The AACR Annual Meeting is the focal point of the cancer research community, the place where scientists, clinicians, other health care professionals, survivors, patients, and advocates gather to share the latest advances in cancer science and medicine. While the global COVID-19 pandemic made meeting together impossible in 2020, the AACR—through the leadership of 2019–2020 President Elaine R. Mardis, PhD, FAACR, and Program Committee Chair Antoni Ribas, MD, PhD, FAACR—presented two virtual Annual Meetings in April and June that enabled more than 80,000 members of the community to explore and advance the frontiers of scientific innovation.

Practice-Changing Clinical Trials

Reflecting the Annual Meeting’s emerging status as a premier forum for clinical research, the April virtual meeting featured 170 clinical trial presentations, including 45 oral presentations in plenary sessions. These presentations highlighted critical advances in cancer care across a range of treatment options and cancer types:

• Immune Checkpoint Inhibitors and Combination Therapies. The first virtual Annual Meeting began on April 27 with an Opening Clinical Plenary Session. Presentations in that session included three trials focused on immune checkpoint inhibitors, a class of immunotherapeutics that has yielded unprecedented long-term responses across a wide array of cancer types. However, these therapeutics are not effective for all patients, and many who respond initially develop treatment resistance. All three trials investigated the use of an immune checkpoint inhibitor in combination with molecularly targeted therapeutics in an effort to increase the number of patients who benefit from the treatment.
  
  Lajos Pusztai, MD, DPhil, presented encouraging data from the phase II I-SPY-2 clinical trial, which indicated that adding the immune checkpoint inhibitor durvalumab (Imfinzi) and the targeted therapeutic olaparib (Lynparza) to standard neoadjuvant chemotherapy could improve outcomes for women with stage II/III, HER2-negative breast cancer. Further, Grant McArthur, PhD, shared the latest results from the phase III IMspire150 trial, which indicated that the combination of vemurafenib (Zelboraf), cobimetinib (Cotellic), and the immune checkpoint inhibitor atezolizumab (Tecentriq) may improve the duration of treatment response and progression-free survival for patients with advanced BRAF-mutated melanoma without introducing new safety concerns.
  
  While the clinical plenary session highlighted the potential of combination therapies, it also addressed the challenges of this approach. In another presentation, Christopher J. Sweeney, MBBS, discussed the phase III IMbassador250 trial, which tested whether adding atezolizumab to enzalutamide (Xtandi) improved survival for men with metastatic castration-resistant prostate cancer compared with enzalutamide alone. Unfortunately, the trial was terminated early when the combination was shown to yield a slightly poorer outcome than the standard treatment. The presenters discussed the lessons that could be learned from the trial and how those lessons could be applied to the development of future treatments for this disease.

• Cutting-Edge Data Supporting FDA Approvals. The Annual Meeting continued to demonstrate its value as a showcase for experimental therapeutic approaches, as two presentations at the meeting led directly to FDA approvals. On April 27, Edward B. Garon, MD, reported results from the GEOMETRY mono-1 phase II clinical trial, which evaluated capmatinib (Tabrecta) as a monotherapy for patients with stage IIIB or stage IV non-small cell lung cancer (NSCLC) that harbors MET gene alterations. Less than two weeks later, the FDA cited the data in its decision to approve capmatinib for treating adult patients with metastatic NSCLC whose tumors have MET exon 14 skipping mutations. And on April 28, Mallika Lala, PhD, presented interim data from the ongoing phase I KEYNOTE-555 trial in which a dosing regimen of 400 mg of pembrolizumab (Keytruda) every six weeks was compared to the standard regimen of 200 mg every three weeks in the treatment of patients with metastatic melanoma. That same day, the FDA approved the new dosing schedule, providing patients with another treatment option that minimizes the number and frequency of visits to the clinic—a critical option during the COVID-19 pandemic.

New Advances in Liquid Biopsies

On April 28, a Clinical Plenary Session titled “Early Detection and ctDNA” featured two liquid biopsy-based tests—the DETECT-A multicancer detection test, and a test developed by the Circulating Cell-free Genome Atlas (CCGA) Consortium and GRAIL Inc. The data presented indicated that both tests could potentially distinguish between blood samples from patients who had cancer and blood samples from patients who did not have cancer and could identify the tissue in which the cancer originated. If validated, these tests have the potential to improve cancer screening and detect cancers before they become metastatic.

Education and Training

The 2020 Annual Meeting program included the largest educational program ever, with more than 70 educational sessions and methods workshops. Topics included best practices in clinical trial design, bioengineering 3D tissue models, a primer on immunotherapy for nonimmunologists, and the use of artificial intelligence and machine learning from diagnosis to therapy.

Addressing the COVID-19 Crisis

The Annual Meeting also addressed the COVID-19 pandemic and its impact on cancer research and cancer patients from multiple perspectives:

• Clinical Plenary Session: COVID-19 and Cancer. Annual Meeting Program Chair (and 2020–2021 President) Antoni Ribas, MD, PhD, FAACR, convened a panel of experts from China, Europe, and the United States. Presentations included studies from Hubei Province, China, and New York City indicating that patients with cancer in those areas had increased odds of death after contracting COVID-19 compared with the general population. (The Hubei Province and New York studies were published during the meeting in the AACR journal Cancer Discovery.)
• Educational Session: COVID-19 and Cancer— Guidance for Clinical Trial Conduct and Considerations for Real-World Evidence. As part of the meeting’s Regulatory Science and Policy track, the AACR’s Office of Science Policy and Government Affairs invited speakers from the FDA to discuss the FDA’s recent Guidance on Conduct of Clinical Trials of Medical Products during COVID-19 Public Health Emergency. The speakers explored how decentralization and the use of real-world evidence could help mitigate the disruption caused by COVID-19 on the conduct of clinical trials.
• MICR Symposium: Health Inequities and Disparities in the COVID-19 Pandemic. Chaired by Robert A. Winn, MD, this session highlighted how COVID-19 has disproportionately affected minority populations—especially Black and Hispanic communities—and how the pandemic has exacerbated disparities in cancer care among racial and ethnic minorities and the medically underserved.

• Special Session: COVID-19 and Cancer Research. This session—which was chaired by Dr. Ribas—showcased the work of leading cancer researchers who changed course to study COVID-19, focusing the tools of cancer science on the pandemic. The session began with a special address by NIH Director Francis Collins, MD, PhD, who outlined NIH initiatives to accelerate the development of COVID-19 tests and treatments, and several presentations discussed immune cell responses to the disease.