High-grade serous ovarian carcinoma (HGSOC) remains a poorly understood and highly lethal disease. Historically, the lack of faithful in vitro and in vivo models that represent HGSOC biology and therapy response has been a major barrier to progress. For example, multiple (if not most) studies have used cell lines that fail to share key genomic/genetic features of HGSOC, rendering questionable the relevance of their findings1,2,3,4. For example, the common ID8 syngeneic mouse model is derived from ovarian surface epithelium (OSE) and is Trp53-wild type5. By contrast, most if not all HGSOC arises in fallopian tube epithelium (FTE)6, and HGSOC is almost universally TP53 mutant or silenced7. Researchers have since tried to rectify this line by integrating Trp53 mutations in it5, but since Trp53 mutation is an early event in HGSOC pathogenesis, this modification comes possibly too late in the transformation of this cell line and likely does not represent normal HGSOC development.
Over the past decade, attempts have been made to rectify this state of affairs by generating more realistic models of HGSOC. For example, genetically engineered mouse models (GEMMs) that harbor relevant mutations on Müllerian-tract lineage cells, often under a Cre-recombinase system to control pathogenesis, allow researchers to better mimic the disease in vivo8,9,10. Unfortunately, these models are often complicated to generate, and may have other issues such as Cre-leaking, Cre-effect or "field-effects"11,12,13. In this regard, syngeneic organoid models appear to be a robust compromise for researchers who wish to better mimic the disease both in vitro and in vivo14,15,16,17,18,19. Indeed, while most HGSOC models available and used at the moment are two-dimensional models, they unfortunately cannot properly simulate the complexity of the extracellular matrix (ECM), a crucial element affecting cell biology. Organoids are self-organized 3D tissues, often generated from stem cells, which can recreate the early structural and functional complexity of an organ in the Petri dish20. Their generation typically works by suspending single cells, which are pluripotent, in a basement membrane matrix (BMM), such as Matrigel21. In vitro, these models are comparatively more accurate at recapitulating in vivo conditions than 2D models. Likewise, due to their syngeneic nature, these models are capable of being transplanted into a mouse with a fully functioning immune system, allowing for a more faithful reconstruction of pathogenesis and development14,15. This is a clear advantage over patient-derived xenografts, which, while having the most realistic tumour genetics, require engraftment in immunocompromised mouse models.
In this protocol, we describe how to develop syngeneic HGSOC organoid models. From the generation of the original wild-type FTE organoid culture extracted from a mouse, their genetic engineering to generate disease-informed genotypes, to finally their transplantation back into the ovarian bursa to generate fully developed tumors. We also included a few additional protocols to help with common experiments, such as immunofluorescence (IF) staining of in vitro organoids, and 2D conversion of cell lines for large-scale production of cells, such as for injections. This protocol is aimed at researchers who want to develop organoid syngeneic models of HGSOC with control over their genetic makeup, with the particular intention to study HGSOC biology in more realistic in vitro conditions as well as the interactions present in the tumor microenvironment in vivo.