Lin FL, Zhou LM, Ye YJ, Luo XL, Ji XL, Chen SQ, Xie JG, Jin BF, Liu ZD. Individual chemotherapy for patients colorectal cancer based on patient-derived tumor-like cell clusters. World J Gastrointest Surg 2026; 18(2): 114286 [DOI: 10.4240/wjgs.v18.i2.114286]
Corresponding Author of This Article
Zhen-Dong Liu, MD, Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. liudong761@163.com
Research Domain of This Article
Oncology
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Basic Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 27, 2026 (publication date) through Feb 26, 2026
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Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Lin FL, Zhou LM, Ye YJ, Luo XL, Ji XL, Chen SQ, Xie JG, Jin BF, Liu ZD. Individual chemotherapy for patients colorectal cancer based on patient-derived tumor-like cell clusters. World J Gastrointest Surg 2026; 18(2): 114286 [DOI: 10.4240/wjgs.v18.i2.114286]
World J Gastrointest Surg. Feb 27, 2026; 18(2): 114286 Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.114286
Individual chemotherapy for patients colorectal cancer based on patient-derived tumor-like cell clusters
Fu-Lin Lin, Li-Min Zhou, Yun-Jie Ye, Xiao-Long Luo, Xue-Lin Ji, Si-Qi Chen, Ji-Guang Xie, Bing-Feng Jin, Zhen-Dong Liu
Fu-Lin Lin, Yun-Jie Ye, Xiao-Long Luo, Xue-Lin Ji, Si-Qi Chen, Ji-Guang Xie, Bing-Feng Jin, Department of Colorectal Surgery, The 903rd Hospital of PLA Joint Logistic Support Force, Hangzhou 310013, Zhejiang Province, China
Li-Min Zhou, Department of Outpatient, The 903rd Hospital of PLA Joint Logistic Support Force, Hangzhou 310013, Zhejiang Province, China
Zhen-Dong Liu, Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Co-first authors: Fu-Lin Lin and Li-Min Zhou.
Author contributions: Liu ZD and Lin FL conceived and designed the study and drafted the manuscript; Lin FL, Zhou LM and Ye YJ collected, analyzed the tumor samples; Luo XL, Ji XL, Chen SQ, Xie JG and Jin BF performed the experiment; Liu ZD and Lin FL revised the manuscript for important intellectual content. All authors read and approved the final manuscript. Lin FL and Zhou LM contributed equally to this work as co-first authors.
Supported by Traditional Chinese Medicine Science and Technology Development Plan in Zhejiang Province of China, No. 2022ZB131.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of 903rd Hospital of PLA Joint Logistic Support Force.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Available upon reasonable request from the corresponding author.
Corresponding author: Zhen-Dong Liu, MD, Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. liudong761@163.com
Received: October 28, 2025 Revised: December 3, 2025 Accepted: January 6, 2026 Published online: February 27, 2026 Processing time: 121 Days and 0.7 Hours
Abstract
BACKGROUND
Colorectal cancer (CRC) is among the most common malignant tumors. Chemotherapy remains central to CRC management, yet many patients still fail to derive optimal benefit. Patient-derived tumor-like cell clusters (PTCs), a preclinical three-dimensional tumor model containing primary epithelial cells, fibroblasts, and immune cells, can more accurately predict drug efficacy because they closely resemble the original tumor tissue.
AIM
To evaluate the feasibility of using PTCs to guide personalized chemotherapy for patients with CRC.
METHODS
Fresh tumor tissues from 54 patients with resectable CRC were used to establish PTCs. Culture duration, diameter, and morphology were monitored. Hematoxylin-eosin staining was performed to assess PTC morphology. Drug sensitivity was evaluated through the PTC drug assay.
RESULTS
PTCs exhibited inter- and intrapatient variability in growth rate, diameter, and morphology. Comparable proportions of PTCs showed strong or effective inhibition in response to FOLFOX and FOLFIRI. FOLFOXIRI demonstrated robust antitumor activity in 97% of PTC models. However, responses to FOLFOX and FOLFIRI varied considerably among individuals. FOLFOXIRI showed cell-killing activity similar to FOLFOX or FOLFIRI.
CONCLUSION
Accounting for patient’s pathological and clinical characteristics, PTC-based drug-sensitivity testing can help accurately identify effective agents for CRC in vitro. This novel preclinical platform may reduce unnecessary chemotherapy and support precision oncology.
Core Tip: Colorectal cancer (CRC) is one of the most common malignant tumors. Currently, FOLFOX serves as the standard postoperative adjuvant chemotherapy for resectable CRC, while FOLFIRI and FOLFOXIRI are widely used for metastatic or recurrent disease, typically in combination with targeted therapies. The microtumor patient-derived tumor-like cell clusters (PTC) drug sensitivity testing technology involves establishing an in vitro tumor model highly similar to the patient's actual tumor using their own tumor cells. This model is then utilized for drug sensitivity testing, enabling the screening and recommendation of effective treatment regimens while filtering out ineffective options based on therapeutic efficacy. This study primarily evaluates the feasibility of using PTC to guide individualized chemotherapy for CRC patients.
