Treatments that focus on the immune system have completely changed the way cancer is treated over the past ten years. Immune checkpoint inhibitors and other treatments, like chimeric antigen receptor ( CAR ) lymphocyte transfer therapies, have been approved as first-line treatments for a number of solid tumors, including melanoma and non-small cell lung cancer. Despite encouraging outcomes in a small subset of patients, intertumoral heterogeneity and therapy resistance limit the overall clinical efficacy of the majority of immunotherapeutics. Therefore, for the effective use of expensive immunotherapeutic drugs as well as for better outcomes, patient-specific response prediction would be of great value. In vitro cultures using the combination of these cells derived from the same patient hold great promise to predict drug efficacy in a personalized manner because many immunotherapeutics work by improving the interaction and / or recognition of malignant target cells by T cells. Due to altered phenotypical behavior of cells when compared to the in vivo situation, using two-dimensional cancer cell lines for such cultures is unreliable. Three-dimensional tumor-derived organoids are thought to be a more realistic way to study the intricate tumor andndash, immune interactions because they are better mimic in vivo tissue. In this review, we provide a summary of how patient-specific tumor organoid-immune co-culture models have been developed to examine the immune interactions and potential therapeutic infringement of tumors. We also talk about how these models can be used to advance personalized therapy efficacy and better understand the tumor microenvironment, such as:( 1 ) Customized immune checkpoint inhibition and CAR therapy screening. ( 2 ) Development of tumor-responsive lymphocytes for treatments involving adoptive cell transfer. ( 3 ) Investigating immune interactions and tumor & ndash to identify cell-specific roles in tumor development and remission. Overall, these onco-immune co-cultures may have a bright future for creating patient-specific therapeutic approaches and deepening our knowledge of tumor and immune interactions.