doi:10.1038/nindia.2013.103 Published online 31 July 2013
The absence of a major cancer research biorepository in the developing countries, which account for more than half of the world's cancer burden, is a cause for concern for Indian cancer researchers. They feel it's time the country had a next generation biobank to source specimens from.
India's diverse ethnic populations make the country a demographic treasure trove of a variety of cancers. This variety also means India is a rich source of cancer research material. Cancer researchers point out that cancers of cervix, stomach, liver, lip and oral cavity are predominantly found in the developing countries, including India. The tissue bank of Mumbai-based Tata Memorial Hospital is the only biobank in India as of now serving a population of over a billion people.
"These cancers are rare in resource rich countries," says Sanjeeva Srivastava from the Department of Biosciences and Bioengineering at the Indian Institute of Technology Bombay. Srivastava and his colleague Sandipan Ray along with Aliasgar Moiyadi of the Advanced Centre for Treatment Research and Education in Cancer at Mumbai's Tata Memorial Centre recently urged in a study that there is an urgent need to establish next-generation bioripositories in developing countries such as India.
They quote a WHO GLOBOCAN estimation to show that 56% of the total cancer incidences and 64% of cancer related deaths occur in the economically developing world. In the coming decade the total number of new cancer cases is expected to increase greatly, they add.
Biobanks store biological specimens, which contain clinically important information. Biopsy of metastatic cancer is now a common procedure in cancer diagnosis and therapy. There are only a limited number of notable biobank initiatives in developing countries — in China, India, Malaysia, Iran and Thailand.
"This can be attributed to lack of awareness, paucity of designated research budgets and infrastructure and social, ethical and political barriers," Srivastava says. Also, it is difficult to obtain samples from these biobanks since they can't share with other institutes due to ethical and logistical concerns. The authors rue the lack of dialogue and cooperation among these small regional biorepositories and call for better cross-talk among them.
"Clinical trial irregularities have led to stricter ethical committee reviews and government intervention, which make clinical research more difficult," the trio write in their paper. They point out that developing countries such as India and China play a significant role in cancer research in the global context, especially in the post-genomic era.
Srivastava emphasises that since cancer research efforts in developing countries are 'plentiful' with strong governmental support, it is important that good quality clinical samples be available in large numbers. "The need to establish next-generation biorepositories in developing countries should, therefore, attract the attention of global policy makers," he points out.
In India, the establishment of a national cancer grid connecting existing and proposed cancer centres has been hailed by the experts as the first step towards linking stand-alone repositories in various parts of the country. The authors suggest that such regional cancer biobanks should be linked with an overarching national cancer biobank for high-quality and uniform diagnosis and treatment protocols across the country.