The 2026 ASCO Annual Meeting (May 29–June 2, Chicago) features more than 7,000 abstracts and several late-breaking presentations with direct implications for formulary committees, prior authorization criteria, and specialty drug spend. This preview identifies the seven presentations most likely to shift payer and access strategy — six late-breaking trials plus the landmark CROWN 7-year update — summarizes what is known before the meeting, and flags what access teams should monitor as data are released.
The seven presentations with the highest access impact
| Abstract | Drug | Mechanism | Trial | Indication | Company |
|---|---|---|---|---|---|
| LBA7506 | Mezigdomide | CELMoD (cereblon E3 ligase modulator) | SUCCESSOR-2 | Relapsed/refractory multiple myeloma | Bristol Myers Squibb |
| LBA5007 | Talzenna (talazoparib) | PARP inhibitor | TALAPRO-3 | Metastatic castration-sensitive prostate cancer (mCSPC) with HRR mutations | Pfizer |
| LBA4000 | Imfinzi + Imjudo (durvalumab + tremelimumab) | PD-L1 + CTLA-4 | EMERALD-3 | Hepatocellular carcinoma | AstraZeneca |
| LBA9503 | Darovasertib | PKC inhibitor | Optimum-02 | Uveal melanoma | IDEAYA Biosciences |
| LBA8500 | Zegfrovy (sunvozertinib) | EGFR exon20ins inhibitor | Wu-Kong28 | NSCLC | Dizal Pharma |
| LBA7000 | Monjuvi (tafasitamab-cxix) | Anti-CD19 monoclonal antibody | Frontmind | Frontline DLBCL | Incyte |
| 8502 | Lorbrena (lorlatinib) | Third-gen ALK TKI | CROWN (7-year update) | ALK+ NSCLC | Pfizer |
Sources: ASCO 2026 Annual Meeting program; pharmaphorum late-breaker preview; ApexOnco ASCO 2026 preview.
SUCCESSOR-2: Mezigdomide in relapsed/refractory multiple myeloma
Why it matters for access teams. BMS's mezigdomide is a next-generation oral cereblon E3 ligase modulator (CELMoD) designed to be more potent than lenalidomide (Revlimid) and pomalidomide (Pomalyst). IQVIA highlighted mezigdomide as a potential $1.5 billion blockbuster in its 2026 drugs-to-watch report. With Revlimid now facing generic competition, mezigdomide could become the new backbone of immunomodulatory-based myeloma regimens — and a new specialty spend category.
SUCCESSOR-2 (LBA7506) is the first phase 3 randomized trial of mezigdomide, tested in combination with carfilzomib (Kyprolis) and dexamethasone (MeziKd) versus carfilzomib and dexamethasone alone in relapsed or refractory multiple myeloma. BMS topline results in March 2026 confirmed a statistically significant improvement in progression-free survival. Full PFS, overall response rate, and safety data will be presented by Paul Richardson, MD (Dana-Farber) on May 29.
What to watch. If the PFS benefit is clinically meaningful and the safety profile is manageable, expect rapid NCCN guideline inclusion and payer coverage under step-therapy or prior authorization protocols. Access teams should prepare for:
- Oral CELMoD cost tiering versus generic lenalidomide
- Combination therapy prior authorization criteria (mezigdomide + carfilzomib + dex)
- Potential for REMS or distribution restrictions given the CELMoD class
TALAPRO-3: Talzenna expanding into earlier-line prostate cancer
Why it matters for access teams. TALAPRO-3 is the first phase 3 trial of a PARP inhibitor in metastatic castration-sensitive prostate cancer (mCSPC), testing Talzenna (talazoparib) plus Xtandi (enzalutamide) in patients with homologous recombination repair (HRR) gene mutations. Topline results reported in March 2026 showed an improvement in radiographic progression-free survival (rPFS) with a strong overall survival trend. If confirmed, this would move Talzenna into a larger, earlier-line market — ahead of AstraZeneca/Merck's Lynparza (olaparib), the current PARP market leader.
What to watch. Key questions for access teams:
- Will rPFS translate into an overall survival benefit?
- What HRR mutation testing will payers require? Companion diagnostic access (BRCA1/2, ATM, and broader HRR panel) will be a bottleneck.
- How will payers tier talazoparib + enzalutamide versus enzalutamide alone in mCSPC?
- Step therapy implications: will payers require prior androgen deprivation therapy failure before covering the combination?
Abstract LBA5007 will be presented as a late-breaking session. Pfizer's late-May press release confirmed that results were consistent across subgroups.
EMERALD-3: Imfinzi/Imjudo in hepatocellular carcinoma
Why it matters for access teams. AstraZeneca's EMERALD-3 tested the Imfinzi (durvalumab) + Imjudo (tremelimumab) combination plus TACE and Lenvima (lenvatinib) in hepatocellular carcinoma. Topline results in April 2026 showed a PFS benefit — but only for the four-drug regimen (Imfinzi + Imjudo + TACE + Lenvima), not for the triplet that excluded Lenvima. This partial success creates a complex formulary decision.
