This research was supported by the National Natural Science Foundation of China (82122048; 82003773; 82203380) and Guangdong Basic and Applied Basic Research Foundation (2023A1515011416).

Human-biopsied tissues were obtained from the respective patient at the Affiliated Cancer Hospital and Institute of Guangzhou Medical University, and informed consent was obtained from the patients. See the Table of Materials for details about all materials, reagents, and instruments used in this protocol.
1. Establishing patient-derived HCC organoids from surgical samples
NOTE: The establishment of HCC organoids encompasses various s...

Optimizing HCC Organoid Formation for Target Identification and Drug Development

<ol>
	<li>Vogel, A., Meyer, T., Sapisochin, G., Salem, R., Saborowski, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hepatocellular+carcinoma.">Hepatocellular carcinoma.</a> Lancet. 400 (10360), 1345-1362 (2022).</li><li>Craig, A. J., von Felden, J., Garcia-Lezana, T., Sarcognato, S., Villanueva, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tumour+evolution+in+hepatocellular+carcinoma.">Tumour evolution in hepatocellular carcinoma.</a> Nature Reviews. Gastroenterology &amp; Hepatology. 17 (3), 139-152 (2020).</li><li>Yang, J. D., 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=A+global+view+of+hepatocellular+carcinoma:+trends,+risk,+prevention+and+management.">A global view of hepatocellular carcinoma: trends, risk, prevention and management.</a> Nature Reviews. Gastroenterology &amp; Hepatology. 16 (10), 589-604 (2019).</li><li>Huang, A., Yang, X. R., Chung, W. Y., Dennison, A. R., Zhou, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeted+therapy+for+hepatocellular+carcinoma.">Targeted therapy for hepatocellular carcinoma.</a> Signal Transduction and Targeted Therapy. 5 (1), 146 (2020).</li><li>Cancer Genome Atlas Research Network. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comprehensive+and+Integrative+Genomic+Characterization+of+Hepatocellular+Carcinoma.">Comprehensive and Integrative Genomic Characterization of Hepatocellular Carcinoma.</a> Cell. 169 (7), 1327.e23-1341.e23 (2017).</li><li>Broutier, L., 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=Human+primary+liver+cancer-derived+organoid+cultures+for+disease+modeling+and+drug+screening.">Human primary liver cancer-derived organoid cultures for disease modeling and drug screening.</a> Nature Medicine. 23 (12), 1424-1435 (2017).</li><li>Driehuis, E., Kretzschmar, K., 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=Establishment+of+patient-derived+cancer+organoids+for+drug-screening+applications.">Establishment of patient-derived cancer organoids for drug-screening applications.</a> Nature Protocols. 15 (10), 3380-3409 (2020).</li><li>Peng, W. C., Kraaier, L. J., Kluiver, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hepatocyte+organoids+and+cell+transplantation:+What+the+future+holds.">Hepatocyte organoids and cell transplantation: What the future holds.</a> Experimental &amp; Molecular Medicine. 53 (10), 1512-1528 (2021).</li><li>Nuciforo, S., 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=Organoid+models+of+human+liver+cancers+derived+from+tumor+needle+biopsies.">Organoid models of human liver cancers derived from tumor needle biopsies.</a> Cell Reports. 24 (5), 1363-1376 (2018).</li><li>Liu, 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=A+hepatocyte+differentiation+model+reveals+two+subtypes+of+liver+cancer+with+different+oncofetal+properties+and+therapeutic+targets.">A hepatocyte differentiation model reveals two subtypes of liver cancer with different oncofetal properties and therapeutic targets.</a> Proceedings of the National Academy of Sciences of the United States of America. 117 (11), 6103-6113 (2020).</li><li>Kong, F. 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=Targeting+tumor+lineage+plasticity+in+hepatocellular+carcinoma+using+an+anti-CLDN6+antibody-drug+conjugate.">Targeting tumor lineage plasticity in hepatocellular carcinoma using an anti-CLDN6 antibody-drug conjugate.</a> Science Translational Medicine. 13 (579), eabb6282 (2021).</li><li>Li, 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=Identification+and+functional+characterization+of+potential+oncofetal+targets+in+human+hepatocellular+carcinoma.">Identification and functional characterization of potential oncofetal targets in human hepatocellular carcinoma.</a> STAR Protocols. 3 (4), 101921 (2022).</li><li>Li, 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=Cancer+stem+cell-mediated+therapeutic+resistance+in+hepatocellular+carcinoma.">Cancer stem cell-mediated therapeutic resistance in hepatocellular carcinoma.</a> Hepatoma Research. 8, 36 (2022).</li></ol>

One notable benefit of patient-derived organoid models lies in their capacity to faithfully replicate the biological characteristics of tumors, encompassing tissue structure and genomic landscape. These models demonstrate a remarkable level of accuracy and effectively mirror the heterogeneity and progression of tumors, even over extended periods of cultivation6,8,9. Through the utilization of this refined organoid culture protoc...

