Core needle biopsy-derived breast cancer microtumors enable functional drug-response testing for precision oncology

Abstract

Summary To predict neoadjuvant chemotherapeutic outcomes, breast cancer organoids have been developed. However, low yields from small tissue specimens and the high cost of niche factor-enriched medium remain barriers to clinical translation. Here, breast cancer patient-derived microtumors (PDMs) from core needle biopsies and small tissue specimens were established using a modified culture protocol and an optimized fetal bovine serum (FBS)-based culture medium, achieving a 75% success rate (6 of 8 cases). PDM characteristics mostly agreed with the tissue origins, according to growth evaluation, histopathology, immunohistochemistry, and genetic profiling. As a proof of concept, PDMs were tested with neoadjuvant chemotherapy alongside the patients’ treatment. Notably, the PDM results were positively correlated with the patient outcomes and were obtained within a clinically relevant time frame (∼2–3 weeks). Collectively, our protocol and FBS-based medium efficiently generate breast cancer PDMs from core needle biopsies and small tissue specimens, with promising potential to guide neoadjuvant chemotherapy decisions.