The ASCO in Action Podcast provides analysis and commentary on cancer policy and practice issues. The podcast is hosted by Dr. Clifford Hudis, CEO of the American Society of Clinical Oncology. ASCO in Action, the society's internal wire-service, provides the latest news and analysis related to cancer policy. These updates provide snapshots of ASCO's ongoing advocacy efforts, as well as opportunities for ASCO members and guests to take action on critical issues affecting the cancer community. Music provided by gmz, via ccmixter.org.

ASCO in Action Podcast
Claim This Podcastby American Society of Clinical Oncology (ASCO)
Podcast Overview
The ASCO in Action Podcast provides analysis and commentary on cancer policy and practice issues. The podcast is hosted by Dr. Clifford Hudis, CEO of the American Society of Clinical Oncology. ASCO in Action, the society's internal wire-service, provides the latest news and analysis related to cancer policy. These updates provide snapshots of ASCO's ongoing advocacy efforts, as well as opportunities for ASCO members and guests to take action on critical issues affecting the cancer community. Music provided by gmz, via ccmixter.org.
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December 21, 2020
ASCO CEO Meets ASCO CMO: Retiring ASCO Chief Medical Officer Dr. Richard L. Schilsky Gives Far-Reaching Interview on this AiA Podcast
<p>Retiring ASCO Chief Medical Officer Dr. Richard L Schilsky gives a far-reaching interview with ASCO in Action podcast host ASCO CEO Dr. Clifford A. Hudis, who examines Dr. Schilsky’s trailblazing medical career, his leadership in ASCO and indelible mark on its research enterprise, and what he sees for the future of oncology. ASCO’s first-ever Chief Medical Officer even offers some friendly advice for Dr Julie Gralow, who starts as ASCO’s next CMO on February 15, 2021. In a touching tribute, Dr. Hudis also shares what Dr. Schilsky’s friendship and mentorship has meant to him personally, and suggests that Rich will still be supporting ASCO on critical priorities moving forward. Don’t miss this exchange with one of oncology’s greats!</p> <p>Transcript</p> <p>DISCLAIMER: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.</p> <p><br /> CLIFFORD HUDIS: Welcome to this ASCO in Action podcast brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insights into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org.</p> <p><br /> The ASCO in Action podcast is a series where we explore the policy and practice issues that impact oncologists, the entire cancer care delivery team, and the individuals we care for-- people with cancer. My name is Dr. Clifford Hudis. And I'm the CEO of ASCO and the host of the ASCO in Action podcast series.</p> <p><br /> For today's podcast, I am especially pleased to have as my guest my friend, colleague, and mentor Dr. Richard Schilsky, ASCO's chief medical officer. Now, I am sure that many of our listeners have already heard that Dr. Schilsky will be leaving ASCO in February of 2021, retiring.</p> <p><br /> However, I want to reassure everybody that even in retirement, he will continue to make contributions and provide leadership to all of us. And his illustrious and path-blazing career in oncology spanning more than four decades is not quite over thankfully.</p> <p><br /> Rich is ASCO's first chief medical officer. And as such, he has made a truly indelible mark on all of us. He started with a proverbial blank piece of paper. The position had no precedent. It had no budget. It had no staff.</p> <p><br /> But now after just eight years in the role, he has helped make the CMO a critically important position at the society. And I have to say that success is more than anything due to Rich's vision and his leadership. And that's some of what we'll be talking about today.</p> <p><br /> So Rich, thank you very much for joining me today for what I hope is going to be a great casual but informative conversation about your amazing career, your unique role at ASCO, and maybe most importantly in the end what you see for the future of oncology not just in the United States, but around the world. Thanks for coming on, Rich.</p> <p><br /> RICHARD SCHILSKY: Thanks, Cliff. It's great to be here today.</p> <p><br /> CLIFFORD HUDIS: So with that, let's just dive right in and start at the very beginning. Rich, tell everybody why you decided to become an oncologist and maybe share a little bit about what those early days looked like for you and, in that context, what it was like to have cancer at the beginning of your career.</p> <p><br /> RICHARD SCHILSKY: Well, I knew from an early age that I wanted to be a doctor. And in fact, I had written a little essay when I was in sixth grade as a homework assignment called My Ambition. And my mother had tucked that away in a scrapbook. And I found it a number of years ago. And on rereading it, it was quite amazing to me to see what I was thinking about even then.</p> <p><br /> Because I said not only did I want to be a doctor, but I didn't think that was enough, that I wanted to be a medical researcher because I wanted to discover new information that would help people heal from whatever their diseases might be.</p> <p><br /> And so it was never really any doubt in my mind that I would be a physician. I went to medical school at the University of Chicago. But I was living in New York City at the time having grown up in Manhattan. And the only year we had off in medical school, the only time we had off in medical school, was the summer between the end of the first year and the beginning of the second year.</p> <p><br /> So during that time, I went back to Manhattan. And I was able to get a fellowship from the American College of Radiology that allowed me to essentially hang out in the radiation therapy department at New York University Medical Center, which was within walking distance of where I grew up. And so I would go over there every day. And I was taken under the wing of a young radiation oncologist.</p> <p><br /> And of course, I wasn't really qualified to do anything at that point except to follow him around, talk and listen to the patients. But that turned out to be a really formative experience for me because we saw the whole gamut of cancer. We saw head and neck cancers. We saw lung cancer. We saw patients with breast cancer and prostate cancer.</p> <p><br /> And in those years-- this is the early 1970s-- many of these patients have fairly locally far advanced disease and were quite debilitated by it. But listening to their stories, hearing about their hopes and their struggles, really demonstrated to me the human side of cancer.</p> <p><br /> So I went back to school and thought about this in the context of my own personal experience, which dated back to when I was in college when my mother's mother, my maternal grandmother, was diagnosed with breast cancer. This was 1968. And as you well know, there were very few therapies available for breast cancer in the late 1960s, mostly hormone therapies.</p> <p><br /> And my grandmother had the treatment that was considered standard of care at that time, which was extended radical mastectomy followed by chest wall radiation. And some years after that first mastectomy, she had a breast cancer that developed in the opposite breast and had a second extended radical mastectomy and chest wall radiation. And these were very traumatic and disfiguring procedures for her to go through.</p> <p><br /> Anyway, long story short is after another few years, she developed bone metastases and then brain metastases. And there was really very little that could be done for her other than hormone therapies. And having observed her go through that illness and realizing how limited our treatment options were and then having the experience after my first year in medical school pretty well cemented for me that I wanted to be an oncologist.</p> <p><br /> I thought actually about being a radiation oncologist. But then I did my internal medicine rotation in medical school, fell in love with internal medicine. And that sort of put me on the path to be a medical oncologist.</p> <p><br /> The clinical challenge of caring for cancer patients, the emotional attachment to those patients, and, of course, even then, the unfolding biology of cancer was so intellectually captivating that I actually applied for oncology fellowship when I was a senior medical student. So even before going off to do my medical residency, I had already been accepted as a clinical associate at the National Cancer Institute to start two years hence. And that's how I became an oncologist.</p> <p><br /> CLIFFORD HUDIS: So it's so interesting. Because, of course, the story I'm sure for many people interested not just in oncology, but even medical education, there are little things that don't happen nowadays that happened with you like that last little vignette about the early acceptance into an advanced training program before your fellowship among other things.</p> <p><br /> Can you remind us about the timeline? Because I think one of the things that many of our listeners often can lose sight of is just how new oncology really is as a specialty. ASCO itself founded in 1964. And the first medical oncology boards were mid-'70s, right? So you were in med school just before that second landmark, right?