Much like the uniqueness of a fingerprint, the way cancer can manifest, progress and respond to treatment varies greatly from person to person. However, current cancer research—which influences the development of cancer therapies—only studies a small percentage of the population. When not representing all people with many socioeconomic and ethnic backgrounds, it is hard to know exactly what type of cancer treatment they need and how they will respond—something that is particularly crucial at Boston Medical Center, where the patient population is incredibly diverse.
“Cancer research in general has been focused on a very small slice of the population and we need to look at the whole picture,” explains Matthew Kulke, MD, chief of hematology and oncology.
In addition to providing patients with cutting-edge cancer care and access to the latest, novel cancer therapies through clinical trials, a core mission of Boston Medical Center’s Department of Hematology and Oncology is to advance the scientific understanding of cancer and cancer treatment in a broad and diverse patient population. Casting a wider net to ensure all people of all backgrounds are included in research means treatments and therapies can be better tailored to patients. For example, research as of late has centered on the relationship between cancer and the microbiome, which is comprised of trillions of microorganisms in the body and is unique to each person.
“We’re looking at predictors of response resistance to immunotherapy and it’s becoming increasingly clear that the microbiome can impact whether people do or don’t respond,” Kulke explains. “It’s not just about cancer tissue. It’s about the whole picture, the microbiome, in terms of what drives response to treatment and discovering new treatment strategies. But, as you can imagine a microbiome in a very diverse population can vary. It can vary by geography and possibly even socioeconomic status.”
In order to facilitate translational research, which aims to impact health outcomes, the department has been closely collaborating with the Department of Pathology and Laboratory Medicine at BMC to collect biospecimens from patients for BMC’s Biospecimen Archive Research Core—also referred to as a biobank. In simplest terms, a biobank is a biospecimen and database archive consisting of biological samples from consented participants which, in this case, are used for cancer research.
BMC first implemented a biobank in 2006, and since then, it has been an important component of cancer care research at the hospital as well as the National Cancer Institute (NCI), especially when studying diverse patient populations. “Historically, biospecimens for research have not always been collected from a diverse patient population,” explains Chris Andry, MPhil, PhD, chief of pathology and laboratory medicine. “As part of our mission to support underserved and underrepresented people, BMC feels it is important to give patients an opportunity to contribute to scientific research.”
While following NCI Best Practices, the department ensures the accurate collection, management and storage of patient samples. Having pristine samples, Andry explains, means scientists are able to work with biospecimens that best represent the disease they are investigating so they can ultimately move clinical care forward.
While a biobank is not new to BMC, the focus on the microbiome is. “We’ve expanded biobanking efforts. We’re not only collecting tumor tissue at the time of surgery but we are also obtaining samples so we can study the microbiome,” Kulke says. “We’re bridging the gap between science and clinical care, and that bridge is the biobank.”
As such, researchers are collecting samples throughout the course of a patient’s cancer treatment in order to look for biomarkers to predict response and resistance to treatment and how that reaction can vary from person to person. The department hopes to have every patient be part of the biobank and it is trending in a positive direction—so far, the majority of patients have agreed to submit biological samples to the biobank, yielding a consent rate of 80 to 90 percent. “Our cancer patients have voiced a desire to contribute in any way to help overcome the disease that they are experiencing,” says Andry. “Donating biospecimens is one way to do this.”
Growth of the biobank will enable strides toward providing the best possible care for every patient. “A big part of cancer research is being able to study patient samples and correlate them with what happens to the patients and what impacts treatment,” Kulke concludes. “We’re at the forefront of cancer therapy, doing research with the foundation of a patient population that is far more reflective of what the population looks like in our country and the world.”