I-Enabled Digital Biomarkers for Precision Cancer Diagnosis, Prognosis, and Therapeutic Monitoring

Abstract

Cancer remains one of the leading causes of morbidity and mortality worldwide despite remarkable advances in molecular diagnostics, targeted therapeutics, immunotherapy, and precision medicine. The rapid expansion of digital health technologies, medical imaging, wearable biosensors, digital pathology, genomic sequencing, electronic health records, and mobile health platforms has introduced a new generation of digital biomarkers capable of continuously characterizing disease biology and patient health. Artificial intelligence (AI) has emerged as the primary computational engine for transforming these heterogeneous digital data streams into clinically actionable biomarkers that support early diagnosis, prognostic prediction, therapeutic optimization, treatment response assessment, toxicity monitoring, and long-term survivorship care. Machine learning, deep learning, transformer architectures, graph neural networks, multimodal foundation models, self-supervised learning, digital twins, and generative AI now enable integration of radiological imaging, computational pathology, multi-omics, physiological monitoring, laboratory biomarkers, wearable devices, and longitudinal clinical records into unified patient-specific computational models. AI-enabled digital biomarkers have demonstrated growing utility across cancer screening, radiogenomics, immunotherapy prediction, adaptive treatment planning, clinical decision support, and real-time disease monitoring. Nevertheless, important challenges remain regarding biomarker validation, standardization, explainability, interoperability, regulatory approval, cybersecurity, ethical governance, and equitable implementation. This review provides a comprehensive overview of AI-enabled digital biomarkers in oncology, highlighting computational principles, clinical applications, implementation challenges, and future perspectives for precision cancer diagnosis, prognosis, and therapeutic monitoring.[1]