Colorectal cancer is an important cause of morbidity and mortality worldwide. The current treatment landscape includes chemotherapy, targeted therapy, immunotherapy, radiotherapy, and surgery. A key challenge to improving patient outcomes is the significant inter-patient heterogeneity in treatment response. Tumour organoids derived from the patients' tumours via surgically resected or endoscopically biopsied tissue, have emerged as promising models for personalised medicine. This review synthesises the findings, to date, of studies which have explored the efficacy of ex vivo organoid sensitivity testing for predicting treatment response. Most studies have focused on predicting the response to standard-of-care radiotherapy and chemotherapy options. There is strong evidence to support organoid sensitivity testing of ionising radiation, 5-fluorouracil, and irinotecan, and to a lesser extent, oxaliplatin and TAS-102. Fewer studies have used organoids to identify patients who are likely to benefit from novel treatment options that otherwise remain in clinical trials. This review also summarises recent advancements in organoid culture to include non-epithelial components of the tumour microenvironment, to allow testing of immunotherapy and certain targeted therapy options. Overall, further prospective trials will support the implementation of organoid-based personalised medicine for colorectal cancer patients in the future.

中文翻译：

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使用患者来源的类器官预测结直肠癌治疗反应的功效。

结直肠癌是全世界发病率和死亡率的重要原因。目前的治疗格局包括化学疗法、靶向疗法、免疫疗法、放射疗法和手术。改善患者预后的一个关键挑战是患者间治疗反应的显着异质性。通过手术切除或内窥镜活检组织从患者肿瘤中提取的肿瘤类器官已成为个性化医疗的有希望的模型。这篇综述综合了迄今为止的研究结果，这些研究探索了离体类器官敏感性测试预测治疗反应的功效。大多数研究都侧重于预测对标准放疗和化疗方案的反应。有强有力的证据支持电离辐射的类器官敏感性测试，5-氟尿嘧啶和伊立替康，以及较小程度上的奥沙利铂和 TAS-102。很少有研究使用类器官来识别可能从新的治疗方案中获益的患者，否则这些方案将留在临床试验中。这篇综述还总结了类器官培养的最新进展，包括肿瘤微环境的非上皮成分，以允许测试免疫疗法和某些靶向治疗方案。总体而言，进一步的前瞻性试验将支持未来针对结直肠癌患者实施基于类器官的个性化医疗。这篇综述还总结了类器官培养的最新进展，包括肿瘤微环境的非上皮成分，以允许测试免疫疗法和某些靶向治疗方案。总体而言，进一步的前瞻性试验将支持未来针对结直肠癌患者实施基于类器官的个性化医疗。这篇综述还总结了类器官培养的最新进展，包括肿瘤微环境的非上皮成分，以允许测试免疫疗法和某些靶向治疗方案。总体而言，进一步的前瞻性试验将支持未来针对结直肠癌患者实施基于类器官的个性化医疗。