July 2020 Edition Vol.11, Issue 7

ASCO20 Takes a Virtual Turn: The New Normal?

By Chase Doyle

For the first time in the history of ASCO, attendees of the Annual Meeting did not gather in the same physical place. Instead, from separate screens around the world, they logged on to a website to hear the latest advances in cancer care.

The research was as state-of-the-art as ever, but the format required adjustment to a new reality. Some elements – the networking, the critical discussion, and the shared feeling of discovery – were missed, while others – the freedom to make one’s own schedule and the addition of video poster presentations – arguably enhanced the experience.

ASCO President Howard A. Burris, III, MD, FACP, FASCO, spoke with OBR about the pros and cons of the virtual format and previewed the upcoming Education Program.

Meeting Demographics: Nobody Left at Home…

The look and feel of the meeting may have been different, but that didn’t discourage attendance, which actually increased slightly from the previous year. ASCO20 had a total of 42,700 attendees versus 42,500 in 2019. The number of attendees listed as oncology professionals, however, increased by nearly 17%, representing a major shift in meeting demographics.

“One of the themes this year was ‘nobody is left at home because everybody is left at home,’”said Dr. Burris, who noted that his institution, Sarah Cannon, has always limited ASCO attendance in the past. “This year everybody got to go, and I think people really appreciated that.”

That included the international community, which represented more countries in attendance than ever before (138) and saw a similar boost in registration of professionals – up approximately 5,000 attendees compared to 2019 numbers.

Positive Feedback

The lack of jet lag and time-zone differences helped to make the international experience a very positive one, said Dr. Burris, and people of all nationalities appreciated not having to choose between competing sessions. No longer limited by constraints of time or convention center space, attendees were free to view content they might not previously have considered, at their own pace, and many ventured outside of their specialty for newsworthy presentations.

“People felt like they had a better view to the overall experience, which was a real positive,” said Dr. Burris.

The biggest contrast in experience between virtual and in-person meetings, however, may have been the poster presentations. This year, authors could upload slides supporting their posters and complete a three-minute video discussion instead of competing for attention among a packed crowd of attendees in the poster hall. Implementing this new feature required a major overhaul of the poster-review process – in just six weeks – but the end result was a real crowd-pleaser.

“Everybody got to give an oral presentation of their research this year, and people really enjoyed that,” said Dr. Burris. “I suspect this will be a legacy that lives on.”

Technical Difficulties

It wasn’t all smooth sailing, though. The new format posed unexpected challenges for organizers at the start of the meeting.

“We were stunned by the number of attendees who were ready to go at 8 AM,” said Dr. Burris. “We thought Friday would be a slow day compared to Saturday and Sunday, but everybody jumped on board at the beginning.”

Dr. Burris likened the technical issues to tailgaters at a football game attempting to enter the stadium all at once before kickoff. With a few quick fixes, including expanded bandwidth and name versus registration check-in, however, these issues remained relatively inconspicuous for the rest of the meeting.

“It wasn’t really a problem of total usage once you got into the stadium,” Dr. Burris explained. “It just was a problem of initial access at the door.”

View an OBR interview with Dr. Liu:

Thought-Provoking Sessions

With the bottleneck resolved, the conference returned to its staple: presenting cutting-edge research and generating debate. According to Dr. Burris, one heavily debated trial was the use of adjuvant osimertinib in early-stage, EGFR-mutated non-small cell lung cancer.1

An interim analysis showed significantly improved disease-free survival compared with placebo, which led to early unblinding of the trial – and differing opinions between lung and breast cancer communities. While lung cancer specialists “hang their hat on overall survival,” said Dr. Burris, the breast cancer field has been driven by advances in disease-free survival and quality of life in recent years.

“Breast cancer doctors looked at the lung cancer data and said, ‘if it’s keeping people in remission, then you have to start giving that therapy; we’ll worry about overall survival later,’” Dr. Burris explained. “Lung cancer doctors, on the other hand, suggested that it may be too early to administer the drug.”

“Non-smoking EGFR lung cancer is an international problem, so it was exciting to see such strong responses,” he added.

A great deal of discussion about the expanded role of immunotherapy also ensued. There had been uncertainty regarding the effectiveness of immune checkpoint inhibitors in bladder cancer, said Dr. Burris, but data presented by Tom Powles, MD, showed significantly longer overall survival with the use of avelumab as maintenance therapy in the first-line setting of advanced urothelial cancer.2

In metastatic colorectal cancer, upfront treatment with immunotherapy doubled median progression-free survival in patients with microsatellite stability-high tumors.3

“It’s becoming apparent to community oncologists that getting a molecular profile or next-generation sequence on your patient is probably the most informative thing you can do,” said Dr. Burris. “All the data that came out about activity against a particular mutation or a particular molecular profile or a subset of patients generated a lot of buzz.”

If the number of views is any indication, these sessions will continue to generate discussion throughout the summer. A few weeks ago, analytics showed more than 2.5 million views on the ASCO site – compared to several hundred-thousand post-meeting views a year ago.

“It’s nice to see that people are going back and continuing to look at the information,” said Dr. Burris, who noted that access will be available all year.

View an OBR interview with Dr. McKay:

ASCO20 Education Program

It may not be obvious to every in-person attendee in Chicago, but the ASCO annual meeting has always been divided between Scientific and Education Programs. It’s only this year that the content is separated by 10 weeks of time instead of designated blocks to avoid competing sessions.

