ideasIdea
Keep a freshly removed tumour alive on a pump and test drugs in it
After surgery, a tumour with its blood vessels can be connected to a pump and kept alive for hours or days, allowing drugs to be tested in genuinely human tissue.
Normothermic machine perfusion is standard in transplantation for livers and kidneys and can be applied to resected tumour-bearing specimens (for example liver segments containing metastases, or isolated limb specimens). Perfusion preserves vasculature and interstitial transport, so drug delivery, penetration and early pharmacodynamics can be measured in intact human tissue that no model reproduces.
Hypothesis
Perfused human tumour specimens remain viable and metabolically stable for at least 24 hours and show drug penetration and pharmacodynamic responses that differ measurably from matched organoid predictions.
Rationale
The transport barrier is the least well modelled part of drug action and cannot be measured in dissociated systems; the perfusion technology and surgical specimens both already exist.
What would test it
Feasibility study on 20 resected liver metastasis specimens: viability over 24 hours, imaging mass spectrometry of drug distribution, and comparison with organoid response from the same tumour.
Maturity
speculative
Who has to act
engineering
Cost to try
Medium ($1M to $50M)
Years to first evidence
5
Bottlenecks it attacks
- Preclinical models that do not predict people · Nine in ten cancer drugs that work in mice fail in humans. Our models are the reason.