Personalized medicine in pediatric cancer

Heads of Pediatric Hematology and Oncology Service Lucas Moreno և Antonio Perez-Martinez

to fight with a horse systematized և: multi-center that: Pediatric cancer In Spain, it is the main goal he hopes to achieve Spanish Society of Pediatric Hematology and Oncology (Sehop) through a new initiative, was baptized as pencil project. He is the coordinator of this new strategy Lucas MorenoHead of Pediatric Oncology and Hematology Service Hebron Valleya hospital that will coordinate almost 50 centers Children with cancer in Spain currently have:

The program has received: state funding through: Charles III Institute of Health : Focuses on generation nodes depending on the skills and abilities that each has involved centers. As Lucas Moreno points out Medical recordIt is vital that the project “multi-center և: multi-regional so you can move forward. In addition, A. in an autonomous system so that the project reaches all the centers thanks to the establishment of multidisciplinary regional committees. ”

Head of Pediatric Hematology Oncology Service La Paz University Hospital, Antonio Perez-Martinezhas also worked closely together to implement this program, which began to make progress earlier this year. The specialist at La Paz Hospital addresses one of the key aspects of the program: flow of knowledge between the centers involved. “We are in the process of designing these nodes, which will unite different centers, hospitals, so what travel from one center to another do not be sick:but: biological material և: knowledge so that there is an adequate return in time. “

How was the Pencil Project born? What are the goals of childhood cancer?

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The goal of the program is to increase the scope of personalized medicine

Lucas Moreno, Head of Val d’Hebron Pediatric Oncology և Hematology ServiceWe at the Spanish Society of Pediatric Oncology and Hematology have been working in the personalized medicine team for many years trying to understand what the situation is like with childhood cancer. We learned that patients had very unequal access to the sequencing methods for different types of childhood cancer.

In this much-needed situation, thanks to the Charles III Institute of Health’s call for personalized medicine projects, we created the project to bring together all members of the scientific community who have worked in various personalized medicine activities to launch the Pencil Project. It started this year,։ we are taking the first steps. The goal is to ensure that personalized medication reaches all patients in any hospital.

What role did the Charles III Institute of Health play?

Lucas MorenoThis is the project funding body. It is a call that is very much aimed at the implementation of personalized medicine, and not to make discoveries. When we complete the program, all regional health systems will make progress to include it in services.

How will this project be implemented in Spain with regard to precision oncology?

90% of all centers for children with cancer participate in the program

Antonio Perez-Martinez, Head of Pediatric Hematology-Oncology Service of La Paz University Hospital. “We are doing a preliminary analysis after seeing what the current situation of the personalized medicine for pediatric cancer is. Nearly 50 centers, where there are currently children with cancer, find it difficult to implement a good approach.

We look at how we can try to make the program fair և access to new tools. Different nodes are offered by the scientific company depending on the competencies and capabilities of each of the centers. We are in the process of designing these nodes, which will bring together different centers – hospitals, so that it is not the patient but the biological material or knowledge that is transferred from one center to another, so that there is a proper return in time. 90% of all centers for children with cancer participate in the project. “


“Biological material և knowledge should be transferred from one center to another, not the patient.”



Lucas MorenoFor the project to progress, it had to be multi-centered, multi-regional. Up to 8 autonomous communities had to participate. There is a coordination center, which is the hospital of Val d’Hebron, as well as beneficiary centers. There is a structure of these genomic centers, which is already functioning, then it was created in the regional system, so that it reaches all the centers, thanks to the establishment of multidisciplinary regional committees.

What are the functions of Val d’Hebron Hospital as a coordination center?

Lucas MorenoThis is a truly collaborative project that combines the efforts of many people to reach our patients. Vall d’Hebron takes on the role of coordinator to understand that each participant has different tasks, և we make sure they all work. There are some goals in the project that should ensure that all patients have access to the panel sequence, to ensure that in the event of a patient recurrence, they have a more detailed sequence, the use of liquid biopsy to diagnose the patient … All. These tasks are organized in work packages.

Is there a set line for applying what the project wants to promote on a daily basis?

Antonio Perez-MartinezWe are trying to unify, today it does not exist. There is still a significant gap between what should be and what is. Scientific progress is much faster than the regulatory part. In the case of childhood cancer, we have significant limitations. There are few clinical trials, little evidence, difficulty in recruitment … The real impact of personalized medicine on pediatric cancer is negligible. This does not mean that there are no patients who can benefit. The first step is for all patients to have an in-depth diagnosis of their tumor. This may change your treatment. As a research firm, our responsibility is for regulatory agencies to change the availability of medicines, allowing for better quality of treatment. That is still the way we have to go.


“The real impact of childhood cancer is small.”



Will there be a paradigm shift in pediatric cancer treatment: monitoring?

Lucas MorenoMedications are available in pediatrics, they are cheap. Our patients today are treated in large doses, but there are also a number of side effects that they will have to suffer for the rest of their lives. The new drugs that are becoming available are much less toxic, and we continue to monitor them for long-term use. We seek to introduce immunotherapy to improve patients’ survival. We want to avoid long-term toxic treatments, such as chemotherapy.

What are the pillars of a national strategy for personalized medicine to fight childhood cancer?

Antonio Perez-MartinezFor now, the cornerstone should be the scientific companies that try to make it universal, recognizing different groups as different competencies. At the organizational care level, we can not change the system. Many of us who work with rare diseases such as childhood cancer would like much more focused clinical care at National Reference Centers. Consolidation of clinical experience in all areas accelerates knowledge. The current system makes it difficult to change it. It is not realistic that there will be 5 pediatric cancer centers in Spain in the coming years.

With existing centers, we can create resource management, identify centers with different competencies that can host other centers on their network. We are looking for a great unit to integrate them all, which will allow us to treat more children, to treat them better. We want to be on the same level, in absolute numbers, but reduce the consequences that child survivors can have as adults.


“It is not a realistic aspiration that in the coming years we will have 5 pediatric cancer centers in Spain.”



How many boys and girls will be treated?

Lucas MorenoThe philosophy of this project is to reach all people suffering from childhood cancer in Spain. There are some hospitals that include the sequence in their daily routine, others are halfway there, and some are just getting started. If there are 1,200 children with cancer each year in Spain, the philosophy is that the studies are available to all patients who may need them. We still have to identify the most at-risk groups, but we want to reach everyone.

Is there rapid progress in pediatric cancer research?

Lucas MorenoWe are moving forward, և the speed is huge. There is currently progress in clinical trials and basic research. Nevertheless, we can not have a satisfactory message. Today almost every week the patient dies or has a relapse. It is unacceptable that there is still so much to go. You can go faster ստանալ get more patient options sooner.

Whether it may contain announcements, data or notes from healthcare providers or professionals, the information contained in the medical record is edited and prepared by journalists. We advise the reader to consult a healthcare professional with any health issues.

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