This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Patient‐derived organoid models help define personalized management of gastrointestinal cancer. BJS 2018; 105: e48-e60.
Published: 17th January 2018
Authors: M. R. Aberle, R. A. Burkhart, H. Tiriac, S. W. M. Olde Damink, C. H. C. Dejong, D. A. Tuveson et al.
Background
The prognosis of patients with different gastrointestinal cancers varies widely. Despite advances in treatment strategies, such as extensive resections and the addition of new drugs to chemotherapy regimens, conventional treatment strategies have failed to improve survival for many tumours. Although promising, the clinical application of molecularly guided personalized treatment has proven to be challenging. This narrative review focuses on the personalization of cancer therapy using patient‐derived three‐dimensional ‘organoid’ models.
Method
A PubMed search was conducted to identify relevant articles. An overview of the literature and published protocols is presented, and the implications of these models for patients with cancer, surgeons and oncologists are explained.
Results
Organoid culture methods have been established for healthy and diseased tissues from oesophagus, stomach, intestine, pancreas, bile duct and liver. Because organoids can be generated with high efficiency and speed from fine‐needle aspirations, biopsies or resection specimens, they can serve as a personal cancer model. Personalized treatment could become a more standard practice by using these cell cultures for extensive molecular diagnosis and drug screening. Drug sensitivity assays can give a clinically actionable sensitivity profile of a patient's tumour. However, the predictive capability of organoid drug screening has not been evaluated in prospective clinical trials.
Conclusion
High‐throughput drug screening on organoids, combined with next‐generation sequencing, proteomic analysis and other state‐of‐the‐art molecular diagnostic methods, can shape cancer treatment to become more effective with fewer side‐effects.
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