Top 5 Takeaways From ASCO 2026 That Patients Should Know

The 2026 American Society of Clinical Oncology (ASCO) Annual Meeting, held May 29 through June 2 in Chicago, drew more than 44,000 oncology professionals and delivered what many experts described as some of the most consequential results seen at the meeting in years.

Across five late-breaking presentations in the meeting's prestigious Plenary Session — reserved for the most practice-changing science — researchers reported advances in pancreatic cancer, prostate cancer, lung cancer and sarcoma. Here are the top five takeaways patients and caregivers should know.

1. A Long-'Undruggable' Gene Is Finally Targeted in Pancreatic Cancer

For more than four decades, researchers tried and failed to develop a drug that could block the KRAS gene — a mutation found in more than 90% of pancreatic cancers. That changed at ASCO 2026.

Results from the phase 3 RASolute 302 trial showed that daraxonrasib, an oral once-daily pill, reduced the risk of death by 60% compared with standard chemotherapy in patients with previously treated metastatic pancreatic ductal adenocarcinoma (PDAC). Median overall survival nearly doubled: 13.2 months with daraxonrasib versus 6.7 months with chemotherapy.

The data drew a standing ovation from the packed auditorium. ASCO Chief Medical Officer Julie Gralow called the finding "a grand slam." Lead investigator Dr. Brian Wolpin, of Dana-Farber Cancer Institute, called daraxonrasib "the new standard of care" for patients who have received at least one prior line of treatment.

Importantly, daraxonrasib worked regardless of which specific RAS mutation a patient carried — meaning most patients with metastatic PDAC may be eligible, without needing a particular tumor subtype. The drug also produced fewer severe side effects than chemotherapy and significantly delayed deterioration in pain and quality of life.

What patients should know: The FDA has authorized an expanded access program for daraxonrasib as of May 1, 2026, allowing eligible patients to receive the drug outside of a clinical trial. Access must be requested by a licensed treating physician. A formal new drug application is expected on an expedited six-month review timeline. Patients should ask their oncologist whether expanded access is appropriate for them.

2. A Gene Test Could Help Many Early Breast Cancer Patients Skip Chemotherapy

A large phase 3 trial called OPTIMA found that a commercially available genomic test can identify patients with common early-stage breast cancer who receive little to no benefit from chemotherapy — potentially sparing thousands of people from its side effects each year.

The trial enrolled 4,429 patients with early-stage estrogen receptor (ER)-positive, HER2-negative breast cancer — the most common subtype of the disease. Using the Prosigna test, which analyzes the activity of 50 genes in a tumor sample, researchers found that approximately 68% of patients who would normally qualify for chemotherapy actually had low-risk tumors. For those patients, hormone therapy alone produced nearly identical five-year outcomes to chemotherapy: a recurrence-free survival rate of 93.6% versus 94.8%, respectively.

In other words, chemotherapy prevented at most two recurrences for every 100 patients treated in this group — a finding that could change how treatment decisions are made for hundreds of thousands of patients worldwide.

What patients should know: The Prosigna test is commercially available now and can be ordered by an oncologist. Patients with newly diagnosed early-stage ER-positive, HER2-negative breast cancer should ask their care team whether genomic testing is right for them and which test is recommended at their institution. Note that current NCCN guidelines recommend a different test, Oncotype DX, so guideline updates may be needed before Prosigna becomes the standard recommendation in the U.S.

3. The First-Ever Positive Phase 3 Trial in a Rare, Aggressive Sarcoma

For patients with dedifferentiated liposarcoma — a rare, aggressive soft tissue cancer with very few effective treatment options — ASCO 2026 brought a historic milestone.

The phase 3 SARC041 trial, the first-ever positive phase 3 trial in this disease, found that Verzenio (abemaciclib) — a drug already widely approved for certain breast cancers — significantly slowed disease progression compared with placebo. Median progression-free survival was 9.7 months with Verzenio versus just 1.5 months with placebo, representing a 62% reduction in the risk of progression or death. Fewer than 1,000 people are diagnosed with this type of sarcoma in the U.S. each year, and prior treatments had historically offered control for only two to four months.

The result works because dedifferentiated liposarcoma is biologically driven by an amplification of CDK4 — the same molecular target that Verzenio was designed to block. Lead investigator Dr. Mark A. Dickson, of Memorial Sloan Kettering Cancer Center, called it "the first positive phase 3 clinical trial ever in dedifferentiated liposarcoma."

