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molecular characteristics of the original tissue, effectively cause of cancer-related death. The main reason for the
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demonstrating typical breast tissue. These PDOs have poor prognosis of gastrointestinal cancer is that the early
3D-ordered structure, and large amount of cell debris symptoms of the tumor are not obvious, resulting in the
extruded at the junction of the two organoid cells indicates tumor progressing to advanced stages at the time of
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high secretory activity and cell turnover ratio. In addition, diagnosis and drug resistance that often occurs during
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the study also assessed the expression of HER-2 and EGFR drug treatment. Therefore, numerous studies have
as cell-surface-related tumor biomarkers. O-POST is effectively established gastrointestinal cancer organoids for
highly correlated with increased EGFR expression and an investigating drug resistance mechanisms and predicting
increased percentage of EGFR-positive cells, indicating that patient responses. 50-56 Among them, Vlachogiannis
neoadjuvant chemotherapy upregulates EGFR expression. et al. first described that a PDO model of metastatic
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Therefore, breast cancer PDO could serve as an excellent gastrointestinal cancer can predict and reproduce a patient’s
3D model for assessing disease evolution. treatment response during clinical treatment. In this study,
scientists used gastric cancer PDO, which has a highly
3.5. Lung cancer similar genotype and phenotype to patients’ tumors, to test
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Lung cancer is a very complex disease that shows the anticancer drugs commonly used in clinical practice.
phenotypic and genotypic diversity in different patients, The results showed that PDO demonstrated effectiveness
posing considerable challenges to precision medicine. comparable to 100% in predicting patient sensitivity to
To date, growing evidence shows the feasibility and chemotherapy and targeted therapy, achieving a positive
superiority of lung cancer organoids. 43-45 Non-small cell predictive value (that is, predicting that a drug is effective)
lung cancer (NSCLC) is the most widely studied subtype of 88% and a negative predictive value (that is, predicting
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of lung cancer. A study established organoid cultures of that a drug is ineffective) of 100%. In another study,
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NSCLC from surgically resected primary patient tissue and scientists established 57 organoids derived from gastric
a patient-derived xenograft model. Short-term and long- cancer patients. Using different chemotherapy drugs and
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term established NSCLC organoids, that are cultivated verifying them in PDOs-based xenograft mice, it was found
in vitro and xenografted, not only reproduce the histological that the drug response results were entirely consistent with
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characteristics and tumorigenicity of their matching tumor the actual clinical response of 91.7% of patients. Overall,
tissues but also retain the sensitivity of the parent tumors these studies have shown that gastrointestinal cancer
to targeted therapy, rendering them ideal for the discovery organoids have an apparent predictive effect on the clinical
and validation of biomarker-drug combinations. Whole- response of chemotherapeutic drugs, which provides a
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exome sequencing and RNA sequencing have shown that powerful help in screening drugs for gastrointestinal cancer
long-term NSCLC organoids retain the mutation, copy patients and personalized medicine. In addition, Ukai
number, and gene expression profiles of their parent tumors et al. and Harada et al. established gastric cancer organoids
despite multiple subcultures in an in vitro environment. exhibiting resistance to 5-FU and oxaliplatin, respectively,
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In addition, Wang et al. generated 212 lung cancer and successfully explored potential therapeutic targets and
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organoids (LCOs) from malignant serous effusion (MSE) biomarkers associated with chemotherapy-resistant gastric
obtained from 107 patients. MSE primarily consists of cancer. 53,54 In addition, research by Seidlitz et al. proved
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tumor cells and can be obtained in a relatively minimally that organoids derived from human gastric cancer can
invasive procedure. As a result, LCOs established through retain identical phenotypes and histological characteristics
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MSE are characterized by their purity as tumor organoids, as parent tissues after 1 year of culture. These findings
making these models highly suitable for drug sensitivity provide strong evidence and confidence for establishing a
tests (DST). LCO faithfully reflects the pathological and biobank of gastrointestinal cancer organoids in the future.
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molecular characteristics of the original tumor. Among
them, the results of LCO-based DSTs (LCO-DSTs) are 3.7. Prostate cancer
highly consistent with clinical treatment responses. For Prostate cancer is currently one of the most common types
example, the LCO-DST results of one patient reflected of cancer in men around the world, and the mortality rate
that dual-targeting drugs showed high tumor control rates, among men is only lower than that of lung cancer. In
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which were confirmed in the subsequent actual clinical addition, the global incidence of prostate cancer is gradually
treatment. Therefore, LCO-DST is expected to become increasing, with 2.9 million new cases expected by 2040.
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an important predictive tool for formulating personalized Therefore, the development of prostate cancer organoids
treatment plans for lung cancer in personalized medicine. is imminent. Gao et al. pioneered the establishment
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of a prostate cancer organoid line from prostate cancer
3.6. Gastrointestinal cancer patients. These organoid lines exhibit several prostate
Gastric cancer currently ranks fifth in the global cancer cancer-specific gene mutations, such as FOXA1 mutations,
incidence rate and is also the fourth most prominent ETS translocation, CHD1 loss, and SPOP mutations. The
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Volume 1 Issue 2 (2025) 7 doi: 10.36922/OR025050008