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

johanna.arola@hus.fi

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