Title: SoC-DT: Standard-of-Care Aligned Digital Twins for Patient-Specific Tumor Dynamics
Primary area: other topics in machine learning (i.e., none of the above)
Keywords: Digital Twins, Medical Image Analysis, Tumor

Abstract: Accurate prediction of tumor trajectories under standard-of-care (SoC) therapies remains a major unmet need in oncology. This capability is essential for optimizing treatment planning and anticipating disease progression. Conventional reaction–diffusion models are limited in scope, as they fail to capture tumor dynamics under heterogeneous therapeutic paradigms. There is hence a critical need for computational frameworks that can realistically simulate SoC interventions while accounting for inter-patient variability in genomics, demographics, and treatment regimens. We introduce Standard-of-Care Digital Twin (SoC-DT), a differentiable framework that unifies reaction–diffusion tumor growth models, discrete SoC interventions (surgery, chemotherapy, radiotherapy) along with genomic and demographic personalization to predict post-treatment tumor structure on imaging. An implicit-explicit exponential time-differencing solver, IMEX-SoC, is also proposed, which ensures stability, positivity, and scalability in SoC treatment situations. Evaluated on both synthetic data and real world glioma data, SoC-DT consistently outperforms classical PDE baselines and purely data-driven neural models in predicting tumor dynamics. By bridging mechanistic interpretability with modern differentiable solvers, SoC-DT establishes a principled foundation for patient-specific digital twins in oncology, enabling biologically consistent tumor dynamics estimation. Code will be made available upon acceptance.