Behind the headlines of ASCO 2026

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0:30Today is Friday, June 5th, and you're listening to The Topline, brought to you by Fierce Pharma and Fierce Biotech. I'm your host, Ayla Ellison. This week on The Topline, we're looking back at ASCO, which wrapped up earlier this week after once again bringing the cancer world to Chicago.

1:03Fierce Pharma's Zoe Becker and Angus Liu, along with Fierce Biotech's Darren and Corvaya, spend the meeting on the ground tracking the biggest data drops, hallway conversations, and industry debates coming out of oncology's marquee event.

Revolution Medicine's RAS Inhibitor Data

1:20In this episode, they break down Revolution Medicine's closely-watched RAS inhibitor data in pancreatic cancer, a KISO's high-profile China-only lung cancer study, Johnson & Johnson's bid to change prostate cancer treatment, and the latest clinical data behind Lilly's bet on InVivo CAR-T. They also get into one of the clearest themes of this year's meeting, the growing influence of Chinese biotechs and China-originated assets across oncology, from bispecific antibodies to ADCs to cell therapy.

1:53Let's get into it. Hi, everyone. We are here recording this podcast from the American Society of Clinical Oncology's 2026 annual meeting, which takes place in beautiful Chicago every year. I'm Fierce Pharma staff writer Zoe Becker. I'm Angus Dew, deputy editor with Fierce Pharma.

2:27And I'm Darren Incarvaya, senior writer with Fierce Biotech. And we have had quite a busy few days of on-the-ground reporting on all the latest trends and news in cancer care. One of the biggest headlines this weekend came from Revolution Medicines. So Revolution Medicines, or RevMed, as they're commonly known, they really kind of took the world by storm a few months ago when they revealed that their phase 3 trial of Daraxin RASib, their RAS inhibitor, had hit the primary endpoint. And now we've kind of got the fullest picture of the data that they've released so far.

3:01So this trial enrolled 500 patients with previously treated metastatic pancreatic ductal adenocarcinoma. And RevMed had revealed previously that their candidate, Daraxin RASib, had doubled overall survival compared to chemotherapy, from 6.5 months to 13.2 months. Now what they've shared here in a plenary session at ASCO is that for progression-free survival, Daraxin RASib basically did the same thing. It doubled progression-free survival from 3.5 months in the chemotherapy arm

3:32to 7.3 months in the Daraxin RASib treatment arm. Another big open question for Daraxin RASib was its safety profile. And here RevMed is reporting that 43.6% of patients, given their investigational molecule, had a treatment-related adverse event of grade 3 or worse, compared to 57.5% for the chemotherapy arm. And really, though, the key difference here, as I sat down with RevMed's chief development officer, Alan Sandler,

4:02and he told me that the key difference with the safety profile is the kinds of side effects that you see with Daraxin RASib, in chemotherapy, patients often experience fatigue, anemia, nausea, and neutropenia, whereas in Daraxin RASib, the main side effects were like rash, diarrhea, some mouth inflammation, and also nausea. The nausea was still there. And so RevMed really feels that the safety profile was more favorable compared to chemotherapy for Daraxin RASib. Now, one patient in the study who was given Daraxin RASib did unfortunately die due to lung inflammation.

4:38RevMed, you know, when I talked to them about it, they told me that they're not entirely sure what happened yet. It was attributed to treatment out of an abundance of caution. The patient had multiple pulmonary nodules on the lungs going in and ultimately declined and went into hospice care. So they're still figuring out what exactly happened there, but the company still feels that overall the safety profile is more favorable for Daraxin RASib, and they also did some measurements of quality of life and found that patients reported better quality of life,

5:09feeling better overall on their treatment compared to chemotherapy. So they think it's not only extending survival, but also giving patients more good days, more good months compared to chemotherapy. Now, because RevMed has been, I guess you could say, dominating a lot of the conversation, that means RAS inhibitors have also been dominating a lot of the conversation. And RevMed, they're not the only company working on them, and there's a couple approved RAS inhibitors already. But now I think it's safe to say we're going to see a lot of kind of follow-ons,