</p> <p><br /> RICHARD SCHILSKY: That's right. I graduated from medical school in 1975. I started my oncology fellowship in 1977. And I got board-certified in medical oncology and joined ASCO in 1980. And so that was the time frame at that point.</p> <p><br /> CLIFFORD HUDIS: So the internal medicine was actually, if I heard you right, just two years, not the now traditional four.</p> <p><br /> RICHARD SCHILSKY: Yeah. I was a short tracker. I did only two years of internal medicine training rather than three. I did my training at Parkland Hospital and University of Texas Southwestern in Dallas with at that time a legendary chair of medicine, Don Seldin, who I had to get permission from him to leave the program prior to completing the third year of residency because I had already been accepted into fellowship at NCI.</p> <p><br /> And he, Seldin, who was a brilliant chairman and a brilliant nephrologist, was not at all interested in cancer. And it took a bit of-- I was going to say arm twisting, but it really took bleeding on my part to get him to agree to allow me to leave the residency program to go to the NCI. But he eventually agreed.</p> <p><br /> And in those years, the first-year clinical fellowship at the NCI was like being an intern all over again. There were about 15 of us. We were on call overnight in the clinical center once every two weeks. We cared for all of our inpatients as well as had a cadre of outpatients.</p> <p><br /> We did all of our own procedures. We had no intensive care unit. So patients who were sick enough to require ventilator support, we cared on the floor in the inpatient service on our own with guidance from senior oncologists. It was a bit different from the way it is now. But, of course, it was fantastic on-the-job training because we just learned a ton and had to learn it very quickly.</p> <p><br /> CLIFFORD HUDIS: So that's actually a great segue to the advances because there was a lot to learn then. But, wow, there's a lot more to learn, I think, now. And I have real sympathy for trainees and younger oncologists for the breadth of what they need to learn. Again, just testing your memory, but platinum came along pretty much in the mid-'70s as well, right? That was a pivotal expansion of the armamentarium for us.</p> <p><br /> So what do you see-- when you summarize progress in cancer research and care over these decades, what do you think are the most pivotal or revolutionary milestones that you identify over the span of your career?</p> <p><br /> RICHARD SCHILSKY: Yeah. It's really interesting to think about it historically. There were the early years of discovery in oncology from the 1950s to the 1970s when we really had the introduction of the first chemotherapy drugs and the miraculous observation that people with advanced cancer could actually obtain a remission and, in some cases, a complete remission with chemotherapy and combination chemotherapy in particular.</p> <p><br /> And so that was the formative years of oncology as a medical specialty and really proof of concept that cancer could be controlled with drugs. When we got into the 1980s, the 1980s in many respects were the doldrums of progress in clinical oncology. There really was not a lot of innovation in the clinic.</p> <p><br /> But what was happening and what was invisible to many of us, of course, was that was the decade of discovery of the fundamental biology of cancer. That's when oncogenes were discovered, when tumor suppressor genes were discovered, when it became clear that cancer was really a genetic disease. And that is what transformed the field and put us on the path to targeted therapy and precision medicine as we think of it today.</p> <p><br /> So I think that clearly understanding the biology of cancer as we do now and all that it took to lead us to that point, which was a combination of understanding biology, developing appropriate technology that would, for example, enable the sequencing of the human genome and then the cancer genome.</p> <p><br /> And the other formative technology in my opinion that really changed the way we care for cancer patients was the introduction of CT scanning. When I was still a fellow at the NCI, we did not have a CT scanner. If we needed to get detailed imaging of a patient, we did tomography. And if you remember what tomograms looked like, they were really blurry images that you could get some depth perception about what was going on in the patient's chest or abdomen. But they really weren't very precise.</p> <p><br /> When CT scanning came along, it really revolutionized our ability to evaluate patients, assess the extent of disease, stage them in a much more precise way, which then allowed for better patient selection for curative surgery, better radiation therapy planning. So we don't often point to imaging advances as some of the transformative things that paved the way in oncology, but I think imaging is really overlooked to some extent.</p> <p><br /> So I think the technology advances, the biological advances, are the things that really allowed the field to move forward very quickly. And by the time we got into the mid-1990s, we were beginning to see the introduction of the targeted therapies that have now become commonplace today.</p> <p><br /> And then it was around 2000, I think, that we saw the introduction of Gleevec. And I'm reminded always about an editorial written by Dan Longo in The New England Journal a few years ago. And Dan and I were fellows together. We worked side by side on the wards at the clinical center and became very good friends.</p> <p><br /> And Dan in his role as a deputy editor of The New England Journal wrote an editorial a few years ago that was titled "Gleevec Changed Everything." And Gleevec did change everything. It changed our entire perception of what were the drivers of cancer and how we might be able to control cancer very effectively and potentially put it into long-term remission.</p> <p><br /> Now, of course, we know now that the whole Gleevec story is more of an exception than a rule in targeted therapy. And, of course, we know that tumors become resistant to targeted therapies. But we couldn't have known any of this back in the early years of oncology because we had no real insight into what caused cancer to grow or progress. And the notion of drug resistance, while we realized that it occurred, we had no idea what the mechanisms were. So it's such a different landscape now than what it used to be. It's quite remarkable.</p> <p><br /> CLIFFORD HUDIS: So as you tell the story, there's, of course, a lot of focus on technology, whether it's biology and understanding the key features of malignancy or imaging or more. But what I also note in your story and I want to come back to is the people. And I can't help but reflect on where we are in this moment of the COVID-19 pandemic. Yes, we've moved to telemedicine. Everything can be accomplished via technology. And, yet, the human touch is so important.</p> <p><br /> When we think about being in the room with people, when we think about face to face from the context of career development and your own career, you touched on Dr. Seldin, I think, already from the perspective of internal medicine training. But are there are other mentors or important shapers of your career that you think we should know about?</p> <p><br /> RICHARD SCHILSKY: Well, probably, the most influential person early in my career in medical school was John Altman. John, you may know, was the inaugural director of the University of Chicago's NCI-designated Cancer Center, which was one of the very first NCI-designated cancer centers in 1973 after the National Cancer Act of 1971 created the cancer centers program.</p> <p><br /> And John, who was a leading oncologist studying Hodgkin and non-Hodgkin's lymphoma, was a faculty member there. He was the director of our cancer center as I said. He took me under his wing even when I was in medical school and served as a real role model and mentor to me.</p> <p><br /> When I was in my internal medicine training as I mentioned earlier, Don Seldin, the chair of medicine, was never particularly interested in oncology. So, to some extent, I didn't have-- I had great internal medicine training. But I did not have good mentorship in oncology. When I got to the NCI, then my whole world really opened up.</p> <p><br /> And the two pivotal people there in my career were Bob Young, who was chief of the medicine branch and was my clinical mentor and remains a mentor and friend to this day, and then, of course, Bruce Chabner, who was the chief of the clinical pharmacology branch.</p> <p><br /> And in my second year of fellowship when we all went into the laboratory, I went into Bruce's lab. And that's where I really got interested in the mechanism of action of anti-cancer drugs and ultimately in drug development and early phase clinical trials. And both Bob and Bruce remain very close to me even today.</p> <p><br /> CLIFFORD HUDIS: So I'm concerned about time on our call today on our discussion. Because we could obviously fill lots of hours on all of these remarkable experiences and amazing people you worked with. But I'm going to ask that we fast forward a little bit.</p> <p><br /> You and I share, I think, passion and love for ASCO. So I think that it's reasonable for us to focus a little bit on that for the time we have left here. You didn't start out obviously as chief medical officer at ASCO. But you were a really active ASCO volunteer and leader. Maybe tell us a little bit about some of the ASCO volunteer roles that you engaged in and what that meant to you at the time and how that led to this role.