The 2025 American Society of Clinical Oncology (ASCO) Annual Meeting held in Chicago brought together some of the world’s top researchers, pharmaceutical innovators, and clinical leaders to share groundbreaking data that could reshape the future of cancer care. From advances in real-world evidence to precision medicine breakthroughs, this year’s meeting emphasized one core idea: the future of oncology is here, and it’s increasingly personal, data-driven, and responsive to patient needs. Here are some of our takeaways:

1. Circulating Tumor DNA (ctDNA) is Reshaping Early Detection and Monitoring

One of the most talked-about topics at ASCO 2025 was the role of circulating tumor DNA (ctDNA) in oncology. ctDNA tests, often performed through a liquid biopsy, can detect fragments of tumor DNA in the bloodstream, offering early insights into cancer progression or recurrence. These tests can signal the likelihood of cancer returning months before it appears on CT or MRI scans and can help clinicians determine how well a therapy is working. At ASCO, dozens of abstracts explored ctDNA’s role in guiding treatment decisions and monitoring disease. Many focused on the use of ctDNA in breast cancer treatment. This technology continues to gain traction due to its non-invasive nature, ability to personalize treatment, and potential to identify relapse before symptoms emerge. While adoption has been swift in some areas, many oncologists emphasized the need for more real-world evidence and standardization to integrate ctDNA testing into routine care.

2. A New Standard of Care for Gastric Cancer May Be Emerging

AstraZeneca presented powerful new data from its MATTERHORN study on gastric and gastroesophageal junction (G/GEJ) cancer. Historically, fewer than half of patients with resectable gastric cancer survive beyond five years, even with perioperative chemotherapy. The MATTERHORN phase 3 trial showed that adding durvalumab—an immunotherapy drug—to the FLOT chemotherapy regimen significantly improved event-free survival compared to FLOT alone. All patient subgroups benefited from this combination therapy, with response rates and overall survival trends favoring the addition of durvalumab. Perioperative administration demonstrated improved outcomes over post-operative adjuvant treatment alone. These results position this immunotherapy combo as a potential new standard of care in a high-risk cancer type that has seen few major breakthroughs in recent years.

3. Precision Medicine is Gaining Ground in Breast Cancer

In the field of breast cancer, AstraZeneca’s SERENA-6 trial drew attention for its innovative use of biomarker-driven decision-making. The trial focused on patients with hormone receptor-positive (HR+), HER2-negative advanced breast cancer who developed ESR1 mutations during first-line therapy. The study showed that patients who switched early to camizestrant, a next-generation oral SERD (selective estrogen receptor degrader), saw median progression-free survival extend to 16 months, compared to 9.2 months for those who remained on aromatase inhibitors. This represented a 56% reduction in the risk of disease progression or death. While camizestrant is not yet FDA-approved, this data strongly supports its future role as a first-line option in patients showing early signs of resistance to endocrine therapy. These results underscore how timely identification of molecular changes can meaningfully improve patient outcomes. It was also notable that patients showed quality of life improvement, not just maintenance, during treatment.

4. Enhertu Could Dramatically Expand Breast Cancer Treatment Options

AstraZeneca and Daiichi Sankyo also shared data from the DESTINY-Breast06 trial, which evaluated Enhertu (trastuzumab deruxtecan) in patients with hormone receptor-positive, HER2-low metastatic breast cancer after endocrine therapy. The results were impressive: Enhertu delayed disease progression by over five months compared to chemotherapy, with a median progression-free survival of 13.2 months vs. 8.1 months. This translated to a 38% reduction in the risk of disease progression or death. Enhertu also showed promise in patients with HER2-ultralow expression, previously thought ineligible for targeted HER2 therapy. While not statistically significant, the finding suggests a new frontier in HER2-targeted treatment could be on the horizon. If Enhertu is approved for both HER2-low and ultralow populations, it could become an option for up to 80% of women with metastatic breast cancer, dramatically broadening its clinical impact.

5. Real-World Evidence is Shaping Cancer Research and Strategy

Beyond traditional clinical trials, real-world data (RWD) and real-world evidence (RWE) played a significant role in this year’s discussions. Companies like Flatiron Health and leaders such as Amy Abernethy are pioneering ways to generate meaningful insights from electronic health records and genomic databases. These efforts aim to support decision-making in real-world clinical settings where randomized controlled trials may not be feasible. While RWE is more scalable and can accelerate understanding of treatment efficacy, it does come with limitations—such as slower timelines and challenges in standardization. Still, as precision medicine continues to evolve, RWE is becoming an increasingly important tool in closing evidence gaps and supporting regulatory submissions.

6. The Innovation is Promising, but Adoption Lags

Despite the encouraging science, speakers and attendees alike acknowledged the reality: adoption of these new tools and treatments often lags. Whether it’s due to reimbursement challenges, lack of familiarity, or infrastructural barriers, integrating innovations like ctDNA testing or new therapies into community oncology practice is not immediate. This adoption gap can delay patient access to life-saving treatments and emphasizes the ongoing need for education, advocacy, and implementation support.

7. Funding and Trial Design Challenges Remain

While scientific momentum was evident, several researchers voiced concern about the difficulty of designing trials in a world of increasingly narrow patient subgroups. As cancer therapies become more targeted, it becomes harder to enroll sufficient numbers of eligible participants. With recent cuts to NIH funding, researchers are bracing for longer timelines and higher costs. These financial and operational pressures could slow down the speed of discovery unless strategic partnerships and novel funding models step in.

Compared to earlier conferences this year, sentiment among oncologists and biopharma professionals at ASCO 2025 seemed more optimistic, but still cautious. While innovation is progressing at a rapid pace, the practicalities of delivering that innovation equitably and affordably remain a significant hurdle.

At Opus Strategy, we understand that staying ahead of these developments isn’t just about reading the latest studies—it’s about translating them into actionable strategy. We partner with biopharmaceutical and life sciences companies to help them interpret evolving market landscapes, assess their competition, and optimize their market positioning. Whether it’s through evaluating real-world evidence, pressure-testing development hurdles, benchmarking global epidemiology data or conducting opportunity assessments, our team ensures you don’t just hear about the future of oncology—you’re ready for it.

For more insights, reach out to the team at Opus Strategy and learn how we can help you chart your course through oncology’s next frontier.