ABOUT THE CHTN

• What is the CHTN
• Divisional Contacts
• Why is the CHTN Different?
• CHTN Coordinating Committee
• History of the CHTN

WHAT IS THE CHTN?

The CHTN was initiated by the Cancer Diagnosis Program of the National Cancer Institute (NCI) in 1987 to provide increased access to human cancer tissue for basic and applied scientists from academia and industry to accelerate the advancement of discoveries in cancer diagnosis and treatment.

The CHTN provides prospective investigator-defined procurement of malignant, benign, diseased and uninvolved (normal adjacent) tissues. The investigator may also choose from several methods to prepare the specimen such as fresh, frozen, or chemically fixed. Tissues are annotated with patient demographics including sex, age, and race. The CHTN also produces tissue microarray (TMA) slides, including surveys of multiple tissue types and disease-specific designs. Additional patient information may be requested where applicable.

Quality control assessments of tissues are provided by the CHTN principal investigators who are actively involved in the practice of anatomic pathology. The CHTN principal investigators are responsible for proper histopathological characterization, participate in research and understand the importance of quality control in the tissues provided.

Specimens are shipped to investigators using IATA guidelines and under conditions supporting the preparation of the tissue. A tissue processing fee and the cost of shipping are paid by the investigator.

The CHTN is organized into five adult divisions and one pediatric division. Each division manages investigator requests from a different geographic region of the United States with the exception of the Pediatric Division which serves all of the U.S. The map below divides the United States into the five (adult) primary divisions. The Eastern Division is responsible for all states bounded by the western and southern borders of Pennsylvania as well as Delaware and includes Hawaii. The Mid-Atlantic Division is responsible for Maryland, Virginia and the District of Columbia. The Midwestern Division includes West Virginia and the states west of Pennsylvania, north to Minnesota and south through Missouri as well as Canada. The Southern Division encompasses Kentucky and all states south and west from the Carolinas to Texas. The Western Division covers all states north of Oklahoma and west of Texas.

Click a region of the map to see a more detailed image of that region.

CHTN U.S. map Western Division Midwestern Division Eastern Division Mid-Atlantic Division Southern Division

PIs from any geographic area REQUESTING PEDIATRIC SPECIMENS ONLY should forward their completed application directly to the Pediatric Division at Nationwide Children's Hospital.

DIVISIONAL CONTACTS

WHY IS THE CHTN DIFFERENT?

The major goal of the CHTN is to facilitate the use of human tissues in biomedical research. This is accomplished not only by the CHTN consistently supplying high quality human tissues to investigators but also by the members of the CHTN taking leading roles in the development of best practices / guidelines for the operation of tissue repositories, aiding in the development of other tissue resources via consultation, supplying our informatics program at no cost, and educating national and international leaders in tissue resources through publications, consultations, site visits and/or formal training programs.

From the standpoint of providing tissues to investigators, the CHTN operates on a unique prospective procurement model rather than a banking model. The CHTN divisions work both independently with individual investigators and together as a seamless unit to fulfill requests that are difficult to serve by any single division. Such networking is accomplished using an informatics system developed by the CHTN, and by providing specimens via harmonized standard operating procedures (SOPs). This means that investigators specify how they want their tissues collected and processed and the CHTN provides consistent, high quality human tissues based upon the specific requirements of each investigator. This includes providing fresh non-frozen tissues to investigators in media of choice. Thus, while a bank collects, processes and stores specimens in a "one-shoe-fits all" approach, the CHTN works with all investigators to tailor the collection, processing, temporary storage and distribution of tissues in order to meet their exact needs for tissue to support their research in a timely manner. Fresh, frozen, fixed and paraffin embedded tissues as well as frozen sections and paraffin sections from single paraffin blocks or from tissue arrays constructed by the CHTN can be supplied. This includes providing fixed and paraffin embedded tissues that have been fixed in a variety of fixatives. All tissues are supplied using Quality Assurance / Quality Control approaches ensuring investigators a high quality product. The CHTN has pioneered the use of quality assurance/control methods in tissue resources and has trained other tissue resources in the importance of quality control of tissues used in research.

The CHTN focuses on being user friendly. Each request for tissues is reviewed by a diagnostic pathologist who, if needed, helps investigators with selecting the proper tissues to support their research. Also, if an investigator does not have a preferred SOP for collection, processing or storage of their tissues, CHTN personnel work with the investigator to develop an SOP depending upon the needs of the investigator and standard SOPs of the CHTN. The CHTN especially works with young investigators to provide advice and assistance to ensure that the tissues and processing requested meet their research goals. If the projects of young investigators are unfunded, the CHTN makes provisions for providing to them a limited number of specimens at no charge.