While the Scientific Program is centered on the latest research in cancer care, the Education Program is organized to complement emerging themes in oncology with formal, educational lectures.

These lectures are not limited to single trials or research experiments but review data across a given field. Attendees can hear lectures on HER2-positive and/or triple-negative breast cancer, for example, to put the latest findings presented during the Scientific Program into perspective.

Like in years past, educational sessions will typically range from 60 to 90 minutes and feature three speakers who address a specific topic for 15 to 20 minutes each, followed by a prerecorded, interactive discussion.

Aside from the prerecorded element, however, what’s different this year is that presenters have been able to wait until after the annual meeting to record their sessions. Thus, the education talks will be more up-to-date, incorporating information released just weeks ago.

View an OBR interview with Dr. Plimack:

Generating Discussion

ASCO organizers have also tweaked the format in an effort to capture the live discussion of the in-person meeting. Faculty will now be available during scheduled broadcast sessions to answer attendee questions directly.

“It’s impossible to replace the fun of seeing one’s colleagues in the halls of McCormick and catching up with people that you see just once a year, but we’re hoping that these designated chat sessions will improve the interactive experience,” said Dr. Burris. “A number of sessions will also feature live interaction between discussants and presenters.”

As part of the opening session, for example, Ned Sharpless, Director of the NCI, Cliff Hudis, CEO of ASCO, and Dr. Burris will present a prerecorded roundtable discussion about COVID-19 that will then be followed by a live ‘fireside chat’. The ASCO Voices Session, in which participants share personal life stories, will follow a similar format.

“Being able to prerecord some interaction between various speakers and discussants will be a nice touch and a little bit different from the Scientific Program,” Dr. Burris said.

In addition to the registered attendees of the Virtual Scientific Program, who were automatically registered at no extra cost for the Education Program, ASCO organizers reported approximately one thousand registrations over the past month. The real question is how many of those registered will actually attend. And when? Perhaps not all at once, Dr. Burris acknowledged.

“Because this program is educational and is not comprised of late-breaking abstracts, we anticipate that there will be a core group of people who tune in during the broadcast, but it won’t be that rush-for-the-door kind of information,” he said. “Rather, we think attendance will be distributed throughout the month of August.”

Looking Ahead

Dr. Burris remains cautiously optimistic that attendees of the Annual Meeting will, eventually, greet each other in the massive halls of McCormick Place. Even if the new normal allows for in-person meetings, however, components of the virtual program will likely remain.

“We will probably have both live and recorded virtual pieces,” he explained. “There will be parts recorded before the meeting that people will watch live, and the oral presentations of the posters were so popular that I predict they will remain going forward as well.”

“Although there may be constraints on international travel in the future, if we can get core groups of people together in Chicago, we’ll be able to record the discussions,” he added. “Forevermore, though, this meeting will be a mix of both live and recorded elements that live on virtually. That’s where technology is heading, and I think it will be a real satisfier.”

Starting on Saturday, August 8, the ASCO2o Education Program will be available in an all-virtual format: on-demand videos, slides, and meeting materials, scheduled broadcast sessions, virtual networking, and exhibits. All 38 scheduled broadcast sessions on Saturday, Sunday and Monday (August 8 – August 10, 2020) will also be available to watch on-demand two hours after the close of the broadcast.


Dr. Burris Recommends…
Broadcast sessions during the Education Program will feature diverse and timely topics in cancer care, from COVID-19 to cancer treatment to health equity. Dr. Burris singled out a few sessions of interest.

1. ASCO Book Club: In Shock by Rana Awdish, MD.
Awdish is an intensivist at Henry Ford who almost died in her own hospital. She has an amazing story to share, said Dr. Burris.

2. Cultural Competency in Cancer Care for Military Service Members Care Delivery
A graduate of the U.S. Military Academy, Dr. Burris also served many years in the Army. With the help of West Point colleagues and veterans within the pharmaceutical industry, this will be ASCO’s first year featuring a session focused on cancer care for military service members (soldiers and veterans). Although the cause is unclear, the number of cancer cases in veterans has increased dramatically – ranging from up 20% for prostate cancer to up 60% for GI cancers.

3. Targeting RAS-Driven Cancers
KRAS alterations have long been considered an undruggable target, but this Sunday session will discuss a number of clinical trials moving forward in patients.

4. Opening Session: COVID-19 Roundtable with Drs. Skip Burris, Cliff Hudis, and Ned Sharpless


References

  • Herbst RS, Tsuboi M, John T, et al: Osimertinib as adjuvant therapy in patients with stage IB-IIIA EGFR mutation positive NSCLC after complete tumor resection: ADAURA. ASCO20 Virtual Scientific Program. Abstract LBA5. Presented in premeeting press briefing on May 26, 2020.
  • Powles T, Park SH, Voog E, et al. Maintenance avelumab + best supportive care (BSC) versus BSC alone after platinum-based first-line (1L) chemotherapy in advanced urothelial carcinoma (UC): JAVELIN Bladder 100 phase III interim analysis. J Clin Oncol 38: 2020 (suppl; abstr LBA1).
  • Andre T, Shiu K-K, Kim TW, et al: Pembrolizumab vs chemotherapy for microsatellite instability-high/mismatch repair deficient metastatic colorectal cancer: The phase 3 KEYNOTE-177 study. ASCO20 Virtual Scientific Program. Abstract LBA4. Presented in premeeting press briefing on May 26, 2020.

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