Do oncologists change practice based on meeting abstracts alone? Although these were not the exact words used, this was the essence of the question first posed on Twitter by STAT senior writer Adam Feuerstein to hematologist-oncologist Vinay Prasad, MD, MPH, just days after the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting concluded. And although the question made for a lively discussion, it remained largely unanswered.
Cancer Therapy Advisor posed the question to several oncologists, and
they provided insight into why some physicians may be quick to change practice
on seemingly scant evidence.
Most of the experts seemed to
suggest there was, perhaps, a bigger problem: the way clinically important
findings are disseminated.
“It’s true that we change our
practice based on an abstract,” oncologist Bishal Gyawali, MD, PhD, Queens
University, Ontario, Canada, told Cancer Therapy
Advisor. “It happens all the time,” he said, although he added that he
certainly did not condone the practice.
Tatiana Prowell, MD, associate
professor of oncology at Johns Hopkins Sidney Kimmel Comprehensive Cancer
Center, Baltimore, MD, and Kevin Knopf, MD, MPH, chairman of hematology/oncology
at Highland Hospital/Alameda Health System, Oakland, California, each told Cancer Therapy Advisor that they, too,
have seen oncologists change practice in this way — and both expressed similar
While a meeting abstract may be
labeled by some as a “presentation,” Dr Gyawali clarified that he still
considers the presented findings to be an “abstract,” because only a limited
number of oncologists will attend the conference in person or watch the actual
presentations after the meeting concludes. “For most others, they’ll just read
the abstract,” he said.
Typically, the treatment changes
that are made based on meeting abstracts alone are relatively minor, such as
the decision to change the dosing or schedule of a particular drug, said Dr
Gyawali. But other times, meeting abstracts — usually those designated as oral
presentations — can influence frontline treatment decisions.
For example, when positive trial
results were presented at the 2018 American Society of Hematology annual
meeting (and simultaneously published in Blood)
for a venetoclax-based drug combination in elderly patients with acute myeloid
leukemia (AML), practice changed.1 David Steensma, MD, Dana-Farber
Cancer Institute, Boston, Massachusetts, told Cancer Therapy Advisor that despite the trial being a phase 2,
single-arm trial, “a lot” of colleagues made the venetoclax combination their
standard of care for older patients with AML, while “more cautious” colleagues are
likely waiting for the readout of the phase 3 trial results before making any
significant changes to their treatment approaches.
This article originally appeared on Cancer Therapy Advisor