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Remarkable advances in genomic profiling of tumors have not translated easily into effective personalized therapies for many patients. Functional precision medicine brings forward an alternative approach, one where the drug-sensitivity phenotype of individual tumors is layered onto the genotype information. Christopher Kemp hail- ing from the Fred Hutchinson Cancer Research Center in Seattle, and Carla Grandori jointly founded Cure First and SEngine Precision Medicine, organizations that are advancing the implementation of cancer functional testing. Here they discuss the chal- lenges and multiple opportunities lying ahead to enable the adoption of functional approaches to precision therapy in oncology.

As researchers improve ways to quickly and cheaply sequence DNA, the concept of precision medicine is gaining a foothold in the medical community. When it comes to cancer, a disease that leaves its mark in a patient's genome, sequencing tumor DNA to tailor treatment plans to individuals seems an obvious application of the technology. "The idea of precision medicine as in individualized treatment, I think that makes so much sense," says Alice Soragni, a cancer biologist at the University of California, Los Angeles (UCLA) David Geffen School of Medicine. "When you work with a few of these tumors, each and every one is a bit different."

Excellent science, here by Dr. Tony Letai, followed by a proper Austrian dinner.

Tumor organoids maintain cell–cell interactions, heterogeneity, microenvironment, and drug response of the sample they originate from. Thus, there is increasing interest in developing tumor organoid models for drug development and personalized medicine applications. Although organoids are in principle amenable to high-throughput screenings, progress has been hampered by technical constraints and extensive manipulations required by current methods.