?Background:
Biobanks are essential infrastructures for advancing precision oncology by providing access to high-quality biospecimens linked to clinical and demographic data. However, large-scale biobanking initiatives are largely concentrated in high-income countries, resulting in limited ancestral and geographic representation in cancer genomics. As a middle-income country with one of the world’s most highly admixed populations, Brazil has a strategic role in reducing global inequities in oncology research. The Barretos Cancer Hospital (BCH), or Hospital de Amor, is one of the largest cancer centers in Brazil, serving only patients from the public health system (SUS) and focusing on populations in remote and underserved regions. BCH has established a biobank network to support further biomedical research and to address gaps in representation among underrepresented Brazilian populations.
Objectives:
To describe the development, geographic coverage, tumor heterogeneity, and ancestry composition of the Barretos Cancer Hospital Biobank Network, and to demonstrate its contribution to capacity-building and diversity inclusion in translational oncology research within a low- and middle-income country context.
Methods:
We conducted a descriptive longitudinal analysis of donors and biospecimens collected between 2006 and 2025 by the BCH Biobank Network. Standardized protocols for biospecimen collection, processing, storage, and data governance were implemented across participating sites. Clinical characteristics, tumor types, biospecimen categories, geographic origin, and self-reported ancestry were analyzed using descriptive statistics.
Results:
The network currently comprises three fully operational biobanks (two in São Paulo State, at Barretos and Jales city; and Porto Velho in Rondônia State- Occidental Amazonia) and three in implementation (Campo Grande, Mato Grosso do Sul; Macapá, Amapá - far North of Brazil-, and Arapiraca, Alagoas), expanding coverage to historically under-resourced regions. More than 55,997 donors have been enrolled, and more than 430,020 biospecimens have been archived, including blood-derived samples, fresh-frozen tumor tissues, and bodily fluids. Donors predominantly originated from the Southeast (75.4%), followed by the Central-West (15.8%), North (6.5%), Northeast (1.5%), and South (0.7%), reflecting progressive geographic expansion. The most prevalent adult tumors were breast, colorectal, uterine, lung, and prostate cancers, while pediatric collections were dominated by bone/soft-tissue tumors, hematologic malignancies, and central nervous system tumors. Self-reported ancestry revealed substantial admixture, with marked regional variation and greater diversity observed in pediatric cohorts. The network has supported participation in major international genomic consortia, including TCGA, ICGC, US-LACRN, and Mutographs.
Conclusions/Implications:
The BCH Biobank Network represents the most comprehensive oncology biobanking initiative in Latin America, integrating geographic, ancestral, and disease diversity within a unified national framework. This model strengthens equity in precision oncology, enhances the relevance of biomarker discovery for admixed populations, and promotes meaningful inclusion of low- and middle-income countries in global cancer research.