{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:44:53Z","timestamp":1792586693100,"version":"4.5.0"},"reference-count":44,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001810","name":"Research and Innovation Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001810","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018877","name":"Research and Innovation Foundation","doi-asserted-by":"publisher","award":["PROGNOSTIC-CODEVELOP-AG-SH- HE \/0823\/0202"],"award-info":[{"award-number":["PROGNOSTIC-CODEVELOP-AG-SH- HE \/0823\/0202"]}],"id":[{"id":"10.13039\/501100018877","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018877","name":"Research and Innovation Foundation","doi-asserted-by":"publisher","award":["OncoPredict-POST- DOC \/0524\/0068"],"award-info":[{"award-number":["OncoPredict-POST- DOC \/0524\/0068"]}],"id":[{"id":"10.13039\/501100018877","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["101141357"],"award-info":[{"award-number":["101141357"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Array"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.array.2026.101168","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T15:27:08Z","timestamp":1787326028000},"page":"101168","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Multimodal transformers predict cancer therapy response from tumor mechanics"],"prefix":"10.1016","volume":"31","author":[{"given":"Styliana","family":"Georgiou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3093-1696","authenticated-orcid":false,"given":"Triantafyllos","family":"Stylianopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-9489","authenticated-orcid":false,"given":"Chrysovalantis","family":"Voutouri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.array.2026.101168_bib1","doi-asserted-by":"crossref","DOI":"10.3390\/cancers14020280","article-title":"Dynamic cancer cell heterogeneity: diagnostic and therapeutic implications","volume":"14","author":"Jacquemin","year":"2022","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.array.2026.101168_bib2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/nrclinonc.2017.166","article-title":"Tumour heterogeneity and resistance to cancer therapies","volume":"15","author":"Dagogo-Jack","year":"2018","journal-title":"Nat Rev Clin Oncol"},{"key":"10.1016\/j.array.2026.101168_bib3","doi-asserted-by":"crossref","first-page":"2025","DOI":"10.3389\/fcell.2025.1564626","article-title":"The mechanopathology of the tumor microenvironment: detection techniques, molecular mechanisms and therapeutic opportunities","volume":"13","author":"Angeli","year":"2025","journal-title":"Front Cell Dev Biol"},{"key":"10.1016\/j.array.2026.101168_bib4","doi-asserted-by":"crossref","DOI":"10.1063\/5.0183302","article-title":"Toward innovative approaches for exploring the mechanically regulated tumor-immune microenvironment","volume":"8","author":"Kalli","year":"2024","journal-title":"APL Bioeng"},{"key":"10.1016\/j.array.2026.101168_bib5","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.trecan.2018.02.005","article-title":"Reengineering the physical microenvironment of tumors to improve drug delivery and efficacy: from mathematical modeling to bench to bedside","volume":"4","author":"Stylianopoulos","year":"2018","journal-title":"Trends Cancer"},{"key":"10.1016\/j.array.2026.101168_bib6","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13174444","article-title":"Normalizing tumor vasculature to reduce hypoxia, enhance perfusion, and optimize therapy uptake","volume":"13","author":"Matuszewska","year":"2021","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.array.2026.101168_bib7","article-title":"Modulating cancer mechanopathology to restore vascular function and enhance immunotherapy","volume":"5","author":"Mpekris","year":"2024","journal-title":"Cell Rep Med"},{"key":"10.1016\/j.array.2026.101168_bib8","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1146\/annurev-bioeng-071813-105259","article-title":"The role of mechanical forces in tumor growth and therapy","volume":"16","author":"Jain","year":"2014","journal-title":"Annu Rev Biomed Eng"},{"key":"10.1016\/j.array.2026.101168_bib9","doi-asserted-by":"crossref","DOI":"10.1016\/j.mcpro.2022.100217","article-title":"Hypoxia is a dominant remodeler of the effector T cell surface proteome relative to activation and regulatory T cell suppression","volume":"21","author":"Byrnes","year":"2022","journal-title":"Mol Cell Proteomics"},{"key":"10.1016\/j.array.2026.101168_bib10","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.3389\/fimmu.2024.1467602","article-title":"Targeting extracellular matrix stiffness for cancer therapy","volume":"15","author":"Feng","year":"2024","journal-title":"Front Immunol"},{"key":"10.1016\/j.array.2026.101168_bib11","doi-asserted-by":"crossref","DOI":"10.1016\/j.mser.2021.100641","article-title":"Collagen- and hyaluronic acid-based hydrogels and their biomedical applications","volume":"146","author":"Xu","year":"2021","journal-title":"Mater Sci Eng R Rep"},{"key":"10.1016\/j.array.2026.101168_bib12","doi-asserted-by":"crossref","DOI":"10.3390\/s25113510","article-title":"The young's modulus as a mechanical biomarker in AFM experiments: a tool for cancer diagnosis and treatment