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Longitudinal liquid biopsy identifies an early predictive biomarker of immune checkpoint blockade response in head and neck squamous cell carcinoma

Nat Commun. 2025 Sep 1;16(1):8161. doi: 10.1038/s41467-025-63538-4.

ABSTRACT

Immune checkpoint blockade (ICB) has improved outcomes for patients with head and neck squamous cell carcinoma (HNSCC), but predictive biomarkers remain limited. Here, we use a time-resolved, multi-omic approach in a murine HNSCC model to characterize peripheral immune responses to ICB. Single-cell transcriptomics and T/B cell receptor analyses reveal early on-treatment expansion of effector memory T and B cell repertoires in responders, preceding tumor regression. These dynamic immune features inform a composite transcriptional signature that accurately predicts ICB response in independent human HNSCC cohorts. LiBIO outperforms existing biomarkers and generalizes to melanoma, non-small cell lung cancer, and breast cancer without retraining. These findings suggest that early treatment-induced changes in circulating immune repertoires reflect the host's capacity to mount an effective antitumor response. This work provides a framework for leveraging transient peripheral immune dynamics to develop non-invasive, high-fidelity biomarkers for response to immunotherapy across cancer types.

PMID:40890155 | PMC:PMC12402333 | DOI:10.1038/s41467-025-63538-4

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Token Probabilities to Mitigate Large Language Models Overconfidence in Answering Medical Questions: Quantitative Study

Background: Chatbots have demonstrated promising capabilities in Medicine, scoring passing grades for board examinations across various specialties. However, their tendency to express high levels of confidence in their responses, even when incorrect, poses a limitation to their utility in clinical settings. Objective: To examine whether token probabilities outperform chatbots' Expressed Confidence levels in predict-ing the accuracy of their responses to medical questions. Methods: Seven large languages models (LLMs), comprising both commercial (GPT-3.5, GPT-4 and GPT-4o) and open-source (Llama 3-8b, Llama 3-70b, Phi-3-Mini, and Phi-3-Medium), were prompted to respond to a set of 2,522 questions from the US Medical Licensing Examination (MedQA database). Addition-ally, the models rated their confidence from 0 to 100 and the token probability of each response was extracted. The models’ success rates were measured, and the predictive performances of both Ex-pressed Confidence and Response Token Probability in predicting response accuracy were evaluated using Area Under the Receiver Operating Characteristic Curve (AUROC), Adapted Calibration Error (ACE) and Brier score. Sensitivity analyses were conducted using additional questions sourced from other databases in English (MedMCQA, n=2,797), Chinese (MedQA Main-land China, n=3,413 and Taiwan, n=2,808), and French (FrMedMCQA, n=1,079). Results: Overall, mean accuracy ranged from 52.7%[50.8-54.7] for Phi-3-Mini to 87.6%[86.2-88.9] for GPT-4o. Across the US Medical Licensing Examination questions, all chatbots consistently expressed high levels of confidence in their responses (ranging from 90[90-90] for Llama 3-70B to 100[100–100] for GPT-3.5). However, Expressed Confidence failed to predict response accuracy (AUROC ranging from 0.52[0.50-0.53] for Phi 3 Mini to 0.68[0.65-0.71] for GPT-4o). In contrast, the Response Token Probability consistently outperformed Expressed Confidence for predicting response accuracy (AU-ROC ranging from 0.67[0.65-0.69] for Phi-3-Mini to 0.83[0.81-0.85] for Llama 3-70B, all p-values
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Integration of Environmental Data Into Electronic Health Records for Clinical and Public Health Decision Making: A Viewpoint on Expanding Development in the United States

Electronic health records are often extracted and combined with environmental data to conduct research or public health surveillance. However, to date, electronic health record systems do not integrate environmental data to aid real-time decisions that could mitigate the health impacts of environmental hazards, including the impacts of climate change. Pursuing this goal requires the enhancement of health record systems and the modification of financial incentives driving healthcare innovation and delivery.
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An eyecare foundation model for clinical assistance: a randomized controlled trial

Nature Medicine, Published online: 28 August 2025; doi:10.1038/s41591-025-03900-7

Trained and validated on multimodal data from 14.5 million images from multicountry datasets, a foundation model is shown to increase diagnostic and referral accuracy of clinicians when used as an assistant in a trial involving 16 ophthalmologists and 668 patients.
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Multiomics Insights into the Mechanism and Enhanced Efficacy of Tumor Treating Fields (TTFields) Therapy in Glioblastoma

J Proteome Res. 2025 Sep 1. doi: 10.1021/acs.jproteome.5c00424. Online ahead of print.

