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Research Thymoma Tissue Bank Thymoma is an extremely rare tumor originating from the thymus. According to data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program, the overall incidence of thymoma is 0.15 per 100,000 person-years. Research and drug development in thymoma are thus limited. Precious tissues collected during surgical removal are scattered among various hospitals. So that these specimens can be shared by research teams, regardless of their locations, a centralized bank is essential. No thymoma-specific tissue banks have been created anywhere in the world until now. The Cadorette Fund for Thymoma Research has made the establishment of the MGH Thymoma Tissue Bank possible, but time-critical research depends on the donation of tissue by anyone facing surgery for Malignant Thymoma. Tumor banking involves not only tissue storage, but also a series of protocols that allow appropriate studies of tumor samples. Moreover, the bank represents a global facility that allows surgeons, clinicians and pathologists to collaborate for a better understanding of the disease. Without tissue samples there can be no meaningful research, understanding and new treatments for the disease. Tissue banking enables:
Massachusetts General Hospital is a major referral center for complex thoracic problems. Its thoracic team offers a multidisciplinary approach to new cases of thymic malignancies that can take advantage of the expertise of the hospital’s thoracic radiologists, thoracic surgeons, radiation oncologists, medical oncologists and dedicated pathologists. The tissue bank is now available. Patients are being screened and our first specimen has been received. To watch a video about tissue banking, please click here. Genetic Testing With the tissue bank now well underway a new project for which the Fund will be used is the support of genetic testing. The genotyping of tumors allows therapy to be targeted by specific drugs. These can be very effective against the tumor cell without a lot of side effects on the normal cell. Particular drugs can be used against specific genes. This holds great promise for the treatment and cure of malignant thymoma. Next Generation Sequencing to Understand Metastasis Current cancer therapies are aimed at shrinking tumors, but little is known about targeting the cells that give rise to metastasis. Whereas primary tumors can be surgically resected or irradiated, once a tumor has spread via the bloodstream to distant sites (such as the lungs, liver, brain or bone) it is usually incurable. Treatments designed to suppress metastasis have not been developed, in large part because of our ignorance about the specific subtypes of cancer cells that are responsible for initiating these distant lesions, their particular sensitivity patterns, and whether or not they are suppressed by therapeutic agents. In order to better understand metastasis, we need to quantitatively define the pattern of gene expression within rare tumor cell populations, including circulating tumor cells (CTCs). Among these rare CTCs are "cancer stem cells" or "metastatic precursors" that are capable of initiating a distant tumor metastasis. Identifying the unique set of genes expressed in these extraordinarily rare metastasis precursors in the bloodstream is key to montiring, targeting and eventually preventing cancer metastasis. While standard nucleotide sequencing and microarray technologies are insufficiently sensitve to accomplish a gene expression study of rare CTCs, the development of "next generation sequencing" (so-called Next Gen) technologies offers tremendous promise. Next Gen sequencing allows analysis of millions of nucleotides which are then assembled computationally, thus providing one hundred fold increased sensitivity compared with standard technologies. The use of this technology on isolated rare circulating tumor cells would allow us to identify changes in gene expression that may direct therapeutic targeting. Additional applications that would greatly benefit from this technology include the comparison of primary and disseminated tumor deposits using paraffin embedded pathology specimens, and the study of interactions between tumor cells and surrounding reactive stromal cells. The impact of next generation sequencing would be revolutionary for our efforts on the molecular study of cancer genes and their application to "smart drug" targeted therapies of cancer.
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