Dis Colon Rectum. 2023 Mar 09.
Ting Wang,
Yuting Tang,
Wenjun Pan,
Botao Yan,
Yifan Hao,
Yunli Zeng,
Zexin Chen,
Jianqiang Lan,
Shuhan Zhao,
Chuxia Deng,
Hang Zheng,
Jun Yan.
BACKGROUND: Recent studies have shown patient-derived tumor organoid can predict the drug response of cancer patients. However, the prognostic value of patient-derived tumor organoid-based drug tests in predicting the progression-free survival of stage IV colorectal cancer patients after surgery remains unknown.
OBJECTIVE: To explore the prognostic value of patient-derived tumor organoid-based drug tests in stage IV colorectal cancer patients after surgery.
DESIGN: Retrospective cohort study.
SETTINGS: Surgical samples were obtained from stage IV colorectal cancer patients at Nanfang Hospital.
PATIENTS: A total of 108 patients who underwent surgery with successful patient-derived tumor organoid culture and drug testing were recruited between June 2018 and June 2019.
INTERVENTIONS: Patient-derived tumor organoid culture and chemotherapeutic drug testing.
MAIN OUTCOMES MEASURES: Progression-free survival.
RESULTS: According to the patient-derived tumor organoid-based drug test, 38 patients were drug-sensitive, and 76 patients were drug-resistant. The median progression-free survival was 16.0 months in the drug-sensitive group and 9.0 months in the drug-resistant group (p < 0.001). Multivariate analyses showed that drug resistance (HR, 3.38; 95% CI, 1.84-6.21; p < 0.001), right-sided colon (HR, 3.50; 95% CI, 1.71-7.15; p < 0.001), mucinous adenocarcinoma (HR, 2.47; 95% CI, 1.34-4.55; p = 0.004), and non-R0 resection (HR, 2.70; 95% CI, 1.61-4.54; p < 0.001) were independent predictors of progression-free survival. The new patient-derived tumor organoid-based drug test model, which includes the patient-derived tumor organoid-based drug test, primary tumor location, histological type, and R0 resection, was more accurate than the traditional clinicopathological model in predicting progression-free survival (p = 0.001).
LIMITATIONS: A single-center cohort study.
CONCLUSIONS: Patient-derived tumor organoid can predict progression-free survival in stage IV colorectal cancer patients after surgery. Patient-derived tumor organoid drug resistance is associated with shorter progression-free survival, and the addition of patient-derived tumor organoid drug tests to existing clinicopathological models improves the ability to predict progression-free survival.