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Empirical identification and validation of tumor-targeting T cell receptors from circulation using autologous pancreatic tumor organoids
BackgroundTumor-specific cytotoxic T cells and T cell receptors are effective tools for cancer immunotherapy. Most efforts to identify them rely on known antigens or lymphocytes that have infiltrated into the tumor bed. Approaches to empirically identify tumor-targeting T cells and T cell receptors...
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Published in: | Journal for immunotherapy of cancer 2021-11, Vol.9 (11), p.e003213 |
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container_title | Journal for immunotherapy of cancer |
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creator | Meng, Qingda Xie, Shanshan Gray, G Kenneth Dezfulian, Mohammad H Li, Weilin Huang, Ling Akshinthala, Dipikaa Ferrer, Elizabeth Conahan, Catherine Perea Del Pino, Sofia Grossman, Joseph Elledge, Stephen J Hidalgo, Manuel Muthuswamy, Senthil K |
description | BackgroundTumor-specific cytotoxic T cells and T cell receptors are effective tools for cancer immunotherapy. Most efforts to identify them rely on known antigens or lymphocytes that have infiltrated into the tumor bed. Approaches to empirically identify tumor-targeting T cells and T cell receptors by exploiting all antigens expressed on tumor cell surfaces are not well developed for most carcinomas, including pancreatic cancer.MethodsAutologous tumor organoids were stimulated with T cells from the patients’ peripheral blood for 2 weeks to generate the organoid-primed T (opT) cells. opT cell phenotype was analyzed by monitoring changes in the expression levels of 28 cell surface and checkpoint proteins. Expression of ligands of the immune checkpoints was investigated by immunohistochemistry staining. T cells were labeled with carboxyfluorescein succinimidyl ester (CFSE) and assayed by flow cytometry to monitor tumor-induced T cell proliferation changes. opT cell-mediated killing of three-dimensional organoids was measured using an M30 ELISA kit. T cell receptors (TCRs) were identified by deep sequencing of gDNA isolated from T cells, and the TCR specificity was confirmed by transferring TCRs to the T cell line SKW-3 or donor T cells.ResultsThe co-culture was effective in the generation of CD8 + or CD4+opT cells. The opT cells killed autologous tumors in a granzyme B or Fas-Fas ligand-dependent manner and expressed markers of tissue-resident memory phenotype. Each patient-derived opT cell culture displayed a unique complement of checkpoint proteins. Interestingly, only NKG2A blockade showed a potent increase in the interferon-γ production compared with blocking programmed cell death protein 1 (PD-1) or programmed cell death ligand 1 (PD-L1) or TIM3 or TIGIT or LAG3. Importantly, TCR sequencing demonstrated a dramatic clonal expansion of T cells with a restricted subset of TCRs. Cloning and transferring the TCRs to heterologous T cells was sufficient to confer tumor cell recognition and cytotoxic properties in a patient-specific manner.ConclusionWe report a platform for expanding tumor-targeting T cells from the peripheral blood of patients with pancreatic cancer. We identify the NKG2A-HLA-E axis as a potentially important checkpoint for CD8 +T cells for pancreatic cancer. Lastly, we demonstrate empirical identification of tumor-targeting TCRs that can be used for TCR-therapeutics. |
doi_str_mv | 10.1136/jitc-2021-003213 |
