COMMENTARY

How to Avoid ASCO's 'Weird,' 'Wall Street' Feel

David J. Kerr, MD, DSc

Disclosures

May 16, 2019

This transcript has been edited for clarity.

Hi. I am David Kerr, Professor of Cancer Medicine at University of Oxford. Rather than give the usual commentary with the usual pre-buildup excitement for the American Society of Clinical Oncology (ASCO) meeting, I thought perhaps we would just do a tiny video called "Lost in ASCO."

For those of you who are about the same age as me, you remember a fantastic television program from the old days called Lost in Space. I wanted to reflect a wee bit as an older doc what it has been like attending ASCO for the past 35 years.

It has changed. I remember the extraordinary excitement when I was a kid of going to ASCO. Why? It was a chance to meet one's heroes in real life at posters and after lectures. It was a chance to hear the latest-breaking science, most of which was promulgated and supported by the National Institutes of Health, the Biomedical Research Council, and the governmental funding bodies. It was a real buzz of excitement being a young cancer fellow in amongst what we considered to be the "gods of oncology"—real groundbreakers and people who had created an environment in which we would flourish.

How does it feel now? It is huge. It feels a dissonant thing to me, but I hate the feeling of being lost in a vast crowd; in a sort of chopping, changing sea of people in which it is impossible to meet anyone without having a very precise idea of where and when and how. I would say the same about the European Society for Medical Oncology (ESMO) meeting. Those of you who see me popping up know that I am a past president of ESMO. ESMO is going the same way, to an extent.

With that cognitive dissociation, for me anyway, is a feeling of a loss of self. That sounds a strange thing, but I do feel it to be the case. Despite valiant attempts by everyone, it feels as if there is a more commercial feel to the meeting. That is not gainsaying anything that pharma contributes in terms of supporting science, individuals, and the meeting. That commercial feel, the involvement of Wall Street, the burst of excitement of late-breaking abstracts, the presidential symposia, somehow linked to share price, is weird. It just feels a bit strange to me that a vast number of men and women in suits come from the financial-analytical sector to judge the market capital value of biotechs and pharma and all the rest of it. That always feels a bit odd.

The size thing has something to do with it. The last time I was at ASCO, I spent all my time in meetings outside. It was absolutely shocking. From 6:00 in the morning until 10:00 at night I was in back-to-back meetings with friends from pharma, academic collaborators, committee meetings, and with this, that, and the other. You could argue that I am too old to be educatable, but I did not get to the meeting at all. All of life seemed to be outside. Again, that is part and parcel of it becoming a vast meeting place, a dating agency, and a forum (in the truest Latin meaning) for people to come together to catch up on the latest trials, the latest ad boards, and all the rest.

It will be a wonderful meeting, you will enjoy it. Maintain your sense of self; that is important. Work out very carefully indeed what you really want to see—that which is critical to your interest and will help you to gain insight on your own science and your own clinical development pathways. Sprinkle in some other stuff. This is a big opportunity to step out from your own narrow field and just go to one or two of the sessions that you would not normally go to. For a gastrointestinal doctor: What is happening in lung cancer? What is the latest in melanoma? That sort of thing.

It is a wonderful meeting but is somehow losing a small sense of self, perhaps a small sense of duty. If only we could step back a little in time and perhaps go back to simpler, smaller, friendlier, easier days. That makes me sound like an old fogey, which I quite possibly am.

Take care and enjoy the meeting. It is fantastic. But pilot through it carefully, pay attention to detail, and pay attention to self.

Thanks for listening, as always. For the time being, Medscapers, bye-bye, and over and out.

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