EACH YEAR, the ASCO President chooses a theme for his or her term, which is not a trivial pursuit. Trying to think up something novel and catchy, yet not schmaltzy, is quite a challenge. However, in my year as Chair of the Scientific Program Committee for the 2010 ASCO Annual Meeting, then during my 3 years as a member of ASCO’s Board of Directors, I recognized that as President I would have the opportunity to make a small dent in one of the greatest professional medical societies in the world—certainly in oncology.
I chose a theme for my tenure as President that symbolizes what I believe ASCO represents—and does—to help us all take better care of patients with or at risk for cancer: “Making a Difference in Cancer Care WITH YOU.” As my presidential term comes to a close, this theme has played out in many ways over the past year. ASCO is an exceedingly complex organization, made up of a brilliant professional staff and dedicated, hardworking volunteers, who are all rowing in the same direction and guided by our mission statement: Conquering cancer through research, education, and promotion of the highest quality patient care to achieve our vision of having a world where cancer is prevented or cured, and every survivor is healthy.
These words are not just corporate lingo—they really do drive all that we do. At the heart of every ASCO committee, department, task force, policy statement, clinical guideline, thematic meeting, and Annual Meeting lies one issue and only one issue: “Does this represent what is best for our patients?”
Appraisal of the Past Year
That said, here are some highlights of the past 12 months. First, we saw the position of Chief Executive Officer of ASCO transition from Allen S. Lichter, MD, FASCO, who transformed the Society during his decade at the helm, to Clifford A. Hudis, MD, FACP, without a hitch. During the past year, Dr. Hudis has maintained the momentum we already had while putting his own stamp on the Society. I have every confidence he will make ASCO even more impactful over the next several years.
The past 12 months have also witnessed interesting political times. Under Dr. Hudis’ experienced hand, we have tried to maintain our singular focus; ASCO is an advocacy organization with one guiding principle: “What is best for our patients?” This question has driven our policy statements regarding the controversial executive order on immigration, as well as the release of the Administration’s proposed “skinny budget,” which includes a nearly 20% cut to the National Institutes of Health. In this regard, we were pleased with the passage of the 21st Century Cures Act, which includes funding for the Cancer Moonshot, inspired by former Vice President Joe Biden.
But we’ve been more than just reactive to the changing political winds. ASCO has also worked diligently to develop new initiatives to improve patient care. Perhaps the most visible legacy of my short time as President is the formation of the ASCO Volunteer Corps, which we are launching at this year’s Annual Meeting and expanding the existing volunteer program. Prior to taking office, I was tasked with filling roughly 250 volunteer slots in our committees and task forces as well as in other areas.
The problem? I had more than 2,000 member requests for appointments. Furthermore, I received dozens of e-mails and phone calls from ASCO committee members who were at the end of their 3-year term and wanted to stay on in their committee positions.
They are all good problems to have but problems nonetheless. The Volunteer Corps will open up more opportunities for anyone who wants to serve in the Society. If you have never been on an ASCO committee or task force, the Volunteer Corps will give you a chance to gain experience in your area of interest and provide the training and preparation to qualify for future committee positions. The program also gives ASCO members rotating off a committee a chance to remain involved in their committee or to learn about other opportunities based on their interest. The Volunteer Corps will also allow experienced members to serve as mentors to new volunteers. Furthermore, participants in the Volunteer Corps will be awarded points toward becoming a Fellow of ASCO (FASCO). We are still working out the details, but we are very excited about this new program. You can read more about it at https://volunteer.asco.org/about/opportunities.
There are other opportunities for building mentee-mentor relationships as well. For example, ASCO’s Health Disparities Committee, under the leadership of Karen M. Winkfield, MD, PhD, has developed a plan that includes a call for increased mentoring opportunities for our younger colleagues from underrepresented racial and ethnic groups who want to serve in ASCO but just don’t know how. This initiative will do nothing but strengthen an already great organization.
