Molecular Tumor Boards (MTBs) are multidisciplinary forums where oncology specialists collaboratively assess complex patient cases to determine optimal treatment strategies. A central element of this process is the patient summary, typically compiled by a medical oncologist, radiation oncologist, or surgeon, or their trained medical assistant, who distills heterogeneous medical records into a concise narrative to facilitate discussion. This manual approach is often labor-intensive, subjective, and prone to omissions of critical information. To address these limitations, we introduce the Healthcare Agent Orchestrator (HAO), a Large Language Model (LLM)-driven AI agent that coordinates a multi-agent clinical workflow to generate accurate and comprehensive patient summaries for MTBs. Evaluating predicted patient summaries against ground truth presents additional challenges due to stylistic variation, ordering, synonym usage, and phrasing differences, which complicate the measurement of both succinctness and completeness. To overcome these evaluation hurdles, we propose TBFact, a ``model-as-a-judge'' framework designed to assess the comprehensiveness and succinctness of generated summaries. Using a benchmark dataset derived from de-identified tumor board discussions, we applied TBFact to evaluate our Patient History agent. Results show that the agent captured 94% of high-importance information (including partial entailments) and achieved a TBFact recall of 0.84 under strict entailment criteria. We further demonstrate that TBFact enables a data-free evaluation framework that institutions can deploy locally without sharing sensitive clinical data. Together, HAO and TBFact establish a robust foundation for delivering reliable and scalable support to MTBs.

Clinical trials are crucial for assessing new treatments; however, recruitment challenges - such as limited awareness, complex eligibility criteria, and referral barriers - hinder their success. With the growth of online platforms, patients increasingly turn to social media and health communities for support, research, and advocacy, expanding recruitment pools and established enrollment pathways. Recognizing this potential, we utilized TrialGPT, a framework that leverages a large language model (LLM) as its backbone, to match 50 online patient cases (collected from published case reports and a social media website) to clinical trials and evaluate performance against traditional keyword-based searches. Our results show that TrialGPT outperforms traditional methods by 46% in identifying eligible trials, with each patient, on average, being eligible for around 7 trials. Additionally, our outreach efforts to case authors and trial organizers regarding these patient-trial matches yielded highly positive feedback, which we present from both perspectives.

Clinical trials drive improvements in cancer treatments and outcomes. However, most adults with cancer do not participate in trials, and trials often fail to enroll enough patients to answer their scientific questions. Artificial intelligence could accelerate matching of patients to appropriate clinical trials. Here, we describe the development and evaluation of the MatchMiner-AI pipeline for clinical trial searching and ranking. MatchMiner-AI focuses on matching patients to potential trials based on core criteria describing clinical "spaces," or disease contexts, targeted by a trial. It aims to accelerate the human work of identifying potential matches, not to fully automate trial screening. The pipeline includes modules for extraction of key information from a patient's longitudinal electronic health record; rapid ranking of candidate trial-patient matches based on embeddings in vector space; and classification of whether a candidate match represents a reasonable clinical consideration. Code and synthetic data are available at https://huggingface.co/ksg-dfci/MatchMiner-AI . Model weights based on synthetic data are available at https://huggingface.co/ksg-dfci/TrialSpace and https://huggingface.co/ksg-dfci/TrialChecker . A simple cancer clinical trial search engine to demonstrate pipeline components is available at https://huggingface.co/spaces/ksg-dfci/trial_search_alpha .

Objective: Retrieval-based Clinical Decision Support (ReCDS) can aid clinical workflow by providing relevant literature and similar patients for a given patient. However, the development of ReCDS systems has been severely obstructed by the lack of diverse patient collections and publicly available large-scale patient-level annotation datasets. In this paper, we aim to define and benchmark two ReCDS tasks: Patient-to-Article Retrieval (ReCDS-PAR) and Patient-to-Patient Retrieval (ReCDS-PPR) using a novel dataset called PMC-Patients. Methods: We extract patient summaries from PubMed Central articles using simple heuristics and utilize the PubMed citation graph to define patient-article relevance and patient-patient similarity. We also implement and evaluate several ReCDS systems on the PMC-Patients benchmarks, including sparse retrievers, dense retrievers, and nearest neighbor retrievers. We conduct several case studies to show the clinical utility of PMC-Patients. Results: PMC-Patients contains 167k patient summaries with 3.1M patient-article relevance annotations and 293k patient-patient similarity annotations, which is the largest-scale resource for ReCDS and also one of the largest patient collections. Human evaluation and analysis show that PMC-Patients is a diverse dataset with high-quality annotations. The evaluation of various ReCDS systems shows that the PMC-Patients benchmark is challenging and calls for further research. Conclusion: We present PMC-Patients, a large-scale, diverse, and publicly available patient summary dataset with the largest-scale patient-level relation annotations. Based on PMC-Patients, we formally define two benchmark tasks for ReCDS systems and evaluate various existing retrieval methods. PMC-Patients can largely facilitate methodology research on ReCDS systems and shows real-world clinical utility.