Every patient’s tumour is different, which is why every patient deserves a tailored treatment. But how do you know which treatment is best for the patient in front of you? One way would be to culture tumour cells from that patient in the lab, to then simply test their sensitivity for a particular therapy. In this thesis, we evaluate this and other applications of tumour organoids, three-dimensionally growing mini-tumours in the lab, derived from specific patients.
First we describe the possibility to create pre-clinical models for rare cancer types, such as neuroendocrine carcinomas. We also evaluate the challenges of growing lung cancer organoids. This is less successful compared to for example colon cancer organoids. That is partly because normal lung tissue can also grow as organoids and can outcompete the tumour organoids. We compare various methods to identify this phenomenon. In addition, we describe the establishment of a model system in which tumour organoids are cultured together with immune cells from that very same patient. This allows determining the sensitivity of tumour cells for immunotherapy. We use this technology in the context of a clinical trial, to determine why some colon cancer patients do, and others don’t respond to immunotherapy. Finally, we determine the feasibility of testing the sensitivity of chemotherapy on colon cancer organoids. We find that sensitivity to irinotecan can be predicted very well, but that there is no predictive value for another type of chemotherapy (irinotecan).