• M R Aberle, R A Burkhart, H Tiriac, Olde DaminkS W MSWMNUTRIM school of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.European Surgical Centre Aa, DejongC H CCHCNUTRIM school of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.Department of Surg, D A Tuveson, and R M van Dam.
• NUTRIM school of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
• Br J Surg. 2018 Jan 1; 105 (2): e48e60e48-e60.

BackgroundThe prognosis of patients with different gastrointestinal cancers varies widely. Despite advances in treatment strategies, such as extensive resections and the addition of new drugs to chemotherapy regimens, conventional treatment strategies have failed to improve survival for many tumours. Although promising, the clinical application of molecularly guided personalized treatment has proven to be challenging. This narrative review focuses on the personalization of cancer therapy using patient-derived three-dimensional 'organoid' models.MethodsA PubMed search was conducted to identify relevant articles. An overview of the literature and published protocols is presented, and the implications of these models for patients with cancer, surgeons and oncologists are explained.ResultsOrganoid culture methods have been established for healthy and diseased tissues from oesophagus, stomach, intestine, pancreas, bile duct and liver. Because organoids can be generated with high efficiency and speed from fine-needle aspirations, biopsies or resection specimens, they can serve as a personal cancer model. Personalized treatment could become a more standard practice by using these cell cultures for extensive molecular diagnosis and drug screening. Drug sensitivity assays can give a clinically actionable sensitivity profile of a patient's tumour. However, the predictive capability of organoid drug screening has not been evaluated in prospective clinical trials.ConclusionHigh-throughput drug screening on organoids, combined with next-generation sequencing, proteomic analysis and other state-of-the-art molecular diagnostic methods, can shape cancer treatment to become more effective with fewer side-effects.© 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

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