With 44,000+ oncology professionals in attendance, ASCO 2026 may have been the most consequential in recent years. From a standing ovation for pancreatic cancer to the first positive sarcoma trial in history, here's everything that mattered at Chicago's McCormick Place this week.

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Oncology has never been in a better scientific position. Precision medicines, adaptive study designs, and biomarker-driven cohorts have opened up treatment possibilities that simply did not exist ten years ago. But the complexity of running these trials has grown at much the same pace as the science itself, and that gap between scientific ambition and operational capability is where many programmes quietly struggle.

For sponsors building oncology portfolios, and for the CROs executing them, the operational challenge is no longer a peripheral concern. Getting it right comes down to three things: being consistent enough to build efficiently, agile enough to adapt when the science changes, and scalable enough to manage a growing portfolio without the overhead growing at the same rate.

Medable has worked with sponsors and CROs across many global oncology programmes, spanning thousands of sites and participants. That experience has given us a clear picture of what separates programmes that move well from those that get stuck.

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