The Fellows Forum Live From ASCO 2024 With Samuel Kareff, MD, MPH; Waqas Haque, MD, MPH; and Matthew Hadfield, DO

At this year’s American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Fellows Forum members Dr. Samuel Kareff, Dr. Waqas Haque, and Dr. Matthew Hadfield sat down to discuss their highlights from ASCO and the importance of attending ASCO as a fellow. In addition, they share a preview of the new Fellows Forum community which all hematology/oncology fellows are invited to join to enhance their fellowship experience and to use their voice!

Oncology Data Advisor: Welcome, all of you, to the Oncology Data Advisor Live Fellows Forum. We’re so excited to be here today with three of our Fellows Forum members: Dr. Sam Kareff, Dr. Waqas Haque, and Dr. Matt Hadfield. It’s so awesome to finally see all of you in person, especially after doing so many Zoom interviews this past year, and it’s wonderful to finally get to connect here.

Waqas Haque, MD, MPH: Thanks so much.

Samuel Kareff, MD, MPH: Thanks for having us.

Matt Hadfield, DO: Absolutely.

Oncology Data Advisor: Would you like to first start by going around and introducing yourselves?

Dr. Kareff: Hi, everyone. My name is Dr. Samuel Kareff. I’m the outgoing Chief Fellow at the University of Miami Sylvester Comprehensive Cancer Center/Jackson Memorial Hospital. I’m very pleased to be here with my colleagues today at another wonderful ASCO meeting.

Dr. Haque: Hey everybody, I’m Dr. Waqas Haque. I’m wrapping up Internal Medicine Residency in a Clinical Investigator Track at New York University (NYU) and starting University of Chicago Oncology Fellowship on July 1st.

Dr. Hadfield: And recently named 40 Under 40 in Cancer!

Dr. Haque: Thanks so much. 

Dr. Hadfield: Absolutely, congratulations. I’m Matt Hadfield. I’m a third-year Medical Oncology Fellow at Brown University in the Legorreta Cancer Center in Providence, Rhode Island. And I’ll soon be joining the faculty there focusing on phase 1 early drug development in melanoma.

Oncology Data Advisor: Amazing. Super excited to be able to do this Live Fellows Forum today.

How have each of you been enjoying ASCO so far?

Dr. Kareff: It’s just been a really wonderful meeting. We were just reminiscing beforehand about having our paths cross with others across the country and across the globe and meeting with so many co-investigators, partners, and patient advocates. It’s just been a wonderful opportunity.

Dr. Haque: Yes, this is my second year going. It’s obviously a privilege to be able to go during residency, where your schedules can be really tight. I think it’s just amazing to have these networking opportunities and get to meet everybody in person.

Dr. Hadfield: I think ASCO is honestly one of the most special meetings, because you run into old friends and people you trained with. But then you quickly start talking about trials and things that are going on, and then before you know it, you’re developing ideas and concepts. It’s the type of things that can only organically happen when you bump into people at a place like ASCO, so it really is a special meeting.

Oncology Data Advisor: It definitely is. What are some of the benefits you’ve found from attending ASCO as a resident or a fellow?

Dr. Kareff: I met you, Keira, just a couple years ago at a poster session. We were talking about HRAS mutations in breast cancer. Thankfully, our pan-tumor analysis was recently published in the Journal of Cancers. But even that brief interaction launched our collaboration here, right? It’s like Dr. Hadfield was saying, these little interactions lead to such great opportunities. So, as a fellow, especially in this Fellows Forum, I’m just very thankful for the opportunity, and I look forward to expanding it for other fellows across the country and hopefully across the world. 

Dr. Haque: For me, as an incoming oncology fellow, I think access to mentorship opportunities is really great here. They have an early career track in the lounge where you can go to find mentorship opportunities and get one-on-one sessions with attendings and people who are involved in admissions. Just getting that whole experience and meeting with other residents and incoming fellows is a huge opportunity.

Dr. Hadfield: Absolutely. I think one of the unique things about ASCO that maybe we don’t talk about enough is that it’s really one of the meetings where industry and academics are so closely meeting together. It really does offer some unique opportunities, particularly as a fellow, just getting a little insight into how those relationships are built and how they’re fostered. You can take ideas and develop concepts by working with companies and get insight into that process works. You start those relationships at ASCO, which is really important, and it can start as a resident or as a fellow and carry on into your career.

