bims-fragic Biomed News
on Fragmentomics
Issue of 2026–05–24
two papers selected by
Laura Mannarino, Humanitas Research



  1. J Clin Invest. 2026 May 19. pii: e196284. [Epub ahead of print]
       BACKGROUND: Minimally invasive biomarkers predicting immunotherapy response in head and neck squamous cell carcinoma (HNSCC) remain an unmet clinical need.
    METHODS: Using patients from a prospective, multi-institutional phase II trial, we performed whole-genome sequencing of 185 longitudinal plasma cell-free DNA (cfDNA) samples from 68 patients with locally advanced, surgically resectable HNSCC who received neoadjuvant and adjuvant pembrolizumab. We developed the regional motif diversity score (rMDS), a fragmentomic metric that quantifies the entropy of cfDNA 5'-end motifs across genomic regions.
    RESULTS: Unsupervised analysis showed rMDS robustly distinguished responders from non-responders, outperforming established fragmentomic metrics and copy number alterations while remaining independent of technical confounders. Longitudinal rMDS changes localized to regions enriched for immune-, lectin-, and keratinization-related genes - hallmarks of squamous cell carcinoma - reflecting tumor-peripheral immunity interplay during treatment. The most dynamic regions clustered at telomere-proximal loci, suggesting a link between telomere biology and cfDNA fragmentation. An rMDS-based machine learning classifier achieved AUC 0.89-0.99 across validation settings, with the highest accuracy post-treatment, outperforming PD-L1 expression and tumor fraction in matched samples. Predicted responders showed improved disease-free survival (log-rank P = 0.035; HR 2.67, 95% CI 1.03-6.92).
    CONCLUSION: rMDS represents a biologically meaningful, clinically actionable biomarker for immunotherapy response in HNSCC, supporting integration into future risk assessment frameworks.
    TRIAL REGISTRATION:
    CLINICALTRIALS: gov NCT02641093.
    FUNDING: NHGRI R56HG012360 and startup funds from Cincinnati Children's Hospital Medical Center, Northwestern University, and Robert H. Lurie Comprehensive Cancer Center (Y.L.); Science Olympiad Alumni Research Grant, Science Olympiad USA Foundation (R.B.); Merck Sharp & Dohme Corp. (T.W.D.).
    Keywords:  Cancer immunotherapy; Epigenetics; Genetics; Head and neck cancer; Oncology
    DOI:  https://doi.org/10.1172/JCI196284
  2. Comput Biol Med. 2026 May 15. pii: S0010-4825(26)00320-3. [Epub ahead of print]211 111756
      Cell-free deoxyribonucleic acid (cfDNA) fragmentation patterns represent significant non-invasive diagnostic markers. In this study, A new paradigm for cfDNA diagnostics is established by Semantic Inductive Graph-based Diagnostics (SIGD) through the unification of semantic encoding and graph topology. A transformative perspective on cfDNA analysis is introduced by treating genomic fragmentation as a structured linguistic problem. In this research, SIGD was developed as a high-performance framework, leveraging a heterogeneous Graph Convolutional Network integrated with Bidirectional Long Short-Term Memory (BiLSTM) semantic encoders. The architecture is centered on a multi-relational graph topology where complex biological interactions are explicitly modeled. Specifically, Inverse Document Frequency (IDF) weights are utilized to quantify sequence-motif relevance, while Pointwise Mutual Information (PMI) is employed to capture co-occurrence dependencies between motifs. Within this framework, the Term Frequency and Category Relevancy Factor (TFCRF) weighting scheme is strategically implemented to formalize the direct relational mapping between motifs and diagnostic labels, enabling the extraction of category-aware features. Through this integrative approach, high-order patterns that often remain undetected by traditional models are effectively captured. Consequently, superior diagnostic sensitivity and enhanced interpretability in cancer detection are achieved. Finally, the framework was evaluated using 2451 plasma samples across multiple sequencing modalities. Superior performance was achieved by SIGD relative to established baselines. In the testing set, a diagnostic accuracy of 91.43% and an area under the receiver operating curve (AUROC) of 0.967 were attained for general cancer detection, with 64 end-motifs. For hepatocellular carcinoma (HCC)-specific classification, the model reached an accuracy of 99% and an AUROC of 0.998. Model reliability was confirmed via calibration analysis, facilitating real-time inductive inference without retraining. The framework is characterized by high accuracy, interpretability and computational efficiency.
    Keywords:  Cancer detection; Category-aware learning; Cell-free DNA; End-motif profiling; Graph convolutional networks; Inductive learning
    DOI:  https://doi.org/10.1016/j.compbiomed.2026.111756