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Live from ASCO: What the Slides Don’t Show
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Released: June 10, 2025

Expiration: June 10, 2026

John Marshall
John Marshall, MD
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Live from ASCO: What the Slides Don’t Show

 

John Marshall, Oncology Unscripted ASCO 2025.

John Marshall, MD: You know what this is? It's called the ASCO Daily News. They hand you one of those as you enter the building here every morning. And yeah, there's a lot of good science here, a lot of cool things, and pictures of prominent presenters. Even old oncologists get their picture here as well. But there's a whole bunch of stuff that's not in the oncology news that's really important to our future.

On Friday, Trump unfolded his budget. His budget includes a 40% reduction in the NIH budget. It is a huge delta in what will happen at the National Cancer Institute, if indeed this happens. 15% indirect rate officially now on the table. The Cancer Center Directors, NCI Cancer Center Directors, visited Capitol Hill last week hosted by Georgetown’s Lou Weiner, my boss, and they all went up to the hill to talk to various congressional folks about what the heck's going on. If you cut this budget, we will lose ground in terms of America's ability to contribute to cancer research at a time when we know more than we ever did.

Our European colleagues have put out advertisements to attract some of our major thought leaders to go to Europe, granting visas so that they can in fact do their own brain drain of us now that our budgets are being cut. So, we really have to figure it out. What we are doing and the impact this is gonna have day to day, not only on our research, but on our cancer care delivery, for our patients here in the United States. And I don't think folks have really thought that through very well.

Secondly, we of course have no NCI director right now. They're sort of an interim. And one of my friends, a guy named Wafik El-Deiry, who's at Brown, has put his hat in the ring. He had said some pro-Trump stuff coming into this year thinking that shaking up clinical research was gonna be a good idea, but he's sort of like, what are we talking about now? And he said, I'll do it. I'll do the job if you give me $50 billion for cancer research. Well, that's more than the current budget is. And of course, I just told you they're cutting the budget. So, I don't see any way that angle, that argument, is gonna take any traction with our current administration. So Wafik, I hope you get what's on your Christmas list, but my guess is you will not. And my guess is we will continue to go without an NCI Director, and an unclear future about the role the NCI is going to play, in global cancer drug discovery and drug development and looking for cures.

The other major theme that we're hearing here at this cancer meeting is that artificial intelligence is gonna be important. That if you're not doing it, if you're not embracing it on the education level, on the research level, any level you wanna look at, then you're gonna fall behind. And I think most of us probably agree that it's gonna be a very, very important tool.

But you that little thing called Make America Healthy again, that just came out from somebody named Kennedy. Well, that actually includes seven papers that were hallucinating. References in our national policy proposal that never were written that AI wrote instead. So, where's truth? How are we gonna know what's real? How are we gonna know what's a hallucination when we do our Google searches? How deeply does a journal need to review a paper to know whether AI wrote it or in fact, some fellow who wants to get a paper on their CV wrote it, right? How are we gonna prove truth going forward when a government policy paper has seven references that never existed, supporting what we're proposing. How are we as a major cancer community gonna keep track of what's real and what's not real? So, I'm very anxious about AI and how we're gonna manage that going forward. We know we need it. We don't know how to control it. Figure this out. Everybody.

John Marshall Oncology Unscripted.​