Publications
& writing

Natangelo S.

Externalizing Epistemic Governance from Stateless Clinical LLMs: Why It Is Necessary and Why It Must Be Constrained

Philosophy & Technology

Single author

A constrained architecture for oncology decision support that separates evidence authority from permission and reimbursement, keeping uncertainty and clinical overrides inspectable.

Publication date pending.

Earlier public version: Toward an Audit-Ready, Constraint-Based Architecture for Oncology Clinical Decision Support with Large Language Models

Natangelo S.

More papers, fewer ideas: How evaluation asymmetries drive scientific convergence

Journal of Scholarly Publishing

Single author

Publication date pending. Linked version: SocArXiv preprint.

Corso F, Peppoloni V, Mazzeo L, et al.

Clinician expertise and prompt engineering enhance cancer information extraction in electronic health records by small language models

Communications Medicine

Co-author

44 authors; Corso, Peppoloni and Mazzeo contributed equally.

Prelaj A, Miskovic V, Sacco M, et al.; I3LUNG Consortium.

Clinical usability of an explainable AI decision support tool and evaluation of multimodal models in NSCLC

Nature Medicine

Consortium author

Cascella M, Granata V, Fusco R, Simonetti I, Porto A, Di Monaco P, Natangelo S, et al.

Artificial intelligence-assisted Mendelian randomization: a methodological framework for causal inference with applications in oncology

Infectious Agents and Cancer

Co-author

Beninato T, Stasi G, Montelatici G, et al.

Composite clinical scores in real-world extensive-stage small-cell lung cancer patients treated with chemo-immunotherapy

Tumori Journal

Co-author

Ciardiello D, Boscolo Bielo L, Pietrantonio F, et al.

Comprehensive genomic profiling by liquid biopsy in refractory metastatic colorectal cancer patients candidate for anti-EGFR rechallenge therapy (CAVE-2 GOIM trial)

ESMO Open

Co-author

Contribution: eCRF clinical data management.

Natangelo S, Trapani D, Koukoutzeli C, et al.

Radiation therapy, tissue radiosensitization, and potential synergism in the era of novel antibody–drug conjugates

Critical Reviews in Oncology/Hematology

First author

Boscolo Bielo L, Natangelo S, Katrini J, Trapani D, Curigliano G.

A comprehensive update of hormone-related pharmacokinetic variations associated with breast cancer drugs

Expert Opinion on Drug Metabolism & Toxicology

Co-first author

Meazza Prina M, Mazzeo L, Occhipinti M, et al.

Transformation of non-small cell lung cancer into small cell lung cancer: a systematic review with exploratory analysis

Clinical Lung Cancer

Co-author

AI-ON-LAB research group; Stefano Natangelo, first author.

The Preservation Gap: The NAT-Clinical Framework for Governing Clinical Large Language Models Across Updates

ESMO AI & Digital Oncology Congress, Berlin

First and presenting author

Abstract #460. ESMO Merit Award. Based on Continuity Is All You Need: Why Clinical AI Governance Requires Structural Persistence.

Montelatici G, Gronchi G, Brambilla M, et al.

Role of the pan-immune-inflammatory value in stage III NSCLC treated with chemoradiotherapy with or without durvalumab (305P)

ESMO Open

Co-author

Lorenzini D, Busico A, Barbetta F, et al.

Molecular landscape of BRCA-mutated NSCLC (512P)

ESMO Open

Co-author

Peppoloni V, Leone G, Mazzeo L, et al.

LungTrial-LLMX: An explainable on-premises LLM system for clinical trial matching in lung cancer

ESMO Real World Data and Digital Oncology

Co-author

Corso F, Mazzeo L, Peppoloni V, et al.

Comprehensive benchmarking of large language models on oncological records reveals variations to prompt engineering and medical expertise

Annals of Oncology · ESMO Congress

Co-author

Rota S, Serino R, Ambrosini P, et al.

Assessing first-line immunotherapy duration in advanced NSCLC

Journal of Thoracic Oncology · ELCC

Co-author

Natangelo S.

The bias is in the eye of the beholder: an epistemological reframing of LLM fairness research

Zenodo

Single author

Distinguishes individual outputs, conditional behaviour and system-level claims, proposing robustness checks for evaluating claims about LLM bias.

Under review at Discover Artificial Intelligence.

Natangelo S.

The Unevaluable Device: Why Standard Evaluation Methods Are Structurally Inadequate for Clinical Large Language Models

Zenodo

Single author

Examines how non-reproducibility, opacity, unrestricted behaviour and global plasticity challenge the assumptions of clinical AI evaluation.

Natangelo S.

Nobody’s Fault: Where Liability Collapses in Clinical LLM Deployment

SSRN

Single author

Examines how clinical LLM architecture complicates causal attribution and the allocation of responsibility across deployment chains.

SSRN abstract 6819179.

Natangelo S.

Continuity Is All You Need: Why Clinical AI Governance Requires Structural Persistence

Zenodo

Single author

Proposes a preservation requirement and a risk–verifiability model for governing validated clinical AI properties across interactions and updates.

