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Recapitulating lung cancer metastasis in vitro: Advances in organoid models and challenges in clinical translation (Review)

Oncol Rep. 2026 Mar;55(3):49. doi: 10.3892/or.2026.9054. Epub 2026 Jan 23.

ABSTRACT

Lung cancer remains a significant global health challenge, with metastatic progression being the leading driver of mortality. Organoid technology provides a tractable, physiologically relevant platform to model key aspects of lung cancer metastasis in vitro. The present review summarized methodologies for constructing and interrogating these models, covering tissue sources, culture modalities, gene editing and in vivo transplantation; applications in studying metastatic mechanisms, drug screening and capturing intra‑ and intertumoral heterogeneity are also highlighted. Persistent challenges include standardizing derivation and culture conditions, improving preservation of tumor‑microenvironmental interactions, expanding immune‑competent and vascularized models, and addressing scalability, cost, and regulatory and ethical considerations for clinical translation. Future directions include integrating multi‑omics approaches and spatial profiling, leveraging artificial intelligence for image and response analytics, advancing immune‑organoid models and establishing shared standards, reference materials and reporting guidelines to enhance reproducibility and clinical impact.

PMID:41574717 | DOI:10.3892/or.2026.9054

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PPGFlowECG: Latent Rectified Flow with Cross-Modal Encoding for PPG-Guided ECG Generation and Cardiovascular Disease Detection

arXiv:2509.19774v2 Announce Type: replace-cross Abstract: Electrocardiography (ECG) is the clinical gold standard for cardiovascular disease (CVD) assessment, yet continuous monitoring is constrained by the need for dedicated hardware and trained personnel. Photoplethysmography (PPG) is ubiquitous in wearable devices and readily scalable, but it lacks electrophysiological specificity, limiting diagnostic reliability. While generative methods aim to translate PPG into clinically useful ECG signals, existing approaches are limited by the misalignment of physiological semantics in generative models and the complexity of modeling in high-dimensional signals. To address these limitations, we propose PPGFlowECG, a two-stage framework that aligns PPG and ECG in a shared latent space using the CardioAlign Encoder and then synthesizes ECGs with latent rectified flow. We further provide a formal analysis of this coupling, showing that the CardioAlign Encoder is necessary to guarantee stable and semantically consistent ECG synthesis under our formulation. Extensive experiments on four datasets demonstrate improved synthesis fidelity and downstream diagnostic utility. These results indicate that PPGFlowECG supports scalable, wearable-first CVD screening when standard ECG acquisition is unavailable.
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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

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SciHorizon-GENE: Benchmarking LLM for Life Sciences Inference from Gene Knowledge to Functional Understanding

arXiv:2601.12805v1 Announce Type: cross Abstract: Large language models (LLMs) have shown growing promise in biomedical research, particularly for knowledge-driven interpretation tasks. However, their ability to reliably reason from gene-level knowledge to functional understanding, However, their ability to reliably reason from gene-level knowledge to functional understanding, a core requirement for knowledge-enhanced cell atlas interpretation, remains largely underexplored. To address this gap, we introduce SciHorizon-GENE, a large-scale gene-centric benchmark constructed from authoritative biological databases. The benchmark integrates curated knowledge for over 190K human genes and comprises more than 540K questions covering diverse gene-to-function reasoning scenarios relevant to cell type annotation, functional interpretation, and mechanism-oriented analysis. Motivated by behavioral patterns observed in preliminary examinations, SciHorizon-GENE evaluates LLMs along four biologically critical perspectives: research attention sensitivity, hallucination tendency, answer completeness, and literature influence, explicitly targeting failure modes that limit the safe adoption of LLMs in biological interpretation pipelines. We systematically evaluate a wide range of state-of-the-art general-purpose and biomedical LLMs, revealing substantial heterogeneity in gene-level reasoning capabilities and persistent challenges in generating faithful, complete, and literature-grounded functional interpretations. Our benchmark establishes a systematic foundation for analyzing LLM behavior at the gene scale and offers insights for model selection and development, with direct relevance to knowledge-enhanced biological interpretation.
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Zero-shot adaptable task planning for autonomous construction robots: a comparative study of lightweight single and multi-AI agent systems

