Authors: J. Mark Treherne.
Novel targeted drugs are already bringing significant benefits to many cancer patients. However, the costs of administering these new treatments often precludes their widespread use in routine clinical practice. The international pharmaceutical industry continues to defend these high prices by emphasising their need to compensate for the high attrition rate of promising new compounds through the drug discovery process and into clinical development. Early decisions on compound selection are often made by using conventional monolayer or suspension cultures of cancer cell lines, which can be poorly predictive of the relevant therapeutic effects subsequently observed on a patient’s tumour in the clinic. As a result, many apparently attractive new drugs that elicit positive data early on in cell-based assays or xenograft animal models then fail to deliver meaningful endpoints in clinical trials. Tumour-derived organoid lines grown in vitro from patient biopsies are a novel solution to this problem, as they have the potential to be more predictive earlier in discovery and thus reduce the high rate of compound attrition in downstream development. Bioprocessing technologies for the industrial expansion of organoids are now emerging to overcome this problem. This review will analyse the challenges and solutions required to exploit human cancer organoids to meet the growing demand for their practical application in drug discovery. By reducing the high rate of attrition of compounds in drug discovery, it is expected that the cost of new cancer treatments can be reduced and, therefore, made more widely available across the world. The future economic and medical benefits of this new approach are discussed, along with some consideration of the resultant carbon footprint of cancer drug discovery.
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