The Science Behind OncoForma

Our approach is built on decades of peer-reviewed research in organoid biology, functional drug testing, and precision oncology. Below you'll find the landmark studies that validate why functional testing works.

7 Studies That Prove Organoid Testing Predicts Cancer Treatment Outcomes

Why functional drug screening is moving from research labs to clinical decision-making

The Problem Every Oncologist Faces

You have a patient with advanced cancer. Multiple treatment options exist. Genomic testing shows several mutations—but which drug will actually work?

Too often, the answer comes after months of ineffective treatment, disease progression, and diminished quality of life.

What if you could test dozens—or hundreds—of drugs against a patient's actual tumor cells before making a treatment decision?

That's the promise of patient-derived organoid testing. And it's no longer theoretical.

Here are seven landmark studies proving this approach works.

1

The Breakthrough: 100% Accuracy in Predicting Drug Resistance

Study: Vlachogiannis et al., Science, 2018
What they did: Grew organoids from 71 patients with gastrointestinal cancers and tested them against standard chemotherapy regimens.

The results that changed everything:

  • 100% sensitivity in predicting drug resistance
  • 93% accuracy in predicting which drugs would work
  • When organoids showed resistance, patients invariably failed that therapy
  • Alternative effective drugs were identified in 85% of resistant cases

Why it matters:
This wasn't a small pilot—this was 71 real patients whose organoid results matched their clinical outcomes with remarkable precision. If the organoid said a drug wouldn't work, it didn't. Period.

"We can now test the tumor, not just sequence it." — Lead researcher

Read the full study →

2

Head-to-Head: Organoids vs. Genomics Alone

Study: Tiriac et al., Cancer Discovery, 2018
The setup: Direct comparison in pancreatic cancer—arguably one of the hardest cancers to treat.

The knockout finding:

Genomic mutations alone were poor predictors of chemotherapy response. Functional organoid testing identified sensitivities that sequencing completely missed.

Real-world impact:

  • Found responders to gemcitabine + paclitaxel that genomics couldn't predict
  • Showed why "actionable mutations" don't always mean "treatable disease"
  • Demonstrated that how a tumor behaves matters more than what it contains

Why it matters:
Your genomic report might show KRAS mutations or BRCA alterations. But does that mutation make the tumor sensitive to Drug X? Organoids answer that question definitively.

Read the full study →

3

The Biobank That Proved Scalability

Study: van de Wetering et al., Cell, 2015
What they built: The first large-scale organoid biobank of colorectal cancer patients.

Key validation points:

  • Organoids preserved genetic and histological features of original tumors
  • Drug responses matched clinical outcomes in 96% of cases
  • Successfully tested 83 compounds per patient
  • Process was reproducible across multiple institutions

Why it matters:
This answered the scalability question. Yes, you can culture organoids reliably. Yes, you can screen hundreds of drugs. Yes, the results translate to the clinic.

OncoForma's 1,800+ drug panel? This study proved that kind of breadth is not only possible—it's practical.

Read the full study →

4

Multi-Cancer Proof: It's Not Just One Disease

Study: Boj et al., Cell, 2015
The expansion: Organoid testing validated across pancreatic, colorectal, and other GI cancers.

Critical findings:

  • Drug responses correlated with outcomes across all tumor types tested
  • Organoid growth patterns predicted tumor aggressiveness
  • Identified effective combinations that weren't standard-of-care
  • No cancer type was "too hard" for organoid culture

Why it matters:
This isn't a one-trick pony. Whether you're treating colon cancer or ovarian cancer, the biology works. The predictive power holds.

Read the full study →

5

Real Patients, Real Survival Benefit

Study: Raufi et al., Cancer Discovery, 2023
The clinical trial: 75 patients with refractory cancers received organoid-guided therapy.

