ASCO 2023 Reflections

As we progress into July, we wanted to reflect on ASCO 2023 and some of what it offered our organization, talent, and partnerships as we look to the remainder of the year ahead.

  1. There is a palpable shift towards more individualized precision oncology care. The emphasis on NGS diagnostics, new assessment of gateway mutations, treatment, acquisition of resistance, resequencing/NGS, new initiation of treatment, etc., was noted in multiple sessions and working meetings around the meeting itself. The progress and promise of ADCs, and new strategies from some companies that already anticipate acquired resistance from the first series of treatments, also add to this shift. While the results of liquid tumor diagnostics for diagnosis, surveillance, and treatment response monitoring were early, it is clear that the industry is poised for a paradigm shift where NGS and liquid will co-exist and change paradigms of care, risk monitoring, and patterns of treatment initiations and discontinuations. The implications of this are profound. We can now change translational strategies, follow-on treatment strategies, and discovery and target validation studies. We can also truly advance the notion that many cancers will increasingly be multi-mutational, multi-treatment, semi-chronic, and with lower burdens on healthy tissues and patients themselves. In partnership with Caris Life Sciences, we announced a broad collaboration facilitating research in this area with the stated goal of building the largest clinico-genomic data asset ever established with full exome, transcriptome, and high depth clinical features being available for clinical research-centric healthcare providers and biopharma innovators.
  2. The notion of multi-modal data analysis that can provide more insights, limit confounders, and fundamentally change strategies for first-in-human studies was noted throughout. In fact, there is a general acceptance of the limitations of single modality analyses and new standards and expectations that multi-modal should underpin all research targeted for peer review and regulatory usages. We have re-dedicated ourselves to this through our collaborations with Caris Life Sciences, PathAI, and others. Our own network of healthcare research provider partnerships allows integration of data from EMRs, LISs, and PACS systems. We also noted at the conference how the veracity and trust in real world data is enhanced by how line of therapy rules are derived and deployed in support of these analyses [insert the URL or hyperlink the text]. Together, multi-modal, definitive RWD, and supporting derived concepts, such as line of therapy, continue to significantly advance the field while aligning with the recent guidance from U.S. FDA supporting broader regulatory uses of RWD.
  3. The move of clinical research into the community settings, the commitment to trial populations being more comparable to the ultimate treated populations, and a generally recognized importance of lowering the burden of clinical research on research sites, investigators, and patients was also a common thread throughout ASCO this year. In partnership with BMS, we introduced early results at the conference that demonstrated that community settings across different regions can operate with consistency and achieve performance levels above legacy operating models and legacy technologies. It was further discussed that the data advanced had full provenance and a higher relative quality level than past approaches and methodologies. We also provided posters and abstracts, accepted for ASCO 2023, that examined how AI could augment expert humans to enable more research to be conducted by existing or smaller research teams, and how these can assure all eligible patients are identified and assessed for eligibility. Together these initiations hod the promise of assuring that critical research is available to more patients, in their local settings, where support is greater.  These approaches further allow that more key biopharma innovations can be advanced more rapidly.
  4. Headlines coming into ASCO 2023 were broadly discussing changes in artificial intelligence, how generative AI might transform how care is provided, and some of the concerns or areas of vigilance we need to have when adopting AI solutions more broadly. We presented results underpinning our Digital Trial Solution and TeraRecon Eureka Clinical AI for radiological interpretations, a deploy own, 1st party, and 3rd party 510K and Software-as-a-Medical Device solutions . While ethics of data access, representativeness, and generalizability for training AI continue to be topics of debate, it was accepted that declining numbers of oncology nurses, trained medical oncologists, and radiologists will create increasing demand for and reliance on these solutions. We proposed, during presentations, that AI need not be seen as a source of bias or of eliminating the roles of highly trained personnel, but rather the opposite, where AI being used by trained personnel offers the promise of broader access to treatment and better assessment of racial, ethnic, and economic subpopulations historically under diagnosed and treated. Overall, we believe that ASCO 2023 will be seen as a watershed moment where AI in radiological, digital pathology, genomic signatures, and clinical trials was seen as integral to all new models, broadened access, and advantaged economics.

The spirit of the meeting was exceptionally positive. It is clear that providers and research entities are in a post-pandemic period where facilities expansions, access, and more could all be advanced. The ability of these communities to handle new variants is high, and the likelihood of returning to a period of delayed diagnosis and restricted access is very low. The levels of biomedical innovations presented, and projected future investments in new areas of biomedical innovations, were never higher. This is both a statement of where pharma and biopharma are in their view of the economy and a redoubled commitment to the proportion of total biomedical innovations that will be focused on oncology and hematological innovations. This is exceptionally positive for everyone, namely: the growing number of research-centric community providers building research enterprises; (b) the patients that will have more treatment strategies and options available over a successive sequence of treatments; early stage biopharma and early stage biopharma investors; allied diagnostic companies providing NGS, liquid, digital pathology, and AI radiological solutions; and AI SaaS solution innovators, like us, that are enabling a new generation of clinical research and integrated treatment solutions in all research and practice settings with advantaged cost, increased precision, and broader accessibility.

Our deepest thanks to all of our partners, healthcare providers, clinical research sites, diagnostic companies, biopharma innovators, and medical societies. The persistent dedication of this network-of-networks allowed resilience through the pandemic, palpable progress in key areas meaningful to research and care, and an overall optimism that’s motivating to us all.