Helena Abolins-Thompson ^1* Kimiora Henare ² Bridget Simonson ^3,4 Mark Chaffin ^3,4 Patrick T. Ellinor ^3,4,5 Claire Henry ¹ Mairarangi Haimona ⁶ Jake Aitken ⁷ Taku Parai ⁸ Bianca Elkington ⁸ Michael Rongo ⁸ Kirsty M. Danielson ¹ Megan P. Leask ⁹

• ¹ Department of Surgery and Anaesthesia, University of Otago, Wellington, Wellington, New Zealand
• ² Faculty of Medical and Health Sciences, The University of Auckland, Auckland, Auckland, New Zealand
• ³ Precision Cardiology Laboratory, Broad Institute, Boston, United States
• ⁴ Cardiovascular disease Initiative, The Broad Institute of MIT and Harvard, Cambridge, United States
• ⁵ Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
• ⁶ Department of General Surgery, Wellington Regional Hospital, Wellington, New Zealand
• ⁷ Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago Wellington, Wellington, New Zealand
• ⁸ Te Rūnanga o Toa Rangatira, Porirua, New Zealand
• ⁹ Department of Physiology, School of Biomedical Sciences, University of Otago, Dunedin, Otago, New Zealand

Indigenous communities globally are inequitably affected by non-communicable diseases such as cancer and coronary artery disease. Increased focus on personalized medicine approaches for the treatment of these diseases offers opportunities to improve the health of Indigenous people. Conversely, poorly implemented approaches pose increased risk of further exacerbating current inequities in health outcomes for Indigenous peoples. The advancement of modern biology techniques, such as three-dimensional (3D) in vitro models and next generation sequencing (NGS) technologies, have enhanced our understanding of disease mechanisms and individualized treatment responses. However, current representation of Indigenous peoples in these datasets is lacking. It is crucial that there is appropriate and ethical representation of Indigenous peoples in generated datasets to ensure these technologies can be used to maximize the benefit of personalized medicine for Indigenous peoples. This project discusses the use of 3D tumor organoids and single cell/nucleus RNA sequencing to study cancer treatment responses and explore immune cell roles in coronary artery disease. Using key pillars from currently available Indigenous bioethics frameworks, strategies were developed for the use of Māori participant samples for live tissue and sequencing studies. These were based on extensive collaborations with local Māori community, scientific leaders, clinical experts, and international collaborators from the Broad Institute of MIT and Harvard. Issues surrounding the use of live tissue, genomic data, sending samples overseas and Indigenous data sovereignty were discussed. This paper illustrates a real-world example of how collaboration with community and the incorporation of Indigenous worldviews can be applied to molecular biology studies in a practical and culturally responsive manner, ensuring fair and equitable representation of Indigenous peoples in modern scientific data.