Collaborative frontiers in pediatric neuro-oncology: establishing an international tumor board for enhanced care and global impact

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

doi:10.1007/s10147-025-02793-3

Collaborative frontiers in pediatric neuro-oncology: establishing an international tumor board for enhanced care and global impact

Int J Clin Oncol. 2025 May 30. doi: 10.1007/s10147-025-02793-3. Online ahead of print.

Authors

Affiliations

¹ Pediatric Neuro-Oncology Program, Department of Pediatric Hematology and Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA. Margaret.shatara@childrensmn.org.
² Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA.
³ Department of Pathology and Immunology, Washington University, St. Louis, MO, USA.
⁴ Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
⁵ Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
⁶ Department of Neurology, Washington University School of Medicine, St Louis, MO, USA.
⁷ Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.

PMID: 40445524
DOI: 10.1007/s10147-025-02793-3

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 multi-disciplinary 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; International collaboration; Pediatric neuro-oncology; Telemedicine.