We are grateful for the guidance of Ron Bose, MD, PhD, and the assistance of Barbara Blachut, MD, in establishing this protocol. We would also like to acknowledge Washington University&#39;s School of Medicine in St. Louis&#39;s Department of Obstetrics and Gynecology and Division of Gynecologic Oncology, Washington University&#39;s Dean&#39;s Scholar Program, and the Reproductive Scientist Development Program for their support of this project.

All human tissue specimens collected for research were obtained according to the Institutional Review Board (IRB)-approved protocol. The protocols outlined below were performed in a sterile human tissue culture environment. Informed written consent was obtained from human subjects. Eligible patients had to have a diagnosis or presumed diagnosis of ovarian cancer, be willing and able to sign informed consent, and be at least 18 years of age. Tumor tissue (malignant primary tumor or metastatic sites), ascites, and pleural ...

<ol>
	<li>Bray, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Global+cancer+statistics+2018:+GLOBOCAN+estimates+of+incidence+and+mortality+worldwide+for+36+cancers+in+185+countries.">Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.</a> CA: A Cancer Journal for Clinicians. 68 (6), 394-424 (2018).</li><li>Drost, J., Clevers, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Organoids+in+cancer+research.">Organoids in cancer research.</a> Nature Reviews Cancer. 18 (7), 407-418 (2018).</li><li>Pauli, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Personalized+in+vitro+and+in+vivo+cancer+models+to+guide+precision+medicine.">Personalized in vitro and in vivo cancer models to guide precision medicine.</a> Cancer Discovery. 7 (5), 462-477 (2017).</li><li>Fujii, E., Kato, A., Suzuki, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient-derived+xenograft+(PDX)+models:+Characteristics+and+points+to+consider+for+the+process+of+establishment.">Patient-derived xenograft (PDX) models: Characteristics and points to consider for the process of establishment.</a> Journal of Toxicologic Pathology. 33 (3), 153-160 (2020).</li><li>Yang, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Application+of+ovarian+cancer+organoids+in+precision+medicine:+Key+challenges+and+current+opportunities.">Application of ovarian cancer organoids in precision medicine: Key challenges and current opportunities.</a> Frontiers in Cell and Developmental Biology. 9, 701429 (2021).</li><li>Yang, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient-derived+organoids:+A+promising+model+for+personalized+cancer+treatment.">Patient-derived organoids: A promising model for personalized cancer treatment.</a> Gastroenterology Report. 6 (4), 243-245 (2018).</li><li>Karakasheva, T. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Generation+and+characterization+of+patient-derived+head+and+neck,+oral,+and+esophageal+cancer+organoids.">Generation and characterization of patient-derived head and neck, oral, and esophageal cancer organoids.</a> Current Protocols in Stem Cell Biology. 53 (1), 109 (2020).</li><li>Madison, B. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Let-7+represses+carcinogenesis+and+a+stem+cell+phenotype+in+the+intestine+via+regulation+of+Hmga2.">Let-7 represses carcinogenesis and a stem cell phenotype in the intestine via regulation of Hmga2.</a> PLoS Genetics. 11 (8), 1005408 (2015).</li><li>Sato, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Single+Lgr5+stem+cells+build+crypt-villus+structures+in+vitro+without+a+mesenchymal+niche.">Single Lgr5 stem cells build crypt-villus structures in vitro without a mesenchymal niche.</a> Nature. 459 (7244), 262-265 (2009).</li><li>Murray, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HER2+and+APC+mutations+promote+altered+crypt-villus+morphology+and+marked+hyperplasia+in+the+intestinal+epithelium.">HER2 and APC mutations promote altered crypt-villus morphology and marked hyperplasia in the intestinal epithelium.</a> Cellular and Molecular Gastroenterology and Hepatology. 12 (3), 1105-1120 (2021).</li><li>Hill, S. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prediction+of+DNA+repair+inhibitor+response+in+short-term+patient-derived+ovarian+cancer+organoids.">Prediction of DNA repair inhibitor response in short-term patient-derived ovarian cancer organoids.</a> Cancer Discovery. 8 (11), 1404-1421 (2018).</li><li>Passarelli, M. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Leucyl-tRNA+synthetase+is+a+tumour+suppressor+in+breast+cancer+and+regulates+codon-dependent+translation+dynamics.">Leucyl-tRNA synthetase is a tumour suppressor in breast cancer and regulates codon-dependent translation dynamics.</a> Nature Cell Biology. 24 (3), 307-315 (2022).</li><li>Pleguezuelos-Manzano, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Establishment+and+culture+of+human+intestinal+organoids+derived+from+adult+stem+cells.">Establishment and culture of human intestinal organoids derived from adult stem cells.</a> Current Protocols in Immunology. 130 (1), 106 (2020).</li><li>Stumm, M. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validation+of+a+postfixation+tissue+storage+and+transport+medium+to+preserve+histopathology+and+molecular+pathology+analyses+(total+and+phosphoactivated+proteins,+and+FISH).">Validation of a postfixation tissue storage and transport medium to preserve histopathology and molecular pathology analyses (total and phosphoactivated proteins, and FISH).</a> American Journal of Clinical Pathology. 137 (3), 429-436 (2012).</li><li>Feldman, A. T., Wolfe, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tissue+processing+and+hematoxylin+and+eosin+staining.">Tissue processing and hematoxylin and eosin staining.</a> Methods in Molecular Biology. 1180, 31-43 (2014).</li><li>Ooft, S. N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient-derived+organoids+can+predict+response+to+chemotherapy+in+metastatic+colorectal+cancer+patients.">Patient-derived organoids can predict response to chemotherapy in metastatic colorectal cancer patients.</a> Science Translational Medicine. 11 (513), (2019).</li><li>Aisenbrey, E. A., Murphy, W. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Synthetic+alternatives+to+Matrigel.">Synthetic alternatives to Matrigel.</a> Nature Reviews Materials. 5 (7), 539-551 (2020).</li><li>Nanki, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient-derived+ovarian+cancer+organoids+capture+the+genomic+profiles+of+primary+tumours+applicable+for+drug+sensitivity+and+resistance+testing.">Patient-derived ovarian cancer organoids capture the genomic profiles of primary tumours applicable for drug sensitivity and resistance testing.</a> Scientific Reports. 10, 12581 (2020).</li><li>Mead, B. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Screening+for+modulators+of+the+cellular+composition+of+gut+epithelia+via+organoid+models+of+intestinal+stem+cell+differentiation.">Screening for modulators of the cellular composition of gut epithelia via organoid models of intestinal stem cell differentiation.</a> Nature Biomedical Engineering. 6 (4), 476-494 (2022).</li></ol>

