Briefings in Bioinformatics
◐ Oxford University Press (OUP)
Preprints posted in the last 7 days, ranked by how well they match Briefings in Bioinformatics's content profile, based on 354 papers previously published here. The average preprint has a 0.32% match score for this journal, so anything above that is already an above-average fit.
Bui, T.-C.; Lee, J.; Ko, J.
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Scoring biomolecular complexes is central to structure assessment and drug discovery, yet the complexes themselves vary widely in pose, size, and molecular composition. A scoring function tuned for one interaction type rarely carries over to another, and most existing methods compound the problem by leaning heavily on task-specific labels. We introduce OmniScore, a universal structure-based framework that learns a shared geometry-aware representation of complexes once and then adapts it to downstream scoring through lightweight task-specific heads. OmniScore couples a graph view and a sequence view of each structure, encodes its three-dimensional geometry, and compresses representations into a compact latent space that a reconstruction module and prediction heads can reuse. We pretrain this backbone on diverse datasets including complexes, monomers, and small molecules with complementary objectives: coordinate recovery, correcting corrupted input tokens, predicting molecular identity, and grounding the representation in structure-level physical quantities. Across the evaluated benchmarks, OmniScore gave the best antibody-antigen and nanobody-antigen quality assessment on all reported metrics compared to state-of-the-art baselines. Its frozen residue embeddings matched the state-of-the-art protein-tokenization method with an average functional-site accuracy of 71.8% on a standard residue-level benchmark. On protein-ligand scoring and ranking benchmarks, it performed on par with methods built specifically for that single task. These results suggest that geometry-aware pretraining can provide a reusable scoring backbone for tasks that depend on interfacial and residue-level structure, within the evaluated settings.
Subramanian, G.; Thiel, W.; Singh, R.
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Aptamers are structured nucleic acid ligands capable of high affinity, high specificity molecular recognition generated using variations of the SELEX (Systematic Evolution of Ligands by Exponential Enrichment) process. However, SELEX often produces sequences that enrich yet may lack binding efficacy. We propose a measure called the Ruggedness Composite Index (RCI) along with a method for computing it, that can be used to distinguish binding-competent ('active') aptamers from weak or non-binding ('inactive') aptamers. Given a set of aptamers, RCI incorporates information on their fragmentation (landscape partitioning), basin entropy (metastable state distribution), cumulative density irregularity (non-uniform occupancy), and structural energy correlation length (structure-energy coupling scale). We test whether secondary-structure folding energy landscape topology distinguishes active from inactive aptamers using a multiscale level set framework across six datasets. Active aptamers show lower RCI values and occupy smoother, funnel-like conformational spaces, while inactive aptamers show higher RCI values, reflecting fragmented, high-entropy landscapes. By contrast, classical thermodynamic features, such as minimum free energy, show limited discrimination between active and inactive aptamers. In all datasets, sequences that exhibit enrichment which is not monotonic but lack specificity exhibit elevated ruggedness, indicating landscape topology can predict non-specific enrichment. These results indicate that folding landscape organization can be used as a predictor of aptamer activity and establish RCI as a simple, mechanistically interpretable measure for improving candidate prioritization, especially in therapeutic aptamer discovery.
Potter, L. A.; Trull, A.; Kumar, N.; Drake, O. R.; Nogueira, M.; Peters, J.; Heinsbroek, J. A.; Day, J. J.; Worthey, E. A.; Ianov, L.
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Recent advances in spatial transcriptomics have enabled the profiling of increasingly larger numbers of genes while retaining single-cell and subcellular resolution in situ. However, standardized bioinformatics workflows for analyzing these datasets have lagged behind, with existing pipelines focusing primarily on image processing and cell segmentation. To address this gap, we present nf_xpatial, a best-practices Nextflow pipeline for the downstream analysis of 10x Genomics Xenium data. The pipeline performs quality control, filtering, log and cell area normalization, multi-sample integration, and both expression-driven and spatially informed clustering across systematic parameter sweeps, allowing users to evaluate and compare clustering resolutions and spatial modeling parameters within a single reproducible run. Overall, nf_xpatial streamlines the processing of Xenium data from platform outputs to integrated single-cell and spatial clustering datasets, providing a standardized starting point from which biologists can fine-tune parameters and proceed to hypothesis-driven spatial analyses.
