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Patient-Derived Orthotopic Xenograft models in gastric cancer: a systematic review

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Abstract

Patient-Derived Xenografts (PDXs) are, so far, the best preclinical model to validate targets and predictors of response to therapy. While subcutaneous implantation very rarely allows metastatic dissemination, orthotopic implantation (Patient-Derived Orthotopic Xenograft—PDOX) increases metastatic capability. Using a modified tool to analyze model validity, we performed a systematic review of Embase, PubMed, and Web of Science up to December 2018 to identify all original publications describing gastric cancer (GC) PDOXs. We identified ten studies of PDOX model validation from January 1981 to December 2018 that fulfilled the inclusion and exclusion criteria. Most models (70%) were derived from human GC cell lines rather than tissue fragments. In 90% of studies, the implantation was performed in the subserosal layer. Tumour engraftment rate ranged from 0 to 100%, despite the technique. Metastases were observed in 40% of PDOX models implanted into the subserosal layer, employing either cell suspension or cell line-derived tumour fragments. According to our modified model validity tool, half of the studies were defined as unclear because one or more validation criteria were not reported. Available GC PDOX models are not adequate according to our model validity tool. There is no demonstration that the submucosal site is more effective than the subserosal layer, and that tissue fragments are better than cell suspensions for successful engraftment and metastatic spread. Further studies should strictly employ model validity tools and large samples with orthotopic implant sites mirroring as much as possible the donor tumour characteristics.

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Acknowledgements

We kindly thank Dr. Carlotta Sacerdote for having served as Biostatistic and Dr. James M. Hughes for his English language revision.

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Authors and Affiliations

  1. Department of Oncology, Division of Surgical Oncology and Digestive Surgery, San Luigi University Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy

    Rossella Reddavid & Maurizio Degiuli

  2. Department of Oncology, University of Torino, Candiolo, Italy

    Simona Corso & Silvia Giordano

  3. Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy

    Simona Corso, Daniel Moya-Rull & Silvia Giordano

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  1. Rossella Reddavid
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  2. Simona Corso
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  3. Daniel Moya-Rull
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  4. Silvia Giordano
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  5. Maurizio Degiuli
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Contributions

All authors have equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.

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Correspondence to Rossella Reddavid or Maurizio Degiuli.

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The manuscript has been kindly revised by Dr. James Hughes, a native English speaker.

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Reddavid, R., Corso, S., Moya-Rull, D. et al. Patient-Derived Orthotopic Xenograft models in gastric cancer: a systematic review. Updates Surg 72, 951–966 (2020). https://doi.org/10.1007/s13304-020-00751-4

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  • DOI: https://doi.org/10.1007/s13304-020-00751-4

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