From a “game-changer” in triple-negative disease to broader paradigm shifts and practice changes, the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting was pivotal for breast cancer care, says Sara M. Tolaney, MD, MPH, chief of the Division of Breast Medical Oncology at the Dana-Farber Cancer Institute in Boston, Massachusetts. Dr. Tolaney broke down some of the top data at ASCO 2025 with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles, California, and Steven Spielberg Family Chair in Hematology-Oncology. She singled out findings from the ASCENT-04 trial, the plenary session on SERENA-6, and the DESTINY-Breast09 trial. “I think it’s been a very exciting ASCO for breast cancer overall, with just so much exciting data,” Dr. Tolaney concluded.

Results from the phase 3 ATOMIC trial are practice changing for colorectal cancer care and raise broader questions about immunotherapy use in patients with mismatch repair deficiencies across tumor types. Frank A. Sinicrope, MD, a professor of oncology and medicine at the Mayo Clinic Comprehensive Cancer Center in Rochester, Minnesota, presented the findings at the 2025 American Society of Clinical Oncology Annual Meeting. He discussed the significance of the ATOMIC results and next steps with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. “I think that microsatellite instability is a terrific predictive biomarker for immunotherapy, and all of these patients should get immunotherapy in some form or another,” Dr. Sinicrope noted.

“An increasingly unrealistic set of performance expectations” is putting a strain on oncologist faculty members, says Clifford Hudis, MD, CEO of the American Society of Clinical Oncology (ASCO). He discussed the mounting challenges for academic cancer physicians and how ASCO is working to address them with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. Dr. Hudis explained that academic oncologists are expected to be clinicians, researchers, teachers, and administrators. “And in most cases, there just isn’t a pay line and salary support for all four of those jobs, nor are there enough hours in the week for somebody to do all four of those jobs in a superb way,” he said. When it comes to ASCO’s ability to enable proactive change, Dr. Hudis explains that “we don’t have an enforcement mechanism. All we can do is shine a very bright light on reality and then ask for collective action to identify best approaches.”

Dr. Hudis reported no relevant financial relationships.

Dr. Figlin reported various financial relationships.

“For the first 15 years of my career, we had nothing new” in bladder cancer care, said Jonathan E. Rosenberg, MD, chief of the genitourinary oncology service at Memorial Sloan Kettering Cancer Center in New York City. Now, “the pace of change has been dizzying,” he told Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. Speaking at the 2025 American Society of Clinical Oncology Annual Meeting, Dr. Rosenberg discussed key studies that have recently changed practice and what questions still remain. For certain laboratory testing and other concerns, “it’s a bit of the Wild West right now,” he noted.

Findings from the SERENA-6 trial, which examined switching therapies in patients with breast cancer ahead of disease progression, made headlines during the 2025 American Society of Clinical Oncology Annual Meeting. However, big questions remain. “I don’t know for sure if the approach is practice changing yet. I think the approach is practice confounding,” said Stephanie Graff, MD, director of breast oncology at Brown University Health Cancer Center in Providence, Rhode Island. Dr. Graff discussed the high-profile data with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology. The trial showed a progression-free survival benefit when patients switched from an aromatase inhibitor to camizestrant, based on circulating tumor DNA information. And yet, issues with the study’s design may make taking the results into clinic challenging. “We don’t have clear evidence on how changing based on molecular therapy changes overall survival,” said Dr. Graff. “I think we’re going to get there, but I don’t know that the point we are at with SERENA-6 has us there.”

From digitizing its guidelines to potential embedding them in EMRs, the National Comprehensive Cancer Network (NCCN) is working to “make the workflow easier and better” for oncologists, Crystal S. Denlinger, MD, FACP, CEO of the NCCN, told Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, at this year’s American Society of Clinical Oncology (ASCO) Annual Meeting. Dr. Denlinger broke down the organization’s current priorities and key initiatives, including how the network is tackling preauthorization challenges and helping to educate clinicians about changes to best practices. She notes that initiatives to ensure NCCN guidelines are available, useful, and up to date are crucial because “I truly believe that guideline-concordant care is one of the ways in which we can cure cancer.”

“Is it time to do something big and different? That’s always a good question to ask,” said W. Kimryn Rathmell, MD, PhD, MMHC, the immediate former director of the National Cancer Institute (NCI) and the current CEO of The Ohio State University Comprehensive Cancer Center–James Cancer Hospital and Solove Research Institute. At the 2025 American Society of Clinical Oncology Annual Meeting, Dr. Rathmell spoke with Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles, and Steven Spielberg Family Chair in Hematology-Oncology, about how the NCI can adapt to the current environment. She also shared her thoughts on educating the next generation of cancer physicians. “How can we help enable them to look at every patient creatively and to think about how we incorporate all this immense amount of knowledge that we’re trying to impart with them?” she asked.

A late-breaking abstract presented at the 2025 American Society of Clinical Oncology Annual Meeting (LBA3) showed that rusfertide significantly increased hematocrit control and improved symptoms for patients with polycythemia vera, a chronic leukemia. “We thought if we could use our understanding of iron regulation, then we could change the game a little bit,” said Andrew Kuykendall, MD, assistant member in the Department of Malignant Hematology at the Moffitt Cancer Center in Tampa, Florida. He told Robert A. Figlin, MD, the interim director of Cedars-Sinai Cancer in Los Angeles and Steven Spielberg Family Chair in Hematology-Oncology, about the rationale behind the trial, broke down key findings, and shared what comes next in this area of research. “I think it is very important that we continue to follow these patients. And this is an ongoing trial that has a part two to it, which is a long-term safety assessment period,” he explained.