ASCO 2026: A future without chemotherapy?

Novel mechanisms of action for some of the most hard-to-treat cancers have taken center stage at this year’s American Society of Clinical Oncology (ASCO) annual meeting in Chicago. This is the largest medical conference on the calendar (with more than 40 thousand attendees), and Bellevue Asset Management’s portfolio manager, Dr. Terence McManus, and biopharma analyst Dr. Markus Schweiger, on the ground speaking with doctors about new innovation in cancer treatment.

One of the biggest themes emerging from ASCO 2026 is that lung cancer treatment may be entering a new era. For years, chemotherapy combined with immunotherapy has been the standard approach for many patients. This year, however, two new treatment strategies have dominated the conversation. The first is antibody-drug conjugates (ADCs), led by Merck and Kelun’s sacituzumab tirumotecan (Sac-TMT), which delivered highly impressive Phase III results in the OptiTROP-Lung05 study. The second is a new generation of PD-1/VEGF bispecific antibodies, led by Summit and Akeso’s ivonescimab in the HARMONi-6 trial, alongside BioNTech/Bristol Myers Squibb’s pumitamig (ROSETTA Lung-02) and Pfizer’s SSGJ-707. Together, these studies suggest that more targeted approaches can improve outcomes beyond current standards, with Sac-TMT demonstrating one of the strongest efficacy signals seen in frontline lung cancer and ivonescimab delivering a statistically significant overall survival benefit in the HARMONI-6 study. However, the discussant at the meeting noted that the results of the China-only HARMONi-6 trial may not be fully translatable to a global patient population. 

Perhaps most interesting, the discussion among key opinion leaders has shifted. The question being asked is not whether ADCs or PD-1/VEGF therapies will win, but how the two can be combined to create more effective, chemotherapy-sparing regimens. For investors, the most compelling opportunities may therefore lie with companies that have exposure to both modalities and are best positioned to build the next generation of combination therapies.

Beyond lung cancer, another standout presentation came from Revolution Medicines, whose RAS(ON) inhibitor daraxonrasib delivered impressive Phase III results in previously treated pancreatic cancer. In the RASolute 302 study, daraxonrasib nearly doubled median overall survival compared with standard chemotherapy (13.2 vs 6.7 months; HR 0.40) while also significantly improving progression-free survival and response rates. Pancreatic cancer remains one of the most difficult cancers to treat, with few meaningful advances in recent years, making these results particularly noteworthy. Indeed, the presentation received a standing ovation. The discussion at ASCO was less about whether the drug works and more about how quickly it could become the new standard of care in the second-line setting and what this means for the broader RAS-targeted oncology landscape.