ASCO Breakthroughs Affirm Value of Biomarker Testing in Lung Cancer

Lung cancer specialists should learn to think like breast medical oncologists, according to Edward S. Kim, MD, MBA.

In a conversation with CancerNetwork®, Kim spoke about key breakthroughs from the 2026 American Society of Clinical Oncology Annual Meeting (ASCO),specifically those that may translate to patient practice in thoracic oncology. New data on targeted therapies directed towards RET mutations and other alterations, Kim said, reinforce the value of molecular testing and biomarker evaluation as part of an initial staging workup.

Just as colleagues in breast medical oncology make informed therapeutic decisions based on available information regarding hormone receptor and HER2 statuses, Kim emphasized that thoracic oncologists should not form treatment strategies until biomarkers have been assessed. Regarding other potential advances in the field, Kim noted a need to improve screening strategies for a “significant population” of individuals who develop lung cancer with a history of tobacco use.

Kim is physician-in-chief at City of Hope Orange County, deputy physician-in-chief at City of Hope National Medical Center, a professor in the Department of Medical Oncology & Therapeutics Research, a member of Construction Industries Alliance City of Hope Orange County, physician-in-chief chair, and system director of the Clinical Trials Office.

Transcript:

One thing we learned at ASCO is that we continue to have major breakthroughs, and they seem to come every year. I always look to see which sessions get standing ovations and applause because that means we are genuinely impressing ourselves, and we are so happy that these [findings] are going to translate into patient practice. I am a lung cancer specialist, and we had some very important data presented in the plenary session looking at different biomarkers with therapies focused on RET and some other rare mutations. We also saw some progress in squamous cell lung cancer, and we are seeing VEGF and PD-1 combinations coming in.

[W]hat continues to be reinforced is that molecular testing and biomarker testing have to be part of the initial staging workup. We have to think like breast medical oncologists and experts, who do not make a treatment decision until they have hormone receptor status and HER2 [status back]. We now have to think that way as lung cancer specialists: you should not be making a treatment decision until you have those biomarkers back. I view it as important as radiographic staging and histology. That has to happen. The fact that we have moved therapies from the advanced, metastatic stage into locally advanced and early-stage [disease] is tremendous. I have always said, early in my career, that we need to be like breast oncology, which took a drug like tamoxifen from the metastatic setting and move it all the way up to the curative-intent, postsurgical setting. We are doing that now, which is phenomenal. I would say lung cancer is even setting the standard now with biomarker-based, locally advanced, and early-stage treatment.

It also shows we still have a lot of work to do. We have approved screening studies for people with smoking histories, but I am asked all the time, “What about me, Dr. Kim? I never smoked. What is my risk for lung cancer?” We know there is a significant population that develops lung cancer without a tobacco history. We still have to figure that out; how do we screen these [people]? We see this a lot in Asia, but it is also present in Western countries.

There were a lot of great things at ASCO [this year], and we continue to look forward to more of the data being reported throughout the year.