Deciphering immune evasion mechanisms in precision oncology: insights from single-cell multiomics approaches

BACKGROUND: Cancer poses a persistent global health challenge, and one of its most formidable characteristics is the ability to evade immune detection. Understanding these immune evasion mechanisms is essential for improving therapeutic outcomes, especially in the era of personalized medicine. Recent advances in single-cell multiomics technologies have opened new avenues for exploring tumor-immune interactions at unprecedented resolution. OBJECTIVE: This review aims to critically examine how single-cell multiomics platforms, integrating genomics, transcriptomics, epigenomics, and proteomics, have been applied to identify immune evasion mechanisms in cancer and how these findings contribute to the development of precision oncology. METHODS: A structured literature search was conducted in PubMed, Scopus, and Web of Science, focusing on studies published between 2018 and 2025. Relevant research articles employing single-cell multiomics in the context of cancer immune evasion were selected, analyzed, and thematically organized according to the type of omics technology used and clinical relevance. RESULTS: The findings highlight that single-cell multiomics enables the detection of rare immune-resistant cellular subtypes, the identification of altered immunoregulatory pathways, and the characterization of epigenetic reprogramming events involved in immune escape. This integrative approach reveals dynamic and context-dependent mechanisms by which tumors adapt and resist immunotherapy. CONCLUSIONS: Single-cell multiomics technologies provide a comprehensive and nuanced understanding of cancer immune evasion. These insights not only explain failures in current immunotherapy strategies but also inform the development of more effective and personalized treatment interventions. The integration of these platforms into clinical research represents a significant step toward overcoming immune resistance in oncology.