Svetlana Nikic, Founder of Precision Oncology Consulting, shared a post on LinkedIn:
“Before starting a day 3, here are some Day 2 ESMO25 highlights:
1. Tumour-agnostic precision medicine is scientifically real — but systemically fragile.
Strong efficacy data across MSI-H, TMB-H, NTRK, RET, HER2-positive ADCs, etc., but real-world adoption is limited by assay access, biomarker prevalence and reimbursement inconsistency.
2. Next wave of agnostic targets is expanding fast.
KRAS (G12C / G12D), FGFR2, NRG1 fusions, MTAP loss, PSMA, TROP-2, PARP+IO combinations are all gaining traction — but sit at different readiness levels depending on biology, assay reliability, clinical evidence, access and real-world usability.
3. Dose optimisation and PK/PD variability — especially sex-based differences — must be addressed before broader access. Fixed-dose approvals are increasingly being challenged by exposure-toxicity divergence between males and females.
4. Breast cancer — T-DXd continues to outperform T-DM1 in both adjuvant and neoadjuvant settings, cutting recurrence by ~50% and showing consistency across clinical risk groups. Shorter-duration, response-guided or ctDNA-informed escalation/de-escalation were mentioned.
5. Clinical teams are actively debating new sequencing strategies:
• Preoperative T-DXd for pCR boost & shorter exposure
• Postoperative for escalation in residual disease
• MRD/ctDNA as real-time trigger for switching
6. Policy and infrastructure are catching up — via the EU Cancer Mission / ECHoS hubs.
Stakeholder engagement tools, policy handbooks, national mission coordination, and a growing coalition of EU-funded synergies are laying the governance backbone precision oncology has been missing.
7. Regarding testing :
- Be tech agnostic (RNA, DNA, IHC — use what works)
- Know your assay (sensitivity matters for access eligibility)
- Engage all stakeholders early (oncologists, labs, payers, policy)
Two favorite quotes from yesterday :
“Therapies should be age, tissue, gender and zip code agnostic “ by Vivek Subbiah, MD
And
“Evidence fails without access; access fails without scaffolding” by Niamh Coleman.
These summaries are far from complete and I’ll aim to provide a more comprehensive summary once the congress has finalized.
Day 3 – here we go!”
You Can Also Read:
ESMO 2025 Day 1 Highlights Not to Miss
ESMO 2025 Day 2 Highlights Not to Miss