Ovarian cancer is extremely deadly due to its advanced stage at diagnosis, as well as the common development of chemotherapy resistance. Many advances in ovarian cancer research have been made by utilizing cancer cell lines and PDX models; however, there is an evident need for a more representative and affordable in vitro model. PDOs have proven to accurately represent the tumor heterogeneity, the tumor microenvironment, and the genomic and transcriptomic features of their primary tumors and, thus, are ideal pre...

In 2021, approximately 21,410 women in the United States were newly diagnosed with epithelial ovarian cancer, and 12,940 women died of this disease1. Although sufficient advancements have been made in surgery and chemotherapy, over 70% of patients with advanced disease develop chemotherapeutic resistance and die within 5 years of diagnosis2,3. Thus, new strategies to treat this deadly disease and representative, reliable models for preclinical research are urgently needed.
Cancer cell lines and patient-derived xenografts (PDX) created from primary ovarian tumors are the main instruments used in ovarian cancer research. A major advantage of cancer cell lines is their rapid expansion. However, their continual culture results in phenotypic and genotypic alterations that cause the cancer cell lines to deviate from the original primary cancer tumor sample. Due to the existing differences between the cancer cell line and the primary tumor, drug assays that have positive effects in cell lines fail to have these same effects in clinical trials2. To overcome these limitations, PDX models are used. These models are created by implanting fresh ovarian cancer tissue into immunodeficient mice. As they are in vivo models, they more accurately resemble human biological characteristics and, in turn, are more predictive of drug outcomes. However, these models also have significant limitations, including the cost, time, and resources needed to generate them4.
PDOs offer an alternative model for preclinical research that overcomes the limitations of both cancer cell lines and PDX models. PDOs recapitulate a patient&#39;s tumor and tumor microenvironment and, thus, provide an in vitro tractable model ideal for preclinical research2,3,5. These 3D models have self-organization capabilities that model the primary tumor, which is a feature that their two-dimensional (2D) cell line counterparts do not possess. Further, these models have been shown to genetically and functionally represent their parent tumors and, thus, are reliable models for studying novel therapeutics and biological processes. In short, they offer long-term expansion and storage capabilities similar to cell lines but also encompass the microenvironment and cell-cell interactions inherent to mouse models4,6.
The present protocol describes the creation of PDOs from patient-derived tumors, ascites, and pleural fluid samples with a higher than 97% success rate. The PDO cultures can then be expanded for multiple generations and used to test drug therapy sensitivity and predictive biomarkers. This method represents a technique that could be used to personalize treatments based on the therapeutic responses of PDOs.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>1% HEPES</td>
			<td>Life Technologies</td>
			<td>15630080</td>
			<td></td>
		</tr>
		<tr>
			<td>1% Penicillin-Streptomycin</td>
			<td>Fisher Scientific</td>
			<td>30002CI</td>
			<td></td>
		</tr>
		<tr>
			<td>1.5 mL Eppendorf Tubes&#160;</td>
			<td>Genesee Scientific</td>
			<td>14125</td>
			<td></td>
		</tr>
		<tr>
			<td>10 cm Tissue Culture Dish&#160;</td>
			<td>TPP</td>
			<td>93100</td>
			<td></td>
		</tr>
		<tr>
			<td>10 mL Serological Pipet</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>100 &#181;m Cell Filter</td>
			<td>MidSci</td>
			<td>100ICS</td>
			<td></td>
		</tr>
		<tr>
			<td>15 mL centrifuge tubes</td>
			<td>Corning</td>
			<td>430052</td>
			<td></td>
		</tr>
		<tr>
			<td>2 mL Cryovial</td>
			<td>Simport Scientific</td>
			<td>T301-2</td>
			<td></td>
		</tr>
		<tr>
			<td>2% Paraformaldehyde Fixative</td>
			<td>Sigma-Aldrich</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>37 &#176;C water bath&#160;</td>
			<td>NEST</td>
			<td>602052</td>
