COMMENTARY

Live Meetings: Is the Juice Still Worth the Squeeze?

H. Jack West, MD

Disclosures

August 01, 2022

Picture this.

You've paid $700 to register for ASCO, another $500 for airfare, waited more than an hour in the taxi line at O'Hare to get downtown, and accepted the usual gouging rate for your ASCO hotel room. After using the mercifully efficient bus shuttle service, you get to McCormick Center for the first day of sessions and happily find a seat in crowded Arie Crown Theatre.

You soon find yourself next to several attendees who aren't wearing masks, one of whom is coughing repeatedly. Fortunately, you remember you can watch the session online, so you excuse yourself to take in the simulcast on your laptop, sitting just outside the live program.

This scenario is probably not hard to imagine. It happened to a colleague of mine at ASCO, who probably wasn't the only one.

While it's important to minimize your risk for infection, the question becomes: Why spend so much time, effort, and money to have the same experience you could have watching sessions from the comfort of home?

A Richer, and Riskier, Experience

In the wake of ASCO 2019, the last in-person ASCO before COVID-19 upended live conferences in every industry, I wrote a column illustrating how virtual meetings remained a shadow of the live event. By necessity, I experienced that virtual alternative for the next 2 years before returning to ASCO in-person this year.

Although I'd say the live meeting remains a fundamentally richer experience, there is good reason for many to wonder whether the juice is still worth the squeeze, especially when it comes with the risk of attending a super-spreader event.

Here's my take.

A key reason to attend a meeting in person is the opportunity to meet directly with colleagues. After years of not seeing each other, this year's ASCO functioned like a reunion. It carried plenty of value by facilitating connections and opportunities, but it also nourished our souls. I had the occasion to meet in person with many longtime friends, several junior colleagues I've been privileged to mentor from afar, and others who traveled from abroad.

The in-person experience also affords an opportunity for companies to meet with potential collaborators and investigators for current or future clinical trials, which is often more productive face-to-face. This year, however, uncertainty around whether COVID would disrupt plans led most companies to send much smaller delegations and rely on ASCO far less as a centralized opportunity to meet than in years past.

In terms of attending sessions, I see two main reasons to be in the "room where it happened."

First, the recollection is more special when it comes alongside sitting alongside friends and chatting about the clinical significance of new findings. Even years later, I recall gathering with friends to watch and gush over, or sometimes criticize, a presentation that has the potential to change practice or otherwise change your perspective. Reviewing important data has a more muted impact when you're watching it on the same screen you just used for a weekly department Zoom meeting.

Second, on rare occasions, the audience can share a collective inspirational experience. Take the plenary session presentation of the DISCOVERY-4 Breast Cancer study, which led to a standing ovation and tears from many in the audience. As breast cancer expert Hope Rugo, MD, mentioned to me, "Standing ovations just don't work virtually."

But such occasions are rare. I'll confess that the lung cancer sessions this year left little inspiration for either standing ovations or tears, unless we're talking tears of disappointment.

An Individualized Approach

Ultimately, perhaps the question shouldn't be whether there's value in meeting in person, but whether the incremental benefit is great enough to justify the costs and challenges compared with watching online. And this applies whether we're talking about ASCO, a meeting of trial investigators, or a clinic visit, for which a telemedicine-based encounter is now a realistic alternative.

This is a judgment call that will vary from person to person. In my column 3 years ago, I discussed the pros and cons of going to the Super Bowl vs watching from home. Though I concluded there's something inimitable about the live experience, it's also telling that I have never paid thousands of dollars and gone to great effort to travel and watch the game live. A similar idea applies to ASCO and other meetings and even to telemedicine — a valuable tool well suited for some, but not all, patients and clinical scenarios.

I think it's a great step forward that we now have alternatives to in-person meetings. For those who are presenting data, who appreciate being there together to share a common experience, and who prioritize connecting with colleagues in a way that cannot be replicated virtually, convening in person is the best option.

But for others who value getting the information with the least amount of hassle and risk, the virtual meeting represents a far more efficient and cost-effective option.

Bottom line: We may never see ASCO or similar events reach the heady attendance records of more than 40,000 people that we saw pre-pandemic. But I don't think that's necessarily a bad thing. "Personalized medicine" can also apply to how we consume the latest information.

Are there benefits or shortcomings of the live or virtual experience I'm not considering? Will we, and should we, ever go back to pre-pandemic patterns for these meetings?

H. Jack West, MD, associate clinical professor and executive director of employer services at City of Hope Comprehensive Cancer Center in Duarte, California, regularly comments on lung cancer for Medscape. Dr West serves as web editor for JAMA Oncology, edits and writes several sections on lung cancer for UpToDate, and leads a wide range of continuing education programs and other educational programs, including hosting the audio podcast West Wind.

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