Researchers from HSE University and the Russian Ministry of Health National Medical Research Radiological Centre have successfully generated a three-dimensional laboratory model of prostate cancer and used the model for testing an anti-tumour drug. In the future, this approach has the potential to significantly enhance the efficacy of cancer treatment for patients. The study’s findings have been published in Cancer Urology.
A primary challenge in managing prostate cancer is the high mortality rate once the disease progresses, even with the introduction of new types of treatment. Prostate cancer ranks as the second most prevalent and the fifth most deadly malignancy affecting men globally. Approximately 1.3 million new cases of prostate cancer are diagnosed worldwide each year, of which more than 38,000 are found in Russia, where this malignancy stands as the third-leading cause of mortality among all cancer types.
This form of cancer is managed through various treatments, including hormone therapy, chemotherapy, immunotherapy, radiotherapy, and targeted therapy. To enhance treatment efficacy, it is essential to select the optimal treatment regimen from the available options.
This can be accomplished by personalising treatment regimens based on the sensitivity of a patient’s tumour cells to drugs, determined through laboratory tests ( in vitro ) and live model experiments ( in vivo ). In some instances, this approach has already led to substantial improvements in treatment outcomes for cancer patients.
In recent years, there has been a growing use of tumour organoids, which are three-dimensional cultures derived from malignant cells. These cultures can preserve the characteristics of the original tumour, and testing drugs on them can reveal how the patient is likely to respond to treatment.
The researchers generated a culture of prostate tumour organoids and used it to assess the efficacy of docetaxel chemotherapy. The cytotoxicity test revealed (82.9%; p = 0.32) that in the case in question, docetaxel did not significantly decrease the viability of prostate cancer cells compared to the no-treatment control. This treatment therefore appeared to be ineffective for that specific tumour.
The potential to eliminate ineffective drugs through such testing could, in the future, prevent the prescription of treatments which only result in side effects without delivering a noticeable therapeutic benefit. Such a test will enable the early detection of ineffective options so that alternative treatment regimens better suited for a particular patient may be explored. However, before implementing this approach in practice, a few technical problems must be solved and clinical trials conducted.
Despite the new possibilities offered by prostate cancer organoid cultures, several factors continue to impede their widespread adoption in clinical practice:
The first challenge is the difficulty of obtaining cultures from specific tissues. While this approach demonstrates an effectiveness rate of 90% for colon cancer and 80% for breast cancer, it is notably lower for prostate cancer. Initially, researchers were able to cultivate organoids with an effectiveness rate of only 20%. Subsequently, this improved to 60%, but nevertheless, it still lags behind the results achieved for other cancers.
The second obstacle is the high cost of the materials required for cultivating organoids. However, recent studies indicate that further development of cultivation methods may lead to a reduction in the cost of this technology in the future.
The third challenge is the lack of studies that compare the results of laboratory tests with real-life treatment outcomes. However, such studies are currently underway, and when their results become available, the practical application of organoids is likely to gain popularity.
We successfully acquired a culture of prostate cancer cells and used it to assess the efficacy of a drug. Less than a month elapsed from the time of sampling to the receipt of results, indicating potential applicability of this technology in clinical practice. However, to put it into practice, further research is required, including comparing laboratory findings with patient outcomes, and enhancing the cell culture growth process to streamline it and reduce costs.