HistoPrism: Unlocking Functional Pathway Analysis from Pan-Cancer Histology via Gene Expression Prediction

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Hauptverfasser: Hu, Susu, Zeng, Qinghe, Bhasker, Nithya, Kather, Jakob Nikolas, Speidel, Stefanie
Format: Preprint
Veröffentlicht: 2026
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author Hu, Susu
Zeng, Qinghe
Bhasker, Nithya
Kather, Jakob Nikolas
Speidel, Stefanie
author_facet Hu, Susu
Zeng, Qinghe
Bhasker, Nithya
Kather, Jakob Nikolas
Speidel, Stefanie
contents Predicting spatial gene expression from H&E histology offers a scalable and clinically accessible alternative to sequencing, but realizing clinical impact requires models that generalize across cancer types and capture biologically coherent signals. Prior work is often limited to per-cancer settings and variance-based evaluation, leaving functional relevance underexplored. We introduce HistoPrism, an efficient transformer-based architecture for pan-cancer prediction of gene expression from histology. To evaluate biological meaning, we introduce a pathway-level benchmark, shifting assessment from isolated gene-level variance to coherent functional pathways. HistoPrism not only surpasses prior state-of-the-art models on highly variable genes , but also more importantly, achieves substantial gains on pathway-level prediction, demonstrating its ability to recover biologically coherent transcriptomic patterns. With strong pan-cancer generalization and improved efficiency, HistoPrism establishes a new standard for clinically relevant transcriptomic modeling from routinely available histology.
format Preprint
id arxiv_https___arxiv_org_abs_2601_21560
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle HistoPrism: Unlocking Functional Pathway Analysis from Pan-Cancer Histology via Gene Expression Prediction
Hu, Susu
Zeng, Qinghe
Bhasker, Nithya
Kather, Jakob Nikolas
Speidel, Stefanie
Machine Learning
Predicting spatial gene expression from H&E histology offers a scalable and clinically accessible alternative to sequencing, but realizing clinical impact requires models that generalize across cancer types and capture biologically coherent signals. Prior work is often limited to per-cancer settings and variance-based evaluation, leaving functional relevance underexplored. We introduce HistoPrism, an efficient transformer-based architecture for pan-cancer prediction of gene expression from histology. To evaluate biological meaning, we introduce a pathway-level benchmark, shifting assessment from isolated gene-level variance to coherent functional pathways. HistoPrism not only surpasses prior state-of-the-art models on highly variable genes , but also more importantly, achieves substantial gains on pathway-level prediction, demonstrating its ability to recover biologically coherent transcriptomic patterns. With strong pan-cancer generalization and improved efficiency, HistoPrism establishes a new standard for clinically relevant transcriptomic modeling from routinely available histology.
title HistoPrism: Unlocking Functional Pathway Analysis from Pan-Cancer Histology via Gene Expression Prediction
topic Machine Learning
url https://arxiv.org/abs/2601.21560