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[Preprint]. 2025 Apr 21:rs.3.rs-5799306.
doi: 10.21203/rs.3.rs-5799306/v1.

Collaborative Frontiers in Pediatric Neuro-Oncology: Establishing an International Tumor Board for Enhanced Care and Global Impact

Margaret Shatara  1 , Nicole M Brossier  2 , Andrew Cluster  2 , Ali Y Mian  2 , Sonika Dahiya  2 , Amy E Armstrong  2 , Angela C Hirbe  2 , David H Gutmann  2 , Kenneth Aldape  3 , Mohamed S Abdelbaki  2
Affiliations

Collaborative Frontiers in Pediatric Neuro-Oncology: Establishing an International Tumor Board for Enhanced Care and Global Impact

Margaret Shatara et al. Res Sq. .

Update in

Abstract

Background: Central nervous system tumors are the leading cause of cancer-related mortality in children, with significant disparities in diagnostic and treatment capabilities between low- and middle-income countries and high-income countries. This study outlines the establishment of an international neuro-oncology tumor board to address these gaps.

Methods: The tumor board was initiated in January 2021 through a partnership between Washington University in St. Louis, USA, and nine institutions, ultimately expanding to 39 institutions across 25 countries. Monthly virtual meetings facilitated multidisciplinary case reviews offering diagnostic and management recommendations. A retrospective analysis of 29 sessions over three years was conducted, and a cross-sectional web-based survey among participants assessed their experiences and satisfaction.

Results: From January 2021 to December 2023, 101 cases were reviewed. The most diagnoses were low-grade gliomas (23.4%) and neurofibromatosis type 1 and 2 (32.7%). Newly diagnosed cases comprised 51%, while 40% involved recurrent or progressive disease, and 9% were inquiries during ongoing therapy. Recommendations predominantly addressed therapeutic strategies (60.7%). Advanced diagnostics, such as methylation profiling, refined diagnoses in several cases. The survey, with a 35% response rate, showed high satisfaction, with 91% finding the meetings educational. Barriers included time constraints (71%) and conflicting commitments (27%).

Conclusion: This initiative, to our knowledge, represents the largest international pediatric neuro-oncology tumor board. Multidisciplinary discussions improved diagnostic precision, informed therapeutic decision-making and facilitated educational exchange. Participants reported positive impacts on professional development and alignment with institutional needs. Despite challenges, this study highlights telemedicine's potential to bridge resource disparities and improve the outcomes globally.

Keywords: CNS Tumors; Global Health Disparities; Internationmal Collaboration; Pediatric Neuro-Oncology; Telemedicine.

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Conflict of interest statement

Conflict of Interest: All authors reported no conflict of interest.

Figures

Figure 1:
Figure 1:
Countries involved in the international pediatric neuro-oncology tumor board as of December 2023.
Figure 2:
Figure 2:
Flow chart of virtual multi-disciplinary tumor board meetings. TB: tumor board.
Figure 3:
Figure 3:
Distribution of different pathologic diagnoses discussed. LGG: low-grade gliomas. HGG: high-grade gliomas. DMG: diffuse midline gliomas. DIPG: diffuse intrinsic pontine glioma. NF: neurofibromatosis.
Figure 4:
Figure 4:
Reasons for case presentation.
Figure 5:
Figure 5:
Factors Influencing Tumor Board Participation
See this image and copyright information in PMC

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