# A public atlas of drug-pair responses across a thousand patient-derived organoids

Source: https://onco.cc/ideas/idea-tr2-organoid-matrix-atlas/  
OnCo record `idea-tr2-organoid-matrix-atlas` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Build a large, openly shared dataset of how tumour organoids respond to drug pairs, so that anyone can look up which combinations might work for which tumour type.

## Summary

Existing combination screens use cell lines (NCI ALMANAC, AZ-DREAM). Organoids preserve more of the patient's tumour biology but no large public pairwise dataset exists. A consortium screening 1,000 characterised organoids (with genomics, transcriptomics and, where available, donor outcome) against a matrix of 100 approved and late-stage drugs would be the training set for every in silico combination model.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Models trained on the atlas will predict clinical combination outcomes (randomised phase 2 success) with better calibration than models trained on cell-line matrices alone, measured against the next fifty combination readouts.
- Rationale: Data scale drove progress in every predictive field. The Human Cancer Models Initiative built the organoids; nobody has systematically screened them in combination.
- Proposed test: Screen the first 200 organoids across 50 drugs in full pairwise matrices, release the data, and run an open prediction challenge scored on held-out organoids and on existing clinical combination results.
- Maturity: preclinical-evidence
- Actor: philanthropy

## Sources

- Cancer Models (HCMI): https://www.cancer.gov/ccg/research/functional-genomics/hcmi

## Connected records

- collections: [Cancer Models (PDCM Finder) & HCMI](https://onco.cc/collections/cancer-models/), [DepMap (Cancer Dependency Map)](https://onco.cc/collections/depmap/)
- ideas: [An open engine that ranks every drug pair by predicted synergy before anyone runs a trial](https://onco.cc/ideas/idea-tr2-synergy-ranking-engine/), [Shared reference organoid and PDX panels that every lab can test against](https://onco.cc/ideas/idea-tr2-reference-model-panels/)
- technologies: [Functional (ex vivo) drug testing](https://onco.cc/technologies/functional-drug-testing/), [Patient-derived organoids](https://onco.cc/technologies/organoids/), [Whole-exome & whole-genome sequencing](https://onco.cc/technologies/wes-wgs/)
- bottlenecks: [Data silos](https://onco.cc/bottlenecks/b-data-silos/), [Lab models that fail to predict what happens in patients](https://onco.cc/bottlenecks/b-preclinical-models/), [Too many combinations to test](https://onco.cc/bottlenecks/b-combination-space/)

---
JSON: https://onco.cc/api/v1/entities/idea-tr2-organoid-matrix-atlas.json