Colorectal cancer organoid co-culture systems and their applications in drug screening

Colorectal cancer (CRC) is a common malignant tumor. The incidence and mortality rates of CRC in China have been rising over the years. Organoids are micro-organs that can self-organize into three-dimensional structures and recapitulate the morphological structures and functions of native organs. Organoid culture technology is developing rapidly and has shown great potential for applications in translational biomedical research such as high-throughput screening, drug development, toxicity assessment, and personalized tumor treatment. In this review, we first introduce the development of patient-derived CRC organoid culture technologies. Then we elucidate CRC pathogenesis, with a systematic categorization of key signaling pathways and non-coding RNA regulatory networks. Next, we focus on established CRC organoid co-culture models that incorporate various components of the tumor microenvironment. Subsequently, we elaborate on the applications of these models in drug screening. Finally, we summarize the existing limitations of CRC organoid research and propose future directions for the field.