Focus on Research, Education, and Patient Care
In addition to supporting research through ASCO’s Conquer Cancer Foundation, ASCO recently collaborated with the Association of American Cancer Institutes (AACI) to develop the ASCO–AACI Best Practices in Cancer Clinical Trials Initiative. Led by my predecessor Julie M. Vose, MD, MBA, FASCO, the goal of the initiative is to address the inefficiencies in designing and conducting clinical trials we believe do little to ensure either scientific integrity or patient safety and are, therefore, unnecessary. We have already addressed the revision of the adverse event reporting system and are now investigating other solutions to improving the efficiency of clinical research.
Similar collaborations were launched between ASCO’s Clinical Research Committee and Friends of Cancer Research, which issued a joint statement to simplify clinical trial eligibility requirements, so trials accrue faster and enroll patients who are more representative of our real-world patients. ASCO is also now directly involved in conducting research through the Targeted Agent and Profiling Utilization Registry (TAPUR) trial, led by our Chief Medical Officer, Richard Schilsky, MD. Moreover, we will soon be making real-world cancer data now housed in CancerLinQ™ available for observational research.
Other new initiatives are on their way, including ASCO’s Education Scholars Program (ESP). Led by Jamie H. Von Roenn, MD, ASCO’s Vice President of the Science, Education, and Professional Development Department, ESP will mirror ASCO’s highly successful Leadership Development Program and incorporate the aspects of learning theory, which can help us be better educators and, in turn, better oncologists. We are also establishing an Education Council, which will be charged with reviewing and coordinating all of ASCO’s educational offerings.
And we are taking bold steps to help us all improve patient care. First, we are reaching out to other medical societies to broaden our approach and have strengthened our decade-old association with the College of American Pathologists (CAP), which began with jointly issued guidelines on testing for HER2 status and hormone receptors in breast cancer. Perhaps one of our most exciting initiatives with CAP is an effort to help low-income countries improve their pathology services. In June 2017, representatives from CAP and ASCO will be making a field trip to Honduras to learn what doctors there would like us to do to help them improve cancer diagnostics, and ultimately patient care, in their country. We hope this will be the kick-start to the development of a global program to better serve patients with cancer.
Transitioning to a Value-Based Payment System
Back home, ASCO is supporting the effort by the Centers for Medicare & Medicaid Services (CMS) to fundamentally alter how clinicians are reimbursed for their efforts and transition from a fee-for-service to a value-based Quality Payment Program (QPP). The Quality Payment Program grew out of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which ended the sustainable growth rate formula. The Quality Payment Program is already underway and will transform not just how we are paid, but how we practice medicine as well.
CMS has issued an aggressive timeline and ambitious goals for the implementation of MACRA and has challenged us to define, implement, and demonstrate high-quality oncology care to participate in alternative payment models, and ASCO has been instrumental in this process. For example, we have provided extensive feedback to proposed program rules, and many of our recommendations were included in the final document. And ASCO’s newly established Clinical Affairs Department, directed by Stephen S. Grubbs, MD, has worked closely with our Clinical Practice Committee, the State Affiliates Council, and other volunteer leaders across ASCO to develop tools to support the practice transformation all of us must undertake. Through programs such as the Quality Oncology Practice Initiative and ASCO’s Come Home Initiative, we can help you not only adapt and survive in this new environment, but thrive in it as well.
The Year Ahead
As you can see, it’s been a great year for ASCO and for me both personally and professionally, and like many of my colleagues who have served as President before me, I hate to see my tenure end.
What’s next for ASCO? I have no doubt continued expansion and success. We are in great hands with Dr. Hudis, our wonderful staff, and with my immediate successor, Bruce E. Johnson, MD, who begins his tenure as President of ASCO at the 2017 Annual Meeting. (See “Setting His Presidential Course on Making Precision Medicine a Reality for More Patients,” on page 170.) Monica M. Bertagnolli, MD, a long-time ASCO member and volunteer, will take office as President-Elect during the meeting.
As for me, I’ll have a busy year as Immediate Past President of ASCO, and then I hope to take a deep breath, work on my golf slice, and catch a few fish.