# TxAgent: An AI Agent for Therapeutic Reasoning Across a Universe of Tools

arXiv: https://arxiv.org/abs/2503.10970 · HTML: https://mlsanity.com/paper/2503.10970/

## Key facts

- Cited by 59 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 14 of its 44 references that are in the map.
- First posted on arXiv 14 Mar 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 14 of 14)

- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [Qwen Technical Report](https://mlsanity.com/paper/2309.16609/) (2023)
- [Mistral 7B](https://mlsanity.com/paper/2310.06825/) (2023)
- [Retrieval-Augmented Generation for Large Language Models: A Survey](https://mlsanity.com/paper/2312.10997/) (2023)
- [Towards General Text Embeddings with Multi-stage Contrastive Learning](https://mlsanity.com/paper/2308.03281/) (2023)
- [ChemCrow: Augmenting large-language models with chemistry tools](https://mlsanity.com/paper/2304.05376/) (2023)
- [MEDITRON-70B: Scaling Medical Pretraining for Large Language Models](https://mlsanity.com/paper/2311.16079/) (2023)
- [ToolACE: Winning the Points of LLM Function Calling](https://mlsanity.com/paper/2409.00920/) (2024)
- [ClinicalBench: Can LLMs Beat Traditional ML Models in Clinical Prediction?](https://mlsanity.com/paper/2411.06469/) (2024)
- [Language Models are Surprisingly Fragile to Drug Names in Biomedical Benchmarks](https://mlsanity.com/paper/2406.12066/) (2024)
- [Multimodal Medical Code Tokenizer](https://mlsanity.com/paper/2502.04397/) (2025)

