5 ASCO updates that could shift treatment decisions in 2026—and the clinical tradeoffs behind them
Updates from ASCO’s 2026 Annual Meeting point to a clear shift: Targeted and immune-based strategies are moving earlier, broader, and closer to curative-intent care. But the most clinically relevant findings also create new sequencing, toxicity, and interpretation challenges for oncologists.
Here are 5 of the most impactful updates—and what they could change about testing, sequencing, and perioperative treatment decisions in cancer care.
Pancreatic cancer: RAS inhibition reaches a phase 3 survival test
For metastatic pancreatic ductal adenocarcinoma (mPDAC), daraxonrasib may represent one of the most important targeted-therapy signals to date. The phase 3 RASolute 302 trial evaluated this oral RAS(ON) multi-selective inhibitor against chemotherapy in previously treated mPDAC.
Your 30-second takeaway
Daraxonrasib targets active RAS across KRAS G12X, G13X, and Q61X alterations, potentially covering far more patients than allele-specific KRAS G12C or G12D approaches.
More than 90% of mPDAC harbors oncogenic RAS mutations, making upfront KRAS testing increasingly relevant.
The tension: without full numerical efficacy details in the provided abstract text, clinicians should treat this as a potentially paradigm-shifting result while awaiting the magnitude, durability, and safety profile of benefit.
Myeloma: Teclistamab advances, but sequencing gets more complex
MajesTEC-9 establishes teclistamab monotherapy as a major option after 1–3 prior lines in relapsed/refractory multiple myeloma. Median PFS was not reached with teclistamab versus 8.2 months with PVd/Kd, with a PFS HR of 0.29 and OS HR of 0.60.
Key practice points
Teclistamab produced a complete response rate of 65.9% versus 16.8% with standard therapy.
Grade 3/4 infections were higher with teclistamab than PVd/Kd.
Real-world sequencing data suggest CAR-T before bispecific therapy may be associated with better long-term survival than the reverse sequence.
The clinical tension is immediate: bispecifics are available off the shelf, while CAR-T requires time, eligibility, and access. Starting with teclistamab may be practical, but could affect later CAR-T efficacy.
NSCLC: PD-(L)1/VEGF bispecifics challenge the checkpoint backbone
In advanced NSCLC, PD-(L)1/VEGF bispecific antibodies are moving from intriguing mechanism to frontline challenger. HARMONi-6 reported phase 3 OS data for ivonescimab plus chemotherapy versus tislelizumab plus chemotherapy in untreated squamous NSCLC.
Additional signals from SSGJ-707 and HB0025 show high response rates across squamous and nonsquamous disease. If OS benefit confirms the earlier PFS advantage, oncologists may need to ask whether dual PD-1/VEGF blockade in one molecule should replace standard checkpoint-plus-chemotherapy strategies.
Perioperative bladder and prostate cancer: Systemic intensification moves into curative care
EV-304/KEYNOTE-B15 may directly challenge cisplatin-based chemotherapy in muscle-invasive bladder cancer. Enfortumab vedotin plus pembrolizumab improved pCR, EFS, and OS versus gemcitabine-cisplatin in cisplatin-eligible disease.
Highlights
pCR: 55.8% vs 32.5%
EFS HR: 0.53
OS HR: 0.65
In prostate cancer, PROTEUS and NeoPRO reinforce a similar theme: metastatic-setting therapies and PSMA PET response assessment are moving into high-risk localized disease.
Survivorship and metabolism: Promising, but not yet ready for the clinic
Lifestyle and metabolic interventions also generated clinically useful data. BWEL supports structured weight loss for symptom and quality-of-life benefit in overweight or obese patients with early breast cancer. A low-glycemic Mediterranean diet plus walking improved metabolic syndrome measures and showed an adherence-linked recurrence signal in hormone receptor–positive disease.
GLP-1 receptor agonist data across seven solid tumors were provocative, especially in NSCLC, breast, colorectal cancer, and HCC, but remain observational. For now, GLP-1RAs are hypothesis-generating in oncology—not anticancer therapy.
Related: More news from the conference floor: ASCO 2026