Publications Repository - Helmholtz-Zentrum Dresden-Rossendorf

Pathological complete response (pCR) has been correlated with overall survival in several
cancer entities including colorectal cancer. Novel total neoadjuvant treatment (TNT) in rectal cancer
has achieved pathological complete response in one‐third of the patients. To define better treatment
options for nonresponding patients, we used patient‐derived organoids (PDOs) as avatars of the
patient´s tumor to apply both photon‐ and proton‐based irradiation as well as single and combined
chemo(radio)therapeutic treatments. While response to photon and proton therapy was similar,
PDOs revealed heterogeneous responses to irradiation and different chemotherapeutic drugs.
Radiotherapeutic response of the PDOs was significantly correlated with their ability to repair
irradiation‐induced DNA damage. The classical combination of 5‐FU and irradiation could not
sensitize radioresistant tumor cells. Ataxia‐telangiectasia mutated (ATM) kinase was activated
upon radiation, and by inhibition of this central sensor of DNA damage, radioresistant PDOs were
resensitized. The study underlined the capability of PDOs to define nonresponders to irradiation
and could delineate therapeutic approaches for radioresistant patients.