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Codon specific readthrough as a mechanism of BRCA2 restoration in acquired PARP inhibitor and chemotherapy resistance

Nucleic Acids Res. 2025 Oct 14;53(19):gkaf990. doi: 10.1093/nar/gkaf990.

ABSTRACT

BRCA2 mutations contribute to the pathogenesis and treatment sensitivity of a subset of ovarian, breast, prostate, and pancreatic cancers. When these cancers become therapy resistant, secondary mutations that restore the BRCA2 open reading frame are found in half the cases, but other causes of resistance remain incompletely understood. Here, we identified translational readthrough of a premature termination codon (PTC) as a cause of resistance to poly(ADP-ribose) polymerase inhibitors (PARPis) and cisplatin in cells derived from the BRCA2-mutated ovarian cancer line PEO1 by PARPi selection. Despite persistence of the signature 4965C > G (p.Y1655X) BRCA2 mutation, low-level expression of full-length BRCA2 protein was detectable in these cells by immunoblotting and tandem mass spectrometry. Either BRCA2 knockdown or gene interruption 5' or 3' to the PTC restored treatment sensitivity, implicating BRCA2 in the resistance. Reporter assays demonstrated UAG-selective readthrough in the resistant clones but not parental cells. Moreover, custom searching of global proteomic data indicated readthrough of stop codons, particularly UAGs, in additional proteins in the resistant clones. Finally, multi-omic analysis identified multiple changes in the nonsense-mediated decay and termination machineries that favor readthrough. Accordingly, the present results identify PTC readthrough as a potential mechanism of drug resistance in cells with BRCA2 nonsense mutations.

PMID:41099700 | PMC:PMC12526053 | DOI:10.1093/nar/gkaf990

HT SpaceM: A high-throughput and reproducible method for small-molecule single-cell metabolomics

Single-cell metabolomics (SCM) can probe metabolic heterogeneity but is hindered by low sensitivity for small molecules, limited scalability, and the lack of standardized frameworks for data analysis. HT SpaceM is a high-throughput MALDI-imaging-based SCM method to robustly detect small-molecule metabolites in single cells. Applied to over 140,000 cells across diverse conditions and cancer cell lines, HT SpaceM enabled reproducible metabolic profiling of over 100 small-molecule metabolites, identification of subpopulation-specific markers, and detection of heterogeneity and pathways coordination, thus facilitating scalable and reproducible SCM.

Framework for the Development and Delivery of Digital Peer Support Programs: Qualitative Study on in-Person and Digital Delivery for People With Cardiovascular Disease

Background: Peer support (sharing experiences/support with others with the same condition) improves health outcomes among people with cardiovascular disease (CVD), including self-management behaviours and self-efficacy. However, current peer support interventions are diverse. Evidence is lacking on peer support attenders perceptions of benefits and the elements that are considered priorities, especially for digital interventions. Objective: The study objectives were to 1) describe perceived benefits and recommendations for CVD peer support programs from people attending in-person peer support, 2) identify priorities for digital peer support from consumers and clinicians testing a peer support app prototype, and 3) develop a framework to inform future peer support intervention development. Methods: Qualitative methodology was used across two components to address the objectives of this study. In Component 1, semi-structured focus groups were conducted with attenders of established in-person CVD peer support groups, exploring the perceived benefits of peer support and recommendations for future programs. In Component 2, semi-structured interactive workshops with consumers with CVD and semi-structured online interviews with CVD clinicians/researchers were undertaken seeking feedback and recommendations for digital peer support using an exploratory digital CVD peer support application prototype. Data were recorded digitally, transcribed verbatim, and analysed thematically. Findings from both components were iteratively synthesised to inform a digital peer support development framework. Results: In Component 1, 22 participants (age range 29-84 years, male 45%) took part in focus groups. The overarching theme was that peer support provides benefits through sharing experiences. Five themes were refined and defined; (i) peer support provides a way of coping, (ii) peers learn from each other, (iii) peers understand what each other are going through, (iv) the peer community uplifts mood and build confidence, and (v) awareness, flexibility and resources are important for engagement. In Component 2, five participants (age range 55-74 years, male 60%) attended two workshops and eight clinicians/researchers (age range 30-65 years, male 10%) were interviewed. Three themes were refined and defined: (i) autonomy is essential to promote engagement, (ii) safeguarding is important to both users and clinicians, and (iii) interfaces that are simple, easy to use and visually attractive enable use. Priorities identified from both components included greater peer support awareness and uptake, flexibility with timing and family participation, healthcare professional involvement, provision of resources, autonomous features enabling choice, checklists and clinician moderation for safeguarding, and simple to use interfaces. Conclusions: Participants in peer support programs derive benefit from sharing their experience of living with CVD which enable coping, learning, feeling understood and a sense of community. Priorities were synthesised to create a framework for digital peer support development for future peer support with recommendations to focus on six key areas: uptake, flexibility, resources, autonomy, safeguarding and interface.

