Abstract 32P
Background
Despite recent advances in precision oncology, the majority of cases do not present druggable alterations. In such a scenario, treatments must be selected empirically with the only support of general guidelines. Functional tests, able to interrogate the in vitro sensitivity to different drugs of a tumor could help to rationalize this decision.
Methods
Onco-PDO© checks the sensitivity of a minimum eight drugs, and their combinations, selected by the attending physician among 100 different options in organoids derived from one given patient. The assay requires a fresh sample with a volume of 1cm3 obtained by surgery or percutaneous punction. After initial digestion, cells are grown as organoids and exposed to the drugs to establish the percentage of cell death induced by each individual drug. In this study, we aimed to compare the in-vitro results with the real outcome of patients.
Results
From August 2019 to April 2021, 67 patients were recruited in four Spanish hospitals obtaining adequate samples in 52. The median age was 57 years (range 4 – 85), 18 were males and 34 females. Tumors included were ovarian cancer (49%), non-small cell lung cancer (24%) prostate cancer (7%), and others 20% (colorectal, melanoma, pancreas, granulosa cells, head-neck, and three pediatric tumors). Organoids could be established in 30 (58%) of the submitted cases. Focusing on the two main tumor types included the success rate for obtaining an OncoPDO© result was 42% in ovarian cancer and 77% in the lung. Drugs in monotherapy that achieved a 50% of cell death in vitro corresponded with clinical benefit in 32% of the cases. This number rose to 50% when assessing combinations.
Conclusions
Studying the in vitro drug sensitivity with patient-derived organoids could support a more rational selection of treatments. The observational design of our study, where patients could have received several lines of therapy before the sample for the study was obtained represent a major limitation that should be addressed in the future.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Fundacion Investigación HM Hospitales.
Funding
Invitrocue Europe AG.
Disclosure
All authors have declared no conflicts of interest.