Abstract

Tumour organoids have emerged as important tools in brain tumour research, addressing long-standing limitations of conventional two-dimensional cultures, xenograft models, and genetically engineered mouse models. By preserving patient-specific genetic alterations, cellular diversity, spatial architecture, and key microenvironmental features, organoid systems enable more faithful modelling of tumour biology across a broad range of intracranial tumours, including gliomas, meningiomas, medulloblastomas, pituitary tumours, and craniopharyngiomas. Patient-derived organoids, genetically engineered models, co-culture systems, and bioprinted platforms have collectively advanced understanding of tumour initiation, invasion, heterogeneity, and therapeutic resistance, while offering clinically relevant systems for drug screening and personalised therapy prediction. Importantly, organoid models facilitate mechanistic interrogation of tumour-microenvironment interactions that are difficult to capture in other systems, including neural-tumour crosstalk, vascular niche formation, and immune modulation. Their compatibility with high-throughput screening and integration with emerging technologies, such as single-cell and spatial omics, CRISPR-based genome editing, microfluidics, and artificial intelligence, has further expanded their utility for functional genomics, biomarker discovery, and predictive modelling of treatment response. The development of large-scale organoid biobanks that represent diverse tumour subtypes and patient populations also provides critical infrastructure for reproducible research and collaborative precision oncology efforts. While challenges remain, including variability in culture protocols, incomplete immune and vascular representation, and barriers related to cost and technical complexity, ongoing methodological innovations are progressively enhancing the physiological fidelity and translational relevance of organoid systems. Overall, tumour organoids represent a promising interface between experimental research and clinical application in neuro-oncology, with significant potential to accelerate therapeutic discovery, refine patient stratification, and ultimately improve outcomes for individuals with brain tumours. [Abstract copyright: © 2026. The Author(s).]