monitoring","volume":"25","author":"Kontomaris","year":"2025","journal-title":"Sensors"},{"key":"10.1016\/j.array.2026.101168_bib13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.actbio.2023.06.007","article-title":"Ultrasound stiffness and perfusion markers correlate with tumor volume responses to immunotherapy","volume":"167","author":"Voutouri","year":"2023","journal-title":"Acta Biomater"},{"key":"10.1016\/j.array.2026.101168_bib14","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1038\/s41392-024-01823-2","article-title":"Tumor biomarkers for diagnosis, prognosis and targeted therapy","volume":"9","author":"Zhou","year":"2024","journal-title":"Signal Transduct Targeted Ther"},{"key":"10.1016\/j.array.2026.101168_bib15","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1038\/nrc.2016.56","article-title":"Biomarker development in the precision medicine era: lung cancer as a case study","volume":"16","author":"Vargas","year":"2016","journal-title":"Nat Rev Cancer"},{"key":"10.1016\/j.array.2026.101168_bib16","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1038\/s42003-024-07268-1","article-title":"Mechanical forces inducing oxaliplatin resistance in pancreatic cancer can be targeted by autophagy inhibition","volume":"7","author":"Kalli","year":"2024","journal-title":"Commun Biol"},{"key":"10.1016\/j.array.2026.101168_bib17","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/s44341-025-00017-3","article-title":"The synergistic potential of mechanotherapy and sonopermeation to enhance cancer treatment effectiveness","volume":"2","author":"Neophytou","year":"2025","journal-title":"npj Biological Physics and Mechanics"},{"key":"10.1016\/j.array.2026.101168_bib18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pcbi.1012676","article-title":"Optimizing therapeutic outcomes with mechanotherapy and ultrasound sonopermeation in solid tumors","volume":"21","author":"Koutsi","year":"2025","journal-title":"PLoS Comput Biol"},{"key":"10.1016\/j.array.2026.101168_bib19","doi-asserted-by":"crossref","DOI":"10.1016\/j.tranon.2024.101944","article-title":"Machine learning analysis reveals tumor stiffness and hypoperfusion as biomarkers predictive of cancer treatment efficacy","volume":"44","author":"Englezos","year":"2024","journal-title":"Transl Oncol"},{"key":"10.1016\/j.array.2026.101168_bib20","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.biomaterials.2017.10.020","article-title":"Biomechanical regulation of drug sensitivity in an engineered model of human tumor","volume":"150","author":"Marturano-Kruik","year":"2018","journal-title":"Biomaterials"},{"key":"10.1016\/j.array.2026.101168_bib21","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1007\/s12020-024-04053-2","article-title":"Improving the diagnostic strategy for thyroid nodules: a combination of artificial intelligence-based computer-aided diagnosis system and shear wave elastography","volume":"87","author":"Chen","year":"2025","journal-title":"Endocrine"},{"key":"10.1016\/j.array.2026.101168_bib22","first-page":"2025","article-title":"Clinical value of quantitative analysis of Sonazoid-contrast enhanced ultrasound combined with shear wave elastography in discriminating and diagnosing breast tumor characteristics","volume":"15","author":"Wang","year":"2025","journal-title":"Front Oncol"},{"key":"10.1016\/j.array.2026.101168_bib23","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1038\/s43856-024-00634-4","article-title":"A convolutional attention model for predicting response to chemo-immunotherapy from ultrasound elastography in mouse tumor models","volume":"4","author":"Voutouri","year":"2024","journal-title":"Commun Med"},{"key":"10.1016\/j.array.2026.101168_bib24","doi-asserted-by":"crossref","first-page":"2798","DOI":"10.1038\/bjc.2013.660","article-title":"Can shear-wave elastography predict response to neoadjuvant chemotherapy in women with invasive breast cancer?","volume":"109","author":"Evans","year":"2013","journal-title":"Br J Cancer"},{"key":"10.1016\/j.array.2026.101168_bib25","series-title":"Proceedings of the 31st international conference on neural information processing systems","first-page":"6000","article-title":"Attention is all you need","author":"Vaswani","year":"2017"},{"key":"10.1016\/j.array.2026.101168_bib26","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1186\/s12911-024-02600-5","article-title":"Transformer models in biomedicine","volume":"24","author":"Madan","year":"2024","journal-title":"BMC Med Inf Decis Making"},{"key":"10.1016\/j.array.2026.101168_bib27","doi-asserted-by":"crossref","DOI":"10.1016\/j.patcog.2025.111715","article-title":"Self-adaptive image-text fusion for medical image classification","volume":"167","author":"Zhang","year":"2025","journal-title":"Pattern Recogn"},{"key":"10.1016\/j.array.2026.101168_bib28","doi-asserted-by":"crossref","DOI":"10.3390\/diagnostics11081384","article-title":"TransMed: transformers advance multi-modal medical image classification","volume":"11","author":"Dai","year":"2021","journal-title":"Diagnostics"},{"key":"10.1016\/j.array.2026.101168_bib29","doi-asserted-by":"crossref","DOI":"10.1016\/j.patcog.2024.111041","article-title":"MMAE: a universal image fusion method via mask attention