Leading with Optimism: Dr Deb Schrag’s Vision for the Future of Oncology

As she prepares to step into her role as president of the American Society of Clinical Oncology (ASCO) for the 2027–2028 term, Deb Schrag, MD, MPH, is bringing a distinct brand of "energy, enthusiasm, and inspiration" to the global stage. A gastrointestinal medical oncologist at Memorial Sloan Kettering Cancer Center, Schrag is stepping into leadership during a pivotal era for cancer care.

"I’m an optimist, and I think we’ve been through a lot of hard times, but there’s still a lot of reason for optimism," she said. "ASCO does an incredible amount of good for the global oncology workforce. And the global oncology workforce does an incredible amount of good for patients around the world. That’s pretty simple."

Harnessing AI to Eliminate "Drudgery"

One of the most immediate challenges—and opportunities—facing the profession is the rapid integration of artificial intelligence (AI). Schrag noted that oncology is currently on the "steep part of the learning curve," but she views AI as a tool for liberation rather than just automation.

"This is a tremendous opportunity for global cancer care, if we can harness AI to eliminate some of the drudgery and repetitive tasks that are not that interesting, but are necessary," she explained. Whether it is filling out forms, documenting notes, or adjusting insulin levels, Schrag believes AI can make care "safer and more efficient."

However, she emphasized a need for clinical rigor: "We’re used to designing trials of drugs, but we have to design trials that test new ways of delivering care, and those new ways include using AI."

Addressing the "Pernicious Rise" of Early-Onset Cancer

As a population scientist, Schrag is deeply concerned by shifting trends in cancer demographics. A top priority for her is investigating why younger populations are increasingly being diagnosed with aggressive diseases.

"I am particularly concerned about this really pernicious rise in early onset cancers... I’ve seen too many 30-year-olds with colorectal cancer. It is unacceptable. We need to understand the root cause. What is it? What’s in our environment, what’s in the way we’re living, and how do we mitigate that?"

To combat this, she is looking toward a transformation in the current screening paradigm, moving toward blood-based screening and imaging to catch cancers at their most treatable stages.

Solving the Care Delivery Gap

Schrag highlighted a frustrating reality in modern medicine: we have the technology to treat cancer, but we often fail at the logistics of delivery.

"We’ve got a long way to go. We’ve got a lot of technologies and ways to treat cancer... but we’re not very good at making them work, because we sort of fall down on the delivery side," she noted. This includes everything from medication adherence to optimizing supportive care so that treatments are less toxic. Her goal is to make care "more effective, easier for patients, and less disruptive."

Protecting the Oncology Workforce

A recurring theme in Schrag’s vision is the preservation of the people behind the medicine. She spoke candidly about the "inundation" of the modern oncology workforce, where digital devices prevent physicians from ever truly disconnecting.

"I have physicians who... are getting texts and messages 24 hours a day, 7 days a week," she said. "We need to work on strategies to help people disconnect... Pilots do it. We have to help oncologists and other people disconnect so that they can play the long game."

For Schrag, workforce well-being is directly tied to patient outcomes. "I need them to be compassionate and empathetic, and that doesn’t work if they’re grouchy," she added.

Building Public Trust

Finally, Schrag believes the scientific community must do a better job of communicating its "why" to the public. She acknowledges that while oncologists may be "nerds at heart" who excel in 1-on-1 patient interactions, they need ASCO’s help to speak to the world.

"If people don’t trust the research enterprise, they won’t participate in it, and if they don’t participate in it, we can’t make progress," she warned. "A big piece of this is building trust and communicating that trust."

As she looks toward 2027, Schrag remains focused on the "impactful discoveries yet to come,” from antibody-drug conjugates to the mysteries of epigenetics, driven by a workforce that is supported, focused, and, above all, optimistic.