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The lack of clear guidelines leads to suboptimal management and poor prognosis. Molecular tumor boards accelerate access to effective therapies by tailoring treatment based on biomarkers, beyond cancer type. Unstructured data that requires manual curation hinders efficient use of biomarker profiling for therapy matching. This study explores the use of large language models (LLMs) to construct digital twins for precision medicine in RGTs. Our proof-of-concept digital twin system integrates clinical and biomarker data from institutional and published cases (<jats:italic>n<\/jats:italic>\u2009=\u200921) and literature-derived data (<jats:italic>n<\/jats:italic>\u2009=\u2009655 publications) to create tailored treatment plans for metastatic uterine carcinosarcoma, identifying options potentially missed by traditional, single-source analysis. LLM-enabled digital twins efficiently model individual patient trajectories. 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J.N.K. declares consulting services for Owkin, France; DoMore Diagnostics, Norway; Panakeia, UK, and Scailyte, Basel, Switzerland; furthermore J.N.K. holds shares in Kather Consulting, Dresden, Germany; and StratifAI GmbH, Dresden, Germany, and has received honoraria for lectures and advisory board participation by AstraZeneca, Bayer, Eisai, MSD, BMS, Roche, Pfizer and Fresenius. D.T. received honoraria for lectures by Bayer and holds shares in StratifAI GmbH, Germany. K.K.B. has received honoraria for lectures by GE HealthCare and Canon Medical Systems Corporation. M.K. has received fees from Springer Press, Biermann Press, Celgene, AstraZeneca, Myriad Genetics, TEVA, Eli Lilly, GSK, Seagen, AllergoSan, FomF, Roche, BESINS, Bayer AG. M.K. has received honoraria for consulting and advisory board participation by Myriad Genetics, Bavarian KVB, DKMS Life, BLAEK, TEVA, Exeltis, Roche, BESINS, Bayer AG. M.K. holds shares in AIM GmbH, in-manas GmbH, Therawis Diagnostic GmbH. H.B. has received personal fees from Roche, AstraZeneca, Gilead, and GlaxoSmithKline outside the submitted work. The authors have no additional financial or non-financial conflicts of interest to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"420"}}