The OJC ASCO 2026 Special Part 2
The Oncology Journal Club podcast's ASCO 2026 Special Part 2 delivers a high-octane, irreverent yet deeply insightful tour of the most impactful cancer research from the conference. The episode reveals a pivotal shift toward precision medicine, with compelling data showing that adjuvant exercise programs can save health systems money—making them a 'dominant strategy' in health economics. A landmark trial, Optima, demonstrates that a low-cost gene assay (ProCigna) can safely spare 70% of high-risk breast cancer patients from chemotherapy without compromising outcomes, challenging long-standing treatment norms. In colorectal cancer, a trial using Folfuri with encorafenib shows superior progression-free survival over Folfox, while a provocative observational study suggests that immune therapy duration could be safely shortened to 'complete response plus two cycles'—a radical departure from the arbitrary two-year standard. The episode also highlights promising new agents like atabimantinib for KRAS-mutant pancreatic cancer and a novel PLK1 inhibitor, onvansertib, that synergizes powerfully with irinotecan. Despite these advances, several high-profile trials failed, reinforcing the need for smarter trial design. The overarching theme? Oncology is moving from shotgun approaches to targeted, patient-centered strategies—where biology, cost, and quality of life are now central to decision-making.
Adjuvant exercise programs in colon cancer are cost-effective and save money by reducing relapses—this is a 'dominant strategy' in health economics.
The Optima trial shows 70% of clinically high-risk breast cancer patients can safely avoid chemotherapy using a low-cost gene assay (ProCigna).
Folfuri with encorafenib achieves 15.2 months median PFS in BRAF-mutant colorectal cancer—superior to Folfox and without new safety signals.
An observational study suggests immune therapy for dMMR colorectal cancer can be safely stopped at CR plus two cycles, with only 1% relapse rate.
Onvansertib, a PLK1 inhibitor, boosts irinotecan response rates to 72% in metastatic colorectal cancer—demonstrating strong synthetic lethality.
…and 3 more takeaways available in PodZeus
Welcome to the ASCO Post-Special: Bingo, Pyjamas, and the Real Talk
The episode kicks off with a playful ASCO Bingo game, where listeners earn points for mentions of Qantas PJs, drug mispronunciations, and sensitive topics like sexual dysfunction. The hosts set a lighthearted tone while teasing the serious science to come.
Colorectal Cancer: From ctDNA to Cost-Effectiveness
“It actually saved money. And that was because, of course, it stopped people relaxing and therefore funding the structured exercise program actually saves their health system money.”
BRAF-Mutant CRC: Folfuri + Encorafenib and the End of Two-Year IO
“It's pretty daft that we use this very arbitrary two year duration of IO, isn't it?”
Breast Cancer: Optima and the End of Chemo for 70% of High-Risk Patients
“70% of women who had clinically high-risk disease were found to be low risk on the Optima tests.”
New Frontiers: GLP-1s, Denosumab, and KRAS Inhibitors
The discussion turns to emerging therapies: GLP-1 agonists show a 30% reduction in breast cancer incidence in a retrospective study, denosumab can be given every 3 months without loss of efficacy, and atabimantinib shows promise in KRAS-mutant pancreatic cancer.
“workforce as well, which also under a lot of strain and we need to tend to all parts of the garden, not just our own bushes.”
“compared to usual care. And that was because, of course, it stopped people relaxing and therefore funding the structured exercise program actually saves their health system money.”
“But, you know, it's pretty daft that we use this very arbitrary two year duration of IO, isn't it?”
Host
Guests
Professor Christopher Jackson
person
ASCO 2026
other
Dr Kate Clark
person
Professor Craig Underhill
person
Oncology Journal Club
media
Optima trial
other
Qantas PJs
product
ProCigna
other
CHALLENGE study
other
Discus trial
other
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