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On day 1 of the NCCN 2026 Annual Conference, attendees heard from experts on the unique issues young adults with cancer face during and post-treatment, advances in treating gastrointestinal cancers, evolving therapies in skin cancers, and novel approaches to treating blood cancers.
From March 27–29, 2026, physicians, nurses, pharmacists, and other oncology professionals gathered virtually and in person in Orlando, Florida, to attend the National Comprehensive Cancer Network (NCCN) 2026 Annual Conference. There, attendees heard from experts on the latest updates to national guidelines, critical issues impacting the patient experience and the delivery of oncology care, and how best to implement new treatments and therapies into their practices.
ACCC attended day 1 of the conference on Friday, March 27, to provide coverage of overarching themes, key takeaways, and progress on the horizon for cancer care.
The conference opened with a panel discussion examining the unique challenges faced by young adults with cancer—a large and growing group of patients that often feels overlooked due to their transitional age group. The panelists spanned the entire multidisciplinary care team, offering insights into the patient experience, current trends in cancer incidence among young adults, and evidence-based approaches to optimize the treatment outcomes of these individuals.
Several key themes emerged from the discussion, the first being late diagnosis as a major barrier to care for this population. According to moderator Christopher H. Lieu, MD, associate director for clinical research, co-director of gastrointestinal medical oncology, and professor of medicine in Medical Oncology at the University of Colorado Cancer Center, in an early-onset colorectal cancer survey, 63% of respondents were not aware that colorectal cancer could occur before age 50. This lack of awareness, coupled with many primary care providers’ (PCPs) tendency to assume a diagnosis other than cancer for young adults, often results in unnecessarily late-stage diagnoses. “Older adults will wait 25 days from the onset of colorectal cancer symptoms before diagnosis. Young adults have to wait 6 to 12 months because they’re told they’re too young to have it,” commented Dr. Lieu.
Larissa Nekhlyudov, MD, MPH, general internist at Dana-Farber/Brigham and Women’s Cancer Center, agreed, conceding that PCPs are tasked with keeping up with a large volume of constantly changing information, as they manage every medical condition. She also emphasized the significance of patient perception during these interactions: “Empower the patient to come back. ‘You know your body better than I do. If you feel something different, come back,’” she said. “Be aware of changing guidelines and take into account the full picture of the patient, including their family history and the potential for genetic contribution.”
As a survivor of cancer herself as a young adult, panelist Stephanie Samolovitch, MSW, founder and executive director of Young Adult Survivors United, spoke to the isolation young adults feel when they’re treated at an adult cancer center. “Many of them feel like they are not a priority compared to older adults,” she said. Samolovitch also described mental health and peer support as a huge unmet need, particularly in 2005 when she was being treated. “The transitional piece from ringing the bell to going back to your life as a young adult is so hard. Not only do they need mental health support, but we need to connect them with a peer who understands what they’re going through,” she urged.
Despite the rise in young adults with cancer, financial toxicity resources are scarce—an unmet need with major consequences for survivors living decades after their treatment has concluded. “Over the years, we’ve grown the support, the awareness, and the guidelines, and now we need to grow the implementation,” said Samolovitch. “How are we learning from those who have already built the infrastructure?”
Anjali Albanese, MSW, LSW, OSW-C, social worker at Fox Chase Cancer Center, added that these resources must be age-appropriate for this population and holistic in nature, rather than focusing solely on the physical aspects of cancer treatment. “We have to remember that this is a whole person standing in front of us,” she stated. “They were a person before cancer ever entered their lives, and they need peer support that takes into account this disruption at a critical life stage.”
Finally, the panelists reiterated the importance of reintroducing both treatment information and the availability of supportive care services multiple times throughout treatment. The first appointment with an oncologist is jarring and stressful for many patients, and they may be unlikely to absorb all the information that is initially presented to them. That first appointment is also a key time to introduce the entire care team—social work, survivorship, navigation—presenting them as a united front designed to support the patient. “There’s often an assumption that something has to be wrong with you mentally to need a social worker,” commented Albanese. “We need to show them that we’re not here to ‘fix’ the patient, but to support them and meet their needs because it’s something that we do for everybody.”
The panel was followed by 4 individual presentations detailing clinical advances and recent trials for gastrointestinal (GI) cancers. The first session, led by Jeffrey Meyerhardt, MD, MPH, professor of medicine at Harvard Medical School and medical oncologist at Dana-Farber Cancer Institute, described current recommendations and best practices for the treatment of early-stage colorectal cancer (CRC) and discussed recent clinical trial findings that may be applied to clinical practice.
