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Organoids cannot replace physiology in cancer drug development
1NOVA Medical School, Faculdade de Ciências Médicas, NMS|FCM, Universidade NOVA de Lisboa, 1169, Lisbon, Portugal; Comprehensive Health Research Centre (CHRC), NOVA Medical School|Faculdade de Ciências Médicas, NMS|FCM, Universidade NOVA de Lisboa, 1169, Lisbon, Portugal.
Trends in Biotechnology
|August 11, 2026
Summary
New approach methodologies show promise in cancer drug development but cannot fully replace animal studies. Integrated physiological evidence is still needed for whole-body assessments like toxicity and therapeutic index.
Area of Science:
- Oncology
- Toxicology
- Pharmacology
Background:
- Regulatory agencies are promoting new approach methodologies (NAMs) for cancer drug development.
- The efficacy of NAMs in replacing traditional animal studies is under scrutiny.
- Context-specific application of NAMs is crucial for their acceptance.
Purpose of the Study:
- To evaluate the capabilities and limitations of NAMs in cancer drug development.
- To determine which aspects of drug development can be addressed by NAMs.
- To identify areas where traditional animal studies remain essential.
Main Methods:
- Review of current literature on organoids, organs-on-chips, and computational models in preclinical cancer research.
- Analysis of regulatory guidelines and scientific consensus on NAMs.
- Comparison of data generated by NAMs versus animal models for specific endpoints.
Main Results:
- Organoids, organs-on-chips, and computational models can effectively address localized questions regarding drug efficacy and mechanism of action.
- These NAMs show potential for replacing animal studies in specific, well-defined contexts.
- Assessing whole-body parameters such as biodistribution, immune response, organ clearance, chronic toxicity, and therapeutic index still necessitates integrated physiological evidence, often from animal models.
Conclusions:
- NAMs offer valuable tools for specific applications in cancer drug development, accelerating research and potentially reducing animal use.
- A hybrid approach, combining NAMs with targeted animal studies, is likely the most effective strategy for comprehensive drug evaluation.
- Further validation and standardization of NAMs are required to expand their regulatory acceptance for complex physiological assessments.