</p> <p><br /> RICHARD SCHILSKY: Well, I'll be brief. I joined ASCO in 1980 at the first moment that I was eligible to join ASCO. I had attended my first ASCO meeting the year before, 1979, when I was still in my fellowship training. And it was clear to me even then when the whole annual meeting was about 2,500 people in two ballrooms in a hotel in New Orleans that that was a community of scholars and physicians that I wanted to be a part of.</p> <p><br /> And so, over the years, I did what people do even today. I volunteered to participate in whatever ASCO activity I could get involved with. Over the years-- I think I counted it up not too long ago-- I think I served or chaired 10 different ASCO committees, more often serving as a member, but in a number of those committees also serving as the chair over many years.</p> <p><br /> And as I became more deeply involved in ASCO and saw other opportunities to engage, I had the opportunity to run for election to the board and was-- after a couple of tries was elected to serve on the board and then eventually elected to serve as ASCO president in 2008-2009.</p> <p><br /> But the attraction of ASCO in many ways was a community of diverse but, in many ways, like-minded people, people who had similar passion and drive and focus. But I think what you get at ASCO in many ways is the wonderful diversity of our field. If you work in a single institution for much of your career as I did and as you did, you get to know that institution pretty well. You get to know its perspectives and its biases and its strengths and its weaknesses.</p> <p><br /> But there's a whole world of oncology out there. And you can get exposed to that at ASCO because you meet and work with colleagues from every clinical setting, every research setting, people who have remarkable skills and interests and passions. And it's just a wonderful environment to help develop your career. So I consider myself to be extremely fortunate to have had the journey in ASCO that I've had culminating, of course, with ultimately my coming on the staff as ASCO's first chief medical officer.</p> <p><br /> CLIFFORD HUDIS: We often joke about that blank sheet of paper. But in retrospect, it's very obvious that you had built up that collection of LEGO blocks, and then you assembled them all into the ASCO Research Enterprise, a name you gave it.</p> <p><br /> And it really, in retrospect, builds, I think, very cleanly upon all of your prior experience, but also the vision that you developed based on that experience for how research should be conducted. Can you maybe share with everybody the scope and vision for the ASCO Research Enterprise, what the intent was, and where you see it going, and what it includes today?</p> <p><br /> RICHARD SCHILSKY: Sure. I won't claim that I came to ASCO with the whole thing fully developed in my mind. As you said, when I came, I literally did have a blank slate. Allen Lichter, who hired me, said, come on board and help me make ASCO better. And so I, in a sense, reverted to what I knew best how to do, which was clinical research.</p> <p><br /> And having in my career been a cancer center director, a hem-onc division chief, a cooperative group chair, I had a lot of experience to draw on. And it was obvious to me that ASCO was fundamentally an organization that took in information from various sources, evaluated it, vetted it, collated it, and then disseminated it through our various channels, most notably our meetings and our journals.</p> <p><br /> But ASCO itself did not contribute to the research enterprise. And that seemed to me to be a lost opportunity. We knew that ASCO had lots of data assets that could be of interest to our members and to the broader cancer community. But they were scattered all around the organization and not particularly well annotated or organized. So we began to collate those. And they are now available to ASCO members on the ASCO data library.</p> <p><br /> I recognized that we did not have an organized unit in ASCO to support or facilitate or conduct research. So, in 2017, we formed the Center for Research and Analytics and brought together staff who were already working at ASCO but scattered in different departments but all people who had an interest in clinical research or research policy and brought them into this new unit, which has really become the focal point for research work at ASCO.</p> <p><br /> We recognized that ASCO members for many years were interested in surveying their colleagues, surveying other ASCO members, to help advance research questions. But ASCO actually had a policy that prohibited that.</p> <p><br /> So that never really made good sense to me. It seemed like a lost opportunity. And we were able to create a program and have the ASCO board approve it whereby any ASCO member could opt in to participate in what we now call the Research Survey Pool.</p> <p><br /> And in doing so, they are essentially agreeing to participate in research surveys conducted by their colleagues. So that program is now up and running. There are, I think, eight surveys that have been completed or are currently in the field. And this is now a service that ASCO provides through CENTRA to its members to enable them to survey their colleagues for research purposes.</p> <p><br /> Most importantly, I think we saw an opportunity back in 2014 or 2015 to begin to learn from what our colleagues were doing in clinical practice as they began to deploy precision medicine. And there was a lot of genomic profiling that was going on at that time. It was revealing actionable alterations in roughly 30% or so of the tumors that were profiled.</p> <p><br /> But there was a lot of difficulty in doctors and patients obtaining the drugs that were thought to be appropriate to treat the cancer at that particular time because most of those drugs would have to be prescribed off label. And there was not a sufficient evidence base to get them reimbursed. And, moreover, even if they could be reimbursed, there was no organized way to collect the patient outcomes and learn from their experiences.</p> <p><br /> So that led to us developing ASCO's first prospective clinical trial, TAPUR, which really solves both of those problems. Through the participation of the eight pharmaceutical companies that are engaged with us in the study, we are providing-- at one point, it was up to 19 different treatments free of charge to patients.</p> <p><br /> These are all marketed drugs but used outside of their FDA-approved indications. And we were collecting data on the patients, the genomic profile of cancer, the treatment they received, and their outcomes in a highly organized way.</p> <p><br /> And so now this is a study that we launched in 2016. We're now almost to 2021. We have more than 3,000 patients who have been registered on the study, meaning consented to participate, more than 2,000 who have been treated on the study. And we are churning out results as quickly as we can about which drugs are used or not useful in the off-label setting for patients whose tumors have a specific genomic profile.</p> <p><br /> So we built all this infrastructure. And having this in place has also then allowed us to respond rapidly to unmet needs. So when the COVID-19 pandemic overwhelmed all of us, and when our members were looking for information about what was the impact of COVID-19 on their patients, one of the things we were able to do because we had CENTRA, because we had a skilled staff and an infrastructure, was to very quickly stand up the ASCO COVID-19 registry, which we launched in April of this year.</p> <p><br /> And there are now about 1,000 patients who've enrolled in the registry from around 60 practices that are participating. And we will follow these patients now longitudinally and learn from their experiences what has been the impact of the COVID-19 illness on them and their outcomes, how has it disrupted their cancer care, and ultimately how that impacts their overall cancer treatment outcomes.</p> <p><br /> So as I now contemplate leaving ASCO after eight years having started with a blank slate, I'm very proud of the fact that I think I'm leaving us with a remarkable infrastructure. We now have a clinical trials network of 124 sites around the country participating in TAPUR that we never had before. We have through the work of CancerLinQ a real-world evidence data generator that is beginning to churn out valuable insights.</p> <p><br /> We have a capacity to survey ASCO members for research purposes. We have an ability to stand up prospective observational registries to gather information longitudinally about patients and their outcomes. We have a core facility in CENTRA with highly skilled data analysts and statisticians that can support these various research activities.</p> <p><br /> So ASCO is now primed, I think, to really contribute in a very meaningful way to the gaps in knowledge that will forever exist in oncology just because of the complexity of all the diseases we call cancer. And that's what I mean by the ASCO Research Enterprise. It is in fact remarkable and, I think, powerful enterprise if we continue to use it effectively.