# Keep a freshly removed tumour alive on a pump and test drugs in it

Source: https://onco.cc/ideas/idea-bio1-ex-vivo-perfused-tumour/  
OnCo record `idea-bio1-ex-vivo-perfused-tumour` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

After surgery, a tumour with its blood vessels can be connected to a pump and kept alive for hours or days, allowing drugs to be tested in genuinely human tissue.

## Summary

Normothermic machine perfusion is standard in transplantation for livers and kidneys and can be applied to resected tumour-bearing specimens (for example liver segments containing metastases, or isolated limb specimens). Perfusion preserves vasculature and interstitial transport, so drug delivery, penetration and early pharmacodynamics can be measured in intact human tissue that no model reproduces.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Perfused human tumour specimens remain viable and metabolically stable for at least 24 hours and show drug penetration and pharmacodynamic responses that differ measurably from matched organoid predictions.
- Rationale: The transport barrier is the least well modelled part of drug action and cannot be measured in dissociated systems; the perfusion technology and surgical specimens both already exist.
- Proposed test: Feasibility study on 20 resected liver metastasis specimens: viability over 24 hours, imaging mass spectrometry of drug distribution, and comparison with organoid response from the same tumour.
- Maturity: speculative
- Actor: engineering

## Sources

- Bottleneck evidence (Lab models that fail to predict what happens in patients): Wong, Siah & Lo, Estimation of clinical trial success rates (Biostatistics 2019): https://doi.org/10.1093/biostatistics/kxx069

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/)
- technologies: [Patient-derived organoids](https://onco.cc/technologies/organoids/), [Proteomics & phosphoproteomics](https://onco.cc/technologies/proteomics/)
- bottlenecks: [Lab models that fail to predict what happens in patients](https://onco.cc/bottlenecks/b-preclinical-models/)
- key papers: [Estimation of clinical trial success rates and related parameters](https://onco.cc/key-papers/paper-wong-biostatistics/)

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