arXiv:2601.14091v1 Announce Type: cross Abstract: Robots are expected to play a major role in the future construction industry but face challenges due to high costs and difficulty adapting to dynamic tasks. This study explores the potential of foundation models to enhance the adaptability and generalizability of task planning in construction robots. Four models are proposed and implemented using lightweight, open-source large language models (LLMs) and vision language models (VLMs). These models include one single agent and three multi-agent teams that collaborate to create robot action plans. The models are evaluated across three construction roles: Painter, Safety Inspector, and Floor Tiling. Results show that the four-agent team outperforms the state-of-the-art GPT-4o in most metrics while being ten times more cost-effective. Additionally, teams with three and four agents demonstrate the improved generalizability. By discussing how agent behaviors influence outputs, this study enhances the understanding of AI teams and supports future research in diverse unstructured environments beyond construction.
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OpenNovelty: An LLM-powered Agentic System for Verifiable Scholarly Novelty Assessment

arXiv:2601.01576v2 Announce Type: replace-cross Abstract: Evaluating novelty is critical yet challenging in peer review, as reviewers must assess submissions against a vast, rapidly evolving literature. This report presents OpenNovelty, an LLM-powered agentic system for transparent, evidence-based novelty analysis. The system operates through four phases: (1) extracting the core task and contribution claims to generate retrieval queries; (2) retrieving relevant prior work based on extracted queries via semantic search engine; (3) constructing a hierarchical taxonomy of core-task-related work and performing contribution-level full-text comparisons against each contribution; and (4) synthesizing all analyses into a structured novelty report with explicit citations and evidence snippets. Unlike naive LLM-based approaches, \textsc{OpenNovelty} grounds all assessments in retrieved real papers, ensuring verifiable judgments. We deploy our system on 500+ ICLR 2026 submissions with all reports publicly available on our website, and preliminary analysis suggests it can identify relevant prior work, including closely related papers that authors may overlook. OpenNovelty aims to empower the research community with a scalable tool that promotes fair, consistent, and evidence-backed peer review.
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Mitigating Gender Bias via Fostering Exploratory Thinking in LLMs

arXiv:2505.17217v3 Announce Type: replace-cross Abstract: Large Language Models (LLMs) often exhibit gender bias, resulting in unequal treatment of male and female subjects across different contexts. To address this issue, we propose a novel data generation framework that fosters exploratory thinking in LLMs. Our approach prompts models to generate story pairs featuring male and female protagonists in structurally identical, morally ambiguous scenarios, then elicits and compares their moral judgments. When inconsistencies arise, the model is guided to produce balanced, gender-neutral judgments. These story-judgment pairs are used to fine-tune or optimize the models via Direct Preference Optimization (DPO). Experimental results show that our method significantly reduces gender bias while preserving or even enhancing general model capabilities. We will release the code and generated data. We release the code and generated data at: https://github.com/WeiKangda/LLMs-Exploratory-Bias-Mitigation/tree/main.
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Complement-secreting CAFs are associated with better prognosis in pancreatic cancer: single-cell multiomics

Gut. 2026 Jan 13:gutjnl-2025-335683. doi: 10.1136/gutjnl-2025-335683. Online ahead of print.

ABSTRACT

BACKGROUND: Accumulating evidence has demonstrated that distinct tumour-promoting and tumour-restraining cancer-associated fibroblast (CAF) subtypes coexist in pancreatic ductal adenocarcinoma.

OBJECTIVE: To develop targeted CAF therapeutic strategies by reprogramming tumour-promoting CAF subtypes.

DESIGN: We leveraged multiomics technologies to systematically identify and characterise CAF subtypes transcriptionally, epigenetically and spatially and correlate them with clinicopathological features.

RESULTS: We found that complement-secreting CAFs (csCAFs), initially identified by our group and inflammatory CAFs (iCAFs) share significant overlap in their transcriptional profiles and chromatin accessibility. iCAFs specifically express transcription factors from the heme and oxidative homeostasis pathway and the activator protein 1 family, which are both involved in cellular response to oxidative stress. Notably, the composition of csCAFs among all CAFs declined during pancreatic carcinogenesis, while trajectory analysis showed that csCAFs could potentially differentiate into iCAFs. Spatially resolved analysis indicated that tumour regions with a higher csCAF composition were associated with lower levels of TGF-β ligands, fewer M2 tumour-associated macrophages and increased levels of lipid mediators. Additionally, we identified a spatially defined CXCL12-CXCR4 ligand-receptor interaction between csCAFs and T cells, but in distinct patterns between different metastatic organs. Patients with a higher composition of csCAFs have significantly longer overall survival and recurrence-free survival through multiplex immunohistochemistry and bulk RNA-seq deconvolution.