</p> <p><br /> CLIFFORD HUDIS: Well, that's an interesting segue to my next thought, which is really about what comes next. I'll talk about you. But let's start with ASCO first. Your successor, Dr. Julie Gralow, obviously has been announced publicly. She's an accomplished clinician and researcher. She has a known recognized passion for patients, patient advocacy, clinical research through her leadership at SWOG but also health care equity and global oncology.</p> <p><br /> So from your perspective, having created all of these assets and resources, what advice would you give Dr. Gralow publicly on how to make the position hers, what to take us to next? And I do want to acknowledge for everybody listening that the hints I've been making up until now are that Rich has agreed that he will continue to contribute as a leader to TAPUR for the short term, at least, at least the next year helping Julie get fully oriented to this program and others. So what will your advice be to Julie?</p> <p><br /> RICHARD SCHILSKY: That's a great question. She's a great selection. And congratulations on hiring her. I think there are two key issues, I think, maybe three. One is to have a broad scope and cast a wide net. Oncology care and cancer research and cancer biology are incredibly complicated and nuanced and broad in scope.</p> <p><br /> And although Julie is an accomplished breast cancer clinician and researcher, in this role at ASCO, you have to be very broad. You have to understand all of cancer care, all of cancer research, all of policy and advocacy not as an expert in necessarily in any one aspect of ASCO's work, but you have to understand the impact of all of those things on cancer care providers and on cancer patients.</p> <p><br /> And it's important to always be looking to the future. The future is going to be here before you know it. And we as a professional society have to prepare our members for that future. So that leads me to the second point, which is listen to the members.</p> <p><br /> The members are the people on the front lines who are delivering care to patients every day. And, fundamentally, ASCO's job is to be sure that our members have all the tools and knowledge and resources that they need to deliver the highest quality care to patients every day. So listening to what they need, what their struggles are, what their burdens are, is extremely important.</p> <p><br /> And then the third thing I would recommend to her is that she get to know the staff and colleagues that she'll be working with. ASCO has a remarkably accomplished, skilled, motivated, passionate staff, many of whom have been with the organization for years, if not decades, who understand what ASCO can and cannot do and who understand what our members need. And she will be well advised to spend a good portion of her first few months on the job just listening and learning from her colleagues.</p> <p><br /> CLIFFORD HUDIS: That's always good advice for anybody making a big career move. But, of course, the wisdom you bring to it is palpable and much appreciated. And I'm sure Julie will be taking your advice. And, by the way, so will I continue to do that even after you make your move. So speaking of your retirement, can you share with us a little bit about what it's actually going to look like for you? Is it about family? Or are you still going to have some professional engagement? Again, I suggest that there might be some already, but maybe you could expand on it.</p> <p><br /> RICHARD SCHILSKY: Yeah. I'm still fully focused on my work at ASCO. And, of course, as you know, when I wake up on February 15, I will no longer be ASCO's chief medical officer. And it's going to be a bit of a rude awakening. Fortunately, I will be able to continue my engagement with ASCO through the TAPUR study as you mentioned. I will, of course, forever be at ASCO member and a donor to Conquer Cancer and be willing to serve the society in any way.</p> <p><br /> I have a number of activities that I've been involved with even throughout my time at ASCO. Not-for-profit boards, for example-- I'm on the board of directors of Friends of Cancer Research. I'm on the board of directors for the Reagan-Udall Foundation for FDA.</p> <p><br /> I plan to continue with those activities as long as they'll have me. I've been serving the last few years on the board also of the EORTC, the large European cooperative clinical research group. And I expect to continue in that role.</p> <p><br /> Beyond that, I will see what opportunities come my way. I think one of the things about retirement if you will that I'm looking forward to is the opportunity to pick and choose what to work on based on what interests me without having the burdens of having a full-time job.</p> <p><br /> On the personal front, of course, we're all looking forward to crawling out from the pandemic. I've basically been locked in my home outside Chicago since March. And I'm looking forward to getting back out to a little bit of a social life. As you know, I have two grown daughters and now three grandchildren, two of whom are in Atlanta, one of whom is near by us in the Chicago area. So looking forward to spending time with them as well.</p> <p><br /> So it will be a change for me to be sure after working as hard as-- I feel like I've worked for really now 45 years since I graduated from medical school. But I also feel like I'm not quite done yet and that I still have ways in which I can contribute. I just feel like at this point, maybe it's time for me to choose how I want to make those contributions and spend a little bit more time doing some other things.</p> <p><br /> CLIFFORD HUDIS: Well, both you and my predecessor, Allen Lichter, are modeling something, have modeled something, that I think is not often discussed but can be very important. For people and for institutions, change is not a bad thing. And setting the expectation that you will pour your heart and soul into something but not necessarily do it alone or forever and not prevent others from taking that role at some point, that's a really-- I think it's a selfless kind of sacrifice in a way.</p> <p><br /> Because, of course, you could stay and do what you're doing for longer. But as you and I have discussed, there is a value for all of us collectively in having fresh eyes and new people take organizations in a new direction. That's how I ended up here frankly. And I think that's the kind of opportunity you're creating right now, something that should be celebrated in my opinion.</p> <p><br /> RICHARD SCHILSKY: Well, thanks. And I couldn't agree more. When I look back at the arc of my career and having all the different kinds of leadership roles that I've had, I basically have made a job change every 8 to 10 years. I was the director of our cancer center for nearly 10 years. I was associate dean for clinical research at the University of Chicago for eight years, another position that I created from a blank slate at that institution.</p> <p><br /> The exception was serving 15 years as a CALGB group chair. But that was a position I really loved and enjoyed and felt like at the end of the first 10 I hadn't quite accomplished everything I wanted to accomplish.</p> <p><br /> But the point is that I think it is both necessary for organizations to have regular leadership change. And it's also refreshing for us as individuals. There gets to a point where you feel like you can do your job in your sleep. And I actually think that's a good time to make a change.</p> <p><br /> Because if that's the way you feel, you're not being sufficiently challenged. And you're probably not being sufficiently creative. And so it's a good time to move on and refresh your own activities and give your organization a chance to bring in someone to hopefully build on whatever you've created and bring it to the next level.</p> <p><br /> CLIFFORD HUDIS: Well, I agree with all that, although I think your comment there about doing the job in your sleep would not apply because I'm pretty confident that the environment and opportunities have continued to evolve in a way that has made it interesting from beginning to end. But you don't have to rebut me on that. I just want to thank you very, very much, Rich.</p> <p><br /> As we set up this podcast, I expected that we would have a really fun and enlightening conversation. And, of course, you did not disappoint. We could talk for much, much longer if we only had the time.</p> <p><br /> On a personal note to you and for the benefit of our listeners, I want to share that Rich has been for me a remarkable friend and mentor and colleague. I first met Rich at the very beginning of my career when my mentor, Larry Norton, pushed me out from Memorial into the larger world. And he did that first and primarily through ASCO and the Cancer and Leukemia Group. Those are really the two places where I was exposed to the world.</p> <p><br /> And through the CALGB, Rich really began to offer me and others, many others, opportunities that shaped careers plural, mine and others. So when I got to ASCO as CEO, Rich was there. And I knew I could always depend on you to be clearheaded, intellectually precise, constructive, visionary. And the thing about you, Rich, is that you never would say yes to anything unless you knew for sure you could do it and indeed, I think, how you could do it.</p> <p><br /> I always share this story which your staff at CENTRA pointed out to me. And I have to admit that I hadn't picked it up myself. But in all the years of now working down the hall from Rich, probably hundreds and hundreds of hours of meetings, he never has taken a note in front of me. And, yet, everything we talk about, every action item we conclude to pursue, they all get done.</p> <p><br /> So I don't know, Rich. You have a remarkable way of organizing your thoughts and your plans, keeping it together, and getting things done. And I'm going to miss that tremendously in the years ahead.</p> <p><br /> So, Rich, I want to say congratulations. Congratulations on reaching this really important milestone in your life. Thank you on behalf of ASCO and the broader oncology community and the patients we care for and their families for making the world a better place. And just as a small thing, thank you for joining me today for this ASCO in Action podcast.</p> <p><br /> RICHARD SCHILSKY: Thank you, Cliff. It's been great.</p> <p><br /> CLIFFORD HUDIS: And, for all of you, if you enjoyed what you heard today, don't forget to give us a rating or a review on Apple Podcasts or wherever you listen. And, while you're there, be sure to subscribe so you never miss an episode. The ASCO in Action podcast is just one of ASCO's many podcasts. You can find all of the shows at podcast.asco.org. Until next time, thank you for listening to this ASCO in Action podcast.</p>