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Most efforts to identify them rely on known antigens or lymphocytes that have infiltrated into the tumor bed. Approaches to empirically identify tumor-targeting T cells and T cell receptors by exploiting all antigens expressed on tumor cell surfaces are not well developed for most carcinomas, including pancreatic cancer.MethodsAutologous tumor organoids were stimulated with T cells from the patients’ peripheral blood for 2 weeks to generate the organoid-primed T (opT) cells. opT cell phenotype was analyzed by monitoring changes in the expression levels of 28 cell surface and checkpoint proteins. Expression of ligands of the immune checkpoints was investigated by immunohistochemistry staining. T cells were labeled with carboxyfluorescein succinimidyl ester (CFSE) and assayed by flow cytometry to monitor tumor-induced T cell proliferation changes. opT cell-mediated killing of three-dimensional organoids was measured using an M30 ELISA kit. T cell receptors (TCRs) were identified by deep sequencing of gDNA isolated from T cells, and the TCR specificity was confirmed by transferring TCRs to the T cell line SKW-3 or donor T cells.ResultsThe co-culture was effective in the generation of CD8 + or CD4+opT cells. The opT cells killed autologous tumors in a granzyme B or Fas-Fas ligand-dependent manner and expressed markers of tissue-resident memory phenotype. Each patient-derived opT cell culture displayed a unique complement of checkpoint proteins. Interestingly, only NKG2A blockade showed a potent increase in the interferon-γ production compared with blocking programmed cell death protein 1 (PD-1) or programmed cell death ligand 1 (PD-L1) or TIM3 or TIGIT or LAG3. Importantly, TCR sequencing demonstrated a dramatic clonal expansion of T cells with a restricted subset of TCRs. Cloning and transferring the TCRs to heterologous T cells was sufficient to confer tumor cell recognition and cytotoxic properties in a patient-specific manner.ConclusionWe report a platform for expanding tumor-targeting T cells from the peripheral blood of patients with pancreatic cancer. We identify the NKG2A-HLA-E axis as a potentially important checkpoint for CD8 +T cells for pancreatic cancer. Lastly, we demonstrate empirical identification of tumor-targeting TCRs that can be used for TCR-therapeutics.</description><identifier>ISSN: 2051-1426</identifier><identifier>EISSN: 2051-1426</identifier><identifier>DOI: 10.1136/jitc-2021-003213</identifier><identifier>PMID: 34789550</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Animals ; Antibodies ; antigen-mediated ; Antigens ; Cancer ; Clinical/Translational Cancer Immunotherapy ; clonal selection ; Cloning ; Cytotoxicity ; Flow cytometry ; gastrointestinal neoplasms ; Humans ; immunologic techniques ; Immunotherapy ; Infections ; Lymphocytes ; Metastasis ; Mice ; Organoids - immunology ; Pancreatic cancer ; Pancreatic Neoplasms - immunology ; Proteins ; Receptors, Antigen, T-Cell - metabolism ; T cell receptors</subject><ispartof>Journal for immunotherapy of cancer, 2021-11, Vol.9 (11), p.e003213</ispartof><rights>Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.</rights><rights>2021 Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See https://creativecommons.org/licenses/by/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b527t-8b33aa4a504be03a9c79321615fbc37c5f53348e45268beb86ad7230bcece4f33</citedby><cites>FETCH-LOGICAL-b527t-8b33aa4a504be03a9c79321615fbc37c5f53348e45268beb86ad7230bcece4f33</cites><orcidid>0000-0001-6564-9634 ; 0000-0001-8855-788X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2598332489/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2598332489?