CONCLUSION: Our study demonstrates that csCAFs may represent an early-stage iCAF subtype and suggests a promising strategy for reprogramming iCAFs into csCAFs.

PMID:41534892 | DOI:10.1136/gutjnl-2025-335683

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Interoperability in AI Safety Governance: Ethics, Regulations, and Standards

arXiv:2601.06153v1 Announce Type: cross Abstract: This policy report draws on country studies from China, South Korea, Singapore, and the United Kingdom to identify effective tools and key barriers to interoperability in AI safety governance. It offers practical recommendations to support a globally informed yet locally grounded governance ecosystem. Interoperability is a central goal of AI governance, vital for reducing risks, fostering innovation, enhancing competitiveness, promoting standardization, and building public trust. However, structural gaps such as fragmented regulations and lack of global coordination, and conceptual gaps, including limited Global South engagement, continue to hinder progress. Focusing on three high-stakes domains - autonomous vehicles, education, and cross-border data flows - the report compares ethical, legal, and technical frameworks across the four countries. It identifies areas of convergence, divergence, and potential alignment, offering policy recommendations that support the development of interoperability mechanisms aligned with the Global Digital Compact and relevant UN resolutions. The analysis covers seven components: objectives, regulators, ethics, binding measures, targeted frameworks, technical standards, and key risks.
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FairMedQA: Benchmarking Bias in Large Language Models for Medical Question Answering

arXiv:2505.19562v2 Announce Type: replace Abstract: Large language models (LLMs) are approaching expert-level performance in medical question answering (QA), demonstrating strong potential to improve public healthcare. However, underlying biases related to sensitive attributes such as sex and race pose life-critical risks. The extent to which such sensitive attributes affect diagnosis remains an open question and requires comprehensive empirical investigation. Additionally, even the latest Counterfactual Patient Variations (CPV) benchmark can hardly distinguish the bias levels of different LLMs. To further explore these dynamics, we propose a new benchmark, FairMedQA, and benchmark 12 representative LLMs. FairMedQA contains 4,806 counterfactual question pairs constructed from 801 clinical vignettes. Our results reveal substantial accuracy disparity ranging from 3 to 19 percentage points across sensitive demographic groups. Notably, FairMedQA exposes biases that are at least 12 percentage points larger than those identified by the latest CPV benchmark, presenting superior benchmarking sensitivity. Our results underscore an urgent need for targeted debiasing techniques and more rigorous, identity-aware validation protocols before LLMs can be safely integrated into practical clinical decision-support systems.
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Streamlining evidence based clinical recommendations with large language models

arXiv:2505.10282v2 Announce Type: replace-cross Abstract: Clinical evidence underpins informed healthcare decisions, yet integrating it into real-time practice remains challenging due to intensive workloads, complex procedures, and time constraints. This study presents Quicker, an LLM-powered system that automates evidence synthesis and generates clinical recommendations following standard guideline development workflows. Quicker delivers an end-to-end pipeline from clinical questions to recommendations and supports customized decision-making through integrated tools and interactive interfaces. To evaluate how closely Quicker can reproduce guideline development processes, we constructed Q2CRBench-3, a benchmark derived from guideline development records for three diseases. Experiments show that Quicker produces precise question decomposition, expert-aligned retrieval, and near-comprehensive screening. Quicker assistance improved the accuracy of extracted study data, and its recommendations were more comprehensive and coherent than clinician-written ones. In system-level testing, Quicker working with one participant reduced recommendation development to 20-40 min. Overall, the findings demonstrate Quicker's potential to enhance the speed and reliability of evidence-based clinical decision-making.
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The role of PCMT1 in prognosis tumor immune microenvironment and therapeutic responses across cancers

Discov Oncol. 2026 Jan 5. doi: 10.1007/s12672-025-04366-2. Online ahead of print.

ABSTRACT

BACKGROUND: Emerging evidence highlights the overexpression of Protein-L-isoaspartate (D-aspartate) O-methyltransferase (PCMT1) in multiple malignancies. However, its pan-cancer prognostic significance, tumor immune microenvironment (TIME) interactions, and therapeutic implications remain underexplored.

