CoxFormer enables spatial omics inference with multimodal generative modeling.

Gene co-expression maps transcriptome-wide gene-gene relationships, yet high-quality estimates cover less than half the genome. Meanwhile, spatial omics either profiles restricted in situ panels or lacks cellular resolution. Extending co-expression transcriptome-wide could overcome these limitations by inferring unassayed gene expression at subcellular resolution. Here we show that CoxFormer integrates literature-derived gene knowledge with co-expression networks from bulk tissues and large-scale single-cell atlases to learn 512-dimensional representations for 32,016 human genes. These embeddings capture functional gene relationships and serve as a generative prior for spatial inference across platforms and modalities. Without requiring a matched single-cell RNA-sequencing reference, CoxFormer supports four applications beyond measured genes: histology-based expression imputation, gene activity prediction from chromatin accessibility, subcellular super-resolution inference, and pathological region detection. Together, CoxFormer extends gene embedding from gene- and cell-level tasks to whole-transcriptome spatial inference, providing a unified framework for biological analysis beyond the limited gene coverage of current spatial omics technologies.