The Machinery Behind ASCO
A conversation with ASCO CEO Dr. Clifford Hudis on scientific progress, institutional memory, and AI
In nine days, thousands of oncologists will converge on McCormick Place in Chicago for the ASCO Annual Meeting. As it does every year, the field will perform its ritual of compression: a year of progress distilled into five days of plenaries, posters, hallway conversations, late dinners, and hurried meetings between sessions.
The person responsible for the machinery behind that ritual is Dr. Clifford Hudis, ASCO’s CEO, and my guest on the latest episode of Precision Signals.
Cliff grew up in Northeast Philadelphia in the 1960s in what he describes as a modest, middle-class household. His father worked continuously from the age of eighteen. His mother went back to school and became a public school teacher. There were no physicians in the family. The early scaffolding came from a cousin training to be an allergist, who served as an informal mentor, and from a summer in eighth grade spent in a laboratory at Hahnemann, grinding up earthworm muscle for someone else’s physiology experiments.
The public schools of that era were investing seriously in math and science. His parents, recognizing something in him, took out a loan to send him to a small Quaker school where AP biology and chemistry classes had only three or four students. From there he entered a six-year accelerated BA/MD program at Lehigh and the Medical College of Pennsylvania and graduated from medical school at twenty.
His internal medicine residency in Philadelphia brought him into oncology through a clinic full of grateful patients and still-incomplete science. In the mid-1980s, he moved to New York and was running the emergency room at Mount Sinai, where the oncology service operated as its own department under James Holland. It was there that Cliff first encountered Dr. Larry Norton from a distance.
Memorial Sloan Kettering had already taken root in his imagination years earlier through an unlikely source: Brian’s Song, the James Caan film in which Chicago Bears running back Brian Piccolo dies of a midline germ cell tumor at Memorial. In 1988, Cliff arrived at MSK as a fellow. That same fall, Larry Norton was recruited from Mount Sinai to launch the breast cancer service.
The team’s first home was not a gleaming cancer center floor. It was a two-bedroom apartment next to the hospital, with Cliff wedged into a corner of the living room.
What followed was an extraordinary decade. G-CSF. Paclitaxel. Trastuzumab. BRCA testing. Aromatase inhibitors. Capecitabine. In roughly ten years, breast cancer treatment changed in ways that still shape practice today. US breast cancer mortality peaked around 1990 and has since fallen by roughly 40%, driven in large part by systemic therapy advances that emerged from that era.
Cliff became Chief of the Breast Service in 1998, succeeding Larry Norton. But throughout our conversation, he is careful to reject any heroic version of the story. He describes himself as a collaborator, one person helping translate a much larger collective enterprise into clinical practice.
His path to ASCO also ran partly through Larry. Norton’s deep involvement with the cooperative groups, especially CALGB, pulled Cliff beyond the walls of Memorial and into the broader oncology community. Cliff eventually won a seat on the ASCO board as treasurer, a position that was directly elected at the time. He spent three years receiving what he calls an informal one-on-one MBA in how a professional society actually works.
He later stood for ASCO president, and his term coincided with the society’s fiftieth anniversary. The theme he chose was Science and Society, a phrase that now feels strikingly prescient. It reflected a decade of flat NIH and NCI funding, amounting to roughly a 25% real-dollar cut after inflation, and the early erosion of public trust in scientific methods. During that period, he found himself knocking on doors in the House and Senate, asking in one form or another when the United States had decided to cede scientific leadership.
When Allen Lichter stepped down after a decade as ASCO’s CEO, Cliff put himself forward. He inherited an organization of five hundred people, sixteen direct reports, and no fully integrated strategic plan. Over the next eighteen months, he reorganized it carefully. He is characteristically humble about the transition. There was, as he puts it, no universe in which he was qualified on his own to run ASCO. But the institution was strong enough to tolerate a new chief executive and bring him along.
On AI, Cliff offers an analogy I have kept thinking about. The future AI-powered electronic medical record, he suggests, may function like the lane-keeping and adaptive cruise control systems already built into ordinary cars. Clinicians will still feel autonomous when they are practicing within the lane, but the system will gently nudge them when they begin to drift.
That view is reflected in ASCO’s collaboration with Google Cloud, which produced a constrained Gemini chatbot that reads only from ASCO material, runs with its creativity dialed to zero, and highlights sources for every sentence it returns. Cliff suspects that the chatbot itself may look quaint in a decade, the way a journal devoted to indoor plumbing would look quaint today. The more durable shift is toward living guidelines, refreshed on an approximately eight-week cadence.
There is an implication here that Cliff does not overstate, but the listener can feel it. If oncology knowledge becomes truly continuous, the ASCO Annual Meeting of 2036 will not look like the Annual Meeting of 2026. The ritual of compression may give way to something more fluid, more continuous, and perhaps more closely aligned with how science now moves.
Cliff closes with a line he borrowed from Albert Bourla about visionary leadership and competent skepticism. It is the right note to carry into McCormick Place next week.