Cancer
Tumour organoids from breast cancer patients successfully cultivated for the first time

Stable tumour organoids have been directly taken from blood samples of breast cancer patients; in a world first that could speed the development of new treatments
Tumour cells circulating in the blood are the “germ cells” of breast cancer metastases – cancer cells that detach from its original tumour and spread around the body. Until now, these cells could not be propagated in culture dishes, posing a barrier to research into therapy resistance.
Using these mini-tumours, researchers have deciphered a molecular signalling pathway that ensures the cancer cells’ survival and resistance to therapy, enabling the development of an approach to eliminate them.
The researchers emphasise that these circulating cancer cells (CTCs) are extremely rare and hide among the billions of blood cells.
Andreas Trumpp, head of a research division at the German Cancer Research Center (DKFZ), which carried out the study, had previously shown that only a few CTCs can form a new metastasis in another organ.
Roberto Würth from Trumpp’s lab and first author of the paper said: “This makes it difficult to develop targeted new therapies that directly attack the metastasis-initiating cells. However, if we understand how these cells survive the initial therapy and what drives their resistance, we could tackle the formation of breast cancer metastases at the root and perhaps one day even prevent them.”
The researchers were able to multiply the CTCs and grow them as stable tumour organoids in the culture dish.
The team say that three-dimensional and patient-specific mini-tumours can be cultivated from blood samples several times during the course of the disease and are ideally suited for investigating the molecular mechanisms that enable tumours to survive despite therapy.
They found that the protein NRG1 acts like a fuel, binding to the HER3 receptor on the cancer cells and, together with the HER2 receptor, activates signalling pathways that ensure the growth and survival of the cells, and that an alternative signalling pathway, controlled by FGFR1, ensures growth and survival.
“With the help of such ‘bypasses’, tumours react to external influences, for example to targeted therapies against HER2. This is a crucial mechanism in the development of therapy resistance,” said Würth.
The researchers then used organoids to show that blocking both the NRG1-HER2/3 and FGFR signalling pathways can effectively stop the tumour growth and induce cell death.
Trumpp said: “The possibility of cultivating CTCs from the blood of breast cancer patients as tumour organoids in the laboratory at different time points is a decisive breakthrough. This makes it much easier to investigate how tumour cells become resistant to therapies.
“On this basis, we can develop new treatments that may also specifically kill resistant tumour cells. Another conceivable approach is to adapt existing therapies in such a way that the development of resistance and metastases is reduced or even prevented from the outset.
“As the organoids are specific to each patient, this method is suitable for identifying or developing customised therapies that are optimally tailored to the respective diseases.”
The team say the method must now be tested in clinical trials.
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Experimental drug drowns triple-negative breast cancer cells in toxic fats

An experimental drug slowed triple-negative breast cancer in mice by flooding tumour cells with toxic fats.
Triple-negative breast cancer lacks three common drug targets, making it one of the hardest-to-treat and most aggressive forms of the disease.
The compound, known as DH20931, appears to push cancer cells past their limits by triggering a surge in ceramides, fat-like molecules that place the cells under intense stress until they self-destruct.
In lab experiments, the drug also made standard chemotherapy more effective. When combined with doxorubicin, researchers were able to reduce the dose needed to kill cancer cells by about fivefold.
The drug targets an enzyme known as CerS2 to sharply increase production of these lipids and stress cancer cells. Healthy cells, by contrast, showed lower sensitivity to the drug in lab tests.
While the early results are promising, further preclinical and clinical trials would still be needed to determine the safety and effectiveness of DH20931 in humans.
Satya Narayan, a professor in the University of Florida’s College of Medicine, led the study with an international group of collaborators.
The researchers published their results on human-derived tumours on 21 April and presented their findings on combination therapy at the annual meeting of the American Association for Cancer Research in San Diego.
Narayan likened the drug’s effects to a home’s electrical system handling a power surge.
While healthy cells act like a properly grounded and installed circuit, cancer cells are more like a jumble of mismatched wires and faulty fuses. DH20931 overwhelms cells not with electricity, but with fats.
He said: “When that surge goes into the cancer cells, they cannot handle the amount of power they are getting. The fuses burn out, the cell can’t handle the surge and it dies.”
The compound was developed at the University of Florida in the lab of Sukwong Hong.
Hong, now a professor at the Gwangju Institute of Science and Technology in South Korea, created DH20931 as one of many drug candidates tested for efficacy in Narayan’s lab.
In the study, researchers implanted human triple-negative breast cancer tumours into mice and treated them with DH20931.
The drug significantly slowed tumour growth without causing noticeable weight loss or signs of toxicity in the animals. In separate lab experiments, it also showed activity against other breast cancer subtypes.
In addition to increasing lipid levels, DH20931 triggers a second stress signal by flooding cells with calcium.
Together, these effects disrupt the mitochondria, the structures that produce a cell’s energy, ultimately leading to cell death.
Narayan said: “It does not just follow one pathway but it goes through multiple pathways. It’s a two-hit hypothesis.
“These pathways are common in all breast cancer types and other solid tumours, so we think this drug can be useful not only in triple-negative breast cancer but potentially other cancers as well.”
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