Abstract
Multi-omics strategies, integrating genomics, transcriptomics, proteomics, and metabolomics, have revolutionized biomarker discovery and enabled novel applications in personalized oncology. Despite rapid technological developments, a comprehensive synthesis addressing integration strategies, analytical workflows, and translational applications has been lacking. This review presents a comprehensive framework of multi-omics integration, encompassing workflows, analytical techniques, and computational tools for both horizontal and vertical integration strategies, with particular emphasis on machine learning and deep learning approaches for data interpretation. Recent applications of multi-omics have yielded promising biomarker panels at the single-molecule, multi-molecule, and cross-omics levels, supporting cancer diagnosis, prognosis, and therapeutic decision-making. However, major challenges persist, particularly in data heterogeneity, reproducibility, and the clinical validation of biomarkers across diverse patient populations. This review also highlights cutting-edge advances in single-cell multi-omics and spatial multi-omics technologies, which are expanding the scope of biomarker discovery and deepening our understanding of tumor heterogeneity. Finally, we discuss the integral role of multi-omics in personalized oncology, with a particular focus on predicting drug responses and optimizing individualized treatment strategies, supported by real-world clinical practice cases. By bridging technological innovations with translational applications, this review aims to provide a valuable resource for researchers and clinicians, offering insights into both current methodologies and future directions for implementing multi-omics data in biomarker discovery and personalized cancer care.