Natangelo S.

Externalising Epistemic Governance for Stateless Large Language Models: The CUL/TCL Architecture

Zenodo

Single author

A two-layer architecture that determines verification requirements and assigns evidence-based truth states before language generation.

Natangelo S.

The Narrative Continuity Test: A Conceptual Framework for Evaluating Identity Persistence in AI Systems

arXiv

Single author

A conceptual framework for assessing whether an AI system preserves memory, goals, self-correction, semantic stability and role continuity over time.

In revision at AI & Ethics.

Natangelo S.

Commentary on the ESMO Guidance for LLM Use in Oncology: Narrative and Process Divergences

Zenodo

Single author

Originally submitted to Annals of Oncology.

Natangelo S.

Artificial intelligence in oncologic pathology: lessons from radiomics and the challenges of responsibility and accountability

Zenodo

Single author

Originally submitted to Annals of Oncology.

Natangelo S.

When Commercial Influence Enters the Answer

JAMA

Single author

In response to: Singh N, Mello MM. Advertising in AI-Powered Clinical Decision Support Tools. The link opens the original article; its DOI is not a DOI for this response.

Natangelo S.

“What comes next” is the wrong question: we should ask first whether trials, oversight, and monitoring work for clinical LLMs

Science

Single author

In response to: Hopkins AM, Cornelisse E. AI can reason like a physician—what comes next? The link opens the original article; its DOI is not a DOI for this response.

Natangelo S.

When the Reference Cannot Hesitate: A Note on Metacognitive Feedback in AI-Augmented Training

JAMA

Single author

In response to: Keren R, Desai BR, West DC. Promoting Clinical Expertise in the Age of AI: No Struggle, No Mastery. The link opens the original article; its DOI is not a DOI for this response.

Natangelo S.

Beyond regulatory evasion: clinical LLMs are unevaluable by design

JAMA

Single author

In response to: Aaron DG, Robertson C. The First AI Drug Prescriber. The link opens the original article; its DOI is not a DOI for this response.

Natangelo S.

From cytotoxic intensification to “living” viral sentinels in metastatic PDAC

BMJ Open

Single author

In response to: Portales F, Gourgou S, Fiess C, et al. GABRINOX-2 protocol: a French, prospective, multicentre, randomised phase II trial evaluating gemcitabine/nab-paclitaxel followed by FOLFIRINOX versus FOLFIRINOX alone as first-line treatment for metastatic pancreatic cancer. The link opens the original article; its DOI is not a DOI for this response.

The Editors of the Journal of Secondary Endpoints

Accept in Current Form

Journal of Secondary Endpoints

Editorial signed as “Editors”

2(1):25–26. Published in an independent journal of scientific satire and research culture.

Natangelo S.

Cumulative Sanctity: A Multinational Multidenominational Protocol for Assessing Lifetime Liturgical Incense Exposure and Respiratory Carcinogenesis Across Religious Career Trajectories

Journal of Secondary Endpoints

Single author

2(1):27–42. Published in an independent journal of scientific satire and research culture.

Natangelo S.

Requiem in LaL Major: A Systematic Review of the Death of Large Language Models

Journal of Secondary Endpoints

Single author

2(1):43–50. Published in an independent journal of scientific satire and research culture.

Natangelo S.

Anti-Germination Stereotactic Radiosurgery in Solanum tuberosum: A Phase 0 Feasibility Study

Journal of Secondary Endpoints

Single author

2(1):51–58. Published in an independent journal of scientific satire and research culture.

Natangelo S.

Divide et Impera: When Will Peer Review Become Modular and Accountable?

Journal of Secondary Endpoints

Single author

2(1):59–67. Published in an independent journal of scientific satire and research culture.

The Editors of the Journal of Secondary Endpoints

Editorial: How We Addressed the Main Unmet Need in the Medical Literature

Journal of Secondary Endpoints

Editorial signed as “Editors”

1(1):1–2. Published in an independent journal of scientific satire and research culture.

Natangelo S.

Therapeutic turricephaly for glioblastoma: randomised sham-controlled trial (XXL-GBM)

Journal of Secondary Endpoints

Single author

1(1):3–8. Published in an independent journal of scientific satire and research culture.

Natangelo S.

A Phase I, Randomized, Double-Blind, Vehicle-Controlled Trial of Virulence-Attenuated Pseudomonas aeruginosa (P.a-Mel) for the Ecological Displacement of Axillary Microbiota: Data on Results, Impact, Safety, and Exploratory Outcomes (The DEODORISE Trial)

Journal of Secondary Endpoints

Single author

1(1):9–14. Published in an independent journal of scientific satire and research culture.

Natangelo S.

Exsudatio urinosa: the man who never passed urine

Journal of Secondary Endpoints

Single author

1(1):15–20. Published in an independent journal of scientific satire and research culture.

Natangelo S.

The Outcome-Equity Mandate: A Satirical Policy Paper on Publication Bias

Journal of Secondary Endpoints

Single author

1(1):21–24. Published in an independent journal of scientific satire and research culture.