Around the world, volunteers save thousands of lives by donating everything from organs, blood, platelets, and even bone marrow to patients in need. Patients at the Duke Cancer Institute are making their own life-saving impact by making a more unusual donation–cancerous tissue removed during surgical treatment and biopsies. Rather than being transplanted like an organ or bone marrow, these tissue samples are used as the basis for many clinical trials within the DCI.
Locating, obtaining and cataloguing these samples is the work of the Biospecimen Repository Processing Core (BRPC) shared resource.
“Tissue donated to the BRPC makes a huge, lifesaving impact, both for furthering our understanding of cancer and impacting the future of patient care”,” said Shannon McCall, MD, director of the BRPC. “These research samples are a huge resource for clinical trials and laboratory investigations throughout the DCI.”
Patients at the Duke Cancer Institute who are undergoing surgery or biopsies can opt to donate leftover excised tissue to the BRPC. BRPC staff then work with surgical pathologists or clinicians to retrieve the tissue, identify parts that are useful for study, and preserve it. These samples are only taken from consenting patients and released for research only after Duke pathologists have completed their work of rendering the patient’s diagnosis. Simply donating does not affect medical treatment in any way, McCall said.
Once preserved, the material can be catalogued and stored for use in clinical trials or other research. Over the past three years, BRPC staff have collected about 10,000 biospecimens from nearly 2,000 patients, McCall said. These samples aid clinical and basic science research in all of the DCI’s program areas.
The BRPC also maintains a legacy collection of nearly 40,000 catalogued frozen research biospecimens that it inherited. For specific research protocols, BRPC can access hundreds of thousands of residual clinical samples from Duke patients. The oldest of these samples, which have been preserved in paraffin, date back nearly 30 years and still contain still useful material.
Steven Patierno, PhD, deputy director of the Duke Cancer Institute, has been making extensive use of the BRPC’s resources to answer one of the most persistent lingering mysteries in prostate cancer research: why aggressive forms of prostate cancer are especially prevalent in African American men.
“In the world of prostate cancer detection and therapy, the biggest challenge that faces us is determining who has aggressive prostate that’s going to be lethal versus who has slow growing, prostate cancer that will never become life-threatening,” Patierno said. “The BRPC is absolutely essential for our research in this area.”
“Their staff plays a critical role in helping us identify and obtain consent from patients, as well as analyzing and grading numerous core tissue samples to find both the normal and cancerous tissues we need,” Patierno said. “Their intellectual input into the science of our studies is also phenomenal. We consider them as collaborators and partners for our research.”
Patierno’s team is working with the BRPC to compare tissue samples from men of European and African ancestry to analyze for biological and genomic differences in prostate cancer. Using dozens of cancer samples taken from hundreds of biopsies, Patierno’s research team, including Jennifer Freedman, PhD and Dan George, MD, have identified genes that are expressed differently in prostate cancers in white men and black men.
Several of the genes they have found had never previously been connected with prostate cancer. Using the population-level differences in tumor aggressiveness between white and black men allowed Patierno’s team to identify genes that drive tumor aggressiveness regardless of race or ancestry. These findings may help future efforts in cancer prevention as well as targeted therapy for men at highest risk for lethal disease, Patierno said.
In the meantime, the BRPC and patients of the Duke Cancer Institute will be working together to advance the next generation of cancer research.