How can oncologists predict which cancer treatment is most likely to work for a given patient? Dr. Andrew Freywald explores that question by growing tiny, living models of real-life patient tumours — organoids— then watching how each one responds to existing cancer drugs.
Freywald, a longtime cancer researcher and professor in the Department of Pathology and Laboratory Medicine at the University of Saskatchewan's College of Medicine, said establishing an organoid development protocol took a "lot of trial and error."
"This is a complex process. It requires a lot of factors and also requires a lot of technical expertise," said Freywald, crediting his laboratory team. He said it took several years to create the right conditions to grow miniature pancreatic and ovarian tumours.
Freywald and his team deliberately chose two of the most difficult cancers to treat. Only 13 per cent of patients diagnosed with pancreatic cancer survive five years.
In women, ovarian cancer causes more deaths than any other cancer.
"Both cancers need serious improvements in treatment protocols," said Freywald.
He said when first-line cancer therapies don't work, modeling tumours in organoids will allow researchers to narrow down the most efficient drugs.
"It was amazing for me how really closely these models represent the regional tumors in terms of their genomic organization and in terms of their morphology," Freywald said.
He said the challenge lies in the tumours themselves. Each one is slightly different from the next.
"This uniqueness makes it very hard for oncologists to predict which tumor, which treatments would or would not work."
Over the coming months, Freywald and his team will test organoids derived from 100 individual tumour samples, assessing them against thousands of approved drugs. Their research is still in the proof-of-principle stage; it isn't yet a routine way to choose a patient's treatment.
But if Freywald and his team succeed, this could help pave the way for clinical trials and more personalised cancer care.
"Our analysis would probably provide these options to them and that would obviously improve their chances for survival," Freywald said.
His research is supported by donations to Saskatoon's Bruce Gordon Memorial Pancreatic Cancer Research Fund, along with Genome Prairie, CIHI, the University of Saskatchewan, the Saskatchewan Health Research Foundation, and health start-up OncoForma.
"Our hope is that when we pass these through initial stages, including clinical trials, we will be able to convince Health Canada to accept it as a standard of care, at least for some cancers," said Freywald.
"It's really exciting."
