ONCO-PDO Welala Oncology Service

Patients are typically treated with drugs demonstrated to be effective from studies of the general population. Should the first treatment not work, oncologist would move on to the next best option. This trial-and-error approach means that while a patient’s particular cancer may be unique, their therapy is likely standardized. However, Welala’s advances in three-dimensional organoid technology have led to the development of the Onco-PDO^TM (Patient-Derived Organoids) test that allows physicians to individualize treatment more effectively.

Onco-PDO™ test offers a strategic approach in targeting and personalizing the cancer treatment by creating a clinically relevant predictive in vitro model that quantifies PDOs response to standard chemotherapeutics.

A sample of the tumor is taken during surgery or routine biopsies and grown in the laboratory. The cells from this tissue sample are grown in a 3-dimensional environment like human body, which form complex structures called, PDOs.

These Onco-PDOs are then tested against standard-of-care chemotherapeutic drugs (as recommended by the physician) to study their response under laboratory conditions. The studied response is then drafted as a Onco-PDO™ report and provided to the physician.

A portion of a patient’s solid tumor (2-3 core biopsies) is mechanically/enzymatically disaggregated and established in primary culture within multi-well plates as organoids.
• These organoids are treated with chemotherapeutic agents (at C_max). C_max is the maximum serum concentration that a drug achieves in the body after the drug has been administrated, based on published literature.
• Following 72-96h of the drug treatment, we perform biochemical assays to determine the viable cells in comparison to a control (without treatment).
• The report illustrates the response of PDOs to the drugs under laboratory conditions and might assist the oncologist to make a more informed decision for each individual patient.

This test provides three key clinical advantages:
• Fast turnaround: The test report is delivered within 3 weeks to ensure continuity of clinical care without delaying treatment.
• Comprehensive: The test can include all standard-of-care chemotherapeutics to ensure the most comprehensive look at the patient’s potential treatment options.
• Actionable: The Onco-PDO™ report might help oncologist to make informed treatment decisions by identifying relevant and actionable findings based upon the response of the patient’s cancer cells to chemotherapeutics in the laboratory.

Next-Generation Sequencing (NGS) analyses cancer specimens for genomic alterations known to be relevant in cancer. The test results can only be used to suggest targeted therapies that are available or associated with the identified genomic alterations, based on published studies of the general population. By comparison, Onco-PDO™ test is a clinically relevant, real-time modelling and in vitro testing service that illustrates how individual patient’s own tumor cells respond to standard-of-care chemotherapies and targeted therapeutic agents.

The test is for patients who need chemotherapy, and most useful for patients with advanced cancer or relapsed patients who have not responded well to first line therapy. First line therapies are usually subjected to strict regulatory guidelines, and oncologists do not have much leeway to choose drugs other than standard-of-care drugs for their patients. For relapsed patients, oncologists have wider choice of drugs, and time is of essence for the patients as the body cannot afford to undergo any unnecessary round of chemotherapy, making every data point that could aid clinical decision-making even more valuable. Our hope is that one day the Onco-PDO™ test will become a standard-of-care test that can screen drugs for first line therapy as well.

To date, this test has been done for breast, ovarian, lung, colorectal, pancreatic, gastric cancers as well as head & neck cancers (Asia only); we are in the process of optimizing the test for other cancer types, such as prostate.

The test report will provide the following information:
• An overview of how the patient’s cancer cells have responded to the panel of standard-of-care chemotherapeutics in the laboratory.

Each individual report is specially designed to clarify the results for the ordering physician and aid in their treatment decision making.

Once your patient’s sample is received for testing, results should be available in 2-3 weeks.

We require fresh tumor tissue from surgery or biopsy, which are needed to be transported in chilled transport media to the laboratory within 24 hours. Formalin-fixed paraffin-embedded tumor tissue cannot be used.

Either a minimum of 1 cm³ of tumor tissue or 2-3 core needle biopsies are required. Anything less may risk the test failing to achieve completion.

Tests for patients in Europe are performed in our laboratory in Munich, Germany with the highest standards of laboratory practice. Tests for patients in Asia are performed in our laboratory in Singapore.