Abstract Precision medicine in cancer treatment depends on deciphering tumor phenotypes to reveal the underlying biological processes. Molecular profiles, including transcriptomics, provide an information-rich tumor view, but their high-dimensional features and assay costs can be prohibitive for clinical translation at scale. Recent studies have suggested jointly leveraging histology and genomics as a strategy for developing practical clinical biomarkers. Here, we use machine learning techniques to identify de novo latent transcriptional processes in squamous cell carcinomas (SCCs) and to accurately predict their activity levels directly from tumor histology images. In contrast to analyses focusing on pre-specified, individual genes or sample groups, our latent space analysis reveals sets of genes associated with both histologically detectable features and clinically relevant processes, including immune response, collagen remodeling, and fibrosis. The results demonstrate an approach for discovering clinically interpretable histological features that indicate complex, potentially treatment-informing biological processes.

Latent transcriptional programs reveal histology-encoded tumor features spanning tissue origins