OnCo
ideasIdea

Use patient organoids to check a cell therapy will work before infusing it

Cell therapies are tested for purity and count, but not for whether they can actually kill that patient's tumour. Testing them against the patient's own mini-tumour would show this.

Release criteria for CAR-T and TIL products measure viability, transduction and sterility, not tumour-specific cytotoxicity. Co-culturing an aliquot of the product with the patient's own organoid or tumour slice gives a functional potency assay with a killing readout. This could flag likely non-responders before lymphodepletion, and provide a comparator when choosing between products or targets.

Hypothesis
Ex vivo killing of the patient's own organoid by the manufactured product predicts clinical response, and products failing a defined potency threshold have a markedly lower response rate.
Rationale
Product potency varies widely and correlates with T-cell fitness in reported series; a patient-specific functional assay is the most direct measure and can be run during the manufacturing window.
What would test it
Prospective blinded correlation in 60 patients receiving CAR-T or TIL therapy, comparing organoid killing scores with response at three months.
Maturity
speculative
Who has to act
research
Cost to try
Medium ($1M to $50M)
Years to first evidence
4
Bottlenecks it attacks

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