johanna arola, md. phd...johanna arola pathologist (liver and endocrine) research group at hu...
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Biobank –
Way to
Sustainable
Research
Johanna Arola, MD. PhD
Biobanking for Future
Research and Health
28-29 May 2018
Academy of Finland
Johanna ArolaPathologist (Liver and Endocrine)
Research group at HU
2012-2015 Editor-in-Chief: Finnish Medical Journal Duodecim
2016 -17 Head of Pathology: Helsinki Biobank
2017-18 Acting CEO: FinBioBank
puh +358 50 551 1853
Twitter @JohannaArola
ᐩ Roadmap to P4 Medicineᐩ Finnish Biobank Conceptᐩ Example of biobank research: Pulmonary carcinoidsᐩ Biobank for researchersᐩ Biobank for participantsᐩ FinBioBank FINBB ᐩ At the end of the day…
Sustainable Biobank Research
Bridge to Future P4 MedicinePRESENTReactive Medicine
Disease = symptom based
diagnoses
Diagnoses = ICD10 codes
Treatment = one size fits all
Treatment guidelines = evidence
based – slow changes
FUTUREP4 Medicine
Predictive
Preventive
Personalized
Participatory
Methods for earlier detection
or prevention of individuals
at risk
More spesific
biomarkers
More rapid drug
development
Better trial design by cohort
stratification based on
clinical and molecular
features
High quality + DATA in Biobank
Finnish Biobank Concept
Grow interest
The Finnish Biobank Concept
The Finnish biobank legistlation of 2013 has been uniqueRegistration of biobanksTransfer of existing sample and data collections to biobanksCollaboration with industry
Wide consentProtection of participantsPossibility to recontact
Possibility to collect samples and data from the health careLink biobank samples with hospital data (EHR) Link biobank samples with data from national registries
Carpén ja Kosma, Duodecim 2013
Health care based biobank
Diagnostic biobank samples….
Carpén ja Kosma, Duodecim 2013
…but legacy samples do not cover enough …
500 000 potilasta vuodessa,
Jokaisella keskimäärin 2.9 diagnoosia Diagnosis Patients
Essential hypertension 14814
Atrial fibrillation or flutter 7316
Type II diabetes 5565
Sleep apnea 5466
Unspecified stomach pain 4918
Acute upper respiratory inf. 4689
Pneumonia 3618
Bronchial asthma 3555
Cataract 3052
Atherosclerotic heart disease 3023
Prospective samples from all patients –
B-Bio-0 (EDTA 10 ml)
Disease specific collection: Helsinki
Urological Biobank (HUB)
• Systematic collection of 2200 Urological cancer samples• Blood (plasma, seerumi)
• Urin
• FF tumor tissue
• FFPE tissue
• 180 000 samples from diagnostic moment as well as follow up samples
Biobank study on pulmonary
carcinoid tumours
Background-1-2% of all lung cancers, biobanked samples needed-Aim to find new diagnostic or prognostic tissuemarkersPatients-Between 1/1990 and 8/2013 all operated patientswith FFPE tissue sample (n=133). FFPE samples wereretrieved through the biobank, clinical data was collected as a separateresearch project.Methods-Tissue Microarray (TMA), immunohistochemistry (IHC), digital pathologyResults100 TC patients, 33 AC patients5- and 10-year survival: TC 99% ja 99%, AC 87% ja 82%
The most remarkable prognostic factors: histological subtype, metastatic disease, tumor size and Ki-67 index
T. Vesterinen May 9,
2018
Biobank study on pulmonary
carcinoid tumours
First paper publishedDescription of the patient cohort (Vesterinen
et al, Acta Oncol 2018)
Second one, including also patient samples
from the Auria Biobank, in the pipeline
Future plansTo apply for samples and clinical data from
all Finnish biobanks to extend the study
material
Sample and
data in the
study
Application
approved,
sample and
data
collection
on-going
T. Vesterinen May 9,
2018
Researchers Biobank – access procedure
RESEARCH QUESTION
or R&D IDEA
CONTACT BIOBANK
for project preparation, sample
availability or budget request.
PROJECT PLAN
Describe the project,
ethical
considerations, and
sample request.
Biobank assists in
planning.
PROJECT REVIEW
HUS ethics
committee provides
recommendation for
sample release. The
decision is made by
biobank’s director.
MTA AND SAMPLE
DELIVERY
Samples and associated
clinical data will be
provided in a
pseudonymised format.
PROJECT COMPLETION
When the project ends,
results of the sample
analysis and/or raw data
is returned to the biobank
as defined in MTA.
ADDITIONAL REQUEST
Contact biobank, in case
additional samples or
recontacting of donors is
needed.
