Beyond the Genome: Five Emerging Leaders in Epigenetics Diagnostics

Epigenetics is increasingly powering cancer diagnostics and liquid biopsies. These emerging private companies are spurring the market with structural DNA, fragmentomics, and DNA methylation tests.

Our understanding of the role of epigenetics in disease is growing rapidly, driven by rapid advances in sequencing technology and computing.

Epigenetic processes such as DNA methylation, histone modifications, and non-coding RNA expression can interact with genomic changes to cause cancer. Therefore, diagnostics can detect early signs of disease by screening for these epigenetic signals.

Players including Illumina, Agilent Technologies, and Roche Diagnostics are leading the global market for epigenetic diagnostics, which is expected to swell by 15.5% per year from $17 billion in 2024 to $39 billion by 2030.

Growth is being driven by the increasing affordability of genome sequencing; the integration of AI tools in data analysis; growing investments; and soaring demand for liquid biopsies—noninvasive cancer tests based on blood and urine samples.

One of the first diagnostics with an epigenetic component to be approved by the U.S. Food and Drug Administration (FDA) was Exact Sciences’ (now part of Abbott Laboratories) ColoGuard® noninvasive stool test for colorectal cancer in 2014.

Since then, epigenetics diagnostics have already been generating M&A activity, with deals in the space including Cardio Diagnostics of the U.S. going public via a merger with special purpose acquisition company Mana Capital in 2022; the takeover of Ireland’s EpiCapture by compatriot Trinity Biotech in 2024; the 2023 acquisition of Germany’s Epigenomics AG by U.S.-based New Day Diagnostics; and U.S. Agilent’s acquisition of Avida Biomed, also in 2023.

There is also corporate venture interest with giants like Illumina Ventures, the Labcorp Venture Fund, and Lilly Asia Ventures making investments in small startups.

Check out below for our take on the most promising privately-owned players in the epigenetics diagnostics space, based on their investor attraction and market potential.

 

1. Arima Genomics

Founded: 2015 | Headquarters: Carlsbad, California

arima genomics logo

Arima Genomics was spun out of UC San Diego and developed research tools to pinpoint the 3D structure of DNA in cells.

However, the company pivoted to cancer diagnostics after its assay discovered vital clues on how to treat a teenage girl with glioblastoma in 2022.

Arima’s Hi-C technology involves locking the DNA structure in place via crosslinking. DNA strands are then cut with enzymes and labeled with a marker called biotin. Arima uses a process called proximity ligation to connect DNA strands that were physically close together into a single strand, and then sequences the resulting molecule.

Last year, Arima launched a lymphoma test that is delivered via the firm’s laboratory testing service, certified by the U.S. Clinical Laboratory Improvement Amendments (CLIA) program. The test is designed to be used to help patient management by discovering gene fusions and rearrangements for 417 genes in different types of lymphoma.

The test helps to fill in the gaps left by the gold standard, fluorescent in situ hybridization, which can be time- and resource-intensive and lead to conflicting results.

Arima raised $22 million in a Series C round led by Illumina Ventures in 2025 and appointed a former venture partner from Illumina Ventures as CEO. The firm is using the proceeds to launch a pipeline of clinical assays in cancer.

Arima also closed a partnership with Fox Chase Cancer Center earlier this year to co-develop diagnostic tests for lymphoma and sarcoma.

 

2. DELFI Diagnostics

Founded: 2019 | Headquarters: Baltimore, Maryland

Delfi logo

DELFI Diagnostics was founded on an “aha” moment at Johns Hopkins University School of Medicine when a group of researchers aimed to overcome the high costs and low sensitivity of traditional liquid biopsies.

The breakthrough involved hunting for the certain way cell-free DNA fragments appear in the blood. Healthy cells and cancer cells package their DNA in different patterns, reflecting changes in the cell’s genomic and epigenomic machinery.

Using this method of “fragmentomics,” DELFI’s technology can tap into orders of magnitude more data than traditional methods.

DELFI’s product FirstLook Lung uses artificial intelligence (AI) and fragmentomics technology to screen a blood sample for signs of lung cancer. It is designed as an adjunct tool to check whether patients are eligible for lung cancer screening, and is regulated under the CLIA program.

The startup’s other product, DELFI-Tumor Fraction (DELFI-TF), allows pharmaceutical companies to track the effectiveness of a cancer therapy based on a sample of less than one milliliter of plasma.

Delfi raised $5.5 million in a seed round when it was founded, with investors including Menlo Ventures and Illumina Ventures.

The startup subsequently raised a $100 million Series A round led by OrbiMed in 2021, a $225 million Series B round led by DFJ Growth in 2022, and a $34 million debt round last year.

 

3. Element Biosciences

Founded: 2017 | Headquarters: San Diego, California

Element Biosciences logo

Element Biosciences was co-founded by three former Illumina employees who dreamed of democratizing access to genomic sequencing.

The company markets devices designed to sequence genetic information at a lower cost and higher performance than traditional next-generation sequencing. These include AVITI™—its flagship benchtop sequencer—and AVITI24, which can simultaneously analyze DNA, RNA, proteins, and phosphorylated proteins.

The company generated $25 million in revenue in 2023, partly driven by orders of AVITI.

The technology, based on a process called Avidite Base Chemistry (ABC™), uses a dye-labeled polymer to bind genetic material and produce sequencing data with the need for fewer reagents than traditional sequencing.

Element is working with epigenetics specialists to boost their research offerings, including Dovetail Genomics and biomodal.

The company has also formed collaborations with diagnostics providers to enhance their offerings, including Revvity’s neonatal genetic tests and Medicover Genetics’ tests for hereditary cancers, metabolic and cardiovascular disorders, infertility, and neonatal diseases.

The company plans to market a clinical diagnostics-focused sequencing product called AVITI Dx, with EU approval expected this year in the form of a CE In Vitro Diagnostic (IVD) mark.

Element Biosciences has raised more than $680 million since it was founded, including a $277 million Series D round in 2024. The asset manager, Wellington Management, led the oversubscribed round, with participation from Samsung Electronics, Fidelity, and more.