			<td></td>
		</tr>
		<tr>
			<td>3dGRO R-Spondin-1 Conditioned Media Supplement</td>
			<td>Millipore Sigma</td>
			<td>SCM104</td>
			<td></td>
		</tr>
		<tr>
			<td>6 well plates</td>
			<td>TPP</td>
			<td>92006</td>
			<td></td>
		</tr>
		<tr>
			<td>70% Ethanol</td>
			<td>Sigma-Aldrich</td>
			<td>R31541GA</td>
			<td></td>
		</tr>
		<tr>
			<td>A83-01</td>
			<td>Sigma-Aldrich</td>
			<td>SML0788</td>
			<td></td>
		</tr>
		<tr>
			<td>Advanced DMEM/F12</td>
			<td>ThermoFisher</td>
			<td>12634028</td>
			<td></td>
		</tr>
		<tr>
			<td>Agar</td>
			<td>Lamda Biotech</td>
			<td>C121</td>
			<td></td>
		</tr>
		<tr>
			<td>B-27</td>
			<td>Life Technologies</td>
			<td>17504044</td>
			<td></td>
		</tr>
		<tr>
			<td>Centrifuge&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Cultrex Type 2</td>
			<td>R&#38;D Systems</td>
			<td>3533-010-02</td>
			<td>basement membrane extract</td>
		</tr>
		<tr>
			<td>DNase I</td>
			<td>New England Bio Labs</td>
			<td>M0303S</td>
			<td></td>
		</tr>
		<tr>
			<td>DNase I Reaction Buffer</td>
			<td>New England Bio Labs</td>
			<td>M0303S</td>
			<td></td>
		</tr>
		<tr>
			<td>EGF</td>
			<td>PeproTech</td>
			<td>AF-100-15</td>
			<td></td>
		</tr>
		<tr>
			<td>FBS&#160;</td>
			<td>Sigma-Aldrich</td>
			<td>F2442</td>
			<td></td>
		</tr>
		<tr>
			<td>FGF-10</td>
			<td>PeproTech</td>
			<td>100-26</td>
			<td></td>
		</tr>
		<tr>
			<td>FGF2</td>
			<td>PeproTech</td>
			<td>100-18B</td>
			<td></td>
		</tr>
		<tr>
			<td>gentleMACS C Tubes</td>
			<td>Miltenyi BioTech</td>
			<td>130-096-334</td>
			<td></td>
		</tr>
		<tr>
			<td>gentleMACS Octo Dissociator with Heaters</td>
			<td>Miltenyi BioTech</td>
			<td>130-096-427</td>
			<td>We use the manufacturers protocol.</td>
		</tr>
		<tr>
			<td>GlutaMAX</td>
			<td>Life Technologies</td>
			<td>35050061</td>
			<td>dipeptide, L-alanyl-L-glutamine</td>
		</tr>
		<tr>
			<td>Hematoxylin and Eosin Staining Kit</td>
			<td>Fisher Scientific</td>
			<td>NC1470670</td>
			<td></td>
		</tr>
		<tr>
			<td>Histoplast Paraffin Wax</td>
			<td>Fisher Scientific</td>
			<td>22900700</td>
			<td></td>
		</tr>
		<tr>
			<td>Microcentrifuge&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Mr. Frosty Freezing Container</td>
			<td>Fisher Scientific</td>
			<td>07202363S</td>
			<td></td>
		</tr>
		<tr>
			<td>N-acetylcysteine</td>
			<td>Sigma-Aldrich</td>
			<td>A9165</td>
			<td></td>
		</tr>
		<tr>
			<td>Nicotinamide</td>
			<td>Sigma-Aldrich</td>
			<td>N0636</td>
			<td></td>
		</tr>
		<tr>
			<td>p1000 Pipette with Tips&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>p200 Pipette with Tips&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Pasteur Pipettes 9&#34;</td>
			<td>Fisher Scientific</td>
			<td>1367820D</td>
			<td></td>
		</tr>
		<tr>
			<td>PBS</td>
			<td>Fisher Scientific</td>
			<td>MT21031CM</td>
			<td></td>
		</tr>
		<tr>
			<td>Pipet Controller</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Prostaglandin E2</td>
			<td>R&#38;D Systems</td>
			<td>2296</td>
			<td></td>
		</tr>
		<tr>
			<td>Puromycin&#160;</td>
			<td>ThermoFisher</td>
			<td>A1113802</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant Murine Noggin</td>
			<td>PeproTech</td>
			<td>250-38</td>
			<td></td>
		</tr>
		<tr>
			<td>Recovery Cell Culture Freezing Medium</td>
			<td>Invitrogen</td>
			<td>12648010</td>
			<td></td>
		</tr>
		<tr>
			<td>Red Blood Cell Lysis Buffer</td>
			<td>BioLegend</td>
			<td>420301</td>
			<td></td>
		</tr>
		<tr>
			<td>ROCK Inhibitor (Y-27632)</td>
			<td>R&#38;D Systems</td>
			<td>1254/1</td>
			<td></td>
		</tr>
		<tr>
			<td>SB202190</td>
			<td>Sigma-Aldrich</td>
			<td>S7076</td>
			<td></td>
		</tr>
		<tr>
			<td>T75 Flask</td>
			<td>MidSci</td>
			<td>TP90076</td>
			<td></td>
		</tr>
		<tr>
			<td>Tissue Culture Hood&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Tissue Embedding Cassette</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>TrypLE Express</td>
			<td>Invitrogen</td>
			<td>12604013</td>
			<td>animal origin-free, recombinant enzyme</td>
		</tr>
		<tr>
			<td>Type II Collagenase</td>
			<td>Life Technologies</td>
			<td>17101015</td>
			<td></td>
		</tr>
		<tr>
			<td>Vortex</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

