Innovative Precision Oncology Platform Enhances Prediction of Chemotherapy Success in Esophageal Cancer

Researchers from Harvard University and McGill University have developed a cutting-edge precision oncology platform that significantly improves the prediction of chemotherapy responses in patients with esophageal adenocarcinoma (EAC), a highly lethal form of esophageal cancer. This breakthrough utilizes advanced microfluidic Organ Chip technology to create patient-specific tumor models that incorporate the tumor microenvironment (TME), including stromal cells and immune components, which traditional organoid models lack.

Esophageal adenocarcinoma remains one of the most deadly cancers worldwide, with limited targeted therapies available. Standard treatment involves neoadjuvant chemotherapy (NACT) administered before surgery to shrink tumors. However, many patients either do not respond or develop resistance to these chemotherapies, leading to poor clinical outcomes and increased toxicity risks. Currently, clinicians continue with a trial-and-error approach, often administering chemotherapy without knowing its likely effectiveness.

The new approach involves deriving organoids from biopsied tumor cells of EAC patients and integrating them with stromal fibroblasts from the same tissue samples to build personalized Cancer Chips. These Chips replicate the tumor's microenvironment and are exposed to chemotherapy regimens similar to clinical treatment protocols. Remarkably, responses in these models align closely with actual patient responses, providing a rapid and reliable method to stratify patients within 12 days.

This technology not only enables better treatment planning by identifying likely responders and non-responders but also facilitates testing of alternative therapies for resistant tumors. The researchers demonstrated that their models reliably predicted patient outcomes post-surgery, offering a promising tool for personalized therapy and drug development. According to Dr. Donald Ingber, this platform could be implemented widely to optimize treatment and discover new therapeutic targets.

Furthermore, this research advances understanding of esophageal pathology, including Barrett’s esophagus—precancerous changes that may lead to EAC—by modeling the disease's early stages. The ability to simulate complex tissue interactions and drug responses in vitro marks a significant stride toward tailored, more effective cancer treatments.

The findings have been published in the Journal of Translational Medicine and pave the way for rapid, personalized treatment strategies that could improve survival rates and reduce unnecessary toxicity for esophageal cancer patients.