Abstract

Lung cancer organoid (LCO) is a novel model of lung cancer that facilitates drug screening. However, the success rate of LCOs varies from 7% to 87%, and the culture medium compositions are markedly different. Airway organoid media can be used for LCO cultures, but this promotes the overgrowth of normal cell organoids especially in LCOs from intrapulmonary lesions. Several modified media are specifically utilized for promoting the cancer cell’s growth. For culturing high-purity LCOs, cancer cells from metastatic lesions and malignant effusions are used. Recently, single-cell RNA sequencing has identified previously unknown cell populations in the lungs and lung cancer. This sequencing technology can be used to validate whether the LCO recapitulates the heterogeneity and functional hierarchy of the primary tumor. Several groups have attempted to culture LCOs with mesenchymal cells and immune cells to recapitulate the tumor microenvironment. Disease modeling using LCO provides novel insight into the pathophysiology of lung cancer and enables high-throughput screening for drug discovery and prognosis prediction. An LCO model would help to identify new concepts as a basis for lung cancer targeting by discovering innovative therapeutic targets.

Highlights

  • Despite innovations in targeted therapy and immunotherapy in the last decade, lung cancer remains the most common cause of cancer related death [1,2,3] Tumor heterogeneity and drug resistance hamper the treatment of lung cancer [4]

  • Because the overgrowth of normal lung organoids is common in Lung cancer organoid (LCO) originating from surgical specimens, tumor cell purity is a critical issue for studies using LCOs

  • The genetic characteristics of tumor specimens and matching LCOs were compared by whole-exome sequencing and assessing copy number (CN) variation, variant allele fraction (VAF) distribution, and single nucleotide polymorphisms [10]

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Summary

Introduction

Despite innovations in targeted therapy and immunotherapy in the last decade, lung cancer remains the most common cause of cancer related death [1,2,3] Tumor heterogeneity and drug resistance hamper the treatment of lung cancer [4]. Organoids are three-dimensional cellular complexes that originate from embryonic stem cells, induced pluripotent stem (iPS) cells, or adult stem/progenitor cells [5,6,7,8]. They mimic the basic structure and function of the primary organ. Because the overgrowth of normal lung organoids is common in LCOs originating from surgical specimens, tumor cell purity is a critical issue for studies using LCOs. There is still controversy as to whether LCOs reflect tumor heterogeneity. Airway organoids originate from basal cells [8,16], which proliferate and differentiate to ciliated, goblet, and club cells in cyst-like structures. NA: nicotinamide, NAC: N-acetylcysteine, MAPKi: MAPK inhibitor, IGF-1: insulin like growth factor, FGF: fibroblast growth factor

Organoid Culture Media
Clinical Application of Lung Organoids
Purity of Cancer Cells in LCOs
Validation of LCOs
Tumor Microenvironment and Co-Culture
Disease Modeling and Clinical Application of LCOs
Findings
Conclusions
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