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


Authors: Ferber, D.; El Nahhas, O. S. M.; Wölflein, G.; Wiest, I. C.; Clusmann, J.; Leßmann, M. E.; Foersch, S.; Lammert, J.; Tschochohei, M.; Jäger, D.; Salto-Tellez, M.; Schultz, N.; Truhn, D.; Kather, J. N.
Article Title: Development and validation of an autonomous artificial intelligence agent for clinical decision-making in oncology
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. © The Author(s) 2025.
Journal Title: Nature Cancer
Volume: 6
Issue: 8
ISSN: 2662-1347
Publisher: Nature Research  
Publication status: Published
Date Published: 2025-08-01
Start Page: 1337
End Page: 1349
Language: English
DOI: 10.1038/s43018-025-00991-6
PROVIDER: scopus
PMCID: PMC12380607
PUBMED: 40481323
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Nikolaus D Schultz
    492 Schultz