{"id":3660,"date":"2018-10-23T16:00:00","date_gmt":"2018-10-23T16:00:00","guid":{"rendered":"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2018\/improving-cancer-research-biopsies"},"modified":"2024-11-03T15:17:32","modified_gmt":"2024-11-03T15:17:32","slug":"study-improves-the-quality-of-biopsy-specimens-for-cancer-research","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/study-improves-the-quality-of-biopsy-specimens-for-cancer-research\/","title":{"rendered":"Study Improves the Quality of Biopsy Specimens for Cancer Research"},"content":{"rendered":"<p class=\"blog-post-publishing-info\">October 23, 2018, by NCI Staff<\/p>\n<figure class=\"image-right-medium centered-set\">\n<div class=\"centered-element\"><img decoding=\"async\" src=\"https:\/\/www.cancer.gov\/PublishedContent\/Images\/news-events\/cancer-currents-blog\/2018\/two-tumor-biopsies-different-tissue-article.__v10041012.jpg\" alt=\"\"\/><\/div><figcaption readability=\"2.5\">\n<div class=\"caption-container no-resize\" readability=\"10\">\n<p>T<span>umor biopsies collected for research often don&#8217;t have enough of the tumor tissue. These two biopsy samples from the same patient have very different amounts of tumor tissue (green boxes).<\/span><\/p>\n<p>Reprinted with permission J Oncol Pract. 2018 Oct 4:JOP1800092.<\/p>\n<\/div>\n<\/figcaption><\/figure>\n<p>Researchers have developed recommendations for improving the quality of <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000045619&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000045619&amp;version=Patient&amp;language=English\">biopsy specimens<\/a> collected from patients participating in cancer clinical trials. Tumor biopsy samples can provide valuable information to researchers, such as insights into how cancer therapies\u00a0behave in the human body.<\/p>\n<p>The <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=30285529\">recommendations provide practical suggestions for the leaders of clinical trials,<\/a> such as ensuring that the interventional radiologists who collect the study biopsy specimens are given clear information about the study\u2019s goals and tissue requirements. Interventional radiologists use <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000046157&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000046157&amp;version=Patient&amp;language=English\">ultrasound<\/a>, <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000046033&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000046033&amp;version=Patient&amp;language=English\">CT scans<\/a>, and <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000045788&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000045788&amp;version=Patient&amp;language=English\">MRI<\/a> to identify locations in tumors from which they extract tissue.\u00a0<\/p>\n<p>Other recommendations include increasing the amount of biological material collected for research and ensuring that patients who are enrolled in a clinical trial that has a requirement for a research biopsy have tissue that is amenable to biopsy.<\/p>\n<p>The recommendations, which appeared in the <em>Journal of Oncology Practice<\/em> on October 4, were based on an analysis of research biopsies conducted by a multidisciplinary team of experts.<\/p>\n<aside class=\"callout-box-full\">\n<h3>Main Recommendations to Improve the Quality of Research Biopsy Specimens in Cancer Clinical Trials<\/h3>\n<ul>\n<li>Include interventional radiologists, who perform the research biopsies, on the research team.<\/li>\n<li>Facilitate communication among all members of the biopsy team to establish the research needs and time points during the trial to assess and discuss success rates and research outcomes.<\/li>\n<li>Obtain informed consent from patients to collect up to five <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000045657&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000045657&amp;version=Patient&amp;language=English\">cores<\/a> per biopsy procedure if safe and feasible.<\/li>\n<li>Create standard operating procedures for each clinical trial that detail research biopsy specimen quality requirements to guide the interventional radiologist and to help ensure that the requirements and expectations of the researcher, radiologist, and patient are met.<\/li>\n<li>Review each patient with an interventional radiologist to ensure that patients who do not have tumors amenable to biopsy are not enrolled in clinical trials that have a research biopsy requirement.<\/li>\n<li>Prepare evidence-based practice guidelines for research biopsies and other materials that convey the added value from collaborative efforts to collect better biopsy samples. This may help develop a reimbursement plan for research tissue sampling that reflects the extra time and imaging approaches the biopsy team needs to obtain better tumor biopsy samples.<\/li>\n<\/ul>\n<\/aside>\n<p>\u201cOur analysis suggests that clear communication by all parties involved in the collection, handling, processing, and storing of biopsies is critical for success,\u201d said Kate Ferry-Galow, Ph.D., of the Clinical Pharmacodynamic Biomarkers Program at NCI\u2019s <a href=\"https:\/\/frederick.cancer.gov\/\">Frederick National Laboratory for Cancer Research<\/a>.<\/p>\n<p>\u201cWe now hold regular meetings throughout a clinical trial, and the biopsy team\u2014including the oncologists, interventional radiologists, pathologists, and <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000044528&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000044528&amp;version=Patient&amp;language=English\">assay<\/a> scientists\u2014communicate about the quality of the biopsies,\u201d Dr. Ferry-Galow continued. \u201cThat communication has helped tremendously.\u201d<\/p>\n<p>When the researchers implemented the recommendations during clinical trials conducted by NCI\u2019s <a href=\"https:\/\/dtc.cancer.gov\/\">Developmental Therapeutics Clinic<\/a>, the new strategy led to a better success rate in terms of obtaining suitable biopsy specimens for analysis, compared with previous studies.<\/p>\n<h2>Using Tumor Samples to Conduct Multiple Tests<\/h2>\n<p>Conducting biopsies for research purposes can be challenging, Dr. Ferry-Galow noted. One challenge is that such biopsies ideally involve the collection of more tissue from a patient than biopsies conducted during routine patient care.