As the worldwide cases of the coronavirus started to mount in February and March, medical societies and organizations monitoring the escalating COVID-19 pandemic and its impact on international and domestic travel made the difficult decision to postpone or cancel their scientific conferences. On March 24, ASCO announced that, although it was canceling its in-person 2020 Annual Meeting, scheduled for May 29 through June 2 in Chicago, it would instead adapt its scientific program in a new, abbreviated virtual format, beginning on Friday, May 29, and ending on Sunday, May 31. A virtual presentation of ASCO’s education program will be presented on August 8–10, 2020.
This is the first time since ASCO’s founding in 1964 that the Society has had to alter the format of the Annual Meeting. However, the content delivered over the 3 days will provide the same level of cutting-edge research in the advancement of oncology care as the past 55 Annual Meetings, according to ASCO Chief Executive Officer, Clifford A. Hudis, MD, FACP, FASCO. The Virtual Scientific Program will feature more than 250 oral abstract presentations and 2,500 poster presentations in 24 disease-based and specialty tracks.
Clifford A. Hudis, MD, FACP, FASCO
The theme of this year’s ASCO meeting is “Unite and Conquer: Accelerating Progress Together,” and ASCO President Howard A. Burris, III, MD, FACP, FASCO, will deliver the Presidential Address on May 30, followed by the keynote address by David Fajgenbaum, MD, MBA, MSc, FCPP, Assistant Professor of Medicine in Translational Medicine & Human Genetics at the Perelman School of Medicine at the University of Pennsylvania, and Co-Founder and Executive Director of the Castleman Disease
The scientific sessions will include new research findings in breast, head/neck, gastrointestinal, lung, and genitourinary cancers, among others, as well as sessions on pediatric oncology, hematologic malignancies, and sarcoma. The virtual meeting will also present clinical science symposia titled “Harnessing Immunotherapy With Novel Approaches Beyond Checkpoint Inhibitors”; “Redefining Cancer of Unknown Primary: Is Genomics the Answer?”; and “Drug Development for Rare Mutations: The Opportunity to Unite and Conquer.” All the presentations will be prerecorded to avoid potential technical difficulties for speakers and attendees and will be available on demand for 180 days.
Registration for the ASCO20 Virtual Scientific Program is required for all attendees, and meeting fees will be waived for ASCO members and discounted for non-ASCO members. Attendees will also have access to the ASCO20 Virtual Education Program at no extra cost. To register for the ASCO20 Virtual Scientific Program, visit https://meetings.asco.org/am/registration.
In a wide-ranging interview with The ASCO Post, Dr. Hudis discussed the unprecedented challenge of presenting the ASCO Annual Meeting virtually and the potential long-lasting impact of the COVID-19 pandemic on oncology care.
Meeting Unprecedented Challenges
Please talk about the considerations that went into the decision-making to adapt the in-person 2020 Annual Meeting to a virtual format.
The Annual Meeting is ASCO for many of our members and nonmembers, so the decision to change the format of the meeting in any substantial way was one we approached with care and caution. I have described the decision as both easy and difficult. Easy because it was so obviously the right thing to do and difficult because it represented such a profound change from the past and was driven by external factors.
As the full scope of the health threat of the COVID-19 pandemic became clear, we knew it would not be possible or responsible to hold the Annual Meeting in Chicago using our usual in-person format. Of course, it is a complex event, and although we wanted to act as early as we could, we also had to take care to minimize the harms and losses, not all of which are immediately obvious. For example, we made our announcement to hold the meeting virtually in late March; we also felt a profound moral and ethical obligation to deliver the expected content on schedule. And, of course, that content, both scientific and educational, would have to be at the high standard our attendees expect and rely upon. This meant that executing the program in a virtual format would be an extraordinary undertaking with a relatively short timeline.
That said, we are very fortunate to have the infrastructure, resources, and culture in place to be able to cope with this unexpected and unprecedented logistical and technical challenge. As critical as the tools are, the “secret sauce” is the dedication of our staff, leadership, volunteers, and participants. They put in the hours, developed the vision, proposed novel solutions and “workarounds,” and any success we achieve will be thanks to them.
Presenting the Annual Meeting in Two Parts
The Annual Meeting is being split into two segments: The Virtual Scientific Program will be presented on May 29–31, and the Virtual Education Program will be presented on August 8–10. Why did you make the decision to present the programs separately?
There were a number of factors that came into play in making the decision to separate the two programs. First, in terms of the scientific program, 6,000 cutting-edge study abstracts were submitted, and we have both a moral and ethical obligation to get that information in those abstracts out on time. The abstract authors rightly expect that, and delays could mean slowing progress in cancer care and research.
