Taking stock of our pooled research

A group of medical research hospitals and universities have agreed to create a network of biobanks, which will use samples donated by patients to conduct research and find better treatments, writes CLAIRE O'CONNELL

THE WORD “BANK” might be somewhat tainted these days, but how about this more altruistic model: depositors donate, the “currency” helps fuel biomedical research and the end results can lead towards improved therapies for patients.

Such banks exist: “biobanks” of patient tissue samples and data can provide material for scientific and medical studies. Now a new initiative is linking cancer biobanks between hospitals in Dublin, Cork and Galway.

“Biobanking is saving biological samples such as human tissue, blood or urine, for research purposes,” explains Prof Eoin Gaffney, a consultant histopathologist at St James’s Hospital and Trinity College Dublin.

The process looks straightforward on the surface – a patient undergoing cancer surgery would give their consent for tissue left over after diagnosis to be banked and used for research that is scientifically and ethically approved.

But there’s more to it in practice, according to Gaffney, a co-founder of the charity Biobank Ireland Trust.

“It’s no use just storing samples, you need to have a good annotated database that tells you where the samples are and what types of samples they are, as well as pathological data and clinical data,” he says.

So how do the samples and linked information feed into research?

“When you have small samples of frozen cancer tissue and normal tissue from the same patient, you are able to extract from that the DNA, the RNA and the proteins and therefore figure out a mechanism as to how that particular cancer was formed,” says Gaffney.

“A cell has to go through certain points along the way [to cancer] and if you can understand those points then you are able to devise new interventions or drugs that can block those points and therefore stop the cancer cells from growing.”

Internationally, biobanked samples have already helped to develop new “targeted” therapies for cancer, including Herceptin, an antibody that blocks the growth of certain breast cancer cells, and Glivec, a drug that targets a particular type of gastrointestinal tumour, explains Gaffney.

“Biobanks helped by providing a lot of samples that could be analysed from different patients and knowing their clinical data, knowing whether they had disease for a year, two years, and what grade and stage the cancer was.”

Gaffney and colleagues have been working on the idea of linked hospital biobanks in Ireland – collections of samples already exist, but networking is the real key, he explains.

“We are at the early stages, but if you do that you greatly amplify the number of samples and you greatly amplify the chances of good research, and the speed of getting the answers is going to be increased,” he says. “This is going to take Ireland’s research to a totally new level.”

The journey has not been without its challenges. “It has been a rollercoaster ride,” says Gaffney, who credits the support of agencies such as Vodafone Ireland and the National Lottery as well as industry in funding Biobank Ireland, and the co-operation of hospital staff and senior management.

And now a major boost is the new sample and data access policy between St James’s and Beaumont Hospitals in Dublin, Cork University Hospital and Galway University Hospital, which opens the way to the hospitals sharing samples with each other and internationally.

There were several factors to line up, including common policies, patient consent forms and information sheets, explains Dr Blanaid Mee, who manages the cancer biobank at St James’s Hospital.

But while the samples themselves would be straightforward enough to move between sites, moving data would be a trickier issue.

“So we have come up with a system where we have partnered with the National Cancer Registry of Ireland,” explains Mee, who describes how it works.

“If I collect a sample from a patient here who has consented to biobanking, then that patient sample is given a code. We need to provide some details such as the patient’s name and date of birth to the [registry] to link that code to a specific patient, but when researchers need data that the [registry] have, they just apply using the code so they never need to find out who the patient is.”

Mee has been biobanking samples from patients with breast and colon cancer at St James’s and says that patients are usually happy to donate: “There is a very high uptake rate, I would say it’s in the region of 90 per cent.”

And for the hospitals, the benefit lies in pooling the resources to strengthen their studies: “They know that no one site is going to collect samples in the numbers required to do high-quality, high-impact research,” says Mee.

The value of the high-quality biobanked samples also lies in fostering collaboration both between groups in Ireland and internationally, says Prof Frank Giles, a consultant haematologist at Galway University Hospital and St James’s Hospital and director of the Health Research Board clinical research facility in Galway.

He hopes the new initiative will pave the way for national biobanking of samples from cancer and other diseases, but says investment is needed.

“If there is support from the Government for a national biobank, the return on investment will be rapid and significant. Our ability to compete for international grants will be greatly improved and we will return that money, and a lot more with it, very quickly to the country,” he says.

At Cork University Hospital, consultant histopathologist Dr Louise Burke sees the value in networking and sharing between banks.

“There’s no point in [biobanking] being done on an ad hoc basis; Ireland is a small country and the more we network this, the better the whole system works,” she says.

“It means we are using standardised protocols, so researchers accessing the tissues would know they are all of the same quality. And if you are doing a study on a particular type of tumour you won’t just be relying on the tissues you have in your own hospital, you will be able to get access to tissues from other centres so your study sizes will be larger. I think it has amazing benefits for everybody.”

Biobanks: One advantage is in comparing the diaspora to the Irish at home

WHEN A person consents to give samples to a biobank, how might those precious biological materials be used?

Approved studies can mine into the samples to look for clues about diseases and develop better ways of treating them. And one of the advantages of storing biological materials in a biobank is that when new technologies or ideas come along, the tissues are already there, waiting to be tested.

“In the event that you have a cancer tissue belonging to a patient and something new comes up in a year or two, if you have samples in your biobank they can be of benefit,” says Dr Louise Burke, a consultant histopathologist at Cork University Hospital.

A particular advantage to biobanking samples from patients in Ireland is that studies can compare the Irish at home with the diaspora – people with “Irish” genetics who have moved to other environments.

“There are lots of diseases, such as specific types of cancer or multiple sclerosis, which have different geographic incidences around the world,” says Frank Giles, professor of cancer therapeutics at NUI Galway and Trinity College Dublin.

“Say you have a region of Ireland where there is a very high incidence of a particular disease. You also have generations separated by perhaps 20 or 30 years who emigrate, and you have a chance now to see when they go to their new homes do they carry that extra risk with them – so it’s genetic – or does [the risk] get modified. We need to be able to have tissues to use as controls for example with the big centres around the world of Irish emigrants – that compare and contrast could be valuable.”

Another case where routine biobanking can come into its own is in collecting samples from “extreme” expressions of a particular disease, notes Giles.

“Every so often there’s a patient with something that’s different, maybe aggressive, or isn’t responding,” he explains. “By having tissues from those people you can try and isolate specifically what is special or vicious about their disease.”

Biobanks can also act as valuable source of “control” tissues for studies of various diseases, he adds.