Eur J Radiol. 2025 Jul 22;191:112327. doi: 10.1016/j.ejrad.2025.112327. Online ahead of print.

ABSTRACT

The NAVIGATOR project established an Italian regional imaging biobank and interactive research platform designed to support precision oncology through the integration of multimodal imaging, clinical, and omics data. The platform goes beyond a static repository, offering a secure Virtual Research Environment (VRE) where users can upload data, test AI algorithms, and execute complete analytical pipelines. The platform incorporates artificial intelligence (AI)-driven radiomics and deep learning methodologies to enable biomarker extraction, disease stratification, and predictive modeling. This manuscript presents the development and implementation of the NAVIGATOR infrastructure, including its data governance framework, ethical and legal considerations, and application to three oncological use cases: prostate, rectal, and gastric cancers. To date, the biobank has collected imaging and clinical data from over 700 patients across these cohorts. AI models were deployed within a dedicated VRE to facilitate image analysis, feature extraction, and classification tasks. The project addresses critical challenges related to data harmonization, regulatory compliance, privacy safeguards and fairness in AI systems. NAVIGATOR demonstrates the feasibility of integrating AI methodologies within imaging biobanks and provides a scalable framework to advance oncological research and support clinical decision-making.

PMID:40743874 | DOI:10.1016/j.ejrad.2025.112327

J Liq Biopsy. 2025 Jul 16;9:100312. doi: 10.1016/j.jlb.2025.100312. eCollection 2025 Sep.

ABSTRACT

Breast cancer (BC) is the most frequent cancer and the leading cause of cancer-related death among women worldwide. It represents a heterogeneous group of diseases with distinct morphological, immunophenotypic, and molecular profiles, which significantly impact clinical behavior and therapeutic response. Moreover, under treatment pressure, tumor cells may undergo molecular changes and phenotypic plasticity, leading to resistance and therapeutic failure. Although tissue biopsy remains the gold standard for diagnosis and molecular characterization, it has several limitations, including invasiveness, sampling bias, and the inability to dynamically capture tumor evolution over time. Hence, a non-invasive and repeatable approach capable of real-time monitoring is increasingly needed. Liquid biopsy (LB), through the analysis of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), has emerged as a powerful tool to complement tissue biopsy. It allows for longitudinal assessment of tumor burden, detection of minimal residual disease, and identification of molecular alterations relevant to targeted therapies. Despite promising results, the integration of LB into clinical practice is still limited by methodological heterogeneity, standardization gaps, and regulatory issues. Nonetheless, LB represents a key advancement toward precision oncology and may become essential in the personalized management of BC patients. In this review, we explore the current applications, benefits, and technical limitations of LB in different BC settings. We provide a comprehensive overview of the biological and clinical significance of CTCs and ctDNA, emphasizing their diagnostic, prognostic, and predictive roles. Finally, we present an updated summary of ongoing clinical trials that incorporate LB for clinical decision-making.

PMID:40740670 | PMC:PMC12308030 | DOI:10.1016/j.jlb.2025.100312

Diabetologia. 2025 Jul 30. doi: 10.1007/s00125-025-06462-y. Online ahead of print.

ABSTRACT

This article summarises the current understanding of the heterogeneity of type 1 diabetes from a June 2024 international Expert Forum organised by the editors of Diabetes, Diabetes Care, and Diabetologia. The Forum reviewed key factors contributing to the development and progression of type 1 diabetes and outlined specific, high-priority research questions. Knowledge gaps were identified and, notably, opportunities to harness disease heterogeneity to develop personalised therapies were outlined. Herein, we summarise our discussions and review the heterogeneity of genetic risk and immunologic and metabolic phenotypes that influence and characterise type 1 diabetes progression (presented as a palette of risk factors). We discuss how these age-related factors determine disease aggressiveness (along gradients) and describe how variable immunogenetic pathways aggregate (into networks) to affect beta cell and other pancreatic pathologies to cause clinical disease at different ages and with variable severity (described as disease-related thresholds). Heterogeneity of pathogenesis and clinical severity opens avenues to prevention and intervention, including the potential of disease-modifying immunotherapy and islet cell replacement. We conclude with a call for (1) continued research to identify more factors contributing to the disease, both overall and in specific subgroups; (2) investigations focusing on both individuals who surpass metabolic and immune thresholds and develop diabetes and those who remain disease free with the same level of immunogenetic risk; and (3) efforts to identify where the current type 1 diabetes staging system may fall short and determine how it can be improved to capture and leverage heterogeneity in prevention and intervention strategies.

PMID:40736750 | DOI:10.1007/s00125-025-06462-y

bioRxiv [Preprint]. 2025 Jun 8:2025.06.08.658506. doi: 10.1101/2025.06.08.658506.

