Table 1.

Clinical trials with patient-derived cancer organoids guiding treatment decisions

Organ system	Cancer	Identifiers	Phase	Country	Drugs	Implementation
Respiratory system	Lung cancer, solid tumours	NCT03778814	I	China	Biologics: TCR T cells	Identification and engineering of tumour-responsive T cells using patient-specific tumour organoids followed by re-injection of TCR T cells into the patients
Gastrointestinal system	Pancreatic cancer	NCT04931394	III	China	Gemcitabine, 5-fluorouracil, paclitaxel, oxaliplatin, irinotecan	PDOs of pancreatic cancer are tested for their sensitivity to first-line pancreatic cancer drugs; patients receive the chemotherapy regimen based on the test results
	Advanced pancreatic cancer	NCT04931381	III	China	Gemcitabine, 5-fluorouracil, paclitaxel, oxaliplatin, irinotecan	PDOs of advanced pancreatic cancer are tested for their sensitivity to first-line pancreatic cancer drugs; patients receive the chemotherapy regimen based on the test results
	Advanced rectal cancer	NCT05352165	NA	China	Neoadjuvant therapy	Clinical efficacy of personalized neoadjuvant therapy based on PDO chemosensitivity combined with standard long-term radiotherapy is compared with efficacy of standard whole-course neoadjuvant therapy
	Abdominal tumours	NCT05378048	II	Hong Kong	PDO-guided treatment using standard-of-care treatments	A multidisciplinary tumour board reviews the drug screen results from PDOs and genome-guided drug screening and chooses the treatment regimen accordingly
Mammary glands	Breast cancer	NCT04450706	NA	USA	Docetaxel, cyclophosphamide, adriamycin, methotrexate, 5-fluorouracil, paclitaxel	Treatment decisions are based on results from PDOs grown from breast cancer biopsies plus genome sequencing
	Breast cancer	NCT05177432	I	Singapore	10–12 anticancer drugs (alpelisib, trastuzumab-emtansine and others not specified)	PDOs are exposed to 10–12 anticancer drugs and a table for treatment sensitivity is obtained; results will be reviewed by an expert panel to decide on the most suitable anticancer drug treatment
Urinary system	Bladder cancer	NCT05024734	II	Switzerland	Epirubicin, mitomycin, gemcitabine, docetaxel	Generation of PDOs and in vitro drug sensitivity testing to guide clinical decision-making
Others	Head and neck squamous cell carcinoma	NCT04279509	NA	Singapore	5-Fluorouracil, carboplatin, cyclophosphamide, docetaxel, doxorubicin, gemcitabine, irinotecan, oxaliplatin, paclitaxel and vinorelbine, etoposide, ifosfamide, methotrexate, pemetrexed and topotecan	Generation of PDOs followed by a 10-drug panel screening and selection of chemotherapy based on a standard rating scale; if more than one drug appears effective in PDOs, the most suitable drug based on patient comorbidities is selected
	Solid tumours such as gastrointestinal and breast cancer	NCT05381038	I and II	Singapore	Azacitidine plus docetaxel, azacitidine plus paclitaxel, azacitidine plus irinotecan	Generation of PDOs followed by drug screening and selection, and artificial intelligence-guided dosing modulation

Clinical trials are as listed on ClinicalTrials.gov. NA, not applicable; PDO, patient-derived organoid; TCR, T cell receptor.