{"entity":{"id":"idea-bio1-ctc-derived-explants","kind":"idea","name":"Grow models from tumour cells in the blood when a biopsy is impossible","aka":[],"tldr":"Some patients cannot have their tumour biopsied safely. Cancer cells captured from a blood sample can sometimes be grown into a model instead.","summary":"Circulating tumour cell-derived explants have been established in small cell lung cancer and reflect donor genomics and chemotherapy response, and CTC-derived organoids have been reported in prostate and breast cancer. Success rates depend on CTC counts, which are highest in exactly the aggressive diseases where biopsies are hardest. Scaling requires better capture, culture media and cryopreservation.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Lab models that fail to predict what happens in patients): Wong, Siah & Lo, Estimation of clinical trial success rates (Biostatistics 2019)","url":"https://doi.org/10.1093/biostatistics/kxx069"}],"tags":[],"related":[],"cancers":["sclc","prostate"],"sections":[],"technologies":["liquid-biopsy","organoids","pdx-models"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-preclinical-models","b-resistance"],"keyPapers":["paper-wong-biostatistics"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"CTC-derived models can be established from a meaningful fraction of patients with high CTC counts and reproduce the donor's response to platinum chemotherapy in the majority of matched cases.","rationale":"Serial blood sampling permits models from multiple timepoints, including at resistance, which tissue biopsy programmes rarely achieve; small cell lung cancer explants have already demonstrated this.","test":"Attempt derivation from 100 patients with high CTC burden across SCLC, prostate and breast cancer; report establishment rate, genomic fidelity and chemotherapy response concordance.","maturity":"preclinical-evidence","actor":"research","cost":"medium","horizonYears":4},"route":"/ideas/idea-bio1-ctc-derived-explants/","neighbours":{"cancer":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"},{"id":"sclc","kind":"cancer","name":"Small-cell lung cancer","route":"/cancers/sclc/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"organoids","kind":"technology","name":"Patient-derived organoids","route":"/technologies/organoids/"},{"id":"pdx-models","kind":"technology","name":"Patient-derived xenografts","route":"/technologies/pdx-models/"}],"bottleneck":[{"id":"b-resistance","kind":"bottleneck","name":"Acquired resistance to every therapy","route":"/bottlenecks/b-resistance/"},{"id":"b-preclinical-models","kind":"bottleneck","name":"Lab models that fail to predict what happens in patients","route":"/bottlenecks/b-preclinical-models/"}],"paper":[{"id":"paper-wong-biostatistics","kind":"paper","name":"Estimation of clinical trial success rates and related parameters","route":"/key-papers/paper-wong-biostatistics/"}],"idea":[{"id":"idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine","kind":"idea","name":"Watch for the cancer changing cell type before the biopsy says neuroendocrine, and act on it","route":"/ideas/idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine/"}]}}