METHODS: Multi-omics data were integrated from UCSC Xena, GTEx, UALCAN, and published cohorts. PCMT1 expression patterns were systematically analyzed across 33 cancer types. Associations between PCMT1 and clinical outcomes, immune infiltration, immune checkpoint genes (ICGs), tumor mutation burden (TMB), microsatellite instability (MSI), and drug sensitivity were evaluated using bioinformatics pipelines.

RESULTS: Our pan-cancer analysis revealed differential expression patterns of PCMT1 across various malignancies, with significant upregulation in 20 cancer types and downregulation in 3 cancer types. Notably, PCMT1 overexpression was predominantly observed in epithelial-origin tumors, such as ACC (adrenocortical carcinoma), BRCA (breast invasive carcinoma), COAD (colon adenocarcinoma), and LUAD (lung adenocarcinoma). Survival analysis demonstrated that elevated PCMT1 expression was significantly correlated with unfavorable prognosis in multiple epithelial tumors, particularly in BRCA, esophageal carcinoma (ESCA), head and neck squamous cell carcinoma (HNSC), liver hepatocellular carcinoma (LIHC), and mesothelioma (MESO). Furthermore, comprehensive analysis identified significant associations between PCMT1 expression and various tumor microenvironment features, including immune scores, six distinct immune cell types, four immunosuppressive cell populations, cancer-associated fibroblasts (CAFs)-related markers, and immunosuppressive factors. PCMT1 expression also showed significant correlations with tumor mutation burden (TMB), microsatellite instability (MSI), DNA stemness score (DNAss), and RNA stemness score (RNAss). Particularly noteworthy was the strong positive correlation between PCMT1 expression and CAFs infiltration, along with their associated factors. These findings were further validated in independent immunotherapy cohorts, where PCMT1 consistently demonstrated immunosuppressive characteristics.

CONCLUSION: Multi-omics analysis suggests that PCMT1 may serve as a potential prognostic biomarker and a novel immunotherapy target for pan-cancer.

PMID:41491065 | DOI:10.1007/s12672-025-04366-2

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Digital Twin AI: Opportunities and Challenges from Large Language Models to World Models

arXiv:2601.01321v1 Announce Type: new Abstract: Digital twins, as precise digital representations of physical systems, have evolved from passive simulation tools into intelligent and autonomous entities through the integration of artificial intelligence technologies. This paper presents a unified four-stage framework that systematically characterizes AI integration across the digital twin lifecycle, spanning modeling, mirroring, intervention, and autonomous management. By synthesizing existing technologies and practices, we distill a unified four-stage framework that systematically characterizes how AI methodologies are embedded across the digital twin lifecycle: (1) modeling the physical twin through physics-based and physics-informed AI approaches, (2) mirroring the physical system into a digital twin with real-time synchronization, (3) intervening in the physical twin through predictive modeling, anomaly detection, and optimization strategies, and (4) achieving autonomous management through large language models, foundation models, and intelligent agents. We analyze the synergy between physics-based modeling and data-driven learning, highlighting the shift from traditional numerical solvers to physics-informed and foundation models for physical systems. Furthermore, we examine how generative AI technologies, including large language models and generative world models, transform digital twins into proactive and self-improving cognitive systems capable of reasoning, communication, and creative scenario generation. Through a cross-domain review spanning eleven application domains, including healthcare, aerospace, smart manufacturing, robotics, and smart cities, we identify common challenges related to scalability, explainability, and trustworthiness, and outline directions for responsible AI-driven digital twin systems.
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OpenNovelty: An LLM-powered Agentic System for Verifiable Scholarly Novelty Assessment

arXiv:2601.01576v1 Announce Type: cross Abstract: Evaluating novelty is critical yet challenging in peer review, as reviewers must assess submissions against a vast, rapidly evolving literature. This report presents OpenNovelty, an LLM-powered agentic system for transparent, evidence-based novelty analysis. The system operates through four phases: (1) extracting the core task and contribution claims to generate retrieval queries; (2) retrieving relevant prior work based on extracted queries via semantic search engine; (3) constructing a hierarchical taxonomy of core-task-related work and performing contribution-level full-text comparisons against each contribution; and (4) synthesizing all analyses into a structured novelty report with explicit citations and evidence snippets. Unlike naive LLM-based approaches, \textsc{OpenNovelty} grounds all assessments in retrieved real papers, ensuring verifiable judgments. We deploy our system on 500+ ICLR 2026 submissions with all reports publicly available on our website, and preliminary analysis suggests it can identify relevant prior work, including closely related papers that authors may overlook. OpenNovelty aims to empower the research community with a scalable tool that promotes fair, consistent, and evidence-backed peer review.
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PathFound: An Agentic Multimodal Model Activating Evidence-seeking Pathological Diagnosis