ABSTRACT

Glioma is an aggressive brain tumor that requires challenging treatments. Tumor Treating Fields (TTFields), an FDA-approved therapy for glioblastoma (GBM), pleural mesothelioma, and platinum-refractory metastatic nonsmall cell lung cancer (in combination with PD-1/PD-L1 inhibitors or docetaxel), employs specific frequency electric fields to disrupt cell division and enhance treatment efficacy. However, their molecular mechanisms remain unclear. This study aimed to elucidate these mechanisms and optimize the therapeutic potential of TTFields through quantitative proteomics, phosphoproteomics, and glycoproteomics. Pathway analysis of the proteomics revealed that TTFields impact the cell cycle, DNA repair, autophagy, and DNA replication. Phosphoproteomic studies further demonstrated a marked decline in the activity of key kinases ABL1 and PDK1, while glycoproteomics highlighted disruptions in cell adhesion and ECM-receptor interactions. Notably, proteomic analysis identified an upregulation of PARP1 and BRD4 protein levels, suggesting a previously unrecognized resistance mechanism. Consistently, combining TTFields with inhibitors targeting these proteins significantly enhanced the treatment efficacy in U87 cells. Thus, this study uncovers comprehensive molecular mechanisms underlying TTFields' effects on GBM cells and supports the development of concomitant therapies to enhance treatment efficacy.

PMID:40889189 | DOI:10.1021/acs.jproteome.5c00424

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Stereo-seq V2: Spatial mapping of total RNA on FFPE sections with high resolution

Cell. 2025 Aug 22:S0092-8674(25)00922-5. doi: 10.1016/j.cell.2025.08.008. Online ahead of print.

ABSTRACT

Performing total RNA profiling on formalin-fixed, paraffin-embedded (FFPE) samples, the predominant sample conservation method in clinical practice, remains challenging for current spatial transcriptomics techniques. Here, we introduce Stereo-seq V2, which employs random primers to capture and sequence RNAs in situ on FFPE sections and provides single-cell resolution. The random-priming-based strategy offers unbiased transcript capturing and uniform gene body coverage, which increase the sensitivity to marker genes, the efficiency of non-polyadenylation (poly(A)) RNA profiling, and immune repertoire coverage. We demonstrated the robust performance of Stereo-seq V2 on clinical FFPE samples using triple-negative breast cancer (TNBC) sections and identified tumor-specific alternative splicing events. In a Mycobacterium tuberculosis (Mtb)-infected mouse model, we monitored gene expression dynamics of host and pathogen transcriptomes simultaneously by utilizing Stereo-seq V2. We also assembled immune repertoires and identified Mtb-specific BCR clones, which could also be observed in human tuberculous lung samples. These results highlight Stereo-seq V2's potential in biomedical research and personalized medicine.

PMID:40882628 | DOI:10.1016/j.cell.2025.08.008

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Development of a Serum Proteomic-Based Diagnostic Model for Lung Cancer Using Machine Learning Algorithms and Unveiling the Role of SLC16A4 in Tumor Progression and Immune Response

Biomolecules. 2025 Jul 26;15(8):1081. doi: 10.3390/biom15081081.

ABSTRACT

Early diagnosis of lung cancer is crucial for improving patient prognosis. In this study, we developed a diagnostic model for lung cancer based on serum proteomic data from the GSE168198 dataset using four machine learning algorithms (nnet, glmnet, svm, and XGBoost). The model's performance was validated on datasets that included normal controls, disease controls, and lung cancer data containing both. Furthermore, the model's diagnostic capability was further validated on an independent external dataset. Our analysis identified SLC16A4 as a key protein in the model, which was significantly downregulated in lung cancer serum samples compared to normal controls. The expression of SLC16A4 was closely associated with clinical pathological features such as gender, tumor stage, lymph node metastasis, and smoking history. Functional assays revealed that overexpression of SLC16A4 significantly inhibited lung cancer cell proliferation and induced cellular senescence, suggesting its potential role in lung cancer development. Additionally, correlation analyses showed that SLC16A4 expression was linked to immune cell infiltration and the expression of immune checkpoint genes, indicating its potential involvement in immune escape mechanisms. Based on multi-omics data from the TCGA database, we further discovered that the low expression of SLC16A4 in lung cancer may be regulated by DNA copy number variations and DNA methylation. In conclusion, this study not only established an efficient diagnostic model for lung cancer but also identified SLC16A4 as a promising biomarker with potential applications in early diagnosis and immunotherapy.

