• J. Am. Coll. Surg. · Sep 2023

    Cancer "Avatar" Models: Patient-Derived Xenograft Growth and Recurrence and Survival after Surgical Resection of Pancreaticobiliary Cancers.

    • Isaac T Lynch, Amro M Abdelrahman, Roberto Alva-Ruiz, Alessandro Fogliati, Rondell P Graham, Rory Smoot, and Mark J Truty.
    • From the Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN (Lynch, Abdelrahman, Alva-Ruiz, Fogliati, Smoot, Truty).
    • J. Am. Coll. Surg. 2023 Sep 1; 237 (3): 483500483-500.

    BackgroundPancreaticobiliary (PB) cancers are a diverse group of cancers with poor prognoses and high rates of recurrence after resection. Patient-derived xenografts (PDX), created from surgical specimens, provide a reliable preclinical research platform and high-fidelity cancer model from which to study these malignancies with consistent recapitulation of their original patient tumors in vivo. However, the relationship between PDX engraftment success (growth or no growth) and patient oncologic outcomes has not been well studied. We sought to evaluate the correlation between successful PDX engraftment and survival in several PB exocrine carcinomas, including the pancreatic and biliary tract.Study DesignIn accordance with IRB and Institutional Animal Care and Use Committee protocols and with appropriate consent and approval, excess tumor tissue obtained from surgical patients was implanted into immunocompromised mice. Mice were monitored for tumor growth to determine engraftment success. PDX tumors were verified to recapitulate their tumors of origin by a hepatobiliary pathologist. Xenograft growth was correlated with clinical recurrence and overall survival data.ResultsA total of 384 PB xenografts were implanted. The successful engraftment rate was 41% (158/384). We found that successful PDX engraftment was highly associated with both recurrence-free survival (p < 0.001) and overall survival (p < 0.001) outcomes. Successful PDX tumor generation occurs significantly in advance of clinical recurrences in their corresponding patients (p < 0.001).ConclusionsSuccessful PB cancer PDX models predict recurrence and survival across tumor types and may provide critical lead time to alter patients' surveillance or treatment plans before cancer recurrence.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Surgeons.

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