{"entity":{"id":"idea-bio2-organotropism-atlas","kind":"idea","name":"An organotropism atlas that predicts where a cancer will spread","aka":[],"tldr":"Different cancers favour different organs, and so do different patients. A model that predicts which organ is at risk could target surveillance and prevention.","summary":"Site of relapse is recorded in registries and trial datasets but almost never modelled as an outcome. Linking primary tumour genomics, transcriptomics and digital pathology to first-relapse site across tens of thousands of patients would produce an organotropism predictor, and would identify the features that drive lung, liver, bone and brain tropism in humans rather than in mice.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Metastasis is understood least and studied last): Dillekås et al., Are 90% of deaths from cancer caused by metastases? (Cancer Medicine 2019)","url":"https://doi.org/10.1002/cam4.2474"}],"tags":[],"related":["genie","seer","cbioportal"],"cancers":["breast-her2-positive","melanoma","prostate"],"sections":[],"technologies":["pathology-foundation-model","rna-seq"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-metastasis-biology","b-data-silos","b-real-world-evidence"],"keyPapers":["paper-dillekas-cancer-med"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A multimodal model trained on primary tumour features predicts first metastatic site with an AUC above 0.7 in held-out cohorts, and its top features nominate druggable organ-specific seeding mechanisms.","rationale":"Human organotropism is strikingly reproducible by subtype (HER2-positive breast to brain, luminal breast to bone, uveal melanoma to liver) but has never been systematically explained. Existing registry and trial data can answer it without collecting new samples.","test":"Federated analysis across three national registries plus genomics-linked outcome data; publish the model, then validate it prospectively by predicting relapse site in an ongoing adjuvant cohort.","maturity":"speculative","actor":"data","cost":"medium","horizonYears":6},"route":"/ideas/idea-bio2-organotropism-atlas/","neighbours":{"collection":[{"id":"genie","kind":"collection","name":"AACR Project GENIE","route":"/collections/genie/"},{"id":"cbioportal","kind":"collection","name":"cBioPortal for Cancer Genomics","route":"/collections/cbioportal/"},{"id":"seer","kind":"collection","name":"SEER (Surveillance, Epidemiology, and End Results)","route":"/collections/seer/"}],"cancer":[{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"technology":[{"id":"pathology-foundation-model","kind":"technology","name":"Pathology & radiology foundation models","route":"/technologies/pathology-foundation-model/"},{"id":"rna-seq","kind":"technology","name":"RNA sequencing & expression profiling","route":"/technologies/rna-seq/"}],"bottleneck":[{"id":"b-data-silos","kind":"bottleneck","name":"Data silos","route":"/bottlenecks/b-data-silos/"},{"id":"b-metastasis-biology","kind":"bottleneck","name":"Metastasis is understood least and studied last","route":"/bottlenecks/b-metastasis-biology/"},{"id":"b-real-world-evidence","kind":"bottleneck","name":"Weak real-world evidence and registries","route":"/bottlenecks/b-real-world-evidence/"}],"paper":[{"id":"paper-dillekas-cancer-med","kind":"paper","name":"Are 90% of deaths from cancer caused by metastases?","route":"/key-papers/paper-dillekas-cancer-med/"}]}}