generation and culturing of high-grade serous ovarian cancer patient-derived organoids

Organoids are 3D dynamic tumor models that can be grown successfully from patient-derived ovarian tumor tissue, ascites, or pleural fluid and aid in the discovery of novel therapeutics and predictive biomarkers for ovarian cancer. These models recapitulate clonal heterogeneity, the tumor microenvironment, and cell-cell and cell-matrix interactions. Additionally, they have been shown to match the primary tumor morphologically, cytologically, immunohistochemically, and genetically. Thus, organoids facilitate research on tumor cells and the tumor microenvironment and are superior to cell lines. The present protocol describes distinct methods to generate patient-derived ovarian cancer organoids from patient tumors, ascites, and pleural fluid samples with a higher than 97% success rate. The patient samples are separated into cellular suspensions by both mechanical and enzymatic digestion. The cells are then plated utilizing a basement membrane extract (BME) and are supported with optimized growth media containing supplements specific to the culturing of high-grade serous ovarian cancer (HGSOC). After forming initial organoids, the PDOs can sustain long-term culture, including passaging for expansion for subsequent experiments.

To generate PDOs, the samples were digested mechanically and enzymatically into single-cell suspensions. The cells were then resuspended in BME and supplemented with specifically engineered media (Figure 3). Organoids are typically established over a time frame of 10 days, after which they demonstrate discrete organoids in culture (Figure 4).
<img alt="Figure 3" class="xfigimg" src="/files/ft...

Watch this Scientific Journal Video about Generation and Culturing of High-Grade Serous Ovarian Cancer Patient-Derived Organoids at JoVE.com

Generation and Culturing of High-Grade Serous Ovarian Cancer Patient-Derived Organoids

Patient-derived organoids (PDO) are a three-dimensional (3D) culture that can mimic the tumor environment in vitro. In high-grade serous ovarian cancer, PDOs represent a model to study novel biomarkers and therapeutics.

Organoids are 3D dynamic tumor models that can be grown successfully from patient-derived ovarian tumor tissue, ascites, or pleural fluid and aid in the ...