September 2, 2020
Sneak Preview: ASCO to Hold First-ever Virtual Congressional Advocacy Summit and Week of Action in 2020
<p>In the latest ASCO in Action podcast, ASCO CEO Dr. Clifford A. Hudis shares a quick preview of what's to come for the 2020 ASCO Advocacy Summit and Week of Action, which will take place September 14-18.</p> <p>Typically, ASCO volunteers from across the country gather in Washington, D.C. to advocate for policies that will improve access to high-quality, equitable care for people with cancer and ensure robust funding for cancer research through in-person meetings with their Members of Congress. Due to the COVID-19 pandemic, the 2020 ASCO Advocacy Summit will be a virtual event, but participants can expect the same important advocacy and education opportunities that the event provides every year. All ASCO members are encouraged to participate in the Congressional Week of Action by signing up with the ACT Network (through the Advocacy Center on ASCO.org).</p> <p>Subscribe to the ASCO in Action podcast through <a href= "https://podcasts.apple.com/us/podcast/asco-in-action-podcast/id1336591077?mt=2"> iTunes</a> and <a href= "https://play.google.com/music/listen#/ps/Ijanchb3n57zxdgfjvle5atf67a"> Google Play</a>.</p> <p> </p> <p><strong>Transcript</strong></p> <p><strong>Disclaimer:</strong> The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.</p> <p><strong>Dr. Clifford Hudis:</strong> Welcome to the ASCO in Action Podcast, brought to you by the ASCO Podcast Network, a collection of 9 programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all of the shows, including this one, at “Podcast dot ASCO dot org” (podcast.asco.org)</p> <p>The ASCO in Action Podcast is ASCO’s podcast series that explores the policy and practice issues that impact oncologists, the entire cancer care delivery team, and the individuals we care for—people with cancer.</p> <p>I’m Dr. Clifford Hudis, CEO of ASCO and the host of the ASCO in Action podcast series. For this podcast, I wanted to share with listeners a preview of the 2020 ASCO Advocacy Summit and Week of Action taking place September 14-18.</p> <p>Typically, ASCO gathers volunteer advocates in Washington, D.C., in September for education sessions and in-person meetings with their Members of Congress.</p> <p>Due to the COVID-19 pandemic—like so many events scheduled to take place this year—the 2020 ASCO Advocacy Summit will be a virtual event, but that said, participants can expect the same advocacy and education opportunities that the event provides every year.</p> <p>ASCO volunteers will meet with Members of Congress and their staff by phone or video to advocate for policies that will improve access to high-quality, equitable care for people with cancer and ensure robust funding for cancer research.</p> <p>Advocacy Summit attendees will also attend webinars to receive education and training on lobbying Congress and the current political landscape.</p> <p>What is different this year is our online Week of Action, which will give all ASCO members an opportunity to advocate on critical issues of great importance to the cancer care delivery system in the United States.</p> <p>Participants in the Week of Action will amplify the Advocacy Summit’s messages through email and social media messages to Members of Congress using ASCO’s ACT Network. And, it’s easy to get involved and make your voice heard. You just need to click on the link to the ACT Network in the Advocacy Center on ASCO.org and sign up to receive ASCO ACT Network emails. Then, you’ll get all the information on the fastest and easiest ways to contact lawmakers delivered directly to your inbox. We hope you will participate as much as you can—the effort will take just minutes. Even one message a day by every ASCO member to your representatives in Congress will have a tremendous impact.</p> <p>During the virtual Advocacy Summit, which will be held in the middle of the Week of Action on September 16, ASCO volunteer advocates will have their virtual meetings with Members of Congress and their staff. The three issues or “legislative asks” that they will be discussing will be the same asks that ASCO members will contact their Members of Congress about during the Week of Action.</p> <p>One, we will ask Congress to support legislation—The CLINICAL TREATMENT Act, which will give all Medicaid beneficiaries coverage of routine costs when enrolled in clinical trials—coverage Medicare and private insurance plans already provide. The importance of improving health equity has become even more apparent during the COVID-19 pandemic, and this legislation takes us one step closer to that goal.</p> <p>Two, ASCO volunteer advocates will request lawmakers to co-sponsor the Safe Step Act, which will help protect patients from harmful step therapy protocols, which ASCO believes is never appropriate in the treatment of cancer.</p> <p>And three, we’ll address the impact COVID-19 has had on cancer practices and research. Specifically, advocates will ask Congress to endorse maintaining reimbursement flexibilities for telehealth, as many oncology practices have rapidly transitioned to telehealth to ensure patients continued receiving treatment during the pandemic. We’ll also be asking Congress to provide emergency funding to the National Institutes of Health to mitigate disruptions caused to labs and clinical trials by COVID-19, and to restart research across the county.</p> <p>These are the same issues that participants in the Week of Action will be advocating for all week long in their outreach to Congress.</p> <p>The goals of the Advocacy Summit and Week of Action are to advance priority legislation, amplify the collective voice of the cancer care community on Capitol Hill, and to get ASCO members involved in advocacy initiatives.</p> <p>Members of Congress and their staff have grown accustomed to virtual constituent meetings, and personal stories continue to be the most effective form of advocacy, so the Advocacy Summit and Week of Action—even virtually—remain critical to ASCO’s larger advocacy efforts.</p> <p>In addition to the meetings and messages between advocates and lawmakers, the ASCO Advocate of the Year and the Congressional Champion for Cancer Care will be named during the Advocacy Summit.</p> <p>In closing today, I encourage everyone listening today to follow the Advocacy Summit through social media by way of the hashtag ASCO Advocacy Summit (#ASCOAdvocacySummit) on Twitter AND to participate in the Week of Action through the ACT Network.</p> <p>A link to the ACT Network and all the information you’ll need to participate in the Week of Action is available at ASCO dot org slash ASCO Action (<a href= "http://www.asco.org/ascoaction">www.asco.org/ascoaction</a>).</p> <p>Until next time, thank you for listening to this ASCO in Action podcast and if you enjoyed what you heard today, don’t forget to give us a rating or review on Apple Podcasts or wherever you listen and while you are there, be sure to subscribe so you never miss an episode.</p> <p>The ASCO in Action Podcast is just one of ASCO’s many podcasts; you can find all of the shows at “Podcast dot ASCO dot org” (podcast.asco.org).</p>

July 31, 2020
Get to Know Dr. Lori J. Pierce and Her Plans to Improve Equity in Cancer Care During Her ASCO Presidential Year
