This is a single center, single arm, open and exploratory clinical study, with 50 cases planned for a period of 3 years. The purpose of this study is to evaluate the consistency and accuracy of a Patient-Derived Organoid (PDO) Model of lung cancer to predict the clinical efficacy of anti-cancer drugs, in order to predict the best chemotherapy regimen for each given patient.

The aim of the project is to use a combination of patient-derived organoid models:

• To amplify tumour tissue to obtain enough material for genomic and histological analysis
• to characterize the lung cancer sub-type
• To predict treatment (non)response.

The following points will be addressed:

1. First, the investigators plan to establish and characterize formation of organoids from biopsies of patients with lung cancer: in spheroids, in the 3D cellular model OncoCilAirTM (OncoTheis), and on the chick chorioallantoic membrane (CAM). Patient-derived organoids from tumoural tissue (PDO) will be characterized and compared to the original tumour.
2. Second, the investigators will test the chemoresponse (chemosensitivity and chemoresistance) of organoids to anti-cancer treatment.

Inclusion Criteria:

• Histologically proven lung cancer
• Age ≥ 18
• Written informed and signed consent
• Accessible to biopsy and/or surgery sample of metastasis and/or primitive tumour

Exclusion Criteria:

• Less than 18 years of age
• Not able to give informed consent (language, intellectual capacities, etc.)
• Not accessible to biopsy and/or surgery sample
• Not enough lung tissue for a histological analysis or the remaining lung tissue is not enough to perform a routine pathological analysis.

All patients (estimated 50 patients) with histologically proven lung cancer undergoing surgery related to this cancer at the University Hospitals of Geneva.