• Challenges in research on human stomach and gastric cancer
• Opportunities on organoid technology in scientific research
• Application of gastric organoids in research
• Example on limitation of current organoid research
• Some future trends on organoid-related cancer research
• Selected compositions for gastric epithelial organoid culture recipe by Lab-A-Porter

Particularly, patient-derived organoids biobanks of gastric cancer act as a useful tool in studying gastric cancer biology:

• • • Gastric cancer ranking as the fifth most common malignancy, the third leading cause of cancer-related deaths. [2]
    • Gastric cancer is a heterogenous disease displaying many different histological and molecular subtypes [1,3]
    • The prognosis of gastric cancer is poor and most advanced forms of the disease remain incurable. [3]
      • • Although treatment effectiveness has improved during the past decade, gastric cancer survival rates remain poor. [3]
        • This suggests an urgent need to advance innovative therapies available to gastric cancer patients. [3]

Patient-derived organoids biobanks provide a great advantage over classical 2D cell lines in gastric tumour research [1]

• • • Nanki and colleagues have generated 37 PDO lines. [1]
      • • They obtained patient-derived organoids of all gastric tumour subtypes except for the Epstein-Barr virus-associated one. [1]
        • Established patient-derived organoids recapitulated the same histopathological features as the original tumour. [1]
    • Yan and colleagues have established 46 PDOs. [1]
      • • They classified them into 4 gastric subtypes with comparable mutational spectra. [1]
        • They observed sub-clonal tumour evolution by comparing multiple biopsies obtained from the primary tumour or even metastasis of the same patient. [1]

1. Use organoids as a preclinical model

Organoids are 3D cultures that can retain the morphologies and gene expression profiles of their organs of origin [3].

2. Use human and mouse organoids for disease modelling

For example, the use of gastric organoids has facilitated many important discoveries regarding H. pylori pathogenesis [5], pediatric gastric homeostasis and pediatric mucosal diseases [6]

3. Use patient-derived organoids to personalize medicine for gastric cancer patients

Patient-derived organoids can be derived from endoscopic tumour biopsies, which maintain heterogeneity in culture. [1] 

• • They can be rapidly established and expanded in a relatively short time for in vitro drug screening experiments, for therapy prediction and guidance. [1]

• • Organoids only contain epithelial layers without tissue microenvironments, such as the immune system and nervous system. [5]
  • Fully maturation to adult organs or tissues is a bottleneck needed to be addressed. [5]
  • Dependence on the extracellular matrix or basement membrane extract of current organoids. [5]
  • The culture medium needs to be further refined for the long-term expansion of some organoids. [5]
  • Growth factors or molecular inhibitors in culture medium might have some effects on drug responses of organoids. [5]

• • Current data suggest a good predictive value of patient-derived organoids in drug and radiation assays, even if the overall mutational landscape is unknown.[1]
  • The evolution of translational research, through its applications with patient-derived tumour organoid models, makes it emerge as a crucial strategy in personalized medicine programs. [3]
  • New clinical trials are required to further validate the benefits of gastric cancer patient-derived tumour organoids in personalized medicine.[3]
    • • To assess the correlation between the in vivo primary tumour response and the ex vivo drug-mediated cytotoxicity. [3]