Pancreatic cancer is one of the deadliest forms of cancer with limited treatment options and a critical need for prognostic biomarkers. Moreover, discerning the molecular characteristics of primary pancreatic tumours is challenging due to their low cellularity.

To circumvent this, Tiriac et al. produced a library of 66 pancreatic cancer patient-derived organoids (PDOs) that recapitulated the genetic and transcriptional profiles of primary pancreatic cancers. The PDO cultures recapitulated common mutations such as KRAS, TP53, CDKN2A and SMAD4, which confirmed their reliability for genetic analysis. The authors established a pancreatic cancer-specific PDO drug-testing pipeline, termed ‘pharmacotyping’ and, in combination with next generation sequencing, demonstrated its suitability to predict patient response to chemotherapies.