France-based biotech endogene.bio has published research suggesting that endometriosis is molecularly heterogeneous across patients, lesion sites, and cell types – a finding that could help explain why patients often experience different outcomes with the same therapy.
The preprint, titled “Beyond one-size-fits-all: single-cell transcriptomic signatures predict drug efficacy and reveal responder subgroups in endometriosis,” combines single-cell RNA sequencing with a computational drug-response framework to identify distinct cellular response patterns that may predict which therapies are most likely to work for specific patient groups.
The researchers analyzed single-cell datasets from eutopic endometrium and endometriotic lesions, identifying disease-associated molecular mechanisms concentrated in stromal, endothelial, and stem-like cell populations. The model predicts which therapeutic mechanisms may counter these disease states and identifies responder subgroups.
“Endometriosis is currently classified based on symptoms and anatomical or surgical features, but these approaches don’t capture the biological programs active inside the tissue,” said Dr. Cristina Fernández Molina, co-founder and Head of Science at endogene.bio. “Our work shows that what looks like unpredictable variability between patients actually reflects recurring cellular states that shape how the disease behaves and responds to treatment. This creates an opportunity to move toward more biologically informed patient stratification in research and clinical trials.”
The company draws parallels to the shift in breast cancer treatment, which moved from a single-disease approach to recognizing HER2-positive, hormone-receptor-positive, and triple-negative subtypes as fundamentally different diseases.
A notable finding is that drug response–associated signatures identified in lesion stromal cells are also detectable in eutopic endometrial stromal cells, which are shed during menstruation. This raises the prospect of using menstrual blood sampling for non-invasive patient stratification and monitoring, avoiding the need for surgical tissue collection.
The preprint follows an earlier study published in July 2025 demonstrating the potential of menstrual-blood-derived methylation signatures as a non-invasive diagnostic tool for endometriosis.
Endogene.bio, founded in 2022, is a precision medicine company developing molecular biomarkers using menstrual blood.
