A Bumpy Virtual #ASCO20; Returning to
Chicago in 2021?

Called 'Incredibly Boring,' Praised as 'Special'

Nick Mulcahy

June 04, 2020

CYBERSPACE — Hope Rugo, MD, was one of the would-be attendees of the American Society of Clinical Oncology annual meeting who could not access the online event on its first day last Friday, May 29.

"Such a shame – virtual ASCO is non existent," tweeted Rugo, who is from the University of California, San Francisco.

The breast cancer specialist tried for more than hour before finally gaining entry in the late morning.

Not everyone was as successful.

That same day, Arjun Balar, MD, of NYU Langone Health in New York City, announced on Twitter that he'd quit for the day. "I give up @ASCO. Time for a cocktail."


Don Dizon, MD, of Brown University in Providence, Rhode Island, tried repeatedly to join the meeting as a live broadcast, using his desktop and laptop computers as well as an iPad. Nothing worked. Limited to seeing data and discussions "after the fact," Dizon looked to next year, tweeting hopefully: "…fingers crossed for an inperson #ASCO21."

Christopher Merlan, ASCO's chief digital officer, said that the meeting ran on infrastructure and technology that was "originally designed and built for other purposes." During the meeting, their team "made adjustments that yielded a relatively smooth experience," he said.

This year’s meeting, which involved 40,000-plus attendees, was shortened to 3 days and limited to scientific presentations because of the COVID-19 pandemic. Education sessions will be held online August 8-10.

Despite those technical glitches, dozens of virtual meeting attendees praised the online effort, which was assembled in just a few months, and called out virtues such as the quick availability of video transcripts as well as the obvious benefits of low cost, zero travel, and overall convenience. But one sentiment was nearly universal: there's nothing like the real thing.

At the same time, a Medscape Oncology online meeting poll indicated that nearly half (48%) of the 335 respondents said "no" they do not envision themselves in person at the real thing in Chicago in 2021. About one fifth (21%) said "yes, if there is a vaccine." Roughly 15% said "yes" and another 15% said "not sure right now."

What did oncologists miss most with virtual ASCO?

Many said face-to-face (F2F) interactions. Collaboration, networking, and catching up with old friends were some of the stock F2F moments cited as losses.

Others described more idiosyncratic disappointments, including Riyaz Shah, MD, of the Kent Oncology Centre in the UK, who dismissed a future with exclusively virtual meetings.

He tweeted: "Not sustainable. We need to meet F2F. Oncology is an odd one. Exposed to human distress daily (if not hourly). V[ery] few people understand what we do, fewer would do it. There aren't many people we can talk to. I love chewing the cud with my colleagues who are close friends."

The virtual meeting inspired more social media engagement but fewer oncologists participated, according to data from social media analytics firm Symplur. This year, 1K users identified as oncologists generated 17.75K tweets. In 2019, 1.3K oncologists put out 15.2K tweets.

Virtual Meeting "Like Homework"

George Sledge, MD, Stanford University, California, asked his 1700 Twitter followers to discuss the virtual ASCO experience, including the spotty functionality of presenter videos (a con) and eating dinner between talks (a pro).

One of his criticisms struck a nerve — that the online meeting was "like homework."

" 'Feels like homework' is the best expression I [have] read so far!" tweeted Gustavo Gössling, MD, from the Kaplan Oncology Institute in Porto Alegre, Brazil.

Yes, it feels "like studying alone," agreed Stanford's Lidia Schapira, MD, in a tweet.

"It's incredibly boring – let's bring back F2F next year," tweeted Ioannis Gounaris, MD, Merck Group, Cambridge, UK, in response to Sledge's request.

Sledge joined many others in saying that, ultimately, the future should include — and will demand — both virtual and in-person meetings.

What Will Happen With ASCO Next Year?

Medscape Medical News asked some virtual attendees whether they envisioned going in-person to the ASCO meeting next year in Chicago.

"Counting on it," said Harold Burstein, MD, PhD, Dana-Farber Cancer Institute, Boston. "But I also recognize that it fully depends on what happens between now and then. Vaccines. Safety of travel. Safety of large, indoor, crowded spaces."

Despite acknowledging the uncertainty of how things will "play out," Burstein advised: "Put it on your calendar and make reservations, and make sure the reservations are fully refundable."

Ahmad Tarhini, MD, from the Moffitt Cancer Center in Tampa, Florida, sounded similarly optimistic: "Hopefully we will have a vaccine by then. I expect the ASCO Annual Meeting will happen in person in 2021."

Moffitt colleague Michelle Echevarria Colon, MD, said "I could see myself attending…in Chicago in 2021." And she added: "I think we'll get to a point where it could happen."

Others were uncertain.

Ishwaria Subbiah, MD, University of Texas MD Anderson Cancer Center, Houston, said: "If someone told us 6 months ago that our 'new normal' would be in this near-total virtual existence, most of us would not have believed them. So it is hard to imagine what our reality will be in a year from now at ASCO 2021."

Jack West, MD, from City of Hope Comprehensive Cancer Center in Duarte, California, thinks the meeting will be changed for a long time, even if 2021 is a live event.

"While I think that there MIGHT be a live conference, I think it will be many years, if ever, before we see it return to its prior magnitude," he wrote in an email, echoing remarks previously made by other healthcare professionals about medical meetings in any post-COVID-19 world.

A year from now, said West, "I strongly suspect that we will still be contending with risk of exposure" and that means clinician attendees might, in turn, expose their cancer patients back home.

Despite his wistful "fingers crossed" tweet during ASCO 2020, Brown's Dizon also recently commented on Medscape that "I wonder whether I will ever sit in a crowded auditorium at an ASCO annual meeting again."

Sagar Sardesai, MBBS, Ohio State Comprehensive Cancer Center, Columbus, responded: "Unless we have a vaccine that is successful or we can demonstrate enough herd immunity in the United States, I can't imagine that such large gatherings are a real possibility. We need to protect our vulnerable populations."

City of Hope's Cary Presant, MD, acknowledged he is one of those vulnerable people. "In 2021, if the environment is safe for oncologists of my age, I will be in Chicago," he said. "But with COVID-19 still a threat, I might have to attend only virtually."

"This Year Was Special"

On social media, MD Anderson's Vivek Subbiah, MD, did not speculate about next year's meeting but observed the uniqueness of the current moment.

He tweeted: "The last 8 years of @asco are a blur in my memory. This year #ASCO was special and I'm sure we will all remember where we were for this year's meeting."

Other oncologists praised the accessibility of the virtual meeting.

"The power of a virtual meeting is it creates an unlimited number of seats at the oncology research table. Anyone globally can be involved and that is really special," said Suneel Kamath, MD, Cleveland Clinic, Ohio.

"Virtual ASCO levels the playing field for oncologists everywhere," says Bishal Gyawali, MD, PhD, from Queen's University, Kingston, Canada. In a Medscape Commentary, he notes that  "attending a typical ASCO meeting is astonishingly cost-prohibitive, especially for colleagues from low- and middle-income countries…now everybody has the same access to the meeting."

ASCO made the best out of a bad situation with the expanded virtual meeting, suggested David Henry, MD, Pennsylvania Hospital, Philadelphia, host of MDEdge's Blood and Cancer podcast, part of the Medscape Professional Network. In an interview with ASCO president Skip Burris, MD, before the meeting, Henry said: "Making lemonade out of lemons. It'll give us something new and different. What an amazing turn of events."

With additional reporting by Zosia Chustecka , Liz Neporent, Neil Osterweil, and Jennifer Smith.

Follow Medscape's Nick Mulcahy on Twitter @MulcahyNick

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