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Post-ASCO Roundup: RAS, Research, and the Road Ahead
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Released: June 30, 2026

John Marshall
John Marshall, MD
Catch Up On All Episodes of Oncology Unscripted

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Main Topic - Post-ASCO Roundup: RAS, Research, and the Road Ahead

[00:00:06] John Marshall, MD: John Marshall, Oncology Unscripted. It’s June. It’s the end of June. It’s been a very busy June for, I’m sure, you, but also for me. End of the scholastic year. We’re saying goodbye to the fellows. Eager to see the new bushy-tailed fellows who don’t yet know how to spell 5-FU. But we’re looking forward to a new academic year here at Georgetown, as well as on Oncology Unscripted.

But as with every academic year, we oncology people end it post-ASCO, and that was at the beginning of June up in Chicago. Forty-five thousand of our closest friends all gathered to hear the latest data in cancer medicine today.

And as a GI oncologist, I am very, very pleased to see—and I know you saw it as well on the front page of your local newspaper, as well as in all of your streaming feeds—the positive data that was seen in pancreatic cancer. RAS, a target that was thought to be untargetable; we already knew with G12C we could target it, and then Revolution Medicines comes up with a medicine that’s a pan-RAS inhibitor that was used in pancreatic cancer, second line against standard-of-care chemotherapy, with a dramatic improvement in response rate, overall survival, and progression-free survival presented at the plenary session.

And frankly, it was the biggest news for a GI oncologist that I’ve seen in a long, long time. Maybe equal to or as important as immunotherapy in MSI-high colon cancers. Not curative like immunotherapy is, but these RAS inhibitors and the ones that are coming behind—the next wave of these that are coming—are really going to have a major impact in the GI cancer space.

First, in pancreatic cancer, you gotta know that every one of our patients—I saw one earlier today—is eager to get ahold of this medicine. There are compassionate-use access programs out there. Of course, they take some time, and we are hoping that if the FDA still is out there, they are doing their best, I promise you. They’re working very, very hard. We hope we will get full approval not too long from now and be able to write prescriptions. But there is this window right now of getting access to the new medicine. Watch out for toxicity, but it is one of those things your patients are gonna ask about, and you’re gonna wanna try and get for them soon.

Follow-up studies, of course, are gonna be in earlier lines of therapy and in the adjuvant setting, where we’re hoping that we will see the positive impact in curative settings, not just in palliative extending progression and overall survival, but also curing more people with pancreatic cancer, something we haven’t been able to do really much at all throughout my entire career. So, it’s very, very exciting.

In a similar way, I was lucky enough to be part of a Colorectal Cancer Alliance effort that was launched at ASCO this year. We’re calling it KLEOS, K-L-E-O-S. Look that up on your computer, ’cause when I first thought about it, I didn’t know what that meant. But we’ve named our platform KLEOS. It’s a Greek word, and it basically is a word that reflects on what we think of those who came before, those heroes, if you will, that came before, and the aura that they have as we go forward in helping support us through our lives that we’re living today.

When we heard about this word, we thought, “This is exactly who we want to honor and name our platform after in colorectal cancer.” All of those people—the patients, the scientists, the researchers, the clinicians who’ve been working very, very hard to change the outcome for patients with colorectal cancer—we’re gonna honor them in our new nationwide platform supported by the Colorectal Cancer Alliance.

And this too is structured in a way to take advantage of not only new RAS drugs, like we’ve talked about, but also all the new biology that we are learning, whether it’s young-onset colon cancer, MRD-positive colorectal cancers, or perioperative metastasectomy colon cancers. How do we more effectively and efficiently test new drugs for quick go/no-go decisions? The cost of clinical research is astronomical. The cost per patient is prohibitive nowadays. And so, our entire cancer model is really based around a US market that has, as we all know, a big markup in pricing that actually funds a lot of the research that’s going on in cancer medicine today.

And so, part of what we’re doing through the KLEOS program is developing a new clinical research model that gets us a stronger go/no-go signal at a cheaper price, believe it or not, so that the risk of investing that bigger amount in those bigger definitive clinical trials goes down and we move the bar; we cure more people.

Because that’s what people are expecting us to do. Sure, progression-free survival matters. Sure, overall survival matters. What our patients want from us is a cure, and that’s what that KLEOS platform is designed to do: to increase the number of patients with colon cancer cured. We launched that at ASCO.

But you know, part of the fun of ASCO—maybe most of the fun of ASCO—is seeing all of those people that you’ve known for the many years. There are some people who wear lots and lots of ribbons. They’re very proud of how many ribbons they wear. Actually, this year you could put any ribbon you wanted on. There were no rules about how many ribbons you put on. Some people didn’t wear any ribbons. They just went sort of naked. I’ve got mine here, so ribbon-less name tag right there. But it is seeing all of these people that you love and you care about and you’ve worked with, or you trained, or they trained you, and catching up.

But also, the fun of ASCO is, of course, wandering around the booths and the floor to see the different exhibits and all of the different things that go on in the pharmaceutical industry. It’s where you have a lot of your meetings and stuff, so you are wandering around in those areas. Who has the best cappuccino, for example? That’s really important.

But I was walking around the booths, going to a meeting actually across the hall, and all of a sudden I heard a voice that was sort of familiar. In fact, it was a voice. It was my voice. I kind of turned around and looked, and there at a booth was me in a video that I had shot, I don’t know, a couple of months ago, that was talking about tumor microenvironment. And I was being projected—I apparently gave them permission to do this—on a big wall, and it was running in a loop pretty continuously with some scary other background video because they made the tumor microenvironment look sort of like a bad Snow White moment from Disney. But it was pretty scary. But then I came on and tried to reassure everybody that we were gonna learn about the tumor microenvironment and improve things.

But apart from that little part of the ASCO booth, the rest of it was pretty cool. There was a race car place where you could go and play race cars with cars going around a track, all sorts of really fun things. There was no flowing water that I remember. There has been that in years past.

But if you weren’t able to go to ASCO, there was a bunch of news, not just the RAS stuff that we talked about. Next year, try to figure out a way to get up there, see some old friends, see some of the new science presented in real time. And if we’re lucky, we run into each other in the hall, give each other a high five, and wish each other a great year ahead. And so, from me to you, from Oncology Unscripted, I’m wishing you a great year ahead.

This transcript has been generated by AI and edited for clarity.