This is an exciting time to be an oncologist. I often say I wish I were 30 again and just starting out in my oncology career. Never before have we had such sophisticated technology for evaluation of the tumor or such a potent arsenal of targeted and effective therapies to treat cancer. Further, the promise of expanded screening capabilities to catch the disease early is also on the horizon.
We’ve seen declining mortality rates and increases in cancer survivors with the tools we already have, and it can only get better. Today, over 14 million people in the United States are living after being diagnosed with cancer, and that number is expected to climb to 24 million by 2025. ASCO has a major footprint in the survivorship arena, including cosponsoring with the American Academy of Family Physicians and the American College of Physicians of this year’s very successful Cancer Survivorship Symposium.
However, this is also a time of unsustainable costs in cancer care and great volatility in oncology practices across the nation. ASCO has been focused on addressing these challenges, especially with the development of CancerLinQ™, a rapid health-care learning system, which is designed to improve clinical care, enhance patient outcomes, and inform research, and the ASCO Value Framework, which will provide clinicians with a way to compare the relative benefit of new cancer agents with established treatments, their side effects, and their cost to patients.
By the start of the ASCO Annual Meeting (June 3–7 in Chicago), more than 30 vanguard practices will have signed agreements to participate in the Web-based portal and hundreds of thousands of patient records will be in the CancerLinQ system. And soon, we will be ready to publish the updated version of the Value Framework, which reflects the public and member feedback we received after publication of the initial concept.
Annual Theme
The Annual Meeting marks the start of my tenure as ASCO President, and I couldn’t be more honored. The theme during my presidential year is “What ASCO Can Do for You,” and that means not just clinical oncologists, but researchers, nurses, advanced practitioners, medical students, and, most importantly, our patients as well. ASCO is an incredible Society, and I want to build on its accomplishments as an advocate for patient access to high-quality, high-value cancer care and adequate funding for cancer research. There has been an erosion of federal funding over the past decade, although this past year, Congress reversed this regrettable trend with increased funding after a decade-long decline. If we continue to see reduced or stagnant funding, we will not make the kind of progress against cancer we have seen over the past 60 years. We hope that Vice President Biden’s Cancer Moonshot initiative will encourage lawmakers to reverse this trend over the coming years.
During my 30 years as an ASCO member, I have served the Society in a variety of volunteer capacities, but I am especially proud of my service on the Tumor Marker Guidelines Panels, which have established specific guidelines for breast, colon, and germline cancers. In addition to the ASCO-convened panels, I was very involved in the first joint guidelines panel involving ASCO and the College of American Pathologists (CAP), with which we addressed both HER2 testing (in 2007) and estrogen receptor/progesterone receptor testing (in 2010) for breast cancer. I have also served on the Annual Meeting Breast Cancer Scientific Review Committee, and in 2010 I was Chair of the Annual Meeting Scientific Program Committee, under then-President Douglas W. Blayney, MD, FASCO. I followed that experience with a 3-year term on the Board of Directors.
Importance of Biomarkers
My clinical practice has focused on breast cancer evaluation and treatment. My principal research interests have focused primarily on the development and testing of new tumor biomarker tests. Indeed, during my membership on the guidelines panels and my leadership experiences within ASCO, my colleagues and I have pushed for increased rigor and value of the diagnostic side of the risk/benefit equation. As a result, we have seen an increased awareness of the importance of biomarker tests in caring for our patients, and my long-held mantra that “a bad tumor biomarker is as bad as a bad drug” is finally catching on.
These panels have established important practice-changing guidelines for the use of specific markers in these cancers and have led to a number of policy statements on how tumor markers should be studied and taken into the clinic. It is truly gratifying to see this come to fruition since so much of the focus of oncology care today is based on the idea of precision medicine. However, to truly deliver personalized medicine with precision, we need accurate and reliable diagnostic tests and high levels of evidence that using them does, indeed, improve patient care.
The collaboration between ASCO and CAP serves as a paradigm of ASCO’s collaboration with our sister diagnostic societies, and we are now moving toward even more initiatives. For example, we are partnering with CAP to help our colleagues in low- and middle-income countries, including Vietnam, Uganda, Honduras, and Haiti, to provide diagnostic training and quality assurance for patients with cancer in their countries with the resources they have available, and it is heartwarming to see the response from these countries.
Continuing the Work of Important Initiatives
I am amazed by the progress we’ve made in treating cancer over the 3 decades I’ve been in the field. But, obviously, there is more to do. Clinical research is the basis of all the better care we have now compared to when I began my career in 1985. I often say to my patients, “I’m glad you have your cancer now instead of 10 years ago, but I wish you had waited 10 more years!” However, clinical research has become increasingly burdened with bureaucratic and administrative busy work that seems to have little to do with the important conduct of the trial.
