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Systematic Identification of Molecular Signatures Dictating Therapeutic Effects of Clinically First-Line Chemotherapy Regimens for Human Gastric Cancer Patients Based on Organoid Model

MedComm (2020). 2026 Mar 2;7(3):e70656. doi: 10.1002/mco2.70656. eCollection 2026 Mar.

ABSTRACT

Chemotherapy is the mainstay in the treatment of advanced gastric cancer (GC); yet, GC showed diverse responses to first-line chemotherapy regimens and the underlying molecular basis is still not clear. Here, we established a system that combined organoid-based chemotherapy regimen screening and transcriptome-based evaluation to identify underlying molecular signatures of different responses to chemotherapy. We generated 19 GC patient-derived organoids (PDOs) from surgically resected specimens with corresponding histological characteristics of parent tumors and tested all of the five most commonly used first-line chemotherapy regimens. Based on the treatment responses, PDOs were classified into double-sensitive, single-sensitive, and not-sensitive groups. PDOs that responded well to chemotherapy presented high expression levels of the P53 pathway genes and low expression levels of cell proliferative activity genes. Furthermore, the chemotherapy-based tumor classification of GC was established. The GC tumor classification was verified by multi-omics features from the TCGA dataset and public drug response datasets. In conclusion, this study systematically evaluated clinical chemotherapy regimens for GC and identified chemotherapy response-associated molecular signatures based on human GC organoids, which are beneficial to the precise treatments of GC.

PMID:41782964 | PMC:PMC12954136 | DOI:10.1002/mco2.70656

Mental Health Professionals’ Perceptions of Benefits and Disadvantages of Telehealth: International Mixed Methods Study

Background: Telehealth has become an integral component of mental health care delivery worldwide. Understanding provider perceptions is essential to guiding its continued implementation. Objective: This international study used quantitative and qualitative methodologies to examine and broaden our understanding of the benefits and concerns related to telehealth for mental health care. Methods: An internet-based survey was conducted during the COVID-19 pandemic between November 11 and December 18, 2020, among mental health professionals, primarily psychiatrists and psychologists, registered with the World Health Organization’s Global Clinical Practice Network. Clinicians completed the survey in 1 of 6 languages (Chinese, English, French, Japanese, Russian, or Spanish). Descriptive statistics and logistic regressions were used to analyze quantitative survey data on concerns and implementation of telehealth. Responses to an open-ended question about providers’ perspectives on the benefits of telehealth were analyzed qualitatively. Results: In total, 847 participants completed the telehealth section of the survey, and 496 provided a response to the open-ended question. Quantitative data on telehealth use and concerns revealed that clinicians’ primary concerns focused on technical issues and clinical effectiveness relative to in-person services, specifically, loss of clinical information (eg, nonverbal behavior) and challenges with establishing a therapeutic alliance. Findings varied by profession, World Health Organization region, and telehealth training and experience. Qualitative data examining benefits fell into 3 major areas: accessibility and reach of mental health services, efficiency and flexibility for clinicians, and enhancement of clinical processes and outcomes. Taken together, findings revealed a trade-off between telehealth benefits and disadvantages. Conclusions: From the perspective of mental health professionals, telehealth practice comes with key challenges and valuable benefits. Findings offer important considerations for the implementation of telehealth systems, including the importance of training and education and balancing trade-offs to optimize care.

Architecting Trust in Artificial Epistemic Agents

arXiv:2603.02960v1 Announce Type: new Abstract: Large language models increasingly function as epistemic agents -- entities that can 1) autonomously pursue epistemic goals and 2) actively shape our shared knowledge environment. They curate the information we receive, often supplanting traditional search-based methods, and are frequently used to generate both personal and deeply specialized advice. How they perform these functions, including whether they are reliable and properly calibrated to both individual and collective epistemic norms, is therefore highly consequential for the choices we make. We argue that the potential impact of epistemic AI agents on practices of knowledge creation, curation and synthesis, particularly in the context of complex multi-agent interactions, creates new informational interdependencies that necessitate a fundamental shift in evaluation and governance of AI. While a well-calibrated ecosystem could augment human judgment and collective decision-making, poorly aligned agents risk causing cognitive deskilling and epistemic drift, making the calibration of these models to human norms a high-stakes necessity. To ensure a beneficial human-AI knowledge ecosystem, we propose a framework centered on building and cultivating the trustworthiness of epistemic AI agents; aligning AI these agents with human epistemic goals; and reinforcing the surrounding socio-epistemic infrastructure. In this context, trustworthy AI agents must demonstrate epistemic competence, robust falsifiability, and epistemically virtuous behaviors, supported by technical provenance systems and "knowledge sanctuaries" designed to protect human resilience. This normative roadmap provides a path toward ensuring that future AI systems act as reliable partners in a robust and inclusive knowledge ecosystem.