This year, Element plans to commercialize a benchtop device, called VITARI, that can sequence a whole genome at high quality for just $100.

 

4. Nucleix

Founded: 2008 | Headquarters: Rehovot, Israel

Nucleix logo

Nucleix was initially founded to use epigenetics to trace falsified DNA in forensic investigations. Although the technology worked well, the management team decided to pivot to cancer screening.

Nucleix’s kits involve screening for specific cancer-linked DNA methylation patterns using polymerase chain reaction (PCR) tests.

The company also uses machine learning to construct biomarker panels best suited to the application of interest.

Nucleix’s Bladder EpiCheck® urine test is designed to detect the recurrence of bladder tumors based on changes in DNA methylation. It can also be used to support standard diagnostics when detecting bladder cancer in cases where malignancy is suspected.

The test has a CE mark in Europe and FDA 510(k) clearance in the U.S. for bladder cancer recurrence, meaning it can be marketed as substantially equivalent to another device in the U.S. market.

Nucleix is also developing a blood test for detecting lung tumors based on their DNA methylation signatures.

The company raised a $55 million funding round led by RA Capital Management in 2021, with participation from investors including BlackRock and corporate venture firm Lilly Asia Ventures. It followed up with a $22 million extension round in 2022.

In 2024, Nucleix sealed a strategic partnership with A. Menarini Diagnostics, part of the Italian Menarini Group, to bring its Bladder EpiCheck test to the European market.

 

5. Precede Biosciences

Founded: 2021 | Headquarters: Boston, Massachusetts

precede biosciences logo

Precede was established by a team comprising Dana Farber Cancer Institute researchers and the venture capital firm 5AM Ventures.

Precede is developing blood tests that measure signals of disease based on the genomic and epigenomic characteristics of cell-free DNA shed into the blood by tumors.

For example, the company tracks gene transcription activity and DNA methylation based on as little as one milliliter of plasma. It can then use machine learning to interpret the results and predict the optimal treatment for each patient.

Precede collaborates with drugmakers to harness its technology to inform the development of next-generation radioligand therapies and antibody-drug conjugates, which depend on the knowledge of target expression and pathway activity rather than single genomic alterations.

The research-focused product Precede Bio Insight™ is designed to track the progress of cancer, with data spanning breast and prostate cancer.

The second product, Precede Bio Dx™, also allows clinicians to select patients for clinical trials based on the blood test results.

The company emerged from stealth mode with $57 million in 2023, and followed up with a Series B round worth $83.5 million in January this year to fund the scaling of its technology as it gains commercial traction.

Among the B round’s syndicate were corporate venture investors Labcorp Venture Fund and Lilly Asia Ventures, and existing investor Illumina Ventures.

 

Jonathan Smith, PhD, is a freelance science journalist based in the U.K. and Spain. He previously worked in Berlin as a reporter and news editor at Labiotech, a website covering the biotech industry. Prior to this, he completed a PhD in behavioral neurobiology at the University of Leicester and freelanced for the U.K. organizations Research Media and Society of Experimental Biology. He has also written for medwireNews, Biopharma Reporter, and Outsourcing Pharma.

The post Beyond the Genome: Five Emerging Leaders in Epigenetics Diagnostics appeared first on Inside Precision Medicine.

Why this year’s World Cup ball may not fly as far

Much is new about this month’s upcoming FIFA World Cup tournament, which will be held in the US, Canada, and Mexico. It hosts more teams than ever before. It’s the first to occur in three different host countries. And, like predecessor cups for over half a century, it will employ a soccer ball with a brand-new design.

One group of researchers that has been testing the physics of World Cup balls for the past 20 years recently studied this new entry, called the Trionda. Made by Adidas, the Trionda features four red, green, and blue panels textured with deep grooves and maple leaf, green eagle, and star emblems to represent the three host countries. Through wind-tunnel experiments, the research team found that this ball improves over previous versions in some ways, but long-distance kicks might not go as far as they did in the past. 

“The simple picture is that Trionda may very slightly punish extreme distance, but it should reward clean technique and predictable flight,” says team member John Eric Goff, who researches sports physics and is an incoming professor of engineering practice at Purdue University.  “Goalkeepers, defenders hitting long passes, and long-range shooters are where I would look first for visible differences.” 

Researchers used a wind tunnel to study the Trionda ball at the University of Tsukuba.
TAKESHI ASAI, SUNGCHAN HONG, AND RICHONG LIU

Adidas has been designing new balls for each World Cup since the 1970s. Some of the design changes in the first few decades were aesthetic: The 1986 ball featured graphics inspired by Aztec temples for the Mexico tournament, and 1994’s had space graphics in honor of the moon landing’s 25th anniversary. There were some structural differences too, such as upgraded foam cores and improved water resistance. But by and large, the balls used the same design of 32 pentagonal panels stitched together. 

That changed in the 2006 World Cup in Germany, when Adidas introduced the +Teamgeist ball. It featured just 14 curved panels, which were thermally bonded together rather than stitched. The design helped keep moisture out so the ball wouldn’t grow heavier throughout the game, Goff says. It was around this time that he started studying soccer balls. In the years since then, he and his colleagues have followed the transformations as Adidas has released balls with different surface textures and even fewer panels—design changes significant enough to affect game play. 

In-flight motion

Goff discovered early on that by analyzing a ball’s trajectory data, he could derive its drag coefficient—a number that determines the air resistance it experiences midflight at a given speed. Shortly after, he began working with a team in Japan to analyze how the World Cup ball’s in-flight behavior changes with each new design. 

The experiments, carried out at the University of Tsukuba in Japan, have been purposely consistent over the years because “maintaining continuity is important for comparing new data with historical data sets,” says Takeshi Asai, a professor there who works on the experiments. They entail attaching the ball to a metal rod connected to an instrument called a force balance, which measures aerodynamic forces such as drag and lift as the ball is exposed to the same wind speeds it would experience in a real soccer game—seven to 35 meters per second. 

The team tests the ball in different orientations, “but you can only do a few because the Trionda ball is $170,” Goff says, and each new test effectively destroys it. The experiments show the team how the drag coefficient changes with speed, and Goff then writes code to simulate the ball’s overall trajectory as it flies through the air.  

