World journal of gastrointestinal oncology · 2025
Patient-derived organoids for the personalized treatment of pancreatic neuroendocrine tumor with liver metastases: A case report.
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Yang Xiao-Min, Sun Wei, He Yong-Gang, Peng Xue-Hui, You Nan, Tang Yi-Chen, Zheng Lu, Huang Xiao-Bing
Аннотация
BACKGROUND: Liver metastases are very common in pancreatic neuroendocrine tumors (pNETs). When surgical resection is possible, it is typically associated with survival benefits in patients with pNET and liver metastases. Patient-derived organoids are a powerful preclinical platform that show great potential for predicting treatment response, and they have been increasingly applied in precision medicine and cancer research.
CASE SUMMARY: A 51-year-old man was admitted to the hospital with the chief complaint of intermittent dull pain in the upper abdomen for over 3 years. Computerized tomography showed multiple space-occupying lesions in the liver and a neoplasm in the pancreatic body. Pathological results suggested a grade 3 pancreas-derived hepatic neuroendocrine tumor. In combination with relevant examinations, the patient was diagnosed with pNET with liver metastases (grade 3). Transarterial chemoembolization was initially performed with oxaliplatin and 5-fluorouracil, after which the chemotherapy regimen was switched to liposomal irinotecan and cisplatin for a subsequent perfusion, guided by organoid-based drug sensitivity testing. Following interventional treatment, the tumor had decreased in size. However, due to poor treatment compliance and the patient's preference for surgical management, multiple resections were performed. Postoperatively, liposomal irinotecan combined with cisplatin was continuously admnistered. To date, the patient has survived 18 months with tumor presence, and tumor markers have returned to normal.
CONCLUSION: This case suggests that patient-derived organoids can aid in the optimization of therapeutic decisions in pNET patients with liver metastases to guide personalized treatment and improve survival outcomes.
CASE SUMMARY: A 51-year-old man was admitted to the hospital with the chief complaint of intermittent dull pain in the upper abdomen for over 3 years. Computerized tomography showed multiple space-occupying lesions in the liver and a neoplasm in the pancreatic body. Pathological results suggested a grade 3 pancreas-derived hepatic neuroendocrine tumor. In combination with relevant examinations, the patient was diagnosed with pNET with liver metastases (grade 3). Transarterial chemoembolization was initially performed with oxaliplatin and 5-fluorouracil, after which the chemotherapy regimen was switched to liposomal irinotecan and cisplatin for a subsequent perfusion, guided by organoid-based drug sensitivity testing. Following interventional treatment, the tumor had decreased in size. However, due to poor treatment compliance and the patient's preference for surgical management, multiple resections were performed. Postoperatively, liposomal irinotecan combined with cisplatin was continuously admnistered. To date, the patient has survived 18 months with tumor presence, and tumor markers have returned to normal.
CONCLUSION: This case suggests that patient-derived organoids can aid in the optimization of therapeutic decisions in pNET patients with liver metastases to guide personalized treatment and improve survival outcomes.