160 Background: Cancer patient’s unique genomic profile can help oncologists select a course of precise personalized treatment for the subject. High throughput next-generation sequencing (NGS) technology allows us to identify genomic alterations simultaneously within a patient’s tumor tissue and blood-circulating tumor DNA (ctDNA) in a single test, however, robust tool for accessing mutation-treatment matching is limited. Methods: OncoGPT was built on a cloud-based elastic computing platform. The NGS data analytical module consists of a cascade of computational algorithms for NGS data processing and gene variant calling. The interactive and univariate Cox proportional hazards models were used for mutation-treatment matching and prognostic effect analysis, respectively. Machine learning algorithms including decision tree, random forest, and neural network were trained and tested with novel features for tissue-of-origin (TO) classification across 8 caner types. Results: We built an AI-driven NGS data analytical platform by integrating computational models, matching algorithms and variant annotation databases to highly accurate achieve cancer-related gene mutations, copy number variation, and structure variants using NGS data from 35,122 tumors across 8 cancer types from three institutions. Next, an AI-driven TO classifier was developed and achieved a weighted F1 score of 0.926 for high confidence predictions (≥ 0.9) on tumor samples. Furthermore, augmented AI matching algorithms were applied to match the optimal personalized treatment and provide prognostic prediction for cancer patients with significantly bett survival outcomes (hazard ratio (HR) = 0.326; 95% confidence interval (CI) = 0.213–0.565; P = 2.52×10−5). Conclusions: We have successfully developed an innovative intelligent system (OncoGPT) with AI capabilities to help accurately find actionable targets from patient tumor or blood ctDNA NGS sequencing data and precisely match individualized therapeutic and clinical trial options for patients. In addition, OncoGPT classified primary tumor sites across 8 different cancer types with high confidence predictions. We believe that OncoGPT would help clinicians make optimal treatment decisions for cancer patients through genomic-driven precision oncology.