[Federal Register Volume 71, Number 82 (Friday, April 28, 2006)]
[Notices]
[Pages 25184-25203]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-3997]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health


First-Generation Guidelines for NCI-Supported Biorepositories

AGENCY: National Institutes of Health (NIH), National Cancer Institute 
(NCI).

ACTION: Notice.

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SUMMARY: The NCI is establishing common guidelines for the collection 
of biospecimens and their accompanying data by NCI-sponsored 
biorepositories. These guidelines are intended to standardize and 
enhance the quality of research material and data used in cancer 
research.

DATES: Effective Date: May 30, 2006.

ADDRESSES: These guidelines are open for public comment for a period of 
30 days. After the comment period has closed, any comments received 
will be considered in a timely manner by the NCI Office of 
Biorepositories and Biospecimen Research and appropriate changes will 
be made and the final guidelines will be published and voluntarily in 
effect. After the effective date of publication of the final 
guidelines, written comments will continue to be accepted for the first 
year of implementation and can be sent to: First-Generation Guidelines, 
Office of Biorepositories and Biospecimen Research, Office of the 
Deputy Director for Advanced Technologies and Strategic Partnerships, 
National Cancer Institute, National Institutes of Health, 31 Center 
Drive, Room 10A03, Bethesda, MD 20892. Comments submitted via e-mail 
should use [email protected] and enter ``First-Generation 
Guidelines Comment'' in the subject line. During the first year of 
implementation, the NCI will review any additional comments and 
experience with the guidelines to evaluate a possible need for future 
guidelines modification.

FOR FURTHER INFORMATION CONTACT: Implementation assistance and 
inquiries should be directed to senior staff of the relevant NCI 
Extramural and Intramural Program offices.

SUPPLEMENTARY INFORMATION: 

I. Introduction

    The guidelines assembled in this document are intended as a first 
step toward unifying policies and procedures for NCI-supported 
biorepositories. This process was initiated by the NCI through a 
multiyear process that began in 2002, including a 2004 report compiled 
for the National Cancer Advisory Board that showed substantial 
heterogeneity in biorepository management practices across the 
Institute (NCAB 2004). This study showed that NCI-supported 
biorepositories are not optimized in terms of operational, legal, and 
ethical policies and procedures, nor are they coordinated to provide a 
unique resource value. Specifically, it showed that:
     The NCI invests more than $50 million annually in 
biorepository programs, not including biorepositories supported through 
individual investigator grants, such as R01s.
     The 125 programs included in the study collected, 
maintained, and/or stored approximately 4 million human biospecimens in 
FY 2003.
     These programs support basic, epidemiologic, 
translational, and clinical research.
     Most programs collect frozen biospecimens and support 
genomic and proteomic research.
     Across the broad range of programs, there are no common 
standard operating procedures (SOPs) or Quality Assurance/Quality 
Control (QA/QC) measures.
     The programs lack a common database.
     There is no consistent, defined mechanism to access NCI-
supported biospecimen resources.

II. Background

    In 2005 the NCI took several actions to respond to these findings, 
including establishment of the Biorepository Coordinating Committee 
(BCC) in early 2005. The BCC is advisory to the NCI's Office of 
Biorepositories and Biospecimen Research (OBBR). The primary purpose of 
the BCC is to work with the OBBR to coordinate the NCI's 
biorepositories in a manner that optimizes the quality and 
accessibility of biospecimens for the broad cancer research community. 
Toward this goal, the OBBR and the BCC organized two workshops during 
the summer of 2005 to inform the development of specific 
recommendations on policy and operational issues. These workshops, 
which were based on the development of a series of white papers that 
consolidated documents and the overall knowledge base in biospecimens, 
brought together diverse representatives from the cancer research 
community as well as ethics, policy, and legal experts to discuss and 
propose approaches that could help unify, integrate, and improve the 
transparency of NCI-supported biorepository activities. The report and 
recommendations that resulted from the workshops are summarized in the 
document Harmonizing Processes and Policies for NCI-Supported 
Biorepositories, which was presented to the National Cancer Advisory 
Board in September, 2005. The report can be found at http://biospecimens.cancer.gov/biorepositories/bcc_summary.asp.
    NCI defines a biorepository as a place, room, or container where 
human biospecimens are stored. Biorepositories may vary considerably, 
ranging from formal organizations to informal collections of materials 
in an individual researcher's freezer.
    Currently biorepositories serve as critical resources to the 
research community in the performance of postgenomics cancer research. 
It is becoming increasingly important that all biorepositories strive 
to achieve the best possible biospecimen quality, which would 
necessarily call for the adoption of consistent documentation, 
collection, processing, storage, and retrieval guidelines such as those 
outlined in this document. The workshops' recommended approaches were 
reported to the NCAB in September 2005. Proposed approaches, as well as 
additional meetings and work over the

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past 3 years, form the basis of the first-generation NCI biorepository 
guidelines. These guidelines will be distributed to managers of all 
NCI-supported intramural and extramural biorepositories, who will be 
initially asked to conform to them on a voluntary basis. It is 
important to note that developing a workable set of guidelines is an 
evolving process that, with the emergence of new technologies and 
clinical practices, will require periodic revision. Therefore, these 
guidelines will be revised iteratively, with input from researchers, 
biorepository managers, advocates, policymakers, and related 
stakeholders.

III. Guidelines

Overview

1. Technical and Operational Guidelines

A. Biospecimen Collection, Processing, Storage, Retrieval, and 
Dissemination
    1. Collect and process biospecimens under conditions appropriate 
for each biospecimen type and for the intended analyses, using 
collection protocols that are based on authoritative best practices or 
solid research data, when available. Ensure that proper informed 
consent protocols are followed.
    2. Base all protocols on SOPs that are established using 
authoritative best practices or solid research data, when available.
    3. Maintain a thorough and consistent level of biospecimen 
annotation while maintaining donor patient privacy pursuant to informed 
consent provisions.
    4. Use a computerized inventory system that tracks the specific 
position of every stored aliquot. Each storage container should be 
labeled with a unique identifier. All other relevant information should 
be tied to this unique identifier. Inventory systems should contain 
security provisions sufficient to safeguard privacy and other informed 
consent provisions.
    5. Develop a comprehensive quality management system (QMS). 
Standardized protocols should be applied consistently to ensure 
biospecimen quality and to avoid introducing variables into research 
studies. Document all collection and processing steps in the 
computerized inventory tracking system.
    6. Ensure that all laboratory personnel are well qualified, trained 
to adhere to biorepository SOPs, and monitored for high-quality 
performance.
    7. Ensure that a pathologist directs the collecting and processing 
of surgical and autopsy biospecimens to ensure that clinically 
important issues related to the biospecimens are adequately and 
accurately addressed and that patient care is not compromised.
    8. Store biospecimens in a stabilized state. In selecting the 
biospecimen storage temperature, consider the biospecimen type, the 
anticipated length of storage, the biomolecules of interest, and 
whether goals include preserving viable cells. Use stabilizing agents 
as appropriate. Storage vessels should be durable under planned storage 
conditions. Follow consistent freezing and thawing protocols to ensure 
consistent quality for assays.
    9. Establish rules for biospecimen disposal before storing the 
biospecimens in the biorepository and monitor compliance with the 
rules. Consider the anticipated storage interval when selecting storage 
conditions.
    10. For tissue biospecimens, minimize the time for collection and 
processing as much as possible (unless inadequate processing time is 
known to interfere with the analysis method); reduce biospecimen 
temperature as soon as possible after collection. Optimal processing 
times may vary for other types of biospecimens depending on the 
analysis method for which they are used.
    11. Establish inventory tracking systems and storage organizational 
methods to minimize disruption of the stable environment during sample 
retrieval.
    12. Regularly review the performance of all long-term storage 
systems and equipment using standardized protocols.
    13. Choose biospecimen containers with analytical goals in mind. 
This may require, for example, screening of containers for trace metals 
that may interfere with laboratory analyses.
    14. Adhere to biosafety, packaging, and shipping regulations. Use a 
tracking system for biospecimen shipments. The biorepository should 
notify a recipient before shipping to confirm that the recipient can 
accept the package and properly store the biospecimen.
    15. Retrieve biospecimens from storage according to SOPs that 
safeguard biospecimen quality.
    16. When it is necessary to control biospecimen temperature during 
shipping, consider the shipping time, distance, climate, season, and 
method of transportation and modify distribution schedules accordingly, 
if possible. Ensure proper temperature during shipment, taking into 
account the type of biospecimen and its intended use. Tracking devices 
may be useful to ensure proper temperature throughout the shipment 
duration.
    17. Prior to shipment, execute appropriate Material Transfer 
Agreements (MTAs) addressing donor privacy, as appropriate, 
intellectual property (IP), data sharing, and other similar 
requirements.
    18. Consult International Society for Biological and Environmental 
Repositories (ISBER) best practices (ISBER 2005) for guidance on 
international transport regulations (governed by the International Air 
Transport Association) and information on classifying biospecimens for 
shipment. Train personnel in the shipment of biospecimens and update 
their training every 2 years. Maintain training records for all 
employees involved in shipping.
B. Collecting and Managing Clinical Data
    1. Strive to collect and store all relevant clinical or 
epidemiologic data associated with a biospecimen, including, as study 
requirements dictate, longitudinal data. Follow applicable informed 
consent requirements and institute appropriate security/data-access 
control measures to address privacy issues. The NCI will work with 
biorepositories to establish a minimal ``universal'' clinical data set.
    2. Use an informatics system that tracks all aspects of biospecimen 
collection, processing, and distribution to prevent biospecimen 
identification discrepancies and to support annotation.
    3. Comply with applicable privacy and human subjects protection 
regulations governing the acquisition of biospecimens and associated 
clinical data. Link biospecimens to clinical data in compliance, as 
applicable, with the Health Insurance Portability and Accountability 
Act of 1996 (HIPAA) and U.S. Department of Health and Human Services 
(HHS) and U.S. Food and Drug Administration (FDA) human subjects 
protection regulations.
C. Quality Assurance/Quality Control (QA/QC)
    1. Adhere to a written QMS. The QMS should describe the 
biorepository's QA/QC programs and approaches for ensuring that program 
requirements are met.
    2. Require that staff be trained in QA/QC and maintain training 
records.
    3. The SOPs should be printed in a manual that is readily available 
to all laboratory personnel and dated according to the most recent 
revision. The SOPs should state policies and define and describe 
procedures in detail. Develop procedures for

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periodically reviewing and revising SOPs as necessary.
    4. Establish security systems, including equipment monitoring and 
alarm systems that are monitored both locally and remotely, with plans 
to respond at any time. Emergency power systems should be ready to 
operate all critical equipment during power outages.
    5. Use a data management system that includes a computerized 
inventory tracking system with appropriate security/access-control 
safeguards.
    6. Develop a facility disaster plan based on a local area risk 
assessment. The plan should include appropriate measures to protect 
personnel and equipment during a disaster.
    7. Maintain and repair all equipment according to SOPs. Establish 
preventive maintenance schedules.
D. Biosafety
    1. Assume that all human biospecimens are potentially infective and 
biohazardous. Use universal precautions practices in biorepositories 
similar to those used in other laboratories and clinical settings. 
Handle biospecimens according to, at a minimum, Biosafety Level 2 (BSL-
2) as outlined in the CDC/NIH booklet Biosafety in Microbiological and 
Biomedical Laboratories.
    2. Immunize employees (e.g., for hepatitis) when appropriate 
vaccines are available.
    3. Develop a safety program and associated training procedures by 
identifying governmental and accrediting agency requirements regarding 
biohazards and likely sources of current information concerning 
laboratory biosafety. Among the agencies that oversee laboratory 
biosafety programs are the Occupational Safety and Health 
Administration (OSHA), the CDC, and the Clinical and Laboratory 
Standards Institute (CLSI).
    4. Identify and address risks and other general issues of 
biosafety. Identify frequent biorepository activities and analyze 
safety issues involved with each activity. Take appropriate actions to 
ameliorate hazards.
    5. Document all incidents where personnel are exposed. Response and 
treatment protocols should be prepared to be available in the event of 
potential exposure and infection.
    6. Establish indemnification agreements with users of biospecimens 
except where prohibited by law.
    7. Follow U.S. regulations concerning chemical safety, which 
protect employees from exposure to biohazardous levels of chemicals. 
Biorepositories should also develop a chemical hygiene plan in 
compliance with the OSHA's laboratory standards.
    8. Properly ground freezers and other electrical equipment.
    9. Establish fire emergency plans and practice them regularly.
    10. Take precautions to prevent repetitive strain and back injuries 
and other accidents and injuries typical of the laboratory/
biorepository environment.
    11. For any laboratory or biorepository that processes radioactive 
materials, ensure that proper training of personnel and acquisition of 
necessary equipment to obtain licenses from the Nuclear Regulatory 
Commission (NRC) and/or local agencies are carried out.
E. Biorepository Informatics: Data Management and Inventory Control and 
Tracking
    1. Assign a unique identifier (such as a number or barcode) to each 
biospecimen at the time of collection. Identify specific clinical and 
epidemiological data by the same number and/or barcode. Use the number 
or code to track a biospecimen from collection through processing, 
storage, and distribution.
    2. Update the biorepository database each time a biospecimen is 
moved within or out of the biorepository.
    3. Use informatics systems that support the linking of biospecimens 
with associated research data and, when available, the limits, if any, 
on the use of the sample. When applicable, track the levels of consent 
that each patient has given for the use of their biospecimens and 
whether that consent has been withdrawn.
    4. To protect the health information of patients, adhere to privacy 
laws with respect to informatics systems.
    5. The NCI Center for Bioinformatics (NCICB) has developed 
additional bioinformatics guidelines and tools that address the issues 
of functionality of informatics systems, integration with existing 
systems, and interoperability among individual systems at 
biorepositories. The NCICB has developed the Cancer Biomedical 
Informatics Grid, or caBIG \TM\. caBIG (see https://cabig.nci.nih.gov/) 
(NCI 2005) is a voluntary network or grid connecting individuals and 
institutions to enable the sharing of data and tools. caBIG silver-
level compatibility is recommended for NCI-supported biorepositories 
(see https://cabig.nci.nih.gov/guidelines_documentation).