Since 2010, the treatment paradigms for colon and rectal cancers have shifted significantly. Previously, colon cancer was treated via surgery, then chemotherapy, depending on the stage, and rectal cancer via chemotherapy and radiation, followed by surgery and more chemotherapy. In 2026, options for rectal cancer have expanded to include methods such as short-course radiation, total neoadjuvant therapy, and nonoperative management. The paradigm for microsatellite instability-high tumors has seen significant change as well, with immunotherapy emerging as a viable treatment option for both colon and rectal cancers of this type. Dr. Meyerhardt also shared research supporting the use of aspirin and cyclooxygenase-2 inhibitors in suppressing tumor cell survival and migration and promoting apoptosis in PIK3CA-mutated tumor cells, as well as the statistically significant benefit of exercise in reducing CRC recurrence.
Next, Mary F. Mulcahy, MD, medical oncologist and professor of medicine in hematology and oncology at Robert H. Lurie Comprehensive Cancer Center of Northwestern University, outlined 3 key molecular findings in gastric, esophageal, and gastroesophageal junction (GEJ) cancers that have significant impact on treatment decisions: HER2 expression in stomach and GEJ cancers, claudin 18.2 expression in gastric cancer, and PD-1 and PD-L1 expression in esophageal and gastric cancers. Accordingly, national guidelines recommend immunohistochemistry testing, cytogenetics testing, and molecular testing to determine if these expressions are present. Dr. Mulcahy emphasized the importance of repeated biopsy of metastatic sites and biomarker evaluation for these cancers, as their tumors are heterogeneous in nature and the type of expression may change in advanced stages of the disease.
The discussion then shifted to novel treatment strategies for the management of advanced hepatocellular carcinoma (HCC). Adam M. Burgoyne, MD, PhD, a medical oncologist at UC San Diego Moores Cancer Center, presented immunotherapy options recommended as first-line treatments for advanced HCC, as well as systemic therapy options recommended as subsequent-line treatments for advanced progressive HCC. These consist of 3 approved immune checkpoint inhibitor regimens (atezolizumab plus bevacizumab, durvalumab plus tremelimumab, and ipilimumab plus nivolumab) for the former, and 4 approved tyrosine kinase inhibitors (sorafenib, lenvatinib, regorafenib, and cabozantinib) for the latter. Dr. Burgoyne also shared several strategies under investigation for the future of HCC treatment, including bispecific antibodies, chimeric antigen receptor (CAR) T-cell therapy, and radiopharmaceuticals.
The segment on GI cancers closed with a discussion of current recommendations and best practices for the treatment of appendiceal neoplasms and cancers—for which national guidelines have recently become available—from Stacey A. Cohen, MD, physician, professor of clinical research at the Fred Hutch Cancer Center. Dr. Cohen explained that appendiceal cancer is not just 1 disease, but a collection of diseases whose classification has changed multiple times over the past several decades, creating challenges in examining retrospective data. She also iterated that surveillance strategies must be tailored to the appendix tumor biology; namely, whether the tumor is indolent or aggressive, as mucinous neoplasms and adenocarcinomas require different follow-up intervals.
The afternoon kicked off with a series of 3 presentations highlighting therapeutic strategies and emerging therapies for various skin cancers. Douglas B. Johnson, MD, MSCI, professor of medicine at Vanderbilt University Medical Center, began by discussing emerging neoadjuvant therapies for advanced melanoma. While surgically removing the melanoma upon detection may offer peace-of-mind for the patient, Dr. Johnson explained the potential benefits of delaying resection. When the tumor remains intact, it acts as a bullseye, or a clear target for T cells to recognize and attack. This robust immune response continues after surgery by attacking cancer cells left behind after resection. In some cases, neoadjuvant therapy is so effective prior to resection that it may reduce or negate the need for surgical intervention entirely.
However, a delay in surgery may cause logistical or treatment hurdles, such as the introduction of toxicities. Even when the neoadjuvant approach is appropriate, there is a growing array of drug options to choose from, including pembrolizumab and the combination of ipilimumab plus nivolumab. While this is a promising treatment option for some patients, Dr. Johnson emphasized the importance of tailoring care to each patient’s tumor and treatment goals.
Dr. Johnson also discussed tumor-infiltrating lymphocyte (TIL) cell therapy as a late-line treatment option for advanced melanoma, including key factors providers should consider when referring patients for this therapy. The time required for TIL cell therapy is a hurdle, as it can take 2 months or more from referral to infusion. Patients must be fit enough at the onset of this process to tolerate the toxicities from chemotherapy and IL-2 that may occur months into treatment. However, close collaboration and clear pathways between referring and administering providers allow patients with advanced melanoma to benefit from this form of immunotherapy.
