One of the biggest illnesses affecting both the general public and the medical sector is cancer. Millions of people die from it every year. Although the disease can affect many sections of the body, colorectal cancer is thought to be one of the most common types of cancer. Emerging research shows that organoids may hold the potential in helping to help predict the response colorectal cancer patients may have to treatments. Let’s take a look at current research, consider the limitations and challenges, and how this will shape cancer treatments in the future.
Colorectal Cancer Overview
Colorectal cancer refers to cancers that affect the colon and rectum. It is considered the third most common type of cancer globally. About 10% of cancer cases are colorectal cancer. It’s also considered the second leading cause of death related to cancer at a global scale.
When colorectal cancer develops, it can cause significant harm to the digestive tract. An estimated 1.9 million new diagnoses of colorectal cancer were recorded worldwide in 2020 [1]. In that same year, the World Health Organization reported deaths from colorectal cancer reached over 930,000. Researchers estimated that by the year 2040, about 3.2 new cases of colorectal cancer will be diagnosed annually. This means it’s expected that cases will increase by 63% within this time.
One of the major issues with colorectal cancer is that the disease is often diagnosed in an advanced stage. The symptoms associated with the cancer can be confused with other conditions. This leads to patients being treated for other conditions, and by the time cancer is considered as a potential diagnosis, the disease has already progressed. It also means there’s an urgent need for regular screening and other techniques that would ultimately help to achieve early diagnosis.
Causes of Colorectal Cancer
There isn’t one single cause behind colorectal cancer that accounts for every case. Instead, it’s essential to understand the risk factors, as these can contribute to the development of cancer. In many cases, there’s also no specific cause linked to a patient’s case of colorectal cancer [2].
Genetic factors, including changes to DNA, are considered to be some of the most important risk factors to consider with this cancer. DNA plays an important role in cellular functions and when it changes, cells may start to grow abnormally. This can lead to the development of tumors in the colon and rectum.
Age is another significant risk factor. Colorectal cancer is most common among individuals who are over 50 years. A family history of cancer also increases the risk, and there are environmental and lifestyle factors that can also contribute to colorectal cancer. This includes unhealthy lifestyle choices, such as choosing processed meats over a balanced diet, a sedentary lifestyle, drinking too much alcohol, and smoking. Obesity has also been linked to an increased risk of developing colorectal cancer [3].
Standard Diagnosis and Treatment Options
The diagnostic process for colorectal cancer generally starts with a physical examination, followed by imaging tests. CT scans, an abdominal ultrasound, and MRI imaging tests are often used when colorectal cancer is suspected. Most patients will also undergo a sigmoidoscopy or a colonoscopy. This allows health specialists to assess the interior of the colon with imaging tools.
If the healthcare provider finds suspicious tissues, they will likely take a biopsy. This involves removing a sample of the affected tissue and sending it for a histopathology exam. The exam helps to identify cancerous cells in the tissue, which also assists in the diagnosis.
Treatment generally depends on the location, severity, and stage of colorectal cancer. It may include the use of radiotherapy, chemotherapy, and sometimes surgery. There are also immunotherapy and targeted therapy options.
If the cancer is localized to the colon and rectum, surgery is often used, especially in early stages. This is usually the case if a doctor can confirm the cancer did not spread to other parts of the patient’s body. The use of radiation and chemotherapy can help to reduce the size of a tumor in the patient’s colon and rectum.
In cases where the disease has advanced, systemic therapy is usually the treatment of choice. This is particularly the case with metastatic colorectal cancer. It focuses on targeting cancerous cells not only in the colon or rectum, but the patient’s entire body.
During the treatment process, genetic mutations may also be studied to help guide the treatment. When certain genetic markers or mutations are present, it can provide doctors with the information they need to offer the patient a more personalized treatment solution.
The role of Organoids in Predicting Cancer treatment response
Due to the public and healthcare burden of cancer, it is often considered a priority when it comes to medical research. A significant number of studies have looked at ways to improve cancer treatment. The goal is to provide tools for earlier diagnostics and more efficient ways to target cancerous cells; thus, focusing on reducing the mortality rate linked to cancer. This includes studies on colorectal cancer.
One particularly interesting area of research that has been emerging recently is organoids. This technology allows researchers to create 3D structures that mimic the physiology and functions of real organs. While the initial focus was to create miniature versions of a patient’s organs, researchers are finding new ways to use organoids in the medical industry.
Some studies show that organoid technology can also be used to develop miniature 3D structures that mimic tumors. When this is done, it provides an opportunity to test different treatments on that tumor and see how it responds.