The team’s analysis has shown how recent World Cup balls evolved since the eight-panel Jabulani ball for the 2010 event. The Jabulani faced much criticism from players—particularly goalkeepers, who said it had a deceptive trajectory that “dipped wickedly,” as one player told the Guardian. 

Adidas JABULANI, official ball of the FIFA World Cup 2010

ALAMY
Adidas Brazuca Match ball for the 2014 World Cup

ADOBE STOCK
Trionda official 2026 FIFA match ball

TAKESHI ASAI, SUNGCHAN HONG, RICHONG LIU

The 2010 Jabulani ball (left) had eight panels and a smooth texture that translated into unpredictable performance. Later balls, like the 2014 Brazuca (center) and this year’s Trionda (right) have fewer panels but more roughness.

The ball had one key flaw: It was too smooth. Even though its drag coefficient was relatively low at high speeds, once the ball slowed to a certain point the coefficient would ratchet up, causing it to lose speed quite fast and behave as the 2010 players complained. This sudden transition—called the drag crisis—occurs at higher speeds for smoother balls, but with added texture like seams and grooves, the transition can be avoided until a ball reaches lower speeds. This allows the ball to travel farther and generally behave in a more predictable way during typical play. 

“It’s the same reason why golf balls have dimples and baseballs have those nice 108 double stitches. If those rough features of those balls were not there, you would not get anywhere near the kind of distance when those balls are thrown or hit that you see now,” Goff says. “There has to be some kind of a roughness on the ball to move this transition to a smaller speed.”

New grooves

Subsequent designs have been able to push the drag crisis to lower speeds, according to the analysis by Goff and his colleagues. The Brazuca ball used in 2014, for instance, has only six panels, but their total seam length is much longer, adding to the surface’s roughness. And this year’s Trionda ball contains just four panels, but each panel also has three deep grooves for more texture. 

There’s a trade-off to this roughness, though. While Goff and his colleagues found that the Trionda ball experiences the drag crisis at the slowest speed since 2010, its drag coefficient is also higher than that of the other balls at high speeds. That means that even though the most dramatic change doesn’t happen until the ball is moving quite slowly, the ball will still slow down faster than its recent predecessors during the faster portion of its flight. So the trajectories of long kicks may be a few meters shorter, Goff says. Adidas did not respond to a request for comment.

Fortunately, players in the upcoming World Cup should already be familiar with these added nuances, as they’ve had access to the new ball for at least a few months. The ball, Goff notes, is quite similar to Nike’s Flight ball in design, so players who’ve spent more time with that ball may have an added advantage. 

Meanwhile, Goff continues sending the group’s papers to his colleagues FIFA and Adidas in hope of providing some new insights, and he’s been sent balls by Adidas in the past. Adidas does perform its own unpublished tests of each new ball. The New York Times reported last year that the Trionda’s 3.5-year testing process included robotics designed to kick the ball at specific speeds as well as testing in seven of the 16 host locations. 

But as Goff sees it, soccer is “the world’s most popular sport, [this is] its most important tournament, and the most important piece of equipment in that tournament is this ball right here,” indicating the the Trionda ball that he had on camera with him during our Zoom call. “I think they’re interested in what some external testing looks like.”

Teachers’ Well-Being and Health in Germany: Representative Cross-Sectional Study

<strong>Background:</strong> Teachers play a fundamental role in the educational system and carry significant responsibilities. However, various occupational demands may compromise their health and well-being. At present, empirical data on the specific correlates of health and well-being among teachers in Germany remain limited, for example, regarding the relevance of health literacy. <strong>Objective:</strong> The primary aim of this study was to conduct a comprehensive assessment of the current health and well-being status among teachers. Specifically, the study aimed to quantify these factors according to the Positive Emotions, Engagement, Relationships, Meaning, and Accomplishments (PERMA) model as well as their general and mental health literacy. Secondary aims were to explore how health and well-being are associated with general and mental health literacy, as well as other personal and professional factors. <strong>Methods:</strong> This cross-sectional web-based survey was conducted in 2022 among teachers currently working in Germany. Participants were randomly sampled from all teachers in a general population panel (&gt;100,000 panelists recruited exclusively offline). In total, 61.6% (1005/1631) of the invited teachers participated (mean 49.99, SD 9.74 years). The final sample was weighted by gender, age, school type, and federal state. Health and well-being (PERMA Profiler questionnaire), general health literacy (European Health Literacy Survey Questionnaire, 16 items), mental health literacy (Mental Health Literacy Tool for the Workplace), sociodemographic (eg, gender and age), and professional information (school type, experience, and teaching load) were assessed. Bivariate (ANOVAs, <i>t</i> tests, and Pearson correlations) and multivariate (multiple regression) analyses were computed to analyze the associations between the health and well-being outcomes and the other factors. <strong>Results:</strong> The teachers reported intermediate to high well-being and health according to the PERMA model. In addition to significant bivariate associations, regression analysis for the well-being outcome (<i>F</i><sub>13, 977</sub>=10.66; <i>P</i>&lt;.001) revealed general (β=.23; <i>P</i>&lt;.001) and mental health literacy (β=.15; <i>P</i>&lt;.001) as significant positive predictors. In addition, teachers aged 40-49 years (β=–.12; <i>P</i>=.002) and 50-59 years (β=–.10; <i>P</i>=.03), as well as those with 10-19 years of experience (β=–.08; <i>P</i>=.04), reported significantly lower well-being than their younger/early-career peers. The regression model for the health outcome (<i>F</i><sub>13, 980</sub>=8.34; <i>P</i>&lt;.001) showed that general health literacy (β=.25; <i>P</i>&lt;.001), teaching at nonprimary schools (β=.10; <i>P</i>=.002), and a high teaching load (≥28 hours: β=.10; <i>P</i>=.02) were positively associated with the health outcome. Teaching experience of 10-19 years (β=–.09; <i>P</i>=.02) and older age (50-59 years: β=–.12; <i>P</i>=.02; ≥60 years: β=–.09; <i>P</i>=.046) predicted lower health scores. Other factors were not significant in the well-being and health regression models (all <i>P</i>&gt;.05). <strong>Conclusions:</strong> This study highlights the potential of health literacy as an intervention target for improving teachers’ health and well-being. To build on these findings, longitudinal and interventional studies are needed. <strong>Trial Registration:</strong>

New Antibiotic, Manikomycin, Acts on Novel Ribosomal Target

Traditionally, antibiotic discovery has involved the isolation of natural products from fungi and bacteria—largely actinomycetes. However, the perception that antibiotic-producing actinomycetes have yielded all they can, with little left to give, has motivated a recent shift toward novel antibiotic discovery processes.

