In 2022, the World Health Organization (WHO) reported over 1.41 million new cancer cases in India, resulting in more than 910,000 deaths. Among these, breast cancer emerged as the most prevalent, accounting for a substantial number of cancer-related fatalities. Despite its high mortality rate, breast cancer is treatable, and ongoing research into new therapies provides hope for improved outcomes.
Biorepositories or biobanks are like vaults of biosamples that play a vital role in advancing cancer research, supporting not only breast cancer studies but also facilitating research on rare and aggressive cancers. Biorepositories support cancer research applications in diverse areas including prevention, early detection, therapy, and surveillance. Biorepositories are vital for fighting cancer, as they help researchers procure “fit-for-purpose” samples needed for developing cancer assays and drugs. By offering high-quality biological materials and associated patient information, biobanks allow scientists to study cancer holistically.
State of Biorepositories
The Global Biobank Directory lists 391 biobanks worldwide, including 41 in Asia and 19 in India. Additionally, India has other non-listed biobanks, indicating that while progress has been made, there is still much work to do in bringing these biobanks to light. With new regulatory guidelines by the Indian Council of Medical Research (ICMR) and the Department of Biotechnology (DBT), India has shown a promising shift in biobanking science in the last decade.
The advent of -omics science (genomics, transcriptomics, proteomics, metabolomics) has also brought the need to store and analyse a large number of samples. In this way, biobanks have a primary role in the era of precision medicine, which is based on analysing samples with clinical data. If more high-quality diverse samples are available through biobanks, researchers will be able to use these resources to advance patient treatment. RGCIRC, for instance, is working with advanced technologies like spatial transcriptomics. This innovative approach allows researchers to study tumours in three dimensions, offering new insights into why certain treatments are effective for some patients but not others. Next-generation biobanking involving the processing of live tissue into various sample formats has also been a game-changer in translational research.
Challenges in maintaining Biorepositories
Despite their importance, biorepositories face several challenges. One of the most pressing is funding. Running a biorepository requires a significant financial commitment, not just in terms of setting it up but also in maintaining it over time. Without sustainable financial backing, many hospitals struggle to operate and expand their biobanks.
Another challenge lies in securing patient consent. While some patients are willing to contribute to research, many cancer patients, understandably, focus on their treatment and may not be aware of the long-term benefits of donating their tissue for research. Encouraging participation while ensuring ethical consent remains a hurdle for hospitals.
Stepping up to research
At Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), the biorepository began with a philanthropic donation following the death of a breast cancer patient. Initially focused on breast cancer, this tissue bank has since expanded to include samples from other cancers, such as ovarian, head and neck, colorectal, kidney, thyroid and many more, also responding to the rising demand for cancer research material.
Today, RGCIRC’s biorepository is playing a crucial role in major cancer research projects. Amongst these is the CSIR-funded Thousand Breast Cancer Genome Atlas project, which aims to decode the genomes of 1000 Indian breast cancer patients.
As a leading tertiary care centre, RGCIRC collects leftover blood and tissue samples from consenting patients diagnosed with cancer who seek treatment at our facility. The hospital stores these samples for future research, making them available to cancer researchers in India, and abroad. The funding model is based on cost recovery from sample sharing, allowing the biobank to self-sustain.
To elevate the standards of clinical research, it has transitioned from a Traditional Biobank to a Next Generation Biobank. This transition is particularly significant for studying cancers like gallbladder and pancreatic cancer, which affect less than 1% of the population and are often challenging to research due to a scarcity of available tissue samples. By collecting and storing these rare tissues, RGCIRC provides a crucial resource for researchers aiming to understand these lesser-studied diseases.
The future of Biorepositories in India
Biobanks have existed for the past century, but only in the last decade have we witnessed significant advancements in the science of biobanking in India. This can be attributed to a massive surge in chronic diseases such as heart disease and cancer. However, the slow pace of drug discovery research in India has resulted in the disease burden surpassing technological advancements. Biorepositories collect and manage biospecimens for research purposes, but there is not a huge market for biobanks unless the pharmaceutical industry (drug discovery research) is improved. On the other hand, the basic research arena flourishes with hugely CSIR-funded projects like the Thousand Breast Cancer Genome Program, so biobanks become a key player here.
The future growth of biorepositories in India will depend on the country’s regulatory framework. Currently, there is no unified system for biobanks to register and operate transparently, which hinders their development. A stronger regulatory structure could pave the way for more biobanks to emerge across the country, potentially leading to breakthroughs in cancer research and treatment.
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