Oncology Data Advisor: Definitely, you have a lot of opportunities here, and like you said, you can meet someone by chance and it sparks into a whole collaboration. There’s definitely a lot of opportunity. For those of you who are presenting posters or sessions, or are authors on any research here, would like to tell us a little bit about the research?

Dr. Kareff: Sure. We’ve been really blessed at the University of Miami. I actually presented a cost-effectiveness analysis that was published in JAMA Network Open yesterday. I had an update in the ASCO Oncology Medical Education Community of Practice, where we talked about updates in medical education—very topical for this forum, of course. That was followed by a poster leading to a phase 1 trial we’re opening at the University of Miami, looking at the TEM8 biomarker in small-cell lung cancer.

After this, we’ll be going to the trainee lounge to talk about ways to exceed in fellowship. So, it’s very topical for this forum, very productive, and like we were reminiscing before this as well, these opportunities just kind of keep escalating as you progress through your career. It’s just a wonderful opportunity.

Dr. Hadfield: I’ve been very fortunate as well to be a co-author and presenting on several interesting things that we’ve been doing at the Legorreta Cancer Center. One thing with Jeremy Warner’s group, who leads our bioinformatics department, has been looking at accelerated FDA approvals. Essentially it’s about the timing between what we are doing with the FDA and the European Regulatory Affairs, looking at that from a higher-level view and seeing what the time to accelerate approvals are, but then what the outcome is in terms of subsequent approval with phase 3 data and if we need to rethink that.

There was a very interesting poster at the American College of Rheumatology (ACR) that looked at a similar topic. I think the accelerated approval process is great in many ways, but there’s also a lot of ways in which I think it could be improved, because we have seen some approvals get taken back by subsequent phase 3 data that just didn’t pan out.

Another very interesting thing that we’re doing is with Don Dizon, an investigator at our cancer center, who did an investigator-initiated trial with Bristol Myers looking at ipilimumab-nivolumab (ipi-nivo) in extra-renal cell clear cell carcinoma. It had a fantastic response rate. It’s an oral presentation this morning, so we’re really proud of him and happy to be doing that at our cancer center.

Oncology Data Advisor: Awesome. Congrats to both of you on this research here. Waqas, huge congratulations to you for winning the Cancer 40 Under 40 award. Would you like to tell us a little bit more about this recognition?

Dr. Haque: Thanks so much. I had the award ceremony last night, and basically, it’s an award for 40 people under the age of 40 who are involved in cancer care in some way. You don’t have to be an oncologist necessarily; you can be a researcher, you can be industry or nonprofit. It’s awarded to 40 people across different areas, even nonprofit as well. It was pretty interesting. They mentioned at the awards ceremony that 40 people were picked, but there were 2,500 applicants, about a 1.6% acceptance rate. So, that was cool. It was special because my fiancé was able to be there with me, and she actually won the Forbes 30 Under 30 this past year. So, it was cool to go.

The reason I got the award was for my research in value-based care. Dr. Hadfield was talking a little bit about accelerated approvals, and one thing that I was researching that got published in JAMA Oncology last year was looking at a study about the delays between approval for a drug in oncology and then coverage by insurance companies. Even if a drug is technically approved, it might not actually be in the hands of patients or available to them for many months to years after. So, that was one of the key papers that helped me get this award.

Oncology Data Advisor: Awesome. Congrats again, and congrats to your fiancé as well. We’re so excited to be launching the new version of the Fellows Forum—Fellows Forum 2.0, I like to say—where in addition to having the leadership board with all of you steering the conversations, we’ll also be opening it to other fellows who are interested in joining and becoming part of the discussion boards. Going into this, what have each of you enjoyed the most about being part of the Fellows Forum over the last year or so?

Dr. Kareff: I think we’ve really covered a lot of the ground here, and it’s just a great opportunity for a lot of connections. Honestly, fellows and other trainees maybe traditionally have had less of a space at the table and less of a voice in these conversations, and I think opportunities like these really elevate those voices, which are just so crucial to making sure that there’s adequate representation. I’m very thankful for that, and like I said earlier, I really invite all fellows and other trainees as well to join the forum if possible.

