Transcriptome-informed multi-modal AI for predicting neoadjuvant therapy response from breast cancer biopsies
This study addresses the scarcity of annotated oncological data that constrains deep learning-based biomarker development by proposing a two-stage multimodal AI framework. The approach first infers transcriptomic features from histopathology images and subsequently integrates clinical variables to predict pathological complete response to neoadjuvant therapy in breast cancer. Its core innovation lies in introducing a biologically informed compression strategy that overcomes the target selection constraints of conventional genomic assays, enabling robust generalization under data-sparse conditions while ensuring reliability through spatial consistency validation. Experimental results demonstrate that the model achieves a mixed AUROC of 0.79, outperforming traditional pathology-based biomarkers. Furthermore, it exhibits strong discriminative capacity across molecular subtypes and exceptional sampling robustness, highlighting its potential for precision oncology applications where labeled training data remain limited.