Biology subjects

Campagnolo, E. M.

Publications and source records attributed to Campagnolo, E. M..

4 recordsLinked to original sources

bioRxiv2025

AI-based supervised treatment response prediction from tumor transcriptomics: A large-scale pan-cancer study

Precision oncology aims to guide treatment decisions using biomarkers. While DNA-based panels are increasingly applied, RNA transcriptomics remain underused due to limited datasets and the absence of robust models. We assembled the largest transcriptomic resource for drug response prediction to date, spanning 91 cohorts, 5,675 patients, nine cancer types, and six frontline therapies: anti-PD-1/PD-L1 immune-checkpoint inhibitors, trastuzumab, bevacizumab, BRAF inhibitors, paclitaxel, and FAC/FEC (Fluorouracil-Adriamycin-Cyclophosphamide/Fluorouracil-Epirubicin-Cyclophosphamide) chemotherapy. We developed EXPRESSO (EXpression-Profile-RESponSe-Optimizer), a supervised machine-learning framework that predicts treatment response from pre-treatment transcriptomes by integrating drug targets and context-specific biomarkers. EXPRESSO achieves mean ROC-AUCs of 0.62-0.73 and median odds ratios of 2.4-4.6 across therapies, outperforming 20 published transcriptomic signatures and other machine learning methods. Prospective validation on 22 independent cohorts confirms that performance generalizes beyond cross-validation. The EXPRESSO signature additionally stratifies progression-free survival in immune checkpoint blockade-treated cohorts, demonstrating prognostic value beyond binary response prediction. Robustness analysis reveals that predictive performance plateaued for some therapies with increasing training cohorts but continued to improve for others. These findings suggest inherent limits of supervised brute-force learning for certain treatments, but additional data and deeper mechanistic modeling may further enhance transcriptomics-based predictors. SIGNIFICANCEEXPRESSO forms the next step in studying the feasibility of harnessing bulk transcriptomic data to inform therapeutic decision-making, advancing the role of transcriptomics from exploratory biomarker discovery to actionable predictive modeling.

cancer biology↗

bioRxiv2025

Pathologist-interpretable breast cancer subtyping and stratification from AI-inferred nuclear features

Artificial intelligence (AI) is making notable advances in digital pathology but faces challenges in human interpretability. Here we introduce EXPAND (EXplainable Pathologist Aligned Nuclear Discriminator), the first pathologist-interpretable AI model to predict breast cancer tumor subtypes and patient survival. EXPAND focuses on a core set of 12 nuclear pathologist-interpretable features (NPIFs), composing the Nottingham grading criteria used by the pathologists. It is a fully automated, end-to-end diagnostic workflow, which automatically extracts NPIFs given a patient tumor slide and uses them to predict tumor subtype and survival. EXPANDs performance is comparable to that of existing deep learning non-interpretable black box AI models. It achieves areas under the ROC curve (AUC) values of 0.73, 0.79 and 0.75 for predicting HER2+, HR+ and TNBC tumor subtypes, respectively, matching the performance of proprietary models that rely on substantially larger and more complex interpretable feature sets. The 12 NPIFs demonstrate strong and independent prognostic value for patient survival, underscoring their potential as biologically grounded, interpretable biomarkers for survival stratification in BC. These results lay the basis for building interpretable AI diagnostic models in other cancer indications. The complete end-to-end pipeline is made publicly available via GitHub (https://github.com/ruppinlab/EXPAND) to support community use and reproducibility.

bioinformatics↗

bioRxiv2025

Deep learning inference of cell type-specific gene expression from breast tumor histopathology

Cell type-specific gene expression from single-cell RNA sequencing (RNA-seq) is valuable for breast cancer precision oncology but available cohorts are still limited due to its high cost. Deconvolution methods infer cell type-specific expression from bulk RNA-seq at a lower cost, yet expenses and processing time of bulk RNA-seq are also non-negligible and limit their application too. To address these limitations, we developed SLIDE-EX (SLide-based Inference of DEconvolved gene EXpression), a deep-learning tool that predicts cell type-specific gene expression and abundances directly from routine breast cancer histopathology whole slide images (WSIs), using deconvolved bulk RNA-seq data as training labels. Trained on the TCGA-breast cohort and tested in cross validation and on an independent cohort of 160 cases, SLIDE-EX robustly infers the expression of thousands of genes across 9 distinct cell types, performing best for cancer associated fibroblasts and cancer cells. The abundance of these two cell types could also be robustly predicted, together with that of myeloid cells. The robustly predicted genes reflect key biological functions of their respective cell types. From a translational perspective, the inferred cell type specific expression profiles predict chemotherapy response more accurately than models based on direct prediction from the slides or from the inferred bulk expression in two independent cohorts. Going forward, SLIDE-EX is a generic approach that opens up possibilities for rapid, cost-effective cell type-specific gene expression inference in potentially any cancer type, further democratizing the characterization of the tumor microenvironment.

cancer biology↗

bioRxiv2024

Path2Space: An AI Approach for Cancer Biomarker Discovery Via Histopathology Inferred Spatial Transcriptomics

Spatial transcriptomics (ST) is transforming our understanding of tumor heterogeneity by enabling high-resolution, location-specific mapping of gene expression across tumors and their microenvironment. However, the associated high cost of the assay has limited cohort size and hence large-scale biomarker discovery. Here we present Path2Space, a deep learning approach that predicts spatial gene expression directly from histopathology slides. Trained on substantial breast cancer ST data, it robustly predicts the spatial expression of over 4,300 genes in independent validations, markedly outperforming existing ST predictors. Path2Space additionally accurately infers cell-type abundances in the tumor microenvironment (TME) based on the inferred ST data. Applied to more than a thousand breast tumor histopathology slides from the TCGA, Path2Space characterizes their TME on an unprecedented scale and identifies three new spatially-grounded breast cancer subgroups with distinct survival rates. Path2Space-inferred TME landscapes enable more accurate predictions of patients response to chemotherapy and trastuzumab directly from H&E slides than those obtained by existing established sequencing-based biomarkers. Path2Space thus offers a transformative, fast and cost-effective approach to robustly delineate the TME directly from their histopathology slides, facilitating the development of spatially-grounded biomarkers to advance precision oncology.

cancer biology↗