ASCO president-elect: Precision medicine advances must be broadly available in oncology community
Bruce E. Johnson, MD, FASCO, professor of medicine at Harvard Medical School and institute physician at Dana-Farber Cancer Institute, will become president of ASCO during the society’s annual meeting in June.
Johnson — an active member of ASCO for 32 years— specializes in lung cancer. His laboratory at Dana-Farber/Harvard Cancer Center has helped to identify patients who respond differently to targeted therapies.
HemOnc Today spoke with Johnson about what he hopes to accomplish during his 2017-2018 term as ASCO president, the areas of practice and policy with which he would like to see ASCO become more involved, and his expectations for the field during the next 5 to 10 years.
Question: Can you describe your reaction to being named ASCO president?
Answer: It was one of the happier times I have had in my life. I was on the ASCO board from 2008 to 2011, and I was interviewed for potentially being on the presidential ballot for a number of years. It was very nice to even get on the ballot in fall 2015. I still remember the day Julie Vose, MD, MBA — the ASCO president at the time — called me to tell me I had won. I was very pleased for two reasons. First, I look forward to serving as ASCO president. Second, it is very flattering to be chosen by your colleagues to be one of their leaders.
Q: What excites you most about the opportunity?
A: My family has been heavily involved in politics for a long time — both on my side and my wife’s side. I have people who have served in the state legislature, and my wife has worked on a statewide campaign. Our daughter, and my wife’s father and brother all served on presidential campaigns. We have interacted closely with politics and politicians. Both being involved in the interactions of members at ASCO as well as interacting at both the state and federal level, is something that very much interests me.
Q: How has your clinical and research experience prepared you for this role?
A: I have led a research group in lung cancer at NCI for more than a decade, and I ran the lung cancer research group at Dana-Farber for about 14 years. During this time, I learned about interacting with large numbers of faculty, engaging with people with different viewpoints, and getting people to agree on a plan of action. I believe this will be pertinent to my role as ASCO president. My role as chief clinical research officer at Dana-Farber Cancer Institute has taught me about building infrastructure to support clinical care, as well as research programs. As we get more scientific advances, we need to translate them into clinical situations where we can use them on a regular basis.
Q: What are you doing as president-elect to prepare yourself for your term as president?
A: Nearly all ASCO presidents have served on ASCO’s board of directors in the past. Serving on the board for 3 years exposes one to what the role entails. ASCO has a program to orient presidents before they take over. We attend an orientation at ASCO headquarters where the president-elect, new board members and treasurer learn the expectations of being an officer or board member. We also have a meeting between the past president, current president and president–elect to go over the responsibilities of the president and work out who will be responsible for what duties. Also of great importance is the ASCO staff, which is supportive to all officers, board members and ASCO members.
Q: What priorities do you hope to address during your term as president?
A: During the 32 years that I have been an ASCO member, the society has grown from a relatively small to a now very large organization of more than 400 employees. Many of the initiatives are multiyear projects. I will be mindful of what the previously existing priorities are and what needs to be done to carry them out. I will continue the effort that ASCO has made to make precision medicine advances — which have taken place largely within academic centers — more broadly available to a greater proportion of the oncology community.
Q: What do you consider the greatest challenge in cancer care, and how can ASCO help to meet that challenge?
A: The greatest challenge in cancer care is to continue to improve the efficacy of treatments available for our patients. This is the singular and unifying principle behind everything we do. To help ASCO meet that challenge, we must give guidance about what we have learned about characterizing different patients’ tumors and finding out how each tumor is different, and then use this information to help guide therapy. Examples of this that we have identified in my research lab at Dana-Farber are to genetically characterize lung cancers to subsets of different EGFR mutations, KRAS mutations and other oncogenic drivers. There are different overlapping sets of markers that predict response to therapy, so we know whether to give the patient targeted therapy, immunotherapy or chemotherapy. Also, ASCO is the leading organization for education for oncologists. We need to teach our providers how to characterize the tumor and how to deploy that information to the benefit of our patients.
Q: Is there a specific area of practice/policy in which you would like to see ASCO become more involved?
A: Because it is a board decision about where ASCO becomes involved, I would like to take this opportunity to discuss where ASCO already is involved and where I would like to see the society become more involved. One area is the evolution of health care in the United States. One of the things that many of our academic practices — as well as our community practices — have become involved in is preparation for changes and expectations of how one meets the standards for getting reimbursed for delivering cancer care to patients. We have had very large efforts to try to prepare our members for the expected evolution of health care. There is a promise of changes in health care with the new administration, so we will try to anticipate what is going to happen. As the changes are rolled out, we will attempt to have as minimal disruption as possible, both within our members’ practices and in delivering the best care to our patients. I suspect there will be a great deal of change in our health care system for both the delivery of care and the reimbursement for delivering care to our patients.
Q: How can ASCO’s membership help you and the society’s other officers succeed and maximize the association’s potential?
A: One of the things into which we have put a lot of effort is making information available to our members about how one can effectively run a practice, as well as how one can anticipate and deal with changes at the national and state levels. ASCO hired Stephen S. Grubbs, MD, to help with issues surrounding community practices, and he has developed a consulting service for getting information on how to adapt to all of the changes and expectations of delivering health care. Through ASCO University, members have access to educational materials that traditionally come with having lectures at meetings. We want ASCO University to evolve in such a way that we can deliver education not only in the face-to-face settings of meetings, but also on the website. Lastly, we have a number of very active and effective state societies, and ASCO has been able to convene different groups within the country for developing means for dealing with all the evolving state regulations. For example, a number of changes went in about how one needed to have appropriate protection for the people who are involved in delivering chemotherapy and how those regulations evolved. The state affiliates were able to come together and discuss how we can deal with these changing regulations.
Q: So much progress has been made in cancer diagnosis and treatment within the past decade. What are your expectations for the field within the next 5 to 10 years?
A: Although we have indeed made dramatic advances in cancer diagnosis and treatments, my expectation is that genetic testing and characterization of the tumors will evolve so that we will be better able to develop predictive markers for the efficacy of targeted therapies, immunotherapy and conventional treatments. Additionally, the ongoing evolution of pharmaceutical agents that are directed against specific targets will continue to get more specific and more potent so that they work longer in our patients. Lastly, I expect the ongoing evolution of immunotherapy — and how well these agents will work with combining different approaches, including targeted agents and conventional chemotherapeutic agents — to make treatment work better for our patients. The part that gets me very excited in the immunotherapy field is if what we see in melanoma turns out to be true in other tumors. A subset of patients with metastatic melanoma who get immunotherapy with either CTLA-4, checkpoint inhibitors or both look as though they go into a durable remission that can last for years. We generally thought of patients with advanced solid tumors as incurable. However, with this information, perhaps a subset of these patients potentially will be cured, and this will continue to transform our field. – by Jennifer Southall
For more information:
Bruce E. Johnson, MD, FASCO, can be reached at Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215;email: firstname.lastname@example.org.
Disclosure: Johnson reports postmarketing royalties from Dana-Farber Cancer Institute for EGFR mutation testing.