Zhao, C.; Ji, Z.
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Spatial domain detection is a central task in spatial transcriptomics, yet existing methods exhibit highly variable performance across datasets. We introduce L-STAR, a visual LLM-guided, consensus-based framework that leverages the visual reasoning capacity of large language models to adaptively rank and integrate spatial domain detection methods. L-STAR achieves robust and consistently improved performance, outperforming single spatial domain detection methods across diverse datasets.
Yelgi, A.; Tavangari, S.; Shakarami, Z.; Janfaza, S.
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Accurate epigenetic age prediction from DNA methylation profiles is intrinsically high-dimensional, creating a need for parsimonious models that preserve predictive performance while reducing the number of assayed cytosine-phosphate-guanine (CpG) loci. This study introduces MOSurvivor, a population-based multi-objective search framework that jointly optimizes a weight-threshold CpG selector and eight XGBoost hyperparameters. Experiments used the GSE40279 whole-blood cohort (656 individuals profiled on the Illumina HumanMethylation450 platform). After retaining 1,000 age-correlated CpGs, five strategies were evaluated on the same 30 seeded 80:20 train/test splits: fixed-parameter XGBoost using all 1,000 CpGs, random search, a genetic algorithm, particle swarm optimization, and MOSurvivor. Internal fitness was estimated using three-fold cross-validation on each training set. Across the 30 held-out test sets, MOSurvivor achieved a mean absolute error (MAE) of 4.149 {+/-} 0.300 years, root mean squared error of 5.545 {+/-} 0.392 years, and R2 of 0.855{+/-} 0.027 while retaining 211.6 {+/-} 54.8 CpGs. Relative to full-feature XGBoost (MAE 4.095 {+/-} 0.285 years), MOSurvivor reduced the feature set by 78.8% at an MAE increase of only 0.054 years (1.3%). Paired Wilcoxon tests found no significant accuracy difference between MOSurvivor and any comparator (all unadjusted p > 0.05; all Holm-adjusted p [≥] 0.476). The most recurrent locus, cg16867657, appeared in 29 runs, whereas mean pairwise Jaccard similarity was 0.124, indicating a small stable core embedded in multiple near-equivalent feature subsets. MOSurvivor thus offers a competitive accuracy-parsimony trade-off rather than superior absolute accuracy. External validation and leakage-free nested feature preselection remain necessary before biological or clinical translation. Keywords: epigenetic clock, DNA methylation, feature selection, multi-objective optimization, XGBoost, metaheuristics, biological aging.
De Luca, S.; Fava, C.; Rizzo, G.; Visconti, A.; Berchialla, P.
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Background. Patient stratification from multi-omics and clinical data is essential for uncovering disease heterogeneity and moving toward more personalized treatment strategies. However, integrating heterogeneous data layers while identifying robust patient strata remains challenging. Methods. We introduce Reduced Fusion of Multi-Omics Stratification (RedFuMOS), a novel three-step approach for patient stratification based on mixed-type multi-omics data. RedFuMOS extends Similarity Network Fusion to accommodate mixed-type data layers and layer-specific similarity measures for data integration, includes a dimensionality reduction step to mitigate the curse of dimensionality, and performs patient stratification using density-based hierarchical clustering with HDBSCAN. It also implemented an automated optimization procedure to identify the best set of hyperparameters, minimizing the need for manual tuning. Results. RedFuMOS outperformed six state-of-the-art tools for multi-omics patient stratification in a comprehensive simulated benchmarking study, which also confirmed that, although computationally expensive, the dimensionality reduction step is crucial for achieving good stratification performance. Additionally, RedFuMOS identified two clinically relevant patient strata in a small real-world cohort of patients with Philadelphia chromosome-positive chronic myeloid leukaemia. Conclusion. RedFuMOS provides a flexible framework for integrating heterogeneous multi-omics and clinical data. RedFuMOS is available as an R package at http://github.com/delucasara/RedFuMOS.
