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Background <p>Contemporary surgical oncology is evolving from a surgery-centred discipline to a biology-driven, multidisciplinary speciality. Advances in genomics, immunotherapy, targeted therapy, biomarkers and perioperative systemic treatment are increasingly influencing surgical decision-making across multiple tumour sites.</p> Methods <p>This narrative review summarises selected presentations from the 2026 Annual Meeting of the American Society of Clinical Oncology (ASCO) with direct relevance to surgical oncologists. Key studies across breast, lung, upper gastrointestinal, colorectal, pancreatic, urinary bladder, prostate, renal and head and neck cancers were reviewed, with emphasis on their implications for contemporary surgical practice and the relevance of Indian data.</p> Results <p>ASCO 2026 highlighted the growing importance of tumour biology, molecular profiling, predictive biomarkers, treatment response and residual disease assessment in surgical decision-making. In breast cancer, mature SENOMAC data supported selective omission of completion axillary lymph node dissection, while OPTIMA reinforced genomic risk assessment for adjuvant chemotherapy selection. In lung cancer, LIBRETTO-432 demonstrated the expanding role of molecular testing in curative-intent pathways. In gastric and gastroesophageal junction cancers, perioperative chemoimmunotherapy emerged as a promising strategy for selected PD-L1-positive patients, while TORCH-C suggested a potential future role for neoadjuvant immunotherapy-based treatment in high-risk MSS/pMMR colon cancer. Updates in pancreatic, bladder, prostate and renal cancers highlighted increasing integration of surgery with targeted therapies, antibody-drug conjugates, immunotherapy and perioperative systemic intensification. Indian and India-relevant head and neck cancer studies, including AREST, TMC-I and MACE-postop, demonstrated that meaningful improvements in outcomes can be achieved through scientifically sound and affordable strategies such as selective adjuvant radiotherapy, low-dose immunotherapy and metronomic therapy.</p> Conclusions <p>ASCO 2026 reinforces that modern surgical oncology is increasingly guided by tumour biology, biomarkers and multidisciplinary treatment planning. In most curative-intent solid tumours, surgery remains a key component of treatment, but optimal outcomes depend on appropriate patient selection, timing and integration with systemic therapies. Contemporary surgical oncologists must combine technical expertise with a strong understanding of genomics, immunology, biomarkers, health economics and real-world applicability.</p>

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ASCO 2026 Highlights for Surgical Oncologists: From Scalpel to Biology-Driven Strategy

  • 期刊论文

  • 发表日期：

    2026年6月20日

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  • Pankaj Kumar Garg,
  • Pallvi Kaul,
  • Kanika Kapur,
  • Rahul Kumar,
  • Dharma Ram Poonia,
  • Ashish Jakhetiya,
  • S. P. Somashekhar

摘要

Background

Contemporary surgical oncology is evolving from a surgery-centred discipline to a biology-driven, multidisciplinary speciality. Advances in genomics, immunotherapy, targeted therapy, biomarkers and perioperative systemic treatment are increasingly influencing surgical decision-making across multiple tumour sites.

Methods

This narrative review summarises selected presentations from the 2026 Annual Meeting of the American Society of Clinical Oncology (ASCO) with direct relevance to surgical oncologists. Key studies across breast, lung, upper gastrointestinal, colorectal, pancreatic, urinary bladder, prostate, renal and head and neck cancers were reviewed, with emphasis on their implications for contemporary surgical practice and the relevance of Indian data.

Results

ASCO 2026 highlighted the growing importance of tumour biology, molecular profiling, predictive biomarkers, treatment response and residual disease assessment in surgical decision-making. In breast cancer, mature SENOMAC data supported selective omission of completion axillary lymph node dissection, while OPTIMA reinforced genomic risk assessment for adjuvant chemotherapy selection. In lung cancer, LIBRETTO-432 demonstrated the expanding role of molecular testing in curative-intent pathways. In gastric and gastroesophageal junction cancers, perioperative chemoimmunotherapy emerged as a promising strategy for selected PD-L1-positive patients, while TORCH-C suggested a potential future role for neoadjuvant immunotherapy-based treatment in high-risk MSS/pMMR colon cancer. Updates in pancreatic, bladder, prostate and renal cancers highlighted increasing integration of surgery with targeted therapies, antibody-drug conjugates, immunotherapy and perioperative systemic intensification. Indian and India-relevant head and neck cancer studies, including AREST, TMC-I and MACE-postop, demonstrated that meaningful improvements in outcomes can be achieved through scientifically sound and affordable strategies such as selective adjuvant radiotherapy, low-dose immunotherapy and metronomic therapy.

Conclusions

ASCO 2026 reinforces that modern surgical oncology is increasingly guided by tumour biology, biomarkers and multidisciplinary treatment planning. In most curative-intent solid tumours, surgery remains a key component of treatment, but optimal outcomes depend on appropriate patient selection, timing and integration with systemic therapies. Contemporary surgical oncologists must combine technical expertise with a strong understanding of genomics, immunology, biomarkers, health economics and real-world applicability.