CIGTSurv: Clinical Information Guided Tri-modal Survival Prediction with Local Prototype Association and Global Feature Alignment

Multimodal learning has significantly advanced survival prediction by integrating pathology images with genomic data. However, clinical information, despite its critical role in reflecting a patient' s overall health, remains underutilized due to its discrete, sparse, and low-dimensional nature. Furthermore, the inherent heterogeneity across these modalities pose significant challenges in modeling cross-modal interactions. In this paper, we propose CIGTSurv, a Clinical Information Guided Tri-modal framework for Survival prediction. Specifically, we first design a holistic text template and use pretrained foundation models to transform clinical tabular data into high-dimensional tokenized embeddings. Using clinical information as an anchor, we then introduce a dual-level interaction mechanism: 1) a local prototype association (LPA) module based on cross-attention to explicitly learn token-level correspondences between different modalities, and 2) a global feature alignment (GFA) loss based on Maximum Mean Discrepancy (MMD) to implicitly enhance cross-modal distribution consistency. Extensive experiments on five TCGA cancer cohorts demonstrate that CIGTSurv achieves state-of-the-art (SOTA) survival prediction performance. Our source code is publicly available at https://github.com/Daijing-ai/CIGT-Surv.git.

HGP-Mamba: Integrating Histology and Generated Protein Features for Mamba-based Multimodal Survival Risk Prediction

Recent advances in multimodal learning have significantly improved cancer survival risk prediction. However, the joint prognostic potential of protein markers and histopathology images remains underexplored, largely due to the high cost and limited availability of protein expression profiling. To address this challenge, we propose HGP-Mamba, a Mamba-based multimodal framework that efficiently integrates histological with generated protein features for survival risk prediction. Specifically, we introduce a protein feature extractor (PFE) that leverages pretrained foundation models to derive high-throughput protein embeddings directly from Whole Slide Images (WSIs), enabling data-efficient incorporation of molecular information. Together with histology embeddings that capture morphological patterns, we further introduce the Local Interaction-aware Mamba (LiAM) for fine-grained feature interaction and the Global Interaction-enhanced Mamba (GiEM) to promote holistic modality fusion at the slide level, thus capture complex cross-modal dependencies. Experiments on four public cancer datasets demonstrate that HGP-Mamba achieves state-of-the-art performance while maintaining superior computational efficiency compared with existing methods. Our source code is publicly available at <a href="https://github.com/Daijing-ai/HGP-Mamba.git">this https URL</a>.

Multi-modal Knowledge Decomposition based Online Distillation for Biomarker Prediction in Breast Cancer Histopathology

Immunohistochemical (IHC) biomarker prediction benefits from multi-modal data fusion analysis. However, the simultaneous acquisition of multi-modal data, such as genomic and pathological information, is often challenging due to cost or technical limitations. To address this challenge, we propose an online distillation approach based on Multi-modal Knowledge Decomposition (MKD) to enhance IHC biomarker prediction in haematoxylin and eosin (H\&E) stained histopathology images. This method leverages paired genomic-pathology data during training while enabling inference using either pathology slides alone or both modalities. Two teacher and one student models are developed to extract modality-specific and modality-general features by minimizing the MKD loss. To maintain the internal structural relationships between samples, Similarity-preserving Knowledge Distillation (SKD) is applied. Additionally, Collaborative Learning for Online Distillation (CLOD) facilitates mutual learning between teacher and student models, encouraging diverse and complementary learning dynamics. Experiments on the TCGA-BRCA and in-house QHSU datasets demonstrate that our approach achieves superior performance in IHC biomarker prediction using uni-modal data. Our code is available at https://github.com/qiyuanzz/MICCAI2025_MKD.