Key vectors of innovation in cancer drug therapy for clinical practice

This review analyzes the main vectors of drug therapy development for solid tumors based on the results of 2025, which have shaped the new landscape of clinical oncology. Key trends include the definitive transition of immunotherapy and antibody-drug conjugates (including trastuzumab deruxtecan, sacituzumab govitecan, and novel molecules) into perioperative and adjuvant regimens across various nosologies, as 
confirmed by the outcomes of the KEYNOTE-905, MATTERHORN, and DESTINY-Breast05 trials. Targeted therapy has further consolidated its position, notably through the introduction of BRAF inhibitors into the first-line treatment of colorectal cancer (BREAKWATER trial) and the expanding potential of KRAS inhibitors. Special attention is given to the dual role of circulating tumor DNA (ctDNA) assessment: its high prognostic value in colon cancer is confirmed, yet limitations in adapting adjuvant therapy have been identified (DYNAMIC-III), while in bladder cancer this strategy has demonstrated clinical success (IMvigor011). Emerging data on the protective effect of GLP-1 agonists against obesity-associated cancer risk and the potential of artificial intelligence in overcoming drug resistance and personalizing care are also highlighted. The review documents a paradigm shift: moving from treating metastatic disease towards preventive and personalized therapy in early stages, thereby setting the direction for the further evolution of oncological care in the coming years.