The ASCO Annual Meeting is one of the highlights of the exchange of new information for oncologists in North America and the world.
I chose the theme “Collaborating to Conquer Cancer” for this year’s Meeting. As a pediatric oncologist, I have seen firsthand the enormous advances that we have made in the management of childhood cancer. We cure almost 80% of our patients. One of the key themes that has emerged from pediatric oncology is the importance of collaboration in order to achieve success. It is in pediatric cancers that the combined-modality approach to curative therapy was pioneered. We understood that no single specialty was sufficient to cure the patient—it really takes a village.
In addition, no single institution had enough patients to conduct the kind of trials that would lead to substantive advances in care. Very early on, pediatric oncologists collaborated with one another by entering their patients on studies that were being led by investigators at other institutions. We understood that this was the way to progress: we needed clinical trials and we needed to collaborate with each other inter-institutionally and even internationally to move the field forward.
One of our most important collaborations is with our patients and their families. Most of what we know emerges from clinical trials, and our patients are our partners in their willingness to participate in trials. Their parents and their families have been some of the most vocal advocates not only for the importance of trials, but for the importance of funding from the government and other sources to make sure that this agenda of research continues.
Our patients have also taught us a lot about the price of cure. In our survivorship clinics we’ve learned about the long-term effects of some of the treatments we are administering, the effect on their lives and the quality of their lives. We have thus altered our treatments, and studied new treatments, to try to cure the patient with the fewest side effects and minimal long-term effects on their quality of life. The willingness of our patients to return to our clinics for follow-up has been an incredibly important collaboration.
Finally, many of the recent advances in cancer care have been derived from our better understanding of the heterogeneity of cancers. We have learned a great deal from the laboratory; we understand, for example, that leukemia is not one disease but many different diseases defined molecularly. We have established this with collaborations with laboratory-based investigators by supplying the tissue. They, in turn, have come back to us with findings that we can use to risk-stratify patients by understanding the biology of their leukemia, and use that to define what therapy is necessary for successful outcome. The collaboration extends from our patients (and their willingness to provide tissue samples) into the laboratory, and allows us to investigate further the biology of cancer.
A multitude of collaborations across specialties, in the laboratory, with patients, and with each other have enabled the major advances we have made. It is this paradigm that will be even more necessary in the future.
Collaboration, and the manner in which the Annual Meeting brings together the spectrum of oncology professionals, is even more important now, because so many of the advances do not pertain to a specific type of cancer or even to a specific age group. What we’ve learned from the age of genomics is that some of the pathways that are driving certain cancers (and therefore some of the targeted agents which are available) don’t understand the description of an organ. A pathway that is active in lung cancer may be important in lymphoma, in a rare subset of childhood neuroblastoma, in a rare sarcoma, and in inflammatory breast cancer. Here we have the beginnings of a collaboration in which pediatricians, lymphoma specialists, lung cancer specialists, and breast cancer specialists are all going to be interested in the same pathway, drugs that target that pathway, and how those drugs should be administered. It is exciting that one is not really certain where the next advance is going to come from. I look forward to seeing the interchange and questions that come up during the Meeting as these kinds of discoveries are presented and discussed.
This year we had a record number of submitted abstracts, a testament to the explosion in new knowledge which will be presented. In addition to the abstracts, we have many exciting topics of discussion to explore. One will be a focus on cancer as a worldwide problem. Our Society may be called the American Society of Clinical Oncology, but we are an international organization and we have great concerns about the burden of cancer in the developing world, as reflected by our strong support of the U.N. High-level Meeting on Non-Communicable Diseases. A very important part of our Society’s agenda is to reach out and determine how we can provide infrastructure, education, and therapies that are applicable in the developing world.
We are also planning several joint sessions with other societies working, as we are, on the cancer problem. We will present, for example, new and emerging technologies in imaging, which will be very exciting in terms of staging and monitoring cancer, and discuss immunotherapy as a technology that has finally arrived as a treatment for cancer. Each of these symposia will introduce some of the highlights that have been presented at other meetings organized by our sister societies.
Also exciting is the availability of the Virtual Meeting, which means one does not have to regret the fact that two papers one is interested in are being presented at the same time. You can go back to the Virtual Meeting and listen to, in high-definition audio beautifully presented with the slides, any presentations that you may have missed or you can revisit a presentation of particular interest.
I have been coming to the ASCO Annual Meeting for more than 30 years and I’ve never been disappointed; I have always come away having learned something that was critical to my own understanding of cancer and applicable to the management of my patients. I hope you will join us in Chicago on June 1-5 to share in the excitement.