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Organoids derived from cancer cells can reduce the need for trial and error in identifying effective treatments

Personalized drug screening in patient-derived organoids of biliary tract cancer and its clinical application

Chemotherapy is often the only treatment option for biliary tract cancer, which is usually found at a late stage, making it one of the most lethal cancers, but existing tools cannot effectively predict which chemotherapy drugs will work best in individual patients, who often have little time for hit-or-miss chemotherapy. In this study, researchers developed organoids derived from 72 patients for testing with seven chemotherapy drugs. They then identified the genetic signatures of organoids in response to different drugs and developed gene-panel tests to predict the patient's treatment response. Drug screening results were first validated in mice that were grafted with the same tumors, and then the results were confirmed in 12 out of the 13 patients treated with the chemotherapy identified by this process. The authors conclude that organoids offer high accuracy in personalized drug screening in biliary tract cancer and that gene-panel testing may help select effective drugs for individual patients.

Aspirin and non-steroidal anti-inflammatory drug use and risk of precursors of early-onset colorectal cancer

Early-onset colorectal cancer (CRC) in patients before age 50 has been rising at an alarming rate. Emerging data suggest that aspirin use is associated with a lower risk of early-onset CRC. However, it remains uncertain whether regular use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a lower risk of early-onset adenomas with greater malignant potential, the major precursor of early onset CRC. For this study, researchers analyzed data related to the use of NSAIDs in 32,058 women from the Nurses' Health Study II. Women included in the study had at least one lower endoscopy before the age of 50 between 1991 and 2015. Researchers found 1,247 early-onset adenomas, including 290 high-risk cases. The study found regular NSAID use was associated with a lower chance of developing both high-risk and low-risk adenomas. Findings highlight the need to further evaluate NSAIDs as promising agents for the prevention of early-onset CRC given the favorable risk-benefit profile in younger people.

Causes of death in patients operated for colorectal cancer

Mortality due to colorectal cancer (CRC) continues to decline with advancements in screening and management strategies. Despite this, CRC remains the one of the leading causes of cancer-related mortality in the U.S. This study examined the causes of death in 576 patients who underwent surgery for CRC between 2004 to 2018 at Massachusetts General Hospital. The study found deaths from CRC gradually decreased over time, while deaths from other causes such as other cancers or systemic diseases increased over time. The study also found that younger patients, patients with fewer comorbidities, and patients with distant metastatic disease were more likely to die from their CRC compared to other causes. Researchers say their findings support the idea that the recent modification of screening age for CRC from 50 to 45 years is a step in the right direction to catch and treat the disease in early stages.

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