Artificial intelligence in oncology: current applications and future perspectives | British Journal of Cancer – Nature.com

Artificial intelligence in oncology: current applications and future perspectives | British Journal of Cancer – Nature.com

In this paper, a comprehensive overview on current applications of AI in oncology-related areas is provided, specifically describing the AI-based devices that have already obtained the official approval to enter into clinical practice. Starting from its birth, AI demonstrated its cross-cutting importance in all scientific branches, showing an impressive growth potential for the future. As highlighted in this study, this growth has interested also oncology and related specialties.

In general, the application of the FDA-approved devices has not been conceived as a substitute of classical analysis/diagnostic workflow, but is intended as an integrative tool, to be used in selected cases, potentially representing the decisive step for improving the management of cancer patients. Currently, in this field, the branches where AI is gaining a larger impact are represented by the diagnostic areas, which count for the vast majority of the approved devices (>80%), and in particular radiology and pathology.

Cancer diagnostics classically represents the necessary point of start for designing appropriate therapeutic approaches and clinical management, and its AI-based refining represents a very important achievement. Furthermore, this indicates that future developments of AI should also consider unexplored but pivotal horizons in this landscape, including drug discovery, therapy administration and follow-up strategies. In our opinion, for determining a decisive improvement in the management of cancer patients, indeed, the growth of AI should follow comprehensive and multidisciplinary patterns. This represents one of the most important opportunities provided by AI, which will allow the correct interactions and integration of oncology-related areas on a specific patient, rendering possible the challenging purposes of personalised medicine.

The specific cancer types that now are experiencing more advantages from AI-based devices in clinical practice are first of all breast cancer, lung cancer and prostate cancer. This should be seen as the direct reflection of their higher incidence compared with other tumour types, but in the future, additional tumour types should be taken into account, including rare tumours that still suffer from the lack of standardised approaches. Since AI is based on the collection and analysis of large datasets of cases, however, the improvement in the treatment of rare neoplasms will likely represent a late achievement. Notably, if together considered, rare tumours are one of the most important category in precision oncology [11]. Thus, in our opinion, ongoing strategies of AI development cannot ignore this tumour group; although the potential benefits seem far away, it is already time to start collecting data on rare neoplasms.

One of the most promising expectancy for AI is the possibility to integrate different and composite data derived from multi-omics approaches to oncologic patients. The promising tools of AI could be the only able to manage the big amount of data from different types of analysis, including information derived from DNA and RNA sequencing. Along this line, the recent release of American College of Medical Genetics standards and guidelines for the interpretation of the sequence variants [12] has fostered a new wave of AI development, with innovative opportunities in precision oncology (https://www.businesswire.com/news/home/20190401005976/en/Fabric-Genomics-Announces-AI-based-ACMG-Classification-Solution-for-Genetic-Testing-with-Hereditary-Panels; last access 09/21/2021). In our opinion, however, the lack of ground-truth information derived from protected health- data repositories still represents a bottleneck in evaluating the accuracy of AI applications for clinical decision-making.

Overall considered, AI is providing a growing impact to all scientific branches, including oncology and its related fields, as highlighted in this study. For designing new development strategies with concrete impacts, the first steps are representing by knowing its historical background and understanding its current achievements. As here highlighted, AI is already entered into the oncologic clinical practice, but continuous and increasing efforts should be warranted to allow AI expressing its entire potential. In our opinion, the creation of multidisciplinary/integrative developmental views, the immediate comprehension of the importance of all neoplasms, including rare tumours and the continuous support for guaranteeing its growth represent in this time the most important challenges for finalising the ‘AI-revolution’ in oncology.

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