Immune-cell origin and assay context determine the question, statistical unit, and permissible inference of patient-derived tumor organoid (PDO) co-cultures.This narrative methodological review used 18 targeted PubMed searches completed on July 2-3, 2026.The complete saved outputs contained 946 retrieval entries and 659 unique PubMed records.Within the prior bibliography, 50 priority records underwent retrospective eligibility adjudication; 38 empirical human PDO-immune studies met the operational definition.Targeted original main-text review was completed for all 38 studies; supplementary files were reviewed selectively, with per-record limitations reported transparently.Literature was organized by origin, donor relationship, lineage, recognition mechanism, processing, architecture, timing, endpoint, and intended use.Autologous blood-derived cells, tumor-infiltrating lymphocytes, retained endogenous immune compartments, allogeneic effectors, and engineered products answer different questions and require different controls.The fit-for-purpose reporting framework has not undergone an external consensus process or prospective validation.Treatmentlinked evidence remains heterogeneous and exploratory.Accordingly, preservation, reconstitution, discovery, matched recognition, and product activity must be distinguished from clinical validity, predictive value, and clinical utility.
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