ASCO 2026 underscored a fundamental truth: the future of cancer care depends not only on breakthrough therapies, but also on our ability to identify the patients who can benefit from them.
From lung cancer screening and biomarker testing to AI-assisted diagnostics and technology-enabled workflows, diagnostics were a recurring theme throughout the meeting. Targeted therapy advances reinforced the promise of matching treatments to tumor biology, while discussions around screening, testing, and implementation highlighted a harder question: are health systems optimized to find, test, and route the right patients to the right care?
As precision oncology advances, however, it is becoming clear that the challenge is no longer just scientific innovation. It is the diagnostic pathway itself, encompassing the journey from risk identification and screening to diagnosis, biomarker testing, treatment selection, and access.
Here are our five key takeaways from ASCO:
1. Precision medicine only works if patients get tested.
ASCO highlighted how rapidly targeted therapies are advancing across cancers, including in molecular defined tumor types where treatment decisions depend on timely and appropriate diagnostic testing. Data from LIBRETTO-432 reinforced both the promise of targeted therapies in a deadly cancer and the need for comprehensive biomarker testing across disease stages.
But those innovations only create value if eligible patients are identified, tested, and connected to care. The next challenge is ensuring patients, providers, labs, and payers are aligned to move patients efficiently from diagnosis to treatment.
2. Screening and risk identification strategies should better reflect biological risk.
Lung cancer screening has proven value, but uptake remains low even among eligible populations. Current approaches are still focused on age and smoking history but are limited in their ability to identify patients who may be at risk biologically, as well.
As targeted therapies move earlier in the treatment paradigm, screening approaches focused on age and behavioral risk without accounting for biological risk, will miss critical patient populations. These gaps become more consequential. Future screening and risk identification models will need to become more personalized to fully realize the benefits of early intervention.
This does not mean screening should expand without evidence, but ASCO made it clear that the evidence must evolve if the system and patients are going to fully realize the benefits of early intervention.
3. AI’s greatest opportunity in oncology is improving the diagnostic pathway.
The most compelling AI applications at ASCO were not replacing clinicians, but helping the system better identify patients, flag testing needs and streamline care decisions. Success will depend on integrating AI into real-world workflows and ensuring patients can act on the insights it generates.
An ASCO presentation of an AI-assisted lung cancer screening platform showed how valuable this technology becomes when paired with navigation, care coordination, EHR integration, and delivery models. But implementation will matter, particularly understanding who receives and acts on this information, and if follow up care is covered and accessible. Without clear answers, AI risks becoming another layer of noise in an already fragmented system.
4. Diagnostic innovation must be matched by evidence, access, and trust.
New technologies such as AI-enabled biomarkers, ctDNA, and multi-cancer early detection are generating excitement, but adoption will depend on more than technical performance. For diagnostic innovation to scale, providers and patients need confidence that a test will not just detect disease but guide what happens next.
Does it support better treatment? Avoid unnecessary treatment? Enable early intervention? Ensure high-value care? Stakeholders will need answers to these questions to trust the diagnostic and the pathway that follows.
5. Diagnostic readiness and launch readiness are inextricably linked.
Companies can no longer treat diagnostics as a downstream consideration. Access to testing, provider education, patient navigation, and evidence generation must be incorporated into launch, access, and advocacy strategies from the start.
Stakeholders will need to understand that the value story of a therapy must account for the diagnostic pathway, and that clinical performance is only one part of adoption. Diagnostic access is increasingly synonymous with patient access.
To deliver on the promise of precision oncology, companies bringing new therapies to market must ensure that patients can move seamlessly from screening and diagnosis, to appropriate testing and treatment. That means diagnostic readiness is a prerequisite for both patient access and launch success.