2. Ethical, Legal, and Policy Guidelines

A. Informed Consent
    1. Use a process of informed consent for each biospecimen 
collection event. The NCI will provide all of its biorepositories with 
a sample consent template, which should be reviewed and adapted by the 
relevant IRB. Biorepositories should adapt the template to their needs. 
The consent form should address the use of biospecimens or data by 
private entities, the possible future development of commercial 
products through research, and the release of individual research 
results to participants.
    2. Allow research participants to specify the types of research for 
which their biospecimens may be used, including use in additional 
future projects.
    3. Document clear policies for biospecimen and data access.
    4. Develop policies to handle biospecimens and data for which 
consent has been withdrawn.
    5. Monitor the need for obtaining informed consent when the 
biorepository houses identifiable biospecimens and data from children, 
that were obtained with parental or guardian permission, when a child 
reaches the legal age to consent for a research study.
    6. Consider FDA regulations concerning research on existing 
biospecimen collections, for any study that could involve FDA oversight 
in the future. These regulations do not exempt in vitro studies from 
the requirement for documented, institutional review board (IRB)-
approved consent from the sources, even in cases where biospecimens 
have been deidentified.
    7. Establish and document transparent policies governing the 
retention of records and biospecimens. For clinical biospecimens, State 
laws may also govern how long records must be retained. For research 
specimens, the ideal is permanent storage if resources and storage 
space are sufficient. However it should be noted that biospecimens 
degrade over time and/or may no longer be useful due to changes in 
science and technology.
    For additional information about IRBs and the requirement for the 
HHS Office for Human Research Protections (OHRP)-approved assurance of 
compliance, see the OHRP Web site at http://www.hhs.gov/ohrp/. Specific 
OHRP guidance concerning tissues and biorepositories is included among 
the documents referenced at http://www.hhs.gov/ohrp/policy/index.html#tissue.

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B. Access to Biospecimens and Data
    1. Establish clear guidelines for sample distribution (and clinical 
data sharing) consistent with ethical principles, prevailing laws, and, 
if applicable, consent form language. The guidelines should be flexible 
so that biorepositories may respond to changing scientific needs.
    2. Ensure that investigators have timely, equitable, and 
appropriate access to human biospecimens and associated clinical data 
stored at NCI-supported biorepositories without undue administrative 
burden. Access should be guided by policies and procedures such as the 
following:
     Scientific validity of the research proposal.
     Investigator's agreement covering confidentiality, use, 
disposition, and security of biospecimens and associated data.
     Investigator's written agreement in a Material Transfer 
Agreement to comply with the NIH Research Tool Guidelines. (http://ott.od.nih.gov/policy/rt_guide_final.html).
     Investigator and institutional research qualifications.
     Ethical oversight where required by Federal regulations or 
local institutional requirements.
     Adequate funding for the biorepository.
    In addition to the above, the following points should also be 
considered while assessing access privileges:
    a. Biospecimens and associated clinical data should be 
appropriately matched with the specific scientific investigations for 
which they are intended.
    b. The local decision-making body should take local principles into 
account. Ethical considerations should come first among principles that 
guide the decisionmaking process.
    c. Biorepositories should establish an appeals process for 
addressing disputes over allocation decisions.
    3. Apply guidelines to all new collections and, whenever possible, 
to existing collections.
    4. If applicable and where monetary charges are necessary, charge 
only to recover costs as appropriate to retrieve and disseminate 
specimens.
    5. If a biorepository must close due to lack of funding or 
otherwise cannot maintain or use the biospecimens, the availability of 
biospecimens should be announced for transfer to the research community 
(e.g., via a Web site). Transfer should be consistent with the informed 
consent and allowable use of biospecimens.
    6. Within the biorepository, use a system of data access with 
defined levels of access privileges. Restrict access to research 
subjects' identities and medical, genetic, social, and personal 
histories to necessary biorepository staff members who need such access 
as part of their duty or to persons permitted access by law. Monitor 
personnel compliance with access restrictions.
    7. Store human biospecimens only for research purposes according to 
approved protocols, not to serve individual research participants' 
needs or wishes.
C. Privacy Protection
    1. Institute the level of security appropriate to the type of 
biorepository and to protect study participant privacy for the 
biospecimens stored in the biorepository.
    2. In applications for support, include documentation of policies, 
mechanisms for auditing the effectiveness and enforcement of policies, 
required training, and security measures pertaining to employee access 
to data or biospecimens.
    3. Institute the level of security appropriate to the type of 
biorepository.
D. Custodianship
    1. In the application for proposal for biorepository funding, 
propose plans for formal and continuing responsibility for 
custodianship (not ownership) of collected biospecimens and associated 
data as part of the biorepository protocol.
    2. In the application for proposal for biorepository funding, also 
address plans for the handling and disposition of biospecimens and 
associated data at one or more of the following points: (a) End of the 
active support of the grant, (b) accomplishment of the specific 
research objectives of the study, (c) depletion of biospecimens, and/or 
(d) achievement of critical data endpoints.
    3. Require disclosure of financial or professional conflicts of 
interests of biorepository personnel, consistent with institutional 
procedures and policies.
    4. Use clear and specific informed consent language to ensure that 
those who contribute biospecimens and/or data for research purposes are 
fully informed that the research done with these biospecimens may help 
develop products, tests, or discoveries that may have commercial value 
(also see A.1. above).
E. Intellectual Property
    1. For the transfer of materials in academic-industrial 
collaborations, use the NIH Simple Letter Agreement (SLA), the Uniform 
Biological Material Transfer Agreement (UBMTA), or other MTA with terms 
consistent with the NIH Research Tools Policy and NIH data sharing 
policies, e.g., the Final NIH Statement on Sharing Research Data. These 
agreements should be modified where necessary to cover human subjects 
research. A sample NIH SLA modified to address the transfer of human 
biospecimens is attached as Appendix 2.
    The following Internet sites are relevant to this issue:
     http://ott.od.nih.gov/policy/research_tool.html.
     http://www.autm.net/aboutTT/aboutTT_umbta.cfm.
     http://grants1.nih.gov/grants/policy/data_sharing/index.htm.
    2. Recognize that biorepository staff members as custodians of 
biospecimens are not a priori considered inventors under patent law for 
inventions made using materials distributed by the biorepository. In 
general, the staff should be informed that one whose sole contribution 
to an invention consists of the routine collection, handling, storage, 
and disbursement of biospecimens might not rise to the level of 
``inventor'' of an invention. Inventorship is determined by patent law 
and must be considered on a case-by-case basis by trained legal 
personnel.
    3. Recognize that biorepositories have no inherent rights to future 
IP, including reach-through rights in inventions made by investigators 
using samples obtained from the biorepository.
    4. Ensure through MTAs that research data developed using 
biospecimens are made available to the research community. (See sample 
in Appendix 2.)

Guidelines Details

1. Technical and Operational Guidelines

A. Biospecimen Collection, Processing, Storage, Retrieval, and 
Dissemination
    Although the specific mission of a biorepository will result in the 
use of different collection and processing procedures, common 
principles should apply to all biospecimen types. The guidelines below 
are based on current, published information and will be revised 
periodically as new information is generated from ongoing research 
projects.
Determining Which Biospecimens To Collect
    1. Collection priorities should be based on the defined purpose of 
each NCI-supported biorepository in supporting specific types of 
research. Biorepositories should track researchers' requests to guide 
the collection and

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storage process and to attempt to anticipate which biospecimen types 
(e.g., matched blood, serum, plasma, buffy coat, saliva, urine) will 
make the biorepository most useful for future research. Researchers 
should involve biorepository scientists as early as possible during 
study planning to develop a strong approach for biospecimen collection.
    2. NCI-sponsored biorepositories should strive to collect materials 
from diverse populations representative of the United States. However, 
this goal may depend on the specific purpose, such as the disease 
focus, of the NCI studies supported by the biorepository.
Biospecimen Collection and Processing
    Biospecimen collection occurs in many contexts, including surgical 
procedures, organ donation and transplantation, autopsies, 
venipuncture, and evacuation; for population-based studies, collection 
may occur in field locations such as hospitals or study participants' 
homes.
    1. The NCI will provide guidance in the future on guidelines for 
biospecimen collection while allowing for flexibility when new 
methodologies are warranted. SOPs will enhance the comparability of 
research results and help make biospecimens interchangeable. This 
guidance will include:
     Collection protocols for various biospecimen types based 
on solid research data.
     A high level of biospecimen annotation, consistent across 
NCI-sponsored biorepositories, recording key data, such as time to 
banking, time of ischemia, time of biospecimen excision, character of 
chemical preservation, time of fixation, etc. For paraffin-embedded 
biospecimens, it may prove important for the interpretation of analytic 
data derived from these biospecimens to have documentation of the 
specific protocol through which a biospecimen was processed before it 
was placed in paraffin. Appropriate and complete documentation 
surrounding biospecimen collection, processing, and storage are 
essential and relevant to the quality of research data to be obtained.
     Uniform, nonredundant sample nomenclature across NCI-
sponsored biorepositories.
     State-of-the-art sample tracking procedures and supporting 
informatics.
     A QMS to ensure adherence to standards.
    2. Biorepositories should record data relevant to research goals. 
As appropriate for the study, for all types of biospecimens, the amount 
of time elapsed during collection and processing should be recorded and 
tracked in the biorepository informatics system. Biorepositories should 
also record data on the collection and processing procedures used.\1\
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    \1\ NCI will support research to determine the effects of 
various biospecimen processing methods on analyte preservation. 
Biorepositories should continually attempt to improve collection and 
processing methods to maximize the quality of materials for 
molecular analysis. NCI-supported biorepositories should document 
the effects of different processing methods and develop guidelines 
for biospecimen processing based on the goal of preserving various 
analytes.
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     For tissue biospecimens, the time for collection should be 
minimized as much as possible; biospecimen temperature should be 
reduced as soon as possible after collection. Biospecimen processing 
time should be minimized if freezing is the stabilization endpoint. If 
fixation is the stabilization endpoint, control of processing time 
between maximum and minimum durations may be required.
     Rapid processing may not be as critical for other types of 
biospecimens, such as blood, and optimal processing times may vary 
depending on the analysis method for which a biospecimen is used. 
Examples of data to record for blood biospecimens include collection 
time relative to treatment or other interventions, time of day at 
collection, whether the patient was fasting, and whether he or she was 
sitting or standing during collection.
    3. NCI-supported biorepositories should seek to use the processing 
method that preserves the greatest number of analytes, unless the aim 
of a particular study specifically requires alternative processing. To 
select processing methods (such as freezing, fixation, and the use of 
stabilizing additives), a biorepository should define its goals and the 
research priorities of the studies it supports. Procedures should 
maximize the potential for biospecimen distribution and research use. 
When possible, individual biospecimens should be divided into aliquots 
or fractions and/or preserved by multiple processing methods. 
Biorepositories that validate biospecimen quality for specific research 
applications should use as little of the biospecimen as possible.
Biorepository Personnel
    Personnel involved in biorepository management and use, including 
researchers, technicians, nurses, surgeons, pathologists, 
anesthesiologists, and assistants, should be aware of the purpose and 
goals of the biorepository. To ensure the collection of high-quality 
biospecimens for research, collection, and processing, personnel should 
be well qualified and trained to adhere to applicable SOPs. A 
pathologist should be involved for expertise in collecting and 
processing surgical and autopsy biospecimens. It is important that a 
pathologist determine what tissue is necessary for pathologic diagnosis 
and what is excess and can be given to the biorepository for research 
purposes. This is crucial in ensuring that patient care is not 
compromised.
Biospecimen Storage
    The following general guidelines section applies to all types of 
biospecimens, such as wet tissue, frozen tissue, paraffin-embedded 
tissue, glass slides, blood, serum, and urine. Individual types of 
biospecimens should be handled according to SOPs specific to each 
biospecimen type and to the biomolecules to be analyzed in that 
biospecimen type (e.g., RNA, DNA, protein, lipid, etc.).
    1. Standardized protocols should be applied consistently in 
preparing and storing biospecimens to ensure their quality and to avoid 
introducing variables into research studies. Biorepositories should 
record storage conditions and especially deviations from SOPs, 
including information about temperature, thaw/refreeze episodes, and 
equipment failures. Each piece of storage equipment should have a log 
containing the manufacturer's manual, records of equipment operation, 
and descriptions of maintenance, repairs, and calibration. Storage 
conditions should be recorded automatically, and the performance of all 
long-term storage systems and equipment should be reviewed annually 
using standardized protocols (Mager et al. 2004). Calibrated devices 
should be used to validate automated temperature measurements.
    2. Biospecimens should be stored in a stabilized state. For blood 
biospecimens, all components should be stored where possible. This is 
particularly important for large, population-based studies, for which 
it is difficult to predict how biospecimens will be analyzed in the 
future.
    A biorepository should avoid unnecessary thawing and refreezing of 
frozen biospecimens or frozen samples of biomolecules extracted from 
the biospecimens. When thawing/refreezing is necessary, a biorepository 
should follow consistent and validated protocols to ensure continued 
stability of the analytes of interest. Methods, such as inventory 
tracking, should be established to minimize disruption of the stable 
environment during sample retrieval.
    In selecting biospecimen storage temperature, consider the 
biospecimen type, the anticipated length of storage,

