No one knows that better than Kathryn Graham, PhD, manager of the CBCF Tumour Bank in Edmonton. (There is a sister facility in Calgary and the research benefits of both extend through Alberta and beyond.) Graham says that many major medical developments start with a well-crafted research idea that requires multiple tissue samples of a certain type. The biobank of tissue samples that she oversees may be behind tomorrow’s breakthroughs. Here’s how a tissue sample gets from the patient to a researcher’s lab.
- Before surgery to remove a tumour, a patient signs a consent form authorizing physicians to save and store samples of her tumour for possible use in future research projects.
- Surgeons remove her tumour and send it to pathology. The pathologists dissect the tumour to confirm the diagnosis. The patient may donate a blood sample, too.
- Because the rest of the tumour is not needed for the patient’s diagnosis and care, the pathologist saves it, placing it in a vial and dropping it in a dewar of liquid nitrogen. A dewar is a small, portable tank that will keep the sample frozen. Less than 30 minutes have passed since surgeons removed her tumour.
- Each vial is labelled with a code that does not identify the patient. Minimal information is recorded so the team can contact the patient later to gain consent to use the sample in research. The patient’s identity is never released to researchers.
- Every two weeks team members from the provincial tumour banks travel to pathology labs, picking up the dewars and replacing them with empty ones. At the Cross Cancer Institute, the team empties the dewars, barcodes the samples and enters the information into a database. They load the tumour samples into huge tanks and store them at -196ºC. Blood samples are stored in tall, upright freezers at -80ºC.
- At this point, team members go back through the records and contact patients to gain full informed consent to perform research on their tissue sample and store their clinical information that relates to the cancer.
- Once patients give consent, clinical information is entered into a database. “We link this data to the patient, at the back end of our system. No researchers or anyone else has access to that information. Patient samples are identified only by a code,” says Graham. Being able to link the disease history to the biological sample makes it more valuable to researchers. It allows them to tie their observations to clinical factors, such as response to a drug, for example.
- Researchers have access to a log of materials stored in the tumour bank. They can apply for samples based on tumour type. But the study must meet with approval from the ethics board; the researchers have to provide study details, which must meet with approval from the scientific review panel.
- At the end of the study, the researcher must destroy anything remaining of the sample. Published findings are shared among researchers and can have a global reach.
- Information researchers gain from experiments on these banked tissue samples adds to the sum total of cancer knowledge and much of it will be the basis of better cancer care and treatment in the future.