Top 10 Lung Cancer Trials to Watch at ASCO 2026

ASCO 2026 should bring a dense run of lung cancer updates, and a handful of studies stand out because they could shape frontline treatment decisions, refine biomarker-specific standards, or push targeted therapy further into earlier-stage disease. Some of these are classic stock-moving readouts tied to a single asset. Others matter more because they can shift the field's treatment logic even if the immediate market reaction is smaller.

For anyone following the meeting in real time, it helps to turn the conference program into a watchlist before the abstracts and presentations start landing all at once. That usually means tracking both the lead asset and the public company behind it, then adding the most relevant tickers or keywords to your [BioPharmSignal livefeed](/livefeed) so you can catch follow-up headlines, conference coverage, and company commentary in one place.

Why this group stands out

What makes this set especially worth watching is that it includes three different kinds of catalyst:

- Trials that could shift first-line standard of care in molecularly defined NSCLC

- Trials that test whether immunotherapy combinations can rescue hard-to-treat biomarker subsets

- Adjuvant studies that could broaden targeted therapy or immunotherapy into earlier-stage disease

That is why investors, clinicians, and biotech teams will probably read these results differently. Some studies matter because they can move a specific stock. Others matter because they can reset how the field thinks about a target, a biomarker group, or a line of therapy.

1. Sunvozertinib in first-line EGFR exon 20 insertion NSCLC

The WU-KONG28 study stands out because EGFR exon 20 insertion NSCLC has historically been one of the harder EGFR subsets to treat effectively in the first-line setting. Standard platinum chemotherapy has remained the practical default for many patients, not because it is ideal, but because targeted options have not consistently displaced it early enough in the treatment sequence.

If sunvozertinib can outperform platinum chemotherapy here, that would not just be a positive data point for one drug. It would suggest that exon 20 insertion disease is finally becoming a real front-line targeted-therapy category instead of a niche salvage setting. That matters because first-line positioning usually changes both treatment sequencing and the commercial value of the asset.

**Related company / asset**

- Sunvozertinib is associated with Dizal.

2. Ivonescimab in first-line advanced squamous NSCLC

HARMONi-6 asks a very direct question: can a PD-1/VEGF bispecific plus chemotherapy do better than a PD-1 plus chemotherapy backbone in first-line advanced squamous NSCLC. That makes the study more important than a typical incremental immunotherapy update, because it is challenging a treatment pattern that already feels familiar to the field.

Ivonescimab has drawn attention because it carries a mechanism that could look more differentiated than a plain checkpoint inhibitor. If this trial reads well, the implication is bigger than one line item in a pipeline. It would strengthen the broader idea that dual-function immunotherapy combinations may have room to take share in frontline lung cancer, especially where chemo-IO standards are established but not unbeatable.

**Related companies / assets**

- Ivonescimab is tied to [Summit Therapeutics](/company/SMMT) through its collaboration with Akeso.

- The comparator arm includes tislelizumab, which is associated with BeiGene.

3. Erlotinib plus ramucirumab versus osimertinib in EGFR L858R disease

This is one of the more nuanced studies on the list because it is not really about whether osimertinib is a strong drug. The question is whether the usual assumption of osimertinib superiority holds in the specific EGFR L858R subgroup, which has often looked less clean than del19 in cross-trial discussions and clinical practice.

That makes the readout important even if it does not completely overturn current treatment habits. A strong showing from erlotinib plus ramucirumab would reopen a real clinical conversation about subtype-specific sequencing inside EGFR-mutant NSCLC. It would also matter for investors because it could remind the market that not every EGFR mutation behaves the same way under a third-generation TKI standard.

**Related companies / assets**

- Ramucirumab belongs to [Eli Lilly](/company/LLY).

- Osimertinib belongs to [AstraZeneca](/company/AZN).

- Erlotinib is a legacy EGFR agent and is not the main listed-company driver in this setup.

4. Adjuvant nivolumab after surgery and chemotherapy in resected NSCLC

The ALCHEMIST study gets attention for a different reason. This is not about introducing a novel target into metastatic disease. It is about defining whether adjuvant immunotherapy still adds enough value in resected NSCLC without an obvious actionable driver after surgery and chemotherapy have already been used.

That matters because adjuvant lung cancer treatment is becoming more crowded. Once targeted therapy claims one molecular subgroup and immunotherapy claims another, the remaining “broad” resected population becomes a harder space to interpret. If nivolumab shows durable value here, it helps preserve a meaningful role for adjuvant checkpoint inhibition outside the mutation-defined lanes.

**Related company / asset**

- Nivolumab belongs to [Bristol Myers Squibb](/company/BMY).

5. Adjuvant selpercatinib in stage IB to IIIA RET fusion-positive NSCLC

LIBRETTO-432 is one of the cleaner precision-oncology studies on this list because the clinical question is easy to understand. If selpercatinib works in the adjuvant setting, RET fusion-positive lung cancer may follow the same broader pattern already seen in other driver-positive subtypes: identify the molecular subset early, operate when appropriate, and then use targeted therapy to reduce recurrence risk.

The reason this matters commercially is that adjuvant success often broadens the life of an asset in a meaningful way. The reason it matters scientifically is that it helps confirm RET as not just a metastatic target, but a true disease-defining axis across stages.

