Now in early access · Patent Pending

Patients deserve a plan made just for them.
We’ve done just that.

OncologyReasoning puts tumor-board reasoning in the palm of your hand. It reasons over a patient’s entire longitudinal record — every prior line, the genomics, the labs, the full course — and builds a patient-specific treatment plan in minutes. No AI, no black box: it’s deterministic, and every claim traces to its source.

Multi-source evidenceHIPAA-readyGenomics-nativeTumor-board-ready
CASE RepresentativeEngine output
58 F · metastatic NSCLC · adenocarcinoma
ECOG 1 · 1L osimertinib, 18 mo → multifocal progression
Molecular profile
EGFR Ex19delBRAF V600E · acquiredTP53✕ T790M absent
Rx
Primary recommendation
Osimertinib + dabrafenib / trametinib
BRAF/MEK bypass-targeting · trial + SOC fallback 

Why this: on confirmed multifocal progression, the acquired BRAF V600E reactivates MAPK downstream of EGFR — a recognized bypass after TKI progression, and T790M is absent. The mechanism-matched move keeps EGFR control on osimertinib and adds BRAF/MEK (dabrafenib + trametinib). The model flags this as emerging, off-label evidence — so it surfaces clinical-trial evaluation alongside and names docetaxel + ramucirumab as the SOC-bridge fallback. TP53 co-mutation noted.

Traces toResistance literatureGuidelines17 trial matches
How it works

From records to reasoning in minutes

No forms, no structured data entry. The engine reads the patient’s records the way they were written — and reasons through every case the same rigorous way, every time.

01

Upload the chart

Drop in the patient’s real records — pathology, molecular panels, labs, prior treatments, imaging and notes. No forms, no data entry. The engine reads the chart the way it was written.

02

Records reassembly

Outside scans, prior-line notes, molecular reports from different labs, records faxed in from another institution — fragmented, duplicated, out of order. The engine reconciles them into one clean, chronological case. No more piecing the chart together by hand.

03

It reads the whole case

From that single source of truth, it works out what’s driving the cancer, how it’s slipping past prior therapy, and the secondary mutations that change the plan. Nothing on the chart gets missed.

04

It pinpoints where the patient stands

Newly diagnosed, responding, progressing, resistant, post-surgery — the engine places the patient in the exact situation and narrows to the options that genuinely apply, for every driver and the driver-negative paths alike.

05

A plan you can take to the board

Out comes a clear recommendation — the preferred move, the alternatives, and the reasoning in plain terms — with matching trials and a source behind every call. Tumor-board-ready, traceable end to end.

Case state engine

Every case state covered, with patient-specific reasoning for each

The outer states plus clinical substates span the full picture. Driver-positive cases route into one of 121 terminal buckets; driver-negative cases route through chemo-immunotherapy pathways stratified by histology and PD-L1.

A Active · Responding

On active therapy with documented response. Monitoring and toxicity management are the clinical priority.

EGFR Ex19del on osimertinib — stable disease, no progression confirmed.
B Active · Monitoring

Active therapy with stable or indeterminate response. Structured monitoring protocol in effect.

ALK fusion on alectinib — mixed early signals, continuation criteria met.
C Post-Progression · Targeted

Confirmed progression on a prior line. A targeted next-line option is available from resistance profiling.

EGFR T790M acquired resistance — osimertinib eligible next line.
D Post-Progression · Trial

Confirmed progression with no standard targeted option. Trial enrollment is the primary pathway.

KRAS G12C after sotorasib — no standard option, trial-eligible.
E Oligoprogression

Isolated site(s) of progression while systemic disease stays controlled. Local ablation may extend systemic therapy.

ALK on lorlatinib — isolated CNS lesion, systemic disease stable.
F Treatment Naive

No prior systemic therapy. First-line selection based on driver, PD-L1 expression, and disease burden.

ROS1 fusion — newly diagnosed stage IV, entrectinib first-line.
G Adjuvant Surveillance

Post-curative-resection on adjuvant therapy — a distinct logic tree from metastatic monitoring.

EGFR Ex19del, resected IB on adjuvant osimertinib — ADAURA-eligible.
H Curative-intent

Neoadjuvant, perioperative, and unresectable stage III consolidation tracks modeled on their own logic.

Stage III unresectable — durvalumab consolidation per PACIFIC.
+5 Substates

Modeled beneath the outer states

  • Neoadjuvant / perioperative active treatment
  • Unresectable stage III / consolidation
  • Post-curative recurrence
  • No actionable driver / IO–chemo pathway
  • Best supportive care / treatment-ineligible
121 terminal route buckets across 11 driver families.

Each driver carries its own buckets — 1L, resistance, bypass amplification, transformation, stage III, and adjuvant. Driver-negative cases route through a parallel chemo-immunotherapy lane stratified by histology and PD-L1.

EGFR21routes1L · Resistance · Bypass
HER214routesExon20 · TKD · ADC
ALK13routes1L · Post-2G · CNS
ROS113routesSolvent-front · CNS
RET13routesSolvent-front · Hinge
BRAF13routesV600E · Class 2/3 · MAPK
KRAS12routesG12C · G12D/V · Resistance
MET12routesEx14 · Amp · Resistance
NRG15routesFusion · Post-targeted
NTRK4routesFusion · CNS-active
FGFR1routeTrial precision
+ driver-negative
IO–chemo lane
Evidence foundation

The standard oncology evidence base, woven into one reasoning trail

Recommendations cite the source for every claim — guidelines, regulatory labels, pivotal trials, and literature — so the rationale is auditable from input to output.

NCCNGuidelines
ESMOGuidelines
ASCOGuidelines
FDAApprovals & labels
AACRResearch
Pivotal trial dataPrimary endpoints
Peer-reviewed literaturePublished
Late-breaking abstractsEmerging
# reasoning trail · representative case

driver EGFR Ex19delbypass BRAF V600E (acquired)mechanism bypass pathway activationroute EGFR → BRAF/MEK bypass-targeting
cited: → FDA label · combination indication → NCCN NSCLC · acquired resistance → pivotal trial · PFS / ORR → 17 matched trials · screened to chart
verify against current guidelines →
Where it fits in your day

This should compress work, not add it

We're early — no clinician testimonials yet. But the engine is built around four concrete moments in the workflow, and the value compounds at each one.

Scenario 01 — Pre-visit

Thinking, already done

Engine output ready before the patient walks in: structured summary, options, and trial matches already organized. The 20-minute slot starts with the work behind you.

Prep replacement
Scenario 02 — Decision points

Nothing missed

Post-progression. Atypical drivers. Resistance configurations. Co-mutation contexts that change sequencing — checked across every major NSCLC driver, every resistance pathway, every case state.

Safety net & sanity check
Scenario 03 — Trials

The right one, in context

Trial relevance surfaced inside the treatment decision, not as a separate research task — the right trial, at the right moment, screened against the chart.

Surfacing, not searching
Scenario 04 — Payer Defense

Approved, not just recommended

The same recommendation generates the prior-authorization, reauthorization, or medical-necessity letter — diagnosis, codes, prior lines, and the supporting evidence already in place. Deterministic and never fabricated; the physician reviews, signs, and submits.

Recommendation to reimbursement
Limited early access

Ready to see it on your cases?

Request access and we'll onboard your institution within 48 hours. No integration required — just your clinical records.

HIPAA-ready · No PHI stored · For clinical decision support only