Top 5 Papers
#1
Source: The New England Journal of Medicine / ASCO 2026 Plenary LBA5 | Authors: Wolpin BM, O'Reilly EM, Hong DS, et al. (multicenter, Revolution Medicines / Dana-Farber / MSKCC) | Published: May 31, 2026
Score: 17/20 — NEJM (10) + Phase 3 RCT (+3) + survival benefit OS (+2) + Colleague engagement on X by @OncBrothers and @DaisukeKotani (+2) = 17. The April 30 EAP authorization and the May 7 Phase 1-2 NEJM paper were prior covers; this is the formal Phase 3 primary publication landing simultaneously with the ASCO Plenary LBA5 presentation on May 31 — definitively new and the practice-defining readout.
RASolute 302 is the first Phase 3 RCT of a pan-RAS(ON) multi-selective inhibitor in any tumor. Patients with previously treated metastatic pancreatic ductal adenocarcinoma carrying a KRAS mutation (predominantly G12D / G12V / G12R) were randomized to oral daraxonrasib monotherapy vs investigator's-choice chemotherapy (FOLFIRI, FOLFOX, or nal-IRI + 5-FU/LV). At the primary analysis, median OS was 13.2 vs 6.7 months — HR 0.40 (95% CI 0.33–0.49), p<0.0001, corresponding to a 60% reduction in the risk of death. PFS was significantly improved across every KRAS subtype assessed. Grade ≥3 treatment-related adverse events were 43.6% with daraxonrasib vs 57.5% with chemotherapy — the experimental arm was actually better tolerated. The most common daraxonrasib AEs were rash, GI toxicity, and asymptomatic LFT elevations. This is the largest single-trial OS gain ever recorded in 2L mPDAC and validates the RAS(ON) class as a tumor-agnostic clinical platform; companion expansion cohorts in CRC and biliary tract cancer are ongoing.
Post angle: 🔥 RASolute 302 lands in NEJM and on the ASCO Plenary stage: daraxonrasib HALVES death risk in 2L KRAS-mut mPDAC. mOS 13.2 vs 6.7 mo, HR 0.40, p<0.0001 — 60% reduction. And the experimental arm is BETTER TOLERATED than chemo. The new standard of care, full stop. #PDAC #KRAS #GIOnc #ASCO26
#2
Source: ASCO 2026 Annual Meeting — LBA4000 (AstraZeneca / multicenter) | Authors: Sangro B, Kudo M, Galle PR, Finn RS, et al. (multicenter, AstraZeneca-sponsored) | Published: June 1, 2026
Score: 15/20 — ASCO plenary (8) + Phase 3 RCT (+3) + survival benefit PFS (+2) + Colleague engagement on X by @OncBrothers and @OncoAlert (+2) = 15. The May 13 and May 27 press-release previews were covered; this is the full ASCO LBA4000 presentation with primary PFS curves, subgroup breakdowns, and interim OS — materially new clinical data.
EMERALD-3 randomized 724 patients with embolization-eligible unresectable HCC to STRIDE (single tremelimumab priming dose + durvalumab) + lenvatinib + TACE vs TACE alone. The primary endpoint of PFS was met: mPFS 13.0 vs 9.8 mo, HR 0.70 (95% CI 0.57–0.86), p=0.0007. The OS trend favors the quad arm (HR 0.84, 95% CI 0.65–1.09, p=0.18) but remains immature at the interim. Objective response (RECIST 1.1) and time to deterioration of liver function also favored the experimental arm. Grade ≥3 TRAEs were higher in the quad arm (61% vs 38%), driven by the expected lenvatinib + IO toxicity profile (hypertension, hepatitis, diarrhea). EMERALD-3 joins LEAP-012 (pembrolizumab + lenvatinib + TACE) and EMERALD-1 (durvalumab + bevacizumab + TACE) as the third positive Phase 3 in embolization-eligible HCC since 2024 — but the head-to-head question of which quad to choose, and which TACE-eligible patient actually benefits, is now the central clinical decision.
