New Horizons for ASCO's Allen Lichter

— Proud that ASCO stayed true to its core mission

MedicalToday
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When , assumed office as the s CEO a decade ago, he said that ASCO's should always be doing what's best for patients.

Now, as he prepares to step down in late June when Clifford A. Hudis, MD, takes the society's helm, he can retire knowing that the moral compass didn't waver under his watch, and the organization grew and expanded during his tenure.

interviewed Lichter by telephone shortly after ASCO announced Hudis' appointment.

He said that he has no specific plans post-ASCO, and that he intends to take the summer off and do a little relaxing, something he thinks he's earned after 43 active years in the oncology community.

"What's next? It's still a mystery at this point. I've gotten some feelers from boards and organizations, but I haven't made any commitments, and I'm taking things one step at a time," he said.

However, as an ASCO member since 1980, he's made it clear to his colleagues that he'll gladly do whatever they want him to do as a volunteer. But he does not intend to hang around and insert any influence in the organization, noting "that will be Cliff's responsibility."

Lichter, 70, said that he will be giving up his home in the Washington, D.C., area, returning instead to Ann Arbor, Mich., with colder months spent in Florida.

Prior to joining ASCO's staff in 2006, he had been dean of the University of Michigan Medical School from 1998 to 2006, and chair and professor of radiation oncology at Michigan from 1984 to 1998. Earlier, he served as director of the Radiation Therapy Section of the National Cancer Institute's Radiation Oncology Branch.

He was the first -- and only -- radiation oncologist to be president of ASCO (1998-1999), and his experience running a medical school provided him with a perspective that transcended oncology.

Lichter's work in breast cancer and in researching and developing three-dimensional treatment planning resulted in a Gold Medal from the American Society for Radiation Oncology, and he was elected a member of the Institute of Medicine of the National Academies of Science in 2002.

During his time at NCI he investigated breast-conserving therapy and helped contribute to the wider use of lumpectomy and radiation as an alternative to radical mastectomy.

When Lichter went from volunteer to top staffer in 2006, ASCO had an annual operating budget of about $65 million and some 23,000 members. Its budget is currently $105 million and it has more than 40,000 members, with many from overseas, making the American society very international as well.

"True north is always best for patients, but we don't treat patients directly, our members do," he said, adding that ASCO's service to patients is through how it serves its members by advocating for policy positions, and expanding and disseminating the knowledge base of oncology so members "can carry out their jobs as humanly as possible."

"I've also said that ASCO has a public responsibility, and that we are not just a membership organization because the consequences of what we do affect people throughout the country and the world, and we remain cognizant of that, and accept and embrace that responsibility."

Lichter said that ASCO's products and services have resonated over the years, which is why people join and stay with the organization, that various constituents engage with the society in commercial transactions that help revenue, and that the annual meeting continues to break attendance records.

"It's all been somewhat of a validation that we're doing something right because people who have choices of things to do make some of those choices to do things with us."

is the big project that will define ASCO for years to come, according to Lichter.

He said that ASCO cannot be a passive participant in aggregating and interpreting oncology big data to define quality of care, and that understanding that data will help gain new insights to make cancer care better.

"We believe that those things are physician responsibilities and are core to what makes medicine and what makes oncology a profession," he said, noting this cannot be delegated to health insurance companies, government agencies, or for-profit companies because these types of developments go right to the heart of what it means to be a physician.

"The quality of medical care can only be defined in the end by physicians themselves, and while we recognize that there will be many others also involved and there is room for many participants in this space, there must be physicians involved."

He said that CancerLinQ is an amazing testament to ASCO's courage and fortitude and it's a very difficult project that challenges even the biggest corporations on the planet.

Another project that Lichter is extremely proud of is TAPUR (Targeted Agent and Profiling Utilization Registry), which is overseen by , ASCO's chief medical officer.

Although ASCO has always had an oncologist as its CEO, Schilksy -- also a former ASCO president -- was the first physician staff hire (in 2013) in addition to the CEO.

Over the last few years Lichter has also brought aboard three other ASCO volunteers as senior staff: , as vice president for education, science, and professional development; , as VP for quality and guidelines (including the , or QOPI), and CancerLinQ medical director; and Stephen S. Grubbs, MD, VP for clinical affairs.

TAPUR was first announced during last year's annual meeting and enrolled its first four patients last month.

It is the first time that ASCO launched a clinical trial, and is an example, Lichter said, of how the organization can serve as a neutral convener bringing together physicians, pharmaceutical manufacturers that have targeted agents in their portfolios, payers, genomic laboratories, knowledge providers, and others.

"We can be the hub that brings all of these parties together and form some knowledge-generating tasks that will allow us to make precision medicine more understandable, more available, and smarter for our members and their patients. It's a big milestone for ASCO and will yield terrific things."

In addition to these projects and initiatives ASCO has added a number of additional specialty meetings (e.g., cancer survivorship, palliative care, and immunology next year) and publications (re-launch of , , and two more to be announced later this year) under Lichter, and issued its first set of (the joint chemotherapy safety standards established by ASCO and the in 2009), raising the bar from what might have been guidelines or recommendations in the past.

The standards were also part of the QOPI certification program started in 2010 to recognize oncology practices committed to deliver the highest quality cancer care.

ASCO has also been active in defining the value of cancer therapies, which Lichter said is in some respects "an impossible task since value framework is imperfect at best, but perfect is the enemy of good and we're trying to make it better and more nuanced, and above all more useful for making smarter decisions about therapies."

He also noted that ASCO has signed another 10-year contract to continue hosting its annual meetings in Chicago, and summed up the society by saying:

"We are an organization that has engendered trust among many of the components around the oncology world and we don't have any ulterior motives other than to make patient care better."