<p>ASCO President Lori J. Pierce, MD, FASTRO, FASCO, joins ASCO CEO Dr. Clifford A. Hudis in the latest ASCO in Action podcast to discuss how her childhood inspired her to become an oncologist and how the theme of her presidential year, “Equity: Every Patient. Every Day. Everywhere.” is more important than ever as the country responds to a healthcare pandemic that is disproportionately impacting people of color.</p> <p>“Every patient, no matter who they are, deserves high-quality care and every patient has the right to equitable care,” says Dr. Pierce. “We have to get to the root causes to understand the barriers that patients face if we’re going to really make a difference, so it’s important to me that equity be front and center of everything that we do."</p> <p>Subscribe to the ASCO in Action podcast through <a href= "https://podcasts.apple.com/us/podcast/asco-in-action-podcast/id1336591077?mt=2"> iTunes</a> and <a href= "https://play.google.com/music/listen#/ps/Ijanchb3n57zxdgfjvle5atf67a"> Google Play</a>.</p> <p> </p> <div style="font-weight: 400;"> <p><strong><span data-contrast= "auto">Transcript</span></strong><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast= "none">Disclaimer</span></strong><span data-contrast="none">: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Welcome to this ASCO in Action podcast, brought to you by the ASCO Podcast Network. This is a collection of nine programs covering a range of educational and scientific content and offering enriching insights into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">The ASCO in Action Podcast is ASCO's series where we explore policy and practice issues that impact oncologists, the entire cancer care delivery team, and the individuals we care for</span><span data-contrast= "auto">--</span><span data-contrast="auto">people with cancer. My name is Dr. Clifford Hudis. And I'm the CEO of ASCO, as well as the host of the ASCO in Action Podcast series.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">Today I'm really pleased to be joined by Dr. Lori J. Pierce, ASCO's president for the 2020-2021 academic year. Dr. Pierce is a practicing radiation oncologist. She is a professor and vice provost for academic and faculty affairs at the University of Michigan. And she is the director of the Michigan Radiation Oncology Quality Consortium.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">Dr. Pierce, thank you so much for joining me for this podcast. My hope today is that our conversation will give our listeners a better idea of who you are, what and who has had important impact and influence over your life, and what your professional career and path as a radiation oncologist has looked like. I also hope to highlight what you hope to accomplish during your presidential year.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Thank you, Dr. Hudis. I'm glad to join you today. Before we get started, I just want to note that I have no relevant financial relationships to disclose.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Now before we start to discuss the details of your presidential theme and your current role at ASCO, I think our listeners will be really interested to learn how your childhood inspired you to become a radiation oncologist. And I hasten to add ASCO staff were really excited by the stories that you shared when you gave an all staff presentation a few weeks back. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> can you talk a little bit about your childhood summers in North Carolina, how they were informative for you, and how they inspired your career?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Sure. I'm happy to. So first of all, I'm originally from Washington D.C. But my father's family, which is quite large, is from a small town in North Carolina called Ahoskie. And that's in the north eastern part of the state, maybe about 30 minutes just beyond Virginia. And I have tons of relatives. I used to love to go visit them every summer because I would get spoiled.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">But that was in the south in the '60s. And in retrospect there was significant segregation there. And I again would have a great time going to visit my family. But I noticed</span><span data-contrast= "auto">--</span><span data-contrast="auto">and it was something you </span><span data-contrast= "auto">noticed</span><span data-contrast="auto"> and you put in the back of your head</span><span data-contrast= "auto">--</span><span data-contrast="auto">that when there were health care issues, there was one doc that my family could use. And he was great. Doc Weaver, he did it all.</span><span data-ccp-props="{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">He was the one who would come to the homes, deliver babies, take care of all the medical issues</span><span data-contrast= "auto">--</span><span data-contrast="auto">he did at all. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> people just revered him because he always seemed to help people. And that stuck in my mind. That was actually when the first times that I thought about possibly becoming a physician because he always seemed to make people better.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">But then also the experience as I got older made me acutely aware that there was indeed segregation in Ahoskie and that there was inequity in care. Even Doc Weaver seemed to be a great doctor for someone</span><span data-contrast= "auto">--</span><span data-contrast="auto">I was 5 or 6 at the time. And to my eyes, he was great. Clearly there weren't choices in terms of care. And that was my first exposure to inequity in terms of health care.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Well that's interesting, of course. And obviously we're going to circle back to this. But before we get to that, one of the things that I always point out to Nancy Daly</span><span data-contrast= "auto">--</span><span data-contrast="auto">who's the CEO of Conquer Cancer</span><span data-contrast= "auto">--</span><span data-contrast="auto">is that all roads lead through Philadelphia in medicine. You proved that true, right?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast= "auto">Yes. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> I went to the University of Pennsylvania. I got my degree in engineering. I should say at that time I clearly was planning to go into medicine. But I was going to go into radiology. And so biomedical engineering was a great area to pursue. I majored in biomedical engineering and minored in chemical engineering from the University of Pennsylvania.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> then I applied to Duke for medical school. I was accepted. But I decided to defer my admission. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> I worked for a while before going into medicine.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Well that's interesting. And when you deferred your admission, was this because you had something you wanted to do, or you needed to essentially to save money in order to go to medical school? What did you do in that break?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast= "auto">Yeah. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> it was very much the latter. My parents were absolutely wonderful people. And they focused very much on education from my sister and me</span><span data-contrast="auto">--</span><span data-contrast= "auto">for us to go to the best possible colleges. My parents never had an opportunity to go to college. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> they very much wanted the best colleges for my sister, Karen, and I.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">But we had a ground rule in our family. And that was that if my sister or I decided to go and pursue education beyond undergraduate degree that we would need to pay for that. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> I knew that. And even though I was very fortunate to get quite a bit of scholarship from Duke, there was still going to be a lot that I was going to have to pay.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And </span><span data-contrast= "auto">so,</span><span data-contrast= "auto"> I </span><span data-contrast="auto">made a decision</span><span data-contrast="auto">, instead of taking out a lot of loans, that I was </span><span data-contrast= "auto">actually going</span><span data-contrast="auto"> to work. At that time</span><span data-contrast= "auto">--</span><span data-contrast="auto">probably now as well</span><span data-contrast="auto">--</span><span data-contrast= "auto">being an engineer brought a very good salary. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> I elected to defer my admission for medical school and take the offer that gave me the most money.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And that ended up being a job in Round Rock, Texas, which is just outside of Austin. And I have to tell you this was back in 1980. And it's not at all what Round Rock is like now. I hear Round Rock</span><span data-contrast= "auto">--</span><span data-contrast="auto">since industry is there now</span><span data-contrast="auto">--</span><span data-contrast= "auto">is really just a suburb of Austin. But at that time, Round Rock was a sleepy town I-35 from Austin. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> I can live in Austin and work in Round Rock.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And it was a very interesting experience. I worked for M</span><span data-contrast= "auto">cN</span><span data-contrast="auto">eil Consumer Products. I was the second shift supervisor. And it was an interesting time because here I was fresh out of undergrad, green behind the ears, and an African-American woman, as a supervisor to people who were generally in their 40s </span><span data-contrast= "auto">through 60s, most of whom had never been out of the state of Texas, and you look at that and you say, oh my gosh. How did I get here? Why am I here? Why did I decide to do this?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And you think about how different people are. But when you start to work with people, you realize that there are common threads. And you find those common denominators. And you learn that even though we may look different on the outside, there are a lot of things that are similar in the inside.