PMID:40867526 | PMC:PMC12383841 | DOI:10.3390/biom15081081

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Global Hypomethylation as Minimal Residual Disease (MRD) Biomarker in Esophageal and Esophagogastric Junction Adenocarcinoma

Cancers (Basel). 2025 Aug 15;17(16):2668. doi: 10.3390/cancers17162668.

ABSTRACT

Background/Objectives: Esophageal and esophagogastric junction adenocarcinoma (EADC-EGJA), which mainly develops from Barrett's esophagus (BE), low-grade dysplasia (LGD), and high-grade dysplasia (HGD), has a poor prognosis and several unmet clinical needs, among which is the detection of minimal residual disease (MRD) after endoscopic/surgical resection. Long interspersed nuclear element-1 (LINE-1), a surrogate marker of global methylation, is considered an emerging biomarker for MRD monitoring. The aim of this study was to determine, by LINE-1 methylation analysis, at which carcinogenesis step global methylation is affected and whether this biomarker could be followed in longitudinal to monitor the disease behavior post-surgery. Methods: Cell-free DNA of 90 patients with non-dysplastic Barrett's esophagus (NDBE), HGD/early EADC-EGJA, or locally advanced/advanced EADC-EGJA were analyzed for LINE-1 methylation, by Methylation-Sensitive Restriction Enzyme droplet digital PCR (MSRE-ddPCR). Twenty-six patients were longitudinally studied by repetitive blood sampling. Results: Global hypomethylation increased during carcinogenesis, with significant difference between locally advanced/advanced EADC-EGJA and NDBE patients (p = 0.028). Longitudinal cases confirmed the rareness of hypomethylation in NDBE cases. The majority of HGD/early EADC-EGJA and locally advanced/advanced EADC-EGJA patients showed methylation changes after resection according to clinical status. Conclusions: This study suggests that global hypomethylation occurs just prior to cancer invasiveness and that it is a promising biomarker to monitor MRD.

PMID:40867295 | PMC:PMC12384112 | DOI:10.3390/cancers17162668

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GeneBits: ultra-sensitive tumour-informed ctDNA monitoring of treatment response and relapse in cancer patients

J Transl Med. 2025 Aug 27;23(1):964. doi: 10.1186/s12967-025-06993-3.

ABSTRACT

BACKGROUND: Circulating tumour DNA (ctDNA) in liquid biopsies has emerged as a powerful biomarker in cancer patients. Its relative abundance in cell-free DNA serves as a proxy for the overall tumour burden. Here we present GeneBits, a method for cancer therapy monitoring and relapse detection. GeneBits employs tumour-informed enrichment panels targeting 20-100 somatic single-nucleotide variants (SNVs) in plasma-derived DNA, combined with ultra-deep sequencing and unique molecular barcoding. In conjunction with the newly developed computational method umiVar, GeneBits enables accurate detection of molecular residual disease and early relapse identification.

RESULTS: To assess the performance of GeneBits and umiVar, we conducted benchmarking experiments using three different commercial cell-free DNA reference standards. These standards were tested with targeted next-generation sequencing (NGS) workflows from both IDT and Twist, allowing us to evaluate the consistency and accuracy of our approach across different oligo-enrichment strategies. GeneBits achieved comparable depth of coverage across all target sites, demonstrating robust performance independent of the enrichment kit used. For duplex reads with ≥ 4x UMI-family size, umiVar achieved exceptionally low error rates, ranging from 7.4×10-7 to 7.5×10-5. Even when including mixed consensus reads (duplex & simplex), error rates remained low, between 6.1×10-6 and 9×10-5. Furthermore, umiVar enabled variant detection at a limit of detection as low as 0.0017%, with no false positive calls in mutation-free reference samples. In a reanalysed melanoma cohort, variant allele frequency kinetics closely mirrored imaging results, confirming the clinical relevance of our method.

