Digestive cancers are a leading cause of cancer-related death worldwide, and share a dismal prognosis at the advanced stages, with a median overall survival ranging from 10 to 30 months. Targeted therapies and immunotherapies, the two recent major breakthroughs in cancer therapy, have only led to minor improvements in the therapeutic armamentarium for advanced digestive cancers. Therefore, there is an urgent need to develop alternative approaches of personalized medicine for these patients.

Organoids are tridimensional, multicellular structures expanded in vitro, which retain the genotypic and phenotypic features of their tumor of origin. This suggests that patient tumor-derived organoids (PDOs) could predict the treatment response of advanced digestive cancers and inform clinical decision on the best therapeutic option for each patient.

Organoids, ex vivo avatars of normal and pathological organs, have been the subject of tremendous interest in fundamental and translational research. They could also possibly be used in the clinic toward the aim of personalized medicine. We propose an innovative multicenter clinical trial assessing the feasibility and the efficiency of organoids used in the personalized treatment of patients with refractory digestive cancers.