## Built on by (most cited first, 30 of 59)

- [From AI for Science to Agentic Science: A Survey on Autonomous Scientific Discovery](https://mlsanity.com/paper/2508.14111/) (2025)
- [Externalization in LLM Agents: A Unified Review of Memory, Skills, Protocols and Harness Engineering](https://mlsanity.com/paper/2604.08224/) (2026)
- [Token Reduction Should Go Beyond Efficiency in Generative Models -- From Vision, Language to Multimodality](https://mlsanity.com/paper/2505.18227/) (2025)
- [A Survey of Agentic Reasoning for Large Language Models: Towards Recursively Self-Improving and Collective Agents](https://mlsanity.com/paper/2601.12538/) (2026)
- [El Agente: An Autonomous Agent for Quantum Chemistry](https://mlsanity.com/paper/2505.02484/) (2025)
- [TxGemma: Efficient and Agentic LLMs for Therapeutics](https://mlsanity.com/paper/2504.06196/) (2025)
- [Harnessing the Reasoning Economy: A Survey of Efficient Reasoning for Large Language Models](https://mlsanity.com/paper/2503.24377/) (2025)
- [RCR-Router: Efficient Role-Aware Context Routing for Multi-Agent LLM Systems with Structured Memory](https://mlsanity.com/paper/2508.04903/) (2025)
- [LLM-based Agentic Reasoning Frameworks: A Survey from Methods to Scenarios](https://mlsanity.com/paper/2508.17692/) (2025)
- [ToolUniverse: An open platform for democratizing AI scientists](https://mlsanity.com/paper/2509.23426/) (2025)
- [MedAgentGym: A Scalable Agentic Training Environment for Code-Centric Reasoning in Biomedical Data Science](https://mlsanity.com/paper/2506.04405/) (2025)
- [A Survey on Agent Workflow -- Status and Future](https://mlsanity.com/paper/2508.01186/) (2025)
- [Benchmarking AI Agents for Addressing Scientific Challenges Across Scales](https://mlsanity.com/paper/2606.12736/) (2026)
- [STELLA: Self-Evolving LLM Agent for Biomedical Research](https://mlsanity.com/paper/2507.02004/) (2025)
- [HealthFlow: A Self-Evolving AI Agent with Meta Planning for Autonomous Healthcare Research](https://mlsanity.com/paper/2508.02621/) (2025)
- [Autonomous Agents for Scientific Discovery: Orchestrating Scientists, Language, Code, and Physics](https://mlsanity.com/paper/2510.09901/) (2025)
- [End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning](https://mlsanity.com/paper/2508.15746/) (2025)
- [Evolving Roles of LLMs in Scientific Innovation: Assistant, Collaborator, Scientist, and Evaluator](https://mlsanity.com/paper/2507.11810/) (2025)
- [AutoScientists: Self-Organizing Agent Teams for Long-Running Scientific Experimentation](https://mlsanity.com/paper/2605.28655/) (2026)
- [Autonomous Research Agents: A Survey of AI Scientists and the Verification Gap](https://mlsanity.com/paper/2608.05179/) (2026)
- [Qworld: Question-Specific Evaluation Criteria for LLMs](https://mlsanity.com/paper/2603.23522/) (2026)
- [MolClaw: An Autonomous Agent with Hierarchical Skills for Drug Molecule Evaluation, Screening, and Optimization](https://mlsanity.com/paper/2604.21937/) (2026)
- [BioVerge: A Comprehensive Benchmark and Study of Self-Evaluating Agents for Biomedical Hypothesis Generation](https://mlsanity.com/paper/2511.08866/) (2025)
- [CGBench: Benchmarking Language Model Scientific Reasoning for Clinical Genetics Research](https://mlsanity.com/paper/2510.11985/) (2025)
- [Unleashing Scientific Reasoning for Bio-experimental Protocol Generation via Structured Component-based Reward Mechanism](https://mlsanity.com/paper/2510.15600/) (2025)
- [One Patient, Many Contexts: Scaling Medical AI with Contextual Intelligence](https://mlsanity.com/paper/2506.10157/) (2025)
- [Traj-CoA: Patient Trajectory Modeling via Chain-of-Agents for Lung Cancer Risk Prediction](https://mlsanity.com/paper/2510.10454/) (2025)
- [MedAI: Evaluating TxAgent's Therapeutic Agentic Reasoning in the NeurIPS CURE-Bench Competition](https://mlsanity.com/paper/2512.11682/) (2025)
- [MolAct: An Agentic RL Framework for Molecular Editing and Property Optimization](https://mlsanity.com/paper/2512.20135/) (2025)
- [Med-CoReasoner: Reducing Language Disparities in Medical Reasoning via Language-Informed Co-Reasoning](https://mlsanity.com/paper/2601.08267/) (2026)

## Abstract (arXiv)

Precision therapeutics require multimodal adaptive models that generate personalized treatment recommendations. We introduce TxAgent, an AI agent that leverages multi-step reasoning and real-time biomedical knowledge retrieval across a toolbox of 211 tools to analyze drug interactions, contraindications, and patient-specific treatment strategies. TxAgent evaluates how drugs interact at molecular, pharmacokinetic, and clinical levels, identifies contraindications based on patient comorbidities and concurrent medications, and tailors treatment strategies to individual patient characteristics. It retrieves and synthesizes evidence from multiple biomedical sources, assesses interactions between drugs and patient conditions, and refines treatment recommendations through iterative reasoning. It selects tools based on task objectives and executes structured function calls to solve therapeutic tasks that require clinical reasoning and cross-source validation. The ToolUniverse consolidates 211 tools from trusted sources, including all US FDA-approved drugs since 1939 and validated clinical insights from Open Targets. TxAgent outperforms leading LLMs, tool-use models, and reasoning agents across five new benchmarks: DrugPC, BrandPC, GenericPC, TreatmentPC, and DescriptionPC, covering 3,168 drug reasoning tasks and 456 personalized treatment scenarios. It achieves 92.1% accuracy in open-ended drug reasoning tasks, surpassing GPT-4o and outperforming DeepSeek-R1 (671B) in structured multi-step reasoning. TxAgent generalizes across drug name variants and descriptions. By integrating multi-step inference, real-time knowledge grounding, and tool-assisted decision-making, TxAgent ensures that treatment recommendations align with established clinical guidelines and real-world evidence, reducing the risk of adverse events and improving therapeutic decision-making.