However, a new study from researchers at McMaster University presents the isolation of a novel antibiotic from Streptomyces rimosus that showed efficacy against multiple bacteria, including multidrug-resistant Enterobacteriaceae. In addition, the compound—known as manikomycin—is the first antibacterial agent known to target the E-site in the large ribosomal subunit, opening the door to an entirely new class of treatments.

“Not a single antibiotic prescribed in clinics today does what manikomycin does,” says Gerry Wright, PhD, professor in the department of biochemistry and biomedical sciences at McMaster University in Ontario, Canada. “Not azithromycin, not tetracycline—none of them. So, we’ve not only found a brand-new drug candidate, but we’ve also established a brand-new target in bacteria that could potentially be exploited with other new drugs.”

This work, published in Nature in the paper, “A natural depsipeptide antibiotic binds the E-site of the bacterial ribosome.”

This discovery marks the fourth new antibiotic candidate from the Wright lab in just over a year, underscoring a promising new approach to drug discovery at a time when antibiotic resistance is a growing global threat.

Given that many antibiotics used today target the ribosome, bacteria have evolved broad defense strategies against them. However, a drug targeting a different part of the ribosome will not face the same resistance mechanisms.

Manikomycin binds in the E-site of the large subunit of the bacterial ribosome, the authors write, “preventing entry of the 3′ end of the tRNA into the E-site and effectively hindering the translocation step of protein synthesis in a sequence-context-specific manner.”

“Even newly discovered drugs that attack those same old targets may quickly face resistance,” says Wright. “But, over the history of medicine, we’ve put absolutely no selective pressure on this particular target, so bacteria have no existing resistance mechanisms for manikomycin.”

The discovery of manikomycin builds on work that began more than 75 years ago, when scientists first discovered that the soil bacterium Streptomyces rimosus produced oxytetracycline, a powerful new drug that would help usher medicine into the antibiotic age.

While the breakthrough was one of several like discoveries made in the mid-1900s, S. rimosus and related bacteria have long since been abandoned as a potential source of new antibiotics.

“There is an overwhelming perception in science that these bacteria have been mined completely dry—that we’ve found all there is to find,” Wright says. “Our lab has found that this is not at all the case.”

Wright’s group, working with collaborators at the University of Illinois Chicago and the University of Hamburg in Germany, used an advanced fractionation method to uncover the new antibiotic. By filtering out oxytetracycline and other abundant compounds from the chemical mixtures produced by S. rimosus, the researchers were able to isolate scarcer molecules that had gone unnoticed over the years.

“There is likely so much still to be discovered through fractionation,” says Manpreet Kaur, PhD, a postdoctoral fellow in Wright’s lab. “Revisiting the extracts of even-well studied bacteria like Streptomyces may lead to similar discoveries in the future.”

Wright’s team is now advancing manikomycin toward clinical development. They have already shown that the new antibiotic is not toxic to human cells, and that it works well in a lab-controlled model of infection—key milestones on the early development pathway.

The team is now working on optimizing the drug’s “residency time”—or how long it stays active in the body—and have produced 60 different derivatives with plans to push the best one forward.

“We’re excited about this molecule’s potential,” Wright says. “There’s a clear path forward, and we may even be able to expand its spectrum so that it eventually affects even more bacteria, too.”

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[Editorial] Climate change and health: closing the gaps

In the past few months, Europeans have heard some good news about climate change. In April, 2026, the European Commission launched a new €601 million LIFE funding programme to support climate adaptation, biodiversity, and clean energy projects across the region. Meanwhile, the German Government announced a €5 billion programme on May 5 to help industry reduce its carbon emissions. Some positive trends are also reported in the 2026 Europe report of the Lancet Countdown on health and climate change published in this issue, which measures 43 indicators, including seven new ones.

Wacker Expands Service Offerings with Launch of Contract Research for Nucleic Acid-Based Therapies

Wacker reports that it is launching contract research services (CRS) at its biotech center in Munich for R&D-grade pDNA, RNA, and LNPs for preclinical studies. The new offering complements services of subsidiary CDMO Wacker Biotech, which has sites in Germany, the Netherlands, and the U.S.

In addition to producing pDNA, RNA, and LNP formulations, Wacker’s CRS team says it offers construct design services, including plasmid and RNA construct design as well as RNA engineering and optimization via partners, e.g., UTR, poly(A) and cap optimization. Company scientists also conduct lipid library screening and lipid nanoparticle formulation and provide functional assays and analytical services.

By integrating early-stage R&D support with a globally interconnected GMP manufacturing network, CRS helps customers streamline development and reduce supply-chain fragmentation, maintains a Wacker spokesperson. The approach enables an accelerated path from design to delivery in the field of advanced therapies, while lowering risk and cost through resourcing in early phases and a scalable transfer to Wacker Biotech for clinical material, continued the company official.

“Every RNA or LNP project is unique. Our goal is to provide flexible, customizable services that adapt to our clients’ specific needs in a rapidly evolving landscape,” explained Christian Dubiella, the CRS global program manager. “Too often, innovative, potentially life-saving therapeutic concepts die on the vine due to the high cost of developing even small amounts of drug substance for R&D studies. Our CRS enable us to serve highly specialized customers, especially small startups.”

One of CRS’ first customers is SRTD Biotech, an emerging biotech in Germany, which is starting small scale on novel therapeutic approaches.

“Our platform technology based on seRNAs (selectively expressed RNAs) can easily be adapted to numerous therapeutic areas by utilizing the transcriptome for selective cell targeting and fusogenic LNPs for organ-specific targeting,” said Bernd Hoffmann, CEO/CSO and cofounder of SRTD. “Wacker is an ideal partner on the road to realizing our vision of delivering seRNAs to patients to improve their lives.”

