Recovery Act Investment in The Cancer Genome Atlas to Create Integrated Network for Prospective Tissue Accrual
From the collection of tumor samples to the development of treatment interventions, every program within the National Cancer Institute (NCI) begins and ends with the cancer patient. The Cancer Genome Atlas (TCGA) stands out in that regard. This large-scale collaborative effort, jointly funded and managed by the NCI and the National Human Genome Research Institute (NHGRI), involves dozens of institutions working together to characterize the key genomic changes that occur in cancer. This information is driving a new generation of research aimed at developing a more targeted approach for preventing, diagnosing and treating cancer.
Since its initiation in 2005 as a pilot project, TCGA has established the policies, production pipeline, collaborative research network, databases and analytical tools necessary for TCGA's large-scale study of cancer genomics. Results from the TCGA pilot studies of brain and ovarian cancers is paving the way for a paradigm shift toward evidence based and more personalized cancer care. TCGA has identified core pathways and discovered new genetic mutations that have potential implications for the diagnosis and treatment of glioblastoma, a common type of brain cancer. Based on the success of the pilot, NIH is investing $175 million of American Recovery and Reinvestment Act funds to enable TCGA to map the genomic changes in more than 20 types of cancers.
TCGA-supported advanced technologies and tools are allowing researchers to take a more scientifically robust approach to understanding the molecular basis of disease and facilitating a deeper analysis of cancer genomics with greater efficiency and precision.
"The TCGA Research Network can comprehensively and systematically analyze the genome across many different technology platforms in a large number of patients to generate data that may be used by the broader cancer community for stratification of patients and the development of new treatment strategies for cancer patients," said Anna Barker, Ph.D., NCI Deputy Director.
TCGA's success to date is due in large part to some very important lessons in its pilot phase. One of these lessons is that there is a critical shortage of high-quality human tumor samples (known as biospecimens) that meet the stringent criteria needed for genomic research projects like TCGA. Genomic research seeks to understand the biology of cancer at its most fundamental molecular level. Biospecimens used for genomic research need to meet a stringent set of criteria so that the DNA and RNA extracted from them can be used by advanced genomic analysis platforms and sequencing.
Thanks to the investment of Recovery Act funds, the ability to obtain the quality and quantity of biospecimens required for TCGA will be significantly improved and the pace of TCGA research accelerated through the creation of a prospective tissue accrual network. "Prospective" tissue collection means that new protocols will be launched at hospitals so that patients, who otherwise would not be approached to participate in research, will now be asked to donate a sample of both cancerous and normal tissue. To date, TCGA has only been able to acquire tissue through retrospective collections, tissue that had been collected and stored in biobanks to be used for cancer research at some later time. This is going to change as we scale up to study more tumors, stated Joe Vockley, Ph.D., Program Director for TCGA.
The benefit of collecting biospecimens prospectively is that patients who have consented or agreed to donate their tissue can be tracked for clinical outcomes, and the quality of materials collected can be controlled using standard operating procedures. In comparison, retrospectively collected biospecimens frequently do not include follow-up clinical outcomes data and the specimen quality can vary significantly due to the lack of standard protocols for collection, annotation and storage. However, NCI has established The Best Practices for Biospecimen Resources and is developing standard operating procedures so that retrospective collections can also meet the stringent criteria needed for genomic cancer research projects like TCGA.
It is expected that the total number of sites involved in both retrospective and prospective biospecimen accrual for TCGA will expand to include hundreds of organizations from hospitals (including NCI-designated cancer centers), cooperative groups and commercial organizations.
In addition to addressing the biospecimens challenge of genomic research, this Recovery Act investment will preserve and create a number of positions designed to handle increased volume at each collection site across the country, including, but not limited to, histologists, pathologists, clinical research associates and research nurses.
"Because of the large-scale, network approach of TCGA and the gold standard it applies to its biospecimens, the data generated by TCGA is unparalleled in its quality and quantity," said Dr. Barker. "This data will ultimately allow the cancer community to categorize tumors into specific subgroups and deliver the most appropriate therapy to specific patients based on their personal molecular profile."