Background on Tumor Tissue Repositories
1. What is a tumour bank?
Changes in technology have created new opportunities and opened new avenues for all medical research sectors to utilize complex tissues and data for both hypothesis generation and testing. As a result, Tumour Banks ( also known as Tumour Tumour Banks or Tumor Repositories) that were once regarded as simple tools for the translational research sector, may now be considered as a critical engine for basic, translational, and clinical research.
However, unlike other research tools such as cell lines and mouse models, Tumour Banks incorporating human tissues and data, invoke more complex social, medical and multidisciplinary issues. These issues include a) striking the appropriate balance of tissue and data acquisition and utilization that can ensure optimal current delivery of health care for individual patients while at the same time ensuring maximal opportunity for future improvements for their families, relatives and the population, b) the evolving clinical practice patterns, clinical decisions for acquisition, expert interpretation of epidemiological, pathological and clinical data, c) recognition of, adherence to, and input into ethical standards and privacy laws. To attain maximal value a Tumour Bank must also be sustained, expand and mature over time, to offer a research tool that can help to address research questions focused on subsets of disease and questions that require knowledge of disease outcomes.
Three types of human tissue and data resources are currently available to BC researchers.
Clinical Pathology Archives are extensive, comprise mostly paraffin embedded tissue blocks, and provide a variety of lesions and tissue components for analysis using specific and often mature research tools and assays. However, these archives are not formally linked to blood samples and outcome data, and have a restricted design and organization since they constitute a part of the clinical record of individual patients. These and other factors seriously limit their availability and their application for discovery research.
Research Study Cohorts are collected in the course of specific research studies, but are variable in size and design and therefore capacity to support more than the original study.
Tumour Banks are collections of tissues, blood, and data, accrued, processed, anotated and linked to clinical data, collected within the terms of an appropriate consent and privacy framework, and organized specifically to support a range of discovery and translational research. The tissues can comprise fresh or processed paraffin or frozen tissue blocks, or derived products such as DNA, RNA, and proteins. The data includes tissue accrual information, composition and pathology data, and clinical, treatment and outcome data related to the patient. Issues of appropriate selection of tissue samples and protection of patient privacy are dealt with at the outset and through the organizational structure, to ensure equitable access by investigators and consistent standards for security, privacy, ethics and peer review.
2. How does a Tumour Bank advance in Cancer Research?
Medical research depends on the ability to study human tissue that is donated by generous individuals. Although researchers can use models of the disease such as cell lines and animal tumours to develop ideas and potential markers and therapies, at some point it becomes essential to study human tissues. So one of the best ways of understanding how a disease like cancer develops in humans is to study human tissues
Tissue samples are used to identify bio-markers, improve treatment efficacy, identify and development of new drug therapies and to train scientists and doctors.
Research that uses donated tissues and data is carefully monitored and can only be carried out if it satisfies particular regulations and has approval from an ethics committee. These regulations are to ensure that the materials are obtained with approriate and informed consent from individual donors, that the research is ethical and that donor privacy is protected.
3. What is the history of tumour banking in Canada?
The initial steps towards formal tumour banking in Canada emerged from a series of National Cancer Institute of Canada (NCIC) sponsored workshops in the early 1990’s. These were followed by the launch of a molecular epidemiology and correlative studies program by the NCIC to support Tumour Banks. This lead to the establishment of 5 NCIC funded Tumour Banks including the Manitoba Breast Tumour Bank (1993) and the NCIC-Clinical Trials Group Tumour Bank (1995). However despite intense ongoing interest and formal discussions (including a national NCIC sponsored workshop on Tumour Banks held in Toronto, 1996 and formation of an NCIC-CTG Biologic Studies and Tumour Bank working group, 1998-), this special NCIC Tumour Bank program was not continued. So despite general agreement on the merits of Tumour Bank infrastructure to support cancer research, the existence of formal grant mechanisms to support Tumour Banks in Canada ended in 2000.
However other large tissue collections and initiatives have since emerged in Canada. The design of these collections varies considerably with respect to the Tumour type or subtype target, tissue format, data collected and mandate. While many of these are referred to as Tumour Banks, they are not necessarily designed, funded, enabled or oriented to provide material support to external investigators.
To address this issue, several provincial organziations, including the BC Cancer Agency initiated the development of Provincial or institutional Tumour Banks. At the BC Cancer Agency, a substantial investment of capital for infrastructure development and ongoing operational support has been comitted to create and develop the BCCA-TTR, which began case collection late 2003.
To further address issues of improved standardization, access, and infrastructure capacity, the BCCA-TTR has recently joined with other leading Tumour Banks to form the Canadian Tumour Repository Network (CTRNet). The CTRNet itself is funded independently from the provincial member banks by the Canadian Institutes of Health Research (CIHR).
Comments/Questions about this page?