Tales from ASCO: The future of cancer research

T.J. and Dr. Amod Sarnaik, the lead oncologist on his first clinical trial, presenting trial data at ASCO 2014

ASCO 2014 was more than just big headlines – press releases trickled in for the entire week afterwards, and while the major announcements hit the wires in real time, the smaller findings and stories had their time to shine, too. Here is a little more insight about the future of cancer research presented at the ASCO annual meeting at the beginning of June, and a few more tales of my beleaguered attempts to capture them.

Let’s start with the poster sessions — picture your local science fair, except replace the dioramas with whiteboard-sized layouts detailing the methods, analysis, and conclusions for dozens and dozens of research trials completed (or, in some cases, ongoing) worldwide. They are significant in both involvement and investment – even small Phase I trials cost, at a minimum, hundreds of thousands of dollars, and can easily top 7 figures; Phase II and III trials for larger drugs are in the hundreds of millions of dollars and can approach or exceed $1 billion. Many of those significant findings started out as a poster of initial investigator results years before hitting the market. Wonder why your insurance premiums are so high? The escalating cost of cancer research, and resulting treatment prices, are partially responsible.

While the biggest announcements happened during the scheduled presentations, the posters revealed insight into the smaller gains being made in research. Not every advancement has made the international splash that PD-1 has; but it also doesn’t mean they are insignificant. The breadth of research is staggering – the GSK COMBI-d study in 14 different countries was a reminder how global this issue really is. For melanoma, BRAF + MEK inhibitors, viral cancer vaccines, PV-10, PD-1 combination therapies, and several others were highlighted in posters and discussions.  The last session I attended touched on PD-1, Yervoy, and TIL/IL-2 therapies. It’s like they designed that series of presentations specifically for me - Alex from the MRA even suggested I stand up on display next to the presentation.   

Let's move on to the ASCO attendees – remember, this wasn’t your average “vacation from the office” conference, these people mean business.  While Americana was still sleeping, making breakfast, or getting ready for church, sports, beach, and summer picnics on Saturday and Sunday morning, 33,000 people in Chicago were dressed in business wear and absorbing detailed oncology studies at 8 a.m. Most of these guys and gals are stat geeks (while not close to 50/50, women have a much larger presence in the pharma/oncology world than when I worked in the industry in the late 90’s). If you liked your science AND statistics classes in school, like my buddy Cuz, cancer research conferences are for you.

The one issue (maybe we’ll call it a conundrum instead) I saw repeatedly is that there is an understandably huge burden of proof placed on the investigators to prove efficacy; that is, prove something works. This topic could be an entire separate post that will happen one day soon; but for now, the clear takeaway is the necessity of the scientific method certainly slows down progress. That statistics mindset? It is needed for objective comparison, but when you listen to presentations or look at poster data as a patient instead of a researcher, it’s difficult not to think, How can we figure out which of those treatments would put me on the ‘blue line’? (blue lines are commonly used to denote the experimental, and theoretically “better,” arm in Kaplan-Meier graphs). 

A lot of the “progress” being reported is really proving what investigators already know, think they know, or have observed. The real challenge is getting that information to the patients so they can make informed decisions on existing treatments versus promising clinical trials.

By Monday, I finally felt less out of place and a little more comfortable (double-socking the new shoes and a $20 belt from Target helped, too). I still had no idea how to interview someone, and, as Ian from the Merck PR team put it, covering ASCO as my first “assignment” was probably a little ambitious. By the time I got something jotted down during a presentation, they were usually two slides ahead. With time frames of less than 20 minutes each, and a lot of ground to cover, each presenter talked like me after a few Sambuca’s (quickly, and incoherent to the normal person). There is soooo much information it’s impossible to digest it all without a specific level of knowledge – one that I certainly don’t have yet. At the conference, I was more Thorton Mellon and less Leonard and Sheldon

On the bright side, I had all kinds of conversation starters when walking through the exhibit hall. As a patient, blogger, advocate (sort of), charity spokesperson, my many hats gave me an angle for almost every company there. (A few of those stories will end up as blog posts one day.) Just as I had a few hats to wear, so too, did many others who have made the prevention, detection, and treatment of cancer their life’s mission. As more of us are faced with this challenge, it is nice to know there is an entire stadium’s worth of people dedicated to helping you overcome the hurdle of a cancer diagnosis.

T.J. Sharpe shares his fight against Stage 4 Melanoma in the Patient #1 blog. Read more »