Hepatocellular carcinoma (HCC), a prevalent and extensively diverse tumor1, has garnered considerable attention within the medical community. The presence of lineage plasticity and substantial heterogeneity in HCC suggests that tumor cells originating from various patients and even distinct lesions within the same patient may manifest dissimilar molecular and phenotypic traits, thereby presenting formidable obstacles in the advancement of innovative therapeutic approaches2,3,4,5. Consequently, there is an imperative need for enhanced comprehension of the biological attributes and mechanisms of drug resistance in HCC to inform the formulation of more efficacious treatment strategies.
In recent decades, researchers have dedicated their efforts to the development of in vitro models for the purpose of studying HCC3,4. Despite some advancements, limitations persist. These models encompass a range of techniques, such as the utilization of cell lines, primary cells, and patient-derived xenografts (PDX). Cell lines serve as in vitro models for long-term culture of tumor cells obtained from HCC patients, offering the benefits of convenience and facile expansion. Primary cell models involve direct isolation and culture of primary tumor cells from patient tumor tissues, thereby providing a representation of biological characteristics that closely resemble those of the patients themselves. PDX models entail the transplantation of patient tumor tissues into mice, with the aim of more faithfully simulating tumor growth and response. These models have been instrumental in HCC research, yet they possess certain limitations, including the heterogeneity of cell lines and the inability to fully replicate in vivo conditions. Furthermore, prolonged in vitro cultivation may result in the deterioration of the cells&#39; original characteristics and functionalities, posing challenges in accurately representing the biological properties of HCC. Additionally, the utilization of PDX models is both time-consuming and costly3.
To address these limitations and more accurately replicate the physiological attributes of HCC, the utilization of organoid technology has been introduced as a promising research platform capable of surpassing previous constraints. Organoids, which are three-dimensional cell models cultured in vitro, have the ability to replicate the structure and functionality of actual organs. However, in the context of HCC, there exist certain challenges in establishing organoid models. These challenges include insufficiently detailed descriptions of HCC organoid construction procedures, a lack of comprehensive protocols for the entire process of HCC organoid construction, and the typically small size of cultured organoids6,7,8. In light of the typically limited dimensions of cultured organoids, we endeavored to tackle these challenges through the development of a comprehensive protocol encompassing the entirety of HCC organoid construction6. This protocol encompasses tissue dissociation, organoid plating, culture, passaging, cryopreservation, and resuscitation. By optimizing the procedural steps and refining the composition of the culture medium, we have successfully established HCC organoid models capable of sustained growth and long-term passaging6,8. In the subsequent sections, a comprehensive account of the operational intricacies and pertinent factors involved in the construction of HCC organoids will be presented.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>[Leu15]-gastrin I human</td>
			<td>Merck</td>
			<td>G9145</td>
			<td></td>
		</tr>
		<tr>
			<td>1.5 mL Microtubes</td>
			<td>Merck</td>
			<td>AXYMCT150LC</td>
			<td></td>
		</tr>
		<tr>
			<td>A8301 (TGF&#946; inhibitor)</td>
			<td>Tocris Bioscience</td>
			<td>2939</td>
			<td></td>
		</tr>
		<tr>
			<td>B27 Supplement (503), minus vitamin A</td>
			<td>Thermo Fisher Scientific</td>
			<td>12587010</td>
			<td></td>
		</tr>
		<tr>
			<td>B-27 Supplement (503), serum-free</td>
			<td>Thermo Fisher Scientific</td>
			<td>17504044</td>
			<td></td>
		</tr>
		<tr>
			<td>BMP7</td>
			<td>Peprotech</td>
			<td>120-03P</td>
			<td></td>
		</tr>
		<tr>
			<td>Cell strainer size 100 &#956;m</td>
			<td>Merck</td>
			<td>CLS352360</td>
			<td></td>
		</tr>
		<tr>
			<td>CHIR99021</td>
			<td>Merck</td>
