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Type: Journal article
Title: Medium-throughput drug screening of patient-derived organoids from colorectal peritoneal metastases to direct personalized therapy
Author: Narasimhan, V.
Wright, J.A.
Churchill, M.
Wang, T.
Rosati, R.
Lannagan, T.R.
Richardson, A.B.
Kobayashi, H.
Price, T.
Tye, G.X.
Marker, J.
Hewett, P.J.
Flood, M.P.
Pereira, S.
Whitney, G.A.
Michael, M.
Tie, J.
Mukherjee, S.
Grandori, C.
Heriot, A.G.
et al.
Citation: Clinical Cancer Research, 2020; 26(14):1-26
Publisher: American Association for Cancer Research
Issue Date: 2020
ISSN: 1078-0432
Statement of
Vignesh Narasimhan, Josephine A Wright, Michael Churchill, Tongtong Wang, Rachele Rosati, Tamsin RM Lannagan ... et al.
Abstract: PURPOSE: Colorectal cancer (CRC) patients with peritoneal metastases (CRPM) have limited treatment options and the lowest CRC survival rates. We aimed to determine whether organoid testing could help guide precision treatment for CRPM patients, as the clinical utility of prospective, functional drug screening including non-standard agents is unknown. EXPERIMENTAL DESIGN: CRPM organoids (peritonoids) isolated from patients underwent parallel next-generation sequencing and medium-throughput drug panel testing ex vivo to identify specific drug sensitivities for each patient. We measured the utility of such a service including: success of peritonoid generation, time to cultivate peritonoids, reproducibility of the medium-throughput drug testing, and documented changes to clinical therapy as a result of the testing. RESULTS: Peritonoids were successfully generated and validated from 68% (19/28) of patients undergoing standard care. Genomic and drug profiling was completed within 8 weeks and a formal report ranking drug sensitivities was provided to the medical oncology team upon failure of standard care treatment. This resulted in a treatment change for 2 patients, one of whom had a partial response despite previously progressing on multiple rounds of standard care chemotherapy. The barrier to implementing this technology in Australia is the need for drug access and funding for off-label indications. CONCLUSIONS: Our approach is feasible, reproducible and can guide novel therapeutic choices in this poor prognosis cohort, where new treatment options are urgently needed. This platform is relevant to many solid organ malignancies.
Keywords: Organoids; precision medicine; colorectal cancer; drug screening; genomics
Rights: Copyright 2020 American Association for Cancer Research
DOI: 10.1158/1078-0432.CCR-20-0073
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