Mapping The Future Of Cancer Around The World

Cancer patients in Savannah are contributing to global DNA research

When a tumor is removed from a cancer patient, its tissue is evaluated by pathologists for diagnosis and treatment. Any excess tissue that is not needed by the pathologist is usually thrown away. But now a team at the Nancy N. and J.C. Lewis Cancer & Research Pavilion (LCRP) is using that excess tissue and turning it into something essential—research material for a worldwide program known as The Cancer Genome Atlas (TCGA).

TCGA is supported by the National Cancer Institute (NCI) and National Human Genome Research Institute at the National Institutes of Health. The LCRP’s biorepository specialists, Judy Miller and Jennifer Sapp, collect the excess tissue and process it in a specific way and within a certain time frame to preserve its DNA, and send it to TCGA, who will then map the tumor’s genome.

A genome is the total amount of the DNA information for each cell. As most of us recall from biology class, DNA, or deoxyribonucleic acid, carries our genetic information in each of our cells. Mutations in DNA can cause dysfunction in cells, including making them grow out of control and developing into cancer.

TCGA analyzes and maps the genetic sequencing of the tumors to identify genomic changes. With hundreds of samples from each type of cancer, TCGA is creating a genetic database that can be accessed by scientists in different parts of the world. By comparing the collected data, researchers have already been able to discover what areas of the genome are affected by different types of cancers. The program has also helped physicians identify which types of cancers respond to different treatments.

The end result is a global collaboration in which the LCRP is participating. By allowing their tissue samples to be collected for the program, cancer patients in Savannah are helping to develop treatment for those who are diagnosed in the future.

“It’s an atlas of the genomics of specific tumors,” explains Miller, the lead biorepository specialist for the LCRP. “For example, if the program has 500 adenocarcinomas that are lung cancer, they can look at the genetic sequencing for all 500 of them and discover if they have something in common. Or they may discover that they are all different, but different in what way?”

“The program also analyzes how a patient with lung cancer differs from another patient with the same type of cancer, and the similarities and differences with other types, such as colon cancer,” Miller says. “With all of this genetic information, there are seemingly endless possibilities for researching the make-up of cancer cells and the various ways to individualize treatment to the genomics of the tumor.”

Miller and Sapp currently collect breast, kidney, lung, pancreas, colon, gynecological, and head and neck cancer tissue for TCGA. They work closely with surgeons and pathologists to make sure the collection process does not impose on their procedures. Patients must give consent to donate their tissue and meet specific qualifications to be enrolled in the study.

Knowing that the research won’t change their own treatment plan, most patients are still happy to participate.

“The patients are really donating out of the kindness of their heart for others,” Sapp says. “They want to help in the hopes that the people of tomorrow who face the same diagnosis will have an easier and better treatment course.”

The LCRP was selected to participate in the NCI Community Cancer Centers Program (NCCCP) in 2007 and was awarded funds to continue the relationship last year. Howard A. Zaren, MD, Medical Director for the LCRP, notes that along with participation in the NCCCP, the LCRP also has a reputation for providing highly-rated specimens that could benefit TCGA’s research goals.

“The tissue is graded for its research viability and how well it can be utilized for study, and we are always at the top,” Zaren says.

Zaren, Miller, and Sapp greatly commend St. Joseph’s/Candler’s pathologists and their assistant who together evaluate the samples and help to assure tissue candidacy and quality.

“The pathologists donate their time and effort to work with us on this,” Zaren says. “Without them, we wouldn’t be able to be a part of this program.”

Dr. Zaren believes that TCGA is part of a beginning of a new level of cancer research and treatment. Advances in just the last few years have developed into what he calls precision care.

“Five or so years ago, we made a diagnosis of cancer and staged it,” Zaren says. “Two or three years ago, we had care that was more personalized, developing a number of tests that looked at the biology of a tumor and any of its anomalies.”

“Now precision care is evolving,” Zaren says. “The components of each individual patient tumor can be characterized down to the cellular level for genomic abnormalities and then targeted therapies can be used to treat those patients. We won’t be thinking of cancer based on the site of origin, but on the cellular components. Genomics is laying the groundwork for the development of this type of precision care.”

Learn more about cancer genomics by visiting the TCGA website at
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