**Related company / asset**

- Selpercatinib belongs to [Eli Lilly](/company/LLY).

6. Lorlatinib versus crizotinib in first-line ALK-positive NSCLC

The CROWN update is not a “new mechanism” story. It is a durability story. Long follow-up in ALK-positive disease matters because the best ALK studies eventually stop being about response rate and become about how long central nervous system control and systemic disease control can actually hold.

That is why seven-year-style durability discussions around lorlatinib can still move sentiment. Once a drug has already earned first-line credibility, the next layer of differentiation comes from how durable that advantage looks over time. For clinicians, that helps with sequencing confidence. For investors, it reinforces how sticky a leading targeted asset can become once long-run data stay clean.

**Related company / asset**

- Lorlatinib and crizotinib both belong to [Pfizer](/company/PFE).

7. Thoracic radiotherapy plus chemo and durvalumab in extensive-stage SCLC

Small cell lung cancer remains one of the hardest places in thoracic oncology to create durable differentiation. That is what makes this study important. Extensive-stage SCLC has seen some progress from immunotherapy, but long-term outcome improvement is still limited enough that even well-known backbones leave room for a better strategy.

Adding concurrent thoracic radiotherapy to chemo and durvalumab is interesting because it tests whether local control and systemic immunotherapy can reinforce each other in a population where relapse is common and durable benefit is still difficult to achieve. If the study is positive, it would not just be a regimen tweak. It would meaningfully alter how aggressive frontline management should be in extensive-stage disease.

**Related company / asset**

- Durvalumab belongs to [AstraZeneca](/company/AZN).

8. TRITON in first-line STK11/KEAP1/KRAS-altered NSCLC

This is one of the most conceptually important studies on the list because STK11 and KEAP1 have become shorthand for a group of NSCLC tumors that often look relatively resistant to standard immunotherapy strategies. That makes TRITON more than a combination trial. It is a test of whether intensified immune blockade can improve outcomes in a biologically harder subgroup.

The comparison also matters because it is not against a weak control. Pembrolizumab plus chemotherapy is a real frontline standard. If tremelimumab plus durvalumab plus chemotherapy can outperform it in this biomarker-defined population, the result would support a more segmented way of thinking about first-line NSCLC instead of treating broad KRAS-associated disease as one bucket.

**Related companies / assets**

- Tremelimumab and durvalumab belong to [AstraZeneca](/company/AZN).

- Pembrolizumab belongs to [Merck](/company/MRK).

9. OptiTROP-Lung05 in PD-L1 high first-line NSCLC

OptiTROP-Lung05 is important because it challenges one of the cleanest single-agent immunotherapy lanes in lung cancer: PD-L1 high NSCLC treated with pembrolizumab alone. Once a standard is that established, a challenger has to offer more than “activity.” It has to show a reason why adding another mechanism changes the clinical tradeoff in a meaningful way.

Sac-TMT plus pembrolizumab is interesting because TROP2 ADC combinations have become one of the more closely watched themes in solid tumors. If this regimen can outperform pembrolizumab monotherapy without creating an unworkable toxicity burden, it would support a broader thesis that ADC-IO combinations still have room to move earlier in treatment.

**Related companies / assets**

- Sac-TMT, also known as sacituzumab tirumotecan, is linked to [Merck](/company/MRK) through the MK-2870 program.

- Pembrolizumab also belongs to [Merck](/company/MRK).

10. Krascendo-170 in first-line KRAS G12C-positive NSCLC

KRAS G12C has already proven that it is druggable, but the next debate is about how these agents perform earlier in the treatment course and in combination with immunotherapy. Krascendo-170 sits right in that debate. Divarasib plus pembrolizumab is not just trying to show activity. It is trying to justify a frontline strategy built on both oncogenic pathway inhibition and immune activation.

That is what makes the study worth watching. If it reads well, it pushes the field toward a more ambitious first-line KRAS G12C model. If it struggles, that would reinforce the idea that targeted KRAS combinations still have more work to do before displacing established chemo-IO patterns.

**Related companies / assets**

- Divarasib is a Roche/Genentech asset.

- Pembrolizumab belongs to [Merck](/company/MRK).

A quick company map for the watchlist

If you want to move from the trial list into company-level follow-up, these are the public names most directly tied to the image:

- [Summit Therapeutics](/company/SMMT): ivonescimab

- [Eli Lilly](/company/LLY): ramucirumab, selpercatinib

- [AstraZeneca](/company/AZN): osimertinib, durvalumab, tremelimumab

- [Bristol Myers Squibb](/company/BMY): nivolumab

- [Pfizer](/company/PFE): lorlatinib, crizotinib

- [Merck](/company/MRK): pembrolizumab, sacituzumab tirumotecan / MK-2870

Final takeaway

The reason this ASCO 2026 list is worth reading closely is that it mixes several different kinds of decision-making moments in lung cancer. Some studies are about defending an existing leader. Some are about opening a new frontline targeted niche. Some are about testing whether immunotherapy combinations can still expand into harder biomarker subsets.

That is also why the company mapping matters. A trial may look like a scientific story on a slide, but once you connect it back to the asset owner, it becomes a much more practical catalyst map for investors and sector watchers. If you are building a follow list for ASCO 2026, these 10 trials give you a pretty good starting point.