What patients should know: While SARC041 was not designed as a registration study, abemaciclib is already listed on the National Comprehensive Cancer Network (NCCN) compendium, which may support insurance coverage. Patients and caregivers affected by dedifferentiated liposarcoma should discuss this data with their oncologist and ask about eligibility for treatment or ongoing trials.

4. A Targeted Therapy Dramatically Cuts Recurrence Risk in a Rare Lung Cancer Subtype

For patients with early-stage non-small cell lung cancer (NSCLC) whose tumors carry a RET fusion — a genetic alteration found in about 1% to 2% of lung cancers — ASCO 2026 brought the first-ever adjuvant treatment option.

The phase 3 LIBRETTO-432 trial found that Retevmo (selpercatinib), taken after surgery or radiation, reduced the risk of disease recurrence or death by 83% compared with placebo. At two years, 91.5% of patients in the Retevmo group were recurrence-free, compared with 61.1% in the placebo group. All three lung cancer deaths in the trial occurred in the placebo arm.

"These compelling results establish a new standard of care for a rare subset of lung cancer and are immediately practice-changing," said Dr. David R. Spigel, President and Chief Medical Officer at Sarah Cannon Research Institute.

What patients should know: RET fusions are rare — but highly actionable when identified. This trial underscores the importance of comprehensive biomarker testing at every stage of lung cancer, including early-stage disease after surgery. Patients diagnosed with NSCLC should ask their oncologist whether their tumor has been tested for RET fusions and other targetable alterations, regardless of stage.

5. A Perioperative Treatment Regimen May Become the New Standard for High-Risk Prostate Cancer

Men with high-risk, localized prostate cancer who are planning to have surgery now have new evidence supporting a treatment intensification approach before and after their procedure.

The phase 3 PROTEUS trial — the largest therapeutic trial ever conducted in localized high-risk prostate cancer, enrolling 2,109 patients across 18 countries — found that adding Erleada (apalutamide) to standard hormone therapy (androgen deprivation therapy, or ADT) for six months before and six months after radical prostatectomy significantly improved outcomes. Patients treated with the combination were nine times more likely to have little to no cancer remaining in the prostate at the time of surgery compared with those receiving hormone therapy alone (8.9% versus 1.0%). The regimen also reduced the risk of developing metastasis or death by 20% and extended the time before patients required additional therapy to more than six years.

Lead investigator Dr. Mary-Ellen Taplin, of Dana-Farber Cancer Institute, said the results "have the potential to be practice changing" and support perioperative Erleada plus ADT as a new standard of care for eligible patients.

What patients should know: These results apply specifically to men with high-risk or locally advanced prostate cancer who are candidates for radical prostatectomy. Patients in this situation should discuss the PROTEUS trial data with their urologist or oncologist before surgery, and ask whether this intensified hormone therapy approach is right for them

References

1. Wolpin BM, 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. Abstract LBA5. Presented at: 2026 ASCO Annual Meeting; May 29–June 2, 2026; Chicago.
2. Stein R, et al. OPTIMA: a randomised, phase 3 trial of genomic test-directed chemotherapy de-escalation in early breast cancer. Presented at: 2026 ASCO Annual Meeting; May 29–June 2, 2026; Chicago.
3. Dickson MA, et al. SARC041: a phase 3 randomized double-blind study of abemaciclib versus placebo in patients with advanced dedifferentiated liposarcoma. Abstract LBA2. Presented at: 2026 ASCO Annual Meeting; May 29–June 2, 2026; Chicago.
4. Goldman JW, et al. LIBRETTO-432: adjuvant selpercatinib in RET fusion-positive non-small cell lung cancer. Abstract LBA3. Presented at: 2026 ASCO Annual Meeting; May 29–June 2, 2026; Chicago.
5. Taplin ME, et al. Perioperative (neoadjuvant and adjuvant) apalutamide + androgen deprivation therapy vs placebo + ADT with radical prostatectomy in high-risk localized or locally advanced prostate cancer: final analysis of the PROTEUS phase 3 study. Abstract LBA1. Presented at: 2026 ASCO Annual Meeting; May 29–June 2, 2026; Chicago.

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