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the biomolecules of interest, and whether goals include preserving 
viable cells. Paraffin blocks should be stored at temperatures below 80 
[deg]F (27 [deg]C) in an area with pest and humidity control. In the 
case of liquids, such as blood and urine, consider separating 
biospecimen components before storage to preserve each constituent 
under its optimal condition. However, whole-blood (rather than 
fractional) cryopreservation is recommended as an efficient and cost-
effective option for processing viable cells in large-scale studies 
(Hayes et al. 2002). When in doubt as to possible future uses, store 
tissues in the vapor phase of liquid nitrogen freezers to ensure long-
term viability. Lower storage temperatures and the use of a 
cryoprotectant (such as DMSO) are recommended to maintain viable cells 
for long periods of time (ISBER 2005). Planned analyses should consider 
the difference in temperature between the bottom and top of a liquid 
nitrogen freezer; the temperature at the top of a liquid nitrogen 
should be consistently below -140 [deg]C.
    Avoid self-defrosting freezers that cause damaging effects to 
biospecimens, even those in capped tubes, by enhancing desiccation 
(Holland et al. 2003).
    3. Biorepositories should establish rules for disposing of 
biospecimens before storing them. Consider the anticipated storage 
interval when selecting storage conditions. If possible with available 
resources, store control biospecimens under each condition used in the 
biorepository and assess these control biospecimens at regular 
intervals to assess the effects of storage time on desired qualities 
such as viability, preservation of morphology, and biochemical 
integrity.
    4. Storage vessels should be stable under planned storage 
conditions. Vial size and number should be suitable for typical 
aliquots, anticipated investigator uses, and number of investigators. 
Volume and type of containers should prevent sample loss and minimize 
the costs of collection and storage. Screw-cap cryovials should be used 
for long-term, low-temperature storage; glass vials or vials with popup 
tops are unsuitable for long-term storage (Caporaso & Vaught 2002). 
Wrap snap-frozen biospecimens in aluminum foil or place them in 
commercial storage containers to minimize desiccation (Grizzle 2004). 
Choose labeling and printing systems that will be stable under the 
long-term storage conditions appropriate for the biospecimen. Face 
shields and appropriate gloves should be worn for worker protection.
    Biospecimen containers should be chosen with analytical goals in 
mind. For example, when samples will be tested for the presence of 
xenobiotic chemicals, containers should be free of xenobiotic 
contamination. Certified RNase-free containers should be used for all 
steps in handling RNA samples.
    5. Each storage container should have a unique identifier for the 
biospecimen aliquot that is firmly affixed to the container, clearly 
and legibly marked, and able to endure storage conditions. All other 
relevant information should be tied to this unique identifier, bearing 
in mind study participant confidentiality, security, and informed 
consent provisions. Inventory systems should relate the presence of 
each aliquot to its specific position in a specific freezer, 
refrigerator, or shelf.
    6. Automated security systems should continuously monitor the 
function of storage equipment. Backup equipment, such as an alternative 
power source, should be automatically activated when necessary. 
Emergency procedures should be in place if freezers fail or exceed a 
preset temperature. SOPs should be in place for alerting personnel and 
for moving biospecimens to alternative storage locations. Biorepository 
SOPs should include procedures for responding to severe weather and 
floods as well as specific power and equipment failures. Personnel 
should be trained in safety related to biospecimen handling, use of 
equipment, and SOPs for responding to emergency situations. For 
particularly valuable biospecimens, an empty, functioning freezer 
should be available in case of single-freezer failure. Also consider 
storing replicate biospecimens in at least two different locations to 
safeguard against storage or handling failures (NBN Blueprint 2003; 
Landi and Caporaso 1997; Caporaso and Vaught 2002; Eiseman et al. 
2003).
Shipping Biospecimens
    1. Retrieval. Biospecimens should be retrieved from storage 
according to biorepository SOPs that safeguard biospecimen quality. 
Before retrieval, systems should be in place to verify that the request 
has received approval from the appropriate committee(s). SOPs should 
include a checklist to confirm completion of the retrieval process. 
Document deviations during retrieval, such as inventory 
inconsistencies, damaged containers, thawing or refreezing, etc.
    2. Shipping conditions. When seeking to regulate biospecimen 
temperature during shipping, consider the shipping time, distance, 
climate, season, method of transportation, and regulations as well as 
the type of biospecimens and their intended use (Landi and Caporaso 
1997). The number of biospecimens per package also affects whether 
temperature can be maintained for all biospecimens in the shipment. 
Send a prior test shipment, of frozen water samples for example, before 
shipping extremely valuable samples, to check the adequacy of coolants 
and any potential obstacles to a successful shipment. In addition, 
conditions throughout a critical shipment can be monitored by enclosing 
a device that records temperature during transport. Placing samples in 
sealed bags with a desiccant can be used to control humidity.
    To maintain proper temperature during shipping, use appropriate 
insulation, gel packs, dry ice, or liquid nitrogen (dry shipper). To 
maintain refrigerated temperatures (2[deg]C to 8[deg]C), use gel packs 
conditioned at -15[deg]C or phase change material rated for 
refrigerated transport. To maintain frozen temperatures, use gel packs 
conditioned at or below -20[deg]C. For frozen temperatures at -
70[deg]C, use dry ice pellets or sheets. Note that dry ice is 
considered a hazardous substance for shipping purposes. For maintaining 
temperatures at or below -150[deg]C, use a liquid nitrogen dry shipper 
(ISBER 2005). Use insulated packaging to protect biospecimens from 
extremely hot or cold ambient conditions. Whenever intending to 
maintain samples below ambient temperature, include enough refrigerant 
to allow for a 24-hour delay in transport (ISBER 2005). Temperature-
sensitive material should be handled by a courier with resources to 
replenish the refrigerant in case of a shipping delay (ISBER 2005).
    Paraffin blocks and slides should be shipped at room temperature in 
an insulated package via overnight carrier. The use of insulated 
packages is important to minimize the effect of temperature 
fluctuations and to protect the blocks from temperatures higher than 
80[deg]F (27[deg]C). Flat biospecimens, such as dried blood samples on 
absorbent pads or cards, should be enclosed in watertight plastic bags 
and shipped in a sturdy outer package or commercial envelope. Samples 
on glass or plastic slides should be cushioned and shipped inside a 
sturdy (not flexible) outer package. Triple packaging should be used 
for liquid samples.
    3. Documentation. The biorepository should notify a recipient 
before shipping to confirm that the recipient can accept the package 
and properly store the biospecimens. Packages should be bar-coded and 
tracked by the biorepository and the recipient. A

[[Page 25190]]

biorepository shipping log, either written or computerized, should 
track shipments from and to the biorepository and include the following 
information: shipment/invoice number; recipient (or source); date 
shipped (or received); courier name and package tracking number; sample 
description; number of samples shipped (or received); condition on 
arrival; study name and number, if available; key investigator's name; 
and signature of biospecimen recipient (ISBER 2005).
    Standardized paperwork should accompany shipments. Biorepository 
personnel should send a shipping manifest, a list of sample 
identification numbers, and descriptions of samples electronically to 
the biospecimen recipient and include a hard copy of the manifest in 
the shipment itself. Identifying data should be available for the use 
of shipping or customs agents as well. Some shipping agents require an 
itemized list of contents between the secondary and outer packaging of 
diagnostic biospecimens.
    Biorepository personnel should verify biospecimen labels and 
pathology reports against the packing list for consistency and 
correctness.
    A feedback questionnaire should be enclosed in each shipment for 
QA/QC purposes, requesting feedback about the quality of samples 
received (Eiseman et al. 2003).
    4. Regulatory considerations. Consult ISBER Best Practices (ISBER 
2005) for information concerning international transport regulations 
and classifying biospecimens for shipment. Failure to conform to 
international air transport regulations will result in delay or refusal 
of shipment and probable biospecimen deterioration. Regulations must be 
followed precisely, since improperly packaged or labeled goods will be 
refused for transport by airlines or delayed at customs (Holland et al. 
2003). For international shipments, biorepository personnel should 
prepare safety declarations for foreign customs (Landi and Caporaso 
1997).
    For packaged biospecimens, International Air Transport Association 
(IATA 2004) regulations require three packaging components: (1) A 
primary inner receptacle, (2) secondary packaging, and (3) rigid outer 
packaging. The primary receptacles should be packed in the secondary 
packaging so that, under normal conditions of transport, they cannot 
break, be punctured, or leak their contents into the secondary 
packaging. Secondary packaging should be secured in outer packaging 
with cushioning material. Secondary containers for diagnostic 
biospecimens should be certified by the manufacturer prior to use. 
Outer packaging is regulated as to material, size, and ability to 
withstand a 1.2-meter drop test as outlined in IATA Section 6.6.1. 
Leakage of the contents should not affect the cushioning material or 
outer packaging (IATA 2004). Some shipping agents designate the same 
three layers of packaging and absorbent material between outer and 
secondary packaging. Specifics of the primary containers for diagnostic 
biospecimens, liquid biospecimens, and solid biospecimens are described 
on the shipping agents' Web sites. Styrofoam[supreg] chests containing 
dry ice may be used to ship samples that should be maintained at low 
temperatures (Landi and Caporaso 1997). However, the shipping agent may 
exclude Styrofoam[supreg] as an acceptable outer packaging. To confirm 
that shipping conditions meet sample needs, shipping personnel should 
review test reports from packaging that has been tested to meet 
regulation requirements. Packaging should be used in the same 
configuration under which it was tested (ISBER 2005).
    Consult OSHA regulations to determine whether a substance requires 
a biohazard label. Ship Category A infectious substances in accordance 
with IATA Packing Instruction (PI) 602 (IATA 2004). Ship Category B 
infectious substances (also designated as diagnostic specimen, clinical 
specimen, or biological specimen, category B) in compliance with IATA 
PI 650.
    Ship dry, noninfectious biospecimens (e.g., dried blood, tissue, 
saliva, or hair) with special packaging as specified by the shipping 
agent. Wet-fixed biospecimens shipped in formalin/formaldehyde should 
include ``ICAO/IATA'' under additional handling information (Grizzle 
2004).
    5. Training. Training of personnel for shipment of biospecimens is 
strongly recommended (ISBER 2005). Training should be updated at least 
every 2 years. Dangerous goods training may be required for some 
biorepository personnel. A record of training should be maintained of 
all employees involved in the shipping process. Training and 
certification are available through various shipping vendors (ISBER 
2005). On completion of training, the training organization issues a 
certificate of completion.
B. Collecting and Managing Clinical Data
    Extensive annotation of tissue biospecimens is crucial to the 
overall usefulness of the biorepository as a resource for scientific 
research (Eiseman et al. 2003). Biorepositories store biospecimens 
collected using multiple methodologies and procedures, including tissue 
collection, blood draws, and buccal cell and urine collections. 
Researchers rely on banked biospecimens for a wide variety of purposes, 
including target discovery and validation, prevention research, 
research on early detection, genetic studies, and epidemiologic 
analyses. The data recorded by biorepositories depend on the types of 
biospecimens they collect and the studies they support. It is 
critically important for excellence in research that NCI-supported 
biorepositories use SOPs for biospecimen collection, processing, and 
storage. While harmonization of these procedures is the ultimate goal, 
the NCI is engaged in research to identify the best set of protocols 
and methods to produce high-quality biospecimens. Regardless, 
biospecimens must maintain donor privacy in all collection of clinical 
data.
Determining Data Sets
    1. The NCI will define the minimal clinical data to be collected 
for all biospecimens, as appropriate for the research protocol at NCI-
supported biorepositories. This universal set will change over time. 
Biorepositories should adopt the harmonized nomenclature being 
developed by the NCI for clinical data and establish algorithms to 
translate raw data into standard nomenclature.
    2. NCI-supported biorepositories should establish additional data 
categories for specific types of research.
Collecting Clinical Data
    1. NCI-funded biorepositories should strive to collect and store 
all relevant clinical data associated with a biospecimen. This will 
maximize the use of biospecimens for current and future short-term and 
longitudinal studies. Biorepositories should encourage participating 
investigators to annotate biospecimens to the fullest extent possible 
consistent with biorepository goals and/or study design. Data 
collection activities should conform to FDA requirements if and where 
applicable, so that the data can be cited and/or used in 
Investigational New Drug and Investigational Device Exemption 
applications.
    2. The NCI will develop a tiered system of clinical data 
annotation, which will define the potential of any given biospecimen in 
supporting high-quality research and will guide decisions on the 
appropriate use of biospecimens by the scientific community.

[[Page 25191]]

    3. NCI-supported biorepositories should employ a uniform, 
nonredundant vocabulary (caBIG common data elements [CDEs]) for 
clinical data across sponsored biorepositories.
    4. NCI-supported biorepositories should track researchers' requests 
for specific clinical data to guide refinements of data collection 
guidelines.
    5. NCI-supported biorepositories should employ a method for 
validating the clinical data collected. These data should be validated 
to ensure accuracy in downstream scientific research.
    6. NCI-supported biorepositories should comply with applicable 
privacy and human subjects protection regulations governing the 
acquisition of biospecimens and associated clinical data. Biospecimens 
should be linked to clinical data in compliance, as applicable, with 
the HIPAA regulations and with HHS and FDA human subjects protection 
regulations.
Longitudinal Clinical Data \2\
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    \2\ The NCI plans to partner with its cancer centers, advocacy 
groups, and relevant stakeholders to collect longitudinal data 
related to particular studies.
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    1. As the study requirements dictate, NCI-supported biorepositories 
should collect and store longitudinal data following applicable 
informed consent requirements.
    2. Depending on the study design, information linked to samples 
should include demographic data, lifestyle factors, environmental and 
occupational exposures, cancer history, structured pathology data, any 
additional diagnostic studies, information on initial staging 
procedure, treatment data, and any other information relevant to 
tracking a patient's future status for clinical outcomes. NCI-supported 
biorepositories should facilitate followup with patients.
    3. NCI-supported biorepositories should maintain identifying and 
contact information as detailed in the study protocol and as permitted 
under law and by patient consent to enable biospecimen use for 
longitudinal studies.
    4. NCI-supported biorepositories should establish, as necessary, 
new policies and protocols to facilitate the submission of outcome 
data, ensure uniformity and patient privacy, and track treatment and 
outcomes.
    5. To collect high-quality longitudinal information, NCI-supported 
biorepositories should require dedicated and trained personnel to 
curate the validation process and QA/QC.
Informatics To Support the Tracking of Data \3\
---------------------------------------------------------------------------

    \3\ The NCI intends to assist biorepositories in choosing 
informatics approaches that meet the necessary data tracking and 
management requirements set forth by the institute.
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    1. A biorepository informatics system should track all aspects of 
biospecimen collection, processing, and distribution to prevent the 
confusion of samples and to support annotation.
    2. A biorepository should comply with applicable privacy laws, 
human subjects regulations, and local institutional requirements 
governing the acquisition of biospecimens and associated clinical data 
(see the section on Ethical, Legal, and Policy Guidelines for more 
discussion of clinical data and the protection of patient privacy).
C. Quality Assurance/Quality Control (QA/QC)
    NCI-supported biorepositories should develop a formalized QA/QC 
policy to minimize errors that could adversely affect scientific 
results. QA/QC policies should be customized for the intended and 
potential uses of biospecimens in a given biorepository.
QMS
    Each biorepository should either establish a written QMS or adhere 
to one published by the organization with which the biorepository is 
associated. The QMS should describe the biorepository's QA/QC programs 
and describe approaches for ensuring that program requirements are met 
(ISBER 2005). The QMS should describe procedures for conducting audits 
in the following areas:
    1. Equipment maintenance and repair.
    2. Training records and adherence of staff to required training 
schedules.
    3. Data management.
    4. Recordkeeping.
    5. Adherence to SOPs.
SOPs Manual
    Each biorepository should develop written policies and procedures 
in an SOPs manual. The SOPs should state policies and define and 
describe all procedures in detail.
    1. Contents. The SOPs manual should specifically include at least 
the following information:
     Biospecimen-handling policies and procedures, including 
supplies, methods, and equipment used.
     Laboratory procedures for tests performed in-house and any 
biospecimen aliquoting or other processing.
     Policies and procedures for shipping and receiving 
biospecimens, including the MTAs to be used.
     Policies for managing records.
     QA/QC policies and procedures for supplies, equipment, 
instruments, reagents, labels, and processes employed in sample 
retrieval and processing.
     Safety programs.
     Emergency safety policies and procedures, including the 
reporting of staff injuries and exposure to potential blood-borne 
pathogens.
     Policies and procedures for the investigation, 
documentation, and reporting of accidents, errors, complaints, and 
adverse outcomes.
     Policies and procedures and schedules for equipment 
inspection, maintenance, repair, and calibration.
     Procedures for disposal of medical waste and other 
biohazardous waste.
     Policies and procedures regarding the training of 
technical and QA/QC staff members.
    2. Implementation. The biorepository director and/or the individual 
responsible for the QA/QC program should review and approve all SOPs 
and associated process validation studies prior to implementation. Upon 
implementation, all SOPs must be followed as written.
    3. Modifications. Each biorepository should have a document control 
program and policies for governing, modifying, or revising SOPs. Each 
modification should be approved by the biorepository director or other 
appropriate individual(s). Implementation dates should be recorded for 
all procedures. All SOPs should be reviewed every 2 years and have the 
current date of renewal on the posted copy.
    4. Staff access and review. Current copies of the SOPs manual 
should be stored in designated locations and available to the staff at 
all times. The staff should review new and revised policies and 
procedures prior to implementation. Documentation of staff review and 
any associated training should be recorded.
D. Biosafety
    Laboratories and biorepositories that handle biospecimens expose 
their employees to risks involving infectious agents and chemicals, as 
well as the general dangers of a laboratory. A predictable, yet small, 
percentage of biospecimens will pose a risk to the biorepository 
workers who process them. All biospecimens should be treated as 
biohazards (Grizzle and Fredenburgh 2001). In addition to taking 
biosafety precautions, biorepositories should adhere to key principles 
of general laboratory safety.