ABSTRACT

Advances in spatial profiling have resulted in the generation of multi-omic atlases that span biological scales. In general, multiple workflows are required for image registration, coordinate registration, and spot deconvolution to integrate modalities. To improve the throughput of registration of multi-omic cohorts, we introduce PIVOT, a user-friendly and open-source interface for streamlined nonlinear registration. We demonstrate PIVOT's strengths through registration of three multi-omic datasets, and show comparison of its performance to existing workflows.

PMID:40661390 | PMC:PMC12259011 | DOI:10.1101/2025.06.08.658506

Biomolecules. 2025 May 31;15(6):803. doi: 10.3390/biom15060803.

ABSTRACT

Lung cancer is responsible for 2.21 million annual cancer cases and is the leading worldwide cause of cancer-related deaths. Specifically, lung adenocarcinoma (LUAD) is the most prevalent lung cancer subtype resulting from genetic causes; LUAD has a 15% patient survival rate due to it commonly being detected in its advanced stages. This study aimed to identify a novel biomarker signature of early-stage LUAD utilizing gene expression analysis of human lung tissue samples. Using 22 pairs of LUAD and matched normal lung microarrays, 229 differentially expressed genes were identified. These genes were networked for their protein-protein interactions, and 44 hub genes were determined from protein essentiality. Survival analysis of 478 LUAD patient samples identified four statistically significant candidates. These candidate genes' expression profiles were validated from GTEx and TCGA (347 normal, 483 LUAD samples); immunohistochemistry validated the subsequent protein presence. Through intensive bioinformatic identification and multiple validations of the four-biomarker gene signature, AGER, MGP, and PECAM1 were identified as downregulated in LUAD; SLC2A1 was identified as upregulated in LUAD. These four biologically significant genes are involved in tumorigenesis and poor LUAD prognosis, meriting their use as a clinical biomarker signature and therapeutic targets for early-stage LUAD.

PMID:40563443 | PMC:PMC12191159 | DOI:10.3390/biom15060803

JCI Insight. 2025 Jun 26:e191595. doi: 10.1172/jci.insight.191595. Online ahead of print.

ABSTRACT

Pancreatic ductal adenocarcinoma (PDAC) has a poor survival rate due to late detection. PDAC arises from precursor microscopic lesions, termed pancreatic intraepithelial neoplasia (PanIN), that develop at least a decade before overt disease--this provides an opportunity to intercept PanIN-to-PDAC progression. However, immune interception strategies require full understanding of PanIN and PDAC cellular architecture. Surgical specimens containing PanIN and PDAC lesions from a unique cohort of five treatment-naïve patients with PDAC were surveyed using spatial-omics (proteomic and transcriptomic). Findings were corroborated by spatial proteomics of PanIN and PDAC from tamoxifen-inducible KPC (tiKPC) mice. We uncovered the organization of lymphoid cells into tertiary lymphoid structures (TLSs) adjacent to PanIN lesions. These TLSs lacked CD21+CD23+ B cells compared to more mature TLSs near the PDAC border. PanINs harbored mostly CD4+ T cells with fewer Tregs and exhausted T cells than PDAC. Peri-tumoral space was enriched with naïve CD4+ and central memory T cells. These observations highlight the opportunity to modulate the immune microenvironment in PanINs before immune exclusion and immunosuppression emerge during progression into PDAC.

PMID:40569674 | DOI:10.1172/jci.insight.191595

bioRxiv [Preprint]. 2025 Feb 17:2025.02.13.637721. doi: 10.1101/2025.02.13.637721.

ABSTRACT

Cell type-specific regulatory programs that drive type 1 diabetes (T1D) in the pancreas are poorly understood. Here we performed single nucleus multiomics and spatial transcriptomics in up to 32 non-diabetic (ND), autoantibody-positive (AAB+), and T1D pancreas donors. Genomic profiles from 853,005 cells mapped to 12 pancreatic cell types, including multiple exocrine sub-types. Beta, acinar, and other cell types, and related cellular niches, had altered abundance and gene activity in T1D progression, including distinct pathways altered in AAB+ compared to T1D. We identified epigenomic drivers of gene activity in T1D and AAB+ which, combined with genetic association, revealed causal pathways of T1D risk including antigen presentation in beta cells. Finally, single cell and spatial profiles together revealed widespread changes in cell-cell signaling in T1D including signals affecting beta cell regulation. Overall, these results revealed drivers of T1D progression in the pancreas, which form the basis for therapeutic targets for disease prevention.

PMID:40027657 | PMC:PMC11870426 | DOI:10.1101/2025.02.13.637721