Cancer is major cause of death worldwide and mortality levels remain high despite the development of new therapeutics and other cancer treatments. Cancer biobanks are an integral part of the fight against cancer because they facilitate research into new diagnostic tests and therapeutic approaches.
Cancer remains a significant health threat because tumors can be very heterogeneous, and therefore, difficult to treat. Cells side-by-side in a tumor can have vastly different genetic changes, gene expression, protein expression and metabolism. These changes become more pronounced over time in many tumor types, making tumors more resistant to treatment as disease progresses (1). Tumor heterogeneity is bad news for patients. Heterogeneity is why the old method of treating cancer based on tumor location does not work for many patients.
The oncology field is now switching from treating breast tumors as breast cancer and prostate tumors as prostate cancer etc. to treating tumors based on molecular signature and mutation pattern. This is a personalized medicine approach.
The personalized medicine field aims to combat tumor heterogeneity by understanding how gene expression, protein expression and metabolism changes in different bulk tumors and cancer cells over time (2). Cancer clinicians want to use this knowledge to tailor treatment plans for individual patients.
For personalized medicine to work, researchers need to generate large amounts of data from different tumor types and cancer cells, and from healthy tissues. Cancer biobanks are essential to personalized cancer medicine because they collect tissues and cells from cancer patients and healthy controls, process and store these samples and distribute them to researchers. Biobanks also collect and securely store clinical data associated with samples.
Challenges for Cancer Biobanks
Cancer research is a complex field supported by many cancer biobanks around the world. Cancer biobanks face significant challenges in collecting, processing and storing samples so the samples are most useful to researchers.
Different Sample Types
Cancer is heterogeneous but so is cancer research. To develop effective treatments, researchers need to study what causes cancer inside cells and tissues, how disease progresses and how cancer cells are different to normal cells.
This means cancer biobanks must collect many different types of samples from patients, including blood, saliva, urine, tumor tissue and healthy tissue. Each of these samples types requires different processing methods.
Different Assays
Furthermore, cancer researchers perform many different assays including genomics, proteomics, metabolomics and histological studies. Each assay also requires different sample processing methods. Samples processed to be used in genomic assays may not be suitable for proteomic assays or histology, and vice versa.
Data Collection and Storage
Patient samples are most useful if they come with de-identified demographic, lifestyle and clinical data. Biobanks must de-identify this data and link it with samples in a secure way that protects patient privacy. Biobanks must liaise with clinicians, ethics committees, funding agencies and researchers to obtain patient consent and to collect, store and distribute data and samples.
Biobanks often work with many different clinicians, hospitals, clinics and research institutions. This means there could be significant differences in how samples are collected and what data is recorded. Biobanks have the challenge of trying to standardize sample and data collection methods to maintain the integrity of their collections.
Solutions
Cancer biobanks can address these challenges by continuing to speak to researchers about their current and future research needs. In this way, biobanks can have a better understanding of how to process and store samples so they are most useful to researchers.
Biobanks can also work with all clinical partners to standardize methods of sample and data collection, processing and transport.
Lastly, harmonizing ethics requirements and patient consent documentation makes it easier to collect samples from multiple different sources and distribute them to different research organizations.
Conclusions
Cancer research is now focused on a personalized medicine approach. Researchers aim to understand how different tumor types change on a molecular level over time. Clinician’s have the goal of developing tailored treatment plans for individual patients. Cancer biobanks play a key role in this research by collecting, processing, storing and distributing patient samples and associated data. Cancer biobanks face significant challenges because they must process and store many different sample types that will be used in a range of different experimental assays.
Open and continuous communication between biobanking organizations, ethics committees, clinicians and researchers can help biobanks to streamline patient consent and ethics approvals, standardize collection methods, and plan and curate their sample collections based on the current and future needs of researchers. This approach will maximize sample use and therefore honor the donations made by patients and healthy controls.
References
- Dagogo-Jack and Shaw. Tumour heterogeneity and resistance to cancer therapies. Nature Reviews Clinical Oncology. 2017
- Patil et al. Cancer oriented biobanks: A comprehensive review. Oncol Rev. 2018