Patient drive organoid models genetically and functionally represent their parent tumors and thus are reliable models for studying novel therapeutics and complex biologic processes in ovarian cancer. By recapitulating clonal heterogeneity, the tumor microenvironment, and in vitro cell to cell interactions, these models overcome the limitations of cancer cell lines and patient derived xenografts. Patient derived organoids offer long-term expansion and storage capabilities and mimic tumor physiology.As a result, they are ideal models for the study of novel therapeutics and predictive biomarkers. Begin harvesting of the organoids by placing the tumor samples in a 10 centimeter tissue culture dish and mincing the tissue to create a homogenous mixture using a disposable scalpel. Place the homogenous tissue mixture into a dissociation tube using forceps.For every one to two milliliters of homogenized tissue add seven to eight milliliters of one milligram per milliliter type two collagenase solution in organoid base medium and one milliliter of DNase One solution. Vortex the solution at 458 G.Liquefy the tissue while it is in the collagenase solution using the dissociation machine. Run the program 37 C underscore H underscore TDK three one hour until it is a single cell suspension.Once done, transfer the homogenized mixture to a new 50 milliliter conical tube. Add 20 to 40 milliliters of organoid base medium and vortex the solution at 458 G.Then filter the solution through a 100 micrometer cell strainer into a newly labeled 50 milliliter conical tube. Next, centrifuge the filtered mixture at 1, 650 G for five minutes at four degrees Celsius and aspirate the supernatant using a glass pasture pipette.Prepare 100 micrograms per milliliter Dnase One and resuspend the cells in one milliliter of Dnase One solution by adding drop wise DNase One solution. After 15 minutes of incubation at room temperature add 25 milliliters of organoid base medium to the cells and invert to mix. Then centrifuge the cells at 1, 650 G for five minutes at four degrees Celsius and carefully aspirate the supernatant using a glass pasture pipette.Resuspend the newly formed cell pellet in five milliliters of pre-warmed red blood cell or RBC lysis buffer. Vortex the solutions in each conical tube at 458 G and incubate for five minutes. Again, centrifuge the pellet suspended in RBC lysis buffer and aspirate the supernatant using a glass pasture pipette.Wash the pellet with 10 milliliter PBS and vortex the cells before centrifugation of the cells. For a large cell pellet, aspirate the PBS and add one milliliter of the organoid base medium on top of the pellet. After vortexing the solution, transfer 300 to 400 microliters of the cell suspension to a microcentrifuge tube.After five minutes of centrifugation, aspirate the supernatant and resuspend it in basement membrane extract, or BME, and organoid base medium using cold tips. Plate the resuspended cell solution into a six-well plate in 40 microliter aliquots. Plate up to five aliquots per well.Immediately place the well plate in the incubator for 20 minutes, and after the incubation, gently add two milliliters of the complete organoid medium into each well. Add one milliliter of organoid base medium to each well and pipette the media up and down directly onto the organoid tabs for dissociation. Collect all the medium containing the resuspended pellets in a 15 milliliter conical tube.Then, centrifuge the 15 milliliter conical tube containing the mixture for five minutes before aspirating the supernatant. Add one milliliter of animal-origin free recombinant enzyme to the cell pellet. Mix by vortexing and transfer the suspension to a 1.5 milliliter microcentrifuge tube.After 15 minutes of incubation in a 37 degree Celsius water bath and five minutes of centrifugation, aspirate the supernatant. Resuspend the pellet in BME and organoid base medium and plate the resuspended cell solution into a six-well plate in 40 microliter aliquots. Plate up to five aliquots per well.After 20 minutes of incubation, gently add two milliliters of the complete organoid medium into each well. Resuspend the passage organoid cell pellet in 0.5 to one milliliter of Recovery Cell Culture Freezing Medium and transfer one milliliter to each cryo vial before transferring them to minus 80 degrees and liquid nitrogen tank for long-term storage. Thaw the organoids by transferring the cryo vials stored in liquid nitrogen to 37 degrees Celsius water bath.Once thawed, transfer the organoids to a 15 milliliter conical tube and centrifuge them before aspirating the supernatant. Next, add one milliliter of PBS to the pellet and transfer the resuspended pellet to a 1.5 milliliter microcentrifuge tube After centrifugation at 1, 650 G for five minutes at four degrees Celsius, carefully aspirate the the supernatant using a glass pasture pipette. Resuspend the pellet in BME and organoid base medium and plate the resuspended cells onto a six-well plate in 40 microliter aliquots.Place up to five aliquots per well. Immediately place the plate in the incubator for 20 minutes before adding two milliliters of complete organoid medium to the wells. Organoids were established over 10 days after which they demonstrated discrete organoids in culture.Patient derived organoid cultures were assessed by embedding them into agarose and evaluating them with hematoxylin and eosin staining. It is important to consider the challenges of working with BME. The resuspension of of the cell pellet and BME must be done on ice ensuring no bubbles are formed in the process.This technique allows for further research on the impact of chemotherapy on organoid generation and development due to the problems encountered by patients who have undergone neoadjuvant chemotherapy.

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Research

JoVE Journal

Cancer Research

3.8K ビュー.  Washington University in St. Louis. 患者駆動型オルガノイドモデルは、遺伝的および機能的に親腫瘍を表すため、卵巣癌における新しい治療法および複雑な生物学的プロセスを研究するための信頼できるモデルです。これらのモデルは、クローンの不均一性、腫瘍微小環境、およびin vitro細胞間相互作用を再現することにより、癌細胞株および患者由来の異種移植片の限界を克服します。患者由来のオルガ...

ビデオ: Generation and Culturing of High-Grade Serous Ovarian Cancer Patient-Derived Organoids

High-Throughput In Vitro Assay using Patient-Derived Tumor Organoids

Patient-derived tumor organoids (PDOs) are expected to be a preclinical cancer model with better reproducibility of disease than traditional cell culture models. PDOs have been successfully generated from a variety of human tumors to recapitulate the architecture and function of tumor tissue accurately and efficiently. However, PDOs are unsuitable for an in vitro high-throughput assay system (HTS) or cell analysis using 96-well or 384-well plates when evaluating anticancer drugs because they are heterogeneous in size and form large clusters in culture. These cultures and assays use extracellular matrices, such as Matrigel, to create tumor tissue scaffolds. Therefore, PDOs have a low throughput and high cost, and it has been difficult to develop a suitable assay system. To address this issue, a simpler and more accurate HTS was established using PDOs to evaluate the potency of anticancer drugs and immunotherapy. An in vitro HTS was created that uses PDOs established from solid tumors cultured in 384-well plates. An HTS was also developed for assessment of antibody-dependent cellular cytotoxicity activity to represent the immune response using PDOs cultured in 96-well plates.

High-Throughput In Vitro Assay using Patient-Derived Tumor Organoids

A highly accurate in vitro high-throughput assay system was developed to evaluate anticancer drugs using patient-derived tumor organoids (PDOs), similar to cancer tissues but are unsuitable for in vitro high-throughput assay systems with 96-well and 384-well plates.