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25752,27923,27924,37011,37012,44589,53790,53792,55349,74997,77531,77557</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34789550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meng, Qingda</creatorcontrib><creatorcontrib>Xie, Shanshan</creatorcontrib><creatorcontrib>Gray, G Kenneth</creatorcontrib><creatorcontrib>Dezfulian, Mohammad H</creatorcontrib><creatorcontrib>Li, Weilin</creatorcontrib><creatorcontrib>Huang, Ling</creatorcontrib><creatorcontrib>Akshinthala, Dipikaa</creatorcontrib><creatorcontrib>Ferrer, Elizabeth</creatorcontrib><creatorcontrib>Conahan, Catherine</creatorcontrib><creatorcontrib>Perea Del Pino, Sofia</creatorcontrib><creatorcontrib>Grossman, Joseph</creatorcontrib><creatorcontrib>Elledge, Stephen J</creatorcontrib><creatorcontrib>Hidalgo, Manuel</creatorcontrib><creatorcontrib>Muthuswamy, Senthil K</creatorcontrib><title>Empirical identification and validation of tumor-targeting T cell receptors from circulation using autologous pancreatic tumor organoids</title><title>Journal for immunotherapy of cancer</title><addtitle>J Immunother Cancer</addtitle><addtitle>J Immunother Cancer</addtitle><description>BackgroundTumor-specific cytotoxic T cells and T cell receptors are effective tools for cancer immunotherapy. Most efforts to identify them rely on known antigens or lymphocytes that have infiltrated into the tumor bed. Approaches to empirically identify tumor-targeting T cells and T cell receptors by exploiting all antigens expressed on tumor cell surfaces are not well developed for most carcinomas, including pancreatic cancer.MethodsAutologous tumor organoids were stimulated with T cells from the patients’ peripheral blood for 2 weeks to generate the organoid-primed T (opT) cells. opT cell phenotype was analyzed by monitoring changes in the expression levels of 28 cell surface and checkpoint proteins. Expression of ligands of the immune checkpoints was investigated by immunohistochemistry staining. T cells were labeled with carboxyfluorescein succinimidyl ester (CFSE) and assayed by flow cytometry to monitor tumor-induced T cell proliferation changes. opT cell-mediated killing of three-dimensional organoids was measured using an M30 ELISA kit. T cell receptors (TCRs) were identified by deep sequencing of gDNA isolated from T cells, and the TCR specificity was confirmed by transferring TCRs to the T cell line SKW-3 or donor T cells.ResultsThe co-culture was effective in the generation of CD8 + or CD4+opT cells. The opT cells killed autologous tumors in a granzyme B or Fas-Fas ligand-dependent manner and expressed markers of tissue-resident memory phenotype. Each patient-derived opT cell culture displayed a unique complement of checkpoint proteins. Interestingly, only NKG2A blockade showed a potent increase in the interferon-γ production compared with blocking programmed cell death protein 1 (PD-1) or programmed cell death ligand 1 (PD-L1) or TIM3 or TIGIT or LAG3. Importantly, TCR sequencing demonstrated a dramatic clonal expansion of T cells with a restricted subset of TCRs. Cloning and transferring the TCRs to heterologous T cells was sufficient to confer tumor cell recognition and cytotoxic properties in a patient-specific manner.ConclusionWe report a platform for expanding tumor-targeting T cells from the peripheral blood of patients with pancreatic cancer. We identify the NKG2A-HLA-E axis as a potentially important checkpoint for CD8 +T cells for pancreatic cancer. Lastly, we demonstrate empirical identification of tumor-targeting TCRs that can be used for TCR-therapeutics.</description><subject>Animals</subject><subject>Antibodies</subject><subject>antigen-mediated</subject><subject>Antigens</subject><subject>Cancer</subject><subject>Clinical/Translational Cancer Immunotherapy</subject><subject>clonal selection</subject><subject>Cloning</subject><subject>Cytotoxicity</subject><subject>Flow cytometry</subject><subject>gastrointestinal neoplasms</subject><subject>Humans</subject><subject>immunologic techniques</subject><subject>Immunotherapy</subject><subject>Infections</subject><subject>Lymphocytes</subject><subject>Metastasis</subject><subject>Mice</subject><subject>Organoids - immunology</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - immunology</subject><subject>Proteins</subject><subject>Receptors, Antigen, T-Cell - metabolism</subject><subject>T cell receptors</subject><issn>2051-1426</issn><issn>2051-1426</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1Ustu0DAQjBCorUrvPSFLXDgQ8DNxLkioKrRSJS7t2do4dnCUxMF2KvUP-Gwc0icSJ6_t2fHseIrilOBPhLDq8-CSLimmpMSYUcJeFUcUC1ISTqvXz-rD4iTGAWNMMGNSyoPikPFaNkLgo-L3-bS44DSMyHVmTs7mOjk_I5g7dAuj6_attyitkw9lgtCb5OYeXSNtxhEFo82SfIjIBj8h7YJex71pjRsO1uRH3_s1ogVmHUy-1Dsb8qGH2bsuvi3eWBijOblfj4ubb-fXZxfl1Y_vl2dfr8pW0DqVsmUMgIPAvDWYQaPrJg9fEWFbzWotrGCMS8MFrWRrWllBV1OGW51VcsvYcXG583YeBrUEN0G4Ux6c-nuQ9SgIWd9oVE01aazN1ursI6PQVcx2FnNModbVxvVl51rWdjKdzv4FGF-QvryZ3U_V-1slq_wZkmeCD_cEwf9aTUxqcnEzFWaT7VJUNA2uucQiQ9__Ax38GuZs1YaSjFEum4zCO0oHH2Mw9lEMwWpLjdpSo7bUqD01ueXd8yEeGx4ykgEfd0A7DU-P_pfvDwU8zy4</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Meng, Qingda</creator><creator>Xie, Shanshan</creator><creator>Gray, G Kenneth</creator><creator>Dezfulian, Mohammad H</creator><creator>Li, Weilin</creator><creator>Huang, Ling</creator><creator>Akshinthala, Dipikaa</creator><creator>Ferrer, Elizabeth</creator><creator>Conahan, Catherine</creator><creator>Perea Del Pino, Sofia</creator><creator>Grossman, Joseph</creator><creator>Elledge, Stephen J</creator><creator>Hidalgo, Manuel</creator><creator>Muthuswamy, Senthil K</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6564-9634</orcidid><orcidid>https://orcid.org/0000-0001-8855-788X</orcidid></search><sort><creationdate>20211101</creationdate><title>Empirical identification and validation of tumor-targeting T cell receptors from circulation using autologous pancreatic tumor organoids</title><author>Meng, Qingda ; Xie, Shanshan ; Gray, G Kenneth ; Dezfulian, Mohammad H ; Li, Weilin ; Huang, Ling ; Akshinthala, Dipikaa ; Ferrer, Elizabeth ; Conahan, Catherine ; Perea Del Pino, Sofia ; Grossman, Joseph ; Elledge, Stephen J ; Hidalgo, Manuel ; Muthuswamy, Senthil K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b527t-8b33aa4a504be03a9c79321615fbc37c5f53348e45268beb86ad7230bcece4f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Animals</topic><topic>Antibodies</topic><topic>antigen-mediated</topic><topic>Antigens</topic><topic>Cancer</topic><topic>Clinical/Translational Cancer Immunotherapy</topic><topic>clonal selection</topic><topic>Cloning</topic><topic>Cytotoxicity</topic><topic>Flow cytometry</topic><topic>gastrointestinal neoplasms</topic><topic>Humans</topic><topic>immunologic techniques</topic><topic>Immunotherapy</topic><topic>Infections</topic><topic>Lymphocytes</topic><topic>Metastasis</topic><topic>Mice</topic><topic>Organoids - immunology</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - immunology</topic><topic>Proteins</topic><topic>Receptors, Antigen, T-Cell - metabolism</topic><topic>T cell receptors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Meng, Qingda</creatorcontrib><creatorcontrib>Xie, Shanshan</creatorcontrib><creatorcontrib>Gray, G Kenneth</creatorcontrib><creatorcontrib>Dezfulian, Mohammad H</creatorcontrib><creatorcontrib>Li, Weilin</creatorcontrib><creatorcontrib>Huang, Ling</creatorcontrib><creatorcontrib>Akshinthala, Dipikaa</creatorcontrib><creatorcontrib>Ferrer, Elizabeth</creatorcontrib><creatorcontrib>Conahan, Catherine</creatorcontrib><creatorcontrib>Perea Del Pino, Sofia</creatorcontrib><creatorcontrib>Grossman, Joseph</creatorcontrib><creatorcontrib>Elledge, Stephen J</creatorcontrib><creatorcontrib>Hidalgo, Manuel</creatorcontrib><creatorcontrib>Muthuswamy, Senthil K</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal for immunotherapy of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meng, Qingda</au><au>Xie, Shanshan</au><au>Gray, G Kenneth</au><au>Dezfulian, Mohammad H</au><au>Li, Weilin</au><au>Huang, Ling</au><au>Akshinthala, Dipikaa</au><au>Ferrer, Elizabeth</au><au>Conahan, Catherine</au><au>Perea Del