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Human Bio Specimen Network Supports All DoD Cancer Research Efforts: Bio-Tissue Bank Gives Researchers Resources

Posted on: Thursday, 1 September 2005, 09:01 CDT

Officials from the U.S. Military Cancer Institute are investing in a program which will greatly expand cancer research efforts throughout the Department of Defense health-care system.

A bio-tissue banking project, started this year at Walter Reed Army Medical Center, will provide more resources than ever to military medical researchers looking for common trends and other clues in the fight against cancer.

There were multiple tissue banking projects already started at Walter Reed and other military medical centers, but nothing that had the resources to draw from medical centers throughout DoD. The Human Bio Specimen Network is the first to build on this concept and target the bigger picture all of DoD's cancer research effort.

DoD health care is the biggest health-care management organization (in the US)," said Colonel Renata Greenspan, director of the USMCI Bio Specimen Network and the Armed Forces Institute of Pathology.

"This will benefit all of us all of the military community," she added. "Involving molecular technology, it has the potential to offer the answer to what causes common diseases. The program represents a wealth of material that no one else in the world can match. It has the potential to determine not only the cause and cure, but the prevention as well."

"The USMCI is a tri-service activity whose headquarters are at Walter Reed and whose academic base is the Uniformed Services University of Health Sciences," noted Dr. John Potter, USMCI director, "The Bio Specimen Network is designed to facilitate genomic and proteomic analyses which will enhance patient care among military beneficiaries.""We are banking tissues for future scientific endeavors," said Lieutenant Colonel Aizen Marrogi, deputy director for the USMCI Bio Specimen Network. "The only place you can put (together) an extensive program like this is DoD," he said. "Because we have access to patient care wherever they go (since patients are always in the same system)."

In the civilian sector researchers normally have access to a variety of tissues, but the tissues might not have been processed with a standardized technique and often lack supporting data about the patients.

"We think it is unique because it's a completely integrated program of biological sample storage and data warehouse of patient information," Marrogi said. Within the USMCI's BSN all tissue samples will be processed in a consistent manner, and will have anonymous background health data.

"In addition to us storing excess tissue from the patients, we have an extensive database that goes with it. The database will involve interviewing of patients and asking them a series of questions about their cancer risk, family history, demographic data basically, dietary data, etc," he explained.

Besides this data and the tissue samples, Marrogi said urine and blood samples will be added to the collection.

"The tissue that is collected is considered 'waste' tissue, or tissue that is removed during surgery for therapeutic or diagnostic reasons but is discarded after the pathologist, who determines the degree of disease present, has finished his or her examination of that tissue," added Col. Barbara Crothers, the project's principle investigator and chief of WRAMC's anatomic pathology Service.

Normally, almost 99 percent of human tissue removed for medical reasons is discarded. "This tissue can be preserved and stored according to its type so that the donor cannot be identified."

"The tissue will be coming from multiple organs, but it's more complex - it's not organ oriented, it's disease process oriented," Marrogi explained. "People who have tumors, both malignant and benign, will be eligible, if they wish, to participate in this."

Unlike other tissue banking programs, which often have tissue from patients undergoing "experimental" therapies that might corrupt pathologic research, USMCI's BSN seeks accurate samples.

"Basically you need virgin tissue - tissues that are not exposed to any therapy in order to understand the carcinogenesis of this process - what genes, what molecules are altered, increased, up regulated, down regulated, stayed the same, and mutated - in order to understand what went on," Marrogi said.

"When we get tissues here, our primary responsibility is to make diagnosis. Anything excess will be stored ... When we get a tumor or a disease process that is dissected or removed, what we submit for diagnostic work is 5, 10, 20 percent based on the size. The rest of it we disposed of. This program will only store tissues after the diagnostic requirement is satisfied. It will not alter patient care.

"While our first duty is to patients, we recognize that it is imp rtant to support research efforts that will eventually translate into better care for our patients," Crothers added. "Because both duties take a considerable amount of time to do correctly, we must alter our usual manner of approaching tissues and start to incorporate research- supportive practices into our daily activities.

In order to reduce the burden of taking on these additional responsibilities as well as to ensure consistent quality of tissue for the repository, our department is standardizing all of these collection processes. This will help to ensure that we can continue to support our surgeons and investigators equally."

The tissue samples are normally about one centimeter in size. "Some are frozen using standard techniques because we're going to make sections and examine those sections, then we'll take a picture of them for documentation," he said. "The other set of tissues, we're going to snap-freeze for possible future use based on what we foresee, as scientists, that we will need," he added. "There will be different ways of storing the tissue. One way is graded freezing in case, in the future, we can revive that tissue and establish cell lines for additional work. You establish cell lines for rare tumors to study the disease entity. If you have a rare tumor and you freeze it - once it is frozen you might not be able to revive the tissue. The graded cooling system will allow researchers to revive cell lines for further study."

"Our primary goal is to find a reasonable, cost-effective and enduring way to support research requiring tissues," Crothers added.

"Some researchers at WRAMC express concerns that they will not have tissue for their particular project if they partner with USMCI. In fact, it is more likely that they will continue to be provided tissues under USMCI, since the organization is a DoD service congressionally mandated to provide this service, whereas individual collection efforts fall under an individual principal investigator, which makes the bank vulnerable to destruction once that PI has left the service. The USMCI BSN's intent is to store tissues indefinitely unless their destruction is requested by the donor."

Marrogi said the program will bank hundreds of specimens each year. "The power of that is we will be in a position to cater to (the researchers) - one thing that I envision, is that people will come to us wanting tissues of rare tumors. We will be able to provide those tissues, on the rarest of the rarest disease and make advances. This is the vision, and with the data base we will have, we can make large population studies like molecular epidemiology, and biomarker risks. You can only do that in this setup where you have a large patient population with very complete history and epidemiology data. We are the only people who can do that. This is a researcher's dream."

END

Source: Pentagon Brief

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