ASCO 2023: a retrospective perspective

An overview from Suzanne Bobadilla and Sean Rooney

Anyone that’s ever been to ASCO’s annual meeting will know that the volume of innovation on show is so vast, it’s easy to get lost in a maze of information. There’s a lot to take in, and an awful lot more that you’ll inevitably miss.  If you don’t go home feeling exhausted, you probably did it wrong. But the weariness is worth it, because it’s impossible not to feel exhilarated by the brilliance of what’s happening in cancer, and what it might mean for patients in the future. ASCO 2023 was no different.  

As usual, teams from across VMLY&R Health went to this year’s meeting, and a month down the line, we’ve finally got our breath back! What did we learn? Well, now we’ve had a chance to reflect on what we saw, here’s our take on some of the key trends.  

#1. People are back! 

For the first time in years, it finally felt like ASCO again. People were back. Official attendance numbers aren’t yet available, but the Windy City was rammed – and only a fraction of that was down to Taylor Swift playing at Soldier Field. (She gatecrashed ASH last December, so it looks like medical congresses might be her thing). 

There was an energy and intimacy about ASCO 2023 that suggests in-person events are resurgent. All week long, colleagues, old acquaintances, friends, and strangers shuffled through the halls excitedly discussing the data, the science, and their real-world experiences. It was uplifting to see so many people connecting. We’ve missed it. Last year, ASCO attracted around 36,000 ‘professional’ delegates – but 11,000 were online-only and a good chunk more had a ‘hybrid’ experience. This year, the halls were heaving and it just felt busier. The takehome? People want connection. That’s something we shouldn’t forget as we make the most of digital disruption. 

#2. The future of cancer innovation is dependent on AI 

AI was everywhere at ASCO this year. Spoiler alert: it’s going to transform cancer care. On the face of it, that’s hardly a groundbreaking revelation. But when you zoom in on the things that are already happening, it’s hard not to get excited about where the tech could take us. 

Wherever you looked, there was evidence of AI driving major gains in drug development, diagnostics and predictive health. One session showed how machine learning – drawing on simple blood tests – achieved a specificity beyond 99% in detecting gastric cancer. Another showed how, as well as guiding discovery and development, AI is informing drug combinations and dosing. For example, in advanced solid tumors and colorectal cancers, the PRECISE.CURATE.AI model suggested optimal, personalized chemotherapy doses that were around 20% lower on average. 

We also saw how AI is building a 3D atlas for cancer. MOSAIC uses machine learning to find new biomarkers and therapeutic targets from patient samples. It could lead to a better understanding of cancer at the molecular level, and improved therapies in difficult-to-treat cancers like NSCLC, glioblastoma, and mesothelioma. 

These are just three examples. There are many more. Bottom line, AI is our gateway to personalized medicines – helping us identify individual mutations, treatments, sequences, and potential responses. We’re not there yet, but it’s coming. And when it does, our ability to deliver better outcomes through personalized care will skyrocket. However, we should never forget that no matter how much AI can be the catalyst for it, personalized care still depends on humans factors like understanding patient needs. That only truly comes through dialogue, interaction and trusted human engagement. 

#3. Adjuvant is where the action is 

One of the biggest takeaways was the attention being placed on adjuvant therapy. The adjuvant setting is blowing up everywhere, with a major focus on using targeted agents earlier, and in patients who are stage 2 or early stage 3. We’re seeing drugs moved up, both in terms of what the stage is and where they’re being used in the treatment pathway. 

Adjuvant studies presented at ASCO included: 

• Adjuvant osimertinib improving survival in patients with resected EGFR-mutated Non-small call lung cancer – lowering the risk of death in adults by 51% 
• Ribociclib + endocrine therapy as an adjuvant treatment in patients with HR+/HER2− early breast cancer – led to a significant improvement in invasive disease-free survival compared with hormonal therapy alone 
• Adjuvant treatment with a combination of atezolizumab and bevacizumab in hepatocellular cancer – led to a clinically meaningful improvement in recurrence-free survival compared with active surveillance alone 
• In patients with resectable stage II, IIIA, and IIIB (T3-4N2) NSCLC, neoadjuvant Keytruda with platinum-based chemotherapy followed by adjuvant Keytruda led to two-year event-free survival of 62.4% after 25.2 months versus 40.6% in placebo. 

#4. Scientific communications is going back to basics 

For all the advances in oncology innovation, and the dizzying potential of tech disruption, one thing stood out at ASCO this year: health is human. This was best illustrated by experiences in the exhibition hall, which felt markedly different from recent meetings. For the past few years – no doubt accelerated by COVID – booths have leaned heavily on digital engagement and virtual reality. This year, whether by accident or design, the industry seemed to go back to basics, adopting an approach that favoured human emotion over digital promotion. Companies – with the odd exception –  kept things simple, seemingly recognizing that we connect best through emotions. The experiences that resonated most didn’t go digital, they went human. 

That’s our ultimate takehome from ASCO this year: we’re humanizing healthcare. Science and tech are unleashing innovation we never thought possible, but human connection is the glue that will make it stick.