 

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Oncology’s Next AI Battleground: Instant Clinical and Commercial Insight

Across the oncology pharmaceutical industry, the bar for precision is constantly being raised. Cancer drug development has become increasingly biomarker-driven, trial populations are narrowing, and the cost of identifying eligible patients for studies continues to rise. At the same time, life sciences organizations are under growing pressure to generate real-world evidence (RWE) faster for commercialization strategies as well as regulators and payers.

The race to operationalize artificial intelligence (AI) across oncology research has entered a new phase. After years of building massive catalogs of real-world data (RWD) from electronic health records (EHRs), molecular testing, and longitudinal patient outcomes, healthcare technology companies are now competing to transform those datasets into interactive intelligence systems capable of answering complex clinical and commercial questions in real time.

That convergence has fueled a wave of oncology AI platform development from companies including SOPHiA GENETICS, Ontada, COTA Healthcare, and now Flatiron Health. “As oncology becomes more complex, the ability to quickly identify the right patients and answer critical research questions is no longer a nice-to-have, it’s essential,” Kate Estep, chief product officer at Flatiron Health, told Inside Precision Medicine.

The move by Flatiron Health supports the continuing trend of data companies in oncology and across healthcare positioning themselves beyond simply aggregating clinical datasets toward creating AI-native research environments where clinicians, commercial strategists, and researchers can interact directly with data using natural language.

The need for speed

Historically, RWE generation has been labor-intensive. Pharmaceutical teams often rely on analysts or biostatistics groups to construct cohorts, validate inclusion criteria, and generate feasibility assessments—a process that can take days or weeks before a research question even begins to take shape. That workflow is increasingly incompatible with modern oncology development, where therapies are often targeted toward highly specific molecular subpopulations.

Cancer research may be uniquely suited for AI-native evidence generation systems. Compared with many therapeutic areas, oncology already produces unusually data-dense patient journeys involving pathology reports, genomic sequencing, imaging, biomarker testing, treatment lines, progression tracking, and survival endpoints. Oncology drug development is also increasingly dependent on identifying narrow molecular populations quickly and accurately. That complexity creates ideal conditions for conversational AI systems capable of navigating structured and unstructured clinical data simultaneously.

Flatiron Telescope attempts to address that bottleneck by giving users a conversational interface layered on top of Flatiron’s oncology-specific datasets. Researchers can describe inclusion and exclusion criteria in natural language, dynamically refine cohorts, and immediately view patient counts, attrition curves, treatment patterns, and survival analyses without writing code. “We were chatting with one of our early access partners last week, and this person was remarking, ‘I could answer my question in 30 minutes, and that would have taken me two days before waiting for my data team to come back to me,’” Estep said during a media briefing ahead of launch.

That acceleration may ultimately become the defining metric in the AI healthcare infrastructure market: not simply the size of a company’s dataset, but how quickly actionable insight can be extracted from it.

From data vendors to research platforms

But the challenge is not merely access to information. Trust and scientific validity remain central concerns. “One of the things our head of data science was sharing is that off-the-shelf models are roughly 60% accurate,” Estep said. “When built and trained with the clinical and scientific best practices that we have applied to model context because we have been asking cohort questions of our data for 15 years, that’s 90% plus accuracy.”

Those comments point toward an increasingly important divide in healthcare AI: the distinction between general-purpose AI models and clinically fine-tuned systems trained on domain-specific workflows. For companies like Flatiron, the competitive moat may ultimately come less from the underlying language models themselves and more from proprietary clinical context, curation methodologies, and validated evidence-generation pipelines.

The emergence of platforms like Telescope also reflects a broader transformation occurring across healthcare AI. The first generation of healthcare data companies focused primarily on aggregation, assembling electronic health record (EHR) data, claims data, genomic profiles, and imaging repositories into structured datasets. The second generation is now focused on orchestration: enabling users to interrogate those datasets continuously through AI-driven systems.

Flatiron is betting that domain specificity will matter more than generic AI capability. “Most people in the space either give you data, they give you analytics, or they give you a platform,” Estep said. “Very few cut across all three buckets.”

That positioning distinguishes Flatiron somewhat from competitors. Tempus AI has built a broad precision medicine tech ecosystem for both providers and life sciences companies. SOPHiA GENETICS has emphasized multimodal analytics and genomic interpretation. Ontada, backed by McKesson, combines oncology data assets with point-of-care tools and network analytics.

Flatiron, by contrast, is leaning heavily into its reputation for longitudinal oncology RWE and EHR-derived clinical depth. The company says Telescope is powered by more than 15 years of oncology-specific data infrastructure spanning over 4,700 providers and 1,600 clinical sites in the United States, representing approximately 40% of U.S. community oncology practices. Globally, the company now manages data from more than five million patient journeys across the U.S., U.K., Germany, and Japan.

That scale matters because oncology AI systems depend heavily on context-rich longitudinal data. Large language models alone are insufficient if the underlying clinical infrastructure lacks standardized outcomes, biomarker histories, treatment sequences, or progression events. “Flatiron has spent the last decade and a half building high-quality, oncology-specific real-world datasets,” Estep said. “Telescope really sits at the epicenter of that.”

Global oncology intelligence

Another major shift underway in oncology AI involves international interoperability. Historically, most RWE systems were fragmented geographically, with datasets built independently for different markets. But as pharmaceutical companies globalize clinical development programs, pressure is increasing to harmonize datasets across countries.

Flatiron says it is now building globally interoperable oncology datasets across the U.S., U.K., Germany, and Japan, beginning with prostate cancer data expected later this year. “We are ensuring that our datasets are interoperable from a global perspective,” Estep said. “Conclusions drawn on definitions of variables and data models in one market can easily be applied or explored in another.”

The long-term implications could be substantial. Globally harmonized oncology datasets would allow researchers to study treatment variation, biomarker prevalence, and outcomes across healthcare systems at a scale previously difficult to achieve. It may also help address longstanding concerns around representativeness in RWE generation. “Representativeness of a RWD is probably one of the single biggest requirements for us as we think about whether this dataset is considered reliable,” Estep said.

