The business of AI in oncology: Who’s building the platforms hospitals trust?

Artificial intelligence is no longer an experimental layer in oncology—it has become a core component of clinical decision support in cancer diagnosis, risk stratification, and personalized treatment. Companies like Tempus AI Inc. (NASDAQ: TEM), Guardant Health, Inc. (NASDAQ: GH), Freenome, and Paige.AI are now at the center of this transformation, developing data-rich platforms that are increasingly being trusted by hospitals, cancer centers, and integrated care networks around the world.

The surge in AI adoption across oncology reflects broader systemic pressures. With cancer cases projected to cross 30 million annually by 2030, health systems face rising costs, clinician burnout, and treatment delays. AI-powered solutions promise to relieve bottlenecks by automating time-intensive processes in diagnostics and enabling earlier, evidence-driven interventions. Importantly for investors and institutional stakeholders, these platforms are now not only clinically validated but also exhibiting strong commercial traction.

Why Are Hospitals Turning to AI Platforms for Cancer Care?

AI’s rising footprint in cancer care is tied to its value across three high-burden domains: diagnostic accuracy, workflow efficiency, and treatment personalization. Oncologists are increasingly being asked to make high-stakes decisions faster, with more data than ever before—from next-generation sequencing to radiology, histopathology, and real-world evidence. This is where decision support platforms like those built by Tempus and Guardant Health come in. By integrating patient genomics, imaging, and historical treatment data into one intelligent interface, these tools reduce time-to-treatment, standardize quality across clinicians, and unlock precision medicine pathways that would otherwise remain inaccessible. Industry analysts believe this trend will reshape how mid-sized hospitals and private cancer clinics operate, especially in markets like the U.S., UK, Japan, and India.

How Is Tempus AI (NASDAQ: TEM) Positioning Itself as a Market Leader?

Tempus AI Inc. (NASDAQ: TEM) is among the most advanced players in clinical-grade oncology AI. In Q1 FY25, Tempus posted $255.7 million in revenue, marking a 75.4% year-over-year increase, with its genomics division contributing $193.8 million, up 88.9% over Q1 FY24. Oncology testing revenue alone stood at $119 million, representing a 31% jump.

The Chicago-based company, co-founded by Eric Lefkofsky, is widely viewed as a hybrid between a precision diagnostics lab and an AI-enabled clinical insights engine. Its key product lines include xT for tumor profiling, xF for liquid biopsy, and AI-driven CDx modules used by major pharmaceutical partners to align treatment selection with biomarkers. Tempus’s platform is now embedded in thousands of oncologist workflows across the U.S., and its integration with EHR systems like Epic and Cerner enhances its utility in real-world hospital settings. Institutional sentiment remains bullish—post-IPO, several hedge funds including Tiger Global and Coatue have increased their holdings, citing Tempus’s revenue stickiness and payer acceptance.

Analysts expect continued topline expansion in FY25-FY26 as Tempus deepens pharma partnerships and expands its lab footprint across APAC and EMEA regions. Platform updates focused on AI explainability and trial-matching features are also expected by Q4 2025.

Why Is Guardant Health (NASDAQ: GH) Gaining Traction in Non-Invasive Testing?

Guardant Health, Inc. (NASDAQ: GH) has built one of the most trusted AI-enhanced liquid biopsy platforms in oncology diagnostics. The company’s core product, Guardant360, provides comprehensive genomic profiling from a simple blood draw, helping clinicians track tumor evolution, resistance mutations, and residual disease.

In Q1 FY25, Guardant posted $203.5 million in total revenue, up 21% from Q1 FY24. Oncology testing revenue reached $150.6 million, marking a 20% year-over-year increase, while test volumes rose by 25%, signaling both market adoption and provider confidence. Guardant’s screening product Shield, targeting early-stage colorectal cancer, is now FDA-approved and positioned for broader payer coverage in H2 2025.