[[Page 25192]]

Biohazard Precautions
    Laboratories and biorepositories must assume that all human 
biospecimens are potentially infective and biohazardous, regardless of 
whether they are frozen, dried, fixed, processed in paraffin, or 
otherwise processed. Human biospecimens are defined as blood, other 
bodily fluids, solid tissues, tissue products, and cell lines. The 
greatest risks are posed by exposure to the human immunodeficiency 
virus (HIV), the hepatitis viruses, and the prion that causes 
Creutzfeldt-Jakob disease, but there are additional significant 
exposures as outlined by Grizzle and Fredenburgh (2001).
    29 CFR 1910.1030 requires that vaccination be offered to all 
personnel who may be potentially exposed to human blood, body fluids 
and tissues, or other potentially infectious materials. Biorepository 
work practices must be based on universal precautions practices similar 
to those used in laboratories and clinical settings. Two basic 
important safety precautions should be followed in laboratories and 
biorepositories that handle biospecimens: Wash hands frequently, and 
always wear face protection and gloves when handling biospecimens or 
working within or around freezers. Additional good general laboratory 
work practices are outlined in Table 4 of Grizzle and Fredenburgh 
(2001).
    A biorepository must establish clear policies regarding the 
inclusion or exclusion of high-risk biospecimens. Human biospecimens 
should be handled according to, at a minimum, BSL-2 as outlined in the 
CDC/NIH booklet Biosafety in Microbiological and Biomedical 
Laboratories (CDC and NIH 1999). Under BSL-2, when biospecimen 
containers are opened for processing, they should be handled in a BSL-2 
biological safety cabinet (hood). All biorepositories that handle human 
biospecimens should operate under the OSHA's blood-borne pathogens 
standard and should develop an exposure control plan (29 CFR 
1910.1030). Additional precautions apply, as outlined in the CDC 
booklet.
    Some activities may require higher containment, and in other cases, 
less stringent practices may be acceptable. Therefore, it is best to 
ensure that biorepository staff members are trained to perform risk 
assessments and determine appropriate biosafety levels.
Guidelines
    1. Identify governmental and accrediting agency requirements 
regarding biohazards and likely sources of current information 
concerning laboratory biosafety for use in developing an overall 
program in safety and associated training programs. Among the agencies 
that oversee laboratory biosafety programs are the OSHA and the CLSI. 
The CDC oversees programs that handle Select Agents.
    2. Identify risks and other general issues of biosafety. Identify 
frequent biorepository activities and analyze safety issues involved 
with each activity, and implement suitable controls.
    3. Improve biosafety by developing written working guidelines that 
are based on Federal and State requirements, experience, and published 
information. These guidelines should be reviewed and updated regularly 
and modified in response to problems or if they prove ineffective.
    4. Develop and implement a training program. Each employee should 
receive training in relevant areas of safety before beginning work, and 
the training should be updated annually.
    5. Record and arrange for treatment for all incidents where 
personnel are exposed to biohazards or are potentially infected.
General Laboratory Safety
    In addition to biosafety, biorepositories need to follow strict 
general safety regulations and procedures. Recommendations regarding 
general laboratory safety follow. Additional details and references 
regarding biorepository safety can be found in the ISBER Best 
Practices, Section J, and Appendix A (ISBER 2005).
    1. Chemical safety. Follow U.S. regulations concerning chemical 
safety, which protect employees from exposure to hazardous levels of 
chemicals in biorepositories, including, for example, formaldehyde used 
to fix tissues. Biorepositories should also comply with OSHA 
regulations governing occupational exposure to hazardous chemicals in 
laboratories (29 CFR 1910.1450).
    2. Electrical safety. Freezers and other biorepository equipment 
must be properly grounded.
    3. Fire safety. Emergency plans must be in place and practiced on a 
regular basis. Purchase noncombustible freezers and refrigerators.
    4. Physical safety. Repetitive strain and back injuries are typical 
occupational biohazards in the biorepository. Take proper precautions 
to prevent these and other accidents and injuries typical of the 
laboratory/biorepository environment.
    5. Radiological safety. Any laboratory or biorepository that 
processes radioactive materials requires proper training and equipment 
to obtain licenses from the NRC and/or local agencies.
E. Biorepository Informatics: Data Management and Inventory Control and 
Tracking
    Driven by advances in genomics and proteomics, informatics systems 
have become increasingly critical to the research enterprise. 
Informatics systems that support NCI-sponsored biorepositories must be 
robust and reliable and able to meet changing needs while remaining 
interoperable.
    An informatics system should support all aspects of biorepository 
operations, including (but not limited to) patient enrollment and 
consent; biospecimen collection, processing, storage, and 
dissemination; QA/QC; collection of patient data; data security; 
validation documentation; and management reporting functions. The 
system should also manage clinical annotations to the biospecimens and, 
where possible, support those patient followup needs permitted by 
ethical considerations and appropriate regulations. Biorepository 
systems should also be interoperable with those that house endpoint 
assay data (e.g., proteomics, genomics) to ensure that integration of 
data from multiple sources will be possible. The NCICB has developed 
caBIG (see https://cabig.nci.nih.gov/), a voluntary network or grid 
connecting individuals and institutions to enable the sharing of data 
and tools. The informatics systems selected or developed for new 
biorepositories should be caBIG-compatible at the ``silver'' level (see 
https://cabig.nci.nih.gov/guidelines_documentation) with the goal of 
interoperability with other systems. Where systems for existing 
biorepositories are being replaced or upgraded, they should also be 
compatible at the silver level. For existing software, migration paths 
to silver level compatibility should be identified, with the 
expectation that this will become a requirement in later versions of 
these guidelines.
General Informatics Guidelines
    1. Each biospecimen should be assigned a unique identifier (number 
and/or barcode) at the time of collection.
    2. Specific clinical and epidemiological data should be identified 
by the same number and/or barcode.
    3. The same number or code should be used to track a biospecimen 
from

[[Page 25193]]

collection through processing, storage, and distribution.
    4. The biorepository database should be updated each time the 
biospecimen is moved within or out of the biorepository.
Functionality of Biorepository Informatics Systems
    1. Biorepository informatics management systems should be based on 
use cases and other domain level modeling techniques (e.g., data or 
object models) that capture the needs for managing biorepositories. 
SOPs for the activities carried out in a biorepository should largely 
drive the design of informatics systems.
    2. At the biorepository level, informatics systems should focus on 
inventory functions, tracking all phases of sample acquisition, 
processing, handling, QA/QC, and distribution from collection site 
(patient) to utilization (researcher). Restocking of returned, unused 
samples from the researcher, if allowed, also must be tracked. Tracking 
should also include documenting multiple, preexisting, external 
physical biospecimen identifiers, such as barcodes with non-identifying 
information.
    3. The informatics system must be able to link the information it 
contains to the physical biospecimen containers via labels on those 
containers (e.g., paper labels/barcodes).
    4. Systems should utilize data elements from a common metadata 
biorepository, such as the Cancer Data Standards Repository (caDSR, see 
http://ncicbsupport.nci.nih.gov/sw/content/caDSR.html).
    5. The informatics system should account for ``legacy'' identifiers 
and be able to track multiple identifiers and any barcodes generated in 
the resource.
    6. Informatics systems should be able to track clinical data 
associated with a biospecimen and minimally should support the 
collection of a ``universal clinical data set.'' The NCI will work with 
biorepositories to develop this minimal clinical data set to be 
collected for all biospecimens, as appropriate for the research 
protocol at NCI-supported biorepositories. This universal data set will 
change over time. The informatics system should be able to link 
biospecimen data with external sources of clinical data.
    7. Tools used to extract structured information from free-text 
data, such as surgical pathology reports, should be validated as to 
their accuracy in performing that task. Biorepositories should 
routinely monitor the performance of such tools.
    8. All NCI-supported biorepository databases at an individual 
institution should be in a secure site monitored by the institution. 
All systems should have a backup plan. Biorepositories should eliminate 
unsecured, ad hoc databases, such as those recorded in Excel, Access, 
and FileMaker Pro, and manage data by the central informatics system. 
Institutions without the capabilities to provide such infrastructure 
should seek external hosting arrangements for such a system.
Integration
    1. The informatics system at each NCI-supported biorepository 
should be able to integrate with the host institution's clinical data 
systems, including the anatomic pathology laboratory information system 
(AP-LIS), the clinical pathology laboratory information system (CP-
LIS), and the Cancer Registry. The NCI is developing the caTISSUE 
Clinical Annotation Engine to assist in this effort.
    2. NCI-supported biorepositories should use informatics systems 
that support the linking of biospecimens with associated research data 
(e.g., genomic and proteomic analyses) and, when available, agreed upon 
limits, if any, on use of the sample. If applicable, NCI-supported 
biorepositories should track the levels of consent that each patient 
has given for the use of his or her biospecimens and whether that 
consent has been withdrawn.
Interoperability
    1. Informatics systems at individual NCI-supported biorepositories 
should be connected through a centralized, enterprise-level framework.
    2. Semantic and syntactic standards should be common across the 
individual bioinformatics systems.
    3. While informatics systems at NCI-supported biorepositories will 
have different informatics requirements based on workflow, systems 
should be interoperable to integrate clinical and research data and 
establish distributed tissue resources.
    4. NCI-supported biorepositories should support a minimum set of 
common queries that can be run across all systems using common data 
elements. In the future, all NCI-supported systems should support 
queries across multiple systems or biorepository networks.
Development
    1. Software and system development methodology should be followed 
for initial development and subsequent revisions.
    2. Software and system engineering organizations should meet at 
least Capability Maturity Model Integration (CMMI) Level 3 (Carnegie 
Mellon 2005).
Ethical and Legal Issues \4\
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    \4\ The NCI will develop and implement SOPs for annotating 
clinical data to accompany samples stored in NCI-supported 
biorepositories. Informatics systems should be designed to accept 
these annotations and link them with samples in a deidentified 
manner.
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    1. An honest broker-guided procedure should be used to protect 
research participants' privacy for samples and data in all NCI-
sponsored biorepositories. The honest broker may be considered a 
function of the informatics system, not necessarily an individual.
    2. The system should allow users to perform only those operations 
for which they have permission at the object, record, and attribute 
levels.
    3. Permissions and user roles should be defined to ensure proper 
access to data and biospecimens in compliance with all applicable 
privacy laws and human subjects regulations (45 CFR part 46). Data 
about biospecimens should be provided on terms that are not exorbitant, 
do not grant reach-through rights, or are otherwise not unduly onerous 
(i.e., are consistent with NIH research tools and data policies--see 
http://www.nih.gov/news/researchtools/ and http://grants1.nih.gov/grants/policy/data_sharing/index.htm).
    4. All existing systems should be mapped to minimal standards (to 
be defined by NCI), and a timeline should be set for implementation to 
encourage the adoption of a federated informatics system.
    5. NCI-supported biorepositories should meet relevant State and 
Federal requirements encouraging the use of electronic signatures where 
appropriate, and IT accessibility standards for handicapped persons.
Assessing Biorepository Informatics Systems
    1. Existing or ``legacy'' biorepositories should be evaluated on 
the basis of their respective levels of informatics capabilities, 
including the usage of CDEs, access to data through standard queries, 
data accuracy, and adherence to other stated guidelines.
    2. The biorepository informatics system should provide reporting 
capabilities that allow biorepository managers to monitor its state in 
terms of the scientific best practices described elsewhere in these 
guidelines. The system should provide information to those managers to 
maintain the requisite level of biospecimen quality.

[[Page 25194]]

    3. Biorepository informatics systems should be able to provide 
vital system statistics and audit logs of all access to protected 
health information in the database.
NCI Infrastructure To Support These Guidelines
    The NCI has developed a number of initiatives that may be used to 
assist its Cancer Centers that wish to implement these guidelines and 
is currently exploring further mechanisms to assist the community with 
overall implementation of these recommendations. These initiatives 
include the caBIGTM (see https://cabig.nci.nih.gov/), an 
infrastructure project designed to facilitate the exchange of data and 
programs among NCI-supported Cancer Centers. An associated Tissue 
Banking and Pathology Tools Workspace provides specifically for the 
needs of biorepositories. As part of this program, the NCI is 
developing the following components:
    1. caTISSUE Core. An Intra/internet-based application for managing 
a biorepository. caTISSUE also provides an object model through which 
existing biorepository systems may be used as a standard to share 
biospecimen data.
    2. caTISSUE-Clinical Annotation. An application for handling the 
annotation of biospecimens with clinical data.
    3. caTIES. A system for extracting concepts from free text 
pathology reports into a structured data model.
    The caDSR and its associated services provide the infrastructure to 
handle the standardized terminologies referred to in the 
recommendations. caBIG silver-level compatibility is outlined in the 
caBIG documentation at https://cabig.nci.nih.gov/guidelines_documentation.

