Establishment and characterization of patient-derived organoids from advanced lung adenocarcinoma. A, Representative H&E and IHC stained images of NSCLC organoids and their parental tumor tissues. The tumor organoids were positive for TTF-1, an adenocarcinoma marker, and negative for Calrectinin, a mesothelial cell marker. NSCLC organoids recapitulated morphologic and histologic features of original tumor tissues. H&E, brightfield, and IHC images are shown. Scale bar, 100 μm. B, Genomic landscape in 61 patient-derived organoids of advanced lung adenocarcinoma. Organoids were derived from TKI-naïve NSCLC, TKI-resistant NSCLC, NSCLC without driver oncogenes, and normal tissue. Clinically relevant somatic alterations selected from the TARGET database are shown. Actionable targets and clinically relevant driver genes based on the NCCN guideline (version 8.2020) and the lung adenocarcinoma TCGA database are indicated (left). Type of alteration is indicated by color codes. The percentage of organoids harboring the indicated alterations are shown (right).