Molecular Profiling Insights from ASCO 2025: Advancing Personalized Cancer Care

Each June, the latest cancer research is presented at the largest oncology conference in the world, the American Society of Clinical Oncology (ASCO) annual meeting. This conference brings together doctors, researchers, industry leaders, and patient advocates to share groundbreaking results that shape the future of cancer care. A team of clinicians and researchers from Private Health Management (PHM) attend each year to ensure that our Personal Care Teams can quickly translate the latest developments in cancer research into personalized, high-quality care for our clients.

Molecular profiling is the analysis of cancer cells to pinpoint their biological differences from normal cells. These differences provide clues about how cancer cells thrive. Understanding the molecular drivers of an individual’s disease can help develop personalized, precision oncology-based treatment strategies. As an early adopter of molecular profiling, PHM has been guiding our clients to the best possible cancer care for almost two decades. We develop a personalized Molecular Profiling Strategy for each client, and in conjunction with expert interpretation of the results, we use it to help optimize a treatment plan. Here are some of the latest developments in molecular profiling.

Using molecular profiling to guide treatment selection

One important application of molecular profiling is guiding therapy selection. Molecular analyses can both help identify which patients are likely to benefit from a specific drug or regimen and inform how risky or aggressive a cancer may be. At PHM, we integrate these personalized results into the decision-making process, to maximize treatment efficacy while minimizing unnecessary side effects.

• Metastatic prostate cancer: Researchers performed a profiling test on DNA from blood samples of patients with metastatic prostate cancer to understand which patients might respond to a treatment called 177Lu-PSMA-617, which is a targeted radiotherapy. They looked for DNA regulatory regions and found that patients with higher amounts of circulating DNA regulating a gene called FOLH1, which encodes PSMA, responded better. While not yet ready for routine clinical use, these results reflect the growing interest in using non-invasive tests to guide treatment selection.¹
• Non-metastatic prostate cancer: Researchers used a Multimodal Artificial Intelligence (MMAI) algorithm to predict which high-risk, non-metastatic prostate cancer patients might benefit from adding an additional hormone-targeting therapy to standard androgen deprivation therapy. Patients who were biomarker-positive showed significantly improved prostate cancer-specific survival with use of the drug, while biomarker-negative patients did not. This novel tool could guide more precise use of intensified therapy and spare patients who might be less likely to benefit from experiencing unnecessary side effects.²
• Breast cancer: In patients with stage II/III HER2-positive breast cancer, a genomic test called HER2Dx was able to predict which patients were likely to have a complete response to treatment with chemotherapy plus a combination of two HER2-targeted therapies, Herceptin® and Perjeta®, independently of tumor stage. With this additional information on risk profile, PHM Care Teams can more robustly help clients with HER2-positive early breast cancer decide on the most appropriate intensity of therapy prior to or after surgery.³

Using molecular monitoring to predict cancer recurrence or progression

Molecular testing is also a powerful surveillance to tool to help detect cancer progression or recurrence earlier than conventional monitoring. By tracking circulating tumor DNA and other biomarkers over time, clinicians can identify treatment resistance or signs of disease progression and intervene proactively. This real-time molecular monitoring can inform evolving personalized treatment strategies to help improve patient outcomes.

• Breast cancer: Some patients with hormone receptor-positive, HER2-negative, metastatic breast cancer eventually develop disease that is resistant to standard first-line hormone therapy, which is often due to a mutation in the estrogen receptor gene (ESR1). To find these early, researchers analyzed circulating DNA from a blood sample every 2-3 months. In a set of patients, they found ESR1 mutations before scans showed cancer progression. Of these patients, those who were switched to a treatment that is effective for ESR1-mutant cells (camizestrant) experienced longer survival without disease progression and improved quality of life. This strategy of using molecular monitoring to guide early intervention represents a potential shift in how breast cancer is treated.⁴
• Sarcoma: In patients with localized, high-risk soft tissue sarcoma, the benefits of adding chemotherapy after surgery remain unclear, and there is currently no tool to predict which patients are likely to have a relapse. Researchers developed a test using whole-genome sequencing from a blood sample to look for structural variants in circulating tumor DNA, allowing them to detect very small numbers of cancer cells in the blood stream. The test was used at time points prior to and after surgery, and they found the presence of tumor DNA in the blood could predict the chance of a recurrence. This information can be used to help determine which patients might benefit from additional chemotherapy.⁵
• Prostate cancer: Looking at genetic changes from more than one source is a reliable way to get a fuller, more accurate picture of a person’s cancer. With a test called HERCULES, researchers analyzed genetic changes from both cell-free DNA and circulating tumor cell DNA in blood from patients with metastatic prostate cancer. The test detected a range of mutations, and researchers found that as the cancer became more resistant to hormone therapy, the number of genetic alterations doubled. This study supports the use of dual-platform testing to monitor how prostate cancer evolves over time, which helps guide precision oncology-based treatment strategies.⁶

These studies represent a small snapshot of the immense and growing field of molecular profiling in oncology and its applications. At PHM, we continue to integrate these innovations into our Molecular Profiling Strategy to help each client receive the most effective, tailored care at every stage of their cancer journey.

PHM’s ASCO 2025 Attendees

Our team of clinicians and researchers are dedicated to ensuring all our clients with cancer receive the best care available. Clinicians: Jennifer Pena, Amber McDonald, Elizbeth Grevengoed, Mary Beth Coffin, Andrea Grace, and Sara Guldin. Researchers: Eva Gordon, David Parker, Nicolas Young, Lee Gibbs, Ross Keller, and Gareth Morrison.

References

1. Plasma epigenomic profiling to reveal molecular correlates of response and resistance to 177Lu-PSMA-617 in metastatic castration-resistant prostate cancer (mCRPC). – ASCO. https://www.asco.org/abstracts-presentations/ABSTRACT504854.

2. Parker, C. T. A. et al. Multimodal artificial intelligence (MMAI) model to identify benefit from 2nd-generation androgen receptor pathway inhibitors (ARPI) in high-risk non-metastatic prostate cancer patients from STAMPEDE. JCO 43, 5001–5001 (2025).

3. Tung, N. M. et al. Predicting pathologic complete response (pCR) from clinicopathologic variables and HER2DX genomic test in stage II/III HER2+ breast cancer treated with taxane, trastuzumab, and pertuzumab (THP): Secondary results from the EA1181/CompassHER2 pCR trial. JCO 43, 501–501 (2025).

4. Turner, N. C. et al. Camizestrant + CDK4/6 inhibitor (CDK4/6i) for the treatment of emergent ESR1 mutations during first-line (1L) endocrine-based therapy (ET) and ahead of disease progression in patients (pts) with HR+/HER2– advanced breast cancer (ABC): Phase 3, double-blind ctDNA-guided SERENA-6 trial. JCO 43, (2025).

5. Park, C. L. et al. Detecting ctDNA using personalized structural variants to forecast recurrence in localized soft tissue sarcoma (STS). JCO 43, 11511–11511 (2025).

6. Bsteh, D. et al. Combined genomic profiling of cell-free DNA (cfDNA) and circulating tumor cell DNA (ctcDNA) in S1802, a prospective phase 3 trial for metastatic prostate cancer (mHSPC). JCO 43, e17111–e17111 (2025).