Supporting Kidney Cancer Research:
Lessons Learned Establishing The Stanford
Kidney Cancer Biospecimen Repository
Thomas J. Metzner, MS1,2, Christian R. Hoerner, PhD2,3, Hongjuan Zhao, PhD 1, Rosalie Nolley, MS1, Sumit A. Shah, MD2,3,
Sandy Srinivas, MD2,3, John P. Higgins, MD2,4, Chia-Sui Kao, MD2, Rajesh P. Shah, MD2,5,9, Joanna E. Liliental, PhD2,6,
Alan E. Thong, MD MPH1,2, Harcharan S. Gill, MD1,2, Benjamin I. Chung, MD, MS1,2, Geoffrey A. Sonn, MD1,2, Eila C. Skinner, MD1,2,
Wendy J. Fantl, PhD1,2, Erinn B. Rankin, PhD2,7, Amato J. Giaccia, PhD2,7, Donna M. Peehl, PhD1,8, James D. Brooks, MD1,2,
Alice C. Fan, MD2,3, John T. Leppert, MD, MS1,2,9
1Department of Urology, Stanford University School of Medicine, Stanford, CA, 2Stanford Kidney Cancer Research Program,
3Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA, 4Department of Pathology,
Stanford University School of Medicine, Stanford, CA, 5Department of Radiology, Stanford University School of Medicine, Stanford, CA
6Department of Medicine Translational Research and Applied Medicine Program, Translational Applications Service Center,
7Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, 8Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, 9Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
Abstract
Advancing our understanding of kidney cancer relies on
the acquisition of biological specimens from patients
with the disease. The increasing complexity of cancer biology
studies necessitates a “team science” approach,
leveraging input from a multidisciplinary team and often
requiring multiple methods for acquiring and preparing
biospecimens. Researchers face many challenges when
developing infrastructure to obtain high-quality specimens,
including limited access to specimens due to regulatory
requirements and institutional barriers, and a
lack of familiarity with clinical care environments. Clinicians
also face challenges when working to collect samples
outside of an individual practice, including access
to multiple locations and other sub-specialty care services.
The collecting of high-quality biospecimens itself is
challenging, as it is important to consider patient characteristics,
pre-analytic variables, collection protocols,
specimen handling, and data management. The purpose
of this paper is to detail our experience addressing these
10 Kidney Cancer Journal
challenges while developing the infrastructure for a kidney
cancer biospecimen repository. We believe that sharing
solutions to these challenges at a single institution
may assist others developing similar programs, and will
aid in fostering future efforts for collaborative group
banking efforts with specimen and data harmonization.
Introduction
Renal cell carcinoma (RCC, kidney cancer) poses a daunting
research and clinical challenge. RCC is not a single
disease, but represents a group of cancers with distinct
biology that happen to arise from the kidney. Moreover,
each variant of RCC can manifest across a broad spectrum
of risk – from slow-growing indolent lesions, to rapidly
growing cancers with high metastatic potential. The
study of RCC specimens has played an integral part in
advancing our understanding of the biology of RCC, and
has led to the global improvement in our ability to care
for patients. Despite these advancements, significant opportunities
remain for basic and translational research
utilizing human RCC biospecimens.1 The Urology Care
Foundation National Urology Research Agenda highlights
the urgency of establishing “biospecimen repositories
of well documented disease and normal tissue” in
the National Urology Research Agenda.3 The importance
of high-quality biospecimens is well established within
the cancer and RCC research communities.4,5 The practice
of biospecimen collection must continue to evolve
to meet the needs of RCC researchers.2 To continue to
improve biospecimen repositories, best practices have
been proposed to ensure the collection of samples that
support reproducible high-quality research.6,7
The Stanford Kidney Cancer Research Program is an
interdisciplinary group of physicians and basic scientists
who are dedicated to pioneering research studies to increase
knowledge of the biology of, and improve treatments
for, RCC. In order to support this growing research
enterprise, we have collaborated to build the infrastruc-
Key words: Renal cell carcinoma, biospecimen, repository, biopsy, biology,
collection, specimen handling, research protocol, tissue banking,
Clinical Research Coordinator.
Corresponding Author: John Leppert, Grant S-289, 300 Pasteur Drive,
Stanford, CA, 94305 jleppert@stanford.edu
Acknowledgements: This manuscript is dedicated to the memory of Larry
Lulofs, and to the hundreds of patients with renal cell carcinoma who have
selflessly donated their tissues to support our research efforts in hopes of
improving treatments for future patients.
Funding: This work was supported in part by the Departments of Urology
and Medicine at Stanford University School of Medicine, the Stanford
Cancer Institute (Translational Developmental Cancer Research Award to
J.T.L. and A.C.F.), the Stanford Translational Research and Applied Medicine
(TRAM) Program Pilot Grant (J.T.L., A.C.F.), the Parker Institute of
Cancer Immunotherapy (W.J.F. and J.T.L.), the US National Institute of
Health (CA169964 to J.T.L. and A.C.F., CA199075 to A.C.F., CA140722 to
A.C.F., CA229933 to J.D.B., CA198291 to A.J.G. and E.B.R., CA217456 to
D.M.P.), the Department of Defense Peer Reviewed Cancer Research Program
(11981051 to J.T.L.), and an Conquer Cancer Foundation of ASCO
Career Development Award (A.C.F.). The content is solely the responsibility
of the authors and does not necessarily represent the official views of
the NIH, the U.S. Department of Veterans Affairs or the U.S. Government.
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