Realizing the promise of machine learning in precision oncology: expert perspectives on opportunities and challenges

Abstract Background The ability of machine learning (ML) to process and learn from large quantities of heterogeneous patient data is gaining attention in the precision oncology community. Some remarkable developments have taken place in the domain of image classification tasks in areas such as digit...

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Main Authors: Vasileios Nittas, Kelly E. Ormond, Effy Vayena, Alessandro Blasimme
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Cancer
Subjects:
Online Access:https://doi.org/10.1186/s12885-025-13621-2
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author Vasileios Nittas
Kelly E. Ormond
Effy Vayena
Alessandro Blasimme
author_facet Vasileios Nittas
Kelly E. Ormond
Effy Vayena
Alessandro Blasimme
author_sort Vasileios Nittas
collection DOAJ
description Abstract Background The ability of machine learning (ML) to process and learn from large quantities of heterogeneous patient data is gaining attention in the precision oncology community. Some remarkable developments have taken place in the domain of image classification tasks in areas such as digital pathology and diagnostic radiology. The application of ML approaches to the analysis of DNA data, including tumor-derived genomic profiles, microRNAs, and cancer epigenetic signatures, while relatively more recent, has demonstrated some utility in identifying driver variants and molecular signatures with possible prognostic and therapeutic applications. Methods We conducted semi-structured interviews with academic and clinical experts to capture the status quo, challenges, opportunities, ethical implications, and future directions. Results Our participants agreed that machine learning in precision oncology is in infant stages, with clinical integration still rare. Overall, participants equated ongoing developments with better clinical workflows and improved treatment decisions for more cancer patients. They underscored the ability of machine learning to tackle the dynamic nature of cancer, break down the complexity of molecular data, and support decision-making. Our participants emphasized obstacles related to molecular data access, clinical utility, and guidelines. The availability of reliable and well-curated data to train and validate machine learning algorithms and integrate multiple data sources were described as constraints yet necessary for future clinical implementation. Frequently mentioned ethical challenges included privacy risks, equity, explainability, trust, and incidental findings, with privacy being the most polarizing. While participants recognized the issue of hype surrounding machine learning in precision oncology, they agreed that, in an assistive role, it represents the future of precision oncology. Conclusions Given the unique nature of medical AI, our findings highlight the field’s potential and remaining challenges. ML will continue to advance cancer research and provide opportunities for patient-centric, personalized, and efficient precision oncology. Yet, the field must move beyond hype and toward concrete efforts to overcome key obstacles, such as ensuring access to molecular data, establishing clinical utility, developing guidelines and regulations, and meaningfully addressing ethical challenges.
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spelling doaj-art-4ee30e74635c4c1abfb91c3982b28b512025-08-20T03:10:57ZengBMCBMC Cancer1471-24072025-02-0125111010.1186/s12885-025-13621-2Realizing the promise of machine learning in precision oncology: expert perspectives on opportunities and challengesVasileios Nittas0Kelly E. Ormond1Effy Vayena2Alessandro Blasimme3Epidemiology, Biostatistics and Prevention Institute, University of ZurichHealth Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich)Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich)Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich)Abstract Background The ability of machine learning (ML) to process and learn from large quantities of heterogeneous patient data is gaining attention in the precision oncology community. Some remarkable developments have taken place in the domain of image classification tasks in areas such as digital pathology and diagnostic radiology. The application of ML approaches to the analysis of DNA data, including tumor-derived genomic profiles, microRNAs, and cancer epigenetic signatures, while relatively more recent, has demonstrated some utility in identifying driver variants and molecular signatures with possible prognostic and therapeutic applications. Methods We conducted semi-structured interviews with academic and clinical experts to capture the status quo, challenges, opportunities, ethical implications, and future directions. Results Our participants agreed that machine learning in precision oncology is in infant stages, with clinical integration still rare. Overall, participants equated ongoing developments with better clinical workflows and improved treatment decisions for more cancer patients. They underscored the ability of machine learning to tackle the dynamic nature of cancer, break down the complexity of molecular data, and support decision-making. Our participants emphasized obstacles related to molecular data access, clinical utility, and guidelines. The availability of reliable and well-curated data to train and validate machine learning algorithms and integrate multiple data sources were described as constraints yet necessary for future clinical implementation. Frequently mentioned ethical challenges included privacy risks, equity, explainability, trust, and incidental findings, with privacy being the most polarizing. While participants recognized the issue of hype surrounding machine learning in precision oncology, they agreed that, in an assistive role, it represents the future of precision oncology. Conclusions Given the unique nature of medical AI, our findings highlight the field’s potential and remaining challenges. ML will continue to advance cancer research and provide opportunities for patient-centric, personalized, and efficient precision oncology. Yet, the field must move beyond hype and toward concrete efforts to overcome key obstacles, such as ensuring access to molecular data, establishing clinical utility, developing guidelines and regulations, and meaningfully addressing ethical challenges.https://doi.org/10.1186/s12885-025-13621-2Precision oncologyArtificial intelligenceMachine learningEthicsAlgorithmic biasBias
spellingShingle Vasileios Nittas
Kelly E. Ormond
Effy Vayena
Alessandro Blasimme
Realizing the promise of machine learning in precision oncology: expert perspectives on opportunities and challenges
BMC Cancer
Precision oncology
Artificial intelligence
Machine learning
Ethics
Algorithmic bias
Bias
title Realizing the promise of machine learning in precision oncology: expert perspectives on opportunities and challenges
title_full Realizing the promise of machine learning in precision oncology: expert perspectives on opportunities and challenges
title_fullStr Realizing the promise of machine learning in precision oncology: expert perspectives on opportunities and challenges
title_full_unstemmed Realizing the promise of machine learning in precision oncology: expert perspectives on opportunities and challenges
title_short Realizing the promise of machine learning in precision oncology: expert perspectives on opportunities and challenges
title_sort realizing the promise of machine learning in precision oncology expert perspectives on opportunities and challenges
topic Precision oncology
Artificial intelligence
Machine learning
Ethics
Algorithmic bias
Bias
url https://doi.org/10.1186/s12885-025-13621-2
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