Highlights From ASCO 2026

As is true every year during the Annual American Society of Clinical Oncology (ASCO) Meeting, the results of several particularly important clinical trials were presented.The task of choosing the best abstracts for presentation is always difficult, with thousands of submissions. However, several stood out as practice-changing presentations based on data from larger clinical trials.One of the most outstanding abstracts, presented at the plenary session, was the phase 3 RASolute 302 trial (NCT06625320) of daraxonrasib in patients with metastatic pancreatic cancer, which showed promising results in the second-line setting. In this trial, the median overall survival doubled from 6.7 months for controls to 13.2 months for patients who received daraxonrasib.¹ The toxicity profile was manageable but did include extensive skin rashes in some patients. These results were so extraordinary in an exceedingly difficult patient population that there was a standing ovation from the audience filled with hematology-oncology professionals. Hopefully, this agent will quickly get out to the patients who could benefit from its use.

Other trials that were of interest included the phase 3 LIBRETTO-432 trial (NCT04819100), which demonstrated that adjuvant selpercatinib (Retevmo) reduced the risk of recurrence or death by 83% in resected RET fusion–positive non–small cell lung cancer.² The phase 3 PROTEUS trial (NCT03767244) evaluated perioperative apalutamide plus androgen deprivation therapy (ADT) given around the time of surgery for high-risk localized prostate cancer.³ In this trial, the experimental arm yielded a nearly 9-fold increase in near-complete pathologic responses (8.9% vs 1.0 % with ADT alone) and cut the risk of metastasis or death by roughly 20%. For patients with a de-differentiated liposarcoma, there was also good news with the positive phase 3 SARC041 trial (NCT04967521).⁴ This trial found that abemaciclib(Verzenio) significantly slowed disease progression, with a median progression-free survival of 9.67 months for abemaciclib vs 1.52 months with placebo (HR, 0.39). Another phase 3 trial, the OPTIMA trial (ISRCTN42400492), found that the Prosigna gene expression test, which analyzes 50 genes in a breast cancer tumor sample, identified that approximately 68% of patients who normally qualify for adjuvant chemotherapy had low-risk tumors.⁵ For those lower-risk patients, hormone therapy alone had a nearly identical 5-year distant recurrence-free survival of 97.0% vs 96.0% in the control arm.

These are just a handful of the outstanding abstracts presented at the 2026 ASCO Annual Meeting. Continued research breakthroughs and expanding information on cancer biology will allow continued development of cancer treatments with the highest potential.

References

1. Wolpin BM, Wainberg ZA, Hendifar AE, et al. Daraxonrasib, a RAS(ON) multi-selective inhibitor vs chemotherapy in previously treated metastatic pancreatic adenocarcinoma (mPDAC): primary and final analysis from the phase 3 RASolute 302 study. J Clin Oncol. 2026;44(suppl 17):LBA5. doi:10.1200/JCO.2026.44.17_suppl.LBA5

2. Goldman J, Yang XN, Hochmair M, et al. Event-free survival with adjuvant selpercatinib in stage IB-IIIA RET fusion-positive NSCLC: primary results of the phase 3 LIBRETTO-432 trial. J Clin Oncol. 2026;44(suppl 17):LBA3. doi:10.1200/JCO.2026.44.17_suppl.LBA3

3. Taplin ME, Gleave M, Shore N, et al. Perioperative (neoadjuvant and adjuvant) apalutamide (APA) + androgen deprivation therapy (ADT) vs placebo (PBO) + ADT with radical prostatectomy (RP) in high-risk localized or locally advanced prostate cancer (HR LPC/LAPC): final analysis of the PROTEUS phase 3 study.J Clin Oncol. 2026;44(suppl 17):LBA1. doi:10.1200/JCO.2026.44.17_suppl.LBA1

4. Dickson MA, Ballman KV, Weiss MC, et al. SARCO41: a phase 3 randomized double-blind study of abemaciclib versus placebo in patients with advanced dedifferentiated liposarcoma. J Clin Oncol. 2026;44(suppl 2):LBA2. doi:10.1200/JCO.2026.44.17_suppl.LBA2

5. Stein RC, Makris A, Macpherson IR, et al. First results from the OPTIMA phase III randomized non-inferiority trial of test-directed chemotherapy in patients with high clinical risk ER-positive HER2-negative early breast cancer. J Clin Oncol. 2026;44(suppl 17):500. doi:10.1200/JCO.2026.44.16_suppl.500