Fabio D. Steffen

Keywords Leukaemia Childhood cancers Very high risk Precision oncology Drug response profiling Evidence before this study We searched PubMed (Jan 2010–May 2025) using “child”, “acute lymphoblastic leukaemia (ALL)”, “measurable residual disease (MRD)” and additional search terms of “relapsed”, “refractory”. Identified publications were further screened for “drug sensitivity testing” and “functional precision medicine”.

Abstract Acute lymphoblastic leukemia (ALL) preferentially localizes in the bone marrow (BM) and displays recurrent patterns of medullary and extra-medullary involvement. Leukemic cells exploit their niche for propagation and survive selective pressure by chemotherapy in the BM microenvironment, suggesting the existence of protective mechanisms.

Abstract High-risk sarcomas, such as metastatic and relapsed Ewing and CIC-rearranged sarcoma, still have a poor prognosis despite intensive therapeutic regimens. Precision medicine approaches offer hope, and ex vivo drug response profiling of patient-derived tumor cells emerges as a promising tool to identify effective therapies for individual patients. Here, we establish ex vivo culture conditions to propagate Ewing sarcoma and CIC::DUX4 sarcoma as tumoroids.