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Patient-derived xenograft (PDX) models have become increasingly important for drug development and research into cancer heterogeneity. This systematic review identified original publications describing the derivation of PDX models of colon, lung and breast and performed a narrative data synthesis. A total of 110 records met inclusion criteria. PDX models were most often derived using NSG, NOD/SCID and Balb/c mouse strains, with engraftment sites varied by tissue of origin (e.g. orthotopic vs subcutaneous for breast vs subrenal pNX for prostate). Most PDX studies did not perform any validation experiments; 133 of these were excluded as the authors did not present validation results. This was mainly due to a failure to confirm that the PDX represented tumour cells and not normal cells, or to demonstrate concordance of histopathology.
Another limiting factor for the use of PDX models was that authors did not clearly define engraftment rate experimental end-points (i.e. number of primary outgrowths or serial passages). This was a common problem in the breast and colon PDX literature. The lack of a consistent definition of engraftment rates limits the ability to compare PDX models and to determine whether differences between PDX and cell line-based results are clinically meaningful.