Dr. Haque: Just because of the Internet, there can be so much access to information, and it’s very hard to rely on things when you might not be sure it’s accurate. So, to have a place where there’s expertise and there’s curated discussion, I think is really important because you don’t really have those spaces online.

Dr. Hadfield: Absolutely. I think one of the things that I’ve found so great about this, and I’m hoping to see it evolve in the future, is that I think the paradigm’s sort of shifting a little bit regarding mentorship in oncology and across other fields too. The idea used to be that you go to a fellowship and you find a mentor there and that’s it, and they’re responsible for your career. Some of this I think is coming out of post-COVID, where everyone’s so interconnected with the ability of Zoom calls and things. These communities can form, and you can find mentors at other institutions, and you can really build your network a lot easier. This type of forum is really perfect for that, so it’s been great to be in.

Oncology Data Advisor: Absolutely. What can other fellows look forward to? What benefits can they look forward to, such as collaboration and networking with other fellows? And why should they join? 

Dr. Kareff: With our new Fellows Forum, well, in the first place, you get to hear my voice less, which is fantastic for everyone involved. But seriously, like Dr. Hadfield was alluding to, I think you’ll be able to get these more organic connections. Another thing that’s kind of changed through the pandemic and training, not only at the fellowship level but really at all trainee levels, is you can look outside your institution, but you also don’t need to go through that straight hierarchy. We’ve been taught you have to go to the senior investigator in your institution, or maybe someone who’s an expert in your site disease group. You really can work with other trainees as mentor/mentee relationships. You can work with folks who aren’t even in the pathway into organized medicine yet. So, really the opportunities are endless, and that’s wonderful.

Dr. Haque: Even when it comes to things like research—of course, sometimes there might be a confidentiality HIPAA that prevents you from collaborating across different institutions, but even doing things like literature reviews, case presentations, just basic articles online, those are new opportunities that can open up even if you’re not able to get access to a different institution’s data.

Dr. Hadfield: And I think too, having people who have been in the same situation you’ve been in at other institutions, maybe they don’t know exactly how it works at your institution, but they can help you navigate the roadblocks that we’ve all encountered before.

For instance, Dr. Kareff just talked about how he took a translational project and turned it into a phase 1 concept, which is amazing, but as you know, there’s a lot behind the scenes on that. There’s a lot of interacting with the company, there’s a lot of developing an investigator-initiated trial. There’s a lot of regulatory aspects to that. If you’re at a center where you don’t have a mentor that’s helping you do those things and you want to be a clinical trialist or work in early drug development, the Fellows Forum offers those organic opportunities to find someone. As you said, another fellow can mentor you through the exact same things that we’ve been going through. So, it’s really perfect for those types of things.

Oncology Data Advisor: Absolutely, looking forward to all these opportunities. We’ve done so many fantastic videos and podcasts on the Fellows Forum this past year, from Cancer Awareness Month, to Waqas’s AI and Tech series. What are some of the other topics that you’re looking forward to covering next?

Dr. Kareff: I think we highlighted a couple here that the Fellows Forum might think about incorporating in the future—things like value-based care, regulation and looking into working with regulatory agencies, even things like early phase trials. These are topics that we talk about traditionally in our more organized didactics, but things that we can expand in the Fellows Forum, which will be really great.

Dr. Haque: I think for me, just going from a resident to a fellow this last year, I’ve been talking a little bit about the application process. Now just being able to go through that experience of fellowship and sharing that with people will be pretty fun.

Dr. Hadfield: I think there’s a lot of things too that we talk a lot about, and the Fellows Forum can help maybe create that groundswell of actually changing some things. One thing that comes right to my mind is diversity in clinical trials. I think we’ve been talking about this for decades, but oftentimes these conversations don’t really go anywhere. Depending on where you’re at, what the priorities are, how your own center’s dealing with that, creating a community of fellows that conversations like this can happen amongst trainees and then we’re growing the next generation of clinical trials. Maybe we can actually come up with some concrete solutions instead of just identifying a problem no one wants to take on and make a solution for it.

