Abstract
Pathology is fundamental to precision oncology, offering molecular and morphologic insights that enable personalized diagnosis and treatment. Recently, deep learning has demonstrated substantial potential in digital pathology, effectively addressing a wide range of diagnostic, prognostic, and biomarker-prediction tasks. Although early approaches based on convolutional neural networks had limited capacity to generalize across tasks and datasets, transformer-based foundation models have substantially advanced the field by enabling scalable representation learning, enhancing cross-cohort robustness, and supporting few- and even zero-shot inference across a wide range of pathology applications. Furthermore, the ability of foundation models to integrate heterogeneous data within a unified processing framework broadens the possibility of developing more generalizable models for medicine. These multimodal foundation models can accelerate the advancement of pathology-based precision oncology by enabling coherent interpretation of histopathology together with radiology, clinical text, and molecular data, thereby supporting more accurate diagnosis, prognostication, and therapeutic decision-making. In this review, we provide a concise overview of these advances and examine how foundation models are driving the ongoing evolution of pathology-based precision oncology.