For the first time in its 56-year history, the ASCO Annual Scientific Meeting was held entirely virtually due to the global outbreak of the COVID-19 that swept the world. Despite the odds, the 3-day scientific program was broadcasted to a record-breaking audience of more than 42,700 attendees from 130 countries. Moreover, the content of the conference has been viewed more than 2.5 million times as of June 4, 2020. During the conference sessions, attendees were able to view 5300 abstracts and more than a hundred on-demand and broadcast sessions and over 2300 poster and oral presentations throughout the weekend. “Although the pandemic prevented us from gathering in Chicago, it didn’t stop us from fulfilling our mission of sharing knowledge to accelerate progress for millions of people worldwide living with cancer” said Howard A. Burris III, MD, FACP, FASCO, the president of ASCO. This is clearly evident in the way attendees networked with their peers via chat and one-on-one video calls and social media. “#ASCO20”, the official meeting hashtag, was used in more than 45,000 tweets from more than 8,800 Twitter users and this meeting generated more than three-quarters of a billion engagements including likes, shares, and comments on social media. This year’s scientific sessions highlighted a remarkable progress and the tremendous efforts underway to capitalize the full potential of immunotherapy and targeted therapy, find the best treatment settings and combinations and match them to the right patients. In a way, this ASCO20 meeting was groundbreaking as it overcame the pandemic barrier and brought together a record-breaking number of clinicians from across the globe to fulfill the mission of sharing knowledge to accelerate progress against cancer.
It is exciting to see the promising results from KEYNOTE-426, KEYNOTE-146, COSMIC-313 and PDIGREE that highlighted optimal strategies for combining and sequencing treatment modalities of targeted and immunotherapies. The initial results of the open-label phase 2 study of MK-6482 that targets hypoxia inducible factor signaling has opened up an avenue of a new class of therapy for treatment of VHL-associated ccRCC. Some other hot topics especially new approaches exploiting PARP inhibitors, glutaminase inhibitors, newer personalized medicine around immunotherapies, and new tyrosine kinase inhibitor strategies were also presented in ASCO20 plenary sessions.
Despite revolutionary approaches in the RCC treatment, it is apparent that intra-tumoral heterogeneity poses a significant problem for cancer management. Precision oncology approaches harnessing knowledge of heterogeneous tumor is crucial to tailor those therapies to ultimately target and improve prognosis and outcomes for patients. The article in this issue by Payal Kapur and James Brugarolas et al present an intriguing molecular genetic and morphologic evolutionary model especially focusing on prototypical model of tumor heterogeneity in renal cell carcinoma. This systematic and comprehensive ontology that captures the breath of ccRCC morphologies has profound implications both for understanding the biology of tumor progression, and for the ability to stratify patients in the clinic. Undoubtedly, this knowledge sets a paradigm for de-convoluting phenotypic complexity and establishes a comprehensive morphologic ontology of ccRCC. The other article by Ritesh Kotecha dicusses the mechanistic insights into the potential mechanisms underlying the counter-intuitive phenomenon known as obesity paradox in clear cell renal cell carcinoma. Emerging trends discussed in this article highlight that differences in the tumour microenvironment could hold the key to apparent survival advantage of obese patients with clear cell RCC versus patients at a normal weight and also emphasize such studies merit careful consideration for designing clinical trials in the future. In the Letter to the Editor column, Nirmish Singla and Shyamli Singla illustrate that the deep machine learning may be harnessed to inform clinical prognosis and therapeutic responsiveness using clear cell renal cell carcinoma as a prototype and also envision that such artificial intelligence approach may effectively shape the future of precision oncology.