Despite improvements in screening, treatment and survival over the past 20 years, cancer still causes one in four deaths in the United States. More than 20 immune checkpoint inhibitor (ICI) cancer drugs are now on the market, but have yet to realize their full potential due to unpredictable and limited response rates.

Draper’s Ex Vivo Immuno-oncology Dynamic Environment for Tumor biopsies (EVIDENT) is a microfluidic platform that maintains tumor fragment viability outside of the human body for periods of a week or more, giving cancer drug researchers the unique opportunity to study in a lab setting how immune cells dynamically interact with tumors, and how various ICI therapies enable the immune system to attack specific types of cancer. An advancement from traditional static histoculture, in which samples degrade within two or three days, EVIDENT can explore the efficacy of potential therapies on actual human tumors before the start of human clinical trials.

Preclinical testing has largely been limited to the use of mouse models, but animal testing is not predictive of effective and/or safe treatments in 92 percent of cancer drugs under development. Eighty-five percent of early clinical trials for novel drugs fail; of those that survive through to phase III, only half become approved for clinical use. The largest proportion of these failures occurs in trials for cancer drugs.

Animal testing also does not permit mechanistic studies, in which real-time tumor progression can be monitored and assayed at the cellular level. And human clinical trials need to be as targeted as possible, particularly for advanced-stage patients who have exhausted other therapies.

These limitations have led to development of “organ-on-a-chip” technologies that mimic conditions in the human body. EVIDENT uses this technology to support parallel testing of emerging cancer therapeutics including ICIs and combination therapies. The current configuration of the platform houses up to 12 tumor fragments contained in parallel fluidic paths, each comprising a microenvironment that supports independent experimental conditions in dynamic studies. The next-generation system currently being designed will support up to 96 parallel experiments on tumor fragments in a dynamic microenvironment.

EVIDENT replicates the body’s response to a drug by leveraging unique components, including viable tumor fragments in a 3D microenvironment, and precision-controlled flow to enable tumor perfusion and immune cell trafficking through microfluidic channels. Once precisely controlled concentrations of immune cells are delivered directly to tumors, EVIDENT uses real-time high-resolution imaging and powerful machine-learning algorithms to map and quantify tumor response data at the cellular level — including local tumor killing and penetration of immune cells into the tumor — without disrupting the process.

Draper’s EVIDENT system is also an effective, powerful and unique tool for patient-specific personalized therapeutics and precision medicine. The precision and scalability of the microfluidic design enables testing of many therapeutic combinations simultaneously, so patients may begin the right treatment, right away.