Application and prospects of precision-medicine-driven breast cancer organoids in therapeutic drug discovery

Mou Jiancheng; Luo Jie; Liu Haotian; Yang Zhuotao; Mu Yuxiao; Qian Da; Meng Xuli

doi:10.12307/2026.244

Abstract：BACKGROUND:Breast cancer organoids,as a novel in vitro model,can not only simulate the biological characteristics of breast cancer but also to some extent reproduce the impact of the tumor microenvironment on the tumor,facilitating research on breast cancer and further promoting precision medicine. OBJECTIVE:To review the application status of breast cancer organoids in the field of therapeutic drugs,including chemotherapy,targeted therapy,and immunotherapy,over the past few years,and to discuss the existing limitations in order to further promote their application in breast cancer treatment. METHODS:The first author conducted a search in the China National Knowledge Infrastructure(CNKI)and PubMed databases in June 2025,with the publication time of the literature ranging from January 2010 to June 2025.The Chinese and English search terms included"organoid,breast organoid,breast cancer organoid,breast cancer experimental model,precision medicine,targeted therapy,chemotherapy,immunotherapy,drug sensitivity."A total of 58 articles were included in the review. RESULTS AND CONCLUSION:(1)Compared with traditional breast cancer cell experiments that lack validation of tissue structure,cell-to-cell interactions,and in vivo microenvironments,breast cancer organoids,with their diverse origins from primary tumor cells and continuous innovation in culture systems,can simulate cell-to-cell interactions and reproduce the biological characteristics of breast cancer and its tumor microenvironment.This makes breast cancer organoids one of the most promising tools in the field of breast cancer research and provides greater potential for improving treatment resistance in clinical breast cancer patients through drug sensitivity screening.(2)The application of drug sensitivity trial results from breast cancer organoids in clinical practice has yielded promising outcomes.By conducting drug sensitivity tests with common chemotherapeutic agents,targeted drugs,and immunotherapeutic agents in breast cancer organoids,the mechanisms of drug action against tumors and the synergistic effects of multiple drugs are validated.This approach helps avoid the use of primarily resistant and highly toxic treatment drugs in patients,enabling the formulation of personalized treatment plans and evidence-based precision medical strategies.(3)Breast cancer organoids still face limitations in practical applications,such as low success rates in model construction,difficulties in model growth,and the lack of angiogenesis processes.To overcome these limitations,it is necessary to increase the amount of source tissue,improve culture systems,and innovate culture techniques.These improvements will facilitate comprehensive therapeutic drug selection through breast cancer organoids and assist in the development of personalized precision medicine.