Bridging the Gap in Access to Care for Children With CNS Tumors Worldwide

Moreira, Daniel C.; Rajagopal, Revathi; Campo, Regina M Navarro-Martin del; Polanco, Ana C.; Alcasabas, Ana Patricia; Arredondo-Navarro, Luis A; Campos, Danny A.; Casavilca‐Zambrano, Sandro; Coronado, Rosdali Yesenia Diaz; Faizal, Nor; Ganesan, Dharmendra; Hamid, Syed Ahmer; Khan, Rafeah; Khu, Kathleen Joy; Loh, Jasmin; Lukban, Marissa; Negreiros, Tatiana; Pineda, Estuardo; Yaqoob, Nausheen; Zia, Nida; Gajjar, Amar; Rodríguez‐Galindo, Carlos; Qaddoumi, Ibrahim

doi:10.1200/go.20.00047

Cited by 20 publications

(14 citation statements)

References 8 publications

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“…The literature search only yielded one worldwide study tackling gaps in access to care for paediatric CNS tumours, which underscored the lack of data on outcomes, particularly from LMICs [12]. There are no published data specific to the treatment gaps involving adult CNS tumours.…”

Section: Neuro-oncology Research In the Philippinesmentioning

confidence: 99%

Neuro-oncology in the Philippines: a scoping review on the state of medical practice, deterrents to care and therapeutic gaps

Mondia¹,

Espiritu²,

Batara³

et al. 2021

ecancer

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Background: Neoplasms of the brain and spine are relatively uncommon compared to breast, lung and gastrointestinal tumours, which occur at higher rates in the Asian population. Updated guidelines in diagnosis and treatment of neuro-oncologic diseases recommend advanced molecular-based precision-medicine; thus the need for increasingly individualised regimens. It is, therefore, necessary to determine whether there are areas of improvement in the provision of care to these patients, especially in low-to middleincome economies like the Philippines. Methods:In this study, we identified gaps in the delivery of medical care to Filipino patients with tumours of the central nervous system. We performed a scoping review on the available literature on clinical experience with treatment of neuro-oncologic cases from the Philippines and performed qualitative analysis viewed through the lens of the existing healthcare system. Results:The medical practice of neuro-oncology in the Philippines lacks robust local data on epidemiology and treatment outcomes. There are existing legislative frameworks to support adequate healthcare delivery and financing to brain tumour patients. However, inequities in the geographic distribution of infrastructure, manpower and medications are roadblocks for accessibility to neuro-oncologic services like specialised molecular markers, neurosurgical procedures, sustained chemotherapy and radiation therapy centres. Conclusion:There are significant treatment gaps in the care of neuro-oncologic patients in the Philippines that need to be addressed. Early detection and initiation of prognosischanging therapeutics through reduction of out-of-pocket expenses, access to readily available diagnostic tools and sustainability of management regimens are the main areas that necessitate strengthened partnership between the public and private sectors of Philippine society.

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Section: Neuro-oncology Research In the Philippinesmentioning

confidence: 99%

Neuro-oncology in the Philippines: a scoping review on the state of medical practice, deterrents to care and therapeutic gaps

Mondia¹,

Espiritu²,

Batara³

et al. 2021

ecancer

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“…Many of these elements are not always available in LMICs. 11 survival rates in low-and high-resource settings and for identifying the specific steps needed to address these disparities. It is also important if we are to track the impact of the GICC, as data on outcomes of pediatric patients with…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review

Ward

Jones

Witt

et al. 2022

JCO Global Oncology

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PURPOSE Pediatric CNS tumors are increasingly a priority, particularly with the WHO designation of low-grade glioma (LGG) as one of six index childhood cancers. There are currently limited data on outcomes of pediatric patients with LGGs in low- and middle-income countries (LMICs). METHODS To better understand the outcomes of LGGs in LMICs, this systematic review interrogated nine literature databases. RESULTS The search identified 14,977 publications. Sixteen studies from 19 countries met the selection criteria and were included for data abstraction and analysis. Eleven studies (69%) were retrospective reviews from single institutions, and one (6%) captured institutional data prospectively. The studies captured a total of 957 patients with a median of 49 patients per study. Seven (44%) of the studies described the treatment modalities used. Of 373 patients for whom there was information, 173 (46%) had a gross total or near total resection, 109 (29%) had a subtotal resection, and 91 (24%) had only a biopsy performed. Seven studies, with a total of 476 patients, described the frequency of use of radiotherapy and/or chemotherapy in the cohorts: 83 of these patients received radiotherapy and 76 received chemotherapy. The 5-year overall survival ranged from 69.2% to 93.5%, although lower survival rates were reported at earlier time points. We identified limitations in the published studies with respect to the cohort sizes and methodologies. CONCLUSION The included studies reported survival rates frequently exceeding 80%, although the ultimate number of studies was limited, pointing to the paucity of studies describing the outcomes of children with LGGs in LMICs. This study underscores the need for more robust data on outcomes in pediatric LGG.

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“…In addition, to achieve their goal of providing high‐quality care for children with CNS tumors in LMICs, the workshop participants created the Global Alliance for Pediatric Neuro‐Oncology (GAP‐NO). To our knowledge, this is the first international multidisciplinary group focusing on pediatric CNS tumors in LMICs 15 . The mission of GAP‐NO is to improve access to quality care and outcomes for children with CNS tumors globally through multidisciplinary collaboration, education, generation and adaptation of knowledge, research, and optimization of resources.…”

Section: Resultsmentioning

confidence: 99%

Creation of a successful multidisciplinary course in pediatric neuro‐oncology with a systematic approach to curriculum development

Moreira

Gajjar

Patay

et al. 2020

Cancer

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Background The St Jude Global Academy Neuro‐Oncology Training Seminar (NOTS) is a hybrid course in pediatric neuro‐oncology specifically designed for physicians from low‐income and middle‐income countries. Methods The curriculum for the course was created by conducting a targeted needs assessment that evaluated 11 domains of care for children with central nervous system (CNS) tumors. The targeted needs assessment was completed by 24 institutions across the world, and the data were used to define 5 core elements included in the 2 components of the NOTS: a 9‐week online course and a 7‐day in‐person workshop. Participant acquisition of knowledge and changes in clinical behavior were evaluated as measures of success. Results Teams from 8 institutions located in 8 countries enrolled in the online course, and it was successfully completed by 36 participants representing 6 specialties. On the basis of their performance in the online course, 20 participants from 7 institutions took part in the on‐site workshop. The participants exhibited improved knowledge in core elements of treating children with CNS tumors, including barriers of care, possible solutions, and steps for project implementation (P < .0001). All participants expressed a belief that they acquired new concepts and knowledge, leading to changes in their clinical practice. Those present at the workshop created an international multidisciplinary group focused on treating CNS tumors in low‐income and middle‐income countries. Conclusions By using a hybrid online and in‐person approach, the authors successfully created a multidisciplinary course focused on pediatric CNS tumors for resource‐limited settings. Their experience supports this strategy as a feasible mechanism for driving further global collaborations.

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Bridging the Gap in Access to Care for Children With CNS Tumors Worldwide

Cited by 20 publications

References 8 publications

Neuro-oncology in the Philippines: a scoping review on the state of medical practice, deterrents to care and therapeutic gaps

Neuro-oncology in the Philippines: a scoping review on the state of medical practice, deterrents to care and therapeutic gaps

Outcomes of Children With Low-Grade Gliomas in Low- and Middle-Income Countries: A Systematic Review

Creation of a successful multidisciplinary course in pediatric neuro‐oncology with a systematic approach to curriculum development

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