Zhao, L.; Zeng, Y.; Abelman, D. D.; Lin, W.; Luo, P.
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Motivation: Cell-free DNA methylation provides a minimally invasive signal for early cancer detection and tissue-of-origin prediction. Most methods represent methylation measurements as independent fixed-window features and therefore do not explicitly model relationships among genomic regions. Results: We developed PANGEM (Pan-cancer Graph-based Cancer Detection Using the Cell-free DNA Methylome), a graph-learning framework that represents genomic bins as nodes and integrates CpG context, genomic proximity, and sample-specific methylation similarity in the graph topology. Across five repeated stratified train-test splits, PANGEM achieved the highest mean performance among evaluated methods, with an AUROC/AUPR of 0.997/1.000 for binary cancer detection and macro-AUROC/AUPR of 0.977/0.870 for multiclass tissue-of-origin prediction. In the independent INSPIRE cohort, 72 of 78 cancer cases (92.3%) exceeded the binary classification threshold, and PANGEM correctly classified 9 of 17 head and neck cancer cases (52.9%), the highest accuracy among evaluated methods. Subnetwork analysis further identified recurrent, graph-connected methylation patterns, including a 111-DMR subnetwork with increased methylation in cancer samples.
Choi, L.; McNeer, E.; Beck, C. A.; Neul, J. L.
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Bayesian borrowing of external information can improve trial efficiency, particularly in pediatric and rare disease settings where patient populations are limited, but may introduce bias and inflate the Type~I error rate when the trial differs from external studies. Recent U.S. Food and Drug Administration (FDA) draft Bayesian guidance emphasizes careful evaluation of external information, prior specification, and assessment of operating characteristics. This paper compares three meta-analytic-predictive (MAP)-based methods for Bayesian borrowing: the MAP prior, robust MAP (RMAP) prior, and self-adapting mixture (SAM) prior. An adaptive platform trial design in Rett syndrome is used as a case study. Simulation studies evaluate frequentist operating characteristics under varying prior--data conflict, between-study heterogeneity, treatment effects, and clinically significant differences (CSDs) for the SAM prior. The MAP prior achieved the greatest efficiency when external and current data were compatible but exhibited the largest bias under substantial prior--data conflict. The RMAP priors improved robustness through fixed robust-component weights, whereas the SAM prior adaptively adjusted borrowing and was less sensitive to prior--data conflict while retaining efficiency gains when the data were compatible. Although the CSD influenced the degree of adaptive borrowing, as reflected by effective sample size, it had only a modest impact on frequentist operating characteristics. Sensitivity analyses using a skeptical robust component yielded similar qualitative conclusions, while accentuating the differences between the MAP and RMAP priors. These findings provide guidance for evaluating and selecting MAP-based borrowing strategies before trial implementation, particularly in rare disease settings, consistent with current FDA recommendations.
Bresnahan, S. T.; Xiong, C.; Head, T.; Chang, Y.-H.; Bhattacharya, A.; Huang, J. Y.
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Unmeasured confounding threatens causal inference and replicability in observational multi-omic studies across variable environments. Genetic instrumental variables (Mendelian randomization) and negative-control calibration each address complementary sources of unmeasured confounding, yet no existing framework unifies them for omics-scale mediation analysis. We introduce ICONIC, an R package that embeds genetic instruments and negative controls within a proximal causal inference framework for total-effect and mediation analysis. ICONIC implements eight estimators spanning five confounding-control strategies, supports continuous, binary, and time-to-event outcomes, and provides extensive diagnostics including sensitivity analyses that map estimator performance across plausible assumptions. Ground-truth benchmarks are calibrated to real-omics covariance structures via a hybrid generative model (GAN + feature-level Gaussian copula) rather than parametric simulation, and a companion planning tool predicts performance gains from collecting additional omic data. We demonstrate ICONIC in two case studies: identifying placental transcriptomic mediators of gestational diabetes on birth weight (n = 164), and tumor-expression mediators of smoking intensity on lung cancer survival (n = 494). Notably, ICONIC's diagnostics recommended different estimation strategies across the two scenarios, reflecting differences in the likely influence of unmeasured confounding. ICONIC is freely available at https://github.com/sbresnahan/iconic/.
