What question did this study set out to answer?

The research aimed to improve diagnosis and treatment methodologies for pediatric high-grade gliomas in low- and middle-income countries.

March 14, 2026Open Access

LMIC-03. Advancing pediatric high-grade glioma diagnosis: Outcomes from the Rady Children’s Hospital San Diego- Hospital General Tijuana Cross-Border Neuro-Oncology Program in northwestern Mexico

Key Points

The research aimed to improve diagnosis and treatment methodologies for pediatric high-grade gliomas in low- and middle-income countries.
Data analysis from children diagnosed with high-grade glioma at Hospital General-Tijuana enrolled in the Cross-Border Neuro-Oncology Program.
Histological and molecular diagnostics were utilized to enhance diagnostic accuracy.
Treatment approaches included chemoradiation and surgical interventions as necessary.
17% of diagnosed cancer cases were brain tumors, with 16% categorized as high-grade gliomas.
85% of children with specific tumor types received histological or molecular confirmation post-CBNOP implementation, compared to 0% beforehand.
The most frequent diagnosis was H3K27M mutant diffuse midline glioma, with relevant mutations identified in tumors via next-generation sequencing.

Abstract

Abstract In low- and middle-income countries (LMIC) pediatric high-grade gliomas are often diagnosed based on neuroimaging findings only. In cases of high-grade gliomas involving the brainstem and basal ganglia/thalamus, biopsy findings help define prognosis and guide treatment. The Hospital General-Tijuana (HGT) established a Cross-Border Neuro-Oncology Program (CBNOP) with Rady Children’s Hospital-San Diego (RCHSD) in 2010 to provide a multidisciplinary approach to pediatric brain tumors in northwestern Mexico, including access to histological, and more recently, molecular diagnostics. We analyzed data from children (18 years) diagnosed with high-grade glioma at HGT enrolled in the CBNOP. Seven-hundred-and-seven children were diagnosed with cancer from 2010 to 2024; 17% (n = 123/707) were diagnosed with brain tumors, and 16% (n = 20/123) were categorized as high-grade glioma (9 brainstem, 6 hemispheric, 2 thalamic/basal ganglia, 2 cerebellar, 1 spinal). Sixty percent (n = 12/20) were male, and median age at diagnosis was 10 years (3–17y). Seventeen of the patients were transferred to RCHSD for neurosurgery (11 biopsy, 6 resection), the average length of stay was 3.6 days (range 1-9d) with no procedure-associated complications. Three patients with progressive brainstem tumors were not transferred to RCHSD due to clinical progression. The most common diagnosis was H3K27M mutant diffuse midline glioma (5 brainstem, 2 cerebellar, 2 thalamic/basal ganglia, 1 spinal). Five tumors underwent next-generation sequencing (2 BRAF V600E mutation/CDK2N2A/B co-deletion, 3 H3K27M mutation) and one methylation analysis (RTK2 subtype pediatric-type diffuse high-grade glioma). Treatment included: chemoradiation with Temozolomide (n = 15), Temozolomide only (n = 4), or radiation only (n = 1). Our CBNOP enabled 85% of children with brainstem/basal ganglia/thalamic tumors to obtain either histological or molecular confirmation without procedure-associated complications; this represents a significant increase from 0% before CBNOP implementation. Future directions include initiatives aimed at improving availability of molecular-guided biopsy tumor testing, increasing access to modern radiation, and tailoring advanced therapies for high-grade gliomas in northwestern Mexico.

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