Stratifying esophago-gastric cancer treatment using a patient-derived organoid-based threshold

Background and aims: This study sought to determine the value of patient-derived organoids (PDOs) from esophago-gastric adenocarcinoma (EGC) for response prediction to neoadjuvant chemotherapy (neoCTx).Methods: Endoscopic biopsies of patients with locally advanced EGC (n = 120) were taken into cultu...

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Hauptverfasser: Schmäche, Tim (VerfasserIn) , Fohgrub, Juliane (VerfasserIn) , Klimova, Anna (VerfasserIn) , Laaber, Karin (VerfasserIn) , Drukewitz, Stephan (VerfasserIn) , Merboth, Felix (VerfasserIn) , Hennig, Alexander (VerfasserIn) , Seidlitz, Therese (VerfasserIn) , Herbst, Friederike (VerfasserIn) , Baenke, Franziska (VerfasserIn) , Ada, Anne-Marlen (VerfasserIn) , Groß, Thomas (VerfasserIn) , Wenzel, Carina (VerfasserIn) , Ball, Claudia R. (VerfasserIn) , Praetorius, Christian (VerfasserIn) , Schmidt, Thomas (VerfasserIn) , Ringelband-Schilling, Barbara (VerfasserIn) , Koschny, Ronald (VerfasserIn) , Stenzinger, Albrecht (VerfasserIn) , Roeder, Ingo (VerfasserIn) , Jäger, Dirk (VerfasserIn) , Zeißig, Sebastian (VerfasserIn) , Welsch, Thilo (VerfasserIn) , Aust, Daniela E. (VerfasserIn) , Glimm, Hanno (VerfasserIn) , Folprecht, Gunnar (VerfasserIn) , Weitz, Jürgen (VerfasserIn) , Haag, Georg Martin (VerfasserIn) , Stange, Daniel Eduard (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 10 January 2024
In: Molecular cancer
Year: 2024, Jahrgang: 23, Pages: 1-8
ISSN:1476-4598
DOI:10.1186/s12943-023-01919-3
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1186/s12943-023-01919-3
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Verfasserangaben:Tim Schmäche, Juliane Fohgrub, Anna Klimova, Karin Laaber, Stephan Drukewitz, Felix Merboth, Alexander Hennig, Therese Seidlitz, Friederike Herbst, Franziska Baenke, Anne-Marlen Ada, Thomas Groß, Carina Wenzel, Claudia R. Ball, Christian Praetorius, Thomas Schmidt, Barbara Ringelband-Schilling, Ronald Koschny, Albrecht Stenzinger, Ingo Roeder, Dirk Jaeger, Sebastian Zeissig, Thilo Welsch, Daniela Aust, Hanno Glimm, Gunnar Folprecht, Jürgen Weitz, Georg M. Haag and Daniel E. Stange

MARC

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520 |a Background and aims: This study sought to determine the value of patient-derived organoids (PDOs) from esophago-gastric adenocarcinoma (EGC) for response prediction to neoadjuvant chemotherapy (neoCTx).Methods: Endoscopic biopsies of patients with locally advanced EGC (n = 120) were taken into culture and PDOs expanded. PDOs' response towards the single substances of the FLOT regimen and the combination treatment were correlated to patients' pathological response using tumor regression grading. A classifier based on FLOT response of PDOs was established in an exploratory cohort (n = 13) and subsequently confirmed in an independent validation cohort (n = 13). Results: EGC PDOs reflected patients' diverse responses to single chemotherapeutics and the combination regimen FLOT. In the exploratory cohort, PDOs response to single 5-FU and FLOT combination treatment correlated with the patients' pathological response (5-FU: Kendall's τ = 0.411, P = 0.001; FLOT: Kendall's τ = 0.694, P = 2.541e-08). For FLOT testing, a high diagnostic precision in receiver operating characteristic (ROC) analysis was reached with an AUCROC of 0.994 (CI 0.980 to 1.000). The discriminative ability of PDO-based FLOT testing allowed the definition of a threshold, which classified in an independent validation cohort FLOT responders from non-responders with high sensitivity (90%), specificity (100%) and accuracy (92%). Conclusion: In vitro drug testing of EGC PDOs has a high predictive accuracy in classifying patients' histological response to neoadjuvant FLOT treatment. Taking into account the high rate of successful PDO expansion from biopsies, the definition of a threshold that allows treatment stratification paves the way for an interventional trial exploring PDO-guided treatment of EGC patients. 
650 4 |a Gastric cancer 
650 4 |a Patient-derived organoids 
650 4 |a Personalized medicine 
650 4 |a Response prediction 
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