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"OncoAgent: A Dual-Tier Multi-Agent Framework for Privacy-Preserving Oncology Clinical Decision Support"

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Technical preprint · May 2026 · OncoAgent Research Group.

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Summary

The team present OncoAgent, an open-source, privacy-preserving clinical decision support system for oncology. The system routes clinical queries through an additive complexity scorer to either a 9B parameter speed-optimised model (Tier 1) or a 27B deep-reasoning model (Tier 2), both fine-tuned via QLoRA on a corpus of 266,854 real and synthetically generated oncological cases using the Unsloth framework on AMD Instinct MI300X hardware (192 GB HBM3). Sequence packing on MI300X enabled full-dataset fine-tuning in approximately 50 minutes enabling hospital deployment without data exfiltration. Large language models have demonstrated significant promise in clinical NLP tasks including diagnostic coding, literature summarisation, and patient communication. Decomposed multi-agent systems have emerged as a principled approach to complex reasoning tasks.

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