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The cancer microenvironment is a critical factor driving cancer progression. Multiple components, including biochemical, biophysical, and cellular cues, determine the pathological features of cancer. Among these, hypoxia is strongly associated with cancer survival, proliferation, and invasion1. Due to the unlimited growth and division of cancer cells, nutrients and oxygen are continuously depleted, and a hypoxic gradient is generated. Under low-oxygen conditions, cells activate hypoxia-inducible transcription factor (HIF)-associated molecular cascade. This process induces a necrotic core, triggers metabolic changes, and initiates blood vessel hyperplasia and metastasis2,3. Subsequently, hypoxia in cancer cells causes the destruction of neighboring normal tissues. Furthermore, hypoxia is strongly associated with the therapeutic resistance of solid tumors in multifactorial manners. Hypoxia may severely impede radiotherapy, as radiosensitivity is limited owing to reactive oxygen species1,4. In addition, it decreases pH levels of cancer microenvironments, which decreases drug accumulation1. Therefore, reproducing pathological features related to hypoxia in vitro is a promising strategy for scientific and pre-clinical findings.
Modeling a specific microenvironment of cancer is essential for understanding cancer development and exploring appropriate treatments. Although animal models have been widely used because of their strong physiological relevance, issues related to species differences and ethical problems exist5. Furthermore, although conventional 2D and 3D models allow for the manipulation and real-time imaging of cancer cells for an in-depth analysis, their architectural and cellular complexity cannot be fully recapitulated. For example, cancer spheroid models have been widely used, as cancer cell aggregation in a spheroid can naturally generate hypoxia in the core. Moreover, large numbers of cellular spheroids of uniform size have been produced using plastic- or silicone-based multi-well systems6,7. However, the lower flexibility with regard to capturing the exact heterogeneous structure of cancerous tissues with conventional platforms has required the establishment of an advanced biofabrication technology to build a highly biomimetic platform to improve cancer research8.
3D microphysiological systems (MPSs) are useful tools to recapitulate the complex geometry and pathological progression of cancer cells9. As cancer cells sense the biochemical gradient of growth factors and chemokines and the mechanical heterogeneity reproduced on the system, important features of cancer development can be investigated in vitro. For instance, cancer viability, metastatic malignancy, and drug resistance depending on the varying oxygen concentrations has been studied using MPSs10,11. Despite recent advancements, generating hypoxic conditions of in vitro models relies on complex fabrication procedures, including connection with physical gas pumps. Therefore, simple, and flexible methods to build cancer-specific microenvironments are needed.
3D cell printing technology has gained considerable attention because of its precise control of the spatial arrangement of biomaterials to recapitulate native biological architectures12. In particular, this technology overcomes the existing limitations of 3D hypoxia models owing to its high controllability and feasibility for building the spatial features of the cancer microenvironment. 3D printing also facilitates computer-aided manufacturing through a layer-by-layer process, thereby providing a rapid, accurate, and reproducible construction of complex geometries to mimic actual tissue architectures. In addition to the advantages of existing manufacturing strategies for 3D MPSs, the pathophysiological features of cancer progression can be reproduced by patterning the biochemical, cellular, and biophysical components13,14.
Herein, we present a 3D cell-printing strategy for a hypoxic cancer-on-a-chip for recapitulating the heterogeneity of a solid cancer (Figure 1)15. The fabrication parameters were determined via a computational simulation of central hypoxia formation in the system. Cancer-stroma concentric rings were printed using collagen bioinks containing glioblastoma cells and endothelial cells to emulate the pathophysiology of glioblastoma, a type of solid cancer. The formation of a radial oxygen gradient aggravated cancer malignancy, indicating strengthened aggressiveness. Furthermore, we indicate future perspectives for the applications of the chip to patient-specific preclinical models. The proposed approach for creating a solid-cancer-mimetic microphysiological system is expected to bridge the gap between in vivo and in vitro models of cancer.