Seppälä, Toni T, Zimmerman, Jacquelyn W, Sereni, Elisabetta, Plenker, Dennis, Suri, Reecha, Rozich, Noah, Blair, Alex, Thomas, Dwayne L, Teinor, Jonathan, Javed, Ammar, Patel, Hardik, Cameron, John L, Burns, William R, He, Jin, Tuveson, David A, Jaffee, Elizabeth M, Eshleman, James, Szabolcs, Annamaria, Ryan, David P, Ting, David T, Wolfgang, Christopher L, Burkhart, Richard A (September 2020) Patient-derived Organoid Pharmacotyping is a Clinically Tractable Strategy for Precision Medicine in Pancreatic Cancer. Annals of Surgery, 272 (3). pp. 427-435. ISSN 0003-4932
Abstract
OBJECTIVE: PDAC patients who undergo surgical resection and receive effective chemotherapy have the best chance of long-term survival. Unfortunately, we lack predictive biomarkers to guide optimal systemic treatment. Ex-vivo generation of PDO for pharmacotyping may serve as predictive biomarkers in PDAC. The goal of the current study was to demonstrate the clinical feasibility of a PDO-guided precision medicine framework of care. METHODS: PDO cultures were established from surgical specimens and endoscopic biopsies, expanded in Matrigel, and used for high-throughput drug testing (pharmacotyping). Efficacy of standard-of-care chemotherapeutics was assessed by measuring cell viability after drug exposure. RESULTS: A framework for rapid pharmacotyping of PDOs was established across a multi-institutional consortium of academic medical centers. Specimens obtained remotely and shipped to a central biorepository maintain viability and allowed generation of PDOs with 77% success. Early cultures maintain the clonal heterogeneity seen in PDAC with similar phenotypes (cystic-solid). Late cultures exhibit a dominant clone with a pharmacotyping profile similar to early passages. The biomass required for accurate pharmacotyping can be minimized by leveraging a high-throughput technology. Twenty-nine cultures were pharmacotyped to derive a population distribution of chemotherapeutic sensitivity at our center. Pharmacotyping rapidly-expanded PDOs was completed in a median of 48 (range 18-102) days. CONCLUSIONS: Rapid development of PDOs from patients undergoing surgery for PDAC is eminently feasible within the perioperative recovery period, enabling the potential for pharmacotyping to guide postoperative adjuvant chemotherapeutic selection. Studies validating PDOs as a promising predictive biomarker are ongoing.
| Item Type: | Paper |
|---|---|
| Subjects: | diseases & disorders > cancer diseases & disorders Investigative techniques and equipment diseases & disorders > neoplasms Investigative techniques and equipment > cell culture > cancer organoids Investigative techniques and equipment > cell culture diseases & disorders > cancer > drugs and therapies > chemotherapy diseases & disorders > cancer > drugs and therapies diseases & disorders > cancer > cancer types > pancreatic cancer diseases & disorders > cancer > drugs and therapies > precision medicine |
| CSHL Authors: | |
| Communities: | CSHL labs > Tuveson lab CSHL Cancer Center Program > Cellular Communication in Cancer Program |
| SWORD Depositor: | CSHL Elements |
| Depositing User: | CSHL Elements |
| Date: | 1 September 2020 |
| Date Deposited: | 25 May 2021 20:51 |
| Last Modified: | 01 Feb 2024 18:25 |
| PMCID: | PMC7901605 |
| URI: | https://repository.cshl.edu/id/eprint/40162 |
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