A colorectal cancer organoid-CAF co-culture chip for drug screening and personalized therapy

The tumor microenvironment (TME) plays a critical role in cancer progression and therapeutic response, with cancer-associated fibroblasts (CAFs) being a key stromal component. Conventional tumor organoid models lack TME elements, and existing co-culture systems have limitations in recapitulating dynamic, multidimensional interactions. Here, we developed a novel dynamic co-culture chip (BAC) to better model the TME and investigate CAF-tumor cell crosstalk. Using this platform, we established a non-contact co-culture model of patient-derived colorectal cancer cells and CAFs. The resulting model closely recapitulated the morphological and molecular characteristics of the original patient tumors. Compared with tumor organoids cultured alone, the co-culture system exhibited significantly higher resistance to the clinically common chemotherapeutics 5-fluorouracil and oxaliplatin. Moreover, the presence of CAFs promoted tumor recurrence. Notably, drug responses in the co-culture model showed superior concordance with clinical outcomes relative to both organoid-only and animal models. Transcriptomic profiling under different culture conditions provided further insights into the mechanisms driving CAF-mediated interactions. These findings demonstrate that the BAC-based tumor organoid-CAF co-culture model serves as a more accurate platform for predicting drug responses, investigating TME-dependent mechanisms, and guiding personalized cancer therapy.