Bou Dagher, L.; Han, Z.; Zhou, S.; Fülöp, T.; Desroches, M.; Rodrigues, S.
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Alzheimer's disease is characterized by the accumulation and aggregation of amyloid-{beta}(A{beta}), but the molecular mechanisms linking environmental and infectious factors to A$\beta$ conformational changes remain incompletely understood. Herpes simplex virus type 1 (HSV-1) has been proposed as a potential contributor to AD pathology, and interactions between the viral glycoprotein B (gB) and A$\beta$ may influence the conformational behaviour of the peptide. Molecular dynamics (MD) simulations provide atomic-scale information on such interactions, but conventional structural descriptors may not fully capture changes in the organization of residue interaction networks. Here, we introduce a graph-geometric framework based on Forman-Ricci curvature to characterize the evolution of residue interaction networks during MD simulations. Each simulation frame is represented as a residue interaction graph based on C--C contacts, and residue-wise curvature profiles are analysed across time. We apply the framework to A{beta}1-42 in isolation and in complex with HSV-1 gB. Conventional MD analyses indicate stable association of the simulated complex, favourable interaction energetics, and conformational changes in A{beta}, including a transition from -helical structure toward {beta}-turn-rich conformations over the simulated timescale. Forman-Ricci curvature reveals pronounced and spatially localized remodelling of the A{beta} residue interaction network in the complex, with the strongest changes concentrated in the C-terminal region. These regions also exhibit reduced temporal curvature fluctuations and progressively distinct geometric behaviour throughout the simulation. Hierarchical clustering further identifies cooperative groups of residues with coordinated curvature dynamics, including a prominent C-terminal domain. Together, these results demonstrate that Forman-Ricci curvature provides a complementary description of biomolecular dynamics by capturing changes in the geometric organization of residue interaction networks that are not directly represented by conventional structural descriptors. The framework provides a general computational approach for studying network-level structural remodelling in protein molecular dynamics and offers a quantitative perspective on the conformational consequences of HSV-1 gB--A{beta} association.
Shi, Z.; Budhkar, A.; Amin, W.; Pollok, K. E.; Su, J.; Huang, K.
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Improvements in data availability, sharing, and integration, together with the development of explainable artificial intelligence (XAI) techniques, are advancing precision medicine for pediatric cancer by facilitating diagnosis, biomarker discovery, and drug development. Data sharing commons and initiatives like the Childhood Cancer Data Initiative (CCDI) provide access to pediatric-specific genomic and clinical data cohorts and improve data availability for pediatric cancer research. Based on CCDI, a scalable AI platform, Graph Artificial Intelligence for Pediatric Oncology (GAIPO), integrates various data modalities from bulk and single-cell omics data to clinical information. Such multi-modal data facilitates the training and development of advanced XAI models for pediatric cancers. We then developed an end-to-end multi-modality framework, PCGS, for pediatric cancer by incorporating omics-specific representation learning via GNN models with cross-attention fusion and multi-objective learning for downstream tasks such as classification, clustering, and survival analysis. This framework outperforms previous supervised multi-omics integration baseline approaches based on glioma and Wilms tumor cohorts and enables GNN model explainability via Shapley value-based feature attribution approaches to explain the contributions of gene-level features across various biomedical tasks, including classification and survival. Given specific background samples (e.g., age groups, sex, grades) as baselines, this explainable GNN model estimates and ranks the importance scores for input features from each omics modality. It identifies background-specific key features for biomarker discovery, risk group identification, and survival analysis in glioma and Wilms tumor, with potential applicability to other pediatric cancers.
