getting it to patients is always a challenge when this happens.

Now, on another level, I think one of the major themes that we will continue to see presented at ASCO this year is around MRD testing. And there are several papers. Here's a recent one from the current JCO. You know I always like print. This is in breast cancer, using a tissue-informed MRD test that really did a nice job of predicting outcomes and the like. There are a bunch of papers being presented at ASCO with MRD testing in the GI cancer space, so this is around and going to stay.

And, of course, just as I mentioned earlier, there's going to be more and more talk about the use of AI, good and bad. And I do want us to refer to some papers that are being presented and actually published that suggest that AI in health care may not be all that good, but we'll talk about that more later.

So, if you can't go to ASCO, at least keep in touch with what's going on out there. See these papers. They're going to be clinically impactful, as will many others. So, the standard of care will be different by the middle of June based on the data presented at ASCO.

So, stay tuned. More to come on Oncology Unscripted.