At the 50th annual meeting of the American Society of Clinical Oncology in early June, the discussion focused on science and society: How can the explosive increase in knowledge about cancer be turned into meaningful progress for the individual and society?
Much of this new knowledge is derived from large collaborative studies of patients and tissues derived from patients. The biggest project in recent years has been the federally-funded effort to carry out intensive molecular characterization of a variety of cancers to learn about how these malignant tissues differ from normal tissues, known as The Cancer Genome Atlas or TCGA. Over the last several years, TCGA has yielded up a treasure trove of information about all kinds of cancers. Dozens of centers and hundreds of investigators across the county participated in this large-scale molecular biology project. We in Pittsburgh should feel tremendous pride that, at last count, the University of Pittsburgh provided more samples for this vital effort than any other cancer center in the country–more than our colleagues at dedicated cancer centers like MD Anderson and Memorial Sloan Kettering. This is a tribute to painstaking efforts from our pathology team led by Rajiv Dhir, M.D., to collect, store and curate residual cancer tissues, normal tissues and blood to facilitate these analyses. As a result, our investigators have served as co-authors on a number of important reports on the molecular portraits of breast, bladder, colorectal, endometrial, lung, ovarian and renal cancers published in the prestigious journal, Nature.
So how will this help patients? On a national level we are uncovering nuances about cancer behavior that will guide development of new tests and therapies. Locally, we are well positioned to take advantage of this data warehouse to propel our research efforts forward through the establishment of the Pittsburgh Genome Resource Repository. This initiative – led by Michael Barmada, Ph.D., Rebecca Crowley, M.D., and Adrian Lee, Ph.D. – marshaled the forces of the Pittsburgh Super Computing Center, UPMC, and Center for Simulation and Modeling to bring the TCGA data home to Pittsburgh to be linked with our rich clinical data derived from the patients whose tumors were analyzed through the TCGA. This living data set is continuously updated and gives our researchers the opportunity to link their research findings with knowledge about real tumors from real people.
Another challenge is how to manage and share “big data” like these. Even a cancer center as large as our own can only begin to scratch the surface of the complex diseases that we call cancer. The science of bioinformatics is moving at high speed to help us to link tissues, medical records, pathology reports and more between centers and investigators. Here Pitt investigators are also taking the lead. Under the leadership of Dr. Crowley and Michael Becich, M.D., Ph.D., the University of Pittsburgh has just received two highly competitive five-year U24 grants from the National Cancer Institute to accelerate this integration. One grant will facilitate a natural language processing system to develop data and tissue sharing across four cancer centers: Roswell Park, University of Pennsylvania, Georgia, and Pittsburgh. The second grant, a collaborative effort with investigators at Children's Hospital in Boston, will facilitate development of new methods to extract cancer phenotype information from the electronic medical record to support personalized medicine and decision support.
Of course the biggest challenge is how these data will be transformed into useful knowledge–knowledge that can be used by practitioners and patients to optimize the care for the individual patient and the system of care for society. This truly is the promise of science for society and we believe that we in Pittsburgh are in the forefront in this transformation.