Virtual Shared Specimen Resource ‘Essential’

BETHESDA, Maryland—A National Cancer Institute (NCI) panel has declared the creation of a Virtual Shared Specimen Resource (VSSR) to be "absolutely necessary for advancing the detection, classification, and treatment of gynecologic cancer."

The envisioned resource would improve specimen collection and allow researchers to share specimens more widely, according to the committee. It would also enhance collaborations across disciplines and institutions aimed at answering important questions about cervical, endometrial, and ovarian cancers.

"The VSSR will enable the research community to exploit emerging genomics, proteomics, and informatics technologies to identify gynecologic cancers early in the disease process and to discover new targets for their prevention and treatment," said the Gynecologic Cancers Progress Review Group. Its report was released at a meeting of the National Cancer Advisory Board (NCAB).

The NCI panel added that the VSSR would be virtual in the sense that information describing the specimens would be housed in a central database but the specimens themselves would reside with the institutions that collected them.

The VSSR will enable molecular profiling to identify the distinct signatures of specific types of gynecologic cancer cells. This information will help answer a number of important questions: How can women at high risk for these cancers be identified? How can ovarian and endometrial cancer be detected early? What strategies can be developed to prevent gynecologic cancers? How can researchers develop better treatments?

Although many specimen collections now exist, they are limited in their usefulness for many reasons, the report said. Specimens may not have been processed or stored appropriately. The banked specimens may not include the needed tissue types; adequate informed consent may not exist; or the specimens may not be sufficiently linked to clinical data.

Overcoming Barriers

The report said the VSSR would help overcome existing barriers to effective specimen banking and distribution in several ways. First, the virtual design will overcome institutional reluctance to join such a collaborative effort. Second, central coordination will provide equitable access to banked specimens and provide a way to collect specimens prospectively when banked specimens are inadequate.

Finally, the VSSR’s scientific oversight mechanism will ensure the development of appropriate policies regarding the rights and responsibilities of consortia members and provide incentives to promote collaboration.

The review group urged NCI to provide the resources needed to facilitate developing the VSSR, and it called for an advisory committee composed of researchers and advocates in gynecologic cancer to monitor and oversee the VSSR and the research it will support. It also urged research institutions to collaborate in developing and using the VSSR.

In addition to singling out the VSSR as the most important priority, the panel listed three "high-impact priorities" whose implementation would expedite the understanding of gynecologic cancer and help to reduce the burden of the disease.

The first of these calls for identifying precursor lesions, risk markers, markers for early detection, molecular disease classifications, prognostic indicators, and new targets for prevention and treatment.

Co-chair Nicole Urban, ScD, of the Fred Hutchinson Cancer Center, cited a recent paper in The Lancet as an example of what advances in proteomics could mean for screening women. An NCI-FDA team reported that a pattern of proteins, which can be detected by a blood test, may indicate the presence of ovarian cancer, even at an early stage. Dr. Urban called that serum marker "a tremendous breakthrough."

The review group’s other two high-impact priorities are to "develop effective human papillomavirus vaccines to prevent biotransmission and development of neoplasia," and to "conduct research to understand and improve the quality of life of gynecologic cancer patients, and reduce or eliminate disparities related to care among patients with gynecologic cancers."

In addition, the progress review group identified six specific scientific opportunities to expedite translational research in the disease.