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GASPS: A Multi-Omics Framework for Defining Genomic Aberration-Driven Signatures and Predicting Patient Outcomes in Lung Cancer

bioRxiv [Preprint]. 2025 Aug 25:2025.08.21.671519. doi: 10.1101/2025.08.21.671519.

ABSTRACT

Lung cancer is the most common cause of cancer-related death worldwide. Recent advancements in targeted therapies and immunotherapies have achieved remarkable success. However, patient responses to treatments with lung cancer vary substantially. The mutation status of driver genes can direct personalized treatment, but their prognostic value and treatment efficacy are limited. In this study, we developed a statistical framework named Genomic Aberration-Derived Signature for Patient Stratification (GASPS) to characterize the transcriptomic deregulation of driver genomic aberrations and stratify patients. By applying GASPS to The Cancer Genome Atlas Lung Adenocarcinoma (TCGA-LUAD) data, we developed gene signatures for 38 driver genomic aberrations, including gene mutations, amplifications, and deletions. These signatures were applied to independent lung cancer transcriptomic datasets containing a total of 2,226 patient samples. Our results indicated that these driver gene signatures are much more prognostic than their corresponding genomic mutations. Interestingly, the two EGFR-related signatures characterizing EGFR mutation and amplification, respectively, exhibited contrasting associations with prognosis, treatment response, and immune infiltration in the tumor microenvironment. Moreover, the STK11 mutation signature, rather than the mutation status, was found to be predictive of the response and long-term benefit of patients treated with immune checkpoint blockade therapy in lung cancer. This framework is readily applicable to most cancer types using existing data to improve prognostic risk assessment and treatment efficacy by guiding personalized therapies.

PMID:40909579 | PMC:PMC12407784 | DOI:10.1101/2025.08.21.671519

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GASPS: A Multi-Omics Framework for Defining Genomic Aberration-Driven Signatures and Predicting Patient Outcomes in Lung Cancer

bioRxiv [Preprint]. 2025 Aug 25:2025.08.21.671519. doi: 10.1101/2025.08.21.671519.

ABSTRACT

Lung cancer is the most common cause of cancer-related death worldwide. Recent advancements in targeted therapies and immunotherapies have achieved remarkable success. However, patient responses to treatments with lung cancer vary substantially. The mutation status of driver genes can direct personalized treatment, but their prognostic value and treatment efficacy are limited. In this study, we developed a statistical framework named Genomic Aberration-Derived Signature for Patient Stratification (GASPS) to characterize the transcriptomic deregulation of driver genomic aberrations and stratify patients. By applying GASPS to The Cancer Genome Atlas Lung Adenocarcinoma (TCGA-LUAD) data, we developed gene signatures for 38 driver genomic aberrations, including gene mutations, amplifications, and deletions. These signatures were applied to independent lung cancer transcriptomic datasets containing a total of 2,226 patient samples. Our results indicated that these driver gene signatures are much more prognostic than their corresponding genomic mutations. Interestingly, the two EGFR-related signatures characterizing EGFR mutation and amplification, respectively, exhibited contrasting associations with prognosis, treatment response, and immune infiltration in the tumor microenvironment. Moreover, the STK11 mutation signature, rather than the mutation status, was found to be predictive of the response and long-term benefit of patients treated with immune checkpoint blockade therapy in lung cancer. This framework is readily applicable to most cancer types using existing data to improve prognostic risk assessment and treatment efficacy by guiding personalized therapies.

PMID:40909579 | PMC:PMC12407784 | DOI:10.1101/2025.08.21.671519

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Extracting Clinical Guideline Information Using Two Large Language Models: Evaluation Study

