Early and mid-career oncologists from Latin America participated in the first two sessions of the new Winship Preceptorship for Breast/Lung Oncologists aimed at increasing their knowledge and skills to improve their clinical practice back home.
Funded by Pfizer, the two-week deep immersion programs brought a total of nine physicians to Atlanta from Brazil, Argentina, Mexico and Colombia. Their travel and lodging costs were covered. The first session was held August 12-28, 2022; the second session was held October 14-30, 2022.
The preceptorship program was co-led by breast oncologist Keerthi Gogineni, MD, MSHP, associate professor in the Department of Hematology and Medical Oncology; Ticiana Leal, MD, director of the Thoracic Medical Oncology Program at Emory University School of Medicine; and Rebecca Pentz, PhD, professor of hematology and oncology in research ethics at Emory University School of Medicine.
Gogineni explains that, together with insights from colleagues practicing in Brazil and Mexico about oncology training needs in Latin America and leadership from the Latin America Lung Cancer Association, program leaders decided to focus on genomic-driven management of lung and breast cancer through a combination of didactics and direct clinical observation.
During the two weeks, participants received a mix of didactic lectures focused on genomic-driven management of breast cancer and lung cancer, and hands-on observorship in a variety of clinical settings. These included shadowing physicians performing patient evaluations and treatment, directly observing all aspects of medical oncology care for patients with lung or breast cancer, attending tumor board meetings and attending research presentations and educational seminars.
The preceptorship aimed to give participants familiarity with the latest systemic treatment modalities, such as targeted therapies, immunotherapy and experimental cell therapy approaches. They also were exposed to advanced pathological diagnosis of cancer, including immunohistochemistry and molecular diagnostics. They gained appreciation for the team-based approach to optimal cancer care and became familiar with clinical research as a key tool to advance cancer care by attending research team meetings.
In interviews with Pentz at the end of the preceptorship, all participants ranked the experience as extremely valuable for their career development. Asked to rate the two weeks, all nine participants rated the lung cancer didactics as extremely valuable; eight of the nine also rated the breast cancer didactics with this highest rating. “The didactics helped to refresh my knowledge,” said one participant in anonymous reviews at the end of the program. “They made the week of activities much more productive for me.” Another participant said, “This was great, and I learned what I wanted—how you work, how you interact, how a university like this can be built. Perhaps we are 20 years from this, but it is something to aspire to.”
Looking back at the two preceptorship sessions, Gogineni says, “We learned quite a bit from these providers about the reality of practice on the ground in their communities and how they approach patients with breast and lung cancer with the resources available to them.” She points out that the participants were largely from areas where health systems had variable access to drugs and diagnostics based on what was approved nationally and was covered. Patient’s insurance status also affected access.
Gogineni points out that the reality is that the cost and accessibility of many approved diagnostics and therapeutics that are used to personalize and tailor therapy for patients with breast and lung cancer are not easily accessible in many settings. “Ultimately,” she says, “we have a responsibility to make these tests and drugs accessible to providers and patients everywhere. We hope this is just the start of future collaborations.”
Leal adds, “The participants provided feedback that being part of this program led to renewed enthusiasm to change or implement new strategies to improve care in their countries. We were also asked by others in Latin America if we would consider making this program available for future groups given the positive experience reported thus far.”