ASCO Plenary Sessions: impact, legacy, future

The ASCO annual meeting draws a large crowd of physicians, cancer researchers, policy makers, and industry representatives. The crown jewel of the annual events is the Plenary session where impactful, influential and visible abstracts are selected for the largest audience. Plenary topics are frequently paired with concurrent New England Journal or Lancet publications.  Here, we review 9 years of ASCO plenary sessions.  Several themes emerge.  First, many of the topics selected have indeed been practice changing, such as the use of ALK inhibitors for ALK rearranged NSCLC, or checkpoint inhibitors in metastatic melanoma.  Second, although some plenary topics seemed destined to change practice, they ultimately falter, such as the use of Cetuximab in NSCLC, vaccine therapy for follicular lymphoma, and even Bevacizumab in metastatic renal cell cancer. Who could have forseen bevacizumab displaced by several VEGF TKIs?  Third, negative trials are rare among Plenary sessions, but when they are presented they are immensely important.  Examples include a seminal study using CA-125 levels to guide treatment of relapsed ovarian cancer, the use of lapatinib combined with traztuzumab in the adjuvant treatment of HER2 + disease, and studies showing no survival benefit to upfront bevacizumab in glioblastoma multiforme.   Fourth, we note a large industry presence among Plenary sessions, as the Industry in part sponsored 62% of Plenary abstracts.  Ultimately a review of 9 years of ASCO plenary reveals the plenary for what it is: a conservative selection of abstracts that, at the time, are thought to change the face of oncology.  Time, however, is the true arbiter, and some succeed in this quest, while others falter.  ASCO plenary sessions reveal the influence, legacy and future of cancer care.