The Australian Breast Cancer Tumor Bank (ABCTB) was established from federal government funding awarded in 2004.1 The original start-up grant of AU$500,000 per year for five years was insufficient to maintain a national best-practice biobank, and therefore the ABCTB sought and received top-up funding from other sources. Now that ten years have passed, researchers are taking stock of achievements and identifying future stumbling blocks. In particular, stabilizing funding sources and increasing efficiency, which are core issues of biobank sustainability, are crucial topics they are discussing.
The ABCTB operates under a hub-and-spoke model, in line with recommendations from two major reviews of the health and medical research sector in Australia, the Wills review2 and the McKeon3 report. The center of the model is the management core, which oversees functions including governance, financial management, grant applications, administrative tasks and ongoing training. Radiating out from the hub are the individual collection sites responsible for donor recruitment and consent, specimen collection, processing and storage, and data entry.
The ABCTB recruits and collects samples from newly diagnosed breast cancer patients at the time of surgery. Therefore, the contents of the biobank reflect the distribution of breast cancer subtypes within the Australian population. To date, the ABCTB holds tissue from over 6,000 donors. The biobank accepts applications for tissue globally, provided they meet ethical standards and are scientifically feasible.
On reflection, although there are over 6,000 donors, certain subgroups of disease have very low sample numbers, and therefore future plans for continued sample selection may include a targeted approach. However, the greatest challenge remains securing ongoing financial support for biobanking activities. There is a small cost recovery system in place that ranges from AU$5,000 to AU$24,000 per year, a figure that is both inconsistent and insufficient to support activities. Typically, grants vary in length from three to five years, making it challenging to plan beyond those time frames.
As a result of mounting costs, the number of collection centers has decreased, with four centers closing. The most successful collection sites have subsisted by pooling resources and working closely with diagnostic anatomical pathology departments and senior pathologists, which results in reduced costs.
The Australian government recognizes that biobanking is an essential component of medical research. As such, in 2014, the New South Wales (NSW) government awarded NSW Health Pathology AU$1.5 million to pilot a statewide approach in an attempt to integrate biobanking into the health care system.
One question that remains is whose responsibility it is to provide biobank funding. The ABCTB has considered the possibility of offering services for profit to researchers. In particular, the ABCTB has strengths in nucleic acid extraction, tissue microarray construction, tissue sectioning and staining, and digital imaging of tissue sections. These could all be used as part of a cost recovery model.
1. Carpenter, J. E. & Clarke, C. L. (2014) “Biobanking sustainability—Experiences of the Australian Breast Cancer Tissue Bank (ABCTB),” Biopreservation and Biobanking, 12(6) (pp. 395–401).
2. NSW Ministry of Health. (2012) NSW Health and Medical Research Strategic Review, 2012, NSW: Population Health Division.
3. McKeon, S.(2013) Strategic Review of Health and Medical Research, 2013, available at http://www.mckeonreview.org.au/.