The next speaker, Vincent T. Ma, MD, hematologist-oncologist from the University of Wisconsin Carbone Cancer Center, shifted the topic to emerging therapeutic options for nonmelanoma skin cancers. For cutaneous squamous cell carcinoma (cSCC), anti–PD-L1/PD-1 drugs are the standard of care, with several FDA-approved options. But ongoing trials are investigating new regimens, including both adjuvant and neoadjuvant therapies, to expand options for patients with high-risk cSCC.
Dr. Ma also highlighted biomarker testing progress in Merkel cell carcinoma (MCC), which has a high rate of recurrence in the first year of remission and requires active surveillance. The AMERK blood test, which measures antibodies to the Merkel cell polyomavirus that causes some cases of MCC, helps to predict if a patient is at risk of recurrence from virus-associated disease. Circulating tumor DNA tests are also prognostic for recurrence, but they are more sensitive and applicable to a broader patient population than the AMERK test. Dr. Ma emphasized that each of these tools comes with logistical challenges, including tissue requirements and wait times for results, but fill an important gap in ensuring recurrence of MCC is addressed early and appropriately.
Finally, Arun D. Singh, MD, director of the Department of Ophthalmic Oncology at Cleveland Clinic’s Cole Eye Institute, shared updates on the treatment of uveal melanoma, a relatively rare cancer of the eye. The incidence of uveal melanoma has been stable for several decades, but so has the rate of survival. Emerging therapies aim to both improve survival and reduce the burden of vision loss from brachytherapy, the most common treatment option.
Dr. Singh explained that treatment and prognosis for uveal melanoma are size-dependent: the larger the tumor, the more intensive the treatment and the higher the risk for vision loss or other adverse outcomes. One promising area of research is neoadjuvant treatments that can reduce tumor size before excision or brachytherapy. Although the field has been stagnant for decades, Dr. Singh expressed his excitement about this approach, which he believes will shift the landscape in the years ahead.
The following afternoon session on hematologic malignancies featured a robust discussion of mantle cell lymphoma (MCL). Paolo F. Caimi, MD, professor of medicine at the Cleveland Clinic Lerner College of Medicine and staff physician at the Cleveland Clinic, described the prevailing “more is better” approach to treating MCL, where patients are given intensive combinations of therapies with mixed outcomes. While these patients tend to have low rates of recurrence, they have high rates of toxicity and secondary cancers.
With regard to TP53 wild-type classical MCL, Dr. Caimi explained that a central research question drives the field: “Is the kitchen sink better than targeted?” He detailed the clinical trials and emerging results showing that more targeted treatments and less reliance on autologous stem cell transplants (ASCT) may be more effective for patients with this type of mutation.
Ann S. LaCasce, MD, MMSc, associate professor of medicine at Harvard Medical School and member of the Lymphoma Program at Dana-Farber Cancer Institute, discussed the treatment landscape for TP53-mutated classical MCL. This type of mutation indicates that patients are unlikely to benefit from ASCT or chemoimmunotherapy, but bispecific antibodies, Bruton tyrosine kinase inhibitors, and CAR T-cell therapy are all emerging options. Dr. LaCasce reviewed the promising clinical trial landscape for these therapies and concluded with a call to recognize the importance of biomarker testing for TP53 mutations in patients with MCL, as it provides vital information for decision-making.
The final presenter, Shaji K. Kumar, MD, professor of hematological malignancies and research chair for the Division of Hematology at Mayo Clinic, shifted the focus to relapsed and refractory (R/R) multiple myeloma. Options for patients with R/R disease have grown significantly in the past decade, creating a complex treatment landscape. Patients may choose from many different therapies, but it can be difficult for providers to assess which drugs will be most effective.
Dr. Kumar identified several current areas of investigation where his colleagues are expanding clinicians’ understanding of how best to treat relapses. When to begin treatment is a particularly salient research question. R/R multiple myeloma typically progresses slowly, and patients can be observed during the early stages before treatment begins. Active clinical trials are assessing whether an earlier start to therapy may be more beneficial for some patients. Bispecific T-cell engager therapy and CAR T-cell therapy are also emerging options being investigated for their efficacy.
The overarching theme of the hematologic malignancy presentations—and many other sessions of the day—was the promising future of emerging therapeutic options. The number of available treatments and the oncology community’s knowledge about how best to deliver them are growing each year, expanding the outlook for patients across oncology.
For more NCCN content, read the highlights from the December Patient Advocacy Summit.
