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 ...

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The authors have nothing to disclose.

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.

generation-culturing-high-grade-serous-ovarian-cancer-patient-derived

Research

JoVE Journal

Cancer Research

3.9K 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...