By developing these miniaturised, simplified versions of an organ from patients' cancer cells, the team were able to monitor genetic mutations in tumours. Studying the organoids is hoped to help create better targeted therapies for patients.
'The great advantage of organoids is that they are essentially avatars of a patient's tumour,' said Professor Michael Shen at the Columbia University Medical Centre in New York, who led the research. 'Having these personalised laboratory models, which we can make in a matter of weeks, will let us test multiple different drugs on the tumour and help us bring precision medicine to individuals with bladder cancer.'
However, developing organoids for molecular profiling is a highly complex process, particularly given the high variability between cancers, and requires the right mix of nutrients, growth factors and tissue culture techniques. In the team's latest study, published this month in Cell, the researchers successfully created organoids from the tumour cells of 22 patients with invasive bladder cancer. These organoids presented with many of the same molecular and genetic characteristics as tumours. The organoids were successfully made using three patients' cells both before and after treatment.
'The creation of bladder cancer organoids is an important advance in the field,' said co-author Professor James McKiernan, also at Columbia. 'This should greatly improve our understanding of the genomics of bladder cancer, how these tumours respond to drugs, and how they develop drug resistance.'
Bladder cancer is the fifth most common cancer in the USA, affecting 55,000 men and 17,000 women a year. However, given the lack of suitable animal models reflecting the disease that are available for research, bladder cancer is not well understood.
Currently, bladder cancer patients undergo immunotherapy or chemotherapy for the removal of tumours, but a high recurrence rate requires repeat treatment. In more severe cases, tumours invade the bladder muscle and bladder-removal surgery is advised, which, according to Professor Shen, most patients seek to avoid given the effect on quality of life.
Next, the team is planning 'co-clinical' trials, where patients and their corresponding organoids will be treated with the same drug to show just how successful the organoids are in predicting patient response to a specific treatment.
'Ultimately, this may allow us to develop new therapies for the disease and predict an individual patient's response to treatment,' said Professor McKiernan.