The Transformative Potential of Liquid Biopsies and Circulating Tumor DNA (ctDNA) in Modern Oncology

Diagnostics (Basel). 2026 Feb 9;16(4):523. doi: 10.3390/diagnostics16040523.

ABSTRACT

Background: Liquid biopsy, particularly through the analysis of circulating tumor DNA (ctDNA), represents a significant advancement in oncology. Unlike traditional tissue biopsies, ctDNA offers a minimally invasive, real-time approach to cancer management. It has demonstrated considerable potential in early cancer detection, monitoring of therapeutic responses, and assessing minimal residual disease (MRD) to predict recurrence. By enabling comprehensive molecular profiling through a simple blood test, ctDNA supports the core principles of precision oncology, facilitating more personalized and adaptive treatment strategies. Methods: In the following article we describe the recent developments focused on refining ctDNA detection assays to improve sensitivity and specificity. Advanced technologies, including next-generation sequencing (NGS) and digital PCR, are commonly employed. The integration of artificial intelligence (AI) and multi-omics approaches-such as combining genomic, epigenomic, and transcriptomic data-has further enhanced the analytical power of ctDNA assays. Results: Emerging evidence shows that ctDNA-based liquid biopsy enables dynamic, real-time tracking of tumor evolution and therapeutic resistance. Clinical studies have demonstrated its efficacy in detecting early-stage cancers, guiding treatment selection, and predicting relapse with higher accuracy than some conventional methods. Moreover, AI-enhanced algorithms have improved signal detection, allowing for more precise and earlier identification of actionable mutations and MRD. Conclusions: ctDNA analysis via liquid biopsy is poised to revolutionize cancer care by offering a non-invasive, precise, and adaptive tool for tumor characterization and monitoring. Although obstacles remain-particularly regarding assay sensitivity, standardization, and economic feasibility-ongoing technological innovations and multi-omics integration are rapidly advancing its clinical viability. With continued progress, ctDNA-based liquid biopsy is likely to become a cornerstone of routine oncology practice.

PMID:41750672 | PMC:PMC12938931 | DOI:10.3390/diagnostics16040523

3D, multi-omic imaging reveals molecular biomarkers of the pre-metastatic niche in lung cancer

bioRxiv [Preprint]. 2026 Feb 18:2026.02.18.706515. doi: 10.64898/2026.02.18.706515.

ABSTRACT

The recurrence rate following complete surgical resection of primary non-small cell lung cancer is as high as 55%, yet no approach currently exists to evaluate the risk of local recurrence. The premetastatic paradigm is the recognition that metastasis is preceded by reprogramming naïve tissues to prime a microenvironment for tumor cell survival and subsequent reactivation. Identification of biomarkers of the pre-metastatic niche would allow us to evaluate a patient's risk of local relapse in the normal lung parenchyma surrounding the resected tumor. We designed a workflow incorporating in vivo modelling, radiology, and deep learning-guided three-dimensional (3D) imaging, spatial proteomics, and transcriptomics to identify previously unreported signals associated with the early transformation of the lung parenchyma announcing regional metastasis. We curated biorepository spanning timepoints before and after resection of primary Lewis Lung Carcinoma (LLC) tumors. Using radiology and cellular resolution 3D histology, we calculated the number and distribution of metastases in mouse lungs and developed an algorithm to guide placement of spatial proteomics and transcriptomics to regions containing early micro-metastases and the pre-metastatic microenvironment. Molecular and tissue features associated with presence, size, and location of metastases guided the identification of both myeloid (F4/80) and senescent (p16/p21) cell signatures in the premetastatic and metastatic environments. Finally, multiparametric flow cytometry of metastatic lungs in a senescence reporter GEMM (tdTomato-p16 INKA mice) resolved senescent cells including alveolar macrophages as the cellular phenotypes associated with these early premetastatic signatures. Altogether, this work highlights a novel AI-assisted approach for detection of biomarkers of tissue remodeling during lung cancer invasion.

