Download TR - National University Cancer Institute, Singapore (NCIS)

Tissue Repository Mission Statement
To provide NUH and NUS researchers with high quality,
well documented samples, in a safe, efficient, and ethical
manner.
Organisational Chart
Tissue
Repository (TR)
Molecular
Biologist
Chon Boon ENG
Excecutive
Wei Ling Tan
Phlebotomist
Consent Nurse
Lay Pheng LIM
Research
Assistant
Kelly LIM
TR/HCR
Director
Robert HEWITT
Aye Thiri MYINT
Consent Nurse
2
Felicia TEE
Research
Assistant
Fiona WONG
Med Tech
Yi Bing AW
Med Tech
Chiou Huey
HEE
Med Tech
Shao Liang SHI
Sr IT Analyst
TR / HCR
Kee Peck TAN
Sr Cancer
Registrar
Pathologist
Rajeev SINGH
Consent Nurse
1
Margaret LOW
Hospital-based
Cancer Registry (HCR)
Cancer
Registrar 1
Wen Tong YANG
Cancer
Registrar 2
Thida Mon AYE
Cancer
Registrar 3
Ni Win
IT Analyst
TR
Lyn XU
IT Analyst
HCR
Med Tech
2009
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Christine GARCIA
Cases collected by the end of 2007
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
High Quality Samples
Dr Rajeev Singh (Pathologist)
• Histological quality control
• Liason with clinicians
• Supervision of technologists
Dr Eng Chon Boon (Mol. Biologist)
• Molecular quality control
• Liason with researchers
• Supervision of research assistants
All samples bar coded and stored in liquid nitrogen
vapor phase, with temperature monitoring and
remote alarm system. Requesters are provided with
samples in many formats including cryostat sections,
DNA, RNA, protein extracts and cell cultures.
Primary cultures established by Kelly Lim and
Fiona Wong from breast (23 cases), colorectal
(17), renal (6), ovary (4) and endometrial cancers
(3). All cultures stored at early passage for future
use.
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Well Documented Samples
• TR database system (TRDS) was developed
in-house by Tan Kee Peck using Microsoft.net
• TRDS is based on the CCRD Oracle platform, it
is Web accesible and integrated with hospital
database systems
• TRDS has multiple security features, including
Trusted Third Party (TTP) Data Escrow System to
de-identify data
• The pathology datasets are being developed in
collaboration with STN
• TRDS development was funded by NHG grant
• Roll-out of TRDS to other NHG hospitals is
planned
• Data entry and quality control is supervised by
Almeda Cruz, cancer registrar.
• The Hospital-based Cancer Registry (HCR)
database will be closely integrated with this
system
http://www.oracle.com
http://www.microsoft.com/net
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Hospital-based Cancer Registry (HCR)
• Purpose: To collect detailed clinical information on every cancer patient treated at NUH, including
demographics, diagnosis, treatment and outcome (244 data elements per patient)
• Benefits: Supports Clinical & Translational Research, Health Services Research, Clinical Audit, and
Patient Care (helps ensure proper follow-up of cancer patients).
• Standards: Following datasets and standards of practice
set by the American College of Surgeons Commission on
Cancer (CoC) and the North American Association of
Central Cancer Registries (NAACCR). Unit aiming for CoC
accreditation.
http://www.naaccr.org/
http://www.facs.org/cancer/coc
• Staff: Four cancer registrars, soon to be increased to eight
with backing from NUCIS.
• Training Course: Brought NAACCR-endorsed cancer
registrar training course to Singapore in March 2008.
Principles of Oncology for Cancer Registry Professionals.
Course tutors: April Fritz and Louanne Corrance. 30 staff
from across Singapore were trained.
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Synergy between TR & HCR
Tissue
Repository (TR)
Tissue collection
Tissue processing
Tissue storage
Hospital-based
Cancer Registry (HCR)
Core facilities
Funding
Administration
Database design
Data collection
Data protection
Support Researchers
Requests for review
Ethical approval
Honest broker
Ensure follow-up
Analyse statistics
Support Clinicians
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Safety: Gold Award for TR Team in 2008
TR team won the Gold Award in the NUS Safety & Health
Improvement Projects (SHIP) Scheme in March 2008.
For a project entitled: “Reduction of exposure to infectious
agents present in human tissues”
Team members (L to R): Shi Shaoliang, Hee Chiou Huey,
Dr Eng Chon Boon (team leader), Fiona Wong, Kelly Lim and
Aw Yi Bing (front).
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Monitoring Efficiency: Collection Rates
(A) Selection from OT list
(B) Informed consent
Selected cases
Consented
cases
(C) Tissue collection
Collected
cases
Examples of cases not selected: Laryngoscopy, cataracts, tubal ligation, haemorrhoidectomy, gastric banding, hip replacements, ECT, laminectomy, vasectomy
(A) 8% of OT list cases are selected
(B) 94% of selected cases are consented
(C) 54% of consented cases provide tissue
Statistics for a period of 6 months in 2006
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Factors Limiting Tissue Collection
(C) Tissue collection
• Specimen too small – 13%
• Sampling will cause distortion – 4%
• Tumour not grossly identifiable – 3%
• No pathologist available – 3%
• Tissue necrotic/bony – 1%
Pathology
constraint
24%
OT constraint 21%
Tissue collected in 289 cases
= 54%
• Operation past 5pm/7pm – 4%
• Resection not done – 4%
• Operation postponed or cancelled – 4%
• Specimen sent for frozen section – 2%
• Specimen fixed in formalin – 2%
• Surgeon refused – 2%
• Patient had infectious disease – 1%
Statistics for a period of 6 months in 2006
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Monitoring Efficiency: Monthly Statistics (April 2008)
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Satisfying User Requirements
Survey of user requirements:
• On-line questionnaire in September 2006 received over 100 responses
• Respondents came from across NUH and NUS, including DBS, Pharmacy and Bioengineering
Survey results:
Requirements: (a) Normal tissues (68.3%); Blood samples (54.5%). (b) Sample storage (64.4%).