I think another area of interest for me that I’m particularly passionate about is immunotherapy toxicities, which I probably talk about too much and everyone’s sort of sick of hearing about it, but I did want to highlight that it’s something that I hope to continue talking about in the Fellows Forum. We actually, in a multicenter collaboration, have created the Aspire Group, which is both a consortium on developing immunotherapy toxicity programs as well as a patient advocacy group. We had our first meeting yesterday, so I’m hoping to highlight that more.

I think raising awareness about toxicities—as we start trickling these into earlier phases, a lot of patients are going to develop chronic toxicities, a lot of patients are going to develop late onset toxicities, and we have to have that information and collaboration to identify them better and counsel patients on those toxicities. So, I think those are all things that, as Dr. Kareff was mentioning, we don’t really get a lot of in didactic lectures. In fellowship, we need to have these conversations, and the Fellows Forum really fosters that.

Oncology Data Advisor: Absolutely. I’m really looking forward to covering all these topics. As we wrap up, is there anything else any of you would like to mention about your ASCO experience or your fellowship experience in general?

Dr. Kareff: If there’s one tip I have for all trainees who are interested in oncology, try to come to ASCO in person at least once during your training. There’s obviously a lot of barriers, it might be institutional approval, funding, et cetera, but I do think it’s highly worth the cost and the time. As we’ve mentioned, a lot of connections develop organically here, and you can’t get that from being virtual.

Dr. Haque: Even taking advantage of the resident and the fellow track is really important. And there’s also a separate medical student research symposium they have. So, even if you can’t get into the main ASCO conference for your abstract or paper, at least trying to get into that would still be very meaningful. 

Dr. Hadfield: Absolutely. I think as someone who’s interested in applying to oncology or someone that’s training in oncology, ASCO really is one of the most unique experiences in the world. I mean, you’re never going to have a situation where there’s this many people in person. Even if you’re not presenting, as we have alluded to, the early training lounge is perfect.

I would say the biggest advice is that ASCO can be so overwhelming. I mean, there’s like 40,000 or 50,000 people here. There are so many sessions—come with a plan, but also do not be afraid to introduce yourself to people, because a lot of times, especially when you’re training, you’re like, “People don’t want to talk to me,” and you feel kind of small. But everyone’s happy to talk, everyone’s happy to chat, and you never know if that could lead to where you go for fellowship, or a research collaboration, or just a mentor. Put yourself out there!

Oncology Data Advisor: Definitely. That’s a great way to wrap up. Thank you all so much for coming by today. It was wonderful to finally do this in-person Fellows Forum, and I’m looking forward to working with you all a lot more in the next year.

Dr. Hadfield: Thank you.

Dr. Kareff: Cheers. Thanks for having us.

Dr. Haque: Thanks so much.

About Dr. Kareff, Dr. Haque, and Dr. Hadfield

Samuel Kareff, MD, MPH, is a Medical Oncologist and the outgoing Chief Oncology Fellow at the University of Miami’s Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital in Florida. He has special research interests in health advocacy, public policy, and the development of cancer therapies.

Waqas Haque, MD, MPH, is a third-year Internal Medicine Resident at New York University (NYU) in a Clinical Investigator Track. He recently matched to the University of Chicago for fellowship, which he will be beginning in summer 2024. As a Clinical Investigator Track Resident, Dr. Haque has balanced his patient care work with a variety of research projects. During his fellowship training at University of Chicago, he plans to further his work in innovative clinical trial design, value-based care delivery to cancer patients, and clinical investigation.

Matthew Hadfield, DO, is an outgoing Hematology/Oncology Fellow at Brown University/Legoretta Cancer Center in Providence, Rhode Island. Prior to fellowship, he completed his Internal Medicine Residency at the University of Connecticut in 2021. Dr. Hadfield’s research focuses on melanoma and early-phase clinical trials. To date, he has published numerous peer-reviewed articles and studies, and he has presented his research at multiple national and international meetings. His main areas of interest include early-phase drug development, novel immunotherapeutic combinations to overcome therapeutic resistance, and predictive biomarkers for immunotherapy toxicities.

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