Department of General Surgery, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Cancer, Nanfang Hospital Guangzhou, Guangdong, People's Republic of China.
Dis Colon Rectum. 2023 May 1;66(5):733-743. doi: 10.1097/DCR.0000000000002511. Epub 2023 Mar 9.
Recent studies have shown patient-derived tumor organoids can predict the drug response of patients with cancer. However, the prognostic value of patient-derived tumor organoid-based drug tests in predicting the progression-free survival of patients with stage IV colorectal cancer after surgery remains unknown.
This study aimed to explore the prognostic value of patient-derived tumor organoid-based drug tests in patients with stage IV colorectal cancer after surgery.
Retrospective cohort study.
Surgical samples were obtained from patients with stage IV colorectal cancer at the Nanfang Hospital.
A total of 108 patients who underwent surgery with successful patient-derived tumor organoid culture and drug testing were recruited between June 2018 and June 2019.
Patient-derived tumor organoid culture and chemotherapeutic drug testing.
Progression-free survival.
According to the patient-derived tumor organoid-based drug test, 38 patients were drug sensitive and 76 patients were drug resistant. The median progression-free survival was 16.0 months in the drug-sensitive group and 9.0 months in the drug resistant group ( p < 0.001). Multivariate analyses showed that drug resistance (HR, 3.38; 95% CI, 1.84-6.21; p < 0.001), right-sided colon (HR, 3.50; 95% CI, 1.71-7.15; p < 0.001), mucinous adenocarcinoma (HR, 2.47; 95% CI, 1.34-4.55; p = 0.004), and non-R0 resection (HR, 2.70; 95% CI, 1.61-4.54; p < 0.001) were independent predictors of progression-free survival. The new patient-derived tumor organoid-based drug test model, which includes the patient-derived tumor organoid-based drug test, primary tumor location, histological type, and R0 resection, was more accurate than the traditional clinicopathological model in predicting progression-free survival ( p = 0.001).
A single-center cohort study.
Patient-derived tumor organoids can predict progression-free survival in patients with stage IV colorectal cancer after surgery. Patient-derived tumor organoid drug resistance is associated with shorter progression-free survival, and the addition of patient-derived tumor organoid drug tests to existing clinicopathological models improves the ability to predict progression-free survival.
最近的研究表明，患者来源的肿瘤类器官可以预测癌症患者的药物反应。然而，患者来源的肿瘤类器官药物测试在预测手术后 IV 期结直肠癌患者无进展生存期方面的预后价值尚不清楚。
本研究旨在探讨患者来源的肿瘤类器官药物测试在手术后 IV 期结直肠癌患者中的预后价值。
回顾性队列研究。
南方医院外科手术样本取自 IV 期结直肠癌患者。
共招募了 2018 年 6 月至 2019 年 6 月间接受成功培养和药物测试的患者源性肿瘤类器官的 108 例患者。
患者源性肿瘤类器官培养和化疗药物测试。
无进展生存期。
根据患者来源的肿瘤类器官药物测试，38 例患者对药物敏感，76 例患者对药物耐药。药物敏感组的中位无进展生存期为 16.0 个月，药物耐药组为 9.0 个月（p<0.001）。多因素分析显示，药物耐药（HR，3.38；95%CI，1.84-6.21；p<0.001）、右半结肠癌（HR，3.50；95%CI，1.71-7.15；p<0.001）、黏液腺癌（HR，2.47；95%CI，1.34-4.55；p=0.004）和非 R0 切除（HR，2.70；95%CI，1.61-4.54；p<0.001）是无进展生存期的独立预测因素。新的患者源性肿瘤类器官药物测试模型，包括患者源性肿瘤类器官药物测试、原发肿瘤位置、组织学类型和 R0 切除，在预测无进展生存期方面比传统的临床病理模型更准确（p=0.001）。
单中心队列研究。
患者来源的肿瘤类器官可以预测手术后 IV 期结直肠癌患者的无进展生存期。患者源性肿瘤类器官耐药与无进展生存期缩短相关，将患者源性肿瘤类器官药物测试加入现有的临床病理模型可提高预测无进展生存期的能力。
