# Organoid-guided therapy at scale

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

## TL;DR

Organoid-guided therapy means routinely growing a piece of each patient's tumour and testing drugs on it before choosing, rather than relying on genetics alone.

## Summary

Patient-derived organoids reproduce genotype and drug response, and prospective series in colorectal, pancreatic and ovarian cancer report meaningful correlation between ex vivo sensitivity and clinical response. Turning that into routine care needs take rates above 70%, results inside three weeks, and a randomised trial showing that acting on the result helps. Companies including Xilis and Curesponse and several academic programmes are pushing on throughput; the randomised evidence does not exist yet.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-09-08
- Tags: frontier; promising
- Principle: Fresh tumour tissue is dissociated and cultured in matrix; a drug panel is applied and viability read out, producing a per-patient sensitivity profile.
- Strengths: Phenotype captures what genotype misses; Tests combinations and sequences; Useful when no actionable mutation is found
- Limitations: Take rate and turnaround time; No stroma or immune compartment in most systems; No randomised proof of benefit

## Sources

- ClinicalTrials.gov: organoid-guided therapy: https://clinicaltrials.gov/search?term=organoid%20guided%20therapy

## Connected records

- fronts: [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/), [Drug Discovery Platforms](https://onco.cc/fronts/drug-discovery/)
- technologies: [Ex vivo drug sensitivity screening in blood cancers (EXALT)](https://onco.cc/technologies/functional-precision-medicine-haematology/), [Functional (ex vivo) drug testing](https://onco.cc/technologies/functional-drug-testing/), [Patient-derived organoids](https://onco.cc/technologies/organoids/), [Patient-derived xenografts](https://onco.cc/technologies/pdx-models/), [PDAC organoid pharmacotyping](https://onco.cc/technologies/pdac-organoid-pharmacotyping/)
- companies: [Curesponse](https://onco.cc/companies/curesponse/), [SEngine Precision Medicine](https://onco.cc/companies/sengine/), [Xilis](https://onco.cc/companies/xilis/)
- roadmaps: [Drug discovery roadmap: screening in mice → maps of dependency → designing in silico](https://onco.cc/roadmaps/drug-discovery-roadmap/), [Paths to cures: interception, eradication, control](https://onco.cc/roadmaps/cure-paths/), [Radical oncology: what could change the war by 2035](https://onco.cc/roadmaps/frontier-2035/)
- key papers: [Sato 2009: single Lgr5 stem cells build crypt-villus organoids](https://onco.cc/key-papers/paper-sato-lgr5-organoids-nature-2009/)

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