Patient-Derived Organoid-on-a-Chip Model for Personalized Prediction of Chemotherapy Efficacy in Pancreatic Cancer

Inclusion Criteria: * Age 18-75 years, both sexes * Pathologically confirmed pancreatic ductal adenocarcinoma (PDAC) in treatment-naïve patients * Ability to obtain sufficient fresh tumor tissue samples for organoid establishment through surgery or biopsy * Planned to receive neoadjuvant therapy for borderline resectable disease, conversion therapy for locally advanced disease, or first-line therapy for metastatic disease, using single-agent or combination chemotherapy * At least one measurable lesion per RECIST 1.1 criteria * ECOG performance status 0-2 * Life expectancy ≥3 months * Adequate organ and bone marrow function: hemoglobin ≥9.0 g/dL; absolute neutrophil count ≥1.5×10⁹/L; platelet count ≥100×10⁹/L; total bilirubin ≤1.5×ULN (or ≤3×ULN with biliary obstruction); ALT/AST ≤2.5×ULN (or ≤5×ULN with biliary obstruction); serum creatinine ≤1.5×ULN or CrCl \>60 mL/min * Willing to sign informed consent, good compliance, and able to comply with follow-up Exclusion Criteria: * Sample quantity, quality, or preservation does not meet requirements * Expected transport time \>24 hours (including samples stored overnight before delivery) * Organoid culture failure or testing quality control failure * Inability to tolerate chemotherapy regimens * Severe comorbidities, uncontrolled conditions, or active infections * Pregnancy or breastfeeding * History of severe autoimmune diseases * Any unstable condition that may compromise patient safety or compliance * Deemed unsuitable for inclusion by the investigator