FBXW7 mutations, like other key genomic alterations, were maintained in CCOs and found to associate with specific tumor immune microenvironment (TIM) classes: all MSI-H organoids fell into the “Exhausted” group (predicting likely response to PD-1/PD-L1 blockade), while organoids with activated Wnt/β-catenin signaling, often driven by FBXW7 loss, clustered in the “Desert” group characterized by immune exclusion. Here, CD274 is linked to neoplasm.