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Large language models improve transferability of electronic health record-based predictions across countries and coding systems
npj Digital Medicine, Published online: 22 January 2026; doi:10.1038/s41746-026-02363-5
Large language models improve transferability of electronic health record-based predictions across countries and coding systemsMultimodal AI generates virtual population for tumor microenvironment modeling
Research progress in diagnosis and treatment of pancreatic cancer with mismatch repair and microsatellite instability
Clin Transl Oncol. 2026 Jan 21. doi: 10.1007/s12094-025-04214-3. Online ahead of print.
ABSTRACT
Pancreatic cancer (PC), predominantly pancreatic ductal adenocarcinoma, remains one of the most lethal malignancies, largely due to late diagnosis and intrinsic resistance to conventional therapies. In recent years, mismatch repair deficiency (dMMR) and microsatellite instability-high (MSI-H) have emerged as clinically actionable biomarkers in a small but distinct subset of PC, accounting for approximately 1-2% of cases. These tumors display unique molecular characteristics, including a high prevalence of wild-type KRAS and TP53, elevated tumor mutational burden, and recurrent kinase fusions, which together confer enhanced immunogenicity and increased sensitivity to immune checkpoint inhibitors (ICIs). In addition to their therapeutic relevance, dMMR/MSI-H status has important diagnostic implications for the identification of Lynch syndrome-associated pancreatic cancers, informing genetic counseling and familial risk assessment. This review summarizes current understanding of the molecular basis of mismatch repair deficiency and microsatellite instability in PC, evaluates available diagnostic approaches such as immunohistochemistry, polymerase chain reaction, and next-generation sequencing, and discusses the prognostic and predictive significance of dMMR/MSI-H status. Emerging clinical evidence supporting the use of ICIs in selected patients across neoadjuvant, adjuvant, and advanced disease settings is also reviewed, along with challenges related to assay discordance, tumor heterogeneity, and immunotherapy resistance. Finally, future directions are highlighted, emphasizing the need for standardized testing algorithms, integration of multi-omics and spatial profiling technologies, and prospective clinical studies to optimize precision treatment strategies for this rare but clinically meaningful subtype of pancreatic cancer.
PMID:41563663 | DOI:10.1007/s12094-025-04214-3
United multi-omics and machine learning refine regulatory T cell-defined hepatocellular carcinoma subtypes
iScience. 2025 Dec 3;29(1):114328. doi: 10.1016/j.isci.2025.114328. eCollection 2026 Jan 16.
ABSTRACT
Hepatocellular carcinoma (HCC) is highly heterogeneous and aggressive, and the absence of precision individual treatment regimen enables repeated immune escape. Exploiting regulatory T cell (Treg) marker genes as key classifiers, we used 10 clustering algorithms to integrate the multi-omics HCC patient data and combined them with 10 machine learning (ML) algorithms to delineate molecular subtypes predictive of prognosis and immune response. We identified two cancer subtypes (CSs) that are associated with prognosis, with the second subtype (CS2) showing the most favorable prognostic outcomes. Subsequently, 9 key genes were screened for HCC model scoring, stratifying patients into low-risk (good prognosis, responsive to immunotherapy) and high-risk (poor outcome, not responsive to immunotherapy) groups. The high-risk group may be effective against the mTOR inhibitor AZD8055. Comprehensive multi-omics data and multiple ML algorithms offer key insights into HCC occurrence and evolution, with model scores guiding patient prognosis and treatment clinically.
PMID:41561382 | PMC:PMC12814435 | DOI:10.1016/j.isci.2025.114328