The CHTN is involved in educating the research community. In addition to assisting young investigators in the application process, the CHTN divisions are involved on a national and international level through participation with ISBER (the International Society for Biological and Environmental Repositories) and CaBIG. In addition to teaching workshops and providing publications on how to develop and operate a tissue repository, CHTN personnel participate in international meetings and conferences regarding issues that relate to tissue repositories (e.g. human subjects and privacy). The CHTN also evaluates factors which may affect the usefulness of human tissues in research and publishes the results of these studies. The CHTN involves patient advocates in order to respond to the public need and increase public awareness of issues related to tissue resources. The CHTN also refers investigators to other repositories that may provide assistance in meeting investigator needs.

The CHTN tries to meet unusual user needs. For example, CHTN personnel will work directly with investigators to test tissue sources (e.g., surgery, autopsy, transplant) as well as SOPs in tissue processing to determine if these methods/tissues meet the research needs of an investigator. Similarly, if an investigator must have clinical data on the patients from whom tissues are collected, the CHTN will provide the investigator with the needed patient-data. Information on clinical outcome can be provided by some divisions for some patients after the tissue has been provided.

The CHTN is one of the more experienced tissue resources from the standpoint of actually providing investigators with human tissues for use in their research. The CHTN has experience with which approaches to tissue resources work or do not work. Since its inception the CHTN has supplied tissues to thousands of different investigators. A major niche that the CHTN fills is supplying tissues to aid in the discovery of molecular features of tumors. Such discovery work can be supported by high quality tissues that can be supplied relatively inexpensively because they do not have to be associated with extensive clinical information and/or with complex processing of tissues. We are aware of no other tissue resource group which has met the needs of so many investigators.

The CHTN can be described as follows:

• The CHTN is not a bank.
• The CHTN is a network.
• The CHTN procures and distributes specimens prospectively, based upon demand.
• The CHTN distributes fresh specimens, as well as frozen, and fixed specimens.
• The CHTN specimens are not limited to cancer, but also include inflammatory disease as well as rare diseases; such specimens are very useful as controls in the study of cancer.
• The CHTN provides normal specimens in addition to benign, malignant, and diseased tissue.
• The CHTN procures tissue from 90% of all pediatric cancer patients in the USA.The CHTN distribution of specimens is not limited to one organ.
• The CHTN procures specimens from diverse geographical regions and ethnic groups.
• The CHTN serves the entire scientific community of the USA and Canada.

CHTN COORDINATING COMMITTEE

The CHTN Coordinating Committee, which serves as the governing body of the CHTN, consists of the Principal Investigators (PI) and coordinators from each division as well as a representative of the NCI. The CHTN Coordinating Committee develops and approves the operational plans for the CHTN and each institutional PI and coordinator implements the plans for their division. The CHTN Coordinating Committee focuses on developing its processes and procedures to serve investigators in a uniform fashion, such as a uniform application, user agreement, data agreement forms, and protocols to manage the investigator requests. The CHTN divisions interact to serve investigators with tissues of interest either independently or as a group depending on the scope and difficulty of the request(s).

HISTORY OF THE CHTN

The CHTN was formed in 1987 by three organizations along with a subcontract with the Children's Cancer Group (CCG). In 1991 the Pediatric Division became an independent group and an additional adult collection center was added to the CHTN. The University of Virginia and Vanderbilt University joined the network in 2001. All six organizations that currently comprise the CHTN have extensive experience in providing human tissues for research.

The University of Pennsylvania (UPENN) serves as the Eastern Division of the CHTN under the direction of Principal Investigator, Dr. Virginia LiVolsi, Professor of Pathology and Laboratory Medicine, who has served as the Eastern Division P.I. since the inception of the CHTN. During that time, the Eastern Division has expanded its tissue procurement network to include numerous hospitals in the Eastern region.

The University of Virginia has had a tissue procurement service since 1993. It served the NCI as a major tissue supplier for the Cancer Genome Anatomy Project. Dr. Christopher Moskaluk, Associate Professor of Pathology, serves as the Principal Investigator of the Mid-Atlantic Division.

The Ohio State University (OSU) has had an internal tissue procurement service sponsored by their Comprehensive Cancer Center since 1975 and it joined the CHTN in 1987. Dr. Wendy Frankel, M.D., is the principal investigator for the Midwestern Division of the CHTN.

Nationwide Children's Hospital, houses the Pediatric Division, under the direction of Nilsa Ramirez, M.D. The Pediatric Division obtains most of its specimens through Children's Oncology Group institutions. Sixty percent of all pediatric cancer patients in the United States are treated at C.O.G. institutions.

The University of Alabama at Birmingham's (UAB) Tissue Collection and Banking Facility has supplied fresh and snap-frozen human tissues to investigators within and outside their Comprehensive Cancer Center since 1978. UAB joined the CHTN in 1987. William E. Grizzle, M.D., Ph.D., the principal investigator for this Southern Division of the CHTN, is a board-certified clinical and anatomic pathologist as well as a funded medical researcher.

Vanderbilt University's Tissue Procurement Facility operated as a subcontract tissue procurement site for the CHTN for six years before becoming the Western Division of the CHTN in 2001. Dr. Mary Kay Washington, Professor of Pathology, is currently the Principal Investigator of the Western Division.