What are Organoids?
To truly understand the significance of these findings, we first have to consider what exactly organoids are. It’s an emerging technique that researchers developed in order to create a miniature “copy” of a patient’s organs. These mini organs are structurally similar to the natural organs found in the patient’s body, but just at a much smaller scale.
These organoids are grown in a laboratory. The key focus point in their development was to create mini organs that are identical to human organs at a cellular level, particularly in terms of their structure. Organoids also have the ability to mimic the functions of the organs they represent.
The interesting thing is, they were first invented with the idea of studying human development, as well as to better understand diseases. These organoids have become a valuable tool for researchers to understand drug toxicity, and subsequently, studies have begun to focus on utilizing them to create personalized medicine and treatment plans.
Over the years, they’ve evolved. Technology continues to improve, and this allows scientists to further enhance the overall accuracy of organoids. They are also no longer limited to organs. Scientists have found that they can be useful for recreating other structures in the body as well, allowing them to test the effectiveness of different treatments before administering it to the patient. It’s not just about understanding how efficient a specific treatment would be. These organoids now also allow researchers to get a better view of potential toxicity problems that could cause complications or affect the disease.
How Organoids work in cancer treatment screening
Now that you have a better idea of what organoids are, there’s another important point we should discuss. This involves how they work.
Organoids are essentially created from human tissue. In the case of colorectal cancer, a biopsy is usually taken in order to get a sample of the tumor tissue in the patient’s body. This is then processed in the laboratory, using very specific techniques. During this processing, researchers are able to use these techniques to grow a miniature version of the tumor.
What makes the organoid so great is the fact that it now has a cell structure and functioning similar to the tumor found in the patient. This means testing out treatments on this tumor would also give the scientists an opportunity to see how the actual tumor would respond. Different treatments are then used to determine their sensitivity.
This can take several days to weeks. Some of these procedures test out a treatment on the organoid over a period of 10 days. However, there are cases where the screening process can go on for over two weeks. In longer studies, scientists often administer an additional dose of the treatment midway through the study period. This helps them continue to monitor the impact of the treatment agents on the tumors and observe how they affect the cell structure.
By using this technique, researchers are able to help patients better understand what kind of treatments would be best for their case of colorectal cancer.
Researchers grow Organoids to test cancer treatment response and effectiveness
The use of organoids is no longer new in the modern day. While it’s still considered an emerging technique, its use has already spread to various areas of healthcare. In 2023, researchers created a comprehensive review paper [4] to outline the findings of organoids and their use in colorectal cancer patients. The review paper focuses on the difficulties that standard treatments face, especially with the unique elements surrounding each patient diagnosed with the disease.
Due to these unique factors, patients respond differently to treatments. The sensitivity to treatment methods used, the accuracy of targeted treatments, and several other factors can vary from one patient to the next. This makes it hard for medical researchers and scientists to provide significant improvements in the treatment outcomes for patients with colorectal cancer.
The researchers behind this review paper wanted to see just how effective these organoids are in providing a more personalized and custom approach to identifying the right treatments for patients.
The key findings of this review paper explain that there is a positive relation between sensitivity in tumor organoids and patient response to treatments. This shows potential, as testing the sensitivity of various treatments on these lab-grown replicas of human tumors minimizes the need for changing therapies due to insufficiency.
Prior to this kind of personalized treatment, doctors would need to constantly monitor a patient’s response to cancer treatments. If a prescribed treatment does not seem to work, adjustments are necessary. This may include increasing the dosage, adding additional therapies, or completely changing the approach to treating the colorectal cancer.
Unfortunately, this also means delaying the onset of an effective treatment, which increases the risk of metastasis. When metastasis occurs and colorectal cancer becomes more advanced, the prognosis becomes more negative. Treating cancer that spreads from the colon and rectum to other parts of the body is significantly harder compared to localized therapies.
Thus, these findings show that growing these organoids in a laboratory to find the most suitable treatment option may reduce the risk of metastasis. The earlier an effective treatment can be identified, the greater the potential for helping the patient survive cancer.
Another study [5] looked at how organoids could be used as biomarkers in personalizing treatments. This particular study focused on reviewing the efficacy of these organoids in cases of metastatic colorectal cancer. As we mentioned before, when colorectal cancer becomes more advanced, it’s harder to treat, which is why personalized treatment becomes even more important.
