Processing Cancer

More than 20 years ago, pediatric cancer pathologist Stephen J. Qualman, MD, had an idea that would change the world. Dr. Qualman was ahead of his time in realizing the importance of developing biobanking as a scientific discipline. Few others had this foresight and fewer still thought of preserving pediatric cancer specimens for future research.

According to a recent article in Time, biobanks are one of 10 ideas helping to remake the global economy. Biobanks are highly complex facilities with expert staff to maintain human biological sample processing and storage functions, characterize specimens, purify DNA and related genetic information, enter data into sophisticated informatics systems, and oversee security, ethical and legal processes to protect the identity of information. A sophisticated, high-quality biobanking effort has existed at Nationwide Children’s since the late 1980s, where one of the largest pediatric biobanks in the country, the Children’s

In 1987, the late Dr. Qualman and William Newton, MD, secured National Cancer Institute (NCI) funding for the first pediatric prospective tissue procurement system within the Cooperative Human Tissue Network (pCHTN). With this, the Biopathology Center (BPC) at Nationwide Children’s was born.

“The Biopathology Center was developed as a tumor storehouse used primarily for banking tissues,” said Julie Gastier-Foster, PhD, director of the BPC’s Molecular Genetics Laboratory. “Dr Qualman knew it was important to bank tumor tissues because people were going to want them for research at some point.”

The BPC has since matured into a combined tissue procurement, biobanking and distribution system supported by the COG and the pCHTN. To this day, the relationship ensures the proper collection and storage of high-quality human specimens that are readily available to biomedical researchers. These are collected from nearly every pediatric cancer patient enrolled in a NCI-funded clinical treatment trial, ensuring that research findings can be correlated with valuable clinical data. In 2003, Dr. Qualman applied for the BPC to become the COG Acute Lymphoblastic Leukemia (ALL) Reference Lab. In leukemia, certain translocations, changes in the tumor’s DNA, are shown to be associated with poor outcomes. If a child has a tumor featuring these changes, he or she is going to require much more aggressive therapy. The ALL Reference Lab examines these tumors for such changes in order to tailor therapy based on what is found in the leukemic cells. Reference Laboratory work at the BPC has since expanded to include testing of many pediatric solid tumors. “Becoming the COG ALL Reference Lab was the BPC’s first step toward tissue sample testing. We now do testing for all children nationwide with either ALL, neuroblastoma, Wilms tumor or some soft tissue sarcoma,” said Dr. Gastier-Foster.

Because of the success of the BPC, the Gynecologic Oncology Group (GOG) asked Dr. Qualman to design and administer their biobanking efforts. Since 1996 the GOG biobank has also been housed at the BPC. The combined COG and GOG biobanks at the BPC now number 1.4 million tumor samples and is one of only two repositories for leukemia samples in the United States, Canada and Australia.

Joining the Cancer Genome Atlas Project

The more than 20 years of experience in banking, categorizing, testing and storing national tissue samples have secured Nationwide Children’s Hospital a place in one of the largest projects ever funded by the National Institutes of Health.

The Cancer Genome Atlas (TCGA) project, an undertaking comparable to the humangenome project, aims to transform the world’s understanding of many cancers by creating a comprehensive catalog of the genomic changes involved in more than 20 common types. An initial $5.5 million contract has named Nationwide Children’s as a Biospecimen Core Resource for The Center Genome Atlas. The BPC will become one of two clearing-houses for all the project’s tumor specimens.

As a Biospecimen Core Resource, the BPC will receive thousands of both tumor and normal specimen samples and their accompanying clinical information from numerous contributing medical and research centers around the world. The samples will be analyzed to ensure they meet rigorous quality standards for each tumor type and ensure that the clinical information for each sample is available. Once examined and processed, the BPC will distribute the DNA and RNA extracted from the specimens to TCGA sequencing and genome characterization centers, including those at Harvard and MIT.

“This is personalized medicine,” said pathologist Nilsa Ramirez, MD, director of the BPC. Researchers will use a patient’s tumor samples and healthy genetic samples to determine which therapies will or will not work. “We are fine-tuning all of this to an individual,” she said.

Read more :: Anatomy of a Tumor Bank