Research Papers:

Real time ex vivo chemosensitivity assay for pancreatic adenocarcinoma

Dae Won Kim, Francisca Beato, Youngchul Kim, Alexandra F. Tassielli, Ruifan Dai, Jason W. Denbo, Pamela J. Hodul, Mokenge P. Malafa and Jason B. Fleming _

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Oncotarget. 2023; 14:811-818. https://doi.org/10.18632/oncotarget.28508

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Dae Won Kim1,*, Francisca Beato1,*, Youngchul Kim2, Alexandra F. Tassielli1, Ruifan Dai1, Jason W. Denbo1, Pamela J. Hodul1, Mokenge P. Malafa1 and Jason B. Fleming1

1 Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA

2 Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612, USA

* These authors contributed equally to this work

Correspondence to:

Jason B. Fleming, email: [email protected]

Keywords: pancreatic cancer; sensitivity assay; chemotherapy

Received: April 06, 2023     Accepted: August 19, 2023     Published: September 15, 2023

Copyright: © 2023 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Patient-derived organoids (PDOs) and xenografts (PDXs) have been extensively studied for drug-screening. However, their usage is limited due to lengthy establishment time, high engraftment failure rates and different tumor microenvironment from original tumors. To overcome the limitations, we developed real time-live tissue sensitivity assay (RT-LTSA) using fresh tumor samples.

Methods: Tissue slices from resected pancreatic cancer samples were placed in 96-well plates, and the slices were treated with chemotherapeutic agents. The correlation between the chemo-sensitivity of tissue slices and each patient’s clinical outcome was analyzed.

Results: The viability and tumor microenvironment of the tissue slices are well-preserved over 5 days. The drug sensitivity assay results are available within 5 days after tissue collection. While all 4 patients who received RT-LTSA sensitive adjuvant regimens did not develop recurrence, 7 of 8 patients who received resistant adjuvant regimens developed recurrence. We observed significantly improved disease-free survival in the patients who received RT-LTSA sensitive adjuvant regimens (median: not reached versus 10.6 months, P = 0.02) compared with the patient who received resistant regimens. A significant negative correlation between RT-LTSA value and relapse-free survival was observed (Somer’s D: −0.58; P = 0.016).

Conclusions: RT-LTSA which maintains the tumor microenvironment and architecture as found in patients may reflect clinical outcome and could be used as a personalized strategy for pancreatic adenocarcinoma. Further, studies are warranted to verify the findings.

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