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Author Spotlight: Advancing Personalized Medicine in Ovarian Cancer
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Author Spotlight: Advancing Personalized Medicine in Ovarian Cancer

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zAvatar-test-A functional precision model to personalize ovarian cancer treatments: Results from a co-clinical study

Marta F Estrada1, Filipa Amorim1, Filipa Ferreira da Silva2

  • 1Champalimaud Research, Champalimaud Foundation, 1400-038 Lisbon, Portugal.

Cell Reports. Medicine
|December 31, 2025
PubMed

Insights

Ovarian cancer patients often relapse. A new zebrafish avatar test accurately predicts chemotherapy response, improving progression-free survival and aiding personalized treatment decisions for recurrent ovarian cancer.

Area of Science:

  • Oncology
  • Translational Medicine
  • Zebrafish Models

Background:

  • Ovarian cancer has a high relapse rate (80%) after initial treatment.
  • Recurrent ovarian cancer lacks reliable tests for guiding chemotherapy selection.
  • This presents a significant unmet clinical need for personalized treatment strategies.

Purpose of the Study:

  • To develop and validate a functional in vivo model, the ovarian cancer zebrafish Avatar-test (zAvatar-test), for predicting patient response to chemotherapy.
  • To assess the accuracy of the zAvatar-test in predicting clinical outcomes in ovarian cancer patients.
  • To investigate the characteristics of patient tumors within the zAvatar model.

Main Methods:

  • Development of the zAvatar-test using patient-derived ovarian tumor cells implanted in zebrafish embryos.
  • Conducting the largest observational study to date (32 patients) to validate the zAvatar-test's predictive accuracy.
  • Analyzing progression-free survival in patients whose tumors were sensitive or resistant in the zAvatar-test.
  • Characterizing tumor dynamics, human-host cell interactions, and metastatic potential within the zAvatar model.

Main Results:

  • The zAvatar-test achieved 91% accuracy in predicting patient treatment outcomes.
  • Patients with zAvatar-sensitive tumors showed significantly longer progression-free survival (17 months vs. 6 months).
  • The zAvatar model exhibited dynamic human-host cell interactions and higher metastatic potential in poor-prognosis cases.
  • Venetoclax demonstrated potential in sensitizing multidrug-resistant tumors within the zAvatar model.

Conclusions:

  • The zAvatar-test is a highly accurate functional in vivo model for predicting ovarian cancer patient response to chemotherapy.
  • This test can assist clinicians in personalizing treatment strategies for ovarian cancer patients, particularly in recurrent settings.
  • Ongoing clinical trials are evaluating the zAvatar-test as a companion diagnostic tool in oncology.
Keywords:
evidence-based medicinefunctional precision medicineovarian cancerpersonalized medicinepre-clinical testingpredict treatment responsetranslationaltumor microenvironmentzAvatar modelzebrafish PDX

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