2. Ethical, Legal, and Policy Guidelines

A. Informed Consent
    Informed consent (pursuant to the human subjects regulations at 45 
CFR part 46) is designed to present potential human research 
participants with sufficient information--including anticipated 
procedures, risks, and benefits--to make an informed decision to 
participate in research studies. Obtaining informed consent for the 
collection and storage of biospecimens and for their use in future 
research is challenging since the specifics of the future research are 
often not known at the time of biospecimen collection. Despite this 
challenge, the informed consent information describing the nature and 
purposes of the research should be as specific as possible. The 
specific type of research that may be done in the future on donated 
biospecimens may be sufficiently anticipated and described in the 
original informed consent to satisfy HHS regulations.
    1. The timing of consent (e.g. before or after surgery) to use 
specimens for research purposes should not be imposed rigidly, but the 
donor must be informed by a number of important considerations, 
including ethical guidelines and logistical constraints.
    2. The NCI will provide biorepositories with a sample consent 
template, for example, the NCI Sample Consent Form for Use of Tissue 
for Research (Appendix 1), which should be adapted to conform to 
applicable state law and local policy, and approved by the appropriate 
IRB. Although there should be areas of uniformity across all NCI-
supported biorepositories, there should also be some flexibility so 
that biorepositories can adapt the sample template to their needs.
    3. The sample consent forms used by NCI-supported biorepositories 
should, if appropriate, address the use of biospecimens or data by non-
government individuals or entities, the issue of research leading to 
future development of commercial products, and the release of 
individual research results to participants.
    4. Research participants should be allowed to specify the types of 
research for which their biospecimens may be used, including use in 
additional future projects.
    5. NCI-supported biorepositories should develop policies and 
procedures to handle biospecimens and associated computer records for 
which consent has been withdrawn. Informed consent documents should 
highlight the research participant's or source's ability to withdraw 
consent and describe what will take place should consent be withdrawn.
     In the event that consent is withdrawn for the continued 
research use of biospecimens, individually identifiable biospecimens 
and any distributed samples must be withdrawn from the biorepository, 
and attempts should be made to retrieve samples. In addition, consent 
can also be withdrawn for the analysis phase of identifiable private 
information, since it is considered human subjects research. However, a 
processed sample and the research data generated from it cannot be 
rescinded.
     In the event that consent is withdrawn, biospecimens 
should be destroyed or alternatively stripped of all direct and 
indirect identifiers. However, biorepository managers should be 
sensitive to cultural issues and should work with affected groups to 
develop mechanisms for returning or destroying biospecimens. The option 
of stripping all direct and indirect identifiers from biospecimens 
should be included in consent forms for subjects who later withdraw 
consent.
    6. NCI-supported biorepositories that house identifiable 
biospecimens and data from children that are obtained with parental or 
guardian permission should continually monitor the need for obtaining 
informed consent when a child reaches the legal age to consent for a 
research study. If the biospecimens/data are used in studies that 
require ongoing interactions or interventions with the subject or that 
continue to meet the regulatory definition of ``human subjects 
research'' and the child reaches the legal age to consent for new 
research, this subject's participation in research is no longer 
regulated by 45 CFR 46.408. A legally effective informed consent should 
be obtained from the child turned adult subject unless the IRB waives 
the requirement for obtaining informed consent under CFR 46.116(d).
    7. FDA regulations must be considered for research on existing 
biospecimen collections. These regulations may not exempt in vitro 
studies from the requirement for documented, IRB-approved consent from 
the sources, even in cases where biospecimens have been deidentified.
    8. NCI-supported biorepositories should establish and document 
transparent policies governing records and biospecimen retention. These 
policies should be made available to participants, either in the 
informed consent document or in supporting information. In addition, 
usage agreements with recipient investigators should specify the 
retention policy of the recipient investigator.
     For clinical biospecimens, the timing is informed by 
Federal and State laws governing how long records are retained.
     For research biospecimens, the ideal is permanent storage 
if there are sufficient resources and storage space, subject to 
reasonable foreseeable research utility (i.e., QA/QC, dated data sets).
     Biorepositories should be reviewed periodically (e.g., at 
the time of funding renewal) to determine the utility of existing 
biospecimens, the need for new biospecimens, etc.
     In the event that biorepositories close because of lack of 
funding or otherwise cannot maintain or use the biospecimens, the 
availability of the biospecimens for transfer should be

[[Page 25195]]

announced to the research community (e.g., via a Web site). The 
transfer of such biospecimens must be consistent with human subjects 
regulations.
    For additional information about IRBs and the requirement for OHRP-
approved assurance of compliance, see the OHRP Web site at http://www.hhs.gov/ohrp/.
B. Access to Biospecimens and Data
    Access to human biospecimens for research purposes is crucial for 
fields such as genomics, proteomics, metabolomics, molecular imaging, 
and nanotechnology. Researchers in these areas often rely on federally 
funded biorepositories for high-quality biospecimens and associated 
data.
    1. NCI-funded biorepositories should establish clear guidelines, as 
the research community's custodian of biospecimens, for sample 
distribution (and clinical data sharing) consistent with ethical 
principles, prevailing laws and regulations, and, if applicable, 
consent form language. The NCI intends to have a substantial role in 
developing the best practices on which these guidelines will be based. 
These guidelines should build on the work of other groups and should 
be:
     Clear to ensure their comprehension and adherence.
     Flexible so that biorepositories may be responsive to 
changing scientific needs.
     Amendable to facilitate their adaptability over time.
     General enough so they may be applied to different kinds 
of biorepositories.
    In addition, the best practices will delineate when biospecimens 
(and clinical data) should be narrowly or broadly accessible and what 
justifications will be expected of funded biorepositories.
    2. Investigators should have timely, equitable, and appropriate 
access to human biospecimens stored at NCI-supported biorepositories 
without undue administrative burden. A prescribed mechanism for rapid 
turnaround of requests should be in place at NCI biorepositories that 
(1) relies on a peer (or stakeholder) review system that sets 
priorities as to how collected biospecimens should be allocated to 
qualified recipient investigators and (2) ensures that proposed uses 
are consistent with the participant's consent, research purpose, and 
allowable use of biospecimens.
     Decisions should be guided by a set of general principles 
that include:
     Fair and clearly communicated access procedures.
     Protocol-specific requirements that must be met before 
other access is considered.
     Preference for access to investigators from the protocol 
coordinating group or NCI-funded investigators before access is granted 
to others.
     Access granted on the basis of scientific merit with the 
following criteria:
    1. Institutional research qualifications and proven investigator 
experience with the method proposed.
    2. Standardized, validated research biomarker assay methodology.
    3. A research plan appropriate to answer the study question.
    4. Statistical evaluation which shows that the study question can 
be addressed with the samples available.
    5. The investigator has defined funding and IRB approval for the 
project.
    6. The investigator has defined a study interval and will provide 
information about the project outcome at the end of that period.
    7. The investigator agrees to group publication guidelines.
    8. The investigator agrees to make assay data available according 
to agreed-upon rules.
     Access includes negotiated arrangement with a clinical 
protocol coordinating group to provide timely statistical analysis of 
study results.
     Investigator agrees to compensate tissue bank for specimen 
preparation and shipping and coordinating group statisticians for 
timely data analysis.
     Provide investigator agreements, principles and process 
for review.
     Access policies and procedures should apply to all 
biorepositories and should include the following:

--Investigator agreement covering confidentiality, use, disposition, 
and security of biospecimens and associated data.
--Investigator's written agreement in a Material Transfer Agreement 
that complies with the NIH Research Tool Policy. (http://ott.od.nih.gov/policy/rt_guide_final.html).
--Appropriate ethical oversight.

     An appropriate model for biospecimen and associated 
clinical data usage should be based on matching usage with appropriate 
scientific investigations (e.g., discovery, prevalence, initial 
validation, hypothesis testing). The level of identifiability of the 
biospecimen should be appropriate for the proposed research.
     The local decisionmaking body should take local principles 
into account. Ethical considerations should come first among principles 
that guide the decisionmaking process.
     Guidelines should apply to all new collections and, 
whenever possible, to existing collections.
     An appeals process should be established for addressing 
disputes over allocation decisions.
    3. Charges for samples should be used only to recover costs. Cost-
recovery models, and thus pricing strategies for biorepositories, can 
vary. If applicable and where monetary charges are necessary, charge 
only to recover costs as appropriate to retrieve and disseminate 
specimens.
    4. NCI-supported biorepositories should use a system of data access 
with defined levels of access privileges.
     Access levels should be described in the protocol for 
operation of the biorepository, as well as in the informed consent 
form, and should be approved by an IRB and/or bioethics-scientific 
advisory board.
     Access to research participants' identities and medical, 
genetic, social, and personal histories should be restricted to only 
those biorepository staff members who need to access such records as 
part of their assigned duty or to those persons permitted access by 
law.
     The number of personnel allowed to access links and 
reidentify information should be kept to a minimum, and access should 
be appropriately monitored to ensure compliance.
    5. NCI-supported biorepositories should store human biospecimens 
for research purposes only and should not serve an individual research 
participant's needs or wishes.
C. Privacy Protection
    Research depends on protecting the privacy of individuals who 
contribute biospecimens to biorepositories and on maintaining the 
confidentiality of associated clinical data and information (Eiseman et 
al. 2003). Applying the highest possible ethical standards is necessary 
to ensure the support and participation of patients, physicians, 
researchers, and others in biorepository activities (NBN Blueprint 
2003). With the recent advances in genomic and proteomic technology, 
the sequencing of the human genome, and the increasing reliance by 
biorepositories on electronic and web-based databases to track data, it 
is even more crucial to address the risk of unintended release or 
disclosure of sensitive information, which can place individuals at 
risk for discrimination and related groups at risk for stigmatization.

[[Page 25196]]

    1. NCI-supported biorepositories should establish clear policies 
for protecting the privacy of information. These policies may include 
data encryption, coding, and establishing limited access or varying 
levels of access to data by biorepository employees.
    2. In applications for support, biorepositories should document 
their policies, describe mechanisms for auditing effectiveness and for 
enforcement, describe required training, and specify security measures 
pertaining to employee access to data and biospecimens.
    3. The level of security should be appropriate to the type of 
biorepository.
D. Custodianship
    1. NCI-supported biorepositories should propose plans for formal 
and continuing responsibility for custodianship (not ownership \5\) of 
collected biospecimens and associated data as part of the biorepository 
protocol. Biorepositories should address this issue in applications for 
funding, specifically, (a) How does the biorepository propose to ensure 
the physical integrity of biospecimens? (b) How does the biorepository 
propose to ensure the integrity of the patient data that accompany the 
biospecimens? (c) What plans and protocols exist for the distribution 
of samples to investigators? (Also see Access to Biospecimens and Data, 
section B.2 above.)
---------------------------------------------------------------------------

    \5\ The issue of ownership of biospecimens, associated data, and 
research findings remains ambiguous and controversial, partly 
because of wide variation and lack of harmonization in the 
regulatory and legal standards used by courts, state legislatures, 
and Federal regulators in determining ownership rights. The end 
result has been the use of unclear or misleading legal language in 
informed consent and other documents that does not adequately 
address the issue of ownership, by either the individual who is the 
source of the biospecimen, the principal investigators who collect 
and bank the biospecimens, the recipient investigators who use the 
samples for research purposes, or the biorepository and its host 
institution.
---------------------------------------------------------------------------

    2. Biorepositories should address plans for the handling and 
disposition of biospecimens and associated data at one or more of the 
following points: (a) End of the budget period of the grant, (b) 
accomplishment of the specific research objectives of the study, (c) 
depletion of biospecimens, or (c) achievement of critical data 
endpoints.
    3. Individuals responsible for allocating biospecimens or 
associated data from biorepositories should disclose financial or 
professional conflicts of interest to existing conflict-of-interest 
committees in the host institution or to the biorepository's governing 
board.
    4. NCI-supported biorepositories should use clear and specific 
informed consent language to ensure that those who contribute 
biospecimens and/or data for research purposes are fully informed that 
the research done with these biospecimens may help to develop products, 
tests, or discoveries that may have commercial value (see sample 
template, Appendix 1).
E. Intellectual Property
    Inventions arising from research using annotated biospecimens may 
have commercial value. As researchers and industry sponsors have 
sharply increased their demand for properly prepared and clinically 
annotated biospecimens, some institutions have begun to assert control 
over biospecimens, associated data, and research findings. The current 
variability in IP policies at institutions hosting NCI-supported 
research and biorepositories may ultimately lead to problems in 
biospecimen and data access, timely and open publication, sharing of 
research findings, and establishment of new biorepositories.
    1. For the transfer of materials in academic-industrial 
collaborations, use the NIH SLA, the UBMTA, or other MTA with terms 
consistent with the NIH Research Tools Policy and NIH data sharing 
policies. The above agreements should be modified where necessary to 
cover human subjects research. A sample NIH SLA modified to address the 
transfer of human biospecimens is attached as Appendix 2.
    The following Internet sites are relevant to this issue:
     http://ott.od.nih.gov/policy/research_tool.html.
     http://www.autm.net/aboutTT/aboutTT_umbta.cfm.
     http://grants1.nih.gov/grants/policy/data_sharing/index.htm.
    2. Recognize that biorepository staff members as custodians of 
biospecimens are not a priori considered inventors under patent law for 
inventions made using materials distributed by the biorepository. In 
general, the staff should be informed that one whose sole contribution 
to an invention consists of the routine collection, handling, storage, 
and disbursement of biospecimens might not rise to the level of 
``inventor'' of an invention. Inventorship is determined by patent law 
and must be considered on a case-by-case basis by trained legal 
personnel.
    3. Recognize that biorepositories have no inherent rights to future 
IP, such as reach-through rights in inventions made by investigators 
using samples obtained from the biorepository.
    4. Ensure through appropriate MTAs that research data obtained 
using biospecimens are made available to the research community, 
consistent with NIH data sharing policies such as the Final NIH 
Statement on Sharing Research Data (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-03-032.html).

