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Merck

Personalized Identification of Optimal HIPEC Perfusion Protocol in Patient-Derived Tumor Organoid Platform.

Annals of surgical oncology (2020-07-08)
Steven D Forsythe, Shyama Sasikumar, Omeed Moaven, Hemamylammal Sivakumar, Perry Shen, Edward A Levine, Shay Soker, Aleksander Skardal, Konstantinos I Votanopoulos
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Chemotherapy dosing duration and perfusion temperature vary significantly in HIPEC protocols. This study investigates patient-derived tumor organoids as a platform to identify the most efficacious perfusion protocol in a personalized approach. Peritoneal tumor tissue from 15 appendiceal and 8 colon cancer patients who underwent CRS/HIPEC were used for personalized organoid development. Organoids were perfused in parallel at 37 and 42ย ยฐC with low- and high-dose oxaliplatin (200ย mg/m2 over 2ย h vs. 460ย mg/m2 over 30ย min) and MMC (40ย mg/3L over 2ย h). Viability assays were performed and pooled for statistical analysis. An adequate organoid number was generated for 75% (6/8) of colon and 73% (11/15) of appendiceal patients. All 42ย ยฐC treatments displayed lower viability than 37ย ยฐC treatments. On pooled analysis, MMC and 200ย mg/m2 oxaliplatin displayed no treatment difference for either appendiceal or colon organoids (19% vs. 25%, pโ€‰=โ€‰0.22 and 27% vs. 31%, pโ€‰=โ€‰0.55, respectively), whereas heated MMC was superior to 460ย mg/m2 oxaliplatin in both primaries (19% vs. 54%, pโ€‰<โ€‰0.001 and 27% vs. 53%, pโ€‰=โ€‰0.002, respectively). In both appendiceal and colon tumor organoids, heated 200ย mg/m2 oxaliplatin displayed increased cytotoxicity as compared with 460ย mg/m2 oxaliplatin (25% vs. 54%, pโ€‰<โ€‰0.001 and 31% vs. 53%, pโ€‰=โ€‰0.008, respectively). Organoids treated with MMC or 200ย mg/m2 heated oxaliplatin for 2 h displayed increased susceptibility in comparison with 30-min 460ย mg/m2 oxaliplatin. Optimal perfusion protocol varies among patients, and organoid technology may offer a platform for tailoring HIPEC conditions to the individual patient level.

MATERIALS
Product Number
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