# Multi-FRuGaL: Multimodal Flexible Redundancy-aware Decomposed Gated Learning for Cancer Diagnosis and Prognosis

arXiv: https://arxiv.org/abs/2606.06867 · HTML: https://mlsanity.com/paper/2606.06867/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 35 of its 75 references that are in the map.
- First posted on arXiv 5 Jun 2026.

## Builds on (most cited first, 30 of 35)

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- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [The Concrete Distribution: A Continuous Relaxation of Discrete Random Variables](https://mlsanity.com/paper/1611.00712/) (2016)
- [Multimodal Transformer for Unaligned Multimodal Language Sequences](https://mlsanity.com/paper/1906.00295/) (2019)
- [Can Spatiotemporal 3D CNNs Retrace the History of 2D CNNs and ImageNet?](https://mlsanity.com/paper/1711.09577/) (2017)
- [Pathomic Fusion: An Integrated Framework for Fusing Histopathology and Genomic Features for Cancer Diagnosis and Prognosis](https://mlsanity.com/paper/1912.08937/) (2019)
- [Deep neural network models for computational histopathology: A survey](https://mlsanity.com/paper/1912.12378/) (2019)
- [Virchow2: Scaling Self-Supervised Mixed Magnification Models in Pathology](https://mlsanity.com/paper/2408.00738/) (2024)
- [Self supervised contrastive learning for digital histopathology](https://mlsanity.com/paper/2011.13971/) (2020)
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- [ClearSight: Visual Signal Enhancement for Object Hallucination Mitigation in Multimodal Large language Models](https://mlsanity.com/paper/2503.13107/) (2025)
- [Deep Multi-modal Fusion of Image and Non-image Data in Disease Diagnosis and Prognosis: A Review](https://mlsanity.com/paper/2203.15588/) (2022)
- [Vision-Language Gradient Descent-driven All-in-One Deep Unfolding Networks](https://mlsanity.com/paper/2503.16930/) (2025)
- [On the Benefits of Early Fusion in Multimodal Representation Learning](https://mlsanity.com/paper/2011.07191/) (2020)
- [A Systematic Review of Intermediate Fusion in Multimodal Deep Learning for Biomedical Applications](https://mlsanity.com/paper/2408.02686/) (2024)
- [COSMOS: Cross-Modality Self-Distillation for Vision Language Pre-training](https://mlsanity.com/paper/2412.01814/) (2024)
- [MIMO: A medical vision language model with visual referring multimodal input and pixel grounding multimodal output](https://mlsanity.com/paper/2510.10011/) (2025)
- [STiL: Semi-supervised Tabular-Image Learning for Comprehensive Task-Relevant Information Exploration in Multimodal Classification](https://mlsanity.com/paper/2503.06277/) (2025)
- [LANISTR: Multimodal Learning from Structured and Unstructured Data](https://mlsanity.com/paper/2305.16556/) (2023)
- [Distilled Prompt Learning for Incomplete Multimodal Survival Prediction](https://mlsanity.com/paper/2503.01653/) (2025)
- [Missing-modality Enabled Multi-modal Fusion Architecture for Medical Data](https://mlsanity.com/paper/2309.15529/) (2023)
- [CustOmics: A versatile deep-learning based strategy for multi-omics integration](https://mlsanity.com/paper/2209.05485/) (2022)
- [HoneyBee: A Scalable Modular Framework for Creating Multimodal Oncology Datasets with Foundational Embedding Models](https://mlsanity.com/paper/2405.07460/) (2024)
- [Asynchronous Events-based Panoptic Segmentation using Graph Mixer Neural Network](https://mlsanity.com/paper/2305.03640/) (2023)

## Abstract (arXiv)

Modern medicine relies on heterogeneous data sources spanning radiology, pathology, text reports, and structured clinical information. However, real-world patient data are frequently incomplete, with missing or sparsely acquired modalities, limiting the effectiveness of standard multimodal fusion approaches. To this end, we propose the Multimodal Flexible Redundancy-aware decomposed GAted Learning (Multi-FRuGaL) framework, a decomposition-aware, adaptive gated intermediate-fusion framework that performs modality-level representation learning under missing data. Multi-FRuGaL integrates per-modality encoders with a signal decomposition layer, an input-conditioned gating network, and an information-aware fusion objective to separate redundant from modality-specific complementary signals, selectively upweighting informative modalities and suppressing redundant or noisy inputs, and remaining well-defined even when multiple modalities are absent. We evaluate Multi-FRuGaL on two multimodal head and neck cancer cohorts: the HANCOCK challenge dataset (N = 763) comprising five modalities and two prognostic endpoints (5-year survival and 2-year recurrence), and the HECKTOR challenge dataset (N = 588) comprising three modalities for human papillomavirus (HPV) status classification. Multi-FRuGaL consistently achieves higher mean performance than the evaluated baselines across multiple tasks, improving AUC from 0.601 to 0.8496 for survival, from 0.672 to 0.8102 for recurrence, and achieving 0.975 AUC for HPV prediction on HECKTOR. For survival analysis, it further achieves a concordance index of 0.6814 for overall survival, 0.7421 for recurrence-free survival, and 0.7143 for progression-free survival on HANCOCK, and 0.7203 for recurrence-free survival on HECKTOR. Qualitative analyses further show that Multi-FRuGaL learns discriminative and robust multimodal representations, even under severe missing-modality conditions.