By Charlie Schmidt
Banking on Tissues
Standardized tissue collection could propel cancer research
By Charlie Schmidt
What's the biggest roadblock to curing cancer? According to a think tank convened in 2002, a shortage of high-quality human tumor and tissue samples is the top barrier to progress in cancer research.
If that surprises you, consider that many cancer scientists are pinning their hopes for new diagnostics and cures on molecular biomarkers. Biomarkers are proteins and other biochemical signs that indicate the presence of a disease, or a response to treatment. Found in tumors and other tissues, biomarkers could enable early cancer detection and provide new targets for drugs. But to study them comprehensively, scientists need better access to human samples from large numbers of people.
TISSUE BANKS PLAY GROWING ROLE
Emerging to meet that need, a variety of tissue banks—also known as tumor banks, biobanks and biorepositories—are specializing in collecting human biological samples and making them available for research.
Tissue collection arguably has a long history—Johns Hopkins University, for instance, began to save tissue samples from autopsies more than 100 years ago. However, traditional tissue banks have a limited capacity to serve modern research. Most of their samples are fixed in formalin and embedded in paraffin, which can degrade the structure of proteins and other biological molecules, such as DNA and RNA.
Researchers must therefore rely on the more sophisticated facilities that can supply fresh tissue samples for broader molecular analyses. Some of them are connected to large-scale clinical research centers that supply a steady flow of material. Still others are hosted by advocacy groups for specific cancers, which collect tumors from around the country to increase sample sizes for research.
The privately funded Multiple Myeloma Research Consortium (MMRC) is one such example. Launched in August 2004 by the Multiple Myeloma Research Foundation, the MMRC coordinates with 11 leading cancer centers to collect bone marrow and blood samples, which wind up in a centralized repository at the Mayo Clinic in Scottsdale, Ariz. According to Steven Young, the MMRC's executive director, a process ensuring anonymity protects patient confidentiality. "Only the patient's own doctor and hospital can link the sample back to a name," he says. "The rest of the consortium members only have access to the sample and associated clinical information."
Young says that the MMRC aims to streamline multiple myeloma research efforts. Up to 50,000 Americans have multiple myeloma at any given time, and about half die within three years of diagnosis. "Our job is to make it easier for institutions to work with each other and to help pharmaceutical companies speed the development of new drugs," he says.
THE INTERNATIONAL ARENA
Some of the most advanced tissue banks in the world are found overseas, particularly in countries with highly educated populations and centralized medical systems. Brett Davis, an executive with IBM Healthcare and Life Sciences, which has sponsored four global biobanking summits during the last two years, says these countries have mounted effective national dialogues to resolve tissue banking's ethical concerns, including confidentiality issues that still plague government-funded programs in the United States.
The Karolinska Institute Biobank in Stockholm, Sweden—hosted by the Karolinska Institute, home of the Nobel Prize in physiology or medicine—provides an example: The biobank, which is working with IBM, collects tissues samples from throughout Sweden. The Singapore Tissue Network is also on the cutting edge of the field, Davis says. Established as an initiative by the Singapore Biomedical Research Council, this tissue bank provides a national repository for tissues, including blood and DNA samples.
WORRIES OVER STANDARDIZATION
Meanwhile, in the United States, the National Cancer Institute (NCI) has launched a broad effort to standardize tissue-banking activities. Headed by pathologist Carolyn Compton, who directs the NCI's Office of Biorepositories and Biospecimen Research, this effort aims to produce tissue-specific standard operating procedures for sample collection, storage and analysis.
Uniform standards are crucial, Compton says, because without them researchers can't always compare results from different institutions. Proteins and RNA are highly sensitive to environmental changes. "Right now, if labs produce different results, we don't know if that reflects a real biological variation, or just a difference in sample-handling methods," Compton explains. "And that's hindering progress—we need to be able to separate biological truth from experimental and technical artifacts."
Compton's office has just released a first set of guidelines, which describe good laboratory practices for biorepositories. Future guidelines will cover handling methods for specific tissue types, such as normal and cancerous tissues, as well as blood, plasma and urine. The guidelines will also address standard procedures for molecular analysis, Compton says.
As these various issues are resolved, tissue banking will likely play a growing role in advancing cancer research. "Most patients want their disease experience to benefit someone else," says Ginny Mason, the executive director of the Inflammatory Breast Cancer Research Foundation, which along with six other disease-specific advocacy groups launched the Genetic Alliance Biobank in October 2004. "We're finding that patients want to help, and our own patients are very excited about this."