Pino, Sofia</au><au>Grossman, Joseph</au><au>Elledge, Stephen J</au><au>Hidalgo, Manuel</au><au>Muthuswamy, Senthil K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Empirical identification and validation of tumor-targeting T cell receptors from circulation using autologous pancreatic tumor organoids</atitle><jtitle>Journal for immunotherapy of cancer</jtitle><stitle>J Immunother Cancer</stitle><addtitle>J Immunother Cancer</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>9</volume><issue>11</issue><spage>e003213</spage><pages>e003213-</pages><issn>2051-1426</issn><eissn>2051-1426</eissn><abstract>BackgroundTumor-specific cytotoxic T cells and T cell receptors are effective tools for cancer immunotherapy. Most efforts to identify them rely on known antigens or lymphocytes that have infiltrated into the tumor bed. Approaches to empirically identify tumor-targeting T cells and T cell receptors by exploiting all antigens expressed on tumor cell surfaces are not well developed for most carcinomas, including pancreatic cancer.MethodsAutologous tumor organoids were stimulated with T cells from the patients’ peripheral blood for 2 weeks to generate the organoid-primed T (opT) cells. opT cell phenotype was analyzed by monitoring changes in the expression levels of 28 cell surface and checkpoint proteins. Expression of ligands of the immune checkpoints was investigated by immunohistochemistry staining. T cells were labeled with carboxyfluorescein succinimidyl ester (CFSE) and assayed by flow cytometry to monitor tumor-induced T cell proliferation changes. opT cell-mediated killing of three-dimensional organoids was measured using an M30 ELISA kit. T cell receptors (TCRs) were identified by deep sequencing of gDNA isolated from T cells, and the TCR specificity was confirmed by transferring TCRs to the T cell line SKW-3 or donor T cells.ResultsThe co-culture was effective in the generation of CD8 + or CD4+opT cells. The opT cells killed autologous tumors in a granzyme B or Fas-Fas ligand-dependent manner and expressed markers of tissue-resident memory phenotype. Each patient-derived opT cell culture displayed a unique complement of checkpoint proteins. Interestingly, only NKG2A blockade showed a potent increase in the interferon-γ production compared with blocking programmed cell death protein 1 (PD-1) or programmed cell death ligand 1 (PD-L1) or TIM3 or TIGIT or LAG3. Importantly, TCR sequencing demonstrated a dramatic clonal expansion of T cells with a restricted subset of TCRs. Cloning and transferring the TCRs to heterologous T cells was sufficient to confer tumor cell recognition and cytotoxic properties in a patient-specific manner.ConclusionWe report a platform for expanding tumor-targeting T cells from the peripheral blood of patients with pancreatic cancer. We identify the NKG2A-HLA-E axis as a potentially important checkpoint for CD8 +T cells for pancreatic cancer. Lastly, we demonstrate empirical identification of tumor-targeting TCRs that can be used for TCR-therapeutics.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>34789550</pmid><doi>10.1136/jitc-2021-003213</doi><orcidid>https://orcid.org/0000-0001-6564-9634</orcidid><orcidid>https://orcid.org/0000-0001-8855-788X</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Animals Antibodies antigen-mediated Antigens Cancer Clinical/Translational Cancer Immunotherapy clonal selection Cloning Cytotoxicity Flow cytometry gastrointestinal neoplasms Humans immunologic techniques Immunotherapy Infections Lymphocytes Metastasis Mice Organoids - immunology Pancreatic cancer Pancreatic Neoplasms - immunology Proteins Receptors, Antigen, T-Cell - metabolism T cell receptors |
title | Empirical identification and validation of tumor-targeting T cell receptors from circulation using autologous pancreatic tumor organoids |
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