Tumor organoids accurately predict bowel cancer drug response

Researchers have grown tumors in the lab to accurately predict which drugs will work for people with bowel cancer—before they begin treatment.

The world-first study led by WEHI (based in Melbourne, Australia) found drug testing on tumor organoids—3D cancer models grown from a patient’s own tissue—could show how they will respond to a specific cancer treatment.

A clinical trial is now being developed based on the results, which will be the first to validate organoid drug testing as an accurate way to guide treatment selection for people living with bowel cancer—the second-deadliest cancer in Australia.

The study, “Unified framework for patient-derived tumor organoid-based predictive testing of standard-of-care therapies in metastatic colorectal cancer,” is published in the journal Cell Reports Medicine.

Bowel cancer, also known as colorectal cancer, remains the second leading cause of cancer-related deaths worldwide. It is also the fourth most diagnosed cancer in Australia.

While bowel cancer cases can be treated successfully if found early, less than half of all patients are diagnosed at the initial stages due to a lack of symptoms. This means that patients are often diagnosed once the cancer has spread to other parts of the body.

Despite an increasing number of treatment options available to treat bowel cancer, there currently is a limited ability to predict which therapy will be most effective for each patient.

A tumor organoid is a miniature 3D model of a cancer that is the size of a grain of sand. Grown in a laboratory from a patient’s own tissue sample, tumor organoids mimic the characteristics of the cancer from which they were created, including sensitivity to drug treatment.

A researcher holding a tray containing lab-grown organoids, which are the size of a grain of sand.Credit: WEHI

In their study, WEHI researchers showed the technology can identify the most effective treatment for individual bowel cancer patients, by assessing how their organoids responded to specific drugs.

Co-lead researcher and medical oncologist, Professor Peter Gibbs, said the finding could end the current trial-and-error process that goes into selecting a cancer treatment for patients and improve their quality of life.

“Each time you give a patient an ineffective treatment, you lose 2–3 months on something that won’t work,” Prof Gibbs, also a WEHI Laboratory Head, said.

The window for successful treatment is often limited, so it is vital that we choose the options with the highest chance of success and avoid other treatments that are unlikely to work.”

“Our findings show that organoid drug testing is a potential game-changer for cancer treatment, suggesting the possibility of revolutionizing personalized medicine and clinician-patient care through improved treatment selection.”

As hundreds of organoids can be grown from one patient tissue sample, it is possible to test a wide range of different therapy options in the laboratory.

“Many patients with advanced bowel cancer only get one or two chances at treatment. Knowing what is most likely to work before they start treatment would make a significant difference to their survival outcomes and quality of life,” Prof Gibbs said.

Source: Walter and Eliza Hall Institute

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