References

Caporaso N, Vaught J. Collection, processing and analysis of 
preneoplastic specimens. In: Cancer Precursors: Epidemiology, 
Detection, and Prevention. EL Franco, TE Rohan, Eds. (New York: 
Springer-Verlag, January 2002).
Carnegie Mellon Software Engineering Institute. Capability Maturity 
Model Integration (CMMI) Web site, 2005. Viewed July 11, 2005, at 
http://www.sei.cmu.edu/cmmi/.
CDC and NIH (Centers for Disease Control and Prevention and National 
Institutes of Health), U.S. Department of Health and Human Services. 
Biosafety in Microbiological and Biomedical Laboratories (BMBL), 4th 
ed. (Washington, DC: U.S. Government Printing Office, May 1999). 
Viewed July 10, 2005, at http://www.cdc.gov/od/ohs/biosfty/bmbl4/bmbl4toc.htm.
Eiseman E, Bloom G, Brower J, et al. Case Studies of Existing Human 
Tissue Repositories: ``Best Practices'' for a Biospecimen Resource 
for the Genomic and Proteomic Era (Santa Monica, CA: RAND 
Corporation, 2003).
Grizzle WE. Practical factors in collecting tissues for research 
(unpublished). In: Cooperative Human Tissue Network, Tissue 
Procurement Training Manual, September 24, 2004.
Grizzle WE, Fredenburgh J. Avoiding biohazards in medical, 
veterinary, and research laboratories. Biotechnic & Histochem 
76:183-206, 2001.
Hayes RB, Smith CO, Huang WY, et al. Whole blood cryopreservation in 
epidemiological studies. Cancer Epidemiol Biomarkers Prev 
11(11):1496-8, 2002.
Health Information Portability and Accountability Act of 1996 
(HIPAA). Viewed July 12, 2005, at http://aspe.hhs.gov/admnsimp/pll04191.htm.
Holland NT, Smith MT, Eskenazi B, et al. Biological sample 
collection and processing for molecular epidemiological studies. 
Mutation Res 543:217-34, 2003.
IATA (International Air Transport Association). Infectious 
Substances and Diagnostic Specimens Shipping Guidelines, 2004, 5th 
ed. Available for purchase at http://www.iata.org/ps/publications/9052.htm.
ISBER (International Society for Biological and Environmental 
Repositories). Best practices for repositories I: collection, 
storage and retrieval of human biological materials for research. 
Cell Preserv Technol 3:5-48, 2005.
Landi MT, Caporaso N. Sample collection, processing and storage. In: 
Applications of Biomarkers in Cancer Epidemiology,

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IARC Scientific Pub. No. 142 (Lyon, France: International Agency for 
Research on Cancer, 1997).
Mager R, Ratcliffe C, Knox K. Developing an operational framework: 
Standard workflows, operating and quality control policies and 
procedures for the collection, storage and distribution of frozen 
and paraffin-embedded tissue and blood. Prepared on behalf of DJ 
Kerr, Director of the National Translational Cancer Research Network 
(NTRAC) and the National Cancer Research Institute (NCRI), 2004.
NBN (National Biospecimen Network) Blueprint, Chapter 3: Biospecimen 
and data collection and distribution. A Friede, R Grossman, R Hunt, 
et al., Eds. (Durham, NC: Constella Group, Inc., 2003). Viewed July 
9, 2005, at http://www.ndoc.org/about_ndc/reports/NBN_comment.asp.
NCAB (National Cancer Advisory Board), U.S. Department of Health and 
Human Services. Summary of National Cancer Advisory Board Meeting, 
November 30-December 1, 2004, Bethesda, MD. Viewed July 10, 2005, at 
http://deainfo.nci.nih.gov/advisory/ncab/132_1104/30nov04mins.pdf.
NCI (National Cancer Institute). The caBIG (cancer Biomedical 
Informatics Grid) Web site, no date. Viewed July 11, 2005, at 
http://cabig.nci.nih.gov">cabig.nci.nih.gov.

Appendix 1--NCI Sample Consent Form for Use of Tissue for Research

    The following tissue consent example has been adapted from the 
NCI Cancer Diagnosis Program's sample consent form, also available 
at: http://www.cancerdiagnosis.nci.nih.gov/specimens/model.pdf. The 
accompanying instruction sheet can be found at http://www.cancerdiagnosis.nci.nih.gov/specimens/patient.pdf.

-----------------------------------------------------------------------
Name of Tissue Repository
-----------------------------------------------------------------------
-----------------------------------------------------------------------
Address and phone number

Consent Form for Use of Tissue for Research

About Using Tissue for Research

    You are going to have a biopsy (or surgery) to see if you have 
cancer. Your doctor will remove some body tissue to do some tests. 
The results of these tests will be given to you by your doctor and 
will be used to plan your care.
    We would like to keep some of the tissue that is left over for 
future research. If you agree, this tissue will be kept and may be 
used in research to learn more about cancer and other diseases. 
Please read the information sheet called ``How Is Tissue Used for 
Research?'' to learn more about tissue research.
    Your tissue may be helpful for research whether you do or do not 
have cancer. The research that may be done with your tissue is not 
designed specifically to help you. It might help people who have 
cancer and other diseases in the future.
    Reports about research done with your tissue will not be given 
to you or your doctor. These reports will not be put in your health 
record. The research will not have an effect on your care.

Things To Think About

    The choice to let us keep the leftover tissue for future 
research is up to you. No matter what you decide to do, it will not 
affect your care.
    If you decide now that your tissue can be kept for research, you 
can change your mind at any time. Just contact us and let us know 
that you do not want us to use your tissue.
    Then any tissue that remains will no longer be used for 
research. However, once knowledge is gained from a sample, that 
knowledge cannot be taken back.
    In the future, people who do research may need to know more 
about your health. While the [INSERT ORGANIZATION NAME] may give 
them reports about your health, it will not give them your name, 
address, phone number, or any other information that will let the 
researchers know who you are.
    Sometimes tissue is used for familial or hereditary genetic 
research (about diseases that are passed on in families). Even if 
your tissue is used for this kind of research, the results will not 
be put in your health records.
    Your tissue will be used only for research and will not be sold. 
However, the research done with your tissue may help develop new 
products, tests, or discoveries in the future, which may have 
commercial value. The [INSERT ORGANIZATION NAME] does not plan to 
share any commercial profits with you.

Benefits

    There will be no direct benefit to you, financially or 
otherwise, by participating in this research study.
    The benefits of research using tissue include learning more 
about what causes cancer and other diseases, how to prevent them, 
and how to treat them.

Risks

    The greatest risk to you is the release of information from your 
health records. The chance that this information will be given to 
someone else is very small.
    Making sure that your identity does not become known will 
minimize the chance that you will experience any psychological or 
social harm. Therefore, we will take every precaution to safeguard 
your identity. As soon as it is collected, your tissue and your 
clinical information will be assigned a code number. That code 
number will be the only information attached to your samples and 
clinical information. All other widely used identifying information, 
such as your name, address, phone number, and Social Security number 
will be removed. The master list, which will link your name and the 
code number, will be kept under lock and key and in a computer with 
electronic safeguards. Only authorized people who have agreed in 
writing to protect your identity will have access to your linked 
information. Therefore, the researchers and others working with your 
samples and clinical information will not know your identity.
    Your privacy is very important to us. However, in spite of these 
safety measures, we cannot guarantee that your identity will never 
become known. Due to scientific advances or human errors, your 
identity could become known. Since your DNA information is unique to 
you, in the future it may become possible for someone to identify 
you. This would require someone to take another tissue sample from 
you, analyze the DNA, and compare it with data resulting from this 
research project. Currently, this risk is very slight.
    If your identity were ever determined, this might cause you and 
your family some distress. In addition, if it became known that you 
have disease-causing DNA changes, there is a very small risk that 
you might have a harder time getting or keeping a job or health 
insurance. Some laws exist that attempt to protect people from such 
job and insurance discrimination. However, these laws may not fully 
protect people from discrimination.
    Since you share genetic characteristics with your children, 
parents, brothers, sisters, and other family members, it is possible 
that some of these risks may apply to them as well. However, their 
risks are likely to be even lower than yours, since it will be even 
more difficult to identify them than to identify you.

Making Your Choice

    Please read each sentence below and think about your choice. 
After reading each sentence, circle ``Yes'' or ``No.'' No matter 
what you decide to do, it will not affect your care. If you have any 
questions, please talk to your doctor or nurse or call our research 
review board at [IRB's phone number]. If you decide now that your 
tissue can be kept for research, you can change your mind at any 
time. Just contact us and let us know that you do not want us to use 
your tissue for research
1. My tissue may be kept for use in research to learn about, 
prevent, or treat cancer.
Yes No
2. My tissue may be kept for use in research to learn about, 
prevent, or treat other health problems (for example: diabetes, 
Alzheimer's disease, or heart disease).
Yes No
3. My medical record information may be associated with research on 
my tissue.
Yes No
4. Someone from the [INSERT ORGANIZATION NAME] may contact me in the 
future to ask me to take part in more research.
Yes No
Please sign your name here after you circle your answers.

Your Signature:--------------------------------------------------------
Date:------------------------------------------------------------------
Signature of Doctor/Nurse:---------------------------------------------
Date:------------------------------------------------------------------

How Is Tissue Used for Research?

(This information brochure is to be distributed with the informed 
consent document.)

Where does tissue come from?

    Whenever a biopsy (or surgery) is performed, the tissue that is 
removed is examined under the microscope by a trained doctor to 
determine the nature of the disease and assist with the diagnosis. 
Your tissue will always be used first to help make

[[Page 25198]]

decisions about your care. After all tests have been done, there is 
usually some leftover tissue. Sometimes, this tissue is not kept 
because it is not needed for the patient's care. Instead, a patient 
can choose to have the tissue kept for future research. People who 
are trained to handle tissue and protect the donor's rights make 
sure that the highest standards are followed by the [INSERT 
ORGANIZATION NAME]. Your doctor does not work for the [INSERT 
ORGANIZATION NAME] but has agreed to help collect tissue from many 
patients. Many doctors across the country are helping in the same 
way. If you agree, only leftover tissue will be saved for research. 
Your doctor will take only the tissue needed for your care during 
surgery.

Why do people do research with tissue?

    Research with tissue can help find out more about what causes 
cancer, how to prevent it, and how to treat it. Research using 
tissue can also answer other health questions. Some of these include 
finding the causes of diabetes and heart disease or finding genetic 
links to Alzheimer's.

What type of research will be done with my tissue?

    Many different kinds of studies use tissue. Some researchers may 
develop new tests to find diseases. Others may develop new ways to 
treat or even cure diseases. In the future, some of the research may 
help develop new products, such as tests and drugs.
    Some research looks at diseases that are passed on in families 
(called familial or hereditary genetic research). Research done with 
your tissue may look for genetic causes and signs of disease.

How do researchers get the tissue?

    Researchers from universities, hospitals, and other health 
organizations conduct research using tissue. They contact the 
[INSERT ORGANIZATION NAME] and request samples for their studies. 
The [INSERT ORGANIZATION NAME] reviews the way that these studies 
will be done, and decides if any of the samples can be used. The 
[INSERT ORGANIZATION NAME] gets the tissue and information about you 
from your hospital and sends the tissue samples and some information 
about you to the researcher. The [INSERT ORGANIZATION NAME] will not 
send your name, address, phone number, Social Security number, or 
any other identifying information to the researcher.

Will I find out the results of the research using my tissue?

    No, you will not receive the results of research done with your 
tissue. This is because research can take a long time and must use 
tissue samples from many people before results are known. Results 
from research using your tissue may not be ready for many years and 
will not affect your care right now, but they may be helpful to 
people like you in the future.
    Though research involves the test results of many different 
people, your biopsy result involves only you. Your doctor will give 
you the results of your biopsy when results are known. These test 
results are ready in a short time and will be used to make decisions 
about your care.

Will I benefit from the research using my tissue?

    There will be no direct benefit to you, financially or 
otherwise. However, it is hoped that the results of research on your 
tissue and tissues from other patients will provide information that 
will help other patients in the future. Your tissue will be helpful 
whether you have cancer or not.

Why do you need information from my health records?

    In order to do research with your tissue, researchers may need 
to know some things about you. (For example: Are you male or female? 
What is your race or ethnic group? How old are you? Have you ever 
smoked?) This helps researchers answer questions about diseases. The 
information that will be given to the researcher includes your age, 
sex, race, diagnosis, treatments, and possibly some family history. 
This information is collected by your hospital from your health 
record and sent to the [INSERT ORGANIZATION NAME] but without your 
name or other identifying information. If more information is 
needed, the [INSERT ORGANIZATION NAME] may send it to the 
researcher.

Will my name be attached to the records that are given to the 
researcher?

    No. Your name, address, phone number, and anything else that 
could identify you will be removed before the other information goes 
to the researcher.

How could the records be used in ways that might be harmful to me?

    Sometimes, health records have been used against patients and 
their families. For example, insurance companies may deny a patient 
insurance or employers may not hire someone with a certain illness 
(such as AIDS or cancer). The results of genetic research may apply 
not only to you but also to your family members. For diseases caused 
by gene changes, the information in one person's health record could 
be used against family members.

How am I protected?

    The [INSERT ORGANIZATION NAME] is in charge of making sure that 
information about you is kept private. The [INSERT ORGANIZATION 
NAME] will take careful steps to prevent misuse of records. Your 
name, address, phone number and other identifying information will 
be taken off anything associated with your tissue before it is given 
to the researcher. This would make it very difficult for any 
research results to be linked to you or your family. Also, people 
outside the research process will not have access to results about 
any one person, which will help protect your privacy.
    Making sure that your identity does not become known will 
minimize the chance that you will experience any psychological or 
social harm. Therefore, we will take every precaution to safeguard 
your identity. As soon it is collected, your tissue and your 
clinical information will be assigned a code number. That code 
number will be the only information attached to your samples and 
clinical information. All other widely used identifying information, 
such as your name, address, phone number, and Social Security 
number, will be removed. The master list, which will link your name 
and the code number, will be kept under lock and key and in a 
computer with electronic safeguards. Only authorized people who have 
agreed in writing to protect your identity will have access to your 
linked information. Therefore, the researchers and others working 
with your samples and clinical information will not know your 
identity.
    Your privacy is very important to us. However, in spite of these 
safety measures, we cannot guarantee that your identity will never 
become known. Due to scientific advances or human errors, your 
identity could become known. Since your DNA information is unique to 
you, in the future it may become possible for someone to identify 
you. This would require someone to take another tissue sample from 
you, analyze the DNA, and compare it with data resulting from this 
research project. Currently, this risk is very slight.
    If your identity were ever determined, this might cause you and 
your family some distress. In addition, if it became known that you 
have disease-causing DNA changes, there is a very small risk that 
you might have a harder time getting or keeping a job or health 
insurance. Some laws exist that attempt to protect people from such 
job and insurance discrimination. However, these laws may not fully 
protect people from discrimination.
    Since you share genetic characteristics with your children, 
parents, brothers, sisters, and other family members, it is possible 
that some of these risks may apply to them as well. However, their 
risks are likely to be even lower than yours, since it will be even 
more difficult to identify them than to identify you.

Appendix 2--Material Transfer Agreement for Human Biospecimens

Provider Organization (``Provider''):----------------------------------
Recipient Organization (``Recipient''):--------------------------------
1(a). The material to be transferred (``MATERIAL'') (Name or 
description of human Biospecimen(s) or Collection, Method of 
Preservation, Organ Source, etc.):

-----------------------------------------------------------------------
-----------------------------------------------------------------------

1(b). Designate the Private Identifiable Information status of the 
MATERIAL (Please see Annex A for definitions) (check one below):
----Unidentified specimens
----Unidentified or ``anonymous'' samples
----Unidentifiable
----Coded specimens
----Coded samples
2. The Recipient will use the MATERIAL (check one only):
----As a biorepository that will distribute the MATERIAL to the 
research community on behalf of the Provider under a separate 
Material Transfer Agreement.
----To conduct an independent research project (Describe the 
``RESEARCH PROJECT'' below):


[[Page 25199]]


-----------------------------------------------------------------------
-----------------------------------------------------------------------

Recipient Serving as a Biorepository

3. If the MATERIAL is being provided by the Provider under this 
Agreement for the purpose of the Recipient distributing the MATERIAL 
to the research community, the Provider hereby grants the Recipient 
explicit permission to further distribute the MATERIAL to the 
research community as a biorepository. Provider Approval (initial 
here) ------
4. If the Recipient is designated as a biorepository in Article 2, 
the Recipient is the custodian of the MATERIAL and therefore does 
not by virtue of this Agreement acquire any intellectual property 
rights in the MATERIAL, nor in any research conducted by third-
parties using the MATERIAL.
5. The MATERIAL will be distributed by Recipient in compliance with 
all applicable statutes and regulations.