mechanism","volume":"158","author":"Wang","year":"2025","journal-title":"Pattern Recogn"},{"key":"10.1016\/j.array.2026.101168_bib30","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.array.2026.101168_bib31","series-title":"2020 4th international conference on trends in electronics and informatics (ICOEI)(48184)","first-page":"934","article-title":"Reducing overfitting problem in machine learning using novel L1\/4 regularization method","author":"Kolluri","year":"2020"},{"key":"10.1016\/j.array.2026.101168_bib32","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s10462-024-10721-6","article-title":"A review of convolutional neural networks in computer vision","volume":"57","author":"Zhao","year":"2024","journal-title":"Artif Intell Rev"},{"key":"10.1016\/j.array.2026.101168_bib33","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-78363-w","article-title":"Fusing global context with multiscale context for enhanced breast cancer classification","volume":"14","author":"Islam","year":"2024","journal-title":"Sci Rep"},{"key":"10.1016\/j.array.2026.101168_bib34","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3390\/jimaging9070147","article-title":"Deep learning and vision transformer for medical image analysis","volume":"9","author":"Zhang","year":"2023","journal-title":"Journal of Imaging"},{"key":"10.1016\/j.array.2026.101168_bib35","doi-asserted-by":"crossref","DOI":"10.1016\/j.media.2023.103000","article-title":"Advances in medical image analysis with vision transformers: a comprehensive review","volume":"91","author":"Azad","year":"2024","journal-title":"Med Image Anal"},{"key":"10.1016\/j.array.2026.101168_bib36","doi-asserted-by":"crossref","first-page":"3928","DOI":"10.1007\/s10278-025-01481-y","article-title":"Vision transformers in medical imaging: a comprehensive review of advancements and applications across multiple diseases","volume":"38","author":"Aburass","year":"2025","journal-title":"J Imaging Inform Med"},{"key":"10.1016\/j.array.2026.101168_bib37","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-025-97837-z","article-title":"Effect of elastic modulus of tumour and non-tumour cells on vibration-induced behaviours","volume":"15","author":"Ku","year":"2025","journal-title":"Sci Rep"},{"key":"10.1016\/j.array.2026.101168_bib38","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0193801","article-title":"Accumulation of mechanical forces in tumors is related to hyaluronan content and tissue stiffness","volume":"13","author":"Voutouri","year":"2018","journal-title":"PLoS One"},{"key":"10.1016\/j.array.2026.101168_bib39","doi-asserted-by":"crossref","DOI":"10.3390\/jimaging11020059","article-title":"Applications of artificial intelligence, deep learning, and machine learning to support the analysis of microscopic images of cells and tissues","volume":"11","author":"Ali","year":"2025","journal-title":"J Imaging"},{"key":"10.1016\/j.array.2026.101168_bib40","doi-asserted-by":"crossref","DOI":"10.1016\/j.jconrel.2025.113722","article-title":"Sonopermeation combined with stroma normalization enables complete cure using nano-immunotherapy in murine breast tumors","volume":"382","author":"Neophytou","year":"2025","journal-title":"J Contr Release"},{"key":"10.1016\/j.array.2026.101168_bib41","series-title":"An image is worth 16x16 words: transformers for image recognition at scale","author":"Dosovitskiy","year":"2021"},{"key":"10.1016\/j.array.2026.101168_bib42","doi-asserted-by":"crossref","DOI":"10.1038\/srep46140","article-title":"Tranilast-induced stress alleviation in solid tumors improves the efficacy of chemo- and nanotherapeutics in a size-independent manner","volume":"7","author":"Papageorgis","year":"2017","journal-title":"Sci Rep"},{"key":"10.1016\/j.array.2026.101168_bib43","doi-asserted-by":"crossref","first-page":"449","DOI":"10.7863\/jum.2013.32.3.449","article-title":"Shear wave elastographic characterization of normal and torn achilles tendons: a pilot study","volume":"32","author":"Chen","year":"2013","journal-title":"J Ultrasound Med"},{"key":"10.1016\/j.array.2026.101168_bib44","doi-asserted-by":"crossref","first-page":"226","DOI":"10.14366\/usg.17025","article-title":"Accurate measurements of liver stiffness using shear wave elastography in children and young adults and the role of the stability index","volume":"37","author":"Hong","year":"2018","journal-title":"Ultrasonography"}],"container-title":["Array"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2590005626004911?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2590005626004911?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:14:52Z","timestamp":1792584892000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2590005626004911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":44,"alternative-id":["S2590005626004911"],"URL":"https:\/\/doi.org\/10.1016\/j.array.2026.101168","relation":{},"ISSN":["2590-0056"],"issn-type":[{"value":"2590-0056","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Multimodal transformers predict cancer therapy response from tumor mechanics","name":"articletitle","label":"Article Title"},{"value":"Array","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.array.2026.101168","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"101168"}}