Organoids in Personalised Oncology: Advances and Clinical Translation Toward Precision Cancer Therapy

Cancer remains one of the most pressing global health challenges due to its high incidence and mortality. Intratumoral and intertumoral heterogeneity pose significant challenges to effective treatment, driving metastasis, recurrence, therapeutic resistance and ultimately treatment failure. The development of precision medicine urgently requires in vitro models that can faithfully capture patient-specific tumour complexity to guide individualised therapies. Recent advances in stem cell-based three-dimensional culture technologies have facilitated the establishment of organoid systems that closely replicate the architecture, molecular features, genomic alterations and microenvironment of primary tumours. Compared with conventional cell lines, organoids exhibit superior fidelity, making them a transformative platform for cancer modelling. They hold considerable promise for high-throughput drug screening, therapeutic response prediction, biomarker discovery and the design of personalised treatment strategies. Despite these advances, clinical translation is still hindered by challenges, such as the lack of standardisation, prolonged culture periods, high costs and regulatory and ethical constraints. This review summarises recent progress in tumour organoid research, with particular emphasis on their ability to replicate the genetic and biological features of parental tumours. We highlight their translational applications in immunotherapy, drug sensitivity prediction and individualised treatment, while also proposing strategies to address current limitations aiming to accelerate the integration of organoid technologies into precision oncology.