Earlier this year, ASCO announced plans for its first-ever international meeting, ASCO Breakthrough: A Global Summit for Oncology Innovators, which will be held October 11–13, 2019, in Bangkok, Thailand. The meeting is a joint effort by ASCO and the Thai Society of Clinical Oncology to bring together leaders in a variety of fields, including information and computer science, artificial intelligence (AI), basic and translational research, social media, and biomedical engineering. The goal of the summit is to transform oncology care delivery and explore how technology will influence cancer care in the coming years.
Peter P. Yu, MD, FACP, FASCO
“We wanted a meeting that was engaging and exciting, and instead of looking back at the past year, which is what a traditional medical meeting does, we wanted to look forward—to ask where we are going in the field of oncology, what innovation is already in development that will transform how we treat patients with cancer, how we educate our members, and how we will conduct research in the future,” said Peter P. Yu, MD, FACP, FASCO, Physician-in-Chief at Hartford HealthCare Cancer Institute; Past President of ASCO; and Chair of the Co-Host Committee for ASCO Breakthrough.
Currently, topics for the ASCO Breakthrough meeting include:
The meeting will feature world-renowned thought leaders from the United States, Asia, and Europe, including Philip Greenberg, MD, Head of Immunology at Fred Hutchinson Cancer Research Center in Seattle; Gilberto Lopes, MD, MBA, FASCO, Associate Professor of Clinical Medicine at the University of Miami, Editor-in-Chief of ASCO’s Journal of Global Oncology, and Co-Chair of the Organizing Committee for the ASCO Breakthrough meeting; Tony S.K. Mok, MD, FRCPC, FASCO, Li Shu Fan Medical Foundation Named Professor of Clinical Oncology and Chair of Clinical Oncology at The Chinese University of Hong Kong, and ASCO Breakthrough Program Committee Chair; and Vivian Li, PhD, Group Leader at the Francis Crick Institute in London. The keynote speakers will be Ge Li, PhD, Co-Founder and CEO, WuXi AppTec Co; Michael P. Snyder, PhD, Stanford W. Ascherman Professor and Chair, Department of Genetics, and Director, Center for Genomics and Personalized Medicine, Stanford University; and Anant Madabhushi, PhD, Researcher, Case Western University.
The ASCO Post talked with Dr. Yu about the goals of ASCO Breakthrough; how technologic innovation has the potential to transform cancer care; and what ethical dilemmas these new advances pose for clinicians, researchers, and patients.
Global Concerns of Patients and Physicians
What was the impetus for ASCO to launch Breakthrough: A Global Summit for Oncology Innovators, and why did you choose Asia to host the meeting?
The idea first surfaced while I was President of ASCO in 2014. At the time, it was important for me to have ASCO think about global health and what our responsibility should be to patients with cancer around the world as well as to the physicians who care for them. Thirty percent of our membership, which now reaches nearly 45,000, is from outside the United States, attesting to the impact we can and do have on global oncology health.
“We have a responsibility to serve all ASCO members, and we realized that United States–based meetings can only reach a fraction of global oncologists.”— Peter P. Yu, MD, FACP, FASCO
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ASCO was started in 1964 with seven physicians in Chicago and grew rapidly in the United States, which was desired, well understood, and planned for, but we didn’t anticipate or plan for such extensive growth internationally. How much greater could our impact be if we devoted greater resources to meeting the needs of our global membership?
We have a responsibility to serve all ASCO members, and we realized that United States–based meetings can only reach a fraction of global oncologists. Instead, we should be bringing our meetings to those outside the United States, and that began the discussion for the ASCO Breakthrough meeting. We selected Asia as the venue for this meeting because it is a region characterized by technologic innovation and diverse cultures, and it includes the two largest countries in the world by population—China and India. This inaugural meeting will be held in Bangkok, Thailand.
We know that many of these countries have their own oncology societies, and it was important for us not to be seen as intruders, but rather, as partners in organizing this event. As a result, we have collaborated with the Thai Society of Clinical Oncology, cohost of the Breakthrough meeting, as well as other regional oncology associations, including the China Anti-Cancer Association, Chinese Society of Clinical Oncology, Clinical Oncology Society of Australia, Hong Kong Cancer Therapy Society, Japanese Society of Medical Oncology, Japan Society of Clinical Oncology, Korean Society of Medical Oncology, Medical Oncology Group of Australia, Philippine Society of Medical Oncology, and Taiwan Oncology Society.
Our intention in developing this international meeting is not to create programs for our international membership that are not relevant to our domestic membership. Rather, we seek to leverage what we are doing domestically and make those components relevant and appropriate for countries outside the United States, develop a new thematic meeting of interest to all ASCO members, and build on our existing international relationships.
We recognize that one of the challenges to holding an international meeting is the travel expenses participants will incur. To offset some of those expenses and encourage presentation of innovative research, ASCO is offering, through our Conquer Cancer Foundation, $1,000 grants to 50 authors of the highest-rated abstracts we receive, as well as Conquer Cancer Foundation Merit Awards, which provide a $1,000 award stipend to high-scoring abstracts submitted by fellows and trainees.
