# Grow tumour organoids together with the patient's own immune cells

Source: https://onco.cc/ideas/idea-bio1-organoid-immune-coculture/  
OnCo record `idea-bio1-organoid-immune-coculture` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Lab-grown mini-tumours usually contain only cancer cells. Adding the patient's own immune cells lets researchers test immunotherapy outside the body.

## Summary

Air-liquid interface organoids and reconstituted co-cultures preserve or restore tumour-infiltrating lymphocytes and myeloid cells, and have been used to model checkpoint blockade responses and to expand tumour-reactive T cells. Standardising these systems, including autologous peripheral blood mononuclear cell co-cultures with defined killing readouts, would give an ex vivo assay for immunotherapy and cell therapy that plain organoids cannot provide.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: A standardised organoid-immune co-culture killing assay discriminates checkpoint inhibitor responders from non-responders in a prospective cohort with accuracy better than PD-L1 immunohistochemistry.
- Rationale: Immunotherapy prediction is the field's most valuable unmet biomarker problem and functional assays outperform expression markers in other settings, such as ex vivo drug sensitivity in leukaemia.
- Proposed test: Assay 150 pre-treatment samples from patients starting checkpoint therapy with blinded scoring; compare accuracy with PD-L1 and tumour mutational burden.
- Maturity: preclinical-evidence
- Actor: research

## Sources

- Bottleneck evidence (Lab models that fail to predict what happens in patients): Wong, Siah & Lo, Estimation of clinical trial success rates (Biostatistics 2019): https://doi.org/10.1093/biostatistics/kxx069

## Connected records

- technologies: [Functional (ex vivo) drug testing](https://onco.cc/technologies/functional-drug-testing/), [Patient-derived organoids](https://onco.cc/technologies/organoids/), [TIL therapy](https://onco.cc/technologies/til-therapy/)
- institutions: [Netherlands Cancer Institute (NKI-AvL)](https://onco.cc/institutions/nki/)
- terms: [Hot vs cold tumours](https://onco.cc/terms/cold-vs-hot/), [Tumour-infiltrating lymphocytes (TILs)](https://onco.cc/terms/tils/)
- bottlenecks: [Lab models that fail to predict what happens in patients](https://onco.cc/bottlenecks/b-preclinical-models/), [No one can predict who responds to immunotherapy](https://onco.cc/bottlenecks/b-immunotherapy-response/)
- key papers: [Estimation of clinical trial success rates and related parameters](https://onco.cc/key-papers/paper-wong-biostatistics/)

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