RTOG TISSUE REPOSITORY Radiation Therapy Oncology Group

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RTOG TISSUE REPOSITORYRadiation Therapy Oncology
Group
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H E SLIDES

• Stained tissue on glass slide.
• Required for every case entered on a protocol for
  central review.

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HE SLIDES

• PROBLEM
• Pathology departments tend to be possessive of
  HE slides.

• RESOLUTION
• Re-cuts
• Must have adequate tissue to show tumor.

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PARAFFIN BLOCKS

• The manner in which biopsies are preserved.
• Verify the block/blocks submitted includes a
  portion of the tumor used for diagnosis.
• Required on most protocols.

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PARAFFIN BLOCKS

• PROBLEM
• Pathology departments tend to be possessive of
  paraffin blocks.

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PLUG SAMPLES

• method uses derm needle to remove selected tumor
  area from paraffin block.

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PLUG SAMPLES

• Request a Specimen Plug Kit.
• Kit contains shipping tube and derm needle.

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PLUG SAMPLES

• Ask pathologist to select tumor area.
• Use the derm needle to punch the selected area
  from the specimen block.

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PLUG SAMPLES

• Label needle with specimen ID.
• Place derm needle into specimen shipping tube,
  without removing specimen from needle.

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PLUG SAMPLES

• Allows your pathology department to keep their
  original block, while submitting a tissue sample
  to us for banking.

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DISADVANTAGES OF UNSTAINED SLIDES

• Easily broken during shipment
• Slides become negative for antibody detection in
  a short time
• Difficult to store
• Limited amount for staining
• Cannot make tissue arrays from slides

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ADVANTAGES OF PARAFFIN BLOCKS

• Easy to store, no freezer necessary
• Hundreds of samples are possible
• Not broken in shipping
• Antibodies are preserved
• Tissue Microarrays are made from paraffin blocks

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TISSUE ARRAYS

• Allows a pathologist to look at many different
  tumor sections at once.
• Helpful in finding common markers in hundreds of
  patients using only 1 slide, instead of hundreds
  of slides.

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TISSUE ARRAYS

• Core sample removed from specimen block.
• Inserted into blank paraffin block.
• Repeated until block is filled with rows of
  specimens, each representing a different case.

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TISSUE ARRAYS

• Grid chart used for documenting the specific
  location of each specimen.

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TISSUE ARRAYS

• Sections are cut from array block, and placed on
  glass slides.
• Slides stained for pathologist review.

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PATHOLOGY

• Explain that patient is participating in research
  study and has given written permission.

• Share letter written by Dr. Hammond to announce
  the funding of the tissue repository by the NCI.

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REIMBURSEMENT

• Only offered for submissions which can be used
  for more than current study.
• 200 Block / blocks submitted with tumor.
• 200 Plug sample from the block, must contain
  tumor
• 300 Blood, Serum, complex materials.
• No reimbursement for HE only submissions.

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SUBMISSION REQUIREMENTS

• TISSUE (HE, blocks, plug samples).
• One or all may be required per protocol.
• Pathology Report.
• Always required.
• RTOG Pathology Submission Form.
• Always required when tissue is being submitted.

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PATHOLOGY SUBMISSION FORM

• MUST check appropriate box on submission form to
  specify level of patient consent.
• Do not send me copy of patients consent.

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OUTSIDE HOSPITALS AND LABORATORIES

• Make sure they understand importance of including
  paperwork with the pathology material.

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PLEASE GO OUT OF YOUR WAY TO MAKE SURE THAT I
RECEIVE EVERYTHING NECESSARY TO PROCESS YOUR
PATHOLOGY MATERIAL!
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WHAT HAPPENS TO TISSUE SUBMISSIONS

• Every piece of paper, every slide and every block
  is marked with protocol and case number.
• Logged on sheet faxed to RTOG Headquarters.
• Receipt information entered on calendar.
• Send copies of paperwork which is put in patients
  file.
• Tissue is filed until sent to pathologist or for
  future study.

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SENDING TISSUE TO PATHOLOGIST

• Periodically or when requested, material is sent
  to pathologist for central review or for a
  research study.
• I am responsible to collect and send the
  following material
• Slides
• Pathology report
• Review form

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DATABASE

• Our database allows us to account for disclosure
  of all information.

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RTOG TISSUE REPOSITORY

• A great resource for even more studies in the
  future.
• To date the tissue bank has currently collected
• 17,251 Cases
• 51,410 H Es
• 16,360 Blocks

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RTOG TISSUE REPOSITORY

• Holly Goold
• LDS Hospital
• [phone]
• Holly.goold_at_ihc.com