CONCLUSION: GeneBits and umiVar enable highly accurate therapy and relapse monitoring in plasma as well as identification of molecular residual disease within four weeks of tumour surgery or biopsy. By leveraging small, tumour-informed sequencing panels, GeneBits provides a targeted, cost-effective, and scalable approach for ctDNA-based cancer monitoring. The benchmarking experiments using multiple commercial cell-free DNA reference standards confirmed the high sensitivity and specificity of GeneBits and umiVar, making them valuable tools for precision oncology. UmiVar is available at https://github.com/imgag/umiVar .

PMID:40866952 | PMC:PMC12382282 | DOI:10.1186/s12967-025-06993-3

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A multilevel genomic approach to uncover causal connections between CPFE and lung cancer subtypes: A two-sample Mendelian randomization study

Medicine (Baltimore). 2025 Aug 22;104(34):e44050. doi: 10.1097/MD.0000000000044050.

ABSTRACT

Combined pulmonary fibrosis and emphysema (CPFE) and lung cancer cast intertwined shadows, yet the molecular nexus binding them remains largely obscured. By integrating high-resolution transcriptomic landscapes, extensive genome-wide association resources, and a stratified Mendelian randomization (MR) framework, we distilled 809 differentially expressed genes and, in successive steps, confirmed their causal ties to squamous cell carcinoma, adenocarcinoma, and small cell lung cancer. The credibility of these associations was bolstered through 3 sequential validation tiers - eQTL-anchored MR, eQTL-anchored SMR, and pQTL-anchored MR analyses - each reinforcing the robustness of the signals. Within this constellation, CPPED1 emerged as a watchful sentinel that mitigates risk in squamous carcinoma, whereas CD300LF proved a formidable oncogenic catalyst in the small cell lineage. Collectively, these insights illuminate the heritable circuitry linking CPFE and lung cancer, chart avenues for proactive surveillance and precision therapeutics in vulnerable patients, and enrich the conceptual framework of the fibrosis-to-carcinoma transition, inviting deeper multi-omic synthesis and incisive mechanistic exploration.

PMID:40859573 | PMC:PMC12385043 | DOI:10.1097/MD.0000000000044050

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RPN1 Is Associated With Immunosuppression in Pan-Cancer and Affects the Malignant Phenotype of Tumor

FASEB J. 2025 Aug 31;39(16):e70978. doi: 10.1096/fj.202500722RR.

ABSTRACT

Ribophorin 1 (RPN1), a key component of the oligosaccharyltransferase complex, is implicated in tumor progression through glycosylation-mediated pathways, yet its pan-cancer roles remain unexplored. This study presents a comprehensive multi-omics analysis of RPN1 across 33 cancers such as sarcoma (SARC), integrating genomic, transcriptomic, and proteomic data from TCGA, GTEx, and CPTAC. RPN1 was significantly overexpressed in 14 malignancies and correlated with advanced tumor stages and poor prognosis in glioblastoma (GBM), lower-grade glioma, SARC and hepatocellular carcinoma, validated in an independent glioma cohort (n = 151). Genomically, RPN1 amplification linked to homologous recombination deficiency and elevated tumor mutational burden, suggesting a role in genomic instability. Critically, multiplex immunofluorescence demonstrates RPN1 overexpression colocalizes with CD206+ M2 macrophages in tumor microenvironments, while in vitro coculture experiments confirm RPN1-dependent microglial recruitment and M2 polarization. RPN1 expression negatively correlates with CD8+ T cell infiltration and predicts resistance to chemotherapy (GBM, ovarian cancer) and immunotherapy (GBM, esophageal carcinoma), though it associates with PD-1 inhibitor sensitivity in bladder cancer. Functional validation shows RPN1 knockdown suppresses proliferation, migration, and invasion in GBM cells. Pathway enrichment connects RPN1 to endoplasmic reticulum stress, glycosylation, DNA repair, and immune checkpoint regulation. These findings position RPN1 as a multimodal oncogenic driver promoting genomic instability, immunosuppressive microenvironment remodeling, and context-dependent therapeutic vulnerabilities across cancers.

PMID:40857034 | DOI:10.1096/fj.202500722RR

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The emerging role of microbiota in lung cancer: a new perspective on lung cancer development and treatment

Cell Oncol (Dordr). 2025 Aug 26. doi: 10.1007/s13402-025-01103-3. Online ahead of print.

