Artificial Intelligence in Ovarian Cancer: A Systematic Review and Meta-Analysis of Predictive AI Models in Genomics, Radiomics, and Immunotherapy
Background/Objectives: Artificial intelligence (AI) is increasingly influencing oncological research by enabling precision medicine in ovarian cancer through enhanced prediction of therapy response and patient stratification. This systematic review and meta-analysis was conducted to assess the performance of AI-driven models across three key domains: genomics and molecular profiling, radiomics-based imaging analysis, and prediction of immunotherapy response. Methods: Relevant studies were identified through a systematic search across multiple databases (2020–2025), adhering to PRISMA guidelines. Results: Thirteen studies met the inclusion criteria, involving over 10,000 ovarian cancer patients and encompassing diverse AI models such as machine learning classifiers and deep learning architectures. Pooled AUCs indicated strong predictive performance for genomics-based (0.78), radiomics-based (0.88), and immunotherapy-based (0.77) models. Notably, radiogenomics-based AI integrating imaging and molecular data yielded the highest accuracy (AUC = 0.975), highlighting the potential of multi-modal approaches. Heterogeneity and risk of bias were assessed, and evidence certainty was graded. Conclusions: Overall, AI demonstrated promise in predicting therapeutic outcomes in ovarian cancer, with radiomics and integrated radiogenomics emerging as leading strategies. Future efforts should prioritize explainability, prospective multi-center validation, and integration of immune and spatial transcriptomic data to support clinical implementation and individualized treatment strategies. Unlike earlier reviews, this study synthesizes a broader range of AI applications in ovarian cancer and provides pooled performance metrics across diverse models. It examines the methodological soundness of the selected studies and highlights current gaps and opportunities for clinical translation, offering a comprehensive and forward-looking perspective in the field.