Tumor Organoids as Platforms for Precision Medicine: Current Status, Methodological Challenges, and Future Directions

Patient-derived tumor organoids have emerged as a transformative preclinical model, bridging the gap between traditional two-dimensional cell cultures and the complexity of human tumors in vivo. By recapitulating the histological architecture, genetic heterogeneity, and, in co-culture systems, elements of the tumor microenvironment, organoids offer a physiologically relevant platform for studying cancer biology and predicting individual patient responses to therapy. Their growing use in drug screening, biomarker discovery, and functional precision medicine positions them as a key tool for closing the gap between genomic profiling and actionable treatment decisions.Despite this promise, significant challenges remain before tumor organoids can be reliably integrated into routine clinical workflows. Establishment efficiency varies widely across tumor types, and current culture systems often fail to capture critical non-epithelial components such as immune cells, stroma, and vasculature, limiting their utility for immunotherapy response prediction. Standardization of organoid generation, characterization, and drug-response assays remains an unresolved issue, complicating cross-study comparisons and clinical validation. Questions also persist regarding the fidelity of organoids to the originating tumor over serial passaging, the turnaround time required for clinically actionable results, and the scalability of these systems for high-throughput applications.This Research Topic aims to consolidate current knowledge on tumor organoid technology as applied to precision oncology, while critically examining the methodological barriers that must be overcome for broader clinical translation. We welcome contributions addressing, but not limited to, the following themes:o Advances in organoid biobanking and their application to drug sensitivity and resistance profilingo Co-culture and bioengineering strategies to incorporate immune, stromal, or vascular components into tumor organoid modelso Comparative analyses of organoid fidelity to parental tumors, including genomic, transcriptomic, and phenotypic concordanceo Standardization and quality control frameworks for organoid generation, culture, and functional assayso Integration of organoid-based functional testing with genomic and molecular profiling for treatment selectiono Applications of high-throughput screening, single-cell technologies, and computational modeling in organoid researcho Clinical validation studies correlating organoid drug response with patient outcomeso Organ- or tumor type-specific advances and challenges (e.g., gastrointestinal, breast, lung, pancreatic, and rare cancers)o Ethical, regulatory, and logistical considerations for implementing organoid-guided therapy in clinical practiceBy bringing together researchers working across organoid biology, tumor immunology, bioengineering, and clinical oncology, this Research Topic seeks to advance a shared understanding of where tumor organoid technology currently stands, what barriers limit its clinical adoption, and what innovations are needed to fully realize its potential as a precision medicine tool. Contributions offering critical perspectives, methodological innovations, and translational insights are strongly encouraged.Please note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal. Topic editors: Dr.Rajeev Nema, Neha Arya, Aashish Soni Source: https://www.frontiersin.org/research-topics/84678/tumor-organoids-as-platforms-for-precision-medicine-current-status-methodological-challenges-and-future-directions