Training in CAR-T therapy in Spain

Antonio Pérez-Martínez and Álvaro Urbano Ispizua.

The training of professionals in Spain for good management of CAR-T therapies is one of the priorities that hematologists they consider that the sooner the better should be addressed. The development of this new type of immunotherapy requires a complete academic instructionin addition to other specialties in the future, such as Oncology either Pediatricsthey will need this knowledge to reliably drive the CAR-T In our country. The Ministry of Health has recently increased the designation of new centers for the elaboration of CAR-T in Spain, for which the specialists see it as crucial to improve the training and instruction of future haematologists, starting with the Degree in Medicine, in addition to moving on to five years residency of Hematology.

Alvaro Urbano IspizuaChief of Hematology Barcelona Clinic and one of the architects of ARI-1 and ARI2, who awaits his hospital exemption, affirms in Medical Writing that an essential requirement is that of “expand training in what is the immunology and the immunotherapy against cancer in general. exist different levelsone is the formation of hematologists at this time, and in the future oncologists. In the training of hematologists, a specific time to drive of the cancer immunotherapy and it has to be part of their training program. Today there is a program for transplantation, hemotherapy, hemostasisetc, so you should also do one focused on cancer immunotherapy”.

This view is shared by Antonio Perez-Martinezhead of the Pediatric Hemato-Oncology Service of the Peace Hospitaland point at Medical Writing that training in this type of immunotherapy should begin in the Medicine degree and not only in the postgraduate: “Regardless of the number of centers designated by the Ministry in CAR-T therapies in Spain, the training in 21st century medicine must be regulated during the degreethe postgraduate and the specialized health training”.

Pérez-Martínez: “We need an additional training period for our residents when they finish Pediatrics, as is done in the United States”

As far as the training programs within the degree of Medicine, Pérez-Martínez sees fit to promote additional training periods and sets an example to follow United States model: “It has to appear in the formation the cellular therapy, advanced Y gene. We have to start modifying to include these notions in the different stages Hematology, Pediatrics, etc. In addition, subspecialties must be promoted in post-MIR training. From Pediatrics we have been claiming it for decades. We are paediatricians, it does not matter if we are children’s oncologists, since we all do the same four-year training. Today, those of us who dedicate ourselves to something as complex as the child cancer we need a additional training period for our residents when they finish Pediatrics, just as it is done in the United States. We should import the model.”

Pass the residency in Hematology to five years, a priority

expand the number of residents in Hematology is not the solution that Urbano contemplates, and the hematologist focuses on increasing the MIR training time in the specialty: “At the present moment we are the European country that has a shorter training programfour years, and at the same time more extensive. We want to teach our MIR in the shortest time in Europe the higher material content. That makes the formation have gaps. The Ministry of Health has been asked many times to go from four years to five years of residence. In the training MIR should have time dedicated to the clinical management of CAR-T”.

The immunology is, for Urbano, another of the pillars which should be further promoted from the Medicine degree to deal with CAR-T therapy with sufficient knowledge: “There is already a subject on the study of the body’s protective system against foreign elements, but the current understanding of the immune system with the attempt to eliminate cancer naturally and its use as a therapy against this disease makes the teaching program has to be increased. It is necessary to provide more hours to this specialty, and not only because of cancer. It has been seen that the immune system plays an extraordinary role”.

Urbano: “We want to teach our MIR in the shortest time in Europe the greatest content of the subject”

Following the same line, Urbano defends the idea of further integrate the clinical immunology service in the departments that treat cancer: “Increasingly, the healthcare organization of a hospital goes by areas and the departments integrate clinical Hematology with medical Oncology. I think that this role that immunotherapy is having in cancer is yet another argument for bring clinical immunology services closer to the areas of canceror even integrateas is the case in other European countries.

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any questions related to health be consulted with a health professional.

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