Organoids and ingestible sensors: Urological applications for cutting-edge science and technology
New medical technologies and their potential applications for urologists were at the forefront of EAU22 today, and particularly at the Special Session of the same name. In a one and half hour session chaired by Netherlands natives Profs. Chris Bangma (Rotterdam, NL) and John Heesakkers (Maastricht, NL), participants were first treated to presentations on the current state of research on the use of patient-derived organoids (PDOs) and their vast potential. For the second half of the session, ingestible sensors and the digitalisation of urology in a broader sense were covered.
Dr. Sylvia Boj (Utrecht, NL) and Dr. Talitha Zuiverloon (The Hague, NL) gave complementary presentations on the use of patient-derived organoids: both their development and their possible clinical applications. Dr. Boj explained the basics of the organoid technology, from discovery to the first trials since 2018, concluding that “with patient-derived organoids, we can change drug development. We can represent all kinds of patients, identify biomarkers and help in the stratification of patients. In some cancers, we can predict the response in patients.”
Dr. Zuiverloon gave examples of organoid use in clinical settings, specifically bladder cancer. “Bladder cancer PDO’s offer a useful preclinical model to study bladder cancer biology, and to investigate an ex vivo treatment response. The next step is to correlate PDO treatment response in parallel to clinical response.” Dr. Zuiverloon also made the point that insurance companies are interested in the application of PDOs because they would be a way of seeing if the patient responds to (costly) cancer treatment before it might prove to be fruitless.
Prof. Roland Seiler (Bern, CH) rounded off the series of talks on organoids with an overview of the great potential but also the limits encountered so far. Limitations are that organoids are less suited to studies that required them to remain viable for longer periods. Prof. Seiler also sketched out how some trials could work, for PCa outlining steps from MRI-guided biopsy to active therapy.
In the panel discussion that followed, Prof. Bangma concluded that it’s unlikely that each hospital will have its own organoid lab, but that the 24-hour period required to bring a sample to the specialised labs meant that this would be perfectly feasible.
Measuring everything
Prof. Chris Van Hoof (Leuven, BE) showed the “Ingestible”, a smart pill that measures gut health as an early indicator for all sorts of other conditions, even mental. Most technical challenges have been bested, including miniaturization of sensors and batteries to guarantee up to 14 days of autonomous use and the development of a “Gut Positioning System” (GPS). The remaining challenges are regulatory, and the first in-human studies are set to start in 2023.
Prof. Van Hoof also showed the first steps in the development of an early-signaling smart toilet seat and bowl, capable of measuring weight, temperature, heart rate, respiration rate, relative blood pressure and even potentially urine biomarkers.
The final word and a sense of perspective was given by Prof. Tillmann Loch (Flensburg, DE), who gave an overview of German hospitals’ experience of “digitalisation”. Prof Loch showed some statistics that showed that hospitals had a long way to go to match sectors like the media in digitalisation. “What’s holding us back? Decades of routines, rigid hierarchies, data protection regulations, and the fear of losing one’s job.”
“Hospitals and clinics must be able to prepare for changing requirements and provide answers.”