I want to take this opportunity to recognize the important work by Julie M. Vose, MD, MBA, FASCO, during her Presidential year, especially the Best Practices in Cancer Clinical Trials Workshop initiative she helped launch, which is the result of a partnership between ASCO and the Association of American Cancer Institutes (AACI). The workshop, which was held in March, focused on developing solutions to improve the efficiency of conducting clinical trials today and was attended by stakeholders from across the cancer research community. At the Annual Meeting, Dr. Vose will present the solutions discussed at the ASCO-AACI Best Practices in Cancer Clinical Trials Workshop, and I look forward to continuing the work that was begun with this workshop.
Last year, ASCO launched TAPUR (Targeted Agent and Profiling Utilization Registry), its first-ever clinical trial, and I’m excited about ASCO’s leadership role in expanding the boundaries of precision medicine with this trial. I look forward to working with ASCO’s Chief Medical Officer Richard L. Schilsky, MD, FASCO, on this important initiative.
I’m also looking forward to the opportunity of working with Stephen S. Grubbs, MD, Vice President of ASCO’s Clinical Affairs Department, on the crucial issue of oncology practice management. Under Dr. Grubbs’ leadership, this new department will provide resources to support our members working in community practices, as well in other practice settings, in response to the growing economic and administrative challenges they face.
With more than 60% of our members in community practice, we must stay focused on these issues. Reforms in oncology payment reimbursement, such as the Center for Medicare & Medicaid (CMS) Innovation’s new Oncology Care Model and the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), and understanding and coping with the vast amounts of genomic sequencing data coming our way are just some examples of the adjustments we will need to make in our clinical practices.
Dr. Grubbs’ considerable experience as a community oncologist and his long-time commitment to ASCO, serving in a number of volunteer capacities, including as a member of the Board of Directors, will provide the leadership and vision to help all of us care for patients in this modern environment.
To cap off my Presidential year, Michael Thompson, MD, and David Smith, MD, my Education and Scientific Co-Chairs, will be working with Jamie von Roenn, MD, and her staff in the Education, Science, and Professional Development Department to plan the 2017 Annual Meeting. We hope to have something for everyone there!
New Beginnings
The start of my year as President of ASCO coincides with the appointment of a new CEO to head ASCO. Clifford A. Hudis, MD, FACP, Chief of the Breast Medicine Service, Vice President for Government Relations, and Chief Advocacy Officer at Memorial Sloan Kettering Cancer Center (MSKCC), and Professor of Medicine at Weill Cornell Medical College, will begin his position as CEO on June 27. Dr. Hudis, who served as President of ASCO from 2013 to 2014, will succeed Allen S. Lichter, MD, FASCO.
Dr. Lichter has been an incredible leader of this Society for the past 10 years. He has guided ASCO to the position of top medical professional oncology society in the country. But his commitment to ASCO extends back to 1980, when he became an ASCO member, and he later served as ASCO President from 1998 to 1999. As CEO, Dr. Lichter has helped the Society grow from 20,000 members in 2006 to more than 40,000 today, and he has overseen the launch of such major initiatives as CancerLinQ, the Value Framework, the TAPUR study, the Patient-Centered Oncology Payment model, and the expansion of the Conquer Cancer Foundation, among others.
To truly deliver personalized medicine with precision, we need accurate and reliable diagnostic tests and high levels of evidence that using them does, indeed, improve patient care.— Daniel F. Hayes, MD, FASCO
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Trained in radiation oncology, Dr. Lichter was an early advocate of breast-conserving approaches in the treatment of breast cancer, and he conducted a landmark study that found the use of lumpectomy and radiation therapy to be as effective in survival outcome as mastectomy in patients with stage I or II breast cancer.1 He went on to turn the Department of Radiation Oncology at the University of Michigan (U-M) Medical School into an international powerhouse.
Later, Dr. Lichter became Dean of the U-M Medical School, during which time he was my boss and my next-door neighbor. He was an early mentor of mine and has been my friend throughout my career. We are not going to let him just disappear from our important work, and I look forward to keeping him involved with ASCO in the future.
Under Dr. Hudis’ leadership, we will take the next step to advance the progress ASCO has made to improve the care of patients with cancer worldwide. He has demonstrated visionary leadership in every aspect of his career, including as President of ASCO, Head of the Breast Medicine Service at MSKCC, member of the Board of Directors of the Alliance for Clinical Trials in Oncology, and Chairman of the Breast Cancer Research Foundation Scientific Advisory Board. In addition to “precision medicine,” ASCO was looking for “precision leadership,” and with Dr. Hudis, we have chosen the right person to lead ASCO at the right time. I am thrilled to be his partner as he begins his tenure as head of our Society.
In summary, I cannot wait to join all of our members as well as the ASCO leadership and staff during this very exciting and challenging time in cancer care. I am humbled by the responsibility and grateful for the opportunity to serve as your next President. My goal is to make a difference in your lives, so that together we can all make a difference in the lives of our patients. ■
Disclosure: Dr. Hayes reported no potential conflicts of interest.
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