尽管癌症基因组学有所进展且基因组医学的使用越来越广泛，但转移性癌症仍然是一种难以治愈且致命的疾病。传统药物发现策略的回报越来越少，临床失败率也很高，因此更多的重心被放在了替代药物发现平台上，如外体方法。外体方法旨在在药物发现早期嵌入生物学相关性和患者间变异性，并为患者提供更精确的治疗分层策略。然而，这些技术也有很高的潜力为患者提供个性化治疗，以补充和增强基因组医学。虽然研究人员有一系列方法可供选择，但只有少数技术在强大的临床试验中成功地直接用于患者治疗。在本综述中，我们讨论外体方法在临床实践中面临的当前挑战，并总结了指导患者治疗的现代文献。最后，我们勾画了外体方法如何从小规模、主要基于研究的技术过渡到强大且经过验证的预测工具。将来，这些临床前方法可以纳入临床癌症途径，帮助个性化治疗选择，并希望改善患者的体验和结果。

Despite advances in cancer genomics and the increased use of genomic medicine, metastatic cancer is still mostly an incurable and fatal disease. With diminishing returns from traditional drug discovery strategies, and high clinical failure rates, more emphasis is being placed on alternative drug discovery platforms, such as ex vivo approaches. Ex vivo approaches aim to embed biological relevance and inter-patient variability at an earlier stage of drug discovery, and to offer more precise treatment stratification for patients. However, these techniques also have a high potential to offer personalised therapies to patients, complementing and enhancing genomic medicine. Although an array of approaches are available to researchers, only a minority of techniques have made it through to direct patient treatment within robust clinical trials. Within this review, we discuss the current challenges to ex vivo approaches within clinical practice and summarise the contemporary literature which has directed patient treatment. Finally, we map out how ex vivo approaches could transition from a small-scale, predominantly research based technology to a robust and validated predictive tool. In future, these pre-clinical approaches may be integrated into clinical cancer pathways to assist in the personalisation of therapy choices and to hopefully improve patient experiences and outcomes.