Bohnenkaemper, L.; Stoye, J.
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The study of evolution between species (phylogenetics) and the study of evolution within a species (population genetics) are highly related, as the same biological mechanisms are fundamental to both fields. Although both have been studied for a long time, their joint study in a unified setting has been prevented by the different time scales they consider and the different data types they employ. A similar discrepancy holds for their whole-genome specializations, comparative genomics and pangenomics. Two active areas in these fields are genome rearrangement studies and graphical pangenomics, respectively. Since the emergence of graphical pangenomics, these have existed as separate fields, despite observations that central data structures representing genomic variants in both fields are highly similar. While there exists a wealth of theoretical results for various rearrangement models in comparative genomics, the application to pangenomic data is hampered by the limitations of rearrangement problem formulations. On the practical side, pangenomes typically contain too many individual genomes for classical problems, such as the often NP-hard parsimony problems, to be solved, or for all-vs-all comparisons using rearrangement distances to be performed. On the theoretical side, some assumptions in the formulation of rearrangement problems, such as the assumption of an underlying tree, are inadequate for many pangenomes. In this work, we propose the Complete Ancestral Reconstruction for Pangenomes (CARP) problem, which overcomes these limitations while retaining intuitive relationships to both classical rearrangement problems and pangenome graphs.
Kouam, C.; Mingle, J.; Alvarez Jerez, P.; Evans, A.; Moller, A.; Baker, B.; Weller, C.; Paquette, K.; Brooks, J.; Grant, S. M.; Ayuketah, A.; Meredith, M.; Palade, J.; Malik, L.; Hise, K.; Raphael Gibbs, J.; Anderson, J.; Ding, J.; Harbert, R.; Fu, Y.; Zheng, X.; Garcia-Ruiz, S.; Gustavsson, E. K.; Blauwendraat, C.; Ryten, M.; Sedlazeck, F.; Ferrucci, L.; Reed, X.; Nalls, M. A.; Cookson, M. R.; Van Keuren-Jensen, K.; Hutchins, E.; Jain, M.; Billingsley, K. J.
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Isoform-resolved transcriptomics is fundamental to decoding the molecular complexity of the human brain, yet population-scale long-read RNA sequencing has remained inaccessible due to labor-intensive library preparation, sensitivity to RNA degradation in postmortem tissue, and the absence of integrated, reproducible analysis pipelines. Here we present SALRR (Scalable Analysis of Long-Read RNA-seq), an integrated wet-lab and computational platform designed to overcome these barriers. Automated ONT long-read cDNA library preparation on the Hamilton Microlab NGS STAR platform reduces hands-on time by 67% and enables 24 libraries per operator per day while maintaining performance across RNA integrity values. A modular, Snakemake-based pipeline performs end-to-end processing from ONT signal data to isoform-level quantification, incorporating SIRV spike-in calibration, multi-stage quality control, and stringent isoform validation. Applied to 10 postmortem frontal cortex samples from the North American Brain Expression Consortium, SALRR identified 31,607 high-confidence isoforms from 10,075 genes, including 8,532 novel splice variants absent from GENCODE v49, and complex splicing events systematically missed by short-read sequencing at neurodegeneration-relevant loci, including GBA1, CCNF, CHCHD10, and TREM2. All protocols and code are openly available, providing a scalable, community-ready framework for isoform-resolved transcriptomics in neurodegeneration, aging, and complex brain disease.
Sadia, H.; Doyon, N.; Duchesne, S.
