Introduction: Drug screening assays employing two-dimensional (2D) cultures of cancer cells have been largely replaced by three-dimensional (3D) multicellular tumor spheroid (MCTS) models which more closely represent patient's tumors. The predictive power of the different MCTSs depends on source of the cells, techniques of preparation, and characteristics of the aggregates. Areas covered: The preparation of MCTSs and a comparison of the spheroids assembled from permanent cancer and patient-derived cell lines in respect to the correlation of their chemosensitivity to clinical responses are discussed. Spheroids formed in in vivo in pleural effusion and blood of cancer patients are presented as interesting sources for drug screening. Expert opinion: 3D tumor models for drug screening were adopted to increase the predictive power of assays for success in clinical trials. Cell lines which form dense spheroids differ in physical properties, gene expression, and chemosensitivity from 2D cultures. Still, most of these MCTS models lack characteristics of complex tumor tissues and have not been validated for their adequacy to select clinically useful drugs. Patient-derived spheroids from pleural effusion or blood, namely tumorospheres of circulating tumor cells, are MCTS models most similar to patient's tumors.
Keywords: Drug screening; ascites; assay validation; chemosensitivity; pleural effusion; tumor spheroid; tumorospheres.