Organoids-on-chip for precision oncology: bridging the preclinical-clinical divide

Cancer remains a leading cause of death worldwide. Effective treatment options require personalized therapies and preclinical model systems that accurately mirror patient tumors. While patient-derived tumor organoids (PDTOs) preserve tumor genetic and phenotypic features, microphysiological systems (MPS) mimic native tissue architecture and support dynamic multicellular interactions. Combining both tools enables the development of dynamic, patient-specific models that more accurately recapitulate interpatient heterogeneity. This review explores how this integration promises to improve drug efficacy testing, resistance prediction, and biomarker discovery, and highlights the opportunities and challenges associated with incorporating organoid and MPS technologies into oncology pipelines and clinical trials to inform patient care.