An organoid-guided platform for ovarian cancer: enabling prediction of patients’ chemotherapy response

BACKGROUND: Organoids represent a new platform for drug screening and personalized medicine. However, the difficulty of organoid construction limits their wide application. METHODS: We collected 153 tumour samples from patients with epithelial ovarian tumours. The associations between patient characteristics and organoid generation were analysed via chi-square tests and Fisher's exact tests. Univariate and multivariate logistic regression analyses were performed to identify independent factors influencing organoid development. We conducted a drug screen on 20 organoids to predict the drug response of clinical patients retrospectively and prospectively. RESULTS: One hundred fifty-three organoids were developed from 153 ovarian tumour patients, with a 57.52% success rate. Preoperative low CA153 levels (OR (95% CI): 3.44 (1.39, 9.00), P = 0.009) and high CA199 levels in patients (OR (95% CI): 0.20 (0.06, 0.57), P = 0.004) correlated with successful organoid generation, whereas other clinical features were not significantly correlated with ovarian tumour organoid generation. The subgroup analyses further showed that CA153 and CA199 were two independent factors influencing organoid construction. Ovarian cancer organoids can retain the pathological and genetic characteristics of the original tumour tissues. The PDOs were able to predict the prior clinical responses of these patients with an efficiency rate of 100%. The prospective prediction efficiency of PDOs was 80%. CONCLUSIONS: Preoperative CA153 and CA199 levels were found to be independent factors influencing ovarian tumour organoid generation. The drug responses of most PDOs to paclitaxel and carboplatin were consistent with the clinical treatment outcomes.