# Functional (ex vivo) drug testing

Source: https://onco.cc/technologies/functional-drug-testing/  
OnCo record `functional-drug-testing` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Growing a patient's own cancer cells in a dish and testing drugs on them directly, instead of guessing from genetics.

## Summary

Patient-derived organoids and short-term ex vivo cultures (SEngine PARIS, Cancertain, Xilis, Curesponse) expose live tumour cells to drug panels. Feasibility and correlation with response are established in colorectal, pancreatic, and ovarian cancer; randomised proof of benefit is pending. Complementary to genomics when no actionable mutation exists.

## Fields

- Kind: Technology
- Status: emerging
- Last checked: 2026-09-04
- Principle: Fresh tumour tissue dissociated and cultured in matrix; viability read-outs per drug within 1-3 weeks.
- Strengths: Phenotype captures what genotype misses; Tests combinations
- Limitations: Take rate and timeline; No stroma or immune component in most systems

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Precision_medicine
- Wikipedia: https://en.wikipedia.org/wiki/Precision_medicine

## Connected records

- technologies: [BH3 profiling (functional apoptosis testing)](https://onco.cc/technologies/bh3-profiling/), [Biobanking and tissue procurement](https://onco.cc/technologies/biobanking/), [Ex vivo drug sensitivity screening in blood cancers (EXALT)](https://onco.cc/technologies/functional-precision-medicine-haematology/), [N-of-1 and rapid platform trials](https://onco.cc/technologies/n-of-1-platforms/), [Organoid-guided therapy at scale](https://onco.cc/technologies/organoid-guided-therapy-scale/), [Parsortix label-free circulating tumour cell harvest](https://onco.cc/technologies/parsortix-ctc-harvest/), [Patient-derived organoids](https://onco.cc/technologies/organoids/), [PDAC organoid pharmacotyping](https://onco.cc/technologies/pdac-organoid-pharmacotyping/)
- fronts: [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/), [Drug Discovery Platforms](https://onco.cc/fronts/drug-discovery/)
- companies: [2cureX](https://onco.cc/companies/2curex/), [CanCertain](https://onco.cc/companies/cancertain/), [Certis Oncology Solutions](https://onco.cc/companies/certis-oncology-solutions/), [Cure-First](https://onco.cc/companies/cure-first/), [Curesponse](https://onco.cc/companies/curesponse/), [First Ascent Biomedical](https://onco.cc/companies/first-ascent-biomedical/), [Kernis Health](https://onco.cc/companies/kernis-health/), [Kiyatec](https://onco.cc/companies/kiyatec/), [Known Medicine](https://onco.cc/companies/known-medicine/), [KYAN Technologies](https://onco.cc/companies/kyan-technologies/), [Notable Labs](https://onco.cc/companies/notable-labs/), [Origin Bio](https://onco.cc/companies/origin-bio/), [Palitra Bio](https://onco.cc/companies/palitra-bio/), [SageMedic](https://onco.cc/companies/sagemedic/), [SEngine Precision Medicine](https://onco.cc/companies/sengine/), [SpeciCare](https://onco.cc/companies/specicare/), [StoreMyTumor](https://onco.cc/companies/storemytumor/), [Travera](https://onco.cc/companies/travera/), [Valius Sciences](https://onco.cc/companies/valius/), [Xilis](https://onco.cc/companies/xilis/), [zPREDICTA](https://onco.cc/companies/zpredicta/)
- roadmaps: [ADC roadmap: from Mylotarg to bispecific and dual-payload ADCs](https://onco.cc/roadmaps/adc-generations/), [Drug discovery roadmap: screening in mice → maps of dependency → designing in silico](https://onco.cc/roadmaps/drug-discovery-roadmap/), [Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on](https://onco.cc/roadmaps/trial-modernisation-roadmap/), [Virtual cell roadmap: from bulk omics to a predictive model of a cancer cell](https://onco.cc/roadmaps/virtual-cell/)