Perhaps the most important industry trend underlying Telescope’s launch is the democratization of advanced analytics. Historically, sophisticated oncology data analysis required teams of data scientists, epidemiologists, or biostatisticians. AI interfaces are beginning to collapse those barriers, enabling clinical operations leaders, medical affairs teams, and commercial strategists to interact directly with research-grade datasets. “There’s no coding required,” Estep said. “Any team member can use it, not just your data analysts.”

That shift could fundamentally change how oncology organizations make decisions, reducing delays between hypothesis generation and evidence generation while broadening access to sophisticated analytical capabilities across enterprise teams.

Whether Telescope ultimately becomes a dominant platform remains to be seen. But its launch reflects a broader reality now reshaping healthcare: in oncology, the future competitive advantage may belong not simply to companies with the most data but to those capable of turning clinical complexity into usable intelligence fastest.

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Tech researchers are suing the Trump administration over the future of online safety

Since its earliest days back in office, the Trump administration has been going after researchers who study and try to counter hate speech, harassment, propaganda, and disinformation online. 

Now, some of those researchers are fighting back. Last week their lawsuit—which could have global repercussions for online safety and free speech—made its first appearance in court. 

This fight started a year ago, when US Secretary of State Marco Rubio announced on X what he called a “visa restriction policy” against “foreign officials and other persons” who were “complicit in censoring Americans.” Since then, a handful of foreign officials and researchers have been barred from travel to the US, and in theory, anyone working in fact-checking or online trust and safety more broadly could face the same restrictions. 

Still, the exact implications of Rubio’s announcement are unclear—purposefully so, argues Carrie DeCell, a lawyer representing the researchers. “This policy is expansive and incredibly vague, and the chilling effects are correspondingly enormous,” DeCell said outside the courthouse in Washington, DC, on May 13.  

The case has been brought by the Coalition for Independent Technology Research (CITR), an advocacy organization for tech researchers. It is suing Rubio, former US secretary of homeland security Kristi Noem, and former US attorney general Pam Bondi and asking the court to strike down the policy as unconstitutional. In their complaint, the plaintiffs say the policy violates the speech and due process rights of foreign-born tech researchers and workers whose “work supports greater moderation of content on the [tech] platforms.”

CITR is represented by Columbia University’s Knight First Amendment Institute and the legal nonprofit Protect Democracy. DeCell, a senior staff attorney at the Knight Institute, tells MIT Technology Review that they’re in court because the Trump administration is effectively “using immigration law to punish people for expressing views that it disagrees with.” 


This story is part of MIT Technology Review’s “America Undone” series, examining how the foundations of US success in science and innovation are currently under threat. You can read the rest here.


Most immediately, the plaintiffs are asking the government to halt these visa restrictions while the case proceeds. Zachariah Lindsey, the assistant US attorney representing Rubio and the other defendants, argued in last week’s hearing that the government is not targeting speech but, rather, “conduct [that] is assisting or facilitating foreign government censorship of free speech.” At the end of the week, the government filed a motion to dismiss the case.

The judge has yet to rule on either motion, and his questions so far appeared to focus on parsing what (and who) is actually affected by the State Department’s announcements, as well as other procedural issues. 

The outcome of the case may ultimately affect how much the public knows about the risks of social media and AI, says Nicole Schneidman, head of Protect Democracy’s technology and data governance team. The workers bringing this suit, she says, “serve a really, really important function in educating the public, holding tech companies accountable, doing research on the ramifications that advanced technology has on our society.” 

“A political witch hunt”

CITR’s lawsuit is the latest salvo in a yearslong battle over how the internet should be moderated, and by whom—a question that has become increasingly political and entangled in allegations of censorship. 

For years, Trump and his allies have claimed to be victims of a vast conspiracy between government agencies, civil society groups, academics, and Big Tech platforms to specifically censor conservative voices online. According to this narrative, a so-called “censorship-industrial complex” helped the Biden administration subvert First Amendment protections on speech by allegedly outsourcing censorship to these groups.

The State Department claims Rubio was able to implement the immigration policy because the Immigration and Nationality Act authorizes him to “render inadmissible any alien whose entry into the United States ‘would have potentially serious adverse foreign policy consequences for the United States.’” Before the current Trump administration, the statute was rarely invoked, and when it was, it was typically with more limited, specific criteria, rather than its current application against anyone who has participated in alleged censorship—an action that has no legal definition. 

The administration first deployed the policy in July 2025, when Rubio issued a statement announcing the revocation of visas for Alexandre de Moraes, the lead justice on the Brazilian Supreme Federal Court, and “his allies on the court” who were involved in prosecuting Jair Bolsonaro, Brazil’s former president. The prosecution was a “political witch hunt,” said Rubio, calling it evidence of a “censorship complex so sweeping that it not only violates basic rights of Brazilians, but also … targets Americans.”

Then, in early December, the State Department issued instructions to embassies to reject H-1B visa applications from individuals who had worked specifically in fact-checking, online trust and safety, and mis- or disinformation research, as Reuters first reported. 

A few weeks later, on December 23, the agency announced visa restrictions for five Europeans whom it accused of censoring Americans. This included two CITR members: Imran Ahmed, founder and CEO of the Center for Countering Digital Hate, which documents hate speech on social media platforms, and Clare Melford, cofounder of the Global Disinformation Index, which ranks websites according to how often they publish hate speech and disinformation. Also banned were the former European Union commissioner Thierry Breton, a key architect of the European Union’s Digital Services Act (which the State Department has called “Orwellian” and an example of censorship), and Josephine Ballon and Anna-Lena von Hodenberg, co-CEOs of HateAid, a German nonprofit that fights online hate speech. 

Ahmed, who lives in the US with his American wife and child, quickly filed his own lawsuit to stave off deportation and halt the policy. A preliminary injunction preventing his detention and deportation is in place as the lawsuit continues. 

