%0 Journal Article %T Platform combining statistical modeling and patient-derived organoids to facilitate personalized treatment of colorectal carcinoma. %A Ramzy GM %A Norkin M %A Koessler T %A Voirol L %A Tihy M %A Hany D %A McKee T %A Ris F %A Buchs N %A Docquier M %A Toso C %A Rubbia-Brandt L %A Bakalli G %A Guerrier S %A Huelsken J %A Nowak-Sliwinska P %J J Exp Clin Cancer Res %V 42 %N 1 %D Apr 2023 3 %M 37013646 暂无%R 10.1186/s13046-023-02650-z %X BACKGROUND: We propose a new approach for designing personalized treatment for colorectal cancer (CRC) patients, by combining ex vivo organoid efficacy testing with mathematical modeling of the results.
METHODS: The validated phenotypic approach called Therapeutically Guided Multidrug Optimization (TGMO) was used to identify four low-dose synergistic optimized drug combinations (ODC) in 3D human CRC models of cells that are either sensitive or resistant to first-line CRC chemotherapy (FOLFOXIRI). Our findings were obtained using second order linear regression and adaptive lasso.
RESULTS: The activity of all ODCs was validated on patient-derived organoids (PDO) from cases with either primary or metastatic CRC. The CRC material was molecularly characterized using whole-exome sequencing and RNAseq. In PDO from patients with liver metastases (stage IV) identified as CMS4/CRIS-A, our ODCs consisting of regorafenib [1 mM], vemurafenib [11 mM], palbociclib [1 mM] and lapatinib [0.5 mM] inhibited cell viability up to 88%, which significantly outperforms FOLFOXIRI administered at clinical doses. Furthermore, we identified patient-specific TGMO-based ODCs that outperform the efficacy of the current chemotherapy standard of care, FOLFOXIRI.
CONCLUSIONS: Our approach allows the optimization of patient-tailored synergistic multi-drug combinations within a clinically relevant timeframe.