Until recently, scientists who wanted to study the bladder had to settle for studying just some of it – established cell lines, grown in a dish. Trinity Bivalacqua, M.D., Ph.D., the R. Christian B. Evensen Professor in Urology, Max Kates, M.D., and colleagues have come up with something much better: a miniature, 3-D version of an organ, grown from the patient’s own cells.

This is a “patient-derived organoid (PDO),” and although it’s a simpler version of the bladder, “it has the same working tissue and cells, both normal and cancerous,” says Bivalacqua, Director of Urologic Oncology. With Kates, Co-Director of the Bladder Cancer Multidisciplinary Clinic, and colleagues, he has pioneered methods to generate PDOs from papillary non-muscle- invasive bladder tumors – from mouse and rat models, as well as from the bladder tumors of his patients.

In the setting of bladder cancer, making a mini-organ using the patient’s own tissue can spare time, money, and disappointment by predicting drug sensitivity and resistance – avoiding weeks or months of trial and error. Bivalacqua’s laboratory has shown that PDOs can be used to identify the molecular subtype of a patient’s tumor and the genetic pathways involved, which could make an important difference in treatment. “With PDOs, we can test common intravesical agents like BCG and chemotherapy, to determine their effectiveness ahead of time.”

Because these PDOs are so new, we have barely begun to tap their usefulness, adds David McConkey, Ph.D., Director of The Greenberg Bladder Cancer Institute. “Organoids have an excellent potential to help us find the vulnerabilities in cancer – so before we start treatment, we can find the option most likely to be successful.” This research was published recently in Investigations in Clinical Urology, Oncotarget, and Urologic Oncology.