Multiomics in Precision Oncology: Emerging Diagnostic Modalities and Translation from Bench to Bedside

Cancer precision medicine is moving beyond static, single-analyte profiling toward a dynamic view of tumour biology and treatment response. A multiomics approach, integrating genomic, transcriptomic, proteomic, metabolomic, and epigenomic information, offers a more comprehensive framework for understanding tumour heterogeneity and therapeutic vulnerability. This review examines the emerging landscape of clinically available, translational, and experimental approaches, spanning commercially available platforms such as CureResponse and Exacta, single-cell and spatial technologies, AI-assisted plasma multiomics, and functional platforms including BH3 profiling and patient-derived organoid drug screening. We also discuss longitudinal liquid biopsy approaches for minimal residual disease assessment and recurrence monitoring. Together, these technologies may extend conventional biopsy by enabling increasingly multidimensional, spatially resolved, and longitudinal assessment of cancer. However, their clinical implementation remains limited by challenges in analytical standardisation, data integration, biological interpretation, validation, and demonstrated clinical utility. The convergence of multiomics, single-cell and spatial profiling, artificial intelligence, and functional testing is therefore reshaping precision oncology, from describing what a tumour is to predicting how it may behave and respond to treatment.