Now in early access

Clinical reasoning,
case by case.

OncologyReasoning reads the full patient picture — genomics, prior therapies, co-mutations, performance status — and produces treatment narratives your tumor board can act on.

🏥Multi-Source Evidence
🔒HIPAA Ready
🧬Genomics-Native
📋Tumor Board Ready
OR
HIPAA · SOC 2 · 256-bit encryption

From records to reasoning in minutes

01
📄
Step 01

Upload the Patient Record

Paste or upload pathology, genomic panel results, prior treatment history, and current imaging summary. No structured input required — the model reads clinical prose.

02
🧬
Step 02

Genomic Driver Identification

The model identifies the dominant oncogenic driver, bypass alterations, co-mutations with treatment implications (TP53, STK11, KEAP1, KRAS), and resistance mechanisms.

03
🗂
Step 03

Case State Classification

Each case is classified across seven outer states plus five clinical substates — covering metastatic, curative-intent, and treatment-eligibility tracks. Driver-positive and driver-negative cases handled alike.

04
📋
Step 04

Treatment Narrative Generation

Recommendations are grounded in the full evidence foundation — guidelines (NCCN, ESMO, ASCO), FDA labels, pivotal trial data, peer-reviewed literature, and late-breaking abstracts — with mechanistic rationale tied to the patient's molecular profile, disease burden, and performance status.

All case states covered. Patient-specific reasoning for each.

Seven outer states plus five clinical substates cover the full clinical picture — metastatic, curative-intent, and treatment-eligibility tracks. Driver-positive cases route into one of 117 terminal buckets; driver-negative cases route through chemo-immunotherapy pathways stratified by histology and PD-L1.

A — Active · Responding

Patient is on active therapy with documented response. Monitoring and toxicity management are the clinical priority.

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

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

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

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

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

Confirmed progression with no standard targeted option. Clinical trial enrollment is the primary recommendation pathway.

Example
KRAS G12C after sotorasib — no standard option, KRYSTAL-1 eligible.
E — Oligoprogression

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

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

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

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

Post-curative-resection patient on adjuvant therapy. Continuation per ADAURA / IMpower010 / KEYNOTE-091 with surveillance imaging — distinct logic tree from metastatic monitoring.

Example
EGFR Ex19del, resected stage IB on adjuvant osimertinib — ADAURA-eligible, surveillance imaging cadence.
+ 5 — Additional Substates

Five clinical contexts modeled beneath the outer states — including driver-negative disease and curative-intent tracks.

  • Neoadjuvant / perioperative active treatment
  • Unresectable stage III / consolidation
  • Post-curative recurrence
  • No actionable driver / immunotherapy-chemo pathway
  • Best supportive care / treatment-ineligible

121 terminal route buckets across 11 driver families.

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

EGFR
21
routes
1L · Resistance · Bypass
HER2
14
routes
Exon20 · TKD · ADC
ALK
13
routes
1L · Post-2G · CNS
ROS1
13
routes
Solvent-front · CNS
RET
13
routes
Solvent-front · Hinge
BRAF
13
routes
V600E · Class 2/3 · MAPK
KRAS
12
routes
G12C · G12D/V · Resistance
MET
12
routes
Ex14 · Amp · Resistance
NRG1
5
routes
Fusion · Post-targeted
NTRK
4
routes
Fusion · CNS-active
FGFR
1
route
Trial precision

Validated against 175 gold-standard cases across 11 case groups, including 15 adversarial safety-gate scenarios that block contraindicated recommendations — e.g., IO monotherapy in EGFR-positive disease, or platinum doublets in PS≥3 patients.

All the prevailing, industry-standard oncology evidence —
combined into a single reasoning trail.

Recommendations cite the source for every claim — guidelines, regulatory labels, pivotal trials, peer-reviewed publications, and late-breaking abstracts — woven together so the rationale is auditable end-to-end.

NCCNESMOASCOFDA approvals & labelsAACRPivotal trial dataPeer-reviewed literatureLate-breaking abstractsand more

This should compress work, not add it.

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

Scenario 01

Pre-visit

Engine output ready before the patient walks in. Structured summary, options, trial matches — already organized. The 20-minute slot starts with the thinking already done.

Time saver. Prep replacement.
Scenario 02

At decision points

Post-progression. Atypical drivers. Resistance configurations. Co-mutation contexts that change sequencing. The cases where you want to make sure nothing was missed — across every major NSCLC driver, every resistance pathway, every case state.

Safety net. Sanity check.
Scenario 03

Around trials

Trial relevance surfaced contextually within the treatment decision — not as a separate research task. The right trial, at the right moment, with eligibility already screened against the chart.

Surfacing, not searching.
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