The secrets within the human genome are slowly getting unlocked as scientists continue to advance their research, especially in the field of precision medicine to treat illnesses. A new study explored the use of organoids - cultures grown from tumor samples- resulting in a new level of accuracy for cancer therapies.

The Translational Genomics Research Institute (TGen) developed a new program called Pathway-based RNA and DNA Integration with Tumor Organoid Testing (PATRIOT) which builds on precision medicine programs designed by Ashion Analytics, a TGen clinical laboratory. Every cancer patient's unique case can then be matched to the best available therapy.

This is accomplished by the GEM ExTra test which processes several variables needed for treatment. The test identifies several points on the entire exome sequencing - mutations, amplifications, deletions, translocations, and both coding and non-coding proteins in genes.

The second is whole transcriptome sequencing, which helps identify which RNA transcript expressions can be used as a guide to therapy, such as targetable genes. The third is exome subtraction to identify the clear differences between benign and cancerous tumors. Genetic markers are then found to match which inhibitor therapies are best and which drugs will complement the therapy needed to treat a patient's cancer.

Dr. Sunil Sharma, Deputy Director of TGen Clinical Sciences and Chief of Translational Oncology and Drug Development at the HonorHealth Research Institute, described the complexity of cancer tumors. Their system uses laboratory-grown organoids which are then used to test several anti-cancer treatments.


Organoids are tissue cultures derived from a patient's stem cells. These cultures can be genetically altered to replicate an organ or express specific parts of an organ by selecting which specific cells scientists want to express.

The researchers can also manipulate the environment where these organoids grow and develop, and under the right ones, they can self-organize by following their genetic instructions. As of today, 'mini-organs' have been developed to resemble the kidney, lung, stomach, intestine, liver, the brain - and now, TGen can recreate their patients' tumors.

'It's a way of conducting clinical trials on a laboratory plate," said Dr. Sharma.'PATRIOT is a very powerful platform that will make GEM ExTra even more powerful. This will expand the use of RNA analysis in a way that has never been used before.' PATRIOT is currently being showcased from June 22-24 in the annual meeting of the American Association for Cancer Research (AACR).

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Tumor Organoids

His presentation at the AACR meeting will be a demonstration of using melanoma tumor samples provided by HonorHealth, and how Ashion's GEM ExTra test has searched for DNA mutations and analyzed the RNA-expressions of the tumor. The PATRIOT system then identifies potential therapeutic targets by analyzing the molecular pathways within tumor cells.

'These druggable targets were validated on the tumor organoids,' said Dr. Sharma. 'This allows for a holistic assessment of a patient's tumor for improving therapy recommendations and expanding personalized therapy options.'

Moreover, medical experts can also test immunotherapy options in their labs. Ashion's GEM ExTra can screen all of their cancer patients' almost three billion nucleotides, including over 19,000 genetic sequences. Other genomic sequencing tests can analyze cancer gene variants only a dozen at a time or by hundreds. Dr. Sharma hopes that they can expand their organoid study in a larger clinical trial.

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