Patient-derived tumor organoids (PDOs) are expected to be a preclinical cancer model with better reproducibility of disease than traditional cell culture ...

Profiling Sensitivity to Targeted Therapies in EGFR-Mutant NSCLC Patient-Derived Organoids

Novel 3D cancer organoid cultures derived from clinical patient specimens represent an important model system to evaluate intratumor heterogeneity and treatment response to targeted inhibitors in cancer. Pioneering work in gastrointestinal and pancreatic cancers has highlighted the promise of patient-derived organoids (PDOs) as a patient-proximate culture system, with an increasing number of models emerging. Similarly, work in other cancer types has focused on establishing organoid models and optimizing culture protocols. Notably, 3D cancer organoid models maintain the genetic complexity of original tumor specimens and thus translate tumor-derived sequencing data into treatment with genetically informed targeted therapies in an experimental setting. Further, PDOs might foster the evaluation of rational combination treatments to overcome resistance-associated adaptation of tumors in the future. The latter focuses on intense research efforts in non-small-cell lung cancer (NSCLC), as resistance development ultimately limits the treatment success of targeted inhibitors. An early assessment of therapeutically targetable mechanisms using NSCLC PDOs could help inform rational combination treatments. This manuscript describes a standardized protocol for the cell culture plate-based assessment of drug sensitivities to targeted inhibitors in NSCLC-derived 3D PDOs, with potential adaptability to combinational treatments and other treatment modalities.

This protocol describes a standardized evaluation of drug sensitivities to targeted signaling inhibitors in NSCLC patient-derived organoid models.

Novel 3D cancer organoid cultures derived from clinical patient specimens represent an important model system to evaluate intratumor heterogeneity and ...

Establishment and Culture of Patient-Derived Breast Organoids

Breast cancer is a complex disease that has been classified into several different histological and molecular subtypes. Patient-derived breast tumor organoids developed in our laboratory consist of a mix of multiple tumor-derived cell populations, and thus represent a better approximation of tumor cell diversity and milieu than the established 2D cancer cell lines. Organoids serve as an ideal in vitro model, allowing for cell-extracellular matrix interactions, known to play an important role in cell-cell interactions and cancer progression. Patient-derived organoids also have advantages over mouse models as they are of human origin. Furthermore, they have been shown to recapitulate the genomic, transcriptomic as well as metabolic heterogeneity of patient tumors; thus, they are capable of representing tumor complexity as well as patient diversity. As a result, they are poised to provide more accurate insights into target discovery and validation and drug sensitivity assays. In this protocol, we provide a detailed demonstration of how patient-derived breast organoids are established from resected breast tumors (cancer organoids) or reductive mammoplasty-derived breast tissue (normal organoids). This is followed by a comprehensive account of 3D organoid culture, expansion, passaging, freezing, as well as thawing of patient-derived breast organoid cultures.

A detailed protocol is provided here for establishing human breast organoids from patient-derived breast tumor resections or normal breast tissue. The protocol provides comprehensive step-by-step instructions for culturing, freezing, and thawing human patient-derived breast organoids.

Breast cancer is a complex disease that has been classified into several different histological and molecular subtypes. Patient-derived breast tumor ...

Visualizing DNA Damage Repair Proteins in Patient-Derived Ovarian Cancer Organoids via Immunofluorescence Assays

Immunofluorescence is one of the most widely used techniques to visualize target antigens with high sensitivity and specificity, allowing for the accurate identification and localization of proteins, glycans, and small molecules. While this technique is well-established in two-dimensional (2D) cell culture, less is known about its use in three-dimensional (3D) cell models. Ovarian cancer organoids are 3D tumor models that recapitulate tumor cell clonal heterogeneity, the tumor microenvironment, and cell-cell and cell-matrix interactions. Thus, they are superior to cell lines for the evaluation of drug sensitivity and functional biomarkers. Therefore, the ability to utilize immunofluorescence on primary ovarian cancer organoids is extremely beneficial in understanding the biology of this cancer. The current study describes the technique of immunofluorescence to detect DNA damage repair proteins in high-grade serous patient-derived ovarian cancer organoids (PDOs). After exposing the PDOs to ionizing radiation, immunofluorescence is performed on intact organoids to evaluate nuclear proteins as foci. Images are collected using z-stack imaging on confocal microscopy and analyzed using automated foci counting software. The described methods allow for the analysis of temporal and special recruitment of DNA damage repair proteins and colocalization of these proteins with cell-cycle markers.

Visualizing DNA Damage Repair Proteins in Patient-Derived Ovarian Cancer Organoids via Immunofluorescence Assays

The present protocol describes methods for evaluating DNA damage repair proteins in patient-derived ovarian cancer organoids. Included here are comprehensive plating and staining methods, as well as detailed, objective quantification procedures.

Immunofluorescence is one of the most widely used techniques to visualize target antigens with high sensitivity and specificity, allowing for the accurate ...

