ASCO Returns to Chicago, With Health Equity and Innovation on the Agenda

The world’s premier oncology gathering, the annual meeting of the American Society of Clinical Oncology (ASCO), opens in Chicago tomorrow for the first time since 2019, bringing the largest crowd of cancer care leaders together since the start of the pandemic.

ASCO organizers said last week more than 36,000 people had registered and 80% were planning to attend the meeting in person; an online option remains available. With COVID-19 cases rising again, however, event organizers now expect all attendees to wear masks and will require proof of vaccination and a negative test within 48 hours of arrival.

For the second year, the meeting will focus on health equity, as ASCO President Everett Vokes, MD, FASCO, has selected the theme, “Advancing Equitable Cancer Care Through Innovation.” In an essay published ahead of the meeting, Vokes wrote that this theme reflects both the transformation in cancer care and research cancer care over the past 50 years, and the unfortunate fact that “progress is uneven, and deep-seated disparities remain in limiting access to the best prevention, detection, and treatment approaches.”

The next wave of progress in cancer innovation must ensure equity for all patients at every stage, from diagnosis, through care, to survivorship, said Vokes, who is chair of the Department of Medicine and physician-in-chief at the University of Chicago Medicine and Biological Sciences.

His presidential symposium on Saturday will feature presentations by Douglas R. Lowy, MD, acting director of the National Cancer Institute, and André Michel Ilbawi, MD, cancer control officer for the World Health Organization.

Sessions across the ASCO meeting will address achieving equity across every stage of care, including training clinicians to be more aware of and responsive to culture differences. The Saturday session, “Knowing What We Don’t Know: The Importance of Cultural Humility in Delivering High-Quality Care,” will respond to racial and ethnic differences in end-of-life care and the need for the health system to respond to patients’ spiritual needs, for example.

ASCO and the Association for Community Cancer Centers (ACCC) recently released a series of recommendations on how clinical trials can enroll study populations that better reflect patients with cancer. The Sunday session, “Strategies to Advance Equity in Cancer Clinical Trials,” led by 2021 ASCO President Lori Pierce, MD, FASTRO, FASCO, is among those that will drill down on how clinicians can ensure they are giving patients more opportunities to be in a trial.

Scientific Program. Of course, the excitement of being in-person revolves around hearing the latest clinical trial data, and there’s plenty on the schedule:

• Friday’s schedule includes a presentation by Michael Wang, MD, of The University of Texas MD Anderson Cancer Center, of primary results from the phase 3 SHINE study of ibrutinib combined with bendamustine-rituximab and rituximab maintenance as a first-line treatment for older patients with mantle cell lymphoma.
• Later Friday, Lipika Goyal, MD, of Mass General Cancer Center and Harvard Medical School, will present updated results from the FOENIX-CCA2 trial involving the efficacy and safety of futbatinib in intrahepatic cholangiocarcinoma in patients with FGFR2 fusions or rearrangements, an area that has seen a flurry of research activity.
• Saturday’s session on metastatic breast cancer features several highly anticipated results, including a safety follow-up for DESTINY-Breast03, which studied trastruzumab deruxtecan vs trastuzumab emtansine in patients with HER2+ unresectable and/or metastatic breast cancer. Erika P. Hamilton, MD, of Sarah Cannon/Tennessee Oncology, will present the findings.
• Also on tap Saturday: Overall survival results from PALOMA-2, which analyzes first-line use of palbociclib plus letrozole vs placebo plus letrozole in women with ER+/HER2- advanced breast cancer. Richard S. Finn, MD, of University of California, Los Angeles, will present the results.
• Sunday’s plenary session offers an international flavor: Takayuki Yoshino, MD, PhD, of National Cancer Center Hospital East in Japan, will present phase 3 results from the PARADIGM trial, comparing panitumumab plus mFOLFOX6 vs bevacizumab plus mFOLFOX6 in first-line treatment of patients with RAS wild-type metastatic colorectal cancer. Then, Martin McCabe, PhD, of the University of Manchester, will present rEECur, an international phase 3 trial involving topotecan and cyclophosphamide and high-dose ifosfamide in recurrent and primary refractory Ewing sarcoma.
• The final plenary presentation, the phase 3 DETERMINATION trial, examines a classic trio in multiple myeloma treatment—lenalidomide, bortezomib, and dexamethasone, plus or minus autologous stem cell transplantation and lenalidomide maintenance to progression for newly diagnosed MM. Paul G. Richardson, MD, of Dana Farber Cancer Institute, presents the results.
• A highlight of Monday’s program will be findings of a phase 2 trial of a pair of targeted therapies, dabrafenib and trametinib, in BRAF V600 mutant pediatric low-grade glioma, which has historically been an understudied area with few treatment options.

Technology, and especially the use of artificial intelligence, will be seen across the conference, given its role in the delivery of precision oncology and the promise of greater health equity. A Monday session, “Is There a Ghost in the Machine? Putting Artificial Intelligence to Work,” will examine several issues in this area.

And ASCO is recognizing Kashyap Patel, MD, the current president of the Community Oncology Alliance (COA) and CEO of Carolina Blood and Cancer Care Associates, for his role in addressing health equity, both in his own clinic and more broadly in his role as COA president. Patel, who is associate editor of Evidence-Based Oncology™, a publication of The American Journal of Managed Care®, is among those featured in the annual Narratives in Oncology feature in The ASCO Post that appears during this year’s annual meeting (see interview).

Patel feels the initiatives he is developing at his clinic, which are the subject of several abstracts published in the ASCO program, will help guide other community practices in achieving greater health equity in cancer care. “I’m very excited that by end of this year, we’ll have a few more publications that ...track the path, almost creating the cookbook or recipe book for how to address disparities in the small community clinic,” he said.