Why Biobanks play a crucial role in accelerating precision oncology research

By Daniel Loos, Coordinator, BioBank NL

“Absolutely! No problem. Is there anything else I can do to help?” said Sarah* as I asked her if she was comfortable collecting a stool sample at home before her surgery.

She was two days out from a hemicolectomy to remove a section of her large intestine that was riddled with cancerous polyps, and I had come to her preadmission appointment to ask her permission to use some of the removed tissue for cancer research.

“Anything for research!” she proudly adds. “Bowel cancer has been the main cause of death in my family, and nothing will change without people like me donating their tissue for science.”  

This is what I hear almost every day as a biobank coordinator here in St. John’s, NL. Patients about to have major surgery put their own worries about their health aside so they can make room to help; and it makes me proud to be working for BioBank NL.

The biggest challenge for researchers is usually the time it takes to collect samples to study, and that is where biobanking comes in. Biobanking is the process of collecting, storing and associating data with biological samples for future use. The goal of biobanking is to preserve biological resources for scientific research and to advance knowledge. Large number of (patient) samples are usually required for such research. Biobanks can store samples from humans, plants, animals, and other aspects of nature. 

The explanation is in the name, bio-BANK. We’re the bank that stores all the tissue samples, as well as the clinical data (medical history, treatment outcomes etc.) associated with them. Researchers can make ‘withdrawals’ and begin their research immediately, rather than having to go through the lengthy process of obtaining the samples themselves, and knowing the samples received have been collected and stored according to international standards.

Every day, I visit the two main hospitals here in St. John’s to ethically ask cancer patients’ permission to collect their excised tissue and store it for future use. At BioBank NL, we store tissue samples, stool and blood fractions in our large -80^oC freezers from patients with various cancer types; but we also prepare DNA and RNA for sequencing (which is basically laying out the patients’ genome from top to bottom and decoding it) so that researchers can look at the whole genome of the patient. When we have this information (called genomic data), combined with patient medical history, clinical outcome data, and details about their lifestyles, researchers can parse out the information and find hidden clues that give us a better understanding of how we can approach treating cancer in patients. This only works if we have thousands of data points to review: the volume makes it worthwhile. Why are all these factors important? Because until we understand the mutational landscape and triggers of cancers, we can’t target them effectively.

For decades, and still to this day, a lot of cancer treatments have been a one size fits all approach. But through research, we’ve found that some patients respond better to certain drugs or therapies based off certain factors in their genome. We’ve also found that patients with certain genes or changes to their genes do not respond at all to some treatments, and some might actually respond negatively. This is part of what has sparked the revolution of precision medicine.

Precision medicine is considered a more ‘holistic’ approach to disease treatment, where doctors consider individual variability in genes, environment and lifestyle for each patient before providing a treatment plan. Having an abundance of genomic data, combined with the other factors mentioned, allows doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people. The Terry Fox Research Institute has been a main driver of improving outcomes and quality of life for cancer patients in Canada; understanding that without a shift towards precision medicine, there will be no improvement in current cancer care.

Since 2019, when the federal government invested $150 million to establish the national Marathon of Hope Cancer Centres Network through the Terry Fox Research Institute, precision medicine has become more than just a pipe dream for researchers and doctors in Canada. It has become a nationwide approach, with biobanks and researchers in every province collaborating, collating and sharing their data. It has ensured we can purchase expensive equipment to help meet international standards and provide the highest quality samples for researchers. This investment has also positioned Canada as a major contender in the global genomic research community and allowed research projects (like several that BioBank NL supports here at Memorial University of Newfoundland) to proceed without delay.

The island of Newfoundland has a unique position in this as it is one of Canada's two internationally recognized human founder populations, characterized by reduced genetic heterogeneity, deep genealogies and traditional lifestyles. The province of Newfoundland and Labrador has one of the highest colorectal cancer rates in the entire world. It also has single gene disorders that are only located in certain pockets of the island. This makes it a great spot for researchers to not only look at patient genomic data, but also what environmental or lifestyle factors that can be attributed to these illnesses. Without the Terry Fox Research Institute and the Marathon of Hope Cancer Centres Network, there would be no BioBank NL to obtain these priceless samples.

In saying that, none of this works without the help of willing participants.

Newfoundlanders and Labradorians are known for welcoming people into their province, homes, sheds, cabins; you name it. As an Australian ex-pat, I know this firsthand. When I first arrived, my wife and I sheltered in a stranger’s house during a blizzard as we were crossing the island; and when the blizzard was over and the roads were plowed, I didn’t want to leave! Hospitality, kindness and willingness to help is a characteristic I’ve noticed not just in this province, but throughout my travels in Canada; and I think that Terry Fox truly embodied the spirit of what it means to be a Canadian. Newfoundlanders and Labradorians have a special connection to him though, as this is where he dipped his toes in the Atlantic before setting off on his journey. Which is why, when I mention to patients that BioBank NL is supported through the Terry Fox Research Institute Marathon of Hope Cancer Centres Network, people stop me and say “You had me at Terry Fox. What can I do to help?” The legacy that his name has left on Canadians is profound and I am proud to carry it with me through my work. 

Sarah has completely recovered from her surgery and I still see her from time to time around town. When I do, she always gives me a smile and a nod, and it makes me realise how lucky I am to be part of this. I am truly privileged to hear each patient’s story and know that with every consent, we’re getting a little bit closer to finding the answers.

* Name altered. All BioBank patient details are deidentified to preserve their privacy. 

Daniel Loos is the coordinator for BioBank NL at Memorial University of Newfoundland. Since joining he has been recognized as a Rising Star at the 2024 International Society for Biological and Environmental Repositories (ISBER) Annual Conference.