Ovarian Cancer Patient-Derived Organoid Models for Pre-Clinical Drug Testing

Ovarian cancer is a fatal gynecologic cancer and the fifth leading cause of cancer death among women in the United States. Developing new drug treatments is crucial to advancing healthcare and improving patient outcomes. Organoids are in-vitro three-dimensional multicellular miniature organs. Patient-derived organoid (PDO) models of ovarian cancer may be optimal for drug screening because they more accurately recapitulate tissues of interest than two-dimensional cell culture models and are inexpensive compared to patient-derived xenografts. In addition, ovarian cancer PDOs mimic the variable tumor microenvironment and genetic background typically observed in ovarian cancer. Here, a method is described that can be used to test conventional and novel drugs on PDOs derived from ovarian cancer tissue and ascites. A luminescence-based adenosine triphosphate (ATP) assay is used to measure viability, growth rate, and drug sensitivity. Drug screens in PDOs can be completed in 7-10 days, depending on the rate of organoid formation and drug treatments.

We present a protocol that can be used to conduct therapeutic drug testing with patient-derived ovarian cancer organoids.

Ovarian cancer is a fatal gynecologic cancer and the fifth leading cause of cancer death among women in the United States. Developing new drug treatments ...

Derivation of 3D Glioma Organoids from Chopper-Processed Patient Tumors

Cultivating Ex Vivo Patient-Derived Glioma Organoids Using a Tissue Chopper

Glioblastoma, IDH-wild type, CNS WHO grade 4 (GBM) is a primary brain tumor associated with poor patient survival despite aggressive treatment. Developing realistic ex vivo models remain challenging. Patient-derived 3-dimensional organoid (PDO) models offer innovative platforms that capture the phenotypic and molecular heterogeneity of GBM, while preserving key characteristics of the original tumors. However, manual dissection for PDO generation is time-consuming, expensive and can result in a number of irregular and unevenly sized PDOs. This study presents an innovative method for PDO production using an automated tissue chopper. Tumor samples from four GBM and one astrocytoma, IDH-mutant, CNS WHO grade 2 patients were processed manually as well as using the tissue chopper. In the manual approach, the tumor material was dissected using scalpels under microscopic control, while the tissue chopper was employed at three different angles. Following culture on an orbital shaker at 37 &#176;C, morphological changes were evaluated using bright field microscopy, while proliferation (Ki67) and apoptosis (CC3) were assessed by immunofluorescence after 6 weeks. The tissue chopper method reduced almost 70% of the manufacturing time and resulted in a significantly higher PDOs mean count compared to the manually processed tissue from the second week onwards (week 2: 801 vs. 601, P = 0.018; week 3: 1105 vs. 771, P = 0.032; and week 4:1195 vs. 784, P &lt; 0.01). Quality assessment revealed similar rates of tumor-cell apoptosis and proliferation for both manufacturing methods. Therefore, the automated tissue chopper method offers a more efficient approach in terms of time and PDO yield. This method holds promise for drug- or immunotherapy-screening of GBM patients.

Author Spotlight: Enhanced Generation of Patient-Derived 3D Organoids for Glioblastoma and Glioma

This study introduces an automated method to generate patient-derived glioblastoma 3-dimensional organoids utilizing a tissue chopper. The method provides a suitable and effective approach to obtain such organoids for therapeutical testing.

Glioblastoma, IDH-wild type, CNS WHO grade 4 (GBM) is a primary brain tumor associated with poor patient survival despite aggressive treatment. Developing ...

Radiation Response in Patient-Derived Tumor Organoids Using a Clonogenic Assay

Live Imaging to Quantify Cellular Radiosensitivity in Patient-Derived Tumor Organoids

Radiation therapy (RT) is one of the mainstays of modern clinical cancer management. However, not all cancer types are equally sensitive to irradiation, often (but not always) because of differences in the ability of malignant cells to repair oxidative DNA damage as elicited by ionizing rays. Clonogenic assays have been employed for decades to assess the sensitivity of cultured cancer cells to ionizing irradiation, largely because irradiated cancer cells often die in a delayed manner that is difficult to quantify with short-term flow cytometry- or microscopy-assisted techniques. Unfortunately, clonogenic assays cannot be employed as such for more complex tumor models, such as patient-derived tumor organoids (PDTOs). Indeed, irradiating established PDTOs may not necessarily abrogate their growth as multicellular units, unless their stem-like compartment is completely eradicated. Moreover, irradiating PDTO-derived single-cell suspensions may not properly recapitulate the sensitivity of malignant cells to RT in the context of established PDTOs. Here, we detail an adaptation of conventional clonogenic assays that involves exposure of established PDTOs to ionizing radiation, followed by single-cell dissociation, replating in suitable culture conditions and live imaging. Non-irradiated (control) PDTO-derived stem-like cells reform growing PDTOs with a PDTO-specific efficiency, which is negatively influenced by irradiation in a dose-dependent manner. In these conditions, PDTO-forming efficiency and growth rate can be quantified as a measure of radiosensitivity on time-lapse images collected until control PDTOs achieve a predefined space occupancy.

