By Peter J. O’Dwyer, MD (left)
and Mitchell D. Schnall, MD, PhD

We begin 2021 in hope and expectation, even as the shadow of 2020 looms across our health, our health care, and our quest for equity and inclusiveness. Each of these areas of discord and concern needs urgent attention at the local level, even as national or global priorities inform the bigger picture. The local level is really where any one of us can have an impact. The health of everyone will be better if—even after vaccination—we continue to observe masking, social distancing, and minimize travel. We can’t convince everyone of that, and there is simply no winning strategy from getting into disputes with random strangers. We can however, as health care professionals, try to portray ideal behaviors and influence in that way.

For vaccination, it is clear that our stance should be to urge the greatest possible number to avail of the opportunity, and to be entirely candid about what we do and do not know at this point in time. Now more than ever, we need civil and empathic conversation. Constructive engagement. Agreement on what are facts, and what might have less supportive evidence. Since the socially torrid summer of 2020, conversation and dialogue have moved our stance on diversity and equity in the direction of specific projects designed to expand our inclusiveness and actively combat systemic racism. A positive effect of those disruptions has been to push us as a group to do more, and to do it faster and more urgently. A similar urgency in the other domains of disagreement would have the potential for equivalent impact.

There is also the recognition that 2020 had many positives in our activities within ECOG-ACRIN. Elsewhere in this newsletter is Dr. Joseph Sparano’s description of the flowering of TAILORx data into an algorithm for breast cancer management, one that is widely available thanks to our partnership with Exact Sciences. This has an impact on the lives of thousands of patients—one that we hope for with all of our trials and should be celebrated when it is successful. We recognize Joe’s insight and leadership, and join in his generous credit to the key leaders (especially Drs. Gray, Tang, Crager, and Shak) who helped make this trial successful.

We have continued throughout 2020 to expand our portfolio of ECOG-ACRIN trials, and despite COVID have maintained accrual after the late spring–early summer downturn. In addition to a focus on accrual, the past six months have also brought some structural changes to our activities and priorities. Under the leadership of Drs. Matthias Weiss and Mike Thompson, community engagement in group leadership, priority-setting, and communication has been entirely revamped. We have increased community participation in both scientific and leadership committees, recruited designated community co-chairs for all our trials, and initiated both this newsletter in blog form and a pilot myeloma interest group on Slack. These are all developments toward broader community participation, and we welcome additional ideas and proposals toward this end.

The year 2020 also brought us to recruitment of more than 2000 women/month to the TMIST trial, and the initiation of a pancreatic cyst screening trial. Prevention and screening have renewed interest at the NCI and beyond, and the leadership of Drs. John Kirkwood and Etta Pisano in this arena has provided a strong platform from which to grow. All of these projects will mature throughout 2021 with your enthusiasm and involvement. We look forward to working with you toward our shared goals.

Read the January 2021 issue here.