Personalized functional profiling using ex-vivo patient-derived spheroids points out the potential of an antiangiogenic treatment in a patient with a metastatic lung atypical carcinoid

• DOI: 10.1080/15384047.2021.2021042
• Publication Date: 2022-02-23T10:55:52Z
• Authors: Hichul Kim; Victoria El-Khoury; Nadine Schulte; Tianzuo Zhan; Johannes Betge; Loic Cousin; Emanuele Felli; Patrick Pessaux; Arnaud Ogier; Oliver G Opitz; Bosung Ku; Matthias P Ebert; Yong-Jun Kwon
• Keywords: Lung Neoplasms; Liver Neoplasms; Neoplasms, Second Primary; Carcinoid Tumor; Sciences du Vivant [q-bio]/Médecine humaine et pathologie; Personalized functional profiling; drug screening; pharmacotyping; personalized medicine; precision medicine; spheroids; neuroendocrine tumors; lung carcinoid; antiangiogenic therapy; 3. Good health; Carcinoma, Neuroendocrine; Pleural Effusion; Bedside-to-Bench Report; Neuroendocrine Tumors; 03 medical and health sciences; 0302 clinical medicine; Humans; Lung; [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology

Lung carcinoids are neuroendocrine tumors representing 1 to 2% of lung cancers. This study outlines the case of a patient with a metastatic lung atypical carcinoid who presented with a pleural effusion and progression of liver metastases after developing resistance to conventional treatments. Personalized functional profiling (PFP), i.e. drug screening, was performed in ex-vivo spheroids obtained from the patient's liver metastasis to identify potential therapeutic options. The drug screening results revealed cediranib, an antiangiogenic drug, as a hit drug for this patient, from a library of 66 Food and Drug Administration (FDA)-approved and investigational drugs. Based on the PFP results and the reported evidence of clinical efficacy of bevacizumab and capecitabine combination in gastro-intestinal neuroendocrine tumors, this combination was given to the patient. Four months later, the pleural effusion and pleura carcinosis regressed and the liver metastasis did not progress. The patient experienced 2 years of a stable disease under the PFP-guided personalized treatment.