From deadly deposits, hope

A national cancer tissue bank is building reserves. Its head tells Zoe Corbyn it could spur advances

September 4, 2008

The description "cancer collector" is not one that immediately resonates with Brian Clark. "I've never described myself using that term, although that is what I do here," he said.

Dr Clark is the chief executive of onCore UK, a national cancer tissue bank that aims to overcome one of the key barriers faced by cancer researchers across the world - the lack of a large and diverse supply of cancerous tissue samples that are linked to information about the patients they came from.

The bank, which began collecting samples in the middle of last year, is steadily building up its stocks. Dr Clark anticipates that it will be open for business "within a year".

"Our input valve is open, but the output valve is not yet open until we build a critical resource," he explained.

The bank operates as an independent charity. It is funded by the Department of Health in England, Cancer Research UK and the Medical Research Council, and £5 million has been provided for its establishment so far. The next phase of the venture is already being planned by Dr Clark.

Cancer tissue banks are not new, and so-called biobanking for a whole range of diseases has been around for a long time. Dr Clark estimates that at least 20 small cancer tissue banks exist within universities. But the aim of onCore UK is to provide the first centralised large-scale repository for cancer tissues.

"Without meaning a pejorative implication, this has been a cottage industry," Dr Clark said. "Banks that existed prior to us have tended to be on short-term funding and locally managed, based on samples linked to a particular hospital or to a particular cancer type."

Having access to real tissue samples is "second to nothing" for laboratory researchers, Dr Clark said, but it is the quantity and diversity of the samples the bank will provide that will, it is hoped, contribute to real gains. The aim is to develop a bank of samples that contains lots of different types and subtypes of tumours. "Lung cancer isn't just lung cancer. There are many different types, each with different responses to treatment and different outcomes for the patient," he said.

"The types of studies that need to be done require large population sizes. A local bank is naturally limited by its local cancer patient population."

Accompanying the samples will be information about the donors, including their age, sex, where they lived, how they were treated and, if known, the outcome of their treatment. "This context allows for more detailed conclusions," Dr Clark said.

Samples come from NHS trusts where patients are treated. The collection network currently includes hospitals in Southampton, Portsmouth, Birmingham and Cambridge, but onCore UK is keen to expand it.

The bank's storage facility, which has been contracted out, is based near Stansted airport. Because storage is not cheap, the bank will charge researchers for samples - but only enough to recover costs. There are strict regulations concerning the making of profits from the sale of human body parts.

Unusually among biobanks, the charity also aims to give patients a chance to see how their donations are used. It recently launched a "donor forum" to involve this most important group of stakeholders.

In preparation for the bank's opening, Dr Clark is writing an access policy. He wants the samples to be made as widely available as possible to researchers, be they in UK or overseas universities, the commercial or charity sectors.

Researchers have in the past had difficulty accessing collections based in institutions of which they were not members. OnCore UK hopes that its centralised bank will reduce the problem.

A central repository also has advantages when it comes to ethics and donor consent. As with any establishment storing human tissue, onCore UK is licensed by the Human Tissue Authority (HTA), which is consulting on its first code of practice on the storage of human tissues for research.

Consent must be at the heart of lawful storage and use of body parts, organs and tissue from the living or the dead.

But Phil Quirke, a consultant and Yorkshire Cancer Research professor of pathology based at the University of Leeds, said that the bureaucracy involved in ensuring the right consent can be a real headache for local banks. Universities, desperate to ensure that they are not engulfed by a scandal such as that at Alder Hey, where tissues were taken without permission, can take an over-cautious approach.

"It is becoming increasingly difficult to access human tissue samples easily due to the increased burden placed on us through ethics (requirements). OnCore UK will be able to provide tissues to us where we don't have to worry that they haven't been appropriately consented," he said.


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