PMID:41756853 | PMC:PMC12934922 | DOI:10.64898/2026.02.18.706515

Exploration of multi-omics liquid biopsy approaches for multi-cancer early detection: The PROMISE study

Innovation (Camb). 2025 Aug 6;7(1):101076. doi: 10.1016/j.xinn.2025.101076. eCollection 2026 Jan 5.

ABSTRACT

Although circulating cell-free DNA (cfDNA) methylation has emerged as the mainstream approach in multi-cancer detection blood tests (MCDBTs), the potential of integrating proteins and mutations, to enhance its performance remains unclear. The PROMISE study (NCT04972201) was conducted to investigate the feasibility of a multi-omics integration strategy in MCDBTs across nine types of cancers in head and neck (excluding nasopharynx), esophagus, lung, stomach, liver, biliary tract, pancreas, colorectum, and ovary. Blood samples were prospectively collected from 1,706 participants (840 non-cancer; 866 cancer) and then randomly divided into training and validation sets. The complementarity between various omics were investigated, and specific omics features were carefully selected for further multimodal model construction. The methylation-based classifier outperformed both the mutation-based and protein-based classifiers. As 95.0% of cancer cases detected by the mutation-based classifier were simultaneously identified by the methylation-based classifier, while 14.0% of the protein-positive samples were missed, protein markers may provide complementary value to the methylation-based classifier. Compared with the methylation-based classifier, the multimodal classifier combining methylation and protein features exhibited an improved sensitivity of 75.1% (95% confidence interval [CI], 69.3%-80.3%) at the same specificity of 98.8% with the accuracy of top predicted origin (TPO1) of 73.1% (95% CI, 66.2%-79.2%). Notably, the TPO1 accuracy reached 100% in liver and ovarian cancers with negative results of the methylation-based classifier. Collectively, these data suggest that the integration of protein markers in the multimodal classifier can offer additional benefits to the methylation-based classifier, particularly in identifying liver and ovarian cancers.

PMID:41737326 | PMC:PMC12925926 | DOI:10.1016/j.xinn.2025.101076

Metabolic dysregulation: Its role in diabetes mellitus and cancers

Mol Aspects Med. 2026 Feb 23;108:101461. doi: 10.1016/j.mam.2026.101461. Online ahead of print.

ABSTRACT

Diabetes mellitus (DM) is a significant risk factor for several cancers, particularly cancers of the liver, pancreas, and endometrium. This review aims to understand the connections between diabetic pathophysiology and cancer biology. We synthesize how core metabolic disturbances-hyperinsulinemia, hyperglycemia, and inflammation-promote tumorigenesis by dysregulating canonical oncogenic pathways such as IGF-1 signaling, DNA damage repair, and immunometabolism. Subsequently, we focus on how key molecular integrators-such as p38 MAPK, Wnt/β-catenin, and the AGEs-RAGE axis-mediate metabolic stress to confer proliferative and invasive advantages to tumor cells. However, a direct translational application of these mechanisms, particularly in the context of repurposing antidiabetic drugs for cancer therapy, remains challenging due to inconsistent clinical outcomes. To address this gap, we suggest that a fundamental shift in approach is required. We propose that future research must move beyond simple pathway categorization and instead utilize spatial analysis techniques to reveal how diabetic metabolites reshape the tumor microenvironment (TME). By integrating single-cell and spatial omics technologies, the field can begin to map the precise cellular niches within tumors where diabetic metabolites exacerbate malignant progression and foster treatment resistance. This perspective is essential for developing targeted strategies to mitigate cancer risk and improve outcomes for the expanding population of patients with DM and cancer.

PMID:41734405 | DOI:10.1016/j.mam.2026.101461

  • ✇STAT
  • STAT+: Nature Medicine to investigate study that found cancer treatment is better in morning Angus Chen
    The notion that oncologists could boost immunotherapy responses simply by giving infusions in the morning, rather than late afternoon, is an attractive one. So when a clinical trial published in Nature Medicine this month showed that lung cancer patients treated in the morning had a massive reduction in the risk of progression compared to those treated in the afternoon, many scientists were intrigued, if skeptical. Now that study is coming under fire, as multiple scientists and sleuths raise
     

STAT+: Nature Medicine to investigate study that found cancer treatment is better in morning

21 February 2026 at 09:13

The notion that oncologists could boost immunotherapy responses simply by giving infusions in the morning, rather than late afternoon, is an attractive one. So when a clinical trial published in Nature Medicine this month showed that lung cancer patients treated in the morning had a massive reduction in the risk of progression compared to those treated in the afternoon, many scientists were intrigued, if skeptical.

