Evidence map›Paper›PMID 40481323›Full record

ArticleNature cancer2025

Development and validation of an autonomous artificial intelligence agent for clinical decision-making in oncology.

Dyke Ferber, Omar S M El Nahhas, Georg Wölflein, Isabella C Wiest, Jan Clusmann, Marie-Elisabeth Leßmann, Sebastian Foersch, Jacqueline Lammert, Maximilian Tschochohei, Dirk Jäger and 4 more

Abstract readValidation Study
In one paragraph

Article in Nature cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

93 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
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  6. Review
  7. AI agents in cancer imaging: Concepts, advances, and clinical perspectives.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2026
    Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Review
  13. Capacity of Understanding the Future Approaches in Cancer Treatment by Multiple Models of Artificial Intelligence.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026
    Article
  14. Review
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. A comprehensive survey of AI agents in healthcare.Journal of biomedical informatics · 2026
    Review

33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Dyke FerberDepartment of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany.
Omar S M El NahhasElse Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany.
Georg WölfleinSchool of Computer Science, University of St Andrews, St Andrews, UK.
Isabella C WiestElse Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany.
Jan ClusmannElse Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany.
Marie-Elisabeth LeßmannElse Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany.
Sebastian FoerschInstitute of Pathology, University Medical Center Mainz, Mainz, Germany.
Jacqueline LammertDepartment of Gynecology and Center for Hereditary Breast and Ovarian Cancer, University Hospital rechts der Isar, Technical University of Munich (TUM), Munich, Germany.
Maximilian TschochoheiGoogle Cloud, Munich, Germany.
Dirk JägerDepartment of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany.ORCID http://orcid.org/0000-0002-1276-7802
Manuel Salto-TellezIntegrated Pathology Unit, Institute for Cancer Research and Royal Marsden Hospital, London, UK.
Nikolaus SchultzDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.ORCID http://orcid.org/0000-0002-0131-4904
Daniel TruhnDepartment of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany.ORCID http://orcid.org/0000-0002-9605-0728
Jakob Nikolas KatherDepartment of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany. jakob-nikolas.kather@alumni.dkfz.de.ORCID http://orcid.org/0000-0002-3730-5348

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

Clinical decision-making in oncology is complex, requiring the integration of multimodal data and multidomain expertise. We developed and evaluated an autonomous clinical artificial intelligence (AI) agent leveraging GPT-4 with multimodal precision oncology tools to support personalized clinical decision-making. The system incorporates vision transformers for detecting microsatellite instability and KRAS and BRAF mutations from histopathology slides, MedSAM for radiological image segmentation and web-based search tools such as OncoKB, PubMed and Google. Evaluated on 20 realistic multimodal patient cases, the AI agent autonomously used appropriate tools with 87.5% accuracy, reached correct clinical conclusions in 91.0% of cases and accurately cited relevant oncology guidelines 75.5% of the time. Compared to GPT-4 alone, the integrated AI agent drastically improved decision-making accuracy from 30.3% to 87.2%. These findings demonstrate that integrating language models with precision oncology and search tools substantially enhances clinical accuracy, establishing a robust foundation for deploying AI-driven personalized oncology support systems.

Indexed as

Artificial IntelligenceClinical Decision-MakingMedical OncologyNeoplasmsDecision Support Systems, ClinicalHumansMicrosatellite InstabilityMutationPrecision MedicineProto-Oncogene Proteins B-rafProto-Oncogene Proteins p21(ras)BRAF protein, humanKRAS protein, humanProto-Oncogene Proteins B-rafProto-Oncogene Proteins p21(ras)

Identifiers

PMID40481323
PMCPMC12380607

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.