5:40a lot of other people trying to get in the game. Even before ASCO, a couple months ago, I think, AbbVie partnered with Kestrel Therapeutics on a preclinical RAS inhibitor, and I was chatting with folks from Gilead Sciences here at ASCO as well, and they said they're looking at RAS inhibitors too, still early days, but they're keen to get in on it as well. Definitely not the end of the story for RAS inhibitors, not the end of the story for RevMed. They're looking to move Daraxin RASib into earlier lines of therapy, other kinds of cancers. So definitely one of the biggest stories of this ASCO and probably one of the biggest stories in cancer treatment in the past few years,

6:20maybe the past decade, I don't know. Wow, I can definitely see why that one is getting a lot of hype, the RAS inhibitor hype.

Akiso's PD-1 VGF Bispecific Antibody

6:27Another plenary this year came from Akiso, and Angus can tell us more about that one. Yeah, this one, I think besides RevMed, this one got a lot of attention too, because unlike RevMed, where we've already got the top-line data, this one, there was a lot of guessing ahead of the data revelation whether they are going to hit meet statistical significance or not, which matters a lot. So this is a data set for Akiso's PD-1 VGF bispecific antibody, which is another hot topic these days

7:04because their potential to replace Akitruda as a new immunotherapy backbone. So this data set is combining Avanizumab by specific with chemotherapy and compare it against another PD-1 inhibitor and chemotherapy in first-line advanced squamous non-sposaline cancer. Before, when Avanizumab first made its name as this potential next immunotherapy,

7:34it beat Akitruda as immunotherapy, but because in a lot, in many parts of the world, the standard of care of first-line advanced squamous melanoma has become like Akitruda plus chemotherapy. So people are curious to see whether you can be combined with chemo and still beat Akitruda and chemo. So this is a big test. So what's special about this plenary is also, this is the first time, this study called Harmoni-6, it is, this is the first time that a China-only data set was selected for presentation at the plenary session at ESCO.

8:12So that's why there are people who are guessing, did they meet statistical significance on overall survival or not? And the data, I should say, it didn't disappoint because I think I covered it in a preview with a lyric analyst, they're in a great rush, and we're talking about like people would say a 30% improvement on overall survival would be a big win here, would be a huge win. And Avanizumab did 34%. So it definitely exceeded expectation there.

8:44And the kind of median overall survival improvement, there were, I think, around four-month improvement. Also, quite, and the control arm performed as expected. So there wasn't any concern, like if there is a weak comparator, you somehow gained an advantage and succeeded there. So this was, all in all, a very successful Chinese study that I think is going to be quickly applied in China. So the thing with this study is I talked to Dr. Julie Bramer, who was invited by ESCO to discuss this data set during the plenary session.

9:28And she, of course, she said this is a promising data set, and there were definitely, this is a positive clinical trial and overall survival. But she, basically, she tore apart this study. Just a lot of elements of the study that could impact its possibility for the data, for the findings to be repeated in a global population. And she mentioned the eligibility criteria, like it excluded older patients above the age of 75, I think,

10:00and also some patients who have a higher risk of bleeding. For the context, standalone VGF inhibitors were not allowed to be used in a first-line scream as non-small sonial cancer because of this bleeding, potentially deadly risk of bleeding. So this study excluded patients who have higher risk of bleeding. But Dr. Bramer was like, how can I decide what's high risk of bleeding and who is not at a very high risk?

10:34So there is something going on there. There is also this, as I mentioned, the age problem because the trial excluded patients who are older. And the subgroup data here show, like, the overall survival subgroup analysis in patients above the age of 65 was not very good. So, and Dr. Bramer mentioned this, in the U.S., the patient population of squamous non-small sonial cancer tends to be older.

11:06So if you can't do better in this population, the entire trial in the global population might be impacted. So this is some of her critique of the study. And that's why she questioned whether this study's findings can be repeated really in a global population. And I think the audience, in a way, agreed. Because we've seen with RevMed, there's a standing ovation of the audience. But with this one, the KISO one, if this were a global clinical trial,

11:40and you beat Kichuda chemotherapy in first-hand non-small sonial cancer, that's huge. And that's definitely, I'd say it'd be definitely bigger than RevMed. But this is a China story, and it got some, this negative review, a lot of different weak points from Dr. Bramer. Again, from China's standpoint, this is a hugely successful clinical trial proved that Ivanecimab really works in this population.

