PROSECCO: Predicting ChemoRadiotherapy Sensitivity in Rectal Cancer Organoids (PRoSecCO)

Patients with locally advanced rectal cancer (LARC) are routinely treated with neoadjuvant chemoradiotherapy, but receive variable benefit. Stratification of patients based on predicted response to this therapy would have multiple benefits, including potential (1) avoidance of surgery in patients who receive a pathological complete response, (2) reduction in potential harmful therapy for patients unlikely to respond, and (3) acceleration of access to alternative therapeutic approaches for these patients that may result in improved outcomes.

We have planned the Predicting ChemoRadiotherapy Sensitivity in Rectal Cancer Organoids (PRoSecCO) study, to test the feasibility of collecting treatment naïve rectal cancer biopsies to grow patient-derived cancer organoids in the laboratory, to predict chemoradiotherapy sensitivity. We plan to recruit 30 patients, successfully establish >75% of samples as organoids, and produce chemoradiotherapy sensitivity data within 4 weeks of initial biopsy. Secondary outcomes of the study will be to assess the correlation between in vitro organoid response to therapy compared to patient response to therapy, identify novel biomarkers of therapeutic response, and establish a well-characterised, living organoid biobank that will be invaluable for the future development of novel therapeutic approaches.