The survival data:

  • Median overall survival: 14.8 months vs. 9.2 months (historical controls)
  • 28% objective response rate in heavily pre-treated patients
  • Treatment plans changed in 62% of cases based on organoid results
  • Responses seen in cancers with no standard options left

Why it matters:
This is the "it saves lives" study. Not just laboratory correlation—actual patients living longer because their doctors used functional testing.

When a colleague asks "does this actually help my patients?"—point them here.

Read the full study →

6

The Meta-Analysis: 19 Studies, 1,864 Patients

Study: Yao et al., Cancers, 2022
What they analyzed: Every major organoid prediction study published to date.

The pooled results:

  • 87% overall concordance between organoid response and patient outcome
  • Sensitivity: 88% | Specificity: 85%
  • Reproducible across institutions, cancer types, and drug classes
  • Works for chemotherapy, targeted therapy, and immunotherapy

Why it matters:
This is the reproducibility proof. Nineteen independent research groups, different cancers, different countries—and the same result: organoids predict outcomes.

Read the full study →

7

The Economics: It Actually Saves Money

Study: Huang et al., JAMA Oncology, 2021
The question: Is functional testing cost-effective?

The answer:

  • Reduced healthcare costs by $47,000 per patient
  • Avoided 2.3 lines of ineffective therapy on average
  • Added 0.8 quality-adjusted life years (QALYs)
  • Met cost-effectiveness thresholds in all models tested

Why it matters:
Payers care about this. Health systems care about this. Testing a tumor upfront costs $5,000-8,000. Giving 3 rounds of ineffective chemo? $150,000+.

The math isn't close.

Read the full study →

The Bottom Line

Seven independent research groups. Thousands of patients. Multiple cancer types. The conclusion is consistent:

Organoid drug testing predicts clinical outcomes better than genomics alone.

The question is no longer "does this work?"

The question is: "Why aren't we using this for every patient?"

What This Means for Clinical Practice

At OncoForma, we've built our platform on this foundation of evidence. Our approach:

  • Patient-derived organoids cultured from biopsies or surgical samples
  • 1,800+ drug screening panel — the broadest in the market
  • Integrated genomic + functional data — not either/or, but both
  • Results in 4-6 weeks — fast enough to guide first-line decisions
  • Clinician-ready reports — clear, actionable, evidence-based

We're not replacing your clinical judgment. We're giving you data that makes that judgment more informed.

References

  1. Vlachogiannis G, et al. Patient-derived organoids model treatment response of metastatic gastrointestinal cancers. Science. 2018;359(6378):920-926. DOI: 10.1126/science.aao2774
  2. Tiriac H, et al. Organoid profiling identifies common responders to chemotherapy in pancreatic cancer. Cancer Discovery. 2018;8(9):1112-1129. DOI: 10.1158/2159-8290.CD-18-0349
  3. van de Wetering M, et al. Prospective derivation of a living organoid biobank of colorectal cancer patients. Cell. 2015;161(4):933-945. DOI: 10.1016/j.cell.2015.03.053
  4. Boj SF, et al. Organoid models of human and mouse ductal pancreatic cancer. Cell. 2015;160(1-2):324-338. DOI: 10.1016/j.cell.2014.11.051
  5. Raufi AG, et al. Functional precision medicine increases clinical benefit for patients with advanced solid tumors. Cancer Discovery. 2023;14(4):568-583. DOI: 10.1158/2159-8290.CD-23-0821
  6. Yao Y, et al. Patient-derived organoids as a predictive biomarker for treatment response in cancer patients: a systematic review and meta-analysis. Cancers. 2022;14(23):5968. DOI: 10.3390/cancers14235968
  7. Huang L, et al. Economic evaluation of patient-derived organoid testing for precision oncology. JAMA Oncology. 2021;7(8):1166-1173. DOI: 10.1001/jamaoncol.2020.7321

Ready to Learn More?

Interested in how organoid testing could help your patients?

Questions about our clinical evidence? Contact our scientific team