Pancreatic cancer organoids created from fine-needle biopsy specimens

Last Updated: 2018-03-01

By Will Boggs MD

NEW YORK (Reuters Health) - Pancreatic cancer organoids can be created for personalized cancer treatment using endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) specimens, researchers report.

Pancreatic cancer organoids, which can be rapidly generated from surgically resected neoplasms, simulate the full spectrum of a patient's tumor and can be used for personalized cancer treatments by testing potential therapeutic targets.

In their prospective pilot study, Dr. Jonathan M. Buscaglia from Stony Brook University School of Medicine, in New York, and colleagues investigated whether human pancreatic ductal adenocarcinoma (PDA) organoids could be generated by means of EUS-FNB, without the need for surgical resection, in patients with a pancreatic mass suspected of being PDA.

The researchers succeeded in obtaining specimens from 38 of 38 tumors using EUS-FNB, all of which were sent for organoid creation, according to the January 6 Gastrointestinal Endoscopy online report.

PDA organoids were successfully isolated within 2 weeks from 33 of 38 tumors (87%), but five tumors failed to yield organoid isolates due to the absence of viable epithelial cells from the FNB specimens upon receipt in the laboratory.

Nearly two-thirds of the organoid lines (25/38, 66%) survived at least five passages or cycles of growth and continued to undergo successful propagation at the time of this report.

Eight tumors failed to reach this status, and an additional five were intentionally frozen after organoid development but before additional passages.

One patient who subsequently underwent surgical resection had identical matching PDA organoids from both EUS-FNB and surgical resection specimens.

"Pancreatic ductal adenocarcinoma is the ideal paradigm for creating organoids by means of FNB because (1) most patients will not undergo surgery; (2) all patients need a tissue diagnosis before systemic therapies may be initiated; and (3) only a small amount of tissue is needed for organoid creation," the researchers conclude. "Our study demonstrates that PDA organoids can be successfully and rapidly created by means of EUS-guided core biopsy using a 22-gauge FNB needle at the time of initial tumor diagnosis."

"Successful organoid generation is essential for expanding the role of personalized medicine in patients with pancreatic cancer," they add.

Dr. Merel R. Aberle from Maastricht University Medical Center, in the Netherlands, who recently reviewed the possible uses of organoids for personalized management of gastrointestinal cancers, told Reuters Health by email, "For me, as a researcher and clinician, it was most interesting to know that establishing organoids from EUS-FNB material is not only feasible (87% success rate), but also safe for patients. This will allow the innovation of organoids to be available also for patients with locally advanced or metastasized disease."

"Organoids can be used to gain a better understanding of the pathophysiology of PDA, which is sorely needed in this lethal disease," she said. "However, they can also be of great value in the clinic."

"Using organoids, conventional and newly established drugs can be tested and the best (combination) therapy can be chosen for each patient," Dr. Aberle explained. "The patients who will most likely benefit most from personalized medicine are those with advanced disease, whose only option is chemotherapy. Moreover, because many patients with pancreatic cancer develop drug resistance, a personalized profile can greatly increase tumor response and reduce unwanted side effects."

Dr. Buscaglia was not available for comment.

SOURCE: http://bit.ly/2F1uDOS

Gastrointest Endosc 2018.