What's Hot (and Overheated?) at ASCO 2018

Zosia Chustecka

May 21, 2018

The largest cancer meeting in the world is coming up soon, with 39,000 attendees descending on Chicago on June 1 for the annual meeting of the American Society of Clinical Oncology (ASCO).

"We use this as a forum for the best and brightest minds in oncology to learn about and discuss the important issues and ongoing controversies in cancer care," said ASCO President Bruce Johnson, MD, from the Dana-Farber Cancer Institute in Boston, Massachusetts.

Even though the meeting is still more than a week away, already most abstracts have been released online and are being highlighted by various vested interests. This includes companies promoting positive results with products in development, causing their stock price to rise, as well as academic cancer centers drawing attention to presentations by members of their faculty.

ASCO got the ball rolling early by highlighting six abstracts in a premeeting presscast, held on May 16, which have already garnered widespread media coverage. The organization will also hold embargoed press briefings for each day of the meeting and prepares detailed press releases for each abstract, which set out the context for the new research and also provide an outside comment. This is a very useful service for journalists preparing reports from the meeting, especially because complex science is often involved.  

But this practice has been criticized by HealthNewsReview.org , a media watchdog site that critically evaluates healthcare coverage.

"Pre-reporting on preliminary, pre-published findings is worrisome," it argues in a report issued ahead of the presscast.

"Many medical meetings do this and I'll have to say I think ASCO does a fairly good job of this Herculean task," Len Lichtenfeld, MD, a deputy chief medical officer at the American Cancer Society, is quoted as saying in the report. "But there are problems with less savvy journalists writing articles based on abstracts that haven't even been presented yet.

"This is incomplete information that hasn't been vetted or peer-reviewed," he continued. "Not infrequently the stories based on these early, embargoed abstracts will be imbalanced."

HealthNewsReview.org also points out that many media outlets produce stories that heavily depend on the prepared press materials and take the same slant on the news. "Such is the power of ASCO — the world's largest organization of cancer doctors — to influence coverage by promoting particular abstracts and framing their importance in news releases," it comments.

One example is an abstract about lung cancer screening highlighted in the premeeting presscast and in an ASCO press release, about a nationwide survey that found only 1.9% of more than 7 million current and former heavy smokers were screened for lung cancer in 2016. 

But there is no mention of "legitimate reasons smokers might have to decline screening including substantial harms and a modest benefit," says  HealthNewsReview.org, and it maintains that  "ASCO pumps up a one-sided view of lung cancer screening."  

News and Views

Much of the news may already be released, but thoughtful views on the news will come from the meeting itself, where the most important presentations are discussed by experts in the field.

At the plenary session on June 3, which will showcase what are considered to be the most important new findings, these discussant presentations will be given equal weight to the new result presentations. It is the reports from these sessions from the meeting  — such as the ones that appear here on Medscape Medical News — that have both background and explanations from experts on the clinical implications of the new research.

This year at ASCO, the plenary session will cover the following:

  • TAILORx, a phase 3 trial of women with early-stage hormone receptor–positive breast cancer who have an intermediate score on OncoType DX: Do they need chemotherapy as well as endocrine therapy?

  • Maintenance low-dose chemotherapy in patients with high-risk rhabdomyosarcoma

  • CARMENA: Do patients with metastatic renal cell carcinoma need surgery (cytoreductive nephrectomy), or can they be treated with drug alone (sunitinib)?

  • KEYNOTE-042, a study of pembrolizumab vs platinum-based chemotherapy as first-line therapy for advanced/metastatic non-small cell lung cancer in patients who do not have high tumor expression of programmed cell death ligand 1.

The plenary session will also feature the "Science of Oncology Lecture" by award recipient Douglas R. Lowy, MD, from the National Institutes of Health, who will discuss the prevention of human papillomavirus–associated cancers by vaccination.

Plus, on every morning of the meeting, in the "Highlights of the Day" session, experts on each cancer type will review the news that was presented the previous day and place the new results into the context of what is already known, commenting on whether the new data have moved the field forward.  

In addition, sessions will feature discussions of thorny issues, such as the high costs of many new cancer therapies. For example, on June 3 there will be a debate on the "Value and Cost of Myeloma Therapy," with Vincent Rajkumar, MD, from the Mayo Clinic, Rochester, Minnesota, arguing that "we cannot afford it'' against his Mayo Clinic colleague, Rafael Fonseca, MD, who counters that "we can."  

As we do every year, Medscape Medical News will have a team of reporters at the meeting, bringing you the news and views on the news as it unfolds in Chicago.

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