Post angle: 📊 EMERALD-3 (ASCO LBA4000) hits PFS: STRIDE + lenvatinib + TACE in embolization-eligible unresectable HCC. mPFS 13.0 vs 9.8 mo, HR 0.70, p=0.0007. OS trend favors quad (HR 0.84) but immature. Third positive IO+TKI+TACE Phase 3 in 2 years — patient selection is now the whole game. #HCC #LiverCancer #GIOnc #ASCO26
#3
Source: ASCO 2026 Annual Meeting — LBA3500 (AIO KRK-0217 / ABCSG) | Authors: Folprecht G, Schmoll HJ, Tannapfel A, et al. (AIO / ABCSG multicenter, Germany / Austria) | Published: May 31, 2026
Score: 15/20 — ASCO plenary (8) + Phase 3 RCT (+3) + new standard of care, biomarker-guided precision (+3, first RCT to prove ctDNA-guided benefit in stage II CRC) + Colleague engagement on X by @DaisukeKotani (+1) = 15. The May 26 ASCO preview was covered; this is the full LBA3500 presentation with primary endpoint data.
CIRCULATE (AIO KRK-0217 / ABCSG) is the first Phase 3 RCT to operationalize ctDNA as a treatment-decision tool in stage II MSS / pMMR colon cancer. After curative resection, patients underwent tumor-informed ctDNA testing (Signatera-style assay); ctDNA-positive patients (~16% of the screened population) were randomized 1:1 to adjuvant FOLFOX/CAPOX vs observation. ctDNA-negative patients (~84%) were followed without chemotherapy as a registry cohort. Primary endpoint: 3-year DFS in the ctDNA-positive randomized cohort. 3-year recurrence rate was 19% in the chemotherapy arm vs 62% in the observation arm — HR 0.23 (95% CI 0.06–0.87), p=0.009. 3-year DFS was 77% vs 38%, HR 0.31 (95% CI 0.09–1.03), p=0.021. The ctDNA-negative registry cohort had a 3-year DFS of 87% without chemotherapy. This is the first prospective, randomized evidence that ctDNA-guided adjuvant decisions deliver an actionable benefit in stage II CRC, and it has the structure of a true biomarker-validation trial rather than a hypothesis-generator like DYNAMIC. The clinical implication: ctDNA-negative stage II patients can safely skip chemotherapy; ctDNA-positive stage II patients now have prospective Phase 3 evidence to treat.
Post angle: 🎯 CIRCULATE (ASCO LBA3500) — first Phase 3 to PROVE ctDNA-guided adjuvant chemo benefits stage II MSS colon cancer. 3-yr recurrence 19% (chemo) vs 62% (observation), HR 0.23, p=0.009. 3-yr DFS 77% vs 38%. ctDNA-neg patients: 87% 3-yr DFS without chemo. ctDNA is now a treatment-decision tool, not a biomarker. #CRC #ColonCancer #ctDNA #PrecisionMedicine #ASCO26
#4
Source: ASCO 2026 Annual Meeting — Abstract 4008 (BioNTech / Sichuan Biokin) | Authors: Lu Z, Wang J, Kato K, et al. (multicenter, BioNTech / Sichuan Biokin) | Published: June 1, 2026
Score: 15/20 — ASCO oral abstract (8) + Phase 3 RCT (+3) + survival benefit OS (+2) + Colleague engagement on X by @DaisukeKotani and @DraMartinezLago (+2) = 15. The May 23 preview was covered; this is the full Phase 3 oral presentation with OS, PFS, ORR and toxicity readouts.
PANKU-Esophagus01 (BL-B01D1-305) is the first positive 2L Phase 3 RCT in advanced ESCC since the IO era. 497 patients with recurrent or metastatic ESCC progressing after prior PD-1 / PD-L1 + platinum doublet were randomized to izalontamab brengitecan (iza-bren, BL-B01D1) — a first-in-class EGFR/HER3 bispecific antibody-drug conjugate carrying a topoisomerase-1 inhibitor payload — vs investigator's choice single-agent chemo (paclitaxel, docetaxel, or irinotecan). Primary endpoint OS: 9.8 vs 7.2 months, HR 0.64 (95% CI 0.49–0.83), p=0.0004. BICR-assessed mPFS 4.2 vs 2.0 months, HR 0.50 (95% CI 0.40–0.63), p<0.0001. ORR 35.3% vs 13.1%. Grade ≥3 TRAEs 85.1% vs 60.2% — toxicity is non-trivial, with anemia, neutropenia, and ILD as the principal concerns. This is the first dual-receptor ADC to demonstrate Phase 3 efficacy in a GI cancer; the bispecific architecture appears to overcome the limitations of monovalent ADCs in ESCC, where T-DXd and DS-7300 have been disappointing.
