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 disapproval.
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.