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Path2Omics Enhances Transcriptomic and Methylation Prediction Accuracy from Tumor Histopathology
Danh-Tai Hoang1,2, Eldad D Shulman1, Saugato Rahman Dhruba1
1Cancer Data Science Laboratory, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
Cancer Research
|October 30, 2025
Summary
Path2Omics, an AI framework, predicts gene expression and methylation from histopathology slides. This computational approach advances precision oncology by using routine tissue samples to infer molecular data for treatment decisions.
Area of Science:
- Computational biology
- Bioinformatics
- Artificial intelligence in oncology
Background:
- Precision oncology relies on molecular data for improved treatment outcomes.
- Acquiring molecular data from patient samples is often expensive and time-consuming.
Purpose of the Study:
- To develop Path2Omics, a deep learning framework for predicting gene expression and methylation from histopathology images.
- To assess the performance of Path2Omics across various cancer types and tissue preservation methods.
Main Methods:
- Developed Path2Omics with two components: a formalin-fixed, paraffin-embedded (FFPE) model and a fresh-frozen (FF) model.
- Trained models on histopathology slides from The Cancer Genome Atlas (TCGA) across 30 cancer types.
- Validated performance on seven external datasets, including FFPE and FF samples.
Main Results:
- The FF model outperformed the FFPE model, even on FFPE-only datasets.
- An integrated model combining FF and FFPE predictions showed a 30% improvement over the FFPE model alone.
- Path2Omics accurately predicted gene expression for approximately 4,400 genes and demonstrated clinical relevance in predicting survival and treatment response.
Conclusions:
- Path2Omics effectively infers gene expression and methylation from routine histopathology slides.
- The framework holds significant potential for advancing precision oncology by leveraging accessible tissue data.
- Inferred molecular data closely matched actual values, supporting clinical utility in predicting patient outcomes.
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