What physicians’ priorities mean for patients, treatment pathways and oncology research
Ahead of ESMO Congress 2026, All Global asked a selection of oncologists on their panel what they will be looking for at the event, where current standards may be challenged and what would make new evidence usable in day-to-day practice. Their answers help research teams to distinguish between a clinically interesting result and one that may genuinely change care. Across the responses, three key considerations become clear: which patients could benefit, where would a treatment fit in the current pathway, and what evidence or infrastructure would clinicians need before adopting something new.
For those in MRAs and consultancies advising pharmaceutical clients, these answers offer a useful perspective for future research design. The strongest studies will explore not just awareness or enthusiasm, but patient selection, sequencing, implementation and the evidence threshold for change.
What are oncologists looking for at ESMO Congress 2026?
More precise treatments moving earlier
Physicians repeatedly mentioned antibody-drug conjugates (ADCs), bispecific antibodies, targeted therapies and new immunotherapy combinations – here, their interest extends beyond the arrival of new products. They want to know whether treatments that are currently used mainly after a cancer has spread or when other options have failed could benefit patients sooner – for example, as the first treatment offered or around the time of surgery. They are also watching whether these options could replace established chemotherapy regimens rather than simply add another treatment.
Dr. Antonia Marquez Aragones, Oncologist from Spain expects “the most dramatic shift in the patient pathway” to be the movement of perioperative immunotherapies, targeted agents and ADCs into frontline metastatic settings. But, using active agents earlier in the journey creates new questions about what comes next when patients relapse.
This makes treatment sequencing central. Research around an emerging therapy should examine the full pathway: where clinicians would place it, which patients they would prioritise, what current treatment it would replace and which options would remain if the cancer later returned or progressed.
Biomarkers that lead to action
Blood-based testing was another clear priority. Liquid biopsy and circulating tumour DNA (ctDNA) can look for genetic material released by a tumour, potentially helping clinicians detect small amounts of disease left after treatment or identify resistance before it appears on a scan. Alongside broader molecular profiling, these tools could support better selection for targeted treatment and help clinicians decide whether to increase, reduce or change therapy. However, more information only improves care if it leads to a useful treatment decision.
Dr. Perminder (Tony) Dhillon, Consultant Oncologist from the UK highlights the practical test. “The critical step will be demonstrating clinical utility: that these tools change management, improve survival or quality of life, and justify their cost without delaying treatment or increasing inequalities in access,” he says.
That distinction matters for insight programmes. It is not enough to ask whether clinicians value a biomarker. Instead, research needs to establish when clinicians would act on the result, how confident they are in the test, what workflow is required and which access barriers may prevent its use.
Evidence that can survive real-world practice
Across the responses, enthusiasm for innovation is balanced by a clear threshold for changing practice. Clinicians want mature evidence that patients live longer, meaningful improvements in quality of life, reliable patient-selection criteria and side effects that can be managed safely. They also need clinical guidelines, regulatory approval, reimbursement, companion diagnostics and operational pathways that work with available resources.
Another Consultant Oncologist from Spain illustrates how demanding that threshold can be. Before changing practice in extensive-stage small-cell lung cancer, she wants to see evidence that a new first-line maintenance approach helps patients live meaningfully longer. In her words, this requires “A clinically meaningful OS HR and absolute gain, not just statistical significance”. She would also need full safety data, evidence that treatment could be delivered in an outpatient setting, findings for relevant patient subgroups, and approval and reimbursement in Spain.
The patient impact therefore extends beyond treatment efficacy. Earlier or more precise treatment could improve outcomes and spare some patients unnecessary toxicity. At the same time, complex toxicities, monitoring requirements and uneven access to testing could create new burdens. These trade-offs should be built into research questions from the outset.
Why does ESMO matter beyond the conference itself?
ESMO Congress 2026 gives the oncology community a dedicated opportunity to compare evidence across cancer types and consider whether promising results are ready to influence care.
Its value goes beyond the headline result. Longer-term outcomes show whether benefits last; subgroup findings indicate whether results apply to different kinds of patients; safety and quality-of-life data reveal the wider effect of treatment; and biomarker evidence helps determine who may benefit. Together, these findings show whether an approach can work in practice across different health systems.
Dr. Sunil Upadhyay, Consultant Oncologist from the UK captures this wider challenge: “Quality of life will become of increasing importance. Sequencing of different regimens, use of liquid biopsy and molecular profiling for targeted therapies leading to increasing cost will have significant impact on our clinical practice considering limited resources. We all have to take a multidisciplinary management approach.”
For pharmaceutical teams, the congress can highlight where the evidence story is strong and where uncertainty remains. For their research partners, it helps define the questions that should follow in the days after the conference. What do clinicians believe? What would alter behaviour? Which practical barriers matter most? How do expectations differ, by tumour type, specialty or market? This moves post-congress research beyond awareness and towards the decisions that determine real-world adoption.
What does this mean for oncology research?
When research post-ESMO is being shaped, four areas deserve particular attention:
- Define the decision. Is the study testing likely uptake, identifying the right patient, mapping a new sequence or understanding what evidence would change practice
- Build the pathway into the design. Explore what a new option replaces, how it changes earlier and later treatment, and which specialists influence the decision.
- Test implementation, not interest alone. Include diagnostics, safety management, service capacity, reimbursement, guideline adoption and equitable access.
- Separate promise from proof. Ask which endpoints, effect sizes, follow-up and patient subgroups clinicians need before they will act.
These considerations call for research approaches that can capture both the scale of opinion and the reasoning behind it. The right design will depend on the business decision the evidence must support, the audience that needs to be reached and the differences that matter across markets.
From congress data to confident decisions
The full responses suggest that ESMO Congress 2026 will be defined less by the volume of new evidence produced, than by its ability to clarify who should receive treatment, when it should be used and whether it can be delivered safely and fairly. For patients, that could mean more personalised pathways, earlier access to effective treatment and less unnecessary toxicity—but only where the evidence and infrastructure support the change.
For MRAs and consultancies, the opportunity is there to help pharmaceutical clients understand the gap between a compelling congress result and a workable treatment decision.
Planning oncology research around emerging ESMO evidence? Speak to All Global early to shape a research approach that tests the clinical decision, patient pathway and implementation questions your client needs to answer.
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This article is part of All Global Healthcare Perspectives, where we share insights and updates on research quality, trust, and integrity in healthcare market research.