Artificial Intelligence-Enhanced Liquid Biopsy and Radiomics in Early-Stage Lung Cancer Detection: A Precision Oncology Paradigm

Cancers (Basel). 2025 Sep 29;17(19):3165. doi: 10.3390/cancers17193165.

ABSTRACT

BACKGROUND: Lung cancer remains the leading cause of cancer-related mortality globally, largely due to delayed diagnosis in its early stages. While conventional diagnostic tools like low-dose CT and tissue biopsy are routinely used, they suffer from limitations including invasiveness, radiation exposure, cost, and limited sensitivity for early-stage detection. Liquid biopsy, a minimally invasive alternative that captures circulating tumor-derived biomarkers such as ctDNA, cfRNA, and exosomes from body fluids, offers promising diagnostic potential-yet its sensitivity in early disease remains suboptimal. Recent advances in Artificial Intelligence (AI) and radiomics are poised to bridge this gap.

OBJECTIVE: This review aims to explore how AI, in combination with radiomics, enhances the diagnostic capabilities of liquid biopsy for early detection of lung cancer and facilitates personalized monitoring strategies. Content Overview: We begin by outlining the molecular heterogeneity of lung cancer, emphasizing the need for earlier, more accurate detection strategies. The discussion then transitions into liquid biopsy and its key analytes, followed by an in-depth overview of AI techniques-including machine learning (e.g., SVMs, Random Forest) and deep learning models (e.g., CNNs, RNNs, GANs)-that enable robust pattern recognition across multi-omics datasets. The role of radiomics, which quantitatively extracts spatial and morphological features from imaging modalities such as CT and PET, is explored in conjunction with AI to provide an integrative, multimodal approach. This convergence supports the broader vision of precision medicine by integrating omics data, imaging, and electronic health records.

DISCUSSION: The synergy between AI, liquid biopsy, and radiomics signifies a shift from traditional diagnostics toward dynamic, patient-specific decision-making. Radiomics contributes spatial information, while AI improves pattern detection and predictive modeling. Despite these advancements, challenges remain-including data standardization, limited annotated datasets, the interpretability of deep learning models, and ethical considerations. A push toward rigorous validation and multimodal AI frameworks is necessary to facilitate clinical adoption.

CONCLUSION: The integration of AI with liquid biopsy and radiomics holds transformative potential for early lung cancer detection. This non-invasive, scalable, and individualized diagnostic paradigm could significantly reduce lung cancer mortality through timely and targeted interventions. As technology and regulatory pathways mature, collaborative research is crucial to standardize methodologies and translate this innovation into routine clinical practice.

PMID:41097693 | PMC:PMC12524159 | DOI:10.3390/cancers17193165

Comparison of Familial and Sporadic Pancreatic Cancer: Clinicopathological and Genomic Features

Ann Surg Oncol. 2025 Oct 14. doi: 10.1245/s10434-025-18556-3. Online ahead of print.

ABSTRACT

BACKGROUND: Familial pancreatic cancer (FPC) will be enriched for germline mutations (GLMs), particularly in homologous recombination repair (HRR) genes, but its distinction from sporadic pancreatic cancer (PC) remains unclear.

METHODS: We retrospectively analyzed 111 resected PCs, including 13 patients with FPC (11.8%) and 98 with non-FPC (88.2%). Whole-exome sequencing targeted 151 cancer-related genes, with parallel gene expression profiling. GLMs were assessed by ClinVar and in silico tools. Homologous recombination deficiency (HRD) scores, COSMIC signatures, immune deconvolution, and survival were compared.

