SPARC: A mechanism-aware spatial representation from routine histology predicts cancer survival and therapy response
Year: 2026
Type: preprint
Abstract: Understanding the molecular mechanisms that drive treatment response is central to personalized cancer care, but assays such as spatial transcriptomics are not yet scalable in routine clinical practice. A critical question, then, is whether this deeper molecular insight can be extracted directly from routine histology. Here, we introduce SPARC, a framework that infers spatially resolved activity maps for 40 gene expression programs directly from H&E slides. Integrating predicted program maps with morphological features improves survival prediction in 17 of 18 cancer types across 8,383 patients and matches a multi-omic method requiring paired RNA sequencing. SPARC also stratifies bevacizumab response in ovarian cancer (odds ratio = 8.08) and trastuzumab response in breast cancer (odds ratio = 3.44), while H&E image-only baselines yield non-significant separation between responders and non-responders. Unsupervised anal-ysis of predicted maps reveals canonical tumor microenvironment compartments and spatial interaction patterns directly from tissue morphology, linking predictive perfor-mance of clinical outcomes to underlying biological mechanisms.
Source: medRxiv
Language: English
Topic: AI in cancer detection
Subfield: Artificial Intelligence
Field: Computer Science
Domain: Physical Sciences
Open Access status: green
OpenAlex ID: W7160429363