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Epigallocatechin gallate offers convergent antifibrotic actions across TGF-\u03b2 signalling, oxidative stress, inflammation and collagen remodelling, yet clinical effects remain inconsistent because instability and rapid clearance prevent sustained intralesional exposure. This Review proposes a precision delivery roadmap that couples engineered local dosage forms and nanocarriers with patient-derived organoids as a functional translational layer. We describe how organoids can benchmark retention, penetration and spatial drug gradients while quantifying fibrosis aligned endpoints including collagen content, \u03b1-SMA, LOX activity, hypoxia and mechanotransduction readouts. Biomarker guided comparisons across molecular subtypes enable responder enrichment and reduce signal dilution in trials. We further outline an auditable evidence chain that connects material attributes to local exposure, mechanism aligned efficacy readouts, safety, and practical constraints such as manufacturability and deployability for clinical adoption. Standardized decision criteria and cross center harmonization are essential for reproducible organoid guided screening.<\/jats:p>","DOI":"10.3389\/fbioe.2026.1792350","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T06:44:23Z","timestamp":1774248263000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["An organoid-guided roadmap for precision delivery of epigallocatechin gallate in oral submucous fibrosis"],"prefix":"10.3389","volume":"14","author":[{"given":"Chenpeng","family":"Chen","sequence":"first","affiliation":[{"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An","family":"Gan","sequence":"additional","affiliation":[{"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenggong","family":"Huang","sequence":"additional","affiliation":[{"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yishun","family":"Weng","sequence":"additional","affiliation":[{"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Wang","sequence":"additional","affiliation":[{"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1089\/hum.2024.249","article-title":"Advancing potency assay development for advanced therapy medicinal products: a comprehensive approach and regulatory insights","volume":"36","author":"Abdellatif","year":"2025","journal-title":"Hum. 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