Getting Ready for Chicago: A Behind the Scenes Look at Designing the Annual Meeting
By Mark L. Fuerst
With the rousing success of the three Clinical Science Symposia at last year’s American Society of Clinical Oncology (ASCO) annual meeting, this year’s meeting will again deliver three symposia with cross-cutting themes to attract a large number of attendees.
The first session, “The View Beyond Single Agent Checkpoint Blockade,” on Saturday, June 4, is unopposed by other sessions, and is designed to “bring together the big immunotherapy papers and present them more broadly to ASCO attendees,” said the chair of the 2016 Scientific Program Committee, Lynn M. Schuchter, MD, FASCO, who is Chief, Division of Hematology Oncology, C. Willard Robinson Professor of Hematology-Oncology, Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, in an interview.
The foundation talk will be on basic immunology. “As we begin to hear results about why combination therapies are important, we need to start with a mechanistic talk to help participants understand the field. Then we will hear information on two studies, and the discussant will take a 30,000-foot view of combinations and how oncologists need to think about these agents,” she said.
According to Schuchter, this session will go beyond PD-1 antibodies and discuss the use of combinations of checkpoint inhibitors, including the perils of combination therapy. Presenters will look to the future with the intent to put into perspective how to build combination therapies, what the new agents are, and will pay special attention to CAR T cells and adoptive cell therapy.
Another symposium, “Immunotherapy – Now We’re Getting Personal – Using Genomics and Biomarkers to Predict Response,” will divulge how to predict which patients respond to immunotherapy. Schuchter indicates that this will be an interesting story on mutational load and antigens, programmed death-ligand1 (PD-L1) expression, and how close the field is to predicting who will benefit from immunotherapy.
The third symposium, “Actionable Mutations Redefined,” will involve new actionable mutations in certain diseases and how to look into redefining these mutations in new tumor types, particularly in solid tumors.
The Program Committee received a 20% increase in immunotherapy abstracts submitted, and immunotherapy is evident in most every session. This continues a trend toward more information on immunology. At the 2015 ASCO annual meeting, Alan Venook, MD, FASCO, Professor, Department of Medicine (Hematology/Oncology) at the University of California at San Francisco, and 2015 chair of the Scientific Program Committee, wanted to give general oncologists an overview of hot topics. Giving immunology a prominent place in last year’s program, Venook, along with the ASCO staff, devised three clinical symposia with the opening one on immunotherapy, which had no other opposing session.
“We wanted to bring people up to speed on immunotherapy, what therapies are coming out and what improves outcomes. We had subsets of different diseases – colon, liver, and melanoma – and the patients who have benefitted,” said Venook in an interview.
The idea worked. A 7,000-seat hall was filled to capacity, and two additional overflow rooms had to be opened for the symposium. “We had one-quarter of the meeting at this one session,” he said. “The ASCO staff pays attention to ratings, but mostly they look at the number of people in the room. They want to make sure to attract people to the meeting.”
The other two Clinical Science Symposia in 2015 were on “Targeting Mutations – Does Disease Matter,” including a discussion on when to use chemotherapy along with immunotherapy, and “When Actionable Becomes Objectionable,” with information on how to deal with the results of commercial assays as well as insurance coverage.
Poster Discussion Makeover
Another innovation from last year will also continue this year – new, improved poster discussion sessions. Last year Venook suggested doing something different, and now each poster discussant highlights three papers. In addition, poster presenters get some face time and are available on the podium to answer questions during the poster discussion session.
Some 5,800 abstracts were submitted for presentation at the 2016 meeting, and more than 5,200 abstracts were accepted. To construct the meeting program, 300 ASCO members participated. “Track members represent key disciplines including medical oncology, radiation, and surgery, reflecting the multidisciplinary approach to patient care and cancer research," noted Schuchter.
As it was last year, value will be another focus of this year’s program. Last year, a value discussant at the Plenary Session was included. This year, content experts in value, cost, and quality of care as well as additional experts will be onsite. Disease tracks had biostatisticians review abstracts as part of the selection committee process.
A category introduced a few years back which has been a big hit is Trials in Progress. “We had a doubling of abstracts in this category,” Schuchter said. “Many ongoing trials are looking at combinations of targeted therapy and immunotherapy. This is the next new wave. We thought we had more studies ready to reveal content this year. These trials are still in the early stages. I predict that next year we will hear about more data combining these two approaches.”
Presentations will be made from a broad array of countries around the world. The top three international countries with abstracts are China, Japan, and France. In addition to the international abstracts, a Global Oncology Clinical Science Symposium on human papillomavirus (HPV)-Associated Malignancies will focus on the biology of HPV and Cancer, HPV screening, prevention and vaccinations, and HPV testing across the globe.
“We wanted to do something with HPV to increase awareness of the importance of vaccinations and to get the message out,” she said.
Schuchter also highlighted the joint ASCO and American Association for Cancer Research joint session on “Next Frontier of Genomics in the Clinic and Clinical Trials – Incorporating Big Data into Clinical Practice, Implementing Personalized Cancer Genomics in Clinical Trials, Potential for Liquid Biopsies,” which will include a discussion on reimbursement and value.
The Program Committee insists on outstanding discussants for abstracts. Venook noted that last year “nobody turned down my invitation to become a discussant. This tells you the impact the meeting has and the stature it gives.” Schuchter agrees that “meeting participants want to know what is practice-changing and whether what they learned affects their practice when they return from ASCO. How do the results frame the design of future clinical trials? Discussants help put this into proper context.”
ASCO President Julie M. Vose, MD, MBA, of the University of Nebraska Medical Center, Omaha, NE, has an interest in hematologic malignancies, and “we have highlighted hematologic malignancies and bone marrow transplants to take advantage of her leadership with a number of important papers on these topics,” said Schuchter.
Value of Networking
Schuchter emphasized the value of networking during the ASCO annual meeting. Even though all of the sessions are available online, attendees, advocacy groups, and big pharma all recognize the value of having 30,000 people gathered in one place. “Attendees are networking in many ways,” said Schuchter. Venook also noted, “We need to demonstrate the value of networking and being there personally.”
Another new item last year at this year’s meeting is special sessions for women in oncology. This will continue to allow for frank conversation, according to Schuchter.
Discussions are also ongoing on how to make the annual meeting more accessible to nurse practitioners (NPs) and physician assistants (PAs). “At Penn, we send more NPs to the annual meeting. They are tremendous partners in delivering cancer care,” said Schuchter. Special sessions for NPs and PAs will not appear at this year’s meeting, although there will be educational sessions for them to attend.