ASCO 2024: A high-level overview

The 60th meeting of the American Society of Clinical Oncology (ASCO) took place from 31 May to 4 June in Chicago. While the developments in various types of cancer were numerous, with over 7,000 abstracts presented to more than 44 thousand attendees, at a high level, the congress demonstrated ASCO’s commitment to all aspects of care for people with cancer. From palliative care, the impact of artificial intelligence, to coordination with national and international organizations, the future of cancer research and patient care is bright.

Introduction from the President of ASCO

Hear Dr Ben Gallarda’s highlights of Dr Lynn M Schuchter’s opening talk at ASCO 2024, including optimal palliative care and how artificial intelligence might help physicians. View transcript.

In the opening session the morning of 1 June, ASCO President Dr Lynn M Schuchter highlighted some of the organization’s priorities. She began by noting that the field has seen significant improvements in patient outcomes, pointing out that people with stage 4 melanoma used to see less than a year of survival, and that some are now living more than 10 years with effective treatments launched in the past decade. She commented, “We know that we can cure cancer. We now need to cure more cancers.”

Another key focus of the congress was palliative care. This term is defined by the American Cancer Society as: “Palliative care focuses on improving the quality of life by helping patients and caregivers manage the symptoms of a serious illness and side effects of treatment”.¹ Palliative care is thought by many to become increasingly relevant the longer a person is on anti-cancer therapy, especially in the case of terminal illness. Dr Schuchter pointed out, however, that while the focus used to be on end-of-life care, managing patients’ comfort throughout the course of their disease is now a priority. Both by releasing updated guidelines² and facilitating physician training programs to orient them around how to deliver appropriate care, ASCO is dedicated to ensuring people with cancer receive optimal care, both with medications and in relation to their healthcare system interactions.

Dr Schuchter also discussed the impact of palliative care. No longer a distant concept, AI is already starting to integrate into various aspects of research and healthcare. In response, ASCO has released a framework for ‘Principles for the responsible use of artificial intelligence in oncology’.³ Dr Schuchter explained that AI could aid in treatment selection in a more individualized manner, assist in matching patients to clinical trials for which they are qualified, and even reduce physician burnout by automating repetitive tasks, such as interacting with electronic health record (EHR) systems.

Dr Schuchter concluded her introduction by raising a virtual glass to all those lost to cancer with an optimism that through the efforts of ASCO and its partners, this number would hopefully decrease in the coming years. For this, she received a standing ovation.

The emergence of generative AI for biomedicine

How is AI being applied in oncology research and patient care? Dr Ben Gallarda discusses main takeaways from ASCO 2024. View transcript.

The opening session continued by expanding on the AI issue raised by Dr Schuchter, with a presentation from Managing Director of Microsoft Health Futures, Dr Jonathan M Carlson. After a brief introduction into what generative AI consists of generally, Dr Carlson noted that over 1,800 papers on AI in healthcare had been indexed on PubMed in the preceding 18 months. He provided a useful overview of the three factors explaining why AI has entered a new era:

• New mathematical models of attention
• Self-supervision
• Scaling laws

Large AI models today can digest enormous amounts of data, and the more computational power behind the model’s training, the better it will perform in using and explaining those data.

Dr Carlson categorized AI-related advances into two categories: technological substitution and ecosystem transformation. Integrating AI into physician notetaking, matching patients to clinical trials, analyzing pathology images, and recommending appropriate treatments based on patient factors are all examples of technological substitution that can be integrated with existing workflows. But there are also signs that AI developments may have significant impact on the entire oncology ecosystem. Predicting protein structure and proposing new small molecules, extracting features from patient images beyond the ability of pathologists, designing more efficient clinical trials; these are all abilities that do not exist in current oncology research. Dr Carlson concluded his presentation by encouraging the audience to take advantage of existing tools, which are quite accessible, to become familiarized with their capabilities and thus be better able to adapt as generative AI continues to expand its influence on cancer research and patient care.

Transforming clinical research with the NCI Director

“Going further, faster.” What did the recently installed NCI Director have to say about the institute’s priorities for research and patient care? Dr Ben Gallarda gives an overview. View transcript.

Another opening session presentation included comments from Dr W Kimryn Rathmell, Director of the United States’ National Cancer Institute (NCI), a major governmental funding source of cancer research. A mere 6 months into this new role, Dr Rathmell enthusiastically described the efforts of the NCI to accelerate clinical research. Two notable initiatives included the Clinical Trials Innovation Unit (CTIU) and a Virtual Clinical Trials Office. The CTIU has launched a novel ‘pragmatic lung cancer trial’ meant to streamline enrolment. Dr Rathmell noted that accrual was already much more rapid than traditional clinical trials, and that the way the trial was designed should make readout more straightforward as well via simplified trial design and innovation in data collection and electronic storage systems.

The NCI’s Virtual Clinical Trials Office is meant to resolve staffing shortages for managing trials, a phenomenon only made worse by the COVID-19 pandemic. This centralized group facilitates provision of nurses, data analysts and clinical research associates, particularly to meet the needs of research outside of major hospitals in communities and rural areas.

Dr Rathmell also noted cross-agency collaborations between the NCI and the Advanced Research Projects Agency for Health and the US Department of Energy to optimize data format. ASCO had already launched the mCODE initiative to standardize data elements in EHRs,⁴ and the NCI is supportive of efforts like this to ensure sufficient government resources in making data useful for research and other needs.

“We don’t have time to wait. We have to be impatient for our patients,” said Dr Rathmell. And indeed, reaching the US Government cancer moon-shot goal to reduce cancer mortality 50% by 2047 is something that should not wait.

Meet Dr Ben Gallarda, who leads strategy at EPG Health. View transcript.