ABSTRACT

Lung cancer remains the leading cause of cancer-related mortality worldwide, with limited treatment efficacy and frequent resistance to conventional therapies. Recent advances have uncovered the critical influence of the human microbiota-complex communities of bacteria, viruses, fungi, and other microorganisms-on lung cancer pathogenesis and therapeutic responses. This review synthesizes current knowledge on the compositional and functional roles of microbiota across multiple body sites, including the gut, lung, tumor microenvironment, circulation, and oral cavity, highlighting their contributions to tumor initiation, progression, metastasis, and immune regulation. We emphasize the bidirectional communication between microbial metabolites and host immune pathways, particularly the gut-lung axis, which modulates systemic and local antitumor immunity. Importantly, microbiota composition has been linked to differential responses and toxicities in chemotherapy, radiotherapy, targeted therapy, and immune checkpoint blockade. Microbiota-targeted interventions, such as probiotics, fecal microbiota transplantation, and selective antibiotics, show promising potential to enhance treatment efficacy and mitigate adverse effects. However, challenges remain in clinical translation due to interindividual microbiome variability, mechanistic complexities, and limited longitudinal data. Future research integrating multi-omics, microbial functional profiling, and controlled clinical trials is essential to harness the microbiome as a precision medicine tool in lung cancer management. This review provides a comprehensive overview of the emerging role of microbiota in lung cancer development and therapy, offering new perspectives for innovative therapeutic strategies.

PMID:40856929 | DOI:10.1007/s13402-025-01103-3

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Systema: a framework for evaluating genetic perturbation response prediction beyond systematic variation

Nature Biotechnology, Published online: 25 August 2025; doi:10.1038/s41587-025-02777-8

An evaluation framework isolates perturbation-specific effects in perturbation datasets.
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Refining treatment strategies for non-small cell lung cancer lacking actionable mutations: insights from multi-omics studies

Br J Cancer. 2025 Aug 23. doi: 10.1038/s41416-025-03139-6. Online ahead of print.

ABSTRACT

Non-small cell lung cancer (NSCLC) represents a heterogeneous group of malignancies characterised by diverse histological and molecular features. Some NSCLCs, particularly adenocarcinomas, harbour genomic alterations in receptor tyrosine kinases or downstream RAS/RAF signalling pathways, which are targets of effective therapies. NSCLCs lacking actionable genomic alterations often benefit from immune checkpoint inhibitors, though only a minority of patients achieve long-term survival. These tumours often carry alterations in tumour suppressor genes like TP53, KEAP1, STK11, or NF1, for which pharmacological strategies are still under investigation. This review explores emerging therapeutic opportunities unveiled by multi-omics studies in NSCLCs without actionable genomic alterations. Proteogenomic approaches-integrating genomic, transcriptomic and proteomic data-enable a comprehensive understanding of NSCLC molecular landscapes and signalling network dysregulation, helping to identify distinct tumour subtypes and potential therapeutic targets. These tumours exhibit alterations in cell cycle regulation, DNA repair, immune signalling, epigenetic modulation and metabolic and redox pathways. Although therapies targeting tumour suppressor genes like p53 remain highly anticipated, extending our understanding of the broader molecular landscape in these tumours may reveal novel vulnerabilities and inform the development of novel drugs or combination strategies. This could further advance precision oncology for NSCLC.

PMID:40849356 | DOI:10.1038/s41416-025-03139-6

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Integrative genomic identification of therapeutic targets for pancreatic cancer

Cell Rep. 2025 Aug 21;44(9):116191. doi: 10.1016/j.celrep.2025.116191. Online ahead of print.

ABSTRACT

Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease, and new therapeutic strategies are urgently needed. Here, we conduct an integrative, genome-scale examination of genetic dependencies and cell surface targets using CRISPR-Cas screening and multi-omic data, including single-nucleus and spatial transcriptomic data from patient tumors. We systematically identify clinically tractable and biomarker-linked PDAC dependencies, including CDS2 as a synthetic lethal target in cancer cells expressing signatures of epithelial-to-mesenchymal transition. We examine biomarkers and co-dependencies of the KRAS oncogene, defining gene expression signatures of sensitivity and resistance associated with response to pharmacological inhibition of KRAS. mRNA and protein profiling reveal cell surface protein-encoding genes with robust expression in patient tumors and minimal expression in non-malignant tissues. Furthermore, we define intratumoral and interpatient heterogeneity of target gene expression and identify orthogonal targets that suggest combinatorial strategies. Collectively, this work identifies multiple targets that may inform therapeutic strategies for patients with PDAC.

PMID:40848256 | DOI:10.1016/j.celrep.2025.116191

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