{"entity":{"id":"idea-bio2-implantable-microdevice-screen","kind":"idea","name":"Implant a tiny device that tests twenty drugs inside the patient's own tumour","aka":[],"tldr":"A rice-grain-sized implant releases microdoses of up to 20 drugs into separate spots of a tumour for one to three days, then is removed so pathologists can see which drug worked in that person's own tumour. First-in-human studies have been done in breast, sarcoma and brain tumours.","summary":"Implantable microdevices developed at MIT and Brigham and Women's Hospital deliver microdoses of up to 20 agents into spatially separated tumour regions for 24-72 hours before retrieval and analysis, and first-in-human studies have been performed in breast, sarcoma and brain tumours. Applied to immune-modulating agents, the device measures local pharmacodynamics in the real human microenvironment, which no model reproduces.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Cold tumours and the immunosuppressive microenvironment): Haslam & Prasad, Estimation of the percentage of US patients eligible for and responding to checkpoint inhibitors (JAMA Netw Open 2019)","url":"https://doi.org/10.1001/jamanetworkopen.2019.2535"}],"tags":[],"related":[],"cancers":["sarcoma","glioblastoma","tnbc"],"sections":[],"technologies":["functional-drug-testing","single-cell-spatial","checkpoint-inhibitor"],"targets":[],"drugs":[],"companies":[],"institutions":["dana-farber","mgh"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-tme-immunosuppression","b-combination-space","b-preclinical-models"],"keyPapers":["paper-haslam-jama-netw-open"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Microdevice-derived local response ranking predicts subsequent systemic response to the same agent, giving a functional assay for immunotherapy combinations that tissue genomics cannot provide.","rationale":"The core problem in combination immunotherapy is a combinatorial space far larger than trial capacity. In-patient microdosing tests many agents per patient rather than one, converting an intractable search into a measurable screen.","test":"Prospective study in patients scheduled for resection: implant, retrieve, profile, then follow subsequent systemic therapy outcomes to test the concordance between local ranking and clinical response.","maturity":"early-clinical","actor":"engineering","cost":"medium","horizonYears":5},"route":"/ideas/idea-bio2-implantable-microdevice-screen/","neighbours":{"cancer":[{"id":"glioblastoma","kind":"cancer","name":"Glioma & glioblastoma","route":"/cancers/glioblastoma/"},{"id":"sarcoma","kind":"cancer","name":"Sarcomas (soft tissue, bone, GIST)","route":"/cancers/sarcoma/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"functional-drug-testing","kind":"technology","name":"Functional (ex vivo) drug testing","route":"/technologies/functional-drug-testing/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"single-cell-spatial","kind":"technology","name":"Single-cell & spatial profiling","route":"/technologies/single-cell-spatial/"}],"institution":[{"id":"dana-farber","kind":"institution","name":"Dana-Farber Brigham Cancer Center","route":"/institutions/dana-farber/"},{"id":"mgh","kind":"institution","name":"Massachusetts General Hospital Cancer Center","route":"/institutions/mgh/"}],"bottleneck":[{"id":"b-tme-immunosuppression","kind":"bottleneck","name":"Cold tumours and the immunosuppressive microenvironment","route":"/bottlenecks/b-tme-immunosuppression/"},{"id":"b-preclinical-models","kind":"bottleneck","name":"Lab models that fail to predict what happens in patients","route":"/bottlenecks/b-preclinical-models/"},{"id":"b-combination-space","kind":"bottleneck","name":"Too many combinations to test","route":"/bottlenecks/b-combination-space/"}],"paper":[{"id":"paper-haslam-jama-netw-open","kind":"paper","name":"Estimation of the Percentage of US Patients With Cancer Who Are Eligible for and Respond to Checkpoint Inhibitor Immunotherapy Drugs","route":"/key-papers/paper-haslam-jama-netw-open/"}]}}