Now that study is coming under fire, as multiple scientists and sleuths raise serious concerns about the data and point out inconsistencies in the trial.

These have called the study’s conclusions even further into question, which experts told STAT already lacked strong biological plausibility, and Nature Medicine appended a note on the study on Thursday that it is starting an investigation into the concerns.

Continue to STAT+ to read the full story…

© Jenny Kane/AP

Gastric cancer occurrence and heterogeneity: integration of clinical data, multi-omics and tumor microenvironment

Future Oncol. 2026 Feb 20:1-14. doi: 10.1080/14796694.2026.2631302. Online ahead of print.

ABSTRACT

Gastric cancer (GC) is an epithelial malignant tumor with high morbidity and mortality. In recent years, more and more studies have strengthened our understanding of how GC develops, including the origin of GC cells, precancerous lesions, gene mutations, transcriptional changes, protein translation and the tumor microenvironment. With the concept of accurate tumor therapy gradually applied to clinical practice, these data provide more reference and basis for early prevention, early screening, early detection and accurate treatment of GC.

PMID:41717787 | DOI:10.1080/14796694.2026.2631302

  • ✇cs.AI, q-bio.NC updates on arXiv.org
  • Intent Laundering: AI Safety Datasets Are Not What They Seem Shahriar Golchin · Marc Wetter
    arXiv:2602.16729v1 Announce Type: cross Abstract: We systematically evaluate the quality of widely used AI safety datasets from two perspectives: in isolation and in practice. In isolation, we examine how well these datasets reflect real-world attacks based on three key properties: driven by ulterior intent, well-crafted, and out-of-distribution. We find that these datasets overrely on "triggering cues": words or phrases with overt negative/sensitive connotations that are intended to trigger sa
     

Intent Laundering: AI Safety Datasets Are Not What They Seem

arXiv:2602.16729v1 Announce Type: cross Abstract: We systematically evaluate the quality of widely used AI safety datasets from two perspectives: in isolation and in practice. In isolation, we examine how well these datasets reflect real-world attacks based on three key properties: driven by ulterior intent, well-crafted, and out-of-distribution. We find that these datasets overrely on "triggering cues": words or phrases with overt negative/sensitive connotations that are intended to trigger safety mechanisms explicitly, which is unrealistic compared to real-world attacks. In practice, we evaluate whether these datasets genuinely measure safety risks or merely provoke refusals through triggering cues. To explore this, we introduce "intent laundering": a procedure that abstracts away triggering cues from attacks (data points) while strictly preserving their malicious intent and all relevant details. Our results indicate that current AI safety datasets fail to faithfully represent real-world attacks due to their overreliance on triggering cues. In fact, once these cues are removed, all previously evaluated "reasonably safe" models become unsafe, including Gemini 3 Pro and Claude Sonnet 3.7. Moreover, when intent laundering is adapted as a jailbreaking technique, it consistently achieves high attack success rates, ranging from 90% to over 98%, under fully black-box access. Overall, our findings expose a significant disconnect between how model safety is evaluated and how real-world adversaries behave.
  • ✇STAT
  • STAT+: Key study of Grail’s cancer detection test fails in setback for company Matthew Herper and Angus Chen
    A blood test for detecting cancer early being developed by the diagnostics firm Grail failed to meet its main goal in a giant study being conducted with England’s National Health Service, the company said Thursday. Grail’s test has been the standard bearer for new technologies that promise a blood test can be used to detect many different types of cancer early and eventually even to indicate to scientists where in the body to look for tumors. The company already sells its test, called Galleri
     

STAT+: Key study of Grail’s cancer detection test fails in setback for company

20 February 2026 at 06:38

A blood test for detecting cancer early being developed by the diagnostics firm Grail failed to meet its main goal in a giant study being conducted with England’s National Health Service, the company said Thursday.