“A total of 6,000 cutting-edge study abstracts were submitted, and we have both a moral and ethical obligation to get that information in those abstracts out on time.”— Clifford A. Hudis, MD, FACP, FASCO
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Then the question became, how do we deploy the program in a way that best duplicates the impact, effectiveness, and engagement of the in-person event? We quickly recognized we had to simplify the program a bit and shorten it, since attendees are unlikely to sit at their computer day after day. We also wanted to maintain as much as possible the usual and expected events and timeline. So, the study abstracts are being released for press publication on schedule, and certain regular events, such as the opening ceremony and the plenary session, will be presented pretty much as they would be at the in-person meeting.
With scheduled but streaming presentations, we hope to maintain the shared experience of hearing new information collectively. We are fortunate to have been delivering content from the Annual Meeting and our thematic meetings for years, so we have much of the technology in hand already. Second, because we wanted to make sure the scientific program goes off as smoothly as possible, we simplified the content by delaying the ASCO20 Virtual Education Program a few months until August.
Broadening Access to the Annual Meeting
What are the possible benefits of presenting the Annual Meeting virtually? Does it have the potential to expand the audience to people who otherwise might not have access to the meeting?
Yes, we hope it expands our reach and impact. Our mission is to present cutting-edge research that has the potential to advance cancer care. We want to reach as many people as we can to accomplish that goal. It is also clear we don’t know what will happen over the next 12 to 36 months in terms of the novel coronavirus and its impact. In that regard, we have to consider what in-person meetings will or might look like in the future. So, while preparing for this virtual meeting has been a steep learning curve for us, it is teaching us how to optimally and flexibly organize this type of meeting and distribute the content, which may be critically important in the coming months and years.
COVID-19 and Cancer Care
Will there be coverage of the COVID-19 pandemic and its impact on cancer care during the virtual scientific program?
Both the Virtual Scientific Program and the Virtual Education Program will have a session on COVID-19 and the challenges it is presenting to the cancer care delivery system.
A recent survey by the American Cancer Society on the COVID-19 pandemic’s effect on patients with cancer and survivors found that 50% of respondents reported some impact on their health care; 27% of patients in active treatment reported a delay in receiving treatment; more than 13% of those in active treatment said they do not know when their treatment will be rescheduled; and 38% reported being worried about their ability to pay for cancer care.1 Please talk about the short- and long-term consequences on oncology care that may result from this pandemic.
This is one of the main issues we want to try to understand through the establishment of the ASCO Survey on COVID-19 in Oncology Registry (www.asco.org/asco-coronavirus-information/coronavirus-registry), as well as through our other work. There is no doubt the pandemic will have a profound and negative impact on cancer care. We have already seen some of the early effects in interruptions in clinical trial accrual and in the decline in cancer screening and treatment rates. If screening is evidence-based and effective, then decreased rates can only mean there will be a compromise in the early detection of some cancers, an increase in advanced-stage presentations with worsened prognoses, and compromised outcomes for some patients who should have been cured.
That is one example, but there are other, less direct impacts. For example, access to both curative and palliative therapies for patients has been compromised in varying degrees in some communities and, again, that can only have a negative effect on survival. Although some types of palliative therapy have little impact on survival, others can prolong life. Even without an impact on survival, compromises in palliative care can mean increases in avoidable suffering.
There are also potential health warnings outside of oncology. A recent report from New York City described a 90% drop in the number of patients presenting with potential acute cardiovascular emergencies.2 However, it cannot be there actually has been a 90% decline in them, which means patients are not receiving care for myocardial infarctions and cerebrovascular accidents, and more. These events and deaths may not be counted as caused by COVID-19, but they represent an indirect effect, and we may see the same in oncology, as people chose not to see physicians for fear of coronavirus exposure.
In addition, the pandemic will likely exaggerate disparities in oncology care, just as it is already widening them specifically with regard to COVID-19 outcomes. As the economy contracts, and access to health insurance is threatened, and as health-care facilities are strained to the point of closing, especially in underprivileged and rural communities, we run the risk of increasing health-care disparities in these patient populations. We have to mobilize now to limit this potential harm.
DISCLOSURE: Dr. Hudis has held unpaid relationships with Alliance Foundation, Columbia University External Scientific Advisory Board, and Memorial Sloan Kettering Cancer Center.
1. American Cancer Society, Cancer Action Network: COVID-19 pandemic impact on cancer patients and survivors: Survey findings summary. Available at www.fightcancer.org/sites/default/files/National%20Documents/Survivor%20Views.COVID19%20Polling%20Memo.Final_.pdf. Accessed April 30, 2020.