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OPTIC: Organoids to Predict Treatment response In metastatic colorectal cancer

Primary objective
To validate the concept that organoids can predict treatment response in metastatic colorectal cancer.

Rationale
Patients with metastatic colorectal cancer are usually treated with chemotherapy and/or targeted therapy. Unfortunately, treatment is not effective for all patients, and patients can experience harsh side effects. To date we are unable to predict upfront to which treatment cancer patients will respond. This emphasizes the need for a predictive test to increase treatment efficacy. In this study, we will evaluate whether we can grow organoids from cancer cells and whether these tumor organoids can be used as a screening tool to predict treatment response in patients with metastatic colorectal cancer. Whole genome sequencing can additionally be performed to compare genetic characteristics with organoid drug screening results and patient response to treatment.

Methods
OPTIC (Organoids to Predict Treatment response In mCRC) is a multicenter observational cohort study. First, we will check whether the patient is eligible for study participation by CT-scan assessment and blood withdrawal. When a patient is eligible, biopsies (small tissue fragments) will be taken from the metastatic tumor lesion before the start of treatment and blood will be collected. The cancer cells from the biopsies will be cultured to grow a 3-dimensional structure: an organoid (mini-organ) that captures the specific characteristics of the tumor. Different treatments will be tested on these organoids. Additionally, a complete genetic test can be performed by whole genome sequencing (WGS).

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