AI and MRD Take Center Stage on Day 2 of ASCO Breakthrough 2026

Artificial intelligence and molecular response assessment emerged as defining themes on day 2 of the 2026 ASCO Breakthrough Meeting, where standing-room-only sessions highlighted how rapidly both fields are transitioning from research concepts to clinical implementation.

One of the day's most attended sessions, moderated by Melvin L.K. Chua, PhD, MBBS, FRCR, FASCO, brought together experts to discuss the expanding role of artificial intelligence (AI) across the oncology continuum.¹ The session exceeded its scheduled time, underscoring the growing enthusiasm and important questions surrounding AI integration into routine cancer care.

Chua is the head of department and senior consultant for the department of Head and Neck and Thoracic Radiation Oncology, principal investigator of the Precision Radiotherapeutics and Oncology Programme, and director of the Data and Computational Science Hub at National Cancer Centre Singapore, where he is also a clinician-scientist.

Among the featured speakers, Arsela Prelaj, MD, PhD, outlined a vision in which AI functions not simply as a clinical decision-support tool but as an intelligent collaborator throughout the cancer care pathway.² She described how AI can streamline multidisciplinary tumor boards by organizing complex clinical information, allowing physicians to devote more time to discussion and decision-making rather than data collection.

Beyond clinical workflow, Prelaj highlighted AI's potential to accelerate translational research by generating hypotheses, designing experiments, and integrating pathology, radiology, genomics, and clinical data to support more personalized treatment selection. She also discussed the emergence of agentic AI—systems composed of multiple specialized AI agents capable of collaborating on complex tasks—while emphasizing that robust governance, thoughtful system architecture, and prospective clinical validation remain essential prerequisites for widespread adoption.

Prelaj is the head of AI-ON-Lab and a medical oncologist in the department of Medical Oncology at Fondazione IRCCS Istituto Nazionale dei Tumori.

Expanding access to clinical trials was another major focus of the day. Speakers discussed how embedding AI within electronic medical records could automatically identify patients eligible for clinical trials, reducing missed opportunities for enrollment while easing the screening burden on clinicians. Such technologies may have particular importance in low- and middle-income countries, where limited infrastructure often restricts access to innovative therapies and research participation.

Another notable presentation explored the convergence of artificial intelligence with diagnostic medicine. Daniel Truhn, MD, MSc, discussed how integrating radiologic and pathologic data through multimodal AI could improve biomarker detection and diagnostic accuracy.³ Rather than viewing these disciplines independently, AI offers an opportunity to synthesize complementary information and generate more comprehensive assessments that may ultimately improve precision oncology.

Truhn is a professor of radiology at University Hospital Aachen.

While AI dominated much of the day's discussion, minimal residual disease (MRD) emerged as another major area of momentum.

Tony S.K. Mok, MD, FRCPC, FASCO, delivered a standing-room-only presentation examining the evolving role of MRD in lung cancer.⁴ Although MRD is increasingly recognized as a powerful prognostic biomarker, he emphasized one of the field's most important unresolved questions: should MRD move beyond risk stratification to directly guide treatment decisions? Ongoing clinical trials are evaluating whether persistent MRD should prompt treatment escalation or whether MRD clearance could support treatment de-escalation without compromising patient outcomes.

Mok is the associate dean of Translation and Entrepreneurship, Li Shu Fan Medical Foundation endowed professor, and chairman of department of Clinical Oncology at the Chinese University of Hong Kong.

That theme continued in a presentation by Jeanne Tie, MD, FRACP, MBChB, who reviewed the growing role of circulating tumor DNA (ctDNA) as a marker of minimal residual disease.⁵ She highlighted clinical trials investigating MRD-guided treatment de-escalation, illustrating how molecular response assessment may enable clinicians to individualize therapy intensity rather than relying exclusively on traditional clinicopathologic risk factors.

Tie is the medical oncology lead for the Lower GI tumour stream at Peter MacCallum Cancer Centre and a senior research fellow within the division of personalised oncology at the Walter and Eliza Hall Institute.

Collectively, the presentations reflected 2 broader trends shaping modern oncology. Artificial intelligence is becoming increasingly integrated into every stage of cancer care, from diagnostics and multidisciplinary decision-making to clinical trial enrollment and translational research. At the same time, MRD and ctDNA are evolving from prognostic biomarkers toward potential tools for therapeutic decision-making, signaling a future in which treatment intensity may be guided by real-time molecular evidence of disease.

As discussions continue throughout ASCO Breakthrough 2026, these rapidly evolving fields remain at the forefront of efforts to deliver more personalized, data-driven, and equitable cancer care.

References

1. Chua MLK. Welcome and session introduction. Presented at: 2026 ASCO Breakthrough Annual Meeting; Singapore and Online; June 25-27, 2026.
2. Prelaj A. Agentic artificial intelligence and tumor boards. Presented at: 2026 ASCO Breakthrough Annual Meeting; Singapore and Online; June 25-27, 2026.
3. Truhn D. Artificial intelligence for diagnostic imaging. Presented at: 2026 ASCO Breakthrough Annual Meeting; Singapore and Online; June 25-27, 2026.
4. Mok TSK. Minimal residual disease updates in lung cancer. Presented at: 2026 ASCO Breakthrough Annual Meeting; Singapore and Online; June 25-27, 2026.
5. Tie J. Clinical trials to demonstrate utility. Presented at: 2026 ASCO Breakthrough Annual Meeting; Singapore and Online; June 25-27, 2026.