An original donor-dependent spheroid system for the prediction of idiosyncratic drug-induced liver injury risk.

One major drawback of preclinical models to test drug-induced liver injury (DILI) is their inability to predict the interindividual difference of DILI effect in a population. Consequently, a high number of molecules that passed preclinical phases, fail clinical trials, and many FDA-approved drugs were removed from the market due to idiosyncratic DILI. We use a proprietary-depleted human serum-based cell educating technology to generate donor-dependent spheroids with distinct morphology and functionality. We demonstrate that educated spheroids could capture the large variations in susceptibility to drug-induced liver injury between donors. We show that the model could predict clinical apparent DILI risk with a high specificity and sensitivity. We provide evidence that the model could address non-genetic factor-associated DILI risk and severity such as age or sex. Our study supports the benefit of using donor-dependent educated spheroids for hepatotoxicity evaluation in preclinical phase or in an exploratory study clinical trial phase 2 to provide a robust safety profile to a drug.