A Pan-Cancer Ex Vivo Drug Screen Atlas for Functional Precision Oncology

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Abstract

Compared to immortalized cell lines, patient-derived organoids and other ex vivo models have been shown to better recapitulate patient responses to therapy. High cost and technical complexity have prevented the creation of pan-cancer ex vivo datasets, limiting comprehensive analyses and predictive modeling for ex vivo drug response. We present the Pan-PreClinical (PPC) project: a drug screen atlas of 2.1M experiments across 1,982 ex vivo samples and 3,100 drugs spanning 134 cancer indications tested across 26 studies. We develop a contrastive Bayesian model to harmonize across studies, identifying 303 tissue-specific drug sensitivities and demonstrating drug sensitivities are predictive of clinically-relevant molecular profiles. Integrating established cell line databases reveals systematic biases across 55 cancer subtypes, with cell line screens favoring drugs targeting highly proliferative cells and undervaluing cell-cell communication targets. We leverage PPC to establish an ex vivo foundation model and computational platform for scalable ex vivo cancer biology and predictive oncology.
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Abstract Compared to immortalized cell lines, patient-derived organoids and other ex vivo models have been shown to better recapitulate patient responses to therapy. High cost and technical complexity have prevented the creation of pan-cancer ex vivo datasets, limiting comprehensive analyses and predictive modeling for ex vivo drug response. We present the Pan-PreClinical (PPC) project: a drug screen atlas of 2.1M experiments across 1,982 ex vivo samples and 3,100 drugs spanning 134 cancer indications tested across 26 studies. We develop a contrastive Bayesian model to harmonize across studies, identifying 303 tissue-specific drug sensitivities and demonstrating drug sensitivities are predictive of clinically-relevant molecular profiles. Integrating established cell line databases reveals systematic biases across 55 cancer subtypes, with cell line screens favoring drugs targeting highly proliferative cells and undervaluing cell-cell communication targets. We leverage PPC to establish an ex vivo foundation model and computational platform for scalable ex vivo cancer biology and predictive oncology. Competing Interest Statement The authors have declared no competing interest.

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last seen: 2026-05-20T01:45:00.602351+00:00