Grail’s test has been the standard bearer for new technologies that promise a blood test can be used to detect many different types of cancer early and eventually even to indicate to scientists where in the body to look for tumors. The company already sells its test, called Galleri, for a list price of $1,000, although it is not yet approved by the Food and Drug Administration. Grail said Thursday it sold 185,000 tests in 2025, generating $136.8 million. 

The company’s shares were down 47% in after-hours trading.

Continue to STAT+ to read the full story…

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Hunt Globally: Deep Research AI Agents for Drug Asset Scouting in Investing, Business Development, and Search & Evaluation

arXiv:2602.15019v1 Announce Type: new Abstract: Bio-pharmaceutical innovation has shifted: many new drug assets now originate outside the United States and are disclosed primarily via regional, non-English channels. Recent data suggests >85% of patent filings originate outside the U.S., with China accounting for nearly half of the global total; a growing share of scholarly output is also non-U.S. Industry estimates put China at ~30% of global drug development, spanning 1,200+ novel candidates. In this high-stakes environment, failing to surface "under-the-radar" assets creates multi-billion-dollar risk for investors and business development teams, making asset scouting a coverage-critical competition where speed and completeness drive value. Yet today's Deep Research AI agents still lag human experts in achieving high-recall discovery across heterogeneous, multilingual sources without hallucinations. We propose a benchmarking methodology for drug asset scouting and a tuned, tree-based self-learning Bioptic Agent aimed at complete, non-hallucinated scouting. We construct a challenging completeness benchmark using a multilingual multi-agent pipeline: complex user queries paired with ground-truth assets that are largely outside U.S.-centric radar. To reflect real deal complexity, we collected screening queries from expert investors, BD, and VC professionals and used them as priors to conditionally generate benchmark queries. For grading, we use LLM-as-judge evaluation calibrated to expert opinions. We compare Bioptic Agent against Claude Opus 4.6, OpenAI GPT-5.2 Pro, Perplexity Deep Research, Gemini 3 Pro + Deep Research, and Exa Websets. Bioptic Agent achieves 79.7% F1 versus 56.2% (Claude Opus 4.6), 50.6% (Gemini 3 Pro + Deep Research), 46.6% (GPT-5.2 Pro), 44.2% (Perplexity Deep Research), and 26.9% (Exa Websets). Performance improves steeply with additional compute, supporting the view that more compute yields better results.

MedScope: Incentivizing "Think with Videos" for Clinical Reasoning via Coarse-to-Fine Tool Calling

arXiv:2602.13332v1 Announce Type: cross Abstract: Long-form clinical videos are central to visual evidence-based decision-making, with growing importance for applications such as surgical robotics and related settings. However, current multimodal large language models typically process videos with passive sampling or weakly grounded inspection, which limits their ability to iteratively locate, verify, and justify predictions with temporally targeted evidence. To close this gap, we propose MedScope, a tool-using clinical video reasoning model that performs coarse-to-fine evidence seeking over long-form procedures. By interleaving intermediate reasoning with targeted tool calls and verification on retrieved observations, MedScope produces more accurate and trustworthy predictions that are explicitly grounded in temporally localized visual evidence. To address the lack of high-fidelity supervision, we build ClinVideoSuite, an evidence-centric, fine-grained clinical video suite. We then optimize MedScope with Grounding-Aware Group Relative Policy Optimization (GA-GRPO), which directly reinforces tool use with grounding-aligned rewards and evidence-weighted advantages. On full and fine-grained video understanding benchmarks, MedScope achieves state-of-the-art performance in both in-domain and out-of-domain evaluations. Our approach illuminates a path toward medical AI agents that can genuinely "think with videos" through tool-integrated reasoning. We will release our code, models, and data.

Rare, Yet Targetable: New Perspectives on Ampullary Carcinomas

Int J Mol Sci. 2026 Feb 6;27(3):1597. doi: 10.3390/ijms27031597.