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Background Understanding the mechanisms underlying brain aging and age-related pathological changes is essential for advancing brain health research. Our group previously developed a mechanistic mathematical model of healthy brain, Chamberland et al. (2024) that integrates key biological processes involved in normal aging, from which Alzheimer's disease (AD) related changes may emerge naturally. Objectives To characterize and validate this brain model by evaluating its sensitivity, calibrating its parameters, and assessing generalizability in independent populations. Methods The model represents the evolution of key biological processes associated with brain aging, including amyloid beta (A{beta}), tau pathologies, neuroinflammation, and neuronal death. After identifying the 30 most influential parameters, we calibrated the model using cognitively normal (CN) participants from the AD Neuroimaging Initiative (ADNI) database (n = 211) by minimizing a loss function composed of three outcomes (AB) plaques, tau tangles, and neuronal density). The calibrated model was then applied to the UK Biobank cohort (n = 35,899) of normal controls (aged 44-82 years). The effects of sex and APOE were evaluated using stratified simulations. Results Parameter calibration significantly reduced the prediction errors for A{beta} and tau. Neuronal density predictions showed strong agreement in the UK Biobank cohort. The variance decomposition identified APOE status as a major contributor to variability in A{beta}. Conclusion Our validated brain health model links mechanistic pathways with population data and reproduces neuronal density patterns in an independent cohort. These findings support its use as a framework for studying brain aging and investigating how Alzheimer's disease related pathological changes may emerge with aging.
Muniz-Chicharro, A.; Tanriver, G.; Gora, A.
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Summary: Prot2Surf is a software tool designed for the characterization and prediction of protein association to surfaces. In this application note, Prot2Surf was tested using catalytic domains of the lytic polysaccharide monooxygenases (LPMOs), interacting with native surfaces. The results show that the software can efficiently analyze key binding features, including protein-surface distances, distances between catalytically reactive atoms, and the orientation angle between surface chains and the protein. These features are essential for distinguishing productive binding poses in these protein-surface systems and for understanding interaction patterns that provide guidance on protein engineering. Prot2Surf performs these analyses within seconds to a few minutes, providing a fast and accessible framework to post-process and characterize protein-surface encounter complexes. Availability and implementation: Prot2Surf, which is written in Fortran90, is documented and freely available as open source on GitHub: https://github.com/TUNNELING-GROUP/Prot2Surf. In order to run Prot2Surf, users should also install the SDA software package which is freely available at https://www.h-its.org/downloads/sda7/.
Zeng, Z.; Wang, Y.
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Motivation: The Interactive Tree of Life (iTOL) is widely used to display and annotate phylogenetic trees, but managing its format-sensitive annotation files impede reproducible high-throughput analyses. Among the maintained Python packages and versions evaluated, none combined template generation, taxonomic monophyly assessment and iTOL batch operations. Results: PyiTOL validates inputs, generates 31 iTOL template schemas (22 accepted by the live batch uploader), performs LCA-based monophyly classification with nested-monophyly detection, sampling-completeness states and polyphyletic subgroup decomposition, plus API upload and session replay. On a topology-constructed benchmark, all calls matched prespecified labels for 4,389 groups; on a 700-genome tree, binary mono/non-mono calls agreed with ETE4 for 409 genera; 17,294 GTDB R232 genera were processed in about 17 s. Availability and Implementation: PyiTOL 1.0.3 (Python [≥]3.10; Linux, macOS and Windows) is MIT-licensed at https://github.com/ZengZichao/PyiTOL and archived with test data at Zenodo (https://doi.org/10.5281/zenodo.22106806).
Yarmolinsky, J.; Cavallo, F. R.; Koskeridis, F.; Yu, X.; Bouras, E.; Richenberg, G.; Costantini, I.; Ray, D.; Woolf, B.; Karhunen, V.; Ellis, L.; Haycock, P. C.; Hemani, G.; Davey Smith, G.; Tsilidis, K. K.; Zuber, V.; McKay, J. D.; Dehghan, A.; Tzoulaki, I.