- ideas: [A bone marrow niche on a chip to study human dormancy](https://onco.cc/ideas/idea-bio2-marrow-niche-on-chip/), [A drug screen that only rewards killing sleeping cancer cells](https://onco.cc/ideas/idea-bio2-dormancy-selective-screen/), [A funded organoid and PDX panel as the go/no-go gate before IND-enabling money](https://onco.cc/ideas/idea-fund-organoid-translation-gate/), [A public atlas of drug-pair responses across a thousand patient-derived organoids](https://onco.cc/ideas/idea-tr2-organoid-matrix-atlas/), [An open atlas of collateral sensitivity for every approved targeted drug](https://onco.cc/ideas/idea-bio1-collateral-sensitivity-atlas/), [An open model bank for the rare tumours nobody has models for](https://onco.cc/ideas/idea-bio2-rare-tumour-model-bank/), [Automated combination discovery: patient-sample screens feeding Bayesian platform trials](https://onco.cc/ideas/idea-moon-automated-combination-discovery/), [Digital twins for treatment selection, validated by predicting before observing](https://onco.cc/ideas/idea-data-digital-twin-predict-then-observe/), [Every drug screen includes standard reference compounds whose performance is published](https://onco.cc/ideas/idea-tr2-reference-compound-panels/), [Every resistance mechanism found in a patient must be rebuilt in the laboratory](https://onco.cc/ideas/idea-bio1-reverse-translation-resistance-models/), [Grow blood-borne tumour cells to test drugs on the cells that actually spread](https://onco.cc/ideas/idea-bio2-ctc-culture-functional-testing/), [Grow each trial patient's tumour as organoids to decide which platform arm opens next](https://onco.cc/ideas/idea-tr2-organoid-coclinical-arms/), [Grow tumour organoids together with the patient's own immune cells](https://onco.cc/ideas/idea-bio1-organoid-immune-coculture/), [Hold organoid drug tests to the same standard as a diagnostic test](https://onco.cc/ideas/idea-bio1-organoid-assay-clinical-validation/), [Implant a tiny device that tests twenty drugs inside the patient's own tumour](https://onco.cc/ideas/idea-bio2-implantable-microdevice-screen/), [Patient-derived organoids to pick ADC payloads](https://onco.cc/ideas/idea-organoid-guided-adc/), [Run the mouse or organoid trial at the same time as the human trial](https://onco.cc/ideas/idea-bio1-co-clinical-avatar-trials/), [Test drugs on freshly cut slices of the patient's own tumour](https://onco.cc/ideas/idea-bio1-tumour-slice-cultures/), [Test drugs on the patient's own cancer cells when there is no trial to join](https://onco.cc/ideas/idea-bio2-functional-precision-rare/), [Zebrafish avatars for a drug answer within a week](https://onco.cc/ideas/idea-bio1-zebrafish-avatars/)
- people: [Anthony Letai](https://onco.cc/people/anthony-letai/), [David A. Tuveson](https://onco.cc/people/david-tuveson/), [Emile Voest](https://onco.cc/people/emile-voest/), [Jane Cooke Wright](https://onco.cc/people/jane-cooke-wright/)
- bottlenecks: [Lab models that fail to predict what happens in patients](https://onco.cc/bottlenecks/b-preclinical-models/), [Preclinical results do not reproduce](https://onco.cc/bottlenecks/b-reproducibility/), [Too many combinations to test](https://onco.cc/bottlenecks/b-combination-space/)
- key papers: [Defining a Cancer Dependency Map: which genes each cancer cell line cannot live without](https://onco.cc/key-papers/paper-depmap-tsherniak-cell-2017/)
- terms: [Cell line](https://onco.cc/terms/cell-line/), [In vitro and in vivo](https://onco.cc/terms/in-vitro-in-vivo/), [Organoid](https://onco.cc/terms/organoid/)
- institutions: [Atrium Health Wake Forest Baptist Comprehensive Cancer Center](https://onco.cc/institutions/wake-forest-cancer/), [HUS Comprehensive Cancer Center, Helsinki University Hospital](https://onco.cc/institutions/helsinki-hus/), [OHSU Knight Cancer Institute](https://onco.cc/institutions/ohsu-knight/), [Sanford Burnham Prebys Medical Discovery Institute](https://onco.cc/institutions/sanford-burnham-prebys/), [Sydney Children's Hospitals Network / Children's Cancer Institute](https://onco.cc/institutions/sydney-childrens-hospitals-network/), [UMC Utrecht Cancer Center](https://onco.cc/institutions/umc-utrecht/), [University of New Mexico Comprehensive Cancer Center](https://onco.cc/institutions/unm-cancer-center/), [Wellcome Sanger Institute](https://onco.cc/institutions/wellcome-sanger/)
- pathways: [Synthetic lethality: paired dependencies](https://onco.cc/pathways/synthetic-lethality-map/)

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