Today I decided to “let ASCO decide” what I would watch for the first hour or so. Finding your way around Virtual Meeting is still somewhat challenging, at least for me. There is a video here that shows you the Virtual Meeting library with some nice music in the background. However, finding exactly where you want to go is still difficult. What I would like to see is a prominent link to take me back to a “favorite page” after I logged in. My favorite navigation page for Virtual Meeting was this one, which I bookmarked eventually using my browser. The page could be improved by some indication of which sections are now populated with video without having to go there, only to find “video not available”. Starting with “ASCO’s choice,” I was disappointed to click on “Today’s Featured Broadcast” only to find that it isn’t available until 3 PM EDT. What’s with that?? This seems to be a part of “Virtual Meeting on Demand” that must be some other initiative related to Comcast or something. In any case, the ASCO Daily News, which also came as an email, had nice links to some highlights from presentations available to the public at large on the summary of key presentations like the ones on nicotinamide for skin cancer prevention and nivolumab compared to docetaxel in refractory non-squamous NSCLC. The videos at the bottom of these pages are excellent “just tell me the facts” snippets from the concluding remarks of the presenters.

My next choice for a video was George Bosl’s talk on “Looking to the Future” in germ cell tumors. This is an area where success has been remarkable for many decades now. George reviewed a number of survivorship issues including early vascular events that can occur in as many as 18% of patients, mostly in either the first or second cycle of CPPD treatment. However, with the growing number of survivors growing into middle or late age, we see more patients with dyslipidemia, hypertension, and Raynaud’s, and second malignancies. The combination of radiation and chemotherapy is particularly worrisome for all of these, raising issues especially for the seminoma population. He feels that radiotherapy should probably no longer be used in seminoma. He proposes linking the intermediate- and poor-risk patients for prospective trials to get enough  patients, and feels that marker studies may help in prognosis, but doesn’t think we will find many “targetable” mutations.

Finally, for this blog, I decided to go to listen to some basic science and watched a great presentation by Leonard Nunney in the Tumor Biology Track, titled "Evolution, Medicine, and Cancer." He tackled the question not of HOW cancer develops, but WHY it develops from an evolutionary point of view. I encountered Peto’s Paradox for the first time. Mice get cancer. Humans get cancer. Humans have 1,000 times the number of cells and live 30 times as long. So if there are comparable rates of genetic events, why don’t all humans die of cancer at a young age? Something must have happened in an evolutionary sense to allow us to live into our 70s/80s. We now know that both longevity and SIZE (height – as a surrogate for cell number) are risk factors for cancer. The answer is that “cancer suppression is an evolving trait.” A fascinating series of investigations looked at rodents and discovered that the naked mole rat, although being in the small size category, nevertheless lives a long time, potentially due to a unique expression of high molecular mass hyaluronan leading to altered contact inhibition and cancer resistance. For more fascinating insights from “out of the box” real biology, you should watch the presentation for yourself.

Summary of Day 2: I found it as hard to wander around the Virtual Meeting as it is to walk around the convention floor in Chicago. BUT, since I didn’t have to worry about missing something, I listened to some of my favorite presenters in my field of interest and got to sample some wonderful biology I would most certainly have missed. PLUS, of course, I can now take a break and do the housework assignments…