Figure 7.

Rationale for precision medicine using patient-derived organoid expansion to characterize tumor.

(A) Pre-treatment core needle biopsies are acquired during a diagnostic endoscopic ultrasound. (B) Patient receives neoadjuvant or induction chemotherapy before (C) surgical resection of the primary tumor. (D) Biopsy-derived tumor cells can be grown into an organoid with a high success rate. A new PDO can be similarly established from the surgical specimen to recapitulate possible changed signature in resistance. (E) After neoadjuvant treatment, clinical response to therapeutic regimen can be compared to chemosensitivity profile of the PDO, and to (F) inform adjuvant chemotherapy selection based on the results of pharmacotyping of the patient-specific culture.