(a)
(b)
Steps taken to satisfy user requirements:
• Recruit phlebotomist to collect blood samples in blood bank (collaboration with Dr Liu Te Chih)
• Collect cardiovascular tissue samples (collaboration with Prof CN Lee)
• Obtained new Eterne freezer to increase capacity for reliable sample storage
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Ethical Issues: Informed Consent & IRB Approval
• TR operates according to the Singapore Bioethics
Advisory Council guidelines on tissue-based research.
• Informed consent has been obtained on all samples
collected prospectively since April 2005.
• Informed consent is taken by TR staff (consent nurses)
who counsel each patient.
• Informed consent is obtained from over 90% of patients.
• Samples are only released for projects in which use of the
samples has received IRB approval
Related activities:
•TR organised a symposium on ethical issues in 2005.
• TR established the ‘Register of Research Tissue Banks’
at NUH, in line with BAC’s recommendations.
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Supporting research projects at NUH, NUS and beyond
Supporting 35 groups in the following departments/institutions:
NUH & NUS departments: Biochemistry, Bioengineering, Lab Medicine, MDC, Medicine, ORI,
Pathology, Pharmacology, Physiology and Surgery; Other hospitals: Alexandra Hospital; Johns
Hopkins Medical Centre; A*Star institutes: GIS, IBN and IMCB; and S*Bio drug discovery
company.
www.scs.a-star.edu.sg
Some Resulting Publications
1. Cancer Research 2003 Oct.
2. Cancer Research 2005
3. Cancer Research 2006 Jul.
4. Mol Cell Proteomics. 2005 Nov.
5. Proteomics. 2005 May
www.sbio.com
Tier 1 ; IF 8.649
Tier 1 ; IF 8.649
Tier 1 ; IF 8.649
Tier 1 ; IF 8.316
Tier 1 ; IF 5.766
Providing consented samples to STN
50% of all samples collected from cancer cases were supplied to STN, for a 3 year period from
March 2005 after signing a memorandum of understanding.
TR Mission: Provide NUH and NUS researchers with high quality,
well-documented samples in a safe, efficient and ethical manner.
Hosted First ISBER Congress in Asia
Dates: May 30th – June 2nd, 2007
Meeting Theme: “International Biobanking Standards”
International Society for Biological & Environmental Repositories (ISBER) - a division of:
Invited Speakers:
NUH-NUS
Mahesh Choolani
Robert Hewitt
Aziz Nather
STN
Tan Chorh Chuan
Edison Liu
Theresa Chow
Asia-Pacific
Lisa Devereux (Australia) – Perter MacCallum
Tim Yam (Singapore) – Botanic Gardens
Terry Kaan (Singapore) - BAC
Sujin Kim (Korea) – Human Biobank Network
Yeonhee Lee (Korea) – Seoul Women’s Uni
Toshihiro Tanaka (Japan) - Japan Biobank
Other International
Faye Betsou (France) – Biobanque de Picardie
Marianna Bledsoe (USA) - NIH
Arthur Caplan (USA) – Center for Bioethics, Univ Pennslvania
Carolyn Compton (USA) - Head, NCI Office of Biobanking
Pasquale DiBlasio (Italy)
Paul Downey (UK) – UK Biobank
Ian Fore (USA) – NCI
Peter Geary (Canada) – Canadian Tumour Rep. Network
Pierre Hainaut (France) – IARC, WHO
Marcia Kean (USA) – Feinstein Kean Healthcare
Cynthia Kleeberger (USA) - NIH
Bartha Knoppers (Canada) - Canada Chair in Medical Ethics
Jan-Eric Litton (Sweden) – Karolinska Inst.
Greg Simon (USA) - FasterCures
Jim Vaught (USA) – NCI
Events:
* Singapore Tissue Network (STN) Tour
* Biobanking Communications Summit
* Night Safari
* Sessions on: Standardization, Informatics, Funding, Quality Management, Legal & Ethical Issues
TR Vision: To become an internationally recognized
centre of excellence for research biobanking
TR’s Expansion Plan
1.
Continue focus on collection of cancer tissue in line with the establishment of NUCIS and to
support the NUS Cancer Research Centre of Excellence
2.
To further expand services - collect and store blood and blood derivatives
3.
Collect and store other tissues and body fluids like bone marrow, urine, saliva, hair, nails, etc
4.
Find more lab space (additional 100m2) + offsite storage facilities (hotel services)
5.
Develop a ‘Federated network’
•
Centres store their own samples, they
share a single database and they share
samples within the network.
•
Under discussion with SCS, STN and SGH.
•
Networking is essential to increase access
to cancer cases.
NUH
SGH
Database
NCC
Networking with other centres is essential to increase the sample numbers available
Site Visits by TR Team in May 2008
1)
Human Tissue Resource Network (HTRN):
A repository serving the Ohio State University
(OSU) Comprehensive Cancer Center and US
Cooperative Human Tissue Network.
Based in Columbus, Ohio.
Visit hosted by Co-Director, Dr Scott Jewell.
2)
Fraunhofer IBMT´s Cryo-research &
Demonstration Bank:
This houses a global HIV cryobank funded by a
grant from the Bill & Melinda Gates Foundation
(part of a new international effort to accelerate the
development of an HIV vaccine).
Based in St Ingbert, Saarland, Germany.
Visit hosted by Professor Heiko Zimmerman
Site visits established contacts and provided useful models for TR’s own expansion