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Biomarker analysis from patients with metastatic PDAC treated with TGFβ antibody, NIS793, plus abraxane+gemcitabine vs. abraxane+gemcitabine alone in a phase II, open label, randomized study.

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Functional Precision in Pancreatic Cancer: Redefining Biomarkers with Patient-Derived Organoids.

Claire Alexandra Chew1,2, Cheng Mun Wun1,2, Yi Fang Lee1,2

  • 1Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.

International Journal of Molecular Sciences
|September 27, 2025
PubMed
Summary

Pancreatic cancer research needs better biomarkers. Patient-derived organoids (PDOs) offer a dynamic platform for functional precision medicine, improving therapeutic strategies for pancreatic ductal adenocarcinoma (PDAC).

Keywords:
biomarkerschemosensitivitypancreatic ductal adenocarcinomapatient-derived organoidsprecision medicine

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Area of Science:

  • Oncology
  • Biomarker Discovery
  • Translational Medicine

Background:

  • Pancreatic cancer, particularly pancreatic ductal adenocarcinoma (PDAC), has a poor prognosis despite treatment advances.
  • Current molecular subtypes lack clinical utility for real-time treatment decisions.
  • Clinically actionable biomarkers for PDAC are urgently needed.

Purpose of the Study:

  • To review limitations of current PDAC biomarker strategies.
  • To propose a functional reframing of biomarker development using patient-derived organoids (PDOs).
  • To highlight PDOs' potential in advancing precision medicine for PDAC.

Main Methods:

  • Review of current literature on PDAC biomarkers and patient-derived organoids.
  • Exploration of four key domains of PDO application: drug response phenotyping, modeling chemoresistance, incorporating tumor microenvironment, and functional profiling (proteomics, metabolomics).

Main Results:

  • Current subtype classifications offer limited prognostic value and do not guide treatment effectively.
  • Patient-derived organoids (PDOs) serve as dynamic platforms for capturing clinically relevant biology.
  • PDOs enable functional profiling, including drug response, chemoresistance, and tumor microenvironment interactions.

Conclusions:

  • Patient-derived organoids (PDOs) represent a promising functional approach to biomarker development in PDAC.
  • PDOs facilitate a shift from static tumor avatars to dynamic platforms for personalized medicine.
  • Functional precision medicine using PDOs may lead to more tailored and effective treatment strategies for pancreatic cancer.