Pharmaceutical Market Europe • June 2025 • 24-26
ASCO 2025
ASCO 2025 –
bringing a sense of urgency to the war against cancer
‘Hot’ tumours, breast cancer breakthroughs and holistic treatment were the standouts at this year’s event
By Costas Saratsis and Suzanne Bobadilla
With the ambitious goal of advancing the future of cancer care, more than 40,000 physicians, researchers, technologists and health marketers converged on Chicago earlier this month for ASCO 2025. Whether drawn by the rollout of clinical research or the opportunity to network with peers across a range of roles and disciplines, they brought with them a powerful weapon in the war against cancer: a sense of urgency.
All attendees shared a vested interest in the rapidly evolving cancer treatment landscape. Nowhere was the vastness of that landscape more evident than the exhibit hall, in which 526 organisations – pharma companies, of course, but also AI firms, hospital networks and advocacy groups – pitched the part they could play in improving treatment.
The signal this sent? That cancer care is no longer strictly a medical play. Only in concert with colleagues across disciplines and platforms can it be defeated.
Top of mind at this year’s ASCO, as always, was the science. In the 11 years since Keytruda and Opdivo sparked the immuno-oncology revolution, one mystery has endured: why some tumours respond to the treatments and others do not. A session led by Dr Antoni Ribas, a professor at the University of California, Los Angeles, attempted to shed some light on the discrepancies.
Ribas explored the challenge of turning ‘cold’ tumours into ‘hot’ ones, which would provide a boost to the immune system. He theorised that the cancer cells use collagen and fibrosis to construct a barrier around them and prevent T cells from penetrating the tumour. (This same mechanism was discussed by Dr Judith Varner, a professor at the University of California, San Diego, and co-lead of the solid tumour therapeutics programme at the Moores Cancer Center, during ‘One Step Ahead: Preventing Tumor Adaptation to Immunotherapy’.)
To combat this, researchers are exploring multiple options:
They also see potential in a host of vaccines, discussed in a session surveying the progress of developmental therapeutics.
Then there were last year’s ASCO darlings: the antibody-drug conjugates (ADCs), recognised for the way they revolutionised drug delivery (slow and constant, as opposed to a single, large, rapidly administered dose). According to Dr Patricia LoRusso, a professor at Yale University’s School of Medicine, there are currently around 450 ADCs being assessed for their treatment potential.
Still, the ADC universe has expanded to include bispecifics, biparatopic agents (JSKN003) and combinations (including sacituzumab govitecan plus pembro in metastatic triple-negative breast cancer). One candidate that generated considerable interest among attendees was zanidatamab, a HER2 bispecific that targets ECD4 and ECD2 epitopes.
While these advances could transform the treatment of cancer, a key challenge will be driving understanding of their impact on the treatment paradigm in a noisy, overloaded environment. But the science itself continues to advance at a brisker pace than even the most bullish researchers anticipated, as evidenced by the myriad clinical studies presented over the course of ASCO weekend.
‘Without doubt, ASCO 2025 made it clear that the future of cancer care won’t be determined by science alone’
Many were in the realm of breast cancer. Results from the DESTINY Breast09 study showed that the Daiichi Sankyo/AstraZeneca co-promote Enhertu demonstrated superior efficacy in first-line treatment of HER2-positive metastatic breast cancer (HER2-mBC), with 40.7 months of progression-free survival (PFS). That amounts to a 44% jump in risk reduction over the 26.9 months offered by the THP chemotherapy regimen, which represents the current standard of care.
Given AstraZeneca’s marketing might and results of the earlier DESTINY Breast06 study in hormone receptor-positive metastatic breast cancer (HR+ mBC), which showed similar improvements in survival rates in both HER2 low and ultra-low populations – Enhertu could emerge as the new standard of care for this cohort of patients. But a potential bump on that road arrived in the form of results from the PATINA study (chemo induction followed by palbo plus HER2-directed endocrine therapy), which demonstrated 44.3 months PFS for the same group of patients.
