Su Chang, Olsen Kelly A, Bond Catherine E, Whitehall Vicki L J
Conjoint Gastroenterology Laboratory, QIMR Berghofer Medical Research Institute, Herston 4006, Australia.
Faculty of Medicine, The University of Queensland, Herston 4006, Australia.
Cancers (Basel). 2023 Jan 28;15(3):805. doi: 10.3390/cancers15030805.
Colorectal cancer is an important cause of morbidity and mortality worldwide. The current treatment landscape includes chemotherapy, targeted therapy, immunotherapy, radiotherapy, and surgery. A key challenge to improving patient outcomes is the significant inter-patient heterogeneity in treatment response. Tumour organoids derived from the patients' tumours via surgically resected or endoscopically biopsied tissue, have emerged as promising models for personalised medicine. This review synthesises the findings, to date, of studies which have explored the efficacy of ex vivo organoid sensitivity testing for predicting treatment response. Most studies have focused on predicting the response to standard-of-care radiotherapy and chemotherapy options. There is strong evidence to support organoid sensitivity testing of ionising radiation, 5-fluorouracil, and irinotecan, and to a lesser extent, oxaliplatin and TAS-102. Fewer studies have used organoids to identify patients who are likely to benefit from novel treatment options that otherwise remain in clinical trials. This review also summarises recent advancements in organoid culture to include non-epithelial components of the tumour microenvironment, to allow testing of immunotherapy and certain targeted therapy options. Overall, further prospective trials will support the implementation of organoid-based personalised medicine for colorectal cancer patients in the future.
结直肠癌是全球发病和死亡的重要原因。当前的治疗方式包括化疗、靶向治疗、免疫治疗、放疗和手术。改善患者治疗效果的一个关键挑战是患者间治疗反应存在显著异质性。通过手术切除或内镜活检组织从患者肿瘤中获取的肿瘤类器官，已成为个性化医疗的有前景的模型。这篇综述总结了迄今为止探索体外类器官敏感性测试预测治疗反应疗效的研究结果。大多数研究集中于预测对标准护理放疗和化疗方案的反应。有强有力的证据支持对电离辐射、5-氟尿嘧啶和伊立替康进行类器官敏感性测试，对奥沙利铂和TAS-102的支持力度较小。较少有研究使用类器官来识别可能从仍处于临床试验阶段的新型治疗方案中获益的患者。这篇综述还总结了类器官培养的最新进展，包括肿瘤微环境的非上皮成分，以允许对免疫治疗和某些靶向治疗方案进行测试。总体而言，进一步的前瞻性试验将支持未来为结直肠癌患者实施基于类器官的个性化医疗。
