Journal Article DKFZ-2026-01417

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Spatial biomarker discovery via interpretable semantic learning in histopathology.

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2026
Cell Press Cambridge, Mass.

Cancer cell nn, nn () [10.1016/j.ccell.2026.05.014]
 GO

Abstract: Spatial biomarkers are critical for precision oncology but remain challenging to systematically discover due to the complexity of whole-slide images. We present PathPrism, an interpretable AI framework for spatial biomarker discovery and virtual experimentation. Unlike black-box models, PathPrism encodes tissue architecture into pathologically informed spatial features, enabling transparent modeling of prognosis, molecular alterations, and therapy response. Applied to 7,000 patients with colorectal cancer across 11 cohorts, PathPrism uncovered hundreds of biomarkers predictive of survival, MSI, BRAF, and TP53 mutations, and stratified chemotherapy benefit in stage II/III disease. Building on these interpretable findings, PathPrism uses large language models as auxiliary tools to generate hypotheses grounded in spatial semantics. We further introduce VirtualWSI, a platform for semantic perturbation within an interpretable spatial biomarker atlas. PathPrism provides a scalable and interpretable framework for spatial biomarker discovery.

Keyword(s): AI-driven discovery ; adjuvant chemotherapy ; colorectal cancer ; computational pathology ; controllable virtual experiments ; interpretable representations ; spatial biomarkers ; transparent modeling ; tumor microenvironment

Classification:

Note: epub

Contributing Institute(s):
  1. DKTK Koordinierungsstelle Dresden (DD01)
  2. Klinische Epidemiologie der Krebsfrüherkennung (C070)
  3. Koordinierungsstelle der Cancer Prevention GS (M320)
  4. DKTK HD zentral (HD01)
Research Program(s):
  1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2026
Database coverage:
Medline ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 50 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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 Record created 2026-06-12, last modified 2026-06-13



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