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. 2022 Apr;69(4):e29568.
doi: 10.1002/pbc.29568. Epub 2022 Jan 27.

Global Neuroblastoma Network: An international multidisciplinary neuroblastoma tumor board for resource-limited countries

Katherine K Matthay  1 , Jennifer Hylton  2 , Neela Penumarthy  3 , Mohammed Khattab  4 , Shui Yen Soh  5 , Hoa Thi Kim Nguyen  6 , Ana Patricia Alcasabas  7 , Mohammed Fawzy  8 , Raya Saab  9 , Muhammad Saghir Khan  10 , Khalil Ghandour  11 , Guillermo Chantada  12 , Nehal S Parikh  13 , Lawrence Faulkner  14 , Catherine G Lam  15 , Scott C Howard  16
Affiliations

Global Neuroblastoma Network: An international multidisciplinary neuroblastoma tumor board for resource-limited countries

Katherine K Matthay et al. Pediatr Blood Cancer. 2022 Apr.

Abstract

Background: Tumor boards are part of standard care of patients with complex cancers, but appropriate multidisciplinary expertise and infrastructure are often not available in low- and middle-income countries (LMIC) for pediatric cancers, such as neuroblastoma. Our goal was to review results of a Global Neuroblastoma Network (GNN) tumor board accessible to LMIC.

Methods: De-identified clinical cases presented via internet conference during a weekly GNN virtual tumor board from 2010 through 2020 were evaluated in a standardized format, including diagnostic imaging, pathology, therapy information, resource limitations, and questions for discussion. Information summarized included the presentations, a survey of the impact on care, and a resource questionnaire.

Results: Registered GNN participants included 575 individuals from 77 countries, with a median of 39 participants per session. Total 412 cases were presented from 32 countries, including 351 unique neuroblastoma patients, 52 follow-up cases, and nine non-neuroblastoma diagnoses. Twenty-eight educational sessions were presented. Limited critical resources for diagnostics and staging of cases included MYCN analysis (54.7%), metaiodobenzylguanidine (MIBG) scans (38.7%), and International Neuroblastoma Pathology Classification (49%). Therapies were also limited, with markedly decreased use of radiation and autologous stem cell transplant for high-risk cases, and no availability of anti-GD2 antibody in LMIC. Limited sampling with a post-presentation survey showed that 100% found the GNN helpful, and 70% altered the care plan based on the discussion.

Conclusion: This report shows the utility of an international tumor board for LMIC focused on a challenging solid tumor where local expertise may be limited, with international multidisciplinary expert participation and educational sessions.

Keywords: low- and middle-income countries; neuroblastoma; solid tumors; support care; telemedicine.

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References

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