			<td>SML1046</td>
			<td></td>
		</tr>
		<tr>
			<td>Collagenase D</td>
			<td>Merck</td>
			<td>11088858001</td>
			<td></td>
		</tr>
		<tr>
			<td>Corning&#160;Costar Ultra-Low</td>
			<td>Merck</td>
			<td>CLS3473</td>
			<td></td>
		</tr>
		<tr>
			<td>Costar 24-well Clear Flat Bottom Ultra-Low Attachment Multiple Well Plates, Individually Wrapped, Sterile</td>
			<td>Corning</td>
			<td>3473</td>
			<td></td>
		</tr>
		<tr>
			<td>Costar 6-well Clear Flat Bottom Ultra-Low Attachment Multiple Well Plates, Individually Wrapped, Sterile</td>
			<td>Corning</td>
			<td>3471</td>
			<td></td>
		</tr>
		<tr>
			<td>Cultrex Organoid Harvesting Solution</td>
			<td>R&#38;D SYSTEMS</td>
			<td>3700-100-01</td>
			<td>Organoid harvesting solution</td>
		</tr>
		<tr>
			<td>Cultrex Reduced Growth Factor BME, Type 2 PathClear (BME)</td>
			<td>Merck</td>
			<td>3533-005-02</td>
			<td></td>
		</tr>
		<tr>
			<td>DAPT</td>
			<td>Merck</td>
			<td>D5942</td>
			<td></td>
		</tr>
		<tr>
			<td>Dexamethasone</td>
			<td>Merck</td>
			<td>D4902</td>
			<td></td>
		</tr>
		<tr>
			<td>DMSO</td>
			<td>Merck</td>
			<td>C6164</td>
			<td></td>
		</tr>
		<tr>
			<td>DNaseI</td>
			<td>Merck</td>
			<td>DN25</td>
			<td></td>
		</tr>
		<tr>
			<td>Dulbecco&#39;s Modified Eagle Medium/Ham&#39;s F-12</td>
			<td>Thermo Fisher Scientific</td>
			<td>12634028</td>
			<td>Advanced DMEM/F-12</td>
		</tr>
		<tr>
			<td>Earle&#8217;s balanced salt solution (EBSS)</td>
			<td>Thermo Fisher Scientific</td>
			<td>24010043</td>
			<td></td>
		</tr>
		<tr>
			<td>Forceps</td>
			<td>N/A</td>
			<td>N/A</td>
			<td></td>
		</tr>
		<tr>
			<td>Forskolin</td>
			<td>Tocris Bioscience</td>
			<td>1099</td>
			<td></td>
		</tr>
		<tr>
			<td>GlutaMAX supplement</td>
			<td>Thermo Fisher Scientific</td>
			<td>35050061</td>
			<td></td>
		</tr>
		<tr>
			<td>HEPES, 1 M</td>
			<td>Thermo Fisher Scientific</td>
			<td>15630080</td>
			<td></td>
		</tr>
		<tr>
			<td>Leica DM6 B Fluorescence Motorized Microscope</td>
			<td>Leica</td>
			<td>N/A</td>
			<td></td>
		</tr>
		<tr>
			<td>N2 supplement (1003)</td>
			<td>Thermo Fisher Scientific</td>
			<td>17502048</td>
			<td></td>
		</tr>
		<tr>
			<td>N-acetylcysteine</td>
			<td>Merck</td>
			<td>A0737-5MG</td>
			<td></td>
		</tr>
		<tr>
			<td>Nicotinamide</td>
			<td>Merck</td>
			<td>N0636</td>
			<td></td>
		</tr>
		<tr>
			<td>Nunc 15 mL Conical Sterile Polypropylene Centrifuge Tubes</td>
			<td>Thermo Fisher Scientific</td>
			<td>339651</td>
			<td></td>
		</tr>
		<tr>
			<td>Nunc 50 mL Conical Sterile Polypropylene Centrifuge Tubes</td>
			<td>Thermo Fisher Scientific</td>
			<td>339653</td>
			<td></td>
		</tr>
		<tr>
			<td>Penicillin/streptomycin (10,000 U/mL)</td>
			<td>Thermo Fisher Scientific</td>
			<td>15140122</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant human EGF</td>
			<td>Peprotech</td>
			<td>AF-100-15</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant human FGF10</td>
			<td>Peprotech</td>
			<td>100-26</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant human FGF19</td>
			<td>Peprotech</td>
			<td>100-32</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant human HGF</td>
			<td>Peprotech</td>
			<td>100-39</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant human Noggin</td>
			<td>Peprotech</td>
			<td>120-10C</td>
			<td></td>
		</tr>
		<tr>
			<td>Rho kinase inhibitor Y-27632 dihydrochloride</td>
			<td>Merck</td>
			<td>Y0503</td>
			<td></td>
		</tr>
		<tr>
			<td>R-spodin1-conditioned medium</td>
			<td>(Broutier et al.)</td>
			<td>N/A</td>
			<td>Secretion of cell lines</td>
		</tr>
		<tr>
			<td>Surgical scissors</td>
			<td>N/A</td>
			<td>N/A</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical specimen of tumor removed from HCC patients</td>
			<td>Affiliated Cancer Hospital and Institute of Guangzhou Medical University</td>
			<td>N/A</td>
			<td></td>
		</tr>
		<tr>
			<td>TNF&#945;</td>
			<td>Peprotech</td>
			<td>315-01A</td>
			<td></td>
		</tr>
		<tr>
			<td>TrypLE Express Enzyme (1x), no phenol red</td>
			<td>Thermo Fisher Scientific</td>
			<td>12604013</td>
			<td>Trypsin substitute</td>
		</tr>
		<tr>
			<td>Wnt-3a-conditioned medium</td>
			<td>(Broutier et al.)</td>
			<td>N/A</td>
			<td>Secretion of cell lines</td>
		</tr>
	</tbody>
</table>