Background: The effective implementation of personalized pharmacogenomics (PGx) requires the integration of released clinical guidelines into decision support systems (CDSS) to facilitate clinical applications. Large language models (LLMs) can be valuable tools for automating information extraction and updates. Objective: To assess the effectiveness of repeated cross-comparisons and an agreement-threshold strategy in two advanced LLMs as supportive tools for updating information. Methods: The study evaluated the performance of two LLMs, GPT-4o and Gemini-1.5-Pro, in extracting PGx clinical guidelines and comparing their outputs with expert-annotated evaluations. The two LLMs classified 385 PGx clinical guidelines, with each recommendation tested 20 times per model. Accuracy was assessed by comparing the results with manually labeled data. Two prospectively defined strategies were employed to identify inconsistent predictions. The first involved repeated cross-comparison, flagging discrepancies between the most frequent classifications from each model. The second employed a consistency threshold strategy, which designated predictions appearing in less than 60% of the 40 combined outputs as unstable. Cases flagged by either strategy were subjected to manual review. This study also estimated the overall cost of model usage and was conducted between October 1 and November 30, 2024. Results: GPT-4o and Gemini-1.5-Pro yielded reproducibility rates of 97.8% (7,534/7,700) and 98.9% (7,612/7,700), respectively, based on the most frequent classification for each query. Compared with expert labels, GPT-4o achieved 93.5% accuracy (Cohen’s Kappa=0.90; P<.001 and gemini-1.5-pro accuracy kappa="0.89;" p both models demonstrated high overall performance with comparable weighted average f1 scores gemini: the generated consistent predictions for of guideline items reducing need manual review by among these agreed-upon cases only one diverged from expert labels. applying a predefined agreement-threshold strategy further reduced number priority to although error rate slightly increased inconsistencies identified through methods prompted prioritization minimize errors enhance clinical applicability. total combined cost using llms was conclusions: findings suggest that two can effectively streamline pgx integration into cdss while maintaining minimal cost. selective remains necessary this approach offers practical scalable solution classification in workflows.>
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Scalable generation and functional classification of genetic variants in inborn errors of immunity to accelerate clinical diagnosis and treatment

In lieu of traditional genetic variant testing approaches, an approach using scalable variant classification in primary human T cells with a clinically relevant readout can inform rapid diagnosis and treatment of inborn errors of immunity.
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STAMP: Single-cell transcriptomics analysis and multimodal profiling through imaging

Single-cell transcriptomics analysis and multimodal profiling (STAMP) by imaging enables single-cell analysis of cells in suspension without the need for sequencing. The markedly reduced costs and flexible experimental designs support the profiling of millions of cells or the large-scale multiplexing of conditions, perturbations, and sample types.
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Spatial joint profiling of DNA methylome and transcriptome in tissues

Nature, Published online: 03 September 2025; doi:10.1038/s41586-025-09478-x

DNA-methylation and gene-expression profiling of tissue sections at near single-cell resolution can be used to create detailed spatial maps showing how methylation and transcription interact to shape cell identity and tissue development.
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Building the AI-enabled enterprise of the future

Artificial intelligence is fundamentally reshaping how the world operates. With its potential to automate repetitive tasks, analyze vast datasets, and augment human capabilities, the use of AI technologies is already driving changes across industries.

In health care and pharmaceuticals, machine learning and AI-powered tools are advancing disease diagnosis, reducing drug discovery timelines by as much as 50%, and heralding a new era of personalized medicine. In supply chain and logistics, AI models can help prevent or mitigate disruptions, allowing businesses to make informed decisions and enhance resilience amid geopolitical uncertainty. Across sectors, AI in research and development cycles may reduce time-to-market by 50% and lower costs in industries like automotive and aerospace by as much as 30%.

“This is one of those inflection points where I don’t think anybody really has a full view of the significance of the change this is going to have on not just companies but society as a whole,” says Patrick Milligan, chief information security officer at Ford, which is making AI an important part of its transformation efforts and expanding its use across company operations.

Given its game-changing potential—and the breakneck speed with which it is evolving—it is perhaps not surprising that companies are feeling the pressure to deploy AI as soon as possible: 98% say they feel an increased sense of urgency in the last year. And 85% believe they have less than 18 months to deploy an AI strategy or they will see negative business effects.

Companies that take a “wait and see” approach will fall behind, says Jeetu Patel, president and chief product officer at Cisco. “If you wait for too long, you risk becoming irrelevant,” he says. “I don’t worry about AI taking my job, but I definitely worry about another person that uses AI better than me or another company that uses AI better taking my job or making my company irrelevant.”

But despite the urgency, just 13% of companies globally say they are ready to leverage AI to its full potential. IT infrastructure is an increasing challenge as workloads grow ever larger. Two-thirds (68%) of organizations say their infrastructure is moderately ready at best to adopt and scale AI technologies.

Essential capabilities include adequate compute power to process complex AI models, optimized network performance across the organization and in data centers, and enhanced cybersecurity capabilities to detect and prevent sophisticated attacks. This must be combined with observability, which ensures the reliable and optimized performance of infrastructure, models, and the overall AI system by providing continuous monitoring and analysis of their behavior. Good quality, well-managed enterprise-wide data is also essential—after all, AI is only as good as the data it draws on. All of this must be supported by AI-focused company culture and talent development.