<\/p>\n<p>As the team&#8217;s analysis revealed, the need for additional tissue has not always been communicated clearly to interventional radiologists on clinical trials. The need for more tissue reflects the fact that research biopsy specimens may be used for a variety of genetic and molecular tests, such as next-generation <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000753867&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000753867&amp;version=Patient&amp;language=English\">DNA sequencing<\/a>.<\/p>\n<p>In some early-phase clinical trials of <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000044763&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000044763&amp;version=Patient&amp;language=English\">investigational<\/a> therapies, for example, researchers may collect tissue from the same tumor before and after a patient receives a drug. Analyzing pairs of biopsy specimens can reveal whether drugs designed to block certain <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000561720&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000561720&amp;version=Patient&amp;language=English\">signaling pathways<\/a> in tumors actually do so in the human body.<\/p>\n<p>\u201cToday, we can develop evidence that a drug is working at the molecular level\u2014and in greater detail than ever before,\u201d said coauthor Alda Tam, M.D., the clinical medical director in the Department of Interventional Radiology at the University of Texas MD Anderson Cancer Center.<\/p>\n<p>Despite the importance of research biopsies, these procedures often\u00a0fail to produce the specimens needed to answer research questions about cancer clinical trials, Dr. Tam noted.<\/p>\n<p>A <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000044120&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000044120&amp;version=Patient&amp;language=English\">retrospective<\/a> analysis of four early-phase clinical trials conducted at NCI\u2019s Developmental Therapeutics Clinic, for example, found that only 83 of 112 (74%) needle biopsies collected to study the activity of drugs in the body produced specimens that met quality-control standards. The reasons included an insufficient amount of tumor collected and\/or specimens of poor quality.<\/p>\n<h2>Bringing Together Experts on Research Biopsies<\/h2>\n<p>To address the need to improve research biopsies, Alice Chen, M.D., of NCI\u2019s <a href=\"https:\/\/dctd.cancer.gov\/\">Division of Cancer Treatment and Diagnosis (DCTD)<\/a>, and her colleagues convened several meetings with oncologists, pathologists, laboratory scientists, and interventional radiologists from around the country. The participants reviewed and discussed all aspects of the processes involved in collecting and analyzing research biopsies.<\/p>\n<p>The discussions \u201crepresent the first time we\u2019ve had a national conversation about research biopsies that included interventional radiologists and pathologists,\u201d said Dr. Tam. \u201cAnd the conversation showed that we all could work better as a team.\u201d<\/p>\n<p>Among other findings, the researchers learned that some radiologists weren\u2019t aware of the different requirements for research biopsies compared with the requirements for other types of biopsies, such as diagnostic biopsies, Dr. Ferry-Galow said.<\/p>\n<p>Another finding was the need for greater recognition and financial support for the investment of time and scientific contributions made by interventional radiologists and pathologists.<\/p>\n<p>\u201cWhat interventional radiologists are asked to do in the research setting is different from what they do in the clinical setting, and they aren\u2019t always being recognized for their time,\u201d said Dr. Ferry-Galow.<\/p>\n<p>The study authors suggested that the important contributions of interventional radiologists and pathologists could be recognized by making them coauthors of studies reporting the results of clinical trials they helped to conduct.<\/p>\n<h2>Sharing the Findings with the Research Community<\/h2>\n<p>As a next step, the study authors are working to communicate the need and the resources available for improving the quality of research biopsy specimens. For example, DCTD posts <a href=\"https:\/\/dctd.cancer.gov\/ResearchResources\/ResearchResources-biomarkers.htm\">standard operating procedures for tissue collection for validated biomarker assays<\/a> online.<\/p>\n<p>In addition, the publicly available <a href=\"https:\/\/brd.nci.nih.gov\/brd\/\">Biospecimen Research Database<\/a>\u2014which includes standard operating procedures in the field of human <a class=\"definition\" onclick=\"javascript:popWindow('defbyid','CDR0000561324&amp;version=Patient&amp;language=English'); return false;\" href=\"https:\/\/www.cancer.gov\/Common\/PopUps\/popDefinition.aspx?id=CDR0000561324&amp;version=Patient&amp;language=English\">biospecimen<\/a> science\u2014is being revised as a resource to promote the dissemination of references, data, and best practices related to radiology and pathology, the study authors wrote.<\/p>\n<p>They plan to conduct additional outreach at national scientific meetings and through professional societies.<\/p>\n<p>\u201cThe findings of our study are incredibly positive,\u201d said Dr. Tam. \u201cThey show that just sitting down and talking through what each person brings to a clinical trial will improve the execution of the biopsy process and quality of the results.\u201d<\/p>\n<p><a href=\"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2018\/improving-cancer-research-biopsies\">Source<\/a><\/p>","protected":false},"excerpt":{"rendered":"<p>October 23, 2018, by NCI Staff Tumor biopsies collected for research often don&#8217;t have enough of the tumor tissue. These two biopsy samples from the same patient have very different amounts of tumor tissue (green boxes). Reprinted with permission J Oncol Pract. 2018 Oct 4:JOP1800092. Researchers have developed recommendations for improving the quality of biopsy [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":3661,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-3660","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/3660","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=3660"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/3660\/revisions"}],"predecessor-version":[{"id":44581,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/3660\/revisions\/44581"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media\/3661"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=3660"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=3660"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=3660"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}