John L. Marshall, MD


May 23, 2013

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Hello, everybody. The 2013 America Society of Clinical Oncology (ASCO®) Annual Meeting is just around the corner. I'm excited. I know that you're excited. We're all pumped up. I've got my plane ticket, I've got my hotel room, and I remembered to add it to my reservation so that I don't screw something up and lose a bunch of money. I love the buses. I love the big excitement, the bustle, and the globalness of this meeting. I really like a lot about it.

One thing I don't like about ASCO is that I can't see anything. It's too big and too full of stuff -- thousands of abstracts and stuff for all different types of cancers. Of course, I will spend my time focused on gastrointestinal (GI) cancers. I'm going to really wallow in GI cancers, most of which I know a lot about already. Therefore, I'm going to learn very little about the other diseases. In fact, I even looked at the plenary session. It's all about bevacizumab here and there in different diseases, and I don't have a big learning curve for it.

And you know what? I have to take the boards again this year. Oh my gosh. It's my third time around. I'm 52 years old and I have to take the boards again. I don't remember how to take care of multiple myeloma or myelodysplastic syndrome, but I'm going to have to cram all of that in. And ASCO is certainly not the place for me to go and learn it. I know that.

What I would like to do, frankly, is change how ASCO works. I would like to stop presenting all those abstracts at ASCO. I think that the smaller subspecialty meetings should be presenting all the abstracts: GI ASCO, breast ASCO, etc. Let's have the data presented in their raw form at those meetings, where just the GI gang, the lung gang, or the GU gang are hanging out, and let them wallow in the data. And then bring to ASCO the information that is most critical to us as an institution, as a global front against cancer.

Let's learn from each other by sharing at that level, only bringing forward the best abstracts: the top 10 or 20 from any given disease group. Let's get them ready with some well-thought-out synthesis rather than the 1 or 2 weeks of preparation that many of us get when we're asked to speak or comment on a series of abstracts. I really continue to harp on this. I know that it's never going to change, but I do think we need to shift a lot of what is presented at ASCO to the subspecialty meetings, making ASCO a much more valuable meeting than it already is.

I am looking forward to it, though. In the GI cancer world, we're not going to see a bunch of rocket science, although I haven't seen the late-breaking abstracts, obviously. For example, we're going to talk a lot about maintenance therapy[1,2] and optimum front-line therapy for colon cancer.[3,4] We're going to look at calcium magnesium. By the way, maybe you won't need to use that much anymore, based on the abstract[5] that is online right now for prevention of neuropathy. We'll look at other treatments for gastric cancer adjuvant therapy[6] and pancreas cancer adjuvant therapy.[7] There are some refining moments for GI cancer this year.

I don't think there are any landmark, breakthrough studies, at least from the data I have seen so far. Frankly, if you're given the choice between ASCO and that great breast symposium that is going to show survival advantage curves taller than I am on a big screen, I would go to watch that. We'll synthesize for you the answers for the GI world by pretty simply following the meeting.

Many of you won't even be there. You won't even be watching online or reading it. You'll wait until the Best of ASCO after the meeting, where you'll get the synthesis that I'm proposing we actually present at the big meeting. Instead of after the fact, let's do it as part of the core mission of the meeting.

I am looking forward to seeing many of you there at ASCO. Have a great travel. This is John Marshall for Medscape.


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