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And I think the lessons that I learned as that second shift supervisor have served me well in medicine because you can always find a common denominator with patients, even when apparently at first look, it looks like you're very, very different. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> they were very good lessons I think that I learned that I wouldn't have done had I not chosen that path.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> I think that some of what you learned will no doubt pop up as we talk in greater detail now about your presidential theme. Let me just start by saying for me personally, this is one of the highlights of the year for me each year, when our president comes on board in a sense and begins to present their vision for their theme and what they hope to see us achieve over the year they serve as president.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And it's amazing because of course the wide range of background experiences as well as aspirations that different people bring. And you certainly I think came into this with a very clear vision of equity for every patient every day everywhere. Can you expand I think</span><span data-contrast= "auto">--</span><span data-contrast="auto">I wouldn't say speak on this because you've already begun to touch on it</span><span data-contrast="auto">--</span><span data-contrast= "auto">but can you expand on what you were hoping to see accomplished through this theme and what motivated you to focus on it specifically in your role as ASCO president?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">A multitude of things. It's hard to really pick out one. But </span><span data-contrast= "auto">certainly,</span><span data-contrast="auto"> I think we all are acutely aware of the different outcomes for people of color. In terms of almost any industry you look at, the outcomes are less favorable, significantly so for people of color. And you look at those numbers and you know that there are reasons to explain this.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And it's not just biology, which is what a lot of people propose. And quite often it's not biology at all, that clearly these patients are lower socioeconomic status. The majority of these patients are poor. Late diagnoses, inability to receive treatment, transportation issues</span><span data-contrast= "auto">--</span><span data-contrast="auto">there's a whole myriad of reasons why the outcomes are different. And you look at that, and you say, every patient no matter who they are, deserves high quality care. And every patient has the right to equitable care.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And we have to get to the root causes to understand the barriers that patients face if we're going to really make a difference. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> it's important to me that equity be front and center in everything we do. And ASCO again has done so much. That's at the heart of ASCO, of making sure the message is there that every patient deserves high quality care.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">But I wanted to actually make equity our theme. Equity has actually never been the theme at ASCO. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> I want to </span><span data-contrast="auto">actually call</span><span data-contrast="auto"> it out and make it our theme for the year.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Well the timing of course in many ways is really quite remarkable. I know a lot of people would use the word fortuitous. And the truth is that just means in a sense coincidental. But that's what it was.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">In early 2020 certainly nobody could have anticipated that we would be facing, nationally and globally, a pandemic that would so disproportionately impact people of color or that there would be a tipping point </span><span data-contrast="auto">through yet another brutal crime against a black American and that this would so completely capture the nation's attention. And I have to say broad support. Can you speak a little bit more therefore about the timing of these events and your theme and why this is so important for us to act at this point?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">I think you summed it up actually very nicely. </span><span data-contrast= "auto">Again,</span><span data-contrast="auto"> the theme was chosen before the pandemic. It was just the theme that I felt was the appropriate theme at this point in ASCO. And then the pandemic happened. And we saw how it disproportionately affected those who had comorbidities, those who were the essential workers, so those people who didn't have the luxury to work from home. Often the people who had a lot of comorbidities and the ones who were most at risk for contracting the virus and subsequently dying from the virus.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And I actually take a little bit of pride in that I'm from the state of Michigan. And Michigan was actually one of the first states that started reporting the COVID data by race and ethnicity. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> it was </span><span data-contrast="auto">actually one</span><span data-contrast="auto"> of the first states that </span><span data-contrast="auto">made the observation</span><span data-contrast="auto"> that there were cohorts of patients that had a significantly worse outcome. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> the country</span><span data-contrast= "auto">--</span><span data-contrast="auto">the world learned that people of color did more poorly with COVID.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">It's not enough to say, OK, these people do poorly with this. We then have to dissect the reasons why and provide explanations, so we get to the root of the problem. So that's COVID. And then we saw that more of the senseless deaths that we've seen in the </span><span data-contrast= "auto">past,</span><span data-contrast="auto"> but we've seen even more of as of late.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And maybe that's because we now have cell phones. And we see things a </span><span data-contrast= "auto">lot</span><span data-contrast= "auto"> more</span><span data-contrast= "auto">--</span><span data-contrast="auto">things that have probably been going on for quite a while. We know that these have been going on, but maybe not to the degree that we know now. And we have to acknowledge there's structural racism. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> once we acknowledge that, then the next thing is we </span><span data-contrast="auto">have to</span><span data-contrast="auto"> initiate steps that eradicate it. And we have to initiate mandatory steps to eradicate it.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">So,</span><span data-contrast= "auto"> then you come back to the theme</span><span data-contrast= "auto">--</span><span data-contrast="auto">equity, every patient, every day, everywhere. And I should have said in everything that we do. We see these horrors playing out. And we can look at that and say</span><span data-contrast="auto">--</span><span data-contrast= "auto">maybe not the pandemic, but the senseless murders</span><span data-contrast= "auto">-</span><span data-contrast= "auto">-</span><span data-contrast="auto">we've been here before. We've been here with the protests. We've seen all that before. And nothing has changed.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">I am cautiously optimistic that this time is different, that the world is in a different place. And this is no longer acceptable. And people are not going to look away, that they are going to stare this down. And they are going to create change.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> I am I'm optimistic that this will not just be another set of deaths of poor people at the hands of police, that the world is awake now, and change will come. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> the theme of equity is perhaps more impactful now than it ever would have been in the past.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">I'm going to just switch gears here a little bit, and speaking from personal experience, both warn you and challenge you that the year as ASCO president goes really quickly. And given that and given the lofty ambition, is there any way that you would be able to commit to what you actually want to see get done? What box can we actually check off during this term?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">I like the way you phrased that. I think back--there was an interview that I did when I was President-elect</span><span data-contrast= "auto">--a</span><span data-contrast="auto">nd someone said what do I want my legacy to be? And I pushed back on that </span><span data-contrast="auto">because you can't create a legacy in a year. It goes by very, very quickly. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> I think the question is, what do you think you can realistically accomplish in a year?