Although therapeutic efficacy of colorectal cancer (CRC) is improving steadily, its prognosis is still poor once it metastasizes to vital organs such as liver and lungs. While it is desirable to personalize the chemotherapeutic regimen, it is still difficult to predict the outcome based on the currently available genomic information. Recently, reports are appearing in which CRC initiating cells (TICs, aka cancer stem cells) are cultured in 3D matrices. Yet, such technologies have not been applied to clinical diagnosis and treatment as commercial services.
  We have developed a newly improved method of culturing CRC-TICs as spheroids at an efficient rate and a relatively low-cost. We further developed accurate diagnosis method for mismatch repair deficiency that can be applied to anti-PD-1 or PD-L1 therapy. We also developed efficacious xenograft models (patient-derived spheroid xenografts: PDSXs) that can predict patient outcomes.
  In this project, we are setting up clinical trials based on drug sensitivities of patient-derived CRC spheroids. We are also developing a spheroid bank with over 200 CRC-TIC spheroid lines have been accumulated. The results of these studies should justify the future para-clinical services provided by commercial operations at more wide and extensive levels.