RESULTS: Patients with FPC and non-FPC were comparable in age, sex, tumor stage, and receipt of adjuvant chemotherapy. ClinVar-annotated GLMs were found in 2/13 patients with FPC (15.4%) and 4/98 patients with non-FPC (4.1%). FPC cases more often carried pancreatitis-associated variants (SPINK1, CFTR), whereas non-FPC included HRR-related variants (PALB2, FANCG). When potentially pathogenic HRR-related variants were considered together, prevalence was similar (23.1% vs. 12.2%, p = 0.380). HRD scores did not differ (median 22 vs. 19, p = 0.591), and high HRD scores (≥ 42) were observed only in two non-FPC cases, including one with PALB2. Differential expression analysis revealed no significant differences after false discovery rate correction. Multivariate analysis indicated that FPC status was not an independent prognostic factor (hazard ratio 1.73, p = 0.084).

CONCLUSIONS: Transcriptomic profiles and HRD status were similar between patients with FPC and patients with non-FPC. A spectrum of GLMs was observed in both groups, suggesting that hereditary risk variants are not exclusive to FPC and underscoring the importance of germline testing in all patients with PC.

PMID:41085800 | DOI:10.1245/s10434-025-18556-3

Tumor microenvironment and macroenvironment: A new perspective on holistic oncology

Cancer Lett. 2025 Oct 11;634:218076. doi: 10.1016/j.canlet.2025.218076. Online ahead of print.

ABSTRACT

The tumor microenvironment (TME) and tumor macroenvironment (TMaE) jointly shape cancer biology by linking local cellular niches with systemic host physiology. The TME provides the immediate soil for tumor initiation, progression, and therapy resistance, whereas the TMaE integrates metabolic, immune, neuroendocrine, microbial, and inflammatory signals that remodel local ecosystems. Recent advances highlight how systemic factors, including aging, energy imbalance, chronic inflammation, cachexia, and psychosocial stress, interact with extracellular matrix remodeling, vascular dynamics, and immune surveillance to influence tumor dormancy, metastatic reactivation, and therapeutic outcomes. However, the conceptual boundaries between TME and TMaE remain unclear, mechanistic insights are limited, and current models insufficiently capture local-systemic crosstalk. Future strategies integrating multi-omics, advanced imaging, and humanized models are essential to map this multidimensional interplay. A deeper understanding of TME-TMaE will be critical to refine precision oncology, advance preventive strategies, and design combinatorial therapies targeting both local and systemic cancer ecosystems. This review highlights the roles of the TME and TMaE in tumor initiation, progression, and heterogeneity, their interactions, and the clinical implications for classification, therapy, and prognosis.

PMID:41083101 | DOI:10.1016/j.canlet.2025.218076

Spatial metabolic gradients in the liver and small intestine

Nature, Published online: 15 October 2025; doi:10.1038/s41586-025-09616-5

Mapping of spatial metabolic gradients in the mouse liver and intestine identifies fructose-induced focal derangements in liver metabolism.

Implementing a Digital Mental Health Intervention—the Lumi Nova App—to Support Children With Anxiety in Economically Disadvantaged Areas: Mixed Methods Study

Background: Anxiety is one of the most common mental health problems experienced by children worldwide. In the UK, many children experiencing anxiety do not receive adequate or timely help. Children living in economically-disadvantaged areas experience more mental health problems than those living in high income areas and are less able to engage in activities that can have a positive or protective impact on their mental health. The need for providing low-cost, accessible and engaging mental health interventions for children living in these areas is high. Objective: The study aimed to explore how a digital mental health therapeutic, ‘Lumi Nova: Tales of Courage’, could be used to support children living with anxiety in economically-disadvantaged areas. Methods: A mixed method study design was used to explore the implementation of Lumi Nova using a supported delivery model with mental health teams based in the North of England. Quantitative data collection on recruitment and engagement patterns were collected and analysed. Qualitative research explored children, parent and practitioner views and experiences with the Lumi Nova app. Results: 113 children were consented to use Lumi Nova and 98 (87%) accessed the intervention at least once. Qualitative semi-structured interviews found that children, their parents and practitioners viewed the Lumi Nova app positively. Quantitative analysis of the recruitment data suggested the feasibility of a future larger roll-out. Analysis of usage data demonstrated varied patterns of engagement with the intervention. The frequency and duration of usage varied across children, as did the activities completed within the game: almost half (49%) completed three in-game challenges indicating progression through the treatment pathway. Conclusions: The study demonstrated that a digital mental health intervention could be successfully deployed within economically-disadvantaged areas in the UK to support children experiencing anxiety. Expected barriers to the deployment of digital mental health interventions in economically-disadvantaged areas (e.g. lack of access to smartphones, data plans, lack of technical skills) were not reported. Digital mental health interventions have the potential to address current gaps in mental health provision for disadvantaged individuals and communities.
  • ✇MIT Technology Review
  • Transforming commercial pharma with agentic AI  MIT Technology Review Insights
    Amid the turbulence of the wider global economy in recent years, the pharmaceuticals industry is weathering its own storms. The rising cost of raw materials and supply chain disruptions are squeezing margins as pharma companies face intense pressure—including from countries like the US—to control drug costs. At the same time, a wave of expiring patents threatens around $300 billion in potential lost sales by 2030. As companies lose the exclusive right to sell the drugs they have developed, compe
     