Download the report.

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 entirely by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

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Challenges in diagnosis of sarcoidosis

Curr Opin Immunol. 2025 Sep 1;97:102652. doi: 10.1016/j.coi.2025.102652. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Diagnosing sarcoidosis remains challenging. Histology findings and a variable clinical presentation can mimic other infectious, malignant, and autoimmune diseases. This review synthesizes current evidence on histopathology, sampling techniques, imaging modalities, and biomarkers and explores how emerging 'omics' and artificial intelligence tools may sharpen diagnostic accuracy.

RECENT FINDINGS: Within the typical granulomatous lesions, limited or 'burned-out' necrosis is an ancillary finding, which can be present in up to one-third of sarcoid biopsies, and demands a careful differential diagnostic work-up. Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes has replaced mediastinoscopy as first-line sampling tool, while cryobiopsy is still under validation. Volumetric PET metrics such as total lung glycolysis and somatostatin-receptor tracers refine activity assessment; combined FDG PET/MRI improves detection of occult cardiac disease. Advanced bronchoalveolar lavage (BAL) immunophenotyping via flow cytometry and serum, BAL, and genetic biomarkers show to correlate with inflammatory burden but have low diagnostic value. Multi-omics signatures and Positron Emission Tomography with Computer Tomography radiomics, supported by deep-learning algorithms, show promising results for noninvasive diagnostic confirmation, phenotyping, and disease monitoring.

SUMMARY: No single test is conclusive for diagnosing sarcoidosis. An integrated, multidisciplinary strategy is needed. Large, multicenter, and multiethnic studies are essential to translate and validate data from emerging AI tools and -omics research into clinical routine.

PMID:40902264 | DOI:10.1016/j.coi.2025.102652

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Enabling Digital Compassion in Digital Health Environments: Modified eDelphi Study to Identify Interprofessional Competencies and Technology Attributes

Background: Health care continues to advance through digital innovation, and technology-enabled processes and interventions are increasingly being introduced to deliver and expand access to care. In this evolving digital health ecosystem, health care professionals (HCPs), learners, and organizations may not be prepared or equipped with the knowledge, skills, and behaviors required to navigate these new digital tools while simultaneously sustaining and integrating compassionate care. Moreover, the tools may not be designed and implemented in a manner that facilitates digital compassion. Objective: This study aimed to identify (1) core digital compassion competencies for health professionals and (2) digital compassion health IT attributes. Methods: We conducted this study based on the Delphi method, a consensus-building technique using structured group communication that allows a group of experts to identify competencies and agree on items such as standards and attributes by achieving consensus on a given topic. To encourage enriched discussions, we used a modified eDelphi method, where the first round consisted of a group activity and focus group rather than a questionnaire. Due to COVID-19 pandemic restrictions, the first round was held online. Subsequent rounds consisted of questionnaires administered via email and a web-based survey. Using purposive sampling, participants were recruited from project partners and networks of the research team. A panel of experts across Canada in the fields of compassion, health professional or medical education, and technology was engaged to identify and prioritize professional domains and competency statements, as well as essential attributes for the development and deployment of digital technologies for compassionate care. Results: A total of 54 experts across Canada were recruited, representing diverse professions including patients or service users, HCPs, administrators, policy makers, health educators, data scientists, health technology designers, and software engineers. Overall, 9 focus groups were conducted and analyzed thematically. Seven domains of digital compassion were identified: (1) digital literacy, (2) patient preference, (3) collaboration and co-design, (4) therapeutic relationship, (5) ethical implications, (6) patient safety, and (7) technology safety. Technology attributes to facilitate digital compassion were also generated. We reached consensus after several subsequent rounds, resulting in 58 digital compassion competency statements and 15 technology attributes. Conclusions: This study identified a digital compassion framework consisting of competencies for HCPs and attributes for digital technologies that would enhance compassion in virtual care encounters. To promote a cultural shift where technologies are perceived to be not only efficient but also compassionate, practices of co-design, training, and ongoing evaluation and iteration must be prioritized within health care organizations. Future research should explore the adaptability of the professional competencies and technology attributes to specific medical specialties or in patient populations.
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Protein lipoylation in cancer: metabolic reprogramming and therapeutic potential

Cell Death Discovery, Published online: 02 September 2025; doi:10.1038/s41420-025-02718-z

Protein lipoylation in cancer: metabolic reprogramming and therapeutic potential
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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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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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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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