arXiv:2512.23545v1 Announce Type: cross Abstract: Recent pathological foundation models have substantially advanced visual representation learning and multimodal interaction. However, most models still rely on a static inference paradigm in which whole-slide images are processed once to produce predictions, without reassessment or targeted evidence acquisition under ambiguous diagnoses. This contrasts with clinical diagnostic workflows that refine hypotheses through repeated slide observations and further examination requests. We propose PathFound, an agentic multimodal model designed to support evidence-seeking inference in pathological diagnosis. PathFound integrates the power of pathological visual foundation models, vision-language models, and reasoning models trained with reinforcement learning to perform proactive information acquisition and diagnosis refinement by progressing through the initial diagnosis, evidence-seeking, and final decision stages. Across several large multimodal models, adopting this strategy consistently improves diagnostic accuracy, indicating the effectiveness of evidence-seeking workflows in computational pathology. Among these models, PathFound achieves state-of-the-art diagnostic performance across diverse clinical scenarios and demonstrates strong potential to discover subtle details, such as nuclear features and local invasions.
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Context matching is not reasoning when performing generalized clinical evaluation of generative language models

npj Digital Medicine, Published online: 27 December 2025; doi:10.1038/s41746-025-02253-2

Context matching is not reasoning when performing generalized clinical evaluation of generative language models
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aiXiv: A Next-Generation Open Access Ecosystem for Scientific Discovery Generated by AI Scientists

arXiv:2508.15126v2 Announce Type: replace Abstract: Recent advances in large language models (LLMs) have enabled AI agents to autonomously generate scientific proposals, conduct experiments, author papers, and perform peer reviews. Yet this flood of AI-generated research content collides with a fragmented and largely closed publication ecosystem. Traditional journals and conferences rely on human peer review, making them difficult to scale and often reluctant to accept AI-generated research content; existing preprint servers (e.g. arXiv) lack rigorous quality-control mechanisms. Consequently, a significant amount of high-quality AI-generated research lacks appropriate venues for dissemination, hindering its potential to advance scientific progress. To address these challenges, we introduce aiXiv, a next-generation open-access platform for human and AI scientists. Its multi-agent architecture allows research proposals and papers to be submitted, reviewed, and iteratively refined by both human and AI scientists. It also provides API and MCP interfaces that enable seamless integration of heterogeneous human and AI scientists, creating a scalable and extensible ecosystem for autonomous scientific discovery. Through extensive experiments, we demonstrate that aiXiv is a reliable and robust platform that significantly enhances the quality of AI-generated research proposals and papers after iterative revising and reviewing on aiXiv. Our work lays the groundwork for a next-generation open-access ecosystem for AI scientists, accelerating the publication and dissemination of high-quality AI-generated research content. Code: https://github.com/aixiv-org aiXiv: https://aixiv.science
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Why Text Prevails: Vision May Undermine Multimodal Medical Decision Making

arXiv:2512.13747v1 Announce Type: cross Abstract: With the rapid progress of large language models (LLMs), advanced multimodal large language models (MLLMs) have demonstrated impressive zero-shot capabilities on vision-language tasks. In the biomedical domain, however, even state-of-the-art MLLMs struggle with basic Medical Decision Making (MDM) tasks. We investigate this limitation using two challenging datasets: (1) three-stage Alzheimer's disease (AD) classification (normal, mild cognitive impairment, dementia), where category differences are visually subtle, and (2) MIMIC-CXR chest radiograph classification with 14 non-mutually exclusive conditions. Our empirical study shows that text-only reasoning consistently outperforms vision-only or vision-text settings, with multimodal inputs often performing worse than text alone. To mitigate this, we explore three strategies: (1) in-context learning with reason-annotated exemplars, (2) vision captioning followed by text-only inference, and (3) few-shot fine-tuning of the vision tower with classification supervision. These findings reveal that current MLLMs lack grounded visual understanding and point to promising directions for improving multimodal decision making in healthcare.
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