ABSTRACT

Ampullary carcinoma (AC) is a rare gastrointestinal malignancy with dual intestinal and pancreatobiliary differentiation, complicating diagnosis, staging, and treatment. This review synthesizes current epidemiology, pathology, and multi-omic data to outline a pragmatic care pathway: lineage-first at presentation, mutation-fast at progression. Histology remains the primary classifier: the intestinal subtype generally aligns with colorectal regimens, whereas pancreatobiliary and mixed subtypes favor pancreaticobiliary therapy. In selected fit patients, modified FOLFIRINOX may address mixed phenotypes. Next-generation sequencing adds precision by identifying therapeutically relevant alterations, including ERBB2/HER2 amplifications, MSI-high/dMMR, BRAF V600E, and rare NTRK or RET fusions, while KRAS mutations are enriched in pancreatobiliary tumors. We recommend early application of a rapid-core panel (KRAS/BRAF, MSI/dMMR, ERBB2/HER2, RNA-based fusions) to capture high-impact targets, followed by comprehensive profiling at first progression. Liquid biopsy, plasma circulating tumor DNA (ctDNA), or bile-derived DNA may complement tissue and help identify the dominant lineage. Research priorities include ampulla-enriched umbrella trials, explicit AC subcohorts in tissue-agnostic studies, and ctDNA-informed endpoints. This lineage-first, mutation-fast paradigm supports precision care and evidence generation in AC.

PMID:41684016 | PMC:PMC12897727 | DOI:10.3390/ijms27031597

Clinical utility of OGN in pan-cancer: diagnostic biomarker and immune microenvironment regulator

12 February 2026 at 19:00

Transl Cancer Res. 2026 Jan 31;15(1):43. doi: 10.21037/tcr-2025-1499. Epub 2026 Jan 27.

ABSTRACT

BACKGROUND: Osteoglycin (OGN), an extracellular matrix protein, has emerging but poorly characterized roles in cancer. This study presents the first pan-cancer investigation of OGN's expression patterns, clinical significance, immune interactions, and functional mechanisms.

METHODS: Multi-omics data from Genotype Tissue Expression (GTEx), Cancer Cell Line Encyclopedia (CCLE), The Cancer Genome Atlas (TCGA), and Human Protein Atlas (HPA) databases were integrated. Differential expression was analyzed in normal tissues and tumor samples. Diagnostic utility was evaluated using area under the curve (AUC) of receiver operating characteristic (ROC) curve. Prognostic value was assessed via Kaplan-Meier [overall survival (OS); disease-specific survival (DSS); disease free interval (DFI); progression-free interval (PFI)] and Cox regression analyses. Immune microenvironment correlations were quantified using ESTIMATE, CIBERSORT, and gene set enrichment. Functional pathways were explored through gene set enrichment analysis (GSEA) and correlation with hallmark cancer signatures.

RESULTS: OGN was broadly expressed in normal tissues (brain, liver, kidney) but significantly downregulated in most tumor types (P<0.05, TCGA; validated at protein level, HPA). OGN demonstrated high diagnostic accuracy in pan-cancer (AUC: 0.703-0.990), achieving near-perfect performance in colon adenocarcinoma (COAD) (AUC: 0.966) and thyroid cancer (THCA) (AUC: 0.920). High OGN expression correlated with improved survival outcomes in thymoma (THYM) (OS/DSS) and cholangiocarcinoma (CHOL) (PFI/DFI), but worse prognosis in lung adenocarcinoma​/liver hepatocellular carcinoma​ (LUAD/LIHC), indicating cancer-type specificity. OGN expression strongly associated with immune cell infiltration (macrophages, natural killer cells, T cells), chemokine signaling, programmed death-ligand 1 (PD-L1) levels, microsatellite instability (MSI), and tumor mutation burden (TMB). GSEA revealed enrichment of OGN-linked genes in epithelial-mesenchymal transition (EMT), angiogenesis, JAK-STAT, and PI3K pathways across cancers.

CONCLUSIONS: Our pan-cancer analysis highlights OGN as a context-dependent regulator linking extracellular matrix (ECM) remodeling with immune and angiogenic signaling. Its pan-cancer dysregulation, diagnostic/prognostic value, and crosstalk with immune evasion mechanisms nominate OGN as a promising multi-functional biomarker and therapeutic target.

PMID:41674945 | PMC:PMC12885879 | DOI:10.21037/tcr-2025-1499

Advancing healthcare AI governance through a comprehensive maturity model based on systematic review

npj Digital Medicine, Published online: 11 February 2026; doi:10.1038/s41746-026-02418-7

Advancing healthcare AI governance through a comprehensive maturity model based on systematic review

Spatial and multi-omics transcriptomic dissects platinum resistance in lung adenocarcinoma: a five-gene predictive model with tumor microenvironment dynamics

9 February 2026 at 19:00

Chem Biol Interact. 2026 Feb 7:111952. doi: 10.1016/j.cbi.2026.111952. Online ahead of print.

