665 - Six Months into a Virtual Global Collaborative Training Program in Pediatric Neuro-Oncology: Early Experience from a Capacity-Building Initiative in Egypt

Publication Number: 3644.665

Amr Elgehiny, MD Anderson Cancer Center, Houston, TX, United States; Alaa Mohamed. Nassar, Borg Elarab University Hospital (BAUH) - Pediatric Oncology Center, Alexandria, Al Iskandariyah, Egypt; Mohamed A. Hassan, Alexandria faculty of medicine, Smouha, Al Iskandariyah, Egypt; Khaled Mohamed. Seddik, Alexandria university, Alexandria, Al Iskandariyah, Egypt; Zeyad Hassanein, Borg e arab University Hospital , Alexandria University, Alexandria, Al Iskandariyah, Egypt; Esraa Sameh. ElRagabawy, Borg ElArab University Hospital, Alexandria,Egypt, Al Iskandariyah, Egypt; Esraa Abd Elnaser, Borg elarab university hospital, Alexandria, Al Iskandariyah, Egypt; Eman Mohammed. Youssef, Borg Al Arab hospital university, Alexandria, Al Iskandariyah, Egypt; Asmaa Mohamed. Naser, Borg El arab (oncology center) University hospital, Borg El arab, Al Iskandariyah, Egypt; Aya Kamal Eldin, Borg el arab, Alexandria, Al Iskandariyah, Egypt; Basant HM. Mahmoud, Balkan centre , Bascom Palmer Institute, MIAMI, FL, United States; Wafik Zaky, MD ANDERSON CANCER CENTER, hOUSTON, TX, United States

Background: Egypt ranks tenth globally and second in the Middle East for childhood cancer, with over 6,800 new cases annually. Care is largely concentrated in Cairo's Children's Cancer Hospital, which has extensive resources and international partnerships. Regional centers like Borg El Arab University Hospital (BAUH) in Alexandria can expand services to share the national burden.

Objective: This project aims to build virtual capacity, which focuses on pediatric cancer care with emphasis on central nervous system tumors (Figure 1). The first phase aimed to identify challenges and explore patient care strategies, institutional, and trainee needs. Long-term goals include expanding regional pediatric oncology capacity, advancing treatment protocols, promoting research, and fostering knowledge exchange across Egypt and the Middle East.

Design/Methods: Under the MD Anderson Global Cancer Care Track, we launched weekly Zoom sessions combining neuro‑oncology lectures, journal clubs, case conferences, and guideline discussions. Program leadership included a pediatric hematology-oncology fellow and a pediatric neuro-oncology attending from MD Anderson Cancer Center, alongside two pediatric oncology trainees and two consultants from BAUH and one medical student.

Results: Launching in May 2025, participation ranged from 10-20 attendees per session, including oncology trainees, consultants, and cross‑discipline guests. Over six months, 20 sessions were held: 11 lectures, 2 journal clubs, 4 case discussions, 1 morbidity & mortality meeting, and 1 workflow session on febrile neutropenia/sepsis. Trainees initiated 4 research projects. Challenges were categorized as implementation-related (time-zone coordination and technical difficulties sharing imaging and pathology slides during virtual discussions), institutional (limited access to advanced diagnostics and molecular testing, lack of transplant services, and limited consult services), and research-related (restricted protected research time and complex regulatory requirements). Real-time feedback indicated higher neuro-oncology and general oncology knowledge, and interest in expanding to other oncology domains.

Conclusion(s): The experience demonstrates that virtual, structured collaboration is feasible and highly impactful in advancing education, mentorship, and decision-making in resource-limited settings. Supporting regional centers beyond one national hub in Egypt allows for more equitable care and high-quality training. Future directions include expanding to additional centers and integrating other pediatric oncology domains to strengthen capacity and ensure sustainability.

Figure 1. Distribution of Newly Diagnosed Pediatric Central Nervous System Tumors at Borg El Arab University Hospital in 2024
Summary of newly diagnosed pediatric brain and spinal cord tumors in 2024 (n = 134). Low-grade gliomas (LGG) were the most common, followed by medulloblastoma, high-grade glioma (HGG), and ependymoma.
FASI = Focal area of signal intensity; SEGA = Subependymal giant cell astrocytoma; DIPG = Diffuse intrinsic pontine glioma; NF1 = Neurofibromatosis type 1; TS = Tuberous sclerosis complex.