Transforming commercial pharma with agentic AI 

Amid the turbulence of the wider global economy in recent years, the pharmaceuticals industry is weathering its own storms. The rising cost of raw materials and supply chain disruptions are squeezing margins as pharma companies face intense pressure—including from countries like the US—to control drug costs. At the same time, a wave of expiring patents threatens around $300 billion in potential lost sales by 2030. As companies lose the exclusive right to sell the drugs they have developed, competitors can enter the market with generic and biosimilar lower-cost alternatives, leading to a sharp decline in branded drug sales—a “patent cliff.” Simultaneously, the cost of bringing new drugs to market is climbing. McKinsey estimates cost per launch is growing 8% each year, reaching $4 billion in 2022. 

In clinics and health-care facilities, norms and expectations are evolving, too. Patients and health-care providers are seeking more personalized services, leading to greater demand for precision drugs and targeted therapies. While proving effective for patients, the complexity of formulating and producing these drugs makes them expensive and restricts their sale to a smaller customer base.

The need for personalization extends to sales and marketing operations too as pharma companies are increasingly needing to compete for the attention of health-care professionals (HCPs). Estimates suggest that biopharmas were able to reach 45% of HCPs in 2024, down from 60% in 2022. Personalization, real-time communication channels, and relevant content offer a way of building trust and reaching HCPs in an increasingly competitive market. But with ever-growing volumes of content requiring medical, legal, and regulatory (MLR) review, companies are struggling to keep up, leading to potential delays and missed opportunities. 

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This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

Combined Immersive and Nonimmersive Virtual Reality With Mirror Therapy for Patients With Stroke: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Stroke frequently leads to various functional impairments. Both virtual reality (VR) and mirror therapy (MT) have shown efficacy in stroke rehabilitation. In recent years, the combination of these two approaches has emerged as a potential treatment for stroke patients. Objective: This systematic review and meta-analysis aim to evaluate the efficacy of combined immersive and non-immersive VR with MT in stroke rehabilitation. Methods: Five electronic databases were systematically searched for relevant articles published up to Jan. 2025. Randomized controlled trials (RCTs) that investigated combination treatment of VR and MT for participants with stroke were included. A grey literature search was also conducted. The risk of bias and the certainty of the evidence were assessed using the Cochrane collaboration’s tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guideline, respectively. Results: A total of 475 participants from 14 RCTs were included, of which 7 were eligible for meta-analysis. Meta-analysis revealed significant improvements in upper extremity (UE) motor function and hand dexterity, as evidenced by Fugl-Meyer assessment of upper extremity (FMA-UE) (MD 3.50, 95% CI 1.47 to 5.53; P=0.0007), manual function test (MFT) (MD 2.15, 95% CI 1.22 to 3.09; P6 months or not) revealed significant differences in the FMA-UE outcome. However, the pooled FMA-UE improvement did not consistently exceed the established minimal clinically important difference (MCID; 4.25–7.25), indicating that while statistically significant, the clinical meaningfulness of the observed effect remains uncertain. Narrative evidence also suggested potential benefits for lower extremity function, dynamic balance, and quality of life, though these findings were not meta-analyzed and should be interpreted with caution. Conclusions: Moderate-quality evidence supports VR-MT as a promising nonpharmacological intervention to improve upper extremity function and hand dexterity in stroke rehabilitation. While the intervention demonstrates statistically significant effects, it does not reach the minimum clinically important difference for the FMA-UE outcome. Preliminary descriptive evidence indicates possible advantages for lower extremity function, balance, and quality of life. Clinical Trial: PROSPERO CRD42024572150

Efficient and accurate search in petabase-scale sequence repositories

Nature, Published online: 08 October 2025; doi:10.1038/s41586-025-09603-w

MetaGraph enables scalable indexing of large sets of DNA, RNA or protein sequences using annotated de Bruijn graphs.
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