DISP-11. Virtual Neuro Oncology Tumor Board and HealthCare Disparity - Syria as an Example

Abstract

Abstract Virtual neuro-oncological tumor boards have become widely implemented in many US institutions in the post-COVID-19 era. With its convenience and easy application, virtual oncology tumor boards have also been explored nationally and internationally. To investigate the role of such a platform in bridging the gap in neuro-oncological care in developing countries, I conducted a physician survey of those who have actively or recently worked in Syria, a war-torn country under economic constraints. The survey was conducted in December 2024, with 21 participants, including neurosurgeons, oncologists, and neurologists. The idea proposed is to have a weekly neuro-oncological tumor board where local physicians present cases of suspected or confirmed primary brain tumors with a panel of trained physicians in neuro-oncology from the US and Europe. Such a project aims to offer clinical guidance and training to the local team, help prioritize cases for surgery, radiation, or medical therapy, collect data to understand the landscape of primary brain tumors in Syria and help find resources. Overall, ~75% of the surveyed physicians felt it would be helpful. However, it unleashed some technical challenges and widespread healthcare disparities. Among those technical challenges are outdated and limited neuroimaging viewing and sharing applications. Additionally, many routine pathologic diagnostics for glioma, like IDH testing, are only available in a few locations nationwide. More sophisticated testing, like next-generation sequencing or MGMT promoter methylation, is also rare. On the therapeutic level, surgical resection is often delayed for weeks and sometimes omitted. Temozolomide also has limited availability and is expensive, and there are only a few functioning linear accelerator machines. However, exploring such a platform might improve neuro-oncological care disparities, allow data collection, and set a realistic prototype example to encourage initiating similar projects.

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