ABSTRACT

The scarcity of reliable biomarkers and predictive models for platinum resistance in lung adenocarcinoma (LUAD) poses a significant clinical challenge. This study endeavors to identify molecular subtypes related to platinum resistance and construct a robust predictive model through multi-omics techniques. We performed integrative analysis of public datasets using advanced bioinformatics strategies, including spatial transcriptome deconvolution and consensus clustering. Bulk RNA deconvolution analysis was conducted to characterize tumor microenvironment heterogeneity. Feature selection was performed using the Supervised Principal Component (SuperPC) algorithm, followed by diagnostic model construction validated through receiver operating characteristic (ROC) analysis. Functional validation was performed through cytological experiments measuring cisplatin IC50 alterations following gene manipulation in LUAD cell lines. Consensus clustering revealed distinct LUAD subtypes, with Cluster1 demonstrating significant platinum resistance. We first subtyped the patients in the bulk transcriptome data based on consistency clustering, and then analyzed the differences between different platinum-resistant subtypes (Cluster 1 and Cluster 2), so as to screen 333 isotype-specific differentially expressed genes and 15 platinum resistance-related (PRR) genes were selected through machine learning. A refined 5-gene signature (ANKRD29/CACNA2D2/DSP/HSD17B6/SPP1) achieved exceptional predictive performance (AUC=0.9639). Spatial transcriptomics demonstrated compartmentalized expression patterns: SPP1/DSP localized to tumor niches, HSD17B6/CACNA2D2 to epithelial regions, and ANKRD29 depletion in stromal areas. Cellular colocalization analysis revealed malignant epithelial PH proximity to myeloid and mast cells. Functional validation confirmed that ANKRD29/CACNA2D2 overexpression sensitized A549/DDP cells to cisplatin, while DSP/SPP1/HSD17B6 overexpression induced resistance. Experiments in nude mice have shown that these genes are closely related to cisplatin resistance in LUAD. This study identifies the Cluster1 subtype and malignant epithelial PH as crucial determinants of platinum resistance in LUAD. Our innovative 5-gene predictive model exhibits clinical-grade diagnostic accuracy, and spatial transcriptomic characterization offers mechanistic insights into the dynamics of the tumor microenvironment.

PMID:41662930 | DOI:10.1016/j.cbi.2026.111952

Problems and Barriers Regarding the Admission, Financing, and Service Provision of Digital Health Apps: Qualitative Stakeholder Survey

Background: Since their introduction with the Digital Care Act in 2019, DiGA are a part of the German statutory healthcare system. In order to become a DiGA, mHealth apps have to complete a certification process covering both technical and evidence related aspects. After completion, DiGA are added to the DiGA-directory, containing a list of all reimbursable DiGA within German statutory health insurance (SHI). The first apps were added at the end of 2020 with the number steadily increasing. The novelty of the introduction leads to problems and barriers to optimal use along the way, which is studied from different stakeholder perspectives in this research article. Objective: The aim of the survey was to identify problems and barriers in the context of certification, financing and use of DiGA in Germany. Methods: We used semi-structured expert interviews to evaluate the perspective of stakeholders of the German healthcare system on DiGA. The interview guide was developed according to Helfferich, the interviews were transcribed and analyzed using the qualitative content approach by Mayring and Kuckartz. Results: We identified problems from stakeholder perspectives regarding the certification/admission, financing and service distribution regarding DiGA. The interviewed stakeholders reported problems with authorization of DiGA and the corresponding process. DiGA prices and the different negotiation positions were criticized, as well as financial challenges for smaller DiGA-manufacturers. Within service provision, technical problems, e. g., with activation codes or software surrounding DiGA-prescription were mentioned. Problems were also seen in insufficient knowledge and skills on the side of the patients as well as the medical providers. Conclusions: mHealth applications provide potentially disruptive innovations within the healthcare sector. Nevertheless, since the evidence-based and regulated use of this technology is relatively new there are still problems and barriers limiting the optimized, patient-centered use. This study provides an overview of problems in the context of DiGA in Germany from the stakeholder perspective. Since other countries showed interest in potentially adopting the German system, valuable implications can be drawn from this survey.
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