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Confounding is a central challenge in observational studies. Here, we propose a framework for identifying confounders of two non-causally related traits by employing cross-trait pleiotropy analysis to detect genetic loci that affect both traits and multi-trait colocalisation to identify molecular phenotypes mediating these effects. We apply this approach to the analysis of C-reactive protein (CRP) - a non-specific marker of inflammation - and 10 inflammation-related cancers. In UK Biobank, higher pre-diagnostic CRP levels are associated with increased risk of multiple cancers, but bidirectional Mendelian randomization provides little evidence for a causal relationship. Cross-trait genetic analyses identify 92 loci with shared CRP-cancer effects including those with established roles in cancer and 50 novel loci such as RSPO3 (breast cancer) and GCKR (colorectal cancer). Integration with proteomic and single-cell transcriptomic data identified putative molecular mediators at 24 loci including plasma TLR1 levels in breast cancer and CD4+ T cell IRF5 expression in kidney cancer. Notably, 15 candidate effector genes encode targets of approved or investigational medications, including IL6, PDE4D, and CASP8, indicating potential opportunities for their repurposing for cancer prevention. The proposed approach provides a generalisable framework for leveraging non-causal phenotypic relationships to yield insights into disease mechanisms and therapeutic targets for disease prevention.
Majumder, B. P.; Linak, J. A.; Adamson, R.; Aguilera, R. L.; Agarwal, D.; Reitz, Z.; Loiselle, S.; Devarakonda, S.; Clark, P.; Paulson, K. G.; Stanton, S.
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In large data sets discovery is often limited to pre-conceived hypotheses and data fishing. Here we tested whether systematic exploration of AI generated hypotheses could uncover clinically meaningful signals in extensively studied data. We deployed AutoDiscovery, a newly launched large language model (LLM) framework designed to search for hypotheses based on surprisal and systematically interrogate complex datasets, on The Cancer Genome Atlas breast cancer cohort. The system did not identify clinically meaningful novel findings without human input. However, a seeded warm-start run with minimal text input from an oncologist revealed multiple interesting and surprising hypotheses. Among these was that a robust immune signature was present across all subtypes of invasive lobular carcinoma (ILC) that exceeded invasive ductal carcinoma (IDC). This observation was independently validated in independent cohorts and confirmed by high-sensitivity multi-immunofluorescence tumor tissue analyses. These results suggest immunotherapy approaches should be tested in ILC including early stage ER+HER2- ILC; these patients are currently excluded from large neoadjuvant immunotherapy trials. They further demonstrate that surprisal-based hypothesis generation frameworks can extract previously unappreciated patterns from deeply interrogated cancer datasets and imply that disease domain experts working with LLMs can derive more meaningful insights from complex data than either could achieve alone.
SHI, J.; Gu, Q.; Pan, J.; Yang, A.; Fan, M.
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To evaluate the cost-utility and 5-year budget impact of first-line olaparib plus abiraterone versus abiraterone alone for metastatic castration-resistant prostate cancer (mCRPC) in China after the eleventh round of volume-based procurement (VBP). The intention-to-treat (ITT) population was assigned primary decision-analytic weight; the prespecified BRCA1/2-mutated (BRCAm) subgroup was a supporting analysis.
Hendrickx, N.; Mentre, F.; Karlsson, M. O.; Hooker, A. C.; Traschütz, A.; Schüle, R.; PROSPAX Consortium, ; EVIDENCE-RND Consortium, ; Synofzik, M.; Comets, E.
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We propose two new tests to detect drug effects (DE) in trials of one to very few patients followed during two periods (before and after initiation of a treatment). Both methods use longitudinal natural history data to inform the estimation of each patient's DE. The first method uses a non linear mixed effect model (NLMEM) reflecting an expected natural history with a hypothetical drug effect, to estimate the Conditional Distribution of the Drug Effect (CDDE). The second method trains a Pareto Depth Analysis (PDA) algorithm, a machine learning based approach based on outlier detection, that we implement using data simulated under the NLMEM. We evaluated the two tests with a simulation study. We used data from the PROSPAX study in Autosomal Recessive Cerebellar Ataxias (ARCAs, to derive a NLMEM for the Scale for the Assessment and Rating of Ataxia score. The CDDE method provided controlled type I error and, in some scenarios, adequate corrected power, though sensitivity analyses showed vulnerability to misspecification. The PDA method demonstrated lower statistical power except with high score precision. These results highlight different strategies for quantifying treatment effects in ultra rare, patient' specific trials. They can inform methodological design for future ARCA precision therapies.