12:11But we just have to wait until a global study to read out. Wow, that is a very interesting situation. And we will get back to more news from Chinese biotechs later, because there was a lot. But here's another plenary for you guys.

Johnson & Johnson's Prostate Cancer Treatment

12:27So this one was from Johnson & Johnson, and it was a phase 3 win for their Erlita, which is an approved prostate cancer drug. It's been around for a few years now, I think, since 2017. And why this one was important is because it could change a long-standing prostate cancer practice. For the last 125 years, patients with prostate cancer have been getting, they've been preparing for the surgical removal of their prostate, a.k.a. a radical prostatectomy.

12:58And this is the typical treatment alongside radiation therapy. But, unfortunately, nearly half of those patients who end up getting that surgery see their cancer return. And at that point, Johnson & Johnson executives told me they might miss the chance in which a cure for their cancer is possible. In Proteus 3, when Erlita was given two patients with high-risk localized or locally advanced disease alongside the typical hormone therapy for the six months before and after their prostatectomy, the regimen reduced the risk of developing metastasis or death by 20%.

13:34And, importantly, it extended the time before patients would need additional therapy to more than six years. This is pretty big because for those in the trial who are on hormone therapy alone, they only lasted three and a half years before they ended up needing extra therapy. So this study could be pretty practice-changing, is what some ASCO experts said. And it could be big for J&J, too, because the drug is pretty important to their oncology ambitions. And it has experienced year-on-year growth for a while, even though it hasn't had a new indication in a few years now.

14:06But this could definitely help boost them to their oncology goal of reaching $50 million in oncology-specific sales by 2030, or being the number one company on oncology by 2030, as their CEO, Joaquin Duato, put it recently in a Criasko interview. Elsewhere on the biotech side, we also got some fresh data from one of Eli Lilly's many M&A targets. Tell us more about that, Darren. Yes, yes. Thank you, Zoe. There's really a few different ways into this story.

14:38One, as you pointed out, is Eli Lilly's ravenous M&A appetite. It seems every day they're buying a new company for one thing or another. It really keeps us busy. But the other kind of side of this is that this is the in vivo car tea company, Colonia Therapeutics, that Lilly announced their intent to acquire. The acquisition hasn't closed yet. But in this case, what we're getting is kind of the largest slice of data that we've seen for an in vivo car tea,

15:09especially for a sponsored study, especially. And if you think back, what feels like a million years ago, but just December 2025 at the American Society of Hematology meeting, Colonia Therapeutics stole the show a little bit with data from just four patients who were given their in vivo car tea, which is KLN 1010, it's called. And these are patients with relapsed or refractory multiple myeloma, which the CEO of Colonia told me is basically like the sickest of the sick, is how he put it.

15:40And at ASH, they showed really strong data from these four patients that they had no cancer anymore. That's great. And so that was enough to attract Lilly's attention. And what we're getting now is 14 more patients on top of those four for a total of 18 patients in this still ongoing trial. And the data, still very strong, 100% response rate. That's not bad. And at this point, all of the patients that Colonia has been able to assess

16:11for minimal residual disease, a test of residual disease in the bone marrow, all the patients they've been assessing have come up MRD negative, right? No cancer in their bone marrow at the points they've been assessed. And again, there's still more follow-up to come. So from Lilly's perspective, of course, the data are really exciting. I spoke with their head of oncology, Jake Van Narden, who also heads up their whole business development strategy. And he called the results nutty in a positive sense because he said for, again,

16:45these to be some of the sickest patients, give it an off-the-shelf therapeutic that's designed to tweak their T cells in their body to fight their cancer, 100% response rate, again, full MRD negativity. He just thinks it's nuts, he told me. And this is really another kind of sign, I think, that the in vivo CAR-T hype that kind of started last year, it's continued. And I think this means it's going to continue going. But as we move forward with this, we're getting more and more kind of clinical proof

17:16that the hype is warranted. And obviously, with that said, it's still early days. We need more and more patients. Lilly is planning multiple phase three trials of this therapy in multiple myeloma. They don't have anything definitive yet, but they're working to sketch it out, they told me. And they think that Colonial's platform can be adapted for other kinds of cancers as well, like lymphoma, maybe even solid tumors. So Lilly sees, obviously, they bought the company, so they see a full potential for the platform, not just for KLN-1010 in multiple myeloma.