Another potential step forward in breast cancer treatment came with the introduction of new endocrine therapy options, including AstraZeneca’s camizestrant, Menarini’s elacestrant (marketed as Orserdu) and Genentech’s giredestrant. They share an advantage over the prior selective oestrogen receptor degrader (SERD): oral administration.
Results from the EMBER3 trial showed that Eli Lilly’s imlunestrant, another orally administered SERD, demonstrated only a marginal advantage as a monotherapy (5.5 months PFS versus 3.8 months for fulvestrant). But when imlunestrant was administered in combination with abemaciclib (marketed by Lilly as Verzenio), PFS surged to 9.4 months – albeit in second-line patients after clinical progression had occurred.
Results from AstraZeneca’s SERENA-6 demonstrated 16 months PFS when patients switched from letrozole/anastrozole to camizestrant after ESR1 mutation detection but before clinical progression had occurred, compared to 9.2 months PFS for patients who didn’t make the switch. That potentially alters the treatment paradigm, which has traditionally looked for disease progression before effecting changes. These positive results support a shift in the way first-line treatment of HR+ mBC is approached.
The SERENA-6 results, however, were based on the ESR1 mutation presence, which complicates interpretation. It assessed biologic progression (circulating tumour DNA [ctDNA]) rather than clinical progression, which may have accounted for part of the difference. It’s worth noting that ctDNA is not a sensitive predictor, although sustained ctDNA negativity is associated with lack of progression.
While breast cancer trial results headlined the ASCO research slate, other studies assessed potential new treatments for colorectal, gastric/GIJ and head and neck cancers. Most confirmed the viability of already established treatments or combinations.
Many oncologists who attended ASCO were there primarily to learn about these and other scientific advancements. But the event also offered them a host of sessions that addressed the challenges – emotional and financial as well as clinical – that come with treating cancer in 2025.
More in recent years than before, members of the oncology HCP community have wrestled with low patient trust, a lack of emotional engagement and increasing bureaucratic burdens. Those issues were tackled in ‘Communication in Late-Stage Cancer’, a session led by Dr Robert Arnold, an emeritus professor of medicine at the University of Pittsburgh, and Dr James Tulsky, a palliative medicine expert at Dana-Farber Cancer Institute. Another session touted the positive impact of exercise on cancer treatment, complete with programme recommendations.
‘A host of sessions addressed the challenges – emotional and financial as well as clinical – that come with treating cancer in 2025’
Then there was ‘What About Cannabis?’, a session featuring Oregon Health and Science University oncologist and palliative care specialist Dr Eric Roeland, which offered attendees a game plan for managing patient discussions around the use of cannabis in treatment. Noting that approximately 20% of cancer patients are including cannabis in their regimens, Roeland stressed the need to actively engage in those conversations, especially as they pertain to the simultaneous usage of cannabis and cancer medications.
A final session addressed one of the elephants in the room: that advances in treatment have intensified stress on long-term cancer patients and survivors. Expect to see the emergence of a new subspecialist: the oncologist/psychologist capable of helping patients manage the impact of disease on their families and themselves. Cancer survivorship, after all, extends beyond the immediate end of treatment; concerns around longevity, quality of life and mental well-being don’t just disappear.
Could the pharmaceutical industry play a role in easing that strain? Marketers at ASCO think so – you could feel the optimism from many speakers that companies will step in and serve as a trusted intermediaries between the medical communities and patient advocacy groups.
These sessions and the conversations that followed in their wake underscored the reality that cancer care is no longer confined to a clinic or a lab. The buzz around the prospect of an ASCO/Google partnership on a new AI platform was telling: it suggested the next big shift in cancer treatment may not be a therapy, but the way it is brought to life.
Without doubt, ASCO 2025 made it clear that the future of cancer care won’t be determined by science alone. It will be shaped by connection across disciplines, platforms and people, and by the collaboration that has characterised many of the essential cancer treatment breakthroughs in recent times.
Costas Saratsis is Managing Director, Medical Strategy and Suzanne Bobadilla is Executive Director, Global Medical Strategy, both at VML Health
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