ESMO 2025 Insights: Emerging oncology trends highlighting the need for Precision Medical Affairs

Authored by: Rudiger Papsch

The ESMO Congress, held in Berlin in October 2025, gathered over 34,000 Oncology professionals from around the world. The congress presented major scientific advancements and reinforced significant progress in Oncology practice, emphasizing the crucial role Medical Affairs plays in bringing these innovations into clinical reality and improving the outcomes of cancer patients.

Key ESMO 2025 Themes Shaping the Future of Oncology

Several core themes emerged throughout the conference, highlighting the future direction for Oncology. Some of these key themes were:

• Biomarker-driven treatment expands: Therapies such as antibody-drug conjugates (ADCs) targeting specific biomarkers (e.g., HER2-expressing cancers) are increasingly moving into first-line treatments, requiring defined diagnostic pathways, coordination and capabilities.
• MRD and ctDNA as clinical decision tools: Positive phase III results highlight the growing clinical utility of minimal residual disease (MRD) and circulating tumor DNA (ctDNA) in guiding treatment decisions. At the same time, it also demands new workflows in terms of testing pathways and patient communication.
• Advanced therapeutics demand greater operational readiness: Innovations such as radioligand therapy underscore the need for expanded healthcare infrastructure and site readiness, standardized referral and treatment protocols, and cross-specialty collaboration.
• AI integration gains momentum with enhanced governance: ESMO introduced structured guidelines (ESMO Guidance on the Use of Large Language Models in Clinical Practice, ELCAP) for deploying large language models and AI responsibly within Oncology, emphasizing quality control, oversight, and transparency.

How are these trends driving the need for Precision Medical Affairs in Oncology?

These four emerging trends highlight the increasing complexity and precision required in Oncology practice. As biomarker-driven therapies and MRD/ctDNA diagnostics shift clinical decision-making toward highly targeted patient groups, Medical Affairs has to tailor engagement, education, and evidence dissemination to these specific needs. At the same time, advanced therapeutic options require identification and management of site-specific operational gaps and infrastructure requirements. Additionally, integrating AI based on governance frameworks enables Medical Affairs to rapidly synthesize and act on medical insights, and to support optimized clinical decision-making with a focused strategy.

These trends underscore the importance of Precision Medical Affairs – a targeted approach to stakeholder engagement that utilizes data, insights and advanced analytics. Building on these, Precision Medical Affairs tailors scientific exchange, stakeholder support, and evidence delivery to specific clinical and operational contexts.

In practice, this involves segmenting centers and stakeholders based on their specific capabilities or knowledge needs, deploying customized, timely content and engagement strategies, and using outcome-based metrics (such as diagnostic testing rates, adherence to care pathways, and time-to-treatment) to demonstrate measurable impact on clinical practice and patient outcomes.

We’d love to hear your perspective, contact us.