Author Spotlight: Radiotherapy and Clonogenic Assays for Advancing Cancer Research and Personalized Medicine

Here, we detail a straightforward live imaging approach for quantifying the sensitivity of patient-derived tumor organoids to ionizing radiation.

Radiation therapy (RT) is one of the mainstays of modern clinical cancer management. However, not all cancer types are equally sensitive to irradiation, ...

Fixation of Ovarian Cancer Organoids for Long-Term Storage

Plating Intact Patient-Derived Organoids and Setting Up Imaging Parameters for Multiplexed Live-Cell Imaging

To begin, take a tube with patient-derived organoids or PDO suspension in an equal amount of basement membrane extracts, or BME. Using a 20 microliter pipette, seed five microliter domes into the center of each well of a pre-warmed 96 well plate. After seeding all the wells, place the lid on the plate and gently invert it.Incubate the inverted plate at 37 degrees Celsius for 20 minutes in the tissue culture incubator to allow the domes to solidify. Flip the plate over so that the lid is facing upwards. Then incubate again.After adding fluorescent dyes and drugs to the plates containing the PDOs. Place the plate in citation five. Start the Gen5 software and in the task manager window, select imager manual mode and click capture now.In the settings, specify the objective, filter, microplate format, and vessel type, select use lid and use slower carrier speed and click okay. Then choose a well of interest. Select the brightfield channel, click on auto expose and adjust the settings as required.Next to set up the Z stack, expand the imaging mode tab, select Z stack, and adjust the focus using the course adjustment arrows until all PDOs are out of focus. Establish this point as the bottom of the Z stack and repeat in reverse to set the top. Afterward, set up the fluorescent channels by opening the edit imaging step.Under channels, select the desired number of channels, designate one channel for the brightfield and additional channels for each fluorescent channel. Close the window by clicking okay, change the dropdown menu to the GFP to set the exposure for the first fluorescent channel, click auto expose and adjust the exposure settings under the exposure tab to reduce the background signal. To copy exposure settings to the image mode tab, click the copy icon and then click edit imaging step to open a new window.In the GFP channel, click the clipboard icon in the exposure line to add settings for illumination, integration time, and camera gain to the channel. Now click on the camera icon and choose image pre-processing under add processing step. On the brightfield tab, uncheck the apply image pre-processing option.For each fluorescent channel tab, ensure apply image pre-processing is checked. Deselect, use same options as channel one, and then click okay to close the window. Now click on Z projection under the add processing step, adjust the slice range if necessary, and close the window by clicking okay.To set up the protocol for kinetic imaging, in the toolbar click image set, and from the dropdown menu, choose create experiment from this image set. Click on options under the other heading and check the discontinuous kinetic procedure box. Under estimated total time, enter the runtime for the experiment.Close the window by clicking okay. Additionally, set plate layout and temperature gradient at this time. Validate the data reduction steps by clicking through the windows.Then navigate to file and click save protocol as in the toolbar. Select a save location. Enter a file name and click save.To begin kinetic imaging, load the protocol into the bio spa on demand scheduling software and choose an available slot. In the procedure info tab, select user from the menu. Next to the protocol slot, click select and choose add a new entry.Now click select next to the protocol slot. Click open to navigate and import the protocol into the scheduling software. Enter the required imaging time for the plate and click okay to close the window.Under interval, input the desired frequency of imaging, select schedule, plate, or vessel to initiate the plate validation sequence, click yes to accept this schedule.

Processing Tumors with Chopper to Obtain Patient-Derived Organoids

1 To begin, transfer the tumor tissue<v>2 immersed in 25 milliliters of hibernate A 3 into a sterilized glass petri dish 4 under a laminar flow cabinet. 5 Using a microscope, carefully eliminate 6 all the necrotic tissue. 7 Then use a scalpel 8 and tissue forceps to dissect the blood vessels out.9 Cut the tumor tissue into 10 one to two cubic centimeter pieces. 11 Transfer them into a plastic petri dish 12 containing three milliliters of H-GPSA medium, 13 and place the dish on ice. 14 To manually process the tumor, transfer the tumor piece 15 to a fresh glass petri dish.16 Using two scalpels, dissect the segment 17 into 0.5 milliliter sections under a microscope. 18 To mechanically process the tumor, first, 19 position the blade properly. 20 Then adjust the slice thickness to 0.45 to 0.50 millimeters, 21 and fix the table release knob to start mode.22 Cut the agaro block into a two centimeter-long cylinder 23 and glue it onto the circular plastic dish of the chopper. 24 Using a scalpel, create a pit in the agaro cylinder 25 and place the tumor tissue in the pit. 26 Then position the plastic disc onto the mounting disc 27 of the cutting table, and press the reset button 28 to start the chopping process.29 After the first round, rotate the mounting disc 30 by 90 degrees, and repeat again 31 to cut the tissue into rectangular pieces. 32 Remove the plastic disc. 33 And then using a tissue spatula, 34 rotate only the tumor tissue by 90 degrees.35 Return the plastic disc to the cutting table 36 and press reset to continue cutting. 37 Then using a five milliliter pipette, 38 transfer the processed material, 39 along with the medium, to the petri dish. 40 Place the dish immediately on ice.