If you have been asked to provide a tissue sample as part of a clinical trial, you may have questions about why it is needed, what the procedure involves, and what happens to your tissue afterwards. This guide answers those questions in plain language.
A biopsy is a procedure to remove a small sample of tissue from your body so it can be examined in a laboratory. Biopsies are used both in routine clinical care (for example, to confirm a cancer diagnosis) and in research (to understand more about how a cancer behaves or responds to treatment).
In clinical trials, biopsies may be required before treatment starts (to confirm your cancer has certain features), during treatment (to see how the cancer is responding), or after treatment (to understand what has changed). Not all trials require biopsies — your Patient Information Sheet will specify exactly what tissue collection is involved.
Core needle biopsy: A needle is inserted into the tumour or lymph node and a small cylinder of tissue (a "core") is removed. This is usually done under local anaesthetic and takes around 20–30 minutes. It is the most common type of biopsy used in solid tumour research.
Fine needle aspiration (FNA): A very thin needle removes individual cells or small clusters. It is less invasive than a core biopsy but gives less tissue to work with.
Bone marrow biopsy: Used in blood cancers, this involves removing a small sample of bone marrow — usually from the back of the hip bone — under local anaesthetic. It is often uncomfortable during the procedure but the discomfort passes quickly.
Liquid biopsy: A blood test that looks for fragments of tumour DNA circulating in the bloodstream. This is non-invasive and increasingly used alongside or instead of tissue biopsies in some research settings.
Archival tissue: Sometimes the research team asks to use a sample taken at a previous biopsy or surgery — tissue stored in the hospital's pathology department, usually in a wax block. This does not involve any new procedure.
Important: A research biopsy is done specifically for the trial — it is separate from any biopsy done for your clinical care. Whether or not you provide a research biopsy does not affect the quality of care you receive. In most cases, if you decline an optional research biopsy, you can still participate in the main trial.
Tumour tissue contains the genetic and molecular information that tells researchers why some cancers respond to a treatment while others don't, and what changes over time. Without access to real tumour tissue, it is very difficult to answer these questions — and impossible to develop better, more targeted treatments.
Specific things researchers learn from tissue include:
After collection, your tissue sample is processed and stored — either as a fresh-frozen specimen (kept at very low temperature) or fixed in a wax block (FFPE). It is labelled with a code, not your name, to protect your privacy. The sample will be sent to a central research laboratory, either at the hospital or at an external facility specified in the trial protocol.
Your tissue will only be used for the purposes described in the consent form. You will be asked to give separate consent for any future use of your tissue beyond the current trial — you cannot be assumed to consent to this automatically.
You have the right to withdraw consent for future use of your tissue at any time. Withdrawing does not usually mean the tissue already analysed is destroyed — because those results will already be part of the trial database — but it does mean your tissue cannot be used for any future research you have not agreed to. If you have questions about this, ask the research team before you consent.
For more information about participating in one of our trials, visit our patient information page or contact our research team.
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