Post angle: 🌍 PANKU-Esophagus01 (ASCO 4008) — first positive 2L Phase 3 in advanced ESCC since the IO era. Iza-bren (EGFR/HER3 bispecific ADC + topo-1 payload) vs chemo after PD-1/platinum: mOS 9.8 vs 7.2 mo (HR 0.64), mPFS 4.2 vs 2.0 mo (HR 0.50), ORR 35.3% vs 13.1%. Toxicity is real (Grade ≥3 TRAEs 85%). Bispecific ADCs are doing what monovalent ADCs couldn't. #EsophagealCancer #ADC #GIOnc #ASCO26
#5
Source: Journal of Clinical Oncology / ASCO 2026 oral abstract | Authors: Kawazoe A, Yamaguchi K, Bando H, et al. (multicenter Japan, Ono Pharmaceutical-sponsored) | Published: June 1, 2026
Score: 13/20 — JCO (8) + Phase 2 randomized (+2) + biomarker-guided (CPS≥1 subgroup activity, +1) + Colleague engagement on X by @DaisukeKotani and @DraMartinezLago (+2) = 13. Published in JCO simultaneously with the ASCO 2026 oral presentation.
ONO-4578-08 is a randomized Phase 2 trial of the oral EP4 antagonist ONO-4578 (vupanorsen-class prostaglandin E2 receptor blockade — repurposes a long-known immunometabolic lever into the 1L gastric pathway) added to nivolumab + chemotherapy backbone in 1L HER2-negative advanced gastric / GEJ adenocarcinoma. Overall: mPFS 9.0 vs 6.9 months, HR 0.67 (90% CI 0.48–0.92), p=0.040. The biomarker-defined PD-L1 CPS≥1 subgroup showed substantially larger benefit: mPFS 9.9 vs 5.7 months (HR 0.52), mOS not reached vs 12.7 months (HR 0.44, 95% CI 0.26–0.77), ORR 70.9% vs 50.9%. No new safety signals — toxicity tracked the nivolumab + chemo control arm. Mechanistically, EP4 blockade is hypothesized to relieve PGE2-driven myeloid-derived suppressor cell and Treg-mediated immune suppression in the gastric tumor microenvironment, restoring effector T-cell function in the PD-L1-positive niche where checkpoint inhibition is doing real work. Ono Pharmaceutical / Deciphera have announced a confirmatory Phase 3.
Post angle: 🧪 ONO-4578-08 (JCO + ASCO oral) — EP4 antagonist + nivo + chemo in 1L HER2-neg G/GEJ. Overall mPFS 9.0 vs 6.9 mo (HR 0.67). PD-L1 CPS≥1 magic: mOS NR vs 12.7 mo (HR 0.44), ORR 70.9% vs 50.9%. EP4 inhibition was the missing immune-modulation lever in PD-L1+ gastric. Phase 3 should be a layup. #GastricCancer #IO #GIOnc #ASCO26
Additional Papers of Interest
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ASCO 2026 Abstract 4011 (HUTCHMED) — IRC-assessed ORR 32.3% (95% CI 21.2–45.1) and DCR 63.1% with savolitinib monotherapy in MET-amplified G/GEJ; mDoR 9.7 mo, mPFS 4.0 mo. NDA accepted by China NMPA with priority review. First targeted therapy with regulatory traction in this 2–5% molecular subset.
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ASCO 2026 Abstract 4010 (Jazz / BeiGene) — PD-L1 CPS≥1 patients drive the PFS / OS benefit of zanidatamab + tislelizumab + chemo in 1L HER2+ GEA, with the magnitude of OS gain (HR 0.61 in CPS≥1 vs HR 0.92 in CPS<1) clarifying who to treat with the IO-containing triplet vs zanidatamab + chemo alone. Companion to the May 28 NEJM primary publication covered in the May 29 digest.
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Journal of Robotic Surgery (Gosavi R, Narasimhan V et al., Monash / Cabrini Health) — robotic TME shows lower CRM positivity (OR 0.58), higher complete TME rates (OR 1.55), lower conversion (OR 0.41), lower 3-yr locoregional recurrence (OR 0.43), and DFS HR 0.78. The first meta-analysis to demonstrate an oncologic — not just operative — benefit signal for robotic over laparoscopic TME.
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OncLive — Beyond the four Top-5 ASCO entries above (RASolute 302, EMERALD-3, CIRCULATE, PANKU-Esophagus01) and ONO-4578-08, the GI weekend delivered savolitinib MET-amp gastric (Abstract 4011), HERIZON-GEA-01 PD-L1 subgroup (Abstract 4010), QLS31905 CLDN18.2 bispecific data (Abstract 4003), and the daraxonrasib + GnP first-line PDAC RASolve 301 enrollment update — a denser GI agenda than 2024 and 2025 combined.
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