(FFPE) samples TMAAutomated IHC/ISH
ANALYSIS TOOLS
(Deep learning/artificial
intelligence)
Datalake with comprehensive
EHR information
2
Genome and other omics
HO
SP
ITA
L B
IOB
AN
KH
OS
PIT
AL
EH
Rs
HEALTH CARE
INNOVATIONS
Infrastructure Supporting Research
TRANSLATIONAL
RESEARCH TOOLS
(e.g. drug testing, cell
cultures)
Condensing information: tissue microarrays
ᐩ Professional, centralized sample collection and storage, where a single sample can
benefit multiple research projects of different disciplines over time
ᐩ The knowledge accumulated on the healthcare sector can be used for the benefit of
research, and the data stemming from research projects can be returned to the health
care units
ᐩ Centralized and cost-efficient operation, wide usability of the samples
ᐩ Availability of phenotype
ᐩ Certified practices enable research data to be used for the benefit of clinical practices
ᐩ Centralized infrastructure supporting research projects, e.g. tissue microarray facilities
Benefits of biobank research
ᐩ Professional, centralized sample collection and storage, where a single sample can benefit multiple research projects of different disciplines over time
ᐩ The knowledge accumulated on the healthcare sector can be used for the benefit of research, and the data stemming from research projects an be returned to the health care units
ᐩ Centralized and cost-efficient operation, wide usability of the samplesᐩ Availability of phenotypeᐩ Certified practices enable research data to be used for the benefit of clinical practicesᐩ Centralized infrastructure supporting research projects, e.g. tissue microarray facilities
ᐩ Samples run outᐩ Someone will use “my” samples and dataᐩ Challenges in implementing new operation and infrastructure
Benefits of biobank research - and
worries
Biobank for Doners
Biobank for patients - participantsParticipatory
Carpén ja Kosma, Duodecim 2013
Biobank for patients - participantsParticipatory
Carpén ja Kosma, Duodecim 2013
1. Right to know the use of your own sample
2. Speed up research of your own disease
3. Recontacting is possible
4. May even benefit personally
ᐩ Six hospital integrated BB
ᐩ Four nationwide BB
ᐩ First private biobank – Terveystalo
ᐩ BBMRI.fi
ᐩ Finland member of BBMRI.eric
ᐩ 2017 – FinBioBank FINBB – Cooperative
for Finnish Hospital Biobanks
Finnish Biobanks 2018
Address:
FinBioBank– FINBB,
Joukahaisenkatu 6, 7 fl.
20520 Turku,
Finland
FinBioBank FINBB
FinBioBank - FINBB
Vision: Advance Health Care
• Serve as a key contributor to making population resources available for advancements in public and personal health.
Mission: Support Biobank Creators and Users
• Provide coordinated services to help biobanks set up infrastructure and processes to create high quality, standardized collections with interoperative utility and critical-mass-based market value.
• Facilitate scalable, sustainable, revenue-generating utilization of biobank resources by academic, public, and commercial biobank users.
25
FINBB: Services & products
• Operational Support on protocols and processes: harmonizationBasic: IC, sample collection, processing, storage, access, utilizationOptional: sample processing, analysis, etc.
• Informatics Infrastructure and Applications; Integrated National BB platform
• Quality Management Systems
• Procurement of External Services and Products
• Ethical, Legal and Structural/Organizational Aspects
Biobank Customers
• Single Point of Contact – One-Stop Shopping of integrated resource
• Standardized, efficient project contracting
• Project management
• Business Development, Marketing, Sales, Channel, Pricing, Contracts, MTAs
Biobank Users
• Communications
• Financials and Accounting
• Project Management
Both
We stand with your rand.
STM3547/2017 – Harmonization and Collaboration of Biobanks
Government funding 2017-18
1M€
◆ Campaign Implementing Biobank Sample Collection - Focus
on New Cancer Patients
● Goal to catch 20% of new patients
● Collect Liquid biopsy + fresh frozen tumor tissue (FF) in
hospital biobanks
◆ Availability data base–one stop shop
FF Tissue Processing in Helsinki Biobank
A
2-4 putkea
2 putkeaLN2
Tiina Vesterinen 13.1.201630
Isomursu A, Kononen J, Kuopio T
Verenkierron Solunulkoinen DNA
syövän merkkiaineena
Duodecim 2015;131:424–32
Liquid biopsy
Availability database
One-
stop-
shop@FinbbSuomi
ᐩ Patients Rights First Lääkärin tai tutkijan etu ei saa koskaan mennä
potilaan edun edelle
• Heikki Mäkisalo
ᐩ Who Stands for the Sick ? Kuka pitää sairaan ihmisen puolia?
• Perttu Lindsberg
ᐩ Equality of Patients Terveydenhuollon ammattilaiset eivät voi
kieltäytyä pyytämästä biopankkisuostumusta potilaalta
• Anne Pitkäranta
At the end of the day