Abstract:Gastric cancer ranks as the fifth most common human malignancy and the third leading cause of cancer related deaths. Depending on tumor stage, endoscopic or surgical resection supported by perioperative chemotherapy is the only curative option for patients. Due to lack of reliable biomarkers and specific early clinical manifestations, the early detection of gastric cancer is challenging, so the overall survival rate remains poor. Traditionally, the mechanisms of tumor initiation and progression in the gastrointestinal tract were studied using cancer cell lines in vitro and animal models, but the abnormal genomic variants could not accurately reflect the original state of tumor cells in terms of their metastatic characteristics or response to treatment because of method of in vitro cell culture being associated with a large number of abnormal genomic variants. However, organoids are cell aggregates cultured in three-dimensions, and their growth characteristics are similar to the original tissues. Being cultured from fresh biopsy tissue, the organoids retain the genetic phenotype and behavioral characteristics of the original tissue and have unlimited self-renewal and proliferation ability. The patient-derived organoid(PDO) serves as a living biobank for an in-depth analysis of tissue-specific functions, development and diseases. The successful establishment of gastric cancer PDOs opens up new perspectives for various clinical transformation applications. This paper summarizes the development process of organoids, the establishment of gastric organoids and its application in gastric cancer, to discuss the limitations of the current organoid model application and possible improvement methods, in order to maximize the benefits in the fulture basic research and translational research, especially in the field of drug discovery and personalized medicine.