17:49But I think Lilly really sees it as this being further proof that they made a good decision to buy Colonial. And I think it's further proof that we're all going to be hearing about in vivo CAR-T for forever, essentially, until the end of time.

Chinese Biotechs and Innovations

18:05Talk about nutty. So back to China. As we know, these Chinese biotechs and their innovations have been getting all the buzz around ASCO and around the world. So Angus, what are some other need-to-know readouts from some other Chinese biotechs this weekend? Yeah, I think I'm just going to continue on the CAR-T front. Darren, you wrote that story about LG NIA CAR-T, their kind of existence crisis in a bit, while this in vivo CAR-T hype is going on.

18:39I'm going to take us on a trip down memory lane that was back nine years ago. It was this little-known biotech company called Nanjing Legend Biotech, came, dropped their abstract last minute at ASCO and wowed everybody with a 100% objective response rate in having appreciated multiple myeloma patients. I remember that was my first ASCO story. And I talked to their scientific founder, Frank Fan, at that time about that data.

19:12And this year, Dr. Fan, he's back with his new company and is working on this LG NIA CAR-T that he says is going to, hopefully, if it works, it's going to be huge from a production perspective and also because it can't be produced without any gene editing. So those two things are big because CAR-T therapies are currently restricted by their manufacturing capacity and also some of the allogeneic CAR-Ts, they do a little bit better on the production

19:48point because you don't have to individualize each patient's CAR-T, but you require some gene editing to prevent your host body from rejecting those therapeutic cells. But that creates a longer-term safety concern because gene editing, there were still in the early days of that, there's some safety risk to that. So he came back with this new technology, very early data again for patients.

20:18And the data, definitely not a home run. There's definitely room for some improvement. But it's interesting to see, like you're going this full circle now, that a Chinese biotech founder is coming back with the new technology. But another data set that I want to highlight is Trop2 ADC that Merck has partnered, has licensed from a Chinese company called Kulun Biotech. Remember, we talked at the beginning that there is some, how evanescimab beat Keytruda in first

20:54line non-smile saline cancer. And here we also have this Trop2 ADC data, SEC-TMT plus Keytruda against Keytruda alone in first line non-smile saline cancer. The combination, it reduced the risk of progression of death by 65%. Compared with Keytruda alone in treatment-naive, PD-L1-positive non-smile saline cancer. And again, as we mentioned earlier, the standard of care in a big part of this population, the

21:26PD-1 low population, has moved from Keytruda monotherapy, PD-1 monotherapy, to the combination of PD-1 plus chemo. So there are some, people are very excited about this data. Keytruda, of course, 65%, very big effect size, but there's, people want to see a little bit more. What's exciting about it is in the PD-L1 high population, Keytruda is still being widely prescribed. Keytruda monotherapy is still being widely prescribed because we know chemotherapy doesn't

21:59add much to Keytruda in that population. And here, SEC-TMT and Keytruda, this is from a subgroup analysis, still showed like a 53% PFS improvement in the PD-L1 high group. So that kind of is a validation in itself that this could be really promising candidate. But an interesting point is Merck, who has licensed this drug, they have opened 17 clinical

22:29trials on this, as I said, they called it a workhorse product. But interestingly, they don't have a phase three, global phase three study in PD-L1 low or negative, non-squamous, non-small cell and cancer. And I ask the company about this like all the time. They just wouldn't say what they want to do about this population. And Merck, they also have a PD-1. Remember, I have a next small discussion. They also have a PD-1 VGF inhibitor with them. So there's a potential maybe they could combine the two, the SEC-TMT, ADC, and the PD-1 VGF

23:08by specific together. But the company is just not revealing their strategy right now. They're saying this is a hyper-competitive environment. They won't reveal their strategy right now. So that is also another interesting thing that we saw also from China. And it's interesting to see like the hottest field in oncology right now for spinal cell cancer is having these Chinese assets from China competing with assets from China, even though they both have multinational pharma companies behind them.