The researchers behind this study were able to develop a five-step optimization strategy. They found a positive relation between the use of patient-derived organoids and the outcomes of colorectal cancer treatment. This marked a significant advance in organoid research. It also created a foundation for future studies that would focus on better understanding the role that these organoids can play in helping to create personalized treatment programs for these patients.
When organoids were used as a drug screening tool, they found that it increased the effectiveness of the implemented treatment methods.
One of the key discoveries in this study was how organoid drug screening affected patient response. When cancer treatments worked effectively on organoid tissues, they provided a similar impact on the patient. This reduced the risk of inefficient treatments where the cancerous tumors in the patient’s body had a low level of sensitivity to the therapies used. It also ensured a greater chance of implementing the most effective treatment the first time.
Going forward, additional research could further focus on understanding how to continue improving the current strategies used. This five-step optimization system has already shown a lot of potential.
A 2025 review paper [6] also revisited the current evidence on organoids in colorectal cancer patients. This paper had a focus on how these organoids could be used in advancing the research into colorectal cancer. It confirmed the advantages that these 3D structures have over 2D cell cultures, which are often considered the standard approach to understanding colorectal cancer and personalizing treatment.
The key benefit mentioned here is the fact that these 3D organoids have the ability to mimic the complicated interactions of tumors in the body much more effectively. This gives healthcare providers and scientists the ability to get a more accurate overview of how the tumor would react to different types of cancer treatments.
Current Challenges
A significant amount of research has already been invested in the development of technologies that enable the creation of organoids. This created an opportunity for researchers to use these organoids in testing treatment options for colorectal cancer patients.
However, the current research is still in its early stages. As researchers continue to look into the use of organoids in these patients, it’s important to understand the challenges.
One of the most important challenges that researchers face at the moment is the fact that these organoids need to mimic a full tumor in the human body. Tumors are complex structures, and mimicking them with 100% accuracy is a challenge that can affect the efficacy of these organoids.
Due to this complexity, another challenge that organoid technology faces is standardization. When the creation of these organoids cannot be standardized, it makes the process of using them in colorectal cancer patients more time-consuming and expensive. In turn, this reduces access to the technology, especially in general medical settings where the majority of colorectal cancer cases are handled.
Future directions of using Organoids in Colorectal Cancer treatment
Many studies will continue to develop strategies to improve the use of organoids. This includes finding ways to ease the creation of organoids that can accurately mimic complex colorectal tumors.
While some researchers remain focused on creating these organoids, others are turning their attention to integrating additional technologies into the process. For example, some research projects are looking to integrate single-cell technology with this organoid creation process. The hope is to make organoids even more accurate in mimicking the structure of organs and other human tissues. When the accuracy increases, experimenting with different treatments on colorectal cancer patients would also yield better results.
This means there’s a positive outlook for organoids when we look at the future. Improving the technology used to create these organoids would lead to advancements in cancer care. This could potentially improve treatment outcomes, as doctors would be able to identify the most appropriate therapy based on the patient’s individual situation.
Conclusion
As researchers continue to make advancements in the development of organoids, studies show their potential in understanding treatment efficacy in colorectal cancer patients. While there are still challenges that experts have to overcome, the current evidence already provides an overview of how this would improve the overall treatment approach to colorectal cancer. It also shows how the growth of organoids in a laboratory environment could pave to way to enhancing treatment for other types of cancer.
References
[1] Colorectal cancer. World Health Organization. 11 Jul 2023. https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer
[2] Causes of bowel cancer. NHS. https://www.nhs.uk/conditions/bowel-cancer/causes/
[3] P. Ye, Y. Xi, Z. Huang, P. Xu. Linking Obesity with Colorectal Cancer: Epidemiology and Mechanistic Insights. MDPI Cancers. 29 May 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7352519/
[4] C. Su, K.A. Olsen, C.E. Bond, V.L.J. Whitehall. The Efficacy of Using Patient-Derived Organoids to Predict Treatment Response in Colorectal Cancer. MDPI Cancers. 2023. https://www.mdpi.com/2072-6694/15/3/805
[5] L.P. Smabers, E. Wensink, C.S. Verissimo, E. Koedoot, et al. Organoids as biomarker for personalized treatment in metastatic colorectal cancer: drug screen optimization and correlation with patient response. Journal of Experimental & Clinical Cancer Research. 27 Feb 2024. https://jeccr.biomedcentral.com/articles/10.1186/s13046-024-02980-6
[6] Z. Heydarl, R.D.A. Balaya, G. Sarkar, L. Boardman. The Role of Organoids in Advancing Colorectal Cancer Research: Insights and Future Directions. MDPI Cancers. 25 Jun 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12248773/