Using Technology to Improve Patient Care
The keynote lecture on the opening day of ASCO Breakthrough is titled “How Technology Will Shape the Future of Cancer Care.” How is technology shaping the near future of oncology care, and what do you expect the long-term results will be?
A good illustration is AI and its potential to drive oncology innovation in such areas as cancer imaging. For example, we know that facial-recognition technology is already a reality and used daily through social media and by law enforcement. This technology can be applied to pathology and diagnostic imaging to incorporate cellular molecular biomarkers for more precise diagnosis of cancer and enhanced understanding of the host response.
Imagine you have a pathology slide with tissue from a biopsy, and there are literally thousands of cells on this one slide. Some of those cells are malignant, some of them are host stromal cells, and some of them are immune cells. The relationship of these cellular components within a slide may reveal important prognostic information. A pathologist can’t look at every single cell on a slide, but AI imaging can.
“A pathologist can’t look at every single cell on a slide, but AI imaging can.”— Peter P. Yu, MD, FACP, FASCO
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Other meeting sessions on AI will focus on biomedical engineering, robotics, and wearable devices, with experts in biomedical engineering from Stanford, Case Western Reserve University, and Johns Hopkins University School of Biomedical Engineering. The commercial availability and consumer use of wearable devices are already allowing consumers to monitor their physical activity and check their vital signs. We know that in the future, wearable and mobile technology will be increasingly used by patients to transmit information to their oncology team on side effects or complications they are experiencing from their treatment.
These devices will also be able to track and measure patients’ metabolic and physiologic function, which will help oncologists keep abreast of what is happening to them when they are not in the office or hospital. Wearable devices could give us a look into what is happening in our patients’ lives when they are not in front of us and give us the opportunity to act sooner to resolve issues. This is another area of technology that will transform and extend the scope of our interactions with patients.
Ethical Challenges of AI
Do you have ethical concerns about the use of AI technology in the context of cancer care?
“Wearable devices could give us a look into what is happening in our patients’ lives when they are not in front of us and give us the opportunity to act sooner to resolve issues.”— Peter P. Yu, MD, FACP, FASCO
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That is an interesting question. We purposely sought to add a session on medical ethics as a sober reminder that not all that glitters is gold. And because this is a meeting about medical innovation, it can include lessons learned from areas of medicine outside of oncology that might give us insight into the medical use of technology for good or bad.
As most of us are aware, the use of CRISPR [clustered regularly interspersed short palindromic repeats] technology to genetically engineer embryos resulted in the birth of the first gene-altered twin girls in 2018.1 That led to an international outcry, both at the Second International Summit on Human Genome Editing in Hong Kong, where the work was disclosed, and in the subsequent public response.
Also in 2018, the World Health Organization (WHO) created an advisory panel to develop global standards for governance and oversight of human genome editing. Earlier this year, the WHO’s advisory committee called for the establishment of a global registry of studies that involve editing of the human genome.2
We have a session at Breakthrough called “The Postgenomic Condition: Ethics, Justice, and Knowledge After the Genome” that will look at the ethical future of human gene editing and the ethical use of CRISPR. The panel includes experts in CRISPR technology, as well as a representative from WHO, who will discuss the ethical issues surrounding CRISPR technology.
ASCO Breakthrough is very different from the traditional medical meeting. It will give ASCO members and nonmembers alike a unique opportunity to learn how technology can be leveraged to treat complex diseases like cancer and improve patient outcomes, as well as how it has the potential to threaten patient privacy and safety.
How has the meeting been received among ASCO members? Has it attracted a lot of interest so far?
Yes, our members are very curious and excited about Breakthrough. They like that this meeting will be different from our Annual Meeting and our thematic meetings throughout the year and that it will focus on innovation and new ideas in cancer care. We don’t want to just give an update on information that has already been presented. We want to present out-of-the-box ideas and fresh research concepts that people are comfortable discussing. We want this meeting to be an opportunity to bring innovators together, so they can network, share ideas, and develop relationships that will help them bring their projects to fruition.
“We want this meeting to be an opportunity to bring innovators together, so they can network, share ideas, and develop relationships that will help them bring their projects to fruition.”— Peter P. Yu, MD, FACP, FASCO
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I’ve heard from several senior ASCO members, and they have voiced such great enthusiasm for this concept that they are planning on bringing to the meeting some of their junior faculty members who are working on innovative projects. In addition to inspiring research ideas, offering access to advances in technologies that can be used to solve real-world problems, and promoting peer-to-peer collaboration, Breakthrough will present study abstracts in a variety of malignancies and areas of innovation.
This conference will be an engaging and exciting opportunity to see where the field of oncology is going and how technologic innovation will transform the treatment of patients with cancer over the near horizon. ■
DISCLOSURE: Dr. Yu is Chair of the Co-Host Committee for ASCO Breakthrough.
1. Cyranoski D: The CRISPR-baby scandal: What’s next for human gene-editing. Nature 566:440-442, 2019.
2. Reardon S: World Health Organization panel weighs in on CRISPR-babies debate. Nature 567:444-445, 2019.