23:40Yeah, Angus, I feel like I've been hearing a lot about combinations just in general as well. Well, during ASCO, speaking with some oncology leaders from AbbVie this morning, and they said that when they're licensing new assets or thinking about even their own internal innovation, they're always thinking about partnering those new assets with their antibody drug conjugate backbone. So they're basically from the beginning, they're thinking about these combinations. But I also wanted to say the allogeneic CAR-T, your story about Frank Fund's new company,

24:14WonderCell Therapeutics, which is a great name for a company, I think, for a cell therapy company. One of the better ones, we get some really awful biotech names, so WonderCell's pretty good. But I just, yeah, you reminded me that during my conversation with Jake Van Narden from Lilly, he mentioned that Lilly was actively thinking about how to get into the CAR-T game. They hadn't really been in the ex vivo cell therapy thing, as he put it. And he said they canvassed all of the allogeneic, the donor-derived CAR-T methods, as well as the

24:46in vivo options. And they thought that in vivo would leapfrog aloe. And leapfrog is a word you hear all the time with these cell therapies. People thought aloe was going to leapfrog autologous CAR-T. Now it's in vivo is going to leapfrog aloe because there's no approved allogeneic CAR-Ts yet. So you just reminded me of that piece of it where, I guess I'll just say, yeah, having written that story about alogeneic CAR-T, it seems that there's still going to be some struggles for them to get the kind of attention, at least from Eli Lilly, that maybe they could

25:20have gotten in the past. But yeah, really another interesting trend to watch. We wanted to also get in on the trend this year. So we went to Chinatown in celebration of all the China news at ASCO. And it was actually my first time in Chinatown. Every ASCO, I go to a new part of Chicago. So that's been exciting for me. We had such a good time. We ate some dumplings. And my personal highlight was there was a lot of loop booboos there. And if any of you loyal listeners remember from January, our JPM podcast recap, that is

25:53where I purchased my first real loop booboo. And it was very exciting. Sadly, I did not indulge in the fake loop booboos this time. But hey, maybe I'll be back. Who knows? Maybe next year will be my loop booboo year. If the China buzz continues, which we think it will. Beyond the headlines this year, what was anyone's other favorite part of ASCO? Angus? I'm just going to say, after covering this meeting several years, this is the year I have interviewed the most Chinese companies.

26:24So that tells you that we're definitely going to see a lot of these Chinese data in the future. One question. How many years have you been going to ASCO, Angus? Oh my God. He needs to think about it. I may not come to this place every year. But like I said, that Kavikti legend data, that was my first year at ASCO. That was 2017. Wow. That is a lot of years. And it's Darren's first year at ASCO.

26:55So tell us, was it like you expected? Any surprises? Yeah, I guess I was warned going into it that there were going to be more people in this, in the McCormick Place Convention Center, more people than I could possibly imagine. And that was true. There were more people here than I think anywhere else on earth just crammed together. I didn't know the whole city of Chicago could fit this many people, let alone one convention center, albeit it is massive. So it was just kind of fun to be among all the folks who traveled from all over the world,

27:28to be here, to hear so many different languages spoken, and see all these different people coming together, all united under a very noble goal of ending cancer. Personally for me, I used to live in Chicago a few years ago. Never went to ASCO while I lived in Chicago. That would have been more convenient. But I had to move away before I came to ASCO. So for me, it was just nice to see Lake Michigan again, to see Chinatown again. I had been to Chinatown before. But so just, yeah, kind of walking down memory lane a little bit while also getting to enjoy

28:00some incredible data sets, some big advances in cancer treatment. Well said. Thank you, Zoe. Any other thoughts, anyone? Any highlight reel recap of your years at ASCO, Angus? No. No, nothing to report. This was my third year at ASCO, and it was a joy. So thank you all for joining me today on this podcast and this weekend. We had a blast, and it was very informative.

28:30Until next year. Yes. See you next year.

28:38That's it for The Top Line. I'm your host, Ayla Ellison. You can find out more about this topic in our show notes at FiercePharma.com. Look for podcasts. And that's The Bottom Line from The Top Line.