The company’s AI infrastructure, built atop proprietary datasets of circulating tumor DNA and clinical outcomes, plays a critical role in interpreting complex mutation landscapes. Compared to traditional tissue biopsies, Guardant’s tools offer speed, safety, and longitudinal monitoring—traits highly valued in precision oncology trials. Analysts from JPMorgan and Baird reiterated ‘Overweight’ ratings post-Q1 results, citing test volume acceleration and the growing addressable market in pan-cancer screening.

What Is Freenome’s Edge in Early Cancer Detection?

While still privately held, Freenome is widely recognized as a future IPO candidate and a strong contender in multi-cancer early detection. The company uses a multiomics platform that combines cfDNA analysis, epigenetics, and protein signatures, interpreted via deep learning algorithms.

In early 2024, Freenome raised $254 million in a Series D+ funding round led by Roche Holding AG, bringing its total capital raised to over $800 million. These funds are earmarked for the advancement of its pivotal clinical trials and FDA submissions, especially around its flagship test for early colorectal cancer detection.

What sets Freenome apart is its long-term focus on primary care integration—building tests that can be deployed routinely and economically at the point of first contact. Unlike Tempus or Guardant, which are primarily oncology-specialist tools, Freenome aims to make AI-driven early detection a population health strategy. Industry observers expect Freenome to file for FDA approval by late 2025 and pursue a U.S. listing in early-to-mid 2026. Its valuation, currently estimated between $2.1 and $2.4 billion, is expected to grow as commercial traction becomes visible.

How Is Paige.AI Powering the Future of Digital Pathology?

Paige, based in New York City, is pioneering the application of computer vision and deep learning in computational pathology. The company’s platform assists pathologists in interpreting whole-slide images of tissue biopsies, with a focus on prostate, breast, and lung cancers.

As of May 2025, Paige has raised approximately $239 million, with investors including Johnson & Johnson Innovation, Casdin Capital, and Breyer Capital. It reported $15 million in FY24 revenue, with hospital deployments growing steadily across U.S. academic centers and EU institutions. The strength of Paige’s business model lies in its ability to deliver AI-as-a-service directly into digital pathology infrastructure, allowing smaller labs and rural hospitals to match the diagnostic accuracy of top-tier institutions.

Paige was the first company to receive FDA approval for an AI-based pathology product and continues to lead in building explainable and clinically validated AI modules. Additional CE-IVDR compliant product launches are expected in Q3 2025, including breast cancer-specific models tailored to EU regulatory pathways.

What Is the Market Outlook for AI in Oncology Platforms?

The global AI in oncology market is forecast to grow at a compound annual growth rate of 29.4%, reaching approximately $11.52 billion by 2030, according to recent estimates from MarketsandMarkets and Signify Research. This growth is being driven by the increasing demand for data-driven treatment personalization, growing shortages of oncologists and pathologists globally, regulatory approvals of AI-enabled clinical decision support systems, and rising venture capital inflows into oncology-focused AI startups, which exceeded $3.2 billion globally in 2024.

Strategically, platform players that combine real-world evidence, payer integration, and regulatory credibility are expected to emerge as category leaders. The oncology segment is also drawing interest from larger cloud providers such as Google Cloud—via its existing partnership with Tempus—and Amazon HealthLake, which are offering cloud-native data infrastructure tailored for large-scale hospital deployments.

What Are Investors Watching Next?

Institutional investors are closely tracking a number of developments across the oncology AI space. Tempus is expected to roll out new features in predictive analytics and real-time clinical trial matching by Q4 2025. Guardant Health’s Shield 2.0 is currently undergoing regulatory review, with expanded FDA indications and reimbursement policy updates expected to drive further oncology revenue in 2026. Freenome is nearing a critical milestone with its pivotal trial readouts and is likely to seek either a dual-track IPO or acquisition by a strategic diagnostics player. Paige is finalizing key partnerships with European pathology networks, potentially boosting its international revenue contribution in FY26.

Analysts broadly agree that AI-native oncology firms with regulatory approvals, health system integrations, and pharma-aligned companion diagnostics are best positioned for sustained growth. Mergers and acquisitions may also accelerate in 2026 as larger diagnostics conglomerates seek to acquire embedded AI capabilities across imaging, pathology, and blood-based testing.