ESMO releases first-ever guidance for safe use of AI Language Models in cancer care

The ELCAP guidance sets standards for responsible AI use in oncology, protecting patients and supporting clinicians

LUGANO, Switzerland and BERLIN, Oct. 20, 2025 /PRNewswire/ -- As artificial intelligence tools like ChatGPT become increasingly common in healthcare, ESMO has taken a decisive step to ensure their safe and effective use in cancer care. ESMO has unveiled its Guidance on the Use of Large Language Models in Clinical Practice (ELCAP), the first structured framework for safely integrating large language models (LLMs) into oncology practice in parallel with a session at the ESMO Congress in Berlin. The paper is published in the Society's peer-reviewed journal Annals of Oncology.

"Innovation must serve oncologists and, ultimately, patients, not confuse or mislead them," said Fabrice André, ESMO President. "With ELCAP, we offer a practical guide for using AI responsibly in oncology, one that protects data, ensures clinical oversight, and supports informed decision-making."

ELCAP divides AI applications into three categories, with specific safety and governance recommendations:

• Patient-facing tools: Chatbots and virtual assistants providing symptom information or treatment guidance. These must operate under supervision and never replace professional medical advice.
• Clinician-facing tools: AI systems supporting decision-making, documentation, translation. These require formal validation and clear accountability.
• Background systems: AI integrated into hospital infrastructure, e.g., electronic health records, for tasks like data extraction or clinical trial matching. These demand institutional oversight and continuous monitoring.

"The value of AI depends on who is using it," said Miriam Koopman, ESMO Real World Data and Digital Health Task Force Chair. "ELCAP sets expectations for each context, ensuring patients are protected, clinicians are supported, and institutions are accountable."

"Trust in AI doesn't come from technology alone, it comes from shared standards," concluded Andrè. "ELCAP is our contribution to making AI a safe and effective ally in oncology."

With 45,000 oncology professionals in its global network, ESMO can be looked up as the global reference for responsible AI adoption in cancer care.

Article here: https://www.annalsofoncology.org/article/%20S0923-7534(25)04698-8/fulltext

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