The predictive power of organoids

Utrecht Platform for Organoid Technology

Surgeons, performing an operation

As a physician, one of my most difficult tasks is telling my cancer patients that we’re going to give them a general treatment that may or may not work for them. In essence, we give cancer therapy almost blindly. We administer one of several standard lines of chemotherapy, and it’s based on what works best at the time for that particular group of patients and not targeted individually. As a researcher, I’m excited about the potential of solving this universal problem through great science.

We’re getting closer to being able to design therapy for each patient’s unique cancer case. In Utrecht, we’re using organoids to figure out how individual patients will respond to a particular drug treatment. Tumor organoids are 3D miniature versions of tumors that we grow in the lab from a patient’s own tumor cells and carry the cancer-causing genes or defective genetic code of that patient. We’re interested in whether we can use organoids to predict which drug or combinations of drugs will work for an individual patient.

OPTIC clinical trial to test cancer drugs on organoids

To do this, we’ve launched the OPTIC clinical trial: Organoids to Predict Therapy Response in Colorectal Cancer (CRC). If CRC is diagnosed at a later stage, as is often the case, the cancer may have already metastasized, spreading to other areas of the body, such as the liver. The OPTIC trial just started and aims to enroll 150 patients with early metastatic CRC, who will start a first line of chemotherapy.

Biopsies of patient liver metastases are deposited into the Hubrecht Living Biobank. In collaboration with the Hubrecht Organoid Technology Foundation, organoids are grown and treated with the exact same treatment that the patient is receiving, as well as monotherapy and other drug combinations, and compare responses. At this moment, we’re conducting the OPTIC trial to test and validate if organoids can predict a patient’s response. One other aspect we’re looking at is heterogeneity (genetic variation) among metastases. We want to know if organoids from one metastasis can represent the others in the drug screening process, which may give us a better indication of treatment efficacy.

We’re getting closer to being able to design therapy for each patient’s unique cancer case

Jeanine Roodhart
UMC Utrecht

The OPTIC trial is an important step in our future design of better cancer therapies, and our patients truly understand the importance of researching and validating this novel approach.  Ideally, we’d like to compress the time from biopsy to drug response results down to 2-3 weeks. This way a patient could wait before starting treatment and can be assured of a more personalized therapy.

Utrecht Platform for Organoid Technology

Clinical trials require a tremendous amount of organization, such as connecting and communicating with different hospitals, patient selection, inclusion and informed consent, tissue acquisition and documentation and coordination of all specialties involved in the process. The Utrecht Platform for Organoid Technology is centralizing and standardizing a logistical framework for this, as well as supporting the development of new organoid model systems. Equally important is the high level of education and training that we offer our current and future generations, and under the Utrecht Platform for Organoid Technology, a new summer school course will be offered in 2018 focused on the generation of organoids.

The  Utrecht Platform for Organoid Technology will increase visibility and opportunities for collaborations and aims to fully capitalize on organoid technology. Together, we can push this technology forward such that every patient can benefit from the treatment he or she receives.

Jeanine Roodhart, MD, PhD
UMC Utrecht