Recipient Conducting an Independent Research Project

6. If the MATERIAL is being provided by the Provider under this 
Agreement for the purpose of the Recipient conducting an independent 
research project, the MATERIAL will be used in compliance with all 
applicable statutes and regulations. The MATERIAL was collected and 
is provided in accordance with appropriate Federal and local laws, 
Assurances, and Institutional Review Board approvals related to 
Human Subjects Research. Recipient is responsible for obtaining any 
necessary Human Subjects research approvals or exemptions required 
to use the MATERIAL for the RESEARCH PROJECT.
7. The Recipient will not further distribute the MATERIAL to others 
who are not under the Recipient Scientist's direct supervision 
without written consent from the Provider. The Recipient shall refer 
any request for the MATERIAL to the Provider.
8. The Recipient will in no way attempt to identify or contact the 
person(s) associated with the biospecimen(s) that make up the 
MATERIAL. Furthermore, Recipient will not attempt to obtain or 
otherwise acquire any private identifiable information associated 
with the biospecimen(s) that make up the MATERIAL under this 
Agreement. The MATERIAL will be coded or otherwise deidentified. Any 
widely used identifying information will have been removed. However, 
it is acknowledged that, due to scientific advances such as DNA 
analyses or human errors, there is a small risk that the identity of 
the person who was the source of the MATERIAL could become known.
9. It is intended that Recipient publish the results of the RESEARCH 
PROJECT and make the associated data available to the research 
community in a manner consistent with the NIH data sharing policies 
found at http://grants1.nih.gov/grants/policy/data_sharing/index.htm. The Recipient agrees to acknowledge the source of the 
MATERIAL in any publications or disclosures reporting use of it.
10. Recipient retains ownership of intellectual property made by its 
employees using the MATERIAL as part of the RESEARCH PROJECT to the 
extent permitted by law or contractual agreements.

All Parties Agree

11. THIS MATERIAL IS NOT FOR USE IN HUMAN SUBJECTS.
12. The above MATERIAL is being distributed as a service to the 
research community. It is acknowledged that the MATERIAL is a 
nonrenewable research resource and that further distribution for 
research purposes may be determined by scientific merit of the 
proposed research project. Accordingly, the MATERIAL will be made 
available to other scientists under a separate Material Transfer 
Agreement for scientifically approved projects and to the extent 
supplies are available.
13. Any MATERIAL delivered pursuant to this Agreement is understood 
to be experimental in nature and may have hazardous properties. THE 
Provider MAKES NO REPRESENTATIONS AND EXTENDS NO WARRANTIES OF ANY 
KIND, EITHER EXPRESSED OR IMPLIED. THERE ARE NO EXPRESS OR IMPLIED 
WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, 
OR THAT THE USE OF THE MATERIAL WILL NOT INFRINGE ANY PATENT, 
COPYRIGHT, TRADEMARK, OR OTHER PROPRIETARY RIGHTS. Unless prohibited 
by law, the Recipient assumes all liability for claims for damages 
against it by third parties that may arise from its use, storage, or 
disposal of the MATERIAL, except that, to the extent permitted by 
law, the Provider shall be liable to the Recipient when the damage 
is caused by the gross negligence or willful misconduct of the 
Provider.

Signatures for Provider

Provider Scientist:----------------------------------------------------
-----------------------------------------------------------------------
Provider Organization:-------------------------------------------------
-----------------------------------------------------------------------
Address:---------------------------------------------------------------
-----------------------------------------------------------------------
-----------------------------------------------------------------------
Name of Authorized Official:-------------------------------------------
-----------------------------------------------------------------------
Title of Authorized Official:------------------------------------------
-----------------------------------------------------------------------
-----------------------------------------------------------------------
Signature of Authorized Official
Date:------------------------------------------------------------------
Certification of Provider Authorized Official: This Agreement--has/
--has not been modified. If modified, the modifications are 
attached.

Signatures for Recipient
Recipient Scientist:---------------------------------------------------
-----------------------------------------------------------------------
Recipient Organization:------------------------------------------------
-----------------------------------------------------------------------
Address:---------------------------------------------------------------
-----------------------------------------------------------------------
Name of Authorized Official:-------------------------------------------
-----------------------------------------------------------------------
-----------------------------------------------------------------------
Title of Authorized Official:------------------------------------------
-----------------------------------------------------------------------
-----------------------------------------------------------------------
Signature of Authorized Official
Date:------------------------------------------------------------------
-----------------------------------------------------------------------
Certification of Recipient Scientist: I have read and understood the 
conditions outlined in this Agreement, and I agree to abide by them 
in the receipt and use of the MATERIAL.
-----------------------------------------------------------------------
Scientist Receiving Material
Date:------------------------------------------------------------------
-----------------------------------------------------------------------

Annex A

Definitions (applicable to Appendix 2)

    Coded samples: Sometimes termed ``linked'' or ``identifiable,'' 
these samples are supplied by repositories to investigators from 
identified specimens with a code rather than with personally 
identifying information, such as a name or Social Security number.
    Coded specimens: Sometimes termed ``linked'' or 
``identifiable,'' these specimens are supplied by repositories to 
investigators with a code rather than with personally identifying 
information, such as a name or Social Security number.
    Unidentifiable: Tissue for which identifiable information was 
not collected or, if collected, was not maintained and cannot be 
retrieved by the repository.
    Unidentified or ``anonymous'' samples: Samples supplied by 
repositories to investigators from a collection of unidentified 
human biological specimens and can never be traced to an individual. 
Unlinked or ``anonymized'' samples lack identifiers or codes that 
can link a particular sample to an identified specimen or a 
particular human being but may have been derived from an identified 
sample in the repository.
    Unidentified specimens: For these specimens, identifiable 
personal information was not collected or, if collected, was not 
maintained and cannot be retrieved by the repository.

IV. Implementation

A. Date of Implementation

    The adoption of these guidelines is voluntary. However, the NCI 
may consider making these guidelines terms and conditions of awards.

B. Roles and Responsibilities

    These guidelines will eventually apply to all applicants of NCI-
supported biomedical research involving biorepositories of human 
biospecimens. Certain individuals and groups have special roles and 
responsibilities with regard to the adoption and implementation of 
these guidelines.
    The NCI staff will provide educational opportunities for the 
extramural and intramural community concerning these guidelines; 
monitor its implementation during the development, review, award and 
conduct of research; and manage the NCI research portfolio to 
address these guidelines.

1. Principal Investigators

    The principal investigator and the applicant institution should 
address the

[[Page 25200]]

inclusion of the guidelines in each application and proposal. 
Applicants should provide a statement of compliance in each area 
relevant to their studies where such information is not already 
provided.

2. Institutional Review Boards (IRBs)

    As the IRBs implement the guidelines, the use of the ``NCI 
Sample Consent Form for Use of Tissue for Research,'' adapted to 
conform with applicable state law and local policy, and the 
``Material Transfer Agreement for Human Biospecimens,'' are strongly 
encouraged in future applications.

3. Peer Review Groups

    In conducting peer review for scientific and technical merit, 
appropriately constituted initial review groups (including study 
sections), technical evaluation groups, and intramural review panels 
will evaluate the proposed plan for the inclusion of the guidelines. 
Where the guidelines have not been adopted or implemented, the peer 
review should evaluate the impact on the quality of the biospecimens 
collected, stored, and or analyzed.

4. National Cancer Advisory Board (NCAB)

    The NCAB has approved these guidelines in their draft form, in 
the interest of ensuring sufficient biospecimens of documented 
quality to support NCI-sponsored research and the findings that 
guide the scientific policy of the NCI. Modifications to these 
guidelines will be considered in light of the overall NCI policy and 
available scientific data.

5. Extramural Program Staff

    NCI Extramural Program staffs are familiar with the scientific 
merits and capabilities of the sponsored researchers. Staff 
understanding of the guidelines and their rationale will be 
essential in assisting in a balanced and rational implementation by 
sponsored researchers.

6. NCI Director

    The NCI Director may recommend modifications to the guidelines 
based on subsequent information.

7. Educational Outreach by NCI To Inform the Professional Community

    NCI-sponsored researchers are located and operate within a wide 
variety of facilities, including pathology laboratories, surgical 
practices, comprehensive cancer treatment centers, and clinical or 
basic research laboratories. The guidelines as published by the NCI 
are not intended to substitute, supersede, or otherwise replace 
existing requirements but to be a complement to these requirements 
and to be applied in the absence of guidelines.

8. Applicability to Foreign Research Involving Human Subjects

    For foreign awards, the NCI guidelines for research conducted 
outside the U.S. are the same as those for research conducted in the 
United States. Where local laws or regulations differ, investigators 
should provide the NCI with a rationale for alternate approaches.

V. Abbreviation Definitions Used in these Guidelines

 
              Abbreviation                          Definition
 
caBIG..................................  cancer Biomedical Informatics
                                          Grid
caDSR..................................  cancer Data Standards
                                          Repository
caTIES.................................  cancer Text Information
                                          Extraction System
caTISSUE...............................   component of the NCI cancer
                                          Biomedical Informatics Grid
CDC....................................  Centers for Disease Control and
                                          Prevention
CDEs...................................  common data elements
CFR....................................  Code of Federal Regulations
CHTN...................................  Cooperative Human Tissue
                                          Network
CLIA...................................  Clinical Laboratory Improvement
                                          Amendments
CLSI...................................  Clinical and Laboratory
                                          Standards Institute (formerly
                                          NCCLS, National Committee for
                                          Clinical Laboratory Standards)
DNA....................................  deoxyribonucleic acid
FDA....................................  U.S. Food and Drug
                                          Administration
GSA....................................  General Services Administration
HHS....................................  U.S. Department of Health and
                                          Human Services
HIPAA..................................  Health Insurance Portability
                                          and Accountability Act of 1996
HIV....................................  human immunodeficiency virus
IATA...................................  International Air Transport
                                          Association
ICAO...................................  International Civil Aviation
                                          Organization
IRB....................................  institutional review board
ISBER..................................  International Society for
                                          Biological and Environmental
                                          Repositories
MTA....................................  Material Transfer Agreement
NBN....................................  National Biospecimen Network
NCAB...................................  National Cancer Advisory Board
NCI....................................  National Cancer Institute
OBBR...................................  Office of Biorepositories and
                                          Biospecimen Research (at the
                                          NCI)
OHRP...................................  Office for Human Research
                                          Protections
OSHA...................................  Occupational Safety and Health
                                          Administration
PI.....................................  packaging instruction
QA.....................................  quality assurance
QC.....................................  quality control
QMS....................................  quality management system
SLA....................................  Simple Letter of Agreement
SOPs...................................  standard operating procedures
UBMTA..................................  Uniform Biological Material
                                          Transfer Agreement
 

NCI Glossary of Terms for Purposes of These Guidelines

    Accident. Any occurrence that deviates from SOPs or applicable 
government laws and regulations during specimen retrieval, 
processing, labeling, storage, or distribution that may affect 
subsequent use of those specimens (ISBER 2005).
    Adverse outcome. An undesirable effect or untoward complication 
consequent to or reasonably related to specimen integrity (ISBER 
2005).
    Aliquot. A portion of a specimen that has been divided into 
separate, smaller parts, usually liquid, which are typically stored 
in separate containers as individual samples. The term aliquot may 
also be used as a noun to denote a single sample (ISBER 2005).
    Annotation. Explanatory or extra information associated with a 
particular biospecimen. Annotations may be added by either the 
pathologist or the resource collector.
    Audit. A documented review of procedures, records, personnel 
functions, equipment materials, facilities, and/or vendors to 
evaluate adherence to written SOPs or government laws and 
regulations (ISBER 2005).
    Bioinformatics. Research, development, or application of 
computational tools and approaches for expanding the use of 
biological, medical, behavioral, or health data, including those to 
acquire, store, organize, archive, analyze, or visualize such data 
(as defined by the NIH Biomedical Information Science and Technology 
Initiative Consortium (http://www.bisti.nih.gov/CompuBioDef.pdf) 
(Eiseman et al. 2003)).
    Biorepository. A place, room, or container where biospecimens 
are stored. Biorepositories vary considerably, ranging from formal 
organizations to informal collections of materials in an individual 
researcher's freezer.
    Biorepository informatics system. The software, hardware, 
written documents, support, and training that are necessary to 
annotate, track, and distribute biospecimens within a biorepository 
or biorepositories.
    Biospecimen or specimen. A quantity of tissue, blood, urine, or 
other biologically derived material used for diagnosis and analysis. 
A single biopsy may generate several specimens, including multiple 
paraffin blocks or frozen specimens. A specimen can include 
everything from subcellular structures (DNA) to cells, tissue (bone, 
muscle, connective tissue, and skin), organs (e.g., liver, bladder, 
heart, kidney), blood, gametes (sperm and ova), embryos, fetal 
tissue, and waste (urine, feces, sweat, hair and nail clippings, 
shed epithelial cells, and placenta).
    caBIG (cancer Biomedical Informatics Grid). A voluntary network 
or grid connecting individuals and institutions to enable the 
sharing of data and tools, creating a World Wide Web of cancer 
research. The goal of this project is to speed the delivery of 
innovative approaches for the prevention and treatment of cancer. 
caBIG is being developed under the leadership of the NCI Center for 
Bioinformatics. Nearly 500 people from approximately 50 NCI-
designated Cancer Centers and other organizations are working 
collaboratively on over 70 projects in a 3-year pilot project. For 
more information on caBIG, visit http://cabig.nci.nih.gov.
    caDSR (cancer Data Standards Repository). The standards 
repository that hosts CDEs developed by various NCI-sponsored