The Department of Homeland Security referred questions from MIT Technology Review to the State Department, which referred “specific questions” to the Department of Justice, while also writing that “the Trump Administration believes that aliens who are or were involved or complicit in censoring American citizens must face appropriate consequences. An American visa is a privilege not a right.” The Department of Justice did not respond to a request for comment. 

“A gut punch”

Now, more tech researchers are fighting back. 

CITR represents 500 individual and institutional members in 47 countries; 40 are based in the United States, including around 30 noncitizens. The organization argues that US-based tech researchers are experiencing a widespread chilling effect and are having to change or reframe what they’re studying so that it’s less explicitly (or less obviously) about content moderation or countering disinformation. Alternatively, some are leaving the US altogether, or making plans to do so, in order to safely carry out their work. 

CITR member Eirliani Abdul Rahman, a Singaporean online safety expert and a founding member of Twitter’s Trust and Safety Council, is one of these individuals. Her experience was included, though described anonymously, in CITR’s initial legal complaint. 

Back in December 2022, shortly after Elon Musk purchased Twitter, Abdul Rahman and two other Trust and Safety Council members publicly resigned. They spoke out against “red lines” the new owner had crossed, including his reinstatement of accounts that had previously been banned, and noted the marked increase in hate speech on the platform. 

Musk disbanded the council days later, but first he retweeted a post that tagged Abdul Rahman and the others and said: “You all belong in jail.” This led to a level of online harassment, doxxing, and death threats that she had never before experienced. “I was trained as an economist, and I could just see line graphs form in my head of the stochastic jump in what happened,” Abdul Rahman says, referring to the way the dangerous attention spiked after Musk effectively endorsed the other user’s provocation. 

This experience inspired her to pursue a new area of research: using quantitative methods to study and hopefully stop social media harassment “in real time,” she says. 

“The ones that are most harassed are people [who] have historically been marginalized,” she adds. “Most of us know about this already, like it’s intuitive. But until you quantify it, sometimes it’s just not seen and taken seriously.”   

But then Trump was reelected, making the work feel untenable. The US quickly became “a funding desert” for scientific research, she says, with federal support for any research perceived by conservatives to focus on mis/disinformation getting cut. At the same time, tech companies shifted their positions on content moderation to align with the president’s, meaning that her research would be unlikely to have any practical implications: “There’s simply no guardrails around social media anymore,” she says. 

Fast-forward to December 2025, and the travel bans on the five Europeans felt like “a gut punch to the stomach,” Abdul Rahman says. She and Ahmed had both testified earlier in the year before the UK Parliament on the role social media played in spreading false claims about the supposed Muslim identity of a murderer who had killed three British girls; this online activity contributed to violent anti-immigrant and Islamophobic riots across the country in the summer of 2024. 

The targeting of Ahmed and the other Europeans “was the last straw” for Abdul Rahman. Soon after, she left the US for a six-year fellowship in Germany aimed at supporting “international academic freedom”—coincidentally arriving in the country on the same day CITR filed its lawsuit. 

“My body just calmed down,” Abdul Rahman says of landing in Germany. “I didn’t wake up in the middle of the night … always wondering about the next executive order and how it pertained to my situation.”

Abdul Rahman believes this legal battle has implications that reach beyond CITR members and their families. It “pertains to all immigrants in the US to protect our First Amendment rights,” she says.

Additionally, whether fact-checkers, online trust and safety workers, and tech researchers can continue to do their work has a broader impact on anyone who uses the internet. 

Earlier this year, for example, Ahmed’s Center for Countering Digital Hate published widely cited research that Grok’s image-editing feature had generated an estimated 3 million sexualized images, including 23,000 images of children, in an 11-day period. This led to government investigations, lawsuits, and even temporary bans for Grok’s parent company, xAI, across the United States and world. 

“The threats have really sharpened”

MIT Technology Review has reported extensively on this right-wing war on supposed censorship; one of our stories revealing that State Department leadership requested communications records from a now-shuttered office focused on countering foreign disinformation has been included as an exhibit in the CITR lawsuit. This request sought insight into communications with a slew of individuals some far-right activists allege are involved in the “censorship-industrial complex,” including journalists, the German foreign minister, and numerous researchers studying disinformation and hate speech (including Medford, Ahmed, and their organizations).

DeCell tells us that over the past year and a half, there have been more lawsuits against the Trump administration regarding free speech—because “the threats have really sharpened,” she says.

Last year, the Knight Institute sued Rubio on behalf of of university faculty and students who have been arrested, detained, and deported for their pro-Palestinian speech; this past January, a judge ruled that the administration’s deportation policy was unconstitutional. The risk to free speech rights is “palpable” when the government “decides to target people specifically with the threat of rounding them off the streets, throwing them into a detention center, and then potentially deporting them from this country,” DeCell says. 

Though Abdul Rahman is safely abroad for now, she says she’s watching the CITR lawsuit closely. Ultimately, she says, she believes it will determine whether researchers will be able to continue to do their work, “which is to take social media platforms to account,” she says—“making sure there’s actual accountability and independent oversight is critical to protecting our democracies.” 

MYC Protein Linked to Tumor Survival Through DNA Repair Pathway

Researchers from Oregon Health & Science University (OHSU) have discovered the the MYC protein, which has long been known to drive cancer growth and development, also helps cancer survive DNA-damaging treatments by repairing the DNA in cancer cells. The research, published in the journal Genes & Development, shows that a form of MYC moves directly to sites of DNA damage to recruit proteins to help cancer cells survive the stress caused by chemotherapy and radiation treatments. The OHSU team’s findings indicate that finding a way to disrupt this repair function could be leveraged to make some tumors more vulnerable to treatment.

“Our work shows that MYC isn’t just helping cancer cells grow—it’s also helping them survive some of the very treatments designed to kill them,” senior author Rosalie Sears, PhD, Krista L. Lake chair in Cancer Research and co-director of the OHSU Brenden-Colson Center for Pancreatic Care said in a press release.

“These insights advance our understanding of MYC’s function beyond transcriptional regulation, highlighting additional contributions to MYC-driven oncogenesis and resistance to cellular stress and DNA-damaging therapies that could be critical for patient outcomes,” Sears told Inside Precision Medicine.

