A robust scientific tool to identify new treatments and drug targets offers real potential to change how we treat colorectal cancer patients in the future.

A Cabrini Monash partnership is leading the advances in organoid technology.

Colorectal cancer is the third most commonly diagnosed and second leading cause of cancer death worldwide – therefore there is a significant need to improve detection and treatment strategies for patients.

A partnership between the Cabrini Monash University Department of Surgery – led by Professor Paul McMurrick – and the Monash BDI Organoid Program – led by Professor Helen Abud – is making significant steps forward by utilising organoid technology for a personalised approach for the treatment of colorectal cancer patients as well as a pathway to new treatment discovery.

Traditionally, we have relied on a standard approach for prescribing chemotherapeutic drugs to cancer patients, relying on more common factors such as which organ the tumour arose from, its histological features, and metastatic tumour staging. Unfortunately, we know patients respond differently, and frequently fail treatments, even if they have many of these features in common.

Our biggest challenge is how to understand every patient’s tumour on an individual level, so that we can prescribe a therapeutic regime that is personalised to them – to gain the best possible outcomes and the fewest side effects.

The Cabrini Monash team are utilising organoid technology for colorectal cancer patients that promises to change how we treat patients and find new treatment options. Their recent publication outlines the development of a colorectal organoid platform derived from 50 patient tumours, plus normal adjacent tissue, and in some cases, matched metastatic tumours from the same patients.

Organoids are an innovative culture model system developed directly from small pieces of patient cancers or normal tissues. They provide a robust, near-physiological model that retains key genetic and phenotypic features of the patient tissue from which it is derived. Increasing evidence suggests that organoids can mimic the treatment responses of the patient in the clinic and therefore may be useful in predicting treatment response. Organoids are powerful models because they overcome many limitations of earlier cell culture systems or animal systems that are expensive, lack cell type diversity, come with ethical issues, and often fail to mimic human tumour characteristics. They represent one of the most significant technological advances in our quest to deliver personalised therapy to every patient.

The latest research, led by Dr Rebekah Engel from the Cabrini Monash team, show the ability to produce colorectal cancer organoids that retain key histopathological, molecular, and phenotypic characteristics from original tumour specimens.

Dr Engel says the organoid platform provides a robust scientific tool that will be used to identify new treatments and drug targets, and offers real potential to change how we treat patients in the future.

“Organoids have incredible potential to fulfil our aim of offering personalised medicine to every cancer patient. They truly have the potential to be able to guide treatment choice for patients, not just for standard of care therapies, but in identifying novel treatment strategies for patients who are resistant to chemotherapy, or have failed all standard therapy options and have no treatment options available,” said Dr Engel.

“Recent research has shown an organoid can be developed from a patient, drug tested, and best therapy approach identified, all before a patient needs to commence treatment. It’s early days yet, but we are excited about a not so distant future where this could be done for every patient. We are working hard to make sure our bench research translates into the clinic.”

Read the full article by Dr Rebekah Engel and the Cabrini Monash team here.