Patient-derived organoids for prediction of treatment response in oesophageal adenocarcinoma

Oesophageal cancer, comprising adenocarcinoma (OAC) and squamous cell carcinoma subtypes, accounts for approximately 450 000 deaths annually worldwide^1,2. For locally advanced OAC, the current standard of care is neoadjuvant chemoradiation (CROSS) or perioperative chemotherapy (FLOT)^3,4. Although both confer a survival benefit, 40% of patients undergoing FLOT and 25% of patients undergoing CROSS demonstrate minimal pathological response, suggesting alternative regimens could be more effective^2–4. The superiority of either regimen is not clear, with a recent randomized controlled trial demonstrating clinical equipoise between perioperative chemotherapy and CROSS^5.