MYC has been studied extensively because of its role in regulating genes involved in cell proliferation, metabolism, and responses to stress. MYC deregulation is found in virtually all human cancers and is associated with chemotherapy resistance and lower patient survival rates. For this new research, the OHSU team focused on how phosphorylation at serine 62 (pS62-MYC) affects the protein’s DNA repair activities.

“Genomic instability is a hallmark of cancer, driving oncogenic mutations that enhance tumor aggressiveness and drug resistance,” the researchers wrote. “[MYC] paradoxically induces replication stress and associated DNA damage while also increasing expression of DNA repair factors and mediating resistance to DNA-damaging therapies.”

The study sought to find out how MYC behaves when DNA double-strand breaks occur. To do this the researchers used DNA double-strand break-specific proximity ligation assay, known as DI-PLA, to determine whether MYC physically associates with damaged DNA. They also used proximity-dependent proteomics to map proteins interacting with MYC and also examined MYC occupancy at chromatin during replication stress.

Their analysis showed that phosphorylation at serine 62 was needed to allow MYC to move to damaged DNA and interact with repair proteins including BRCA1 and RAD51.

“We identify a noncanonical role of MYC in DNA damage response (DDR) through its association with DNA breaks,” the researchers wrote, adding that phosphorylation at serine 62 “is crucial for the efficient recruitment of MYC to damage sites, its interaction with repair factors BRCA1 and RAD51, and effective DNA repair to support cell survival under stress.”

These findings help explain why some MYC-driven tumors often are resistant to treatments that are designed to overwhelm cancer cells with DNA damage. Chemotherapy agents and radiation therapy often work by creating DNA lesions that cancer cells cannot repair. The study suggests that tumors with high MYC activity may evade these treatments because MYC enhances repair pathways that restore damaged DNA.

“Cancer therapies often depend on overwhelming tumor cells with DNA damage,” Sears said. “If a cancer cell is very good at fixing that damage, it can survive treatment and keep growing.”

The implications of this may be especially pertinent for finding new methods of treating pancreatic ductal adenocarcinoma (PDAC). The researchers said MYC activity is elevated in a subset of aggressive PDAC tumors characterized by replication stress, liver metastasis, and increased DNA repair signaling. They linked this environment to oncogenic KRAS signaling and loss of tumor suppressors such as p53, both of which contribute to elevated pS62-MYC levels.

“These findings are particularly relevant for aggressive cancers like pancreatic cancer, where MYC activity is often very high,” said first author Gabriel Cohn, PhD, formerly of OHSU and now a postdoctoral researcher at the University of Würzburg, Germany. “Tumor cells in these cancers experience significant DNA damage and replication stress, yet they continue to survive and grow. Our work suggests that MYC helps these cells cope with that stress by actively promoting DNA repair.”

The study built on prior research that showed MYC can contribute to genomic maintenance during transcription and replication stress. Previous work demonstrated that MYC recruits topoisomerases to relieve DNA torsional stress, facilitates repair during transcriptional elongation, and stabilizes stalled replication forks. Other studies had shown that MYC and the related protein MYCN interact with DNA repair proteins, including BRCA1. But the researchers said their research is the first fully explore if MYC has a direct role in mediating DNA repair.

While MYC has long been considered an “undruggable” because its structure is difficult to target without affecting normal cellular functions, uncovering its role in DNA repair could provide a new avenue for selectively influencing its function, as opposed to attempting to block all MYC functions.

“MYC is one of the two most important oncogenes in all of human cancer,” Sears said. “If we can interfere with MYC’s role in DNA repair—without shutting down everything MYC does in healthy cells—we may be able to make cancer cells more vulnerable to treatment.”

At OHSU, investigators are currently studying a first-in-class MYC inhibitor called OMO-103 in a window-of-opportunity trial involving patients with advanced pancreatic cancer. The study includes biopsies collected before and after treatment to evaluate how MYC inhibition affects tumors in patients. Future studies will examine how MYC organizes repair complexes at DNA damage sites and whether blocking pS62-MYC-dependent repair functions can improve responses to DNA-damaging therapies in MYC-driven cancers.

The post MYC Protein Linked to Tumor Survival Through DNA Repair Pathway appeared first on Inside Precision Medicine.

Barriers and Facilitators for the Implementation of an Online Portal in Hospital Mental Health Care: Implementation Study

Background: In recent years, digital patient portals have become an increasingly common feature of care in various medical fields. Despite growing scientific evidence of their effectiveness and the benefits they offer to patients and caregivers, their implementation, especially in hospital mental health settings, lags behind expectations. Objective: The study aimed to identify the barriers and facilitators to implementing a patient portal in a public mental health hospital setting in Germany. Moreover, it aimed to develop recommendations for implementing a patient portal. Methods: Three psychiatric clinics in the early stages of implementing an online portal for patients participated in this implementation study. We assessed objective usage data (log data from the patient portal) and performed qualitative interviews with professionals and questionnaire surveys with both patients and professionals. We combined the results to develop generic recommendations for the implementation of patient portals in a mental hospital setting using a 2-stage Delphi method with a group of professionals and patients. Results: Portal log data from 71 patients indicated variation in the use of the portal functions. On average, users logged in 9.5 (SD 14.9) times (median 4, IQR 2-7 times). The variability in the number of logins per patient, ranging from 1 to 72, indicated a high variance in the frequency of use. On average, the portal was used for 47 (SD 59) days (median 27, IQR 2-62 days). Questionnaire data from 27 patients showed satisfaction with the portal and elucidated perceived barriers to usage. Qualitative interview data from 15 professionals revealed patient-related, professional-related, organizational, structural, and technical facilitators and barriers to the implementation process. We developed 10 actionable recommendations for the implementation of digital patient portals in psychiatric hospitals, which were rated by an expert group on different dimensions. Conclusions: To our knowledge, this is the first implementation study in a German mental health hospital setting that provides experience-based recommendations for advancing the implementation of digital patient portals in hospital mental health care. The next steps will include the analysis of a larger number of users and functions, which will help to specify recommendations for different target groups and settings. Trial Registration: German Clinical Trials Register DRKS00036894; https://drks.de/search/en/trial/DRKS00036894
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