Organoid Profiling Identifies Common Responders to Chemotherapy in Pancreatic Cancer

  • Cancer Discov. 2018 Sep;8(9):1112-1129. doi: 10.1158/2159-8290.CD-18-0349.
Hervé Tiriac  1 ,  Pascal Belleau  #  1 ,  Dannielle D Engle  #  1 ,  Dennis Plenker  1 ,  Astrid Deschênes  1 ,  Tim D D Somerville  1 ,  Fieke E M Froeling  1 ,  Richard A Burkhart  2 ,  Robert E Denroche  3 ,  Gun-Ho Jang  3 ,  Koji Miyabayashi  1 ,  C Megan Young  1  4 ,  Hardik Patel  1 ,  Michelle Ma  1 ,  Joseph F LaComb  5 ,  Randze Lerie D Palmaira  6 ,  Ammar A Javed  2 ,  Jasmine C Huynh  7 ,  Molly Johnson  8 ,  Kanika Arora  8 ,  Nicolas Robine  8 ,  Minita Shah  8 ,  Rashesh Sanghvi  8 ,  Austin B Goetz  9 ,  Cinthya Y Lowder  9 ,  Laura Martello  10 ,  Else Driehuis  11  12 ,  Nicolas LeComte  6 ,  Gokce Askan  6 ,  Christine A Iacobuzio-Donahue  6 ,  Hans Clevers  11  12  13 ,  Laura D Wood  14 ,  Ralph H Hruban  14 ,  Elizabeth Thompson  14 ,  Andrew J Aguirre  15 ,  Brian M Wolpin  15 ,  Aaron Sasson  16 ,  Joseph Kim  16 ,  Maoxin Wu  17 ,  Juan Carlos Bucobo  5 ,  Peter Allen  6 ,  Divyesh V Sejpal  18 ,  William Nealon  19 ,  James D Sullivan  19 ,  Jordan M Winter  9 ,  Phyllis A Gimotty  20 ,  Jean L Grem  21 ,  Dominick J DiMaio  22 ,  Jonathan M Buscaglia  5 ,  Paul M Grandgenett  23 ,  Jonathan R Brody  9 ,  Michael A Hollingsworth  23 ,  Grainne M O'Kane  24 ,  Faiyaz Notta  3 ,  Edward Kim  7 ,  James M Crawford  25 ,  Craig Devoe  26 ,  Allyson Ocean  27 ,  Christopher L Wolfgang  2 ,  Kenneth H Yu  6 ,  Ellen Li  5 ,  Christopher R Vakoc  1 ,  Benjamin Hubert  8 ,  Sandra E Fischer  28  29 ,  Julie M Wilson  3 ,  Richard Moffitt  16  30 ,  Jennifer Knox  24 ,  Alexander Krasnitz  1 ,  Steven Gallinger  31  24  32  33 ,  David A Tuveson  34
Affiliations
  • 1. Cold Spring Harbor Laboratory, Cold Spring Harbor, New York.
  • 2. Johns Hopkins University, Division of Hepatobiliary and Pancreatic Surgery, Baltimore, Maryland.
  • 3. PanCuRx Translational Research Initiative, Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
  • 4. Swiss Federal Institute of Technology Lausanne (EPFL), School of Life Sciences, Swiss Institute for Experimental Cancer Research (ISREC), Laboratory of Tumor Heterogeneity and Stemness in Cancer, Lausanne, Switzerland.
  • 5. Department of Medicine, Stony Brook University, Stony Brook, New York.
  • 6. Memorial Sloan Kettering Cancer Center, New York, New York.
  • 7. University of California, Davis, Comprehensive Cancer Center, Division of Hematology and Oncology, Sacramento, California.
  • 8. New York Genome Center, New York, New York.
  • 9. Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
  • 10. SUNY Downstate Medical Center, Department of Medicine, New York, New York.
  • 11. Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW), Utrecht, the Netherlands.
  • 12. University Medical Center (UMC), Utrecht, the Netherlands.
  • 13. Princess Maxime Center (PMC), Utrecht, the Netherlands.
  • 14. Department of Pathology, Johns Hopkins University, Baltimore, Maryland.
  • 15. Dana-Farber Cancer Institute, Broad Institute, Boston, Massachusetts.
  • 16. Department of Surgery, Stony Brook University, Stony Brook, New York.
  • 17. Department of Pathology, Stony Brook University, Stony Brook, New York.
  • 18. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Division of Gastroenterology, Hempstead, New York.
  • 19. Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
  • 20. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania.
  • 21. Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
  • 22. Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska.
  • 23. University of Nebraska Medical Center, Eppley Institute for Research in Cancer and Allied Diseases, Fred & Pamela Buffet Cancer Center, Omaha, Nebraska.
  • 24. Wallace McCain Centre for Pancreatic Cancer, Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • 25. Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
  • 26. Division of Medical Oncology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
  • 27. Weill Cornell Medical College, New York, New York.
  • 28. Department of Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • 29. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
  • 30. Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York.
  • 31. PanCuRx Translational Research Initiative, Ontario Institute for Cancer Research, Toronto, Ontario, Canada. [email protected] [email protected].
  • 32. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
  • 33. Hepatobiliary/Pancreatic Surgical Oncology Program, University Health Network, Toronto, Ontario, Canada.
  • 34. Cold Spring Harbor Laboratory, Cold Spring Harbor, New York. [email protected] [email protected].
  • # Contributed equally.
Abstract

Pancreatic Cancer is the most lethal common solid malignancy. Systemic therapies are often ineffective, and predictive biomarkers to guide treatment are urgently needed. We generated a Pancreatic Cancer patient-derived Organoid (PDO) library that recapitulates the mutational spectrum and transcriptional subtypes of primary Pancreatic Cancer. New driver oncogenes were nominated and transcriptomic analyses revealed unique clusters. PDOs exhibited heterogeneous responses to standard-of-care chemotherapeutics and investigational agents. In a case study manner, we found that PDO therapeutic profiles paralleled patient outcomes and that PDOs enabled longitudinal assessment of chemosensitivity and evaluation of synchronous metastases. We derived organoid-based gene expression signatures of chemosensitivity that predicted improved responses for many patients to chemotherapy in both the Adjuvant and advanced disease settings. Finally, we nominated alternative treatment strategies for chemorefractory PDOs using targeted agent therapeutic profiling. We propose that combined molecular and therapeutic profiling of PDOs may predict clinical response and enable prospective therapeutic selection.Significance: New approaches to prioritize treatment strategies are urgently needed to improve survival and quality of life for patients with Pancreatic Cancer. Combined genomic, transcriptomic, and therapeutic profiling of PDOs can identify molecular and functional subtypes of Pancreatic Cancer, predict therapeutic responses, and facilitate precision medicine for patients with Pancreatic Cancer. Cancer Discov; 8(9); 1112-29. ©2018 AACR.See related commentary by Collisson, p. 1062This article is highlighted in the In This Issue feature, p. 1047.