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And the answer that I gave to them is going to be similar to the answer that I give to you. And that is you want to use your time and take a great organization like ASCO and perhaps make it even greater. And I think that is a very real goal here because again, I am building on a strong foundation of a lot of what ASCO already has in place.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">Equity is at the heart of everything ASCO does. You know this. You're the CEO. You know this. And so ASCO has stood up so many programs in their various divisions that relate and are based on equity of care. But ASCO by being large and being complicated can have some of these programs in silos. And if I can help to connect the dots, if you will, and make it almost a seamless presentation of equity, that will be a major strength.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">For example, one of the things that I want to do</span><span data-contrast= "auto">--</span><span data-contrast="auto">and people have told me I will not be successful</span><span data-contrast= "auto">-</span><span data-contrast= "auto">-</span><span data-contrast="auto">others have tried and were not successful</span><span data-contrast= "auto">--</span><span data-contrast="auto">and that was to embed equity in our annual meeting. As you know what we've typically done is have sessions that are dedicated for equity, which is great. And they've been fabulous sessions and wonderful speakers.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">The problem is a lot of our members have not taken advantage of those opportunities. And it's not because people don't want to know about equity. I'm sure it's just they're trying to fit so much in a short amount of time because there's so much going on at the same time at ASCO, trying to learn all the latest therapies. And they just don't have time for the equity sessions.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">So,</span><span data-contrast= "auto"> I get that. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> a strategy would be to embed equity in the sessions. And again, I've been told that this has been tried before and has failed. That doesn't deter me. That doesn't dissuade me from moving forward with this and being optimistic that it will succeed this time, again, because we're in a different time now. I think the world has awakened. And equity is very important. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> it is very high up on people's checklist when they go to ASCO.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And then second, I'm the president of ASCO. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> I hope to use both of those to gently push this idea so that we really can capture more of equity in all of the sessions, or the appropriate sessions at the annual meeting.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Well I've got to say</span><span data-contrast="auto">--</span><span data-contrast= "auto">speaking of connecting the dots, which was the image you used-</span><span data-contrast="auto">-</span><span data-contrast= "auto">there is one I think area of progress that's already taking shape. And that's this exciting new collaboration between ASCO and the Association of Community Cancer Centers, or ACCC. This is focusing on increasing participation of both racial and ethnic minority populations in cancer research, which to your point, is something that we have been focusing on for years. But we really need somebody to move the needle. Can you talk a little bit about this initiative and what you hope to see formed and accomplished through this?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast= "auto">Sure. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> I am very </span><span data-contrast="auto">happy--actually, largely</span><span data-contrast="auto"> thanks to you for putting Randy </span><span data-contrast= "auto">Oyer</span><span data-contrast="auto">, who is the president of ACCC, and I in contact with one another--to set up this collaboration. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> we all know that if you look at people of color--let's say </span><span data-contrast="auto">African Americans</span><span data-contrast="auto"> and Hispanics--and look at their participation in clinical trials, it is much lower than their representation as cancer patients. If you look at most the numbers, maybe it's around 3% to 5% of patients in the clinical trials are Hispanic or </span><span data-contrast= "auto">African American</span><span data-contrast="auto">, whereas those two groups make up about roughly 15% of patients with cancer. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> there's clearly a disconnect in the representation of those ethnicities and races in our clinical trials.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And so many have tried to come up with strategies to improve the enrollment. And we are working together</span><span data-contrast= "auto">--</span><span data-contrast="auto">ACCC and ASCO</span><span data-contrast="auto">--</span><span data-contrast= "auto">we're putting together a very robust steering committee of individuals who have thought long and hard about accrual of minorities under clinical trials. And we are sending out an RFI to request ideas from people in ASCO and ACCC who also have been thinking long and hard about this issue for their strategies</span><span data-contrast= "auto">--</span><span data-contrast="auto">their suggestions for strategies for how we can improve accrual.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And then the steering committee will review what we take in as well as our own thoughts and then try one or two of these strategies within TAPUR. As you know TAPUR is the trial with an ASCO. TAPUR is completely run by ASCO. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> we have the flexibility to be able to try out new things. It's almost </span><span data-contrast= "auto">like</span><span data-contrast="auto"> a laboratory, if you will, for new ideas.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">And if we see that there are one or two strategies that do seem to be successful in terms of increasing the uptake of minorities, these will be strategies that we can suggest to some of the cooperative groups to employ in their trial. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> it's an exciting time to use TAPUR as a laboratory to try out new strategies. And I am very grateful for the opportunity to be able to work with Randy and all of the infrastructure that ASCO has to make this a reality. </span><span data-contrast= "auto">So,</span><span data-contrast="auto"> we're working on that.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Well that's great. This is not to put you on the spot. And there may not be any more. But is there anything else that you want to make sure ASCO members hear or take away from this conversation? What's the one message that you think that they should receive from our conversation?</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">I guess we're all in this together. The beauty of ASCO is from member engagement. We just have fabulous members in terms of their motivation to make lives better for our patients. And </span><span data-contrast= "auto">so,</span><span data-contrast="auto"> I guess I would ask if there are any additional ideas that our members have that will help us move the needle even more and even more quickly, please reach out to me.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">I would love to hear people's thoughts. We're always open for new concepts. And it takes a village. And I just would hope people would feel comfortable providing ideas for us to go forward.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Well that's great. Thank you, Dr. Pierce, for taking the time to speak with me today. I'm really grateful to you for this. And I'm excited as well for the year ahead, both for you and for all of us at ASCO.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Lori Pierce:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">Thank you so much.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><strong><span data-contrast="auto">Dr. Clifford Hudis:</span></strong><span data-contrast= "auto"> </span><span data-contrast="auto">I want to remind listeners that you can visit asco.org to learn more about the ASCO ACCC initiative. And even better that's where you can submit ideas that will help address the issues related to longstanding barriers to diversity in cancer clinical trials. We want to hear from you.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">Until next time, thank you for listening to this ASCO in Action podcast. And if you enjoyed what you heard today, please don't forget to give</span><span data-contrast="auto"> us a rating or review on Apple Podcasts or wherever you listen. And while you're there, be sure to subscribe so you never miss an episode.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div> <div style="font-weight: 400;"> <p><span data-contrast="auto">The ASCO in Action podcast is just one of ASCO's many podcasts. You can find all of the shows at podcast.asco.org.</span><span data-ccp-props= "{"201341983":0,"335559739":160,"335559740":259}"> </span></p> </div>
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