development and optimization of a human hepatocellular carcinoma patient-derived organoid model for potential target identification and drug discovery

Hepatocellular carcinoma (HCC) is a highly prevalent and lethal tumor worldwide and its late discovery and lack of effective specific therapeutic agents necessitate further research into its pathogenesis and treatment. Organoids, a novel model that closely resembles native tumor tissue and can be cultured in vitro, have garnered significant interest in recent years, with numerous reports on the development of organoid models for liver cancer. In this study, we have successfully optimized the procedure and established a culture protocol that enables the formation of larger-sized HCC organoids with stable passaging and culture conditions. We have comprehensively outlined each step of the procedure, covering the entire process of HCC tissue dissociation, organoid plating, culture, passaging, cryopreservation, and resuscitation, and provided detailed precautions in this paper. These organoids exhibit genetic similarity to the original HCC tissues and can be utilized for diverse applications, including the identification of potential therapeutic targets for tumors and subsequent drug development.

Author Spotlight: Investigating Liver Cancer Pathogenesis Using Patient-Derived Organoids 

Development and Optimization of A Human Hepatocellular Carcinoma Patient-Derived Organoid Model for Potential Target Identification and Drug Discovery

Our lab aims to investigate the molecular pathogenesis of liver cancer and identify novel therapeutic targets for drug development. We would like to answer how cancer initiates, metastasis, and progress to drug tolerance utilizing novel disease models such as patient derived organoids. The current experimental challenges are in two aspects.First, there is a lack of complete set of protocols for constructing hepatocellular carcinoma organoids for the whole process. Second, the size of cultured HCC organoids is too small for subsequent experimental processing. In this protocol, we provide the details of the optimized organoids culture and subsequent transfer and freezing procedures, as well as the precautions to be taken during all the procedures.We optimized the composition of the organoid medium for organoids with close to the original tissue characteristics. We may monitor the tumor evolution using the patient-derived organoids and try to identify novel molecular and therapeutic targets for HCC treatment.

Upon implementing the aforementioned procedure, the emergence of HCC organoid spheroids is typically observable within a span of 3 days (Figure 1). Figure 1A,B show the established HCC organoid, which promptly develops compact spheroids characterized by rounded edges and permeable cytosol on the initial day of establishment. During the growth of HCC organoids, the use of different concentrations of BME had different effects on the growth rate of...

Watch this Scientific Journal Video about Investigating Liver Cancer Pathogenesis Using Patient-Derived Organoids at JoVE.com

We provide a comprehensive overview and refinement of existing protocols for hepatocellular carcinoma (HCC) organoid formation, encompassing all stages of organoid cultivation. This system serves as a valuable model for the identification of potential therapeutic targets and the assessment of drug candidate effectiveness.

Hepatocellular carcinoma (HCC) is a highly prevalent and lethal tumor worldwide and its late discovery and lack of effective specific therapeutic agents ...

development-optimization-human-hepatocellular-carcinoma-patient