111 Successful Creation of Pancreatic Cancer Organoids By Means of Eus-Guided Fine-Needle Biopsy (EUS-FNB) for Personalized Cancer Treatment

AGA White Paper: Optimizing Endoscopic Ultrasound–Guided Tissue Acquisition and Future Directions

“…For EUS-FNB specimen prepared by formalin-fixed, paraffinembedded, a 95% success rate for NGS is expected when samples have a tissue volume of 1.2 cm 2 and at least 5 ng/mL of analyzable DNA. 49 Although much of the initial work on EUS-TA has focused on NGS and is the focus of this paper, numerous additional methods, such as RNA and microRNA sequencing, [59][60][61][62] use of fluorescence in situ hybridization, 63,64 identification of protein and immune markers, the creation of tumor organoids, [65][66][67][68] and low cost whole-exome sequencing are emerging. Of these methods, the ability to create organoids, which are in vitro 3-dimensional tissue models, is particularly promising.…”

“…In surgically unresectable patients, the creation of human pancreatic ductal adenocarcinoma organoids at the time of tissue diagnosis could allow them to benefit from precision medicine with individualized treatment. 68 Whether EUS-FNB will offer advantages over EUS-FNA with respect to these methods remains to be determined. Given that organoids are 3 dimensional and incorporate tumor stroma, it seems that FNB would be preferred for the creation of these tissue cultures.…”

“…Furthermore, the organoids that were created matched with 2 surgically created organoids and also allowed for successful in vitro drug sensitivity testing in 3 cases. 68…”

Present and Future of Endoscopic Ultrasound-Guided Tissue Acquisition in Solid Pancreatic Tumors

“…Among these methods, liquid cytological sampling (FNA rinse material) is excellent and often superior for personalized medicine [61,62]. Further, RNA and microRNA sequencing [63-66], fluorescence in situ hybridization [67], use of protein and immune markers and tumor organoids [68-71], and low-cost whole-exome sequencing are currently the emerging fields in EUS-TA. Successful NGS from single circulating tumor cells was also reported [72,73].…”

Advanced EUS Guided Tissue Acquisition Methods for Pancreatic Cancer

“…After diagnosis was confirmed suggestive of PDAC with EUS-FNA, two additional passes with FNB needles (22G) were performed to create organoids. The main outcome of the study was successful creation of PDAC organoids by EUS-FNB [ 93 ]. PDAC was the final diagnosis in 23 patients, lymphoma in two, and recurrent PDAC in one.…”