Each year, the ASCO Annual Meeting offers a glimpse into where oncology research is heading next. In 2026, the conversations extended beyond breakthrough data alone. This year’s meeting reflected a broader shift toward smarter, more adaptive, and increasingly personalized approaches to cancer treatment and development.
Across tumor types and therapeutic modalities, researchers highlighted advances in molecular monitoring, biomarker strategies, combination therapies, targeted treatment platforms such as ADCs and next-generation RAS-targeted therapies, and data-driven approaches to clinical development. Many of the most discussed presentations focused not only on improving efficacy, but also on refining decision-making and optimizing how oncology therapies are developed and delivered.
Here are five of the key trends that stood out at ASCO 2026:
1. ctDNA and MRD Are Reshaping Clinical Decision-Making
Circulating tumor DNA (ctDNA) and measurable residual disease (MRD) testing continued to gain traction at ASCO 2026 as tools for guiding treatment decisions and monitoring disease progression.
Several studies highlighted how ctDNA-guided approaches may help clinicians identify recurrence risk earlier, tailor adjuvant therapy decisions, and potentially avoid overtreatment in selected patient populations. Across colorectal, breast, and lung cancers, presenters explored how molecular monitoring could support more dynamic treatment adjustments throughout the patient journey.
One of the clearest themes from this year’s meeting was that ctDNA is no longer viewed solely as a prognostic marker. Instead, investigators increasingly positioned MRD assessment as a clinical decision-making tool capable of informing escalation, de-escalation, and surveillance strategies.
This shift also has significant implications for oncology drug development. Sponsors are now evaluating how ctDNA endpoints may accelerate trial timelines, enrich patient selection, and support adaptive trial designs. Growing clinical evidence and increasing regulatory attention to molecular response data are likely to drive broader integration of ctDNA and MRD strategies throughout oncology development programs.
2. Combination Strategies Are Reshaping Oncology Treatment Approaches
Combination approaches remained a prominent force at ASCO 2026, with growing momentum behind regimens that pair immunotherapies, targeted therapies, and chemotherapy regimens.
Across multiple tumor types, investigators presented data showing improved progression-free survival and response rates through increasingly sophisticated therapeutic combinations. Many of the most closely watched studies reflected a broader industry shift toward combining therapies with complementary mechanisms of action, including immunotherapies, targeted therapies, and bispecific antibodies.
At the same time, discussions throughout the meeting highlighted the operational and regulatory complexities associated with combination development. Questions around sequencing, toxicity management, comparator selection, and biomarker stratification remain central challenges for sponsors advancing these programs.
The overall direction is clear: oncology development and treatment strategies are becoming increasingly combination-driven. For developers, success will depend not only on demonstrating efficacy, but also on strategically designing trials that can isolate clinical value within increasingly crowded therapeutic landscapes.
3. ADCs Continue to Gain Momentum Across Oncology
Antibody-drug conjugates (ADCs) continued to generate significant interest at ASCO 2026, reflecting growing momentum behind therapies designed to deliver potent treatments more selectively to tumor cells while limiting off-target effects.
Researchers presented new data exploring next-generation ADCs, novel targets, and expanded applications across tumor types and treatment settings. ADCs also continued to feature prominently in combination strategies, with investigators evaluating approaches aimed at improving efficacy while managing toxicity.
At the same time, radiopharmaceuticals and other targeted delivery approaches gained increasing visibility throughout the meeting. These therapies leverage highly specific targeting mechanisms to deliver radioactive or therapeutic payloads directly to cancer cells, representing another evolution in precision oncology.
Beyond ADCs and radiopharmaceuticals, data presented at an ASCO plenary session highlighted the remarkable results, published in NEJM, from a Phase 3 trial in pancreatic cancer reporting an almost doubling of median overall survival (from 6.7 months to 13.2). This represents a much-needed advance in pancreatic cancer from a pan-RAS oral inhibitor program, highlighting growing momentum behind efforts to address historically difficult-to-target RAS mutations and demonstrating continued progress in next-generation targeted therapeutic approaches.
As these platforms mature, developers face important considerations related to patient selection, biomarker strategies, safety management, manufacturing, and regulatory requirements. The growing interest in ADCs and other targeted therapeutic approaches underscores a broader industry focus on improving precision while expanding treatment options for patients with difficult-to-treat cancers.
4. Biomarker Strategies Are Evolving Beyond Baseline Testing
Precision oncology continued to mature at ASCO 2026, but with an important shift: biomarker strategies are moving beyond one-time testing toward ongoing molecular monitoring throughout the patient journey.
Rather than relying solely on static baseline biomarkers, researchers increasingly discussed the value of serial molecular profiling and biomarker assessment throughout treatment. Dynamic biomarker assessment, including serial ctDNA analysis, evolving resistance signatures, and real-time genomic monitoring, emerged as a major focus across presentations.
This trend reflects a broader shift toward viewing cancer as a continuously evolving disease rather than a static diagnosis. As tumors adapt under therapeutic pressure, biomarker strategies must evolve alongside them.
For drug developers, this creates both opportunity and complexity. Trial protocols increasingly require flexible biomarker frameworks, serial sampling approaches, and companion diagnostic considerations that can support adaptive treatment strategies over time.
5. AI, Modeling, and Data-Driven Trial Optimization Continue to Influence Oncology Development
Artificial intelligence continued to gain visibility at ASCO 2026, with discussions expanding well beyond diagnostics and imaging applications.
This year’s meeting highlighted growing interest in how AI and computational modeling can support clinical trial design, patient stratification, operational efficiency, and predictive analytics throughout oncology development programs. Researchers discussed AI-enabled approaches for identifying eligible patients, improving biomarker interpretation, and modeling treatment response trajectories.
Model-informed approaches also gained visibility, particularly in relation to dose optimization and simulation-based trial planning. These tools may become increasingly valuable as oncology trials grow more biomarker-driven and operationally complex.
At the same time, ASCO attendees repeatedly emphasized the need for rigorous validation, transparency, and regulatory alignment. While enthusiasm around AI continues to grow, stakeholders remain focused on ensuring that emerging technologies deliver clinically meaningful and reproducible results.
Looking Ahead
The discussions at ASCO 2026 reflected an oncology landscape that is becoming increasingly data-driven, adaptive, and precision-focused. From ctDNA-guided treatment decisions and evolving biomarker strategies to expanding combination approaches, ADCs, and AI-enabled trial optimization, the meeting highlighted how emerging technologies and innovative development strategies are reshaping cancer drug development.
As oncology development continues to evolve, biopharma companies will need flexible, integrated development strategies capable of navigating growing scientific and regulatory complexity while maintaining a clear focus on patient outcomes.
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