What to watch. Key questions:
- Will payers cover a four-drug combination in HCC? The combined cost of checkpoint inhibitors plus a multikinase inhibitor plus TACE procedures will be significant.
- Prior authorization criteria will need to specify the exact four-drug regimen, not just "Imfinzi + Imjudo."
- Does the PFS benefit justify the incremental cost over existing standard of care (atezolizumab + bevacizumab)?
Abstract LBA4000 will present full cohort-level data.
Optimum-02: Darovasertib in uveal melanoma
Why it matters for access teams. IDEAYA's darovasertib, a protein kinase C (PKC) inhibitor, is being tested in combination with Xalkori (crizotinib) versus pembrolizumab or nivolumab + ipilimumab in uveal melanoma — a rare cancer with very limited treatment options. IDEAYA has already disclosed remarkable response rate and PFS data from Optimum-02 on April 13, 2026, with the darovasertib/Xalkori combo showing superiority over checkpoint inhibitors.
If approved, darovasertib would be the first targeted therapy specifically for uveal melanoma. This creates a rare disease access pathway with specialty pharmacy distribution, limited patient population, and likely orphan drug pricing.
What to watch. Key questions:
- Will the full ASCO data confirm the early disclosure?
- How will payers manage a rare disease targeted therapy likely priced above $100,000/year?
- Companion testing for GNAQ/GNA11 mutations will be required for prior authorization.
Abstract LBA9503 will present full data.
CROWN 7-year update: Lorlatinib in ALK+ NSCLC
Why it matters for access teams. Pfizer's CROWN trial has already established lorlatinib (Lorbrena) as a first-line standard in ALK-positive NSCLC. The 7-year update (Abstract 8502) will provide the longest PFS follow-up ever reported in advanced NSCLC. After 5 years, median PFS had not yet been reached — an unprecedented result.
For payers, the question is not whether to cover lorlatinib, but how to manage the cost of multi-year therapy. Payers should anticipate:
- Duration of therapy cost projections based on 7-year PFS data
- Reauthorization criteria tied to ongoing response assessment
- Intracranial efficacy data supporting first-line use versus alectinib
Frontmind: Monjuvi in frontline DLBCL
Incyte's Frontmind study (LBA7000) tested Monjuvi (tafasitamab-cxix) in frontline diffuse large B-cell lymphoma (DLBCL). Topline results in January 2026 were positive. If the full data support frontline use, Monjuvi could move from its current relapsed/refractory niche into a much broader market, with corresponding payer implications for combination therapy prior authorization.
What access teams should do before ASCO ends
- Monitor late-breaking abstract releases. LBAs are embargoed until their presentation day. Key sessions are May 29 (mezigdomide, EMERALD-3), May 30 (TALAPRO-3, darovasertib), and May 31.
- Prepare formulary impact assessments. For mezigdomide and Talzenna, model the budget impact of new indications in existing therapeutic areas.
- Update PA criteria drafts. Mezigdomide (if approved) will require new PA criteria for the CELMoD class. TALAPRO-3 will expand existing PARP PA criteria to mCSPC.
- Track NCCN updates. Previous patterns suggest NCCN will issue guideline updates within 1–2 weeks of practice-changing ASCO presentations.
- Watch for companion diagnostic updates. TALAPRO-3 (HRR testing) and darovasertib (GNAQ/GNA11 testing) will create new biomarker testing requirements.
Sources
- ASCO 2026 Annual Meeting program and abstract search: https://www.asco.org/annual-meeting
- ASCO late-breaking data submission guidelines: https://www.asco.org/annual-meeting/abstracts-presentations/submission-details/late-breaking-data-submission-guidelines
- pharmaphorum: "Late-breakers to look out for at ASCO 2026": https://pharmaphorum.com/news/late-breakers-look-out-asco-2026
- ApexOnco: "ASCO 2026 preview — recent wins come under the spotlight": https://www.oncologypipeline.com/apexonco/asco-2026-preview-recent-wins-come-under-spotlight
- Dana-Farber Cancer Institute press release, May 2026: https://www.dana-farber.org/newsroom/news-releases/2026/dana-farber-researchers-to-present-two-plenary-studies-and-additional-late-breaking-cancer-research-at-2026-asco-0
- BMS press release on ASCO 2026 presentations: https://news.bms.com/news/corporate-financial/2026/Bristol-Myers-Squibb-to-Unveil-New-Data-at-ASCO-2026-Demonstrating-Strength-and-Breadth-of-Scientific-Innovation-Across-Oncology-Portfolio-and-Next-Generation-Pipeline/default.aspx
- Pfizer press release on ASCO 2026 presentations: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-showcases-oncology-innovation-and-next-generation
- ASCO Post: "Lorlatinib vs Crizotinib for Advanced ALK-Positive NSCLC: Extended CROWN Follow-up": https://ascopost.com/news/may-2024/lorlatinib-vs-crizotinib-for-advanced-alk-positive-nsclc-extended-crown-follow-up
- ClinicalTrials.gov MYR301 (NCT03852719): https://clinicaltrials.gov/study/NCT03852719