[[Page 25201]]

organizations. caDSR components are instrumental in the collection 
of metadata associated with clinical trials. caDSR tools facilitate 
the search and retrieval of CDEs and caDSR is the single, 
authoritative source of common data.
    caTIES (cancer Text Information Extraction System). A project 
that will focus on two important challenges of biomedical 
informatics; namely, information extraction from free text and 
access to tissue. Specifically, caTIES has three primary goals: (1) 
Extract coded information from free-text surgical pathology reports 
using controlled terminologies to populate caBIG-compliant data 
structures, (2) provide researchers with the ability to query, 
browse, and acquire annotated tissue data and physical material 
across a network of federated sources, and (3) pioneer research for 
distributed text information extraction within the context of caBIG. 
caTIES modules will be developed as generalized components available 
on the caBIG, in order to facilitate reuse by other caBIG projects 
requiring tissue information extraction.
    caTISSUE. A modular, open-source specimen inventory and tracking 
system that will encompass a core database module for those Centers 
in need of new solutions, as well as application programming 
interfaces (APIs), software development toolkits (SDKs), and 
additional annotation modules for those centers with legacy systems 
that wish to link into the virtual tissue repositories and query 
across Cancer Centers. The caBIG Tissue Banks and Pathology Tools 
Workspace (TBPTW) is responsible for the release of caTISSUE.
    Clinical data. Data pertaining to or founded on actual 
observation and treatment of patients.
    Clinical trial research. Research studies that evaluate new 
interventions, drugs, or medical therapies given to human research 
participants in strictly scientifically controlled settings. The 
purpose of such trials is to determine whether one or more 
screening, prevention, and/or treatment options are safe, effective, 
and better than current standard care.
    Code of Federal Regulations (CFR). The Code of Federal 
Regulations is a publication that codifies the general and permanent 
rules published in the Federal Register by the executive departments 
and agencies of the Federal Government. It is published by the 
Office of the Federal Register, National Archives and Records 
Administration, Washington, DC (ISBER 2003).
    Coded samples. Sometimes termed ``linked'' or ``identifiable,'' 
these samples are supplied by biorepositories to investigators from 
identified specimens with a code rather than with personally 
identifying information, such as a name or Social Security number.
    Collection. See Retrieval.
    Common Data Elements (CDEs). CDEs standardize metadata between a 
series of software systems. Such standardization ensures that the 
same meaning of words is used and that data model and application 
components are reusable. In addition, it eases the integration of 
systems.
    Confidentiality. A principle emergent from a relationship in 
which something about an individual, information, or material has 
been shared (with some degree of loss of privacy) in confidence (NBN 
Blueprint 2003).
    Container. Enclosure for one unit or units of specimen(s) (ISBER 
2005).
    Cooperative Human Tissue Network (CHTN). A six-division, 
decentralized, NCI-funded, infrastructure that provides biomedical 
researchers with access to human tissue. Established in response to 
a Request for Applications in 1987, the CHTN has provided more than 
500,000 high-quality tissue biospecimens from a variety of organs to 
more than 1,000 investigators for the conduct of basic and 
developmental cancer research. Eighty percent of these researchers 
are from academic or government institutions; only 20 percent of 
users are from industry.
    Cryoprotectant. An additive that serves to minimize osmotic 
imbalances that occur with the progression of freezing fronts 
through a substance and is intended to limit the amount of cell 
damage due to cell shrinkage and intracellular ice formation (ISBER 
2005).
    Custodianship. Relates to the caretaking responsibility for the 
specimen collection, including management and documentation, as well 
as rights to determine the conditions under which the specimens are 
accessed and used.
    Data. Values derived from scientific experiments or diagnostic 
procedures organized especially for scientific analysis in a 
numerical form suitable for processing by computer (NBN Blueprint 
2003).
    Data Sharing Policy (NIH Data Sharing Policy). ``NIH believes 
that data sharing is essential for expedited translation of research 
results into knowledge, products, and procedures to improve human 
health. NIH endorses the sharing of final research data to serve 
these and other important scientific goals and expects and supports 
the timely release and sharing of final research data from NIH-
supported studies for use by other researchers. ``Timely release and 
sharing'' is defined as no later than the acceptance for publication 
of the main findings from the final data set. Effective with the 
October 1, 2003 receipt date, investigators submitting an NIH 
application seeking $500,000 or more in direct costs in any single 
budget period are expected to include a plan for data sharing or 
state why data sharing is not possible'' (Grants Policy Statement, 
12/03). The NIH Data Sharing Policy is not itself a requirement to 
share data but rather to have a plan to address sharing of data or 
to state why sharing is not possible. (NIH Grants Policy Statement 
Web site http://grants2.nih.gov/grants/policy/data_sharing/data_sharing_guidance.htm).
    Deidentified protected health information. Health information 
that does not identify an individual and with respect to which there 
is no reasonable basis to believe that the information can be used 
to identify an individual. Such information is not individually 
identifiable health information (45 CFR 164.514(a)-(c)) (Eiseman et 
al. 2003).
    Demographic data. Data relating to statistical characteristics 
of human populations (e.g., age, gender).
    Deviation. An intentional or unintentional event that is a 
departure from a procedure or a normal practice (ISBER 2005).
    Disposition. Final destination of specimens (ISBER 2005).
    Distribution. A process that includes receipt of request for 
specimens, selection of appropriate specimens, and final inspection, 
in conjunction with subsequent shipment and delivery of specimens to 
another biorepository, specimen collection center, or laboratory 
(ISBER 2005).
    Dry ice. Solid-phase carbon dioxide.
    Genomics. The study of genes and their function; the study of 
all or a substantial portion of the genes of an organism as a 
dynamic system, over time, to determine how those genes interact and 
influence biological pathways, networks, and physiology.
    Honest broker. A neutral intermediary between the individual 
whose tissue and data are being studied and the researcher. The 
honest broker collects and collates pertinent information regarding 
the tissue source, replaces identifiers with a code, and releases 
only coded information to the researcher (Eiseman et al. 2003).
    Human subject. A living individual about whom an investigator, 
either professional or student, conducting research obtains (1) Data 
through intervention or interaction with the individual or (2) 
identifiable private information (45 CFR 46.102(f)). A Human subject 
may also be a patient, but is not necessarily one.
    Indemnification. A legal term of art meaning to secure a person 
or entity against hurt, loss, injury, or other damages suffered.
    Informatics. The use of science, computer science, information 
technologies, and other technologies to provide data, information, 
and knowledge to an individual or an organization. The term is 
synonymous with information science. See also biorepository 
informatics system.
    Informatics system. Refers to the software, hardware, written 
documents, support, and training necessary to annotate, track, and 
distribute biospecimens within a biorepository or biorepositories.
    Informed consent. An educational process between the 
investigator and the prospective subject (or the subject's legally 
authorized representative) as a means to ensure respect for persons; 
mutual understanding of research procedures, risks, rights, and 
responsibilities; and continuous voluntary participation (NBN 
Blueprint 2003).
    Institutional review board. A specially constituted review body 
established or designated by an entity to protect the welfare of 
human subjects recruited to participate in biomedical or behavioral 
research.
    Intellectual property. Creative ideas and expressions of the 
human mind that have commercial value and receive the legal 
protection of a property right. The major legal mechanisms for 
protecting intellectual property rights are copyrights, patents, and 
trademarks. Another form of protection for data sets available in 
Europe and most of the industrialized world, except the US, is 
called ``sui generis rights in data.'' Intellectual property rights 
enable owners to deny some parties or persons from access and use of 
the property and thus to protect it from unauthorized use.
    Interoperability. The ability of two or more systems or 
components to exchange

[[Page 25202]]

information and to use the information that has been exchanged.
    Invention. A new and useful process, machine, manufacture or 
composition of matter, or any new and useful improvement, finding, 
or product that advances the state of the art or practice and may be 
patentable.
    Label. Any written, printed, or graphic material on or affixed 
to a specimen container or package (ISBER 2005).
    Liquid nitrogen dry shipper. A container used for sending 
samples in the vapor phase of liquid nitrogen (ISBER 2005).
    Longitudinal data. Clinical data acquired over the course of 
time.
    Material Transfer Agreement (MTA). A binding legal agreement 
between the provider of research materials and the recipient of the 
materials that sets forth conditions of transfer and use, protects 
proprietary interests, and restricts distribution of the material. 
An important aspect of the MTA is that it normally removes liability 
on the part of the provider that might arise from recipient's use of 
the research material.
    Package. A labeled carton, receptacle, or wrapper containing one 
or more containers and accompanying labeling material (ISBER 2005).
    Paraffin-embedded. Tissue that is formalin fixed and then 
embedded in wax. (Note: Other alternative fixation methods may be 
used to fix the tissue.)
    Patent. A property right granted by the Federal Government or a 
Sovereign State to an inventor. In order to be patentable, an 
invention must contain an idea that serves some utility, is novel, 
and is patentable as defined under U.S. Patent Law.
    Patient. A person undergoing medical treatment.
    Preservation. Use of chemical agents, alterations in 
environmental conditions, or other means during processing to 
prevent or retard biological or physical deterioration of a specimen 
(ISBER 2005).
    Prevalence. Number of cases of a disease, infected persons, or 
persons with some other attribute present during a particular 
interval of time.
    Privacy. The state or condition of limited access to an 
individual and/or to information about that individual.
    Procedure. A series of steps designed to result in a specific 
outcome when followed in order (ISBER 2005).
    Process validation studies. The process of demonstrating that a 
specific procedure will consistently produce expected results within 
predetermined specifications (ISBER 2005).
    Processing. Any procedure employed after specimen collection but 
prior to its distribution, including preparation, testing, and 
releasing the specimen to inventory and labeling (ISBER 2005).
    Prospective. When an intervention of interest is performed and 
all relevant information and observations on its effects are 
gathered after entry into the study. By contrast, ``retrospective'' 
studies focus on information that has already been collected.
    Protected health information (PHI). Any health information that 
is collected by a covered entity and is individually identifiable 
(NBN Blueprint 2003). Also, a subset of individually identifiable 
information that can be disclosed only under the following 
conditions: (1) The use or disclosure is sought solely to review PHI 
as necessary to prepare the research protocol or other similar 
preparatory purposes, (2) no PHI is removed from the covered entity 
during review, and (3) the PHI that the researcher seeks to use or 
access is necessary for the research purposes. PHI can be 
deidentified by removing all 18 identifiers listed in section 
164.514(b)(2) of the Federal regulations or by having a qualified 
statistician perform an analysis stating that the risk of the 
information being used is small (ISBER 2005).
    Proteomics. The study of the full set of proteins encoded by a 
genome; the study of the identities, quantities, structures, and 
biochemical and cellular functions of all proteins in an organism, 
organ, or organelle and how these properties vary in space, time, 
and physiological state.
    Quality assurance (QA). An integrated system of management 
activities involving planning, implementation, documentation, 
assessment, and improvement to ensure that a process or item is of 
the type and quality needed for the project. Same as quality 
management system (QMS) (ISBER 2005).
    Quality control (QC). Specific tests defined by the QA or QMS 
Program to be performed to monitor procurement, processing, 
preservation and storage, specimen quality, and test accuracy. These 
may include but are not limited to performance evaluations, testing, 
and controls used to determine accuracy and reliability of the 
biorepository's equipment and operational procedures as well as 
monitoring of the supplies, reagents, equipment, and facilities 
(ISBER 2005).
    Quality management system (QMS). Same as Quality assurance (QA) 
(ISBER 2005).
    Quality. Conformance of a specimen or process with 
preestablished specifications or standards (ISBER 2005).
    Reach-through provisions. Material transfer agreements do not 
usually require financial payments at the time of the transfer, but 
many allow the provider to either own, or license exclusively, or 
obtain payments upon the sale of, developments that the recipient 
makes with the provider's materials. These are loosely termed 
``reach-through'' provisions and are considered by many providers to 
be desirable because they allow the provider to obtain rights in 
subject matter to which the provider would not otherwise have rights 
through its ownership or patent coverage of the material alone. 
Reach-through provisions are considered undesirable by many 
recipients because they burden all the developments created after 
the use of the material and because they are seen as providing an 
unfairly high level of compensation to the provider for use of the 
material.
    Repository. See Biorepository, above.
    Research. Systematic investigation, including research 
development, testing, and evaluation, designed to develop or 
contribute to generalizable knowledge.
    Retrieval. The removal, acquisition, recovery, harvesting, or 
collection of specimens (ISBER 2005).
    Safety. Processes, procedures, and technologies to ensure 
freedom from danger or harm.
    Sample. Portions of specimens distributed to researchers 
(Eiseman et al. 2003).
    Semantics. Refers to the ways that information in a data file 
should be interpreted by others.
    Shipping manifest. A written description of the contents of the 
shipped package (ISBER 2005).
    Simple Letter of Agreement. A short form of a standard material 
transfer agreement.
    Specimen. A portion of tissue, blood, urine, or other material 
used for diagnosis and analysis. A single biopsy may generate 
several specimens, including a number of slides, paraffin blocks, 
and/or frozen specimens. See Biospecimen.
    Standard operating procedures (SOPs) manual. A group of standard 
operating procedures detailing the specific policies of a 
biorepository and the procedures used by the staff/personnel (ISBER 
2005).
    Storage. Maintenance of specimens for future use.
    Tissue. Refers generally to a biologic collection of cells, and 
the extracellular matrix and/or intercellular substances surrounding 
them. Tissue is most often referred to in the context of solid 
tissue, as originating from a solid organ; however, tissue can also 
be defined broadly to include collections of cells and intercellular 
substances from bodily fluids such as blood.
    Tissue Banks and Pathology Tools Workspace (TBPTW). As one of 
three caBIG pilot domain workspaces, the goal of the TBPTW is to 
develop a set of tools to inventory, track, mine, and visualize 
tissue samples and related information from a geographically 
dispersed biorepository. This Workspace provides an opportunity to 
bind Cancer Center systems together into a unified resource through 
a shared informatics infrastructure. Cancer Centers with experience 
in successfully developing tools in this domain are acting as 
developers, while other Centers are included as testing and 
validation sites. Cancer Centers that have expressed an interest in 
sharing information regarding specimen repositories and data sets 
are participating as early test sites, providing an opportunity to 
demonstrate how the tools perform in actual practice.
    Translational research. The process of applying ideas, insights, 
and discoveries generated through basic scientific inquiry to the 
prevention or treatment of human disease.
    Uniform Biological Material Transfer Agreement (UBMTA). A 
standardized material transfer agreement with generic language for 
biological material transfers. It was created to increase the 
efficiency of the process by decreasing delays in research progress 
during negotiation of material transfer agreements, while providing 
uniform protection for biological materials. The National Institutes 
of Health published the Uniform Biological Material Transfer 
Agreement in 1995 and recommends its use by all public and nonprofit 
research institutions. The Association of University Technology 
Managers (AUTM) administers the process of becoming a signatory to 
the

[[Page 25203]]

Master Agreement. See http://www.autm.net/aboutTT/aboutTT_umbta.cfm.
    Use case. A description of the process used to perform a 
particular modeling task on a particular model. It is a user-
centered description of the activities performed by a user to 
accomplish a particular goal. The collected use cases specify all 
the ways the system can be used.

    Dated: April 10, 2006.
John Niederhuber,
Deputy Director, Translational and Clinical Sciences.

[FR Doc. 06-3997 Filed 4-27-06; 8:45 am]
BILLING CODE 4140-01-P