RT Book, Section A1 Willis, Jason A. A1 Goldstein, Jennifer B. A1 Zhang, Zhijing A1 Futreal, Andy A2 Kantarjian, Hagop M. A2 Wolff, Robert A. A2 Rieber, Alyssa G. SR Print(0) ID 1190839035 T1 Cancer Genomics T2 The MD Anderson Manual of Medical Oncology, 4e YR 2022 FD 2022 PB McGraw Hill Education PP New York, NY SN 9781260467642 LK accessmedicine.mhmedical.com/content.aspx?aid=1190839035 RD 2024/03/29 AB KEY CONCEPTSThe cancer genomics era has been driven by rapid technological and computational advancements, which have enabled large-scale multidimensional analyses of rare and common cancers and precursor lesions.The vast majority of human cancers are characterized by both inter- and intratumor molecular heterogeneity, which adds further complexity to the identification of robust and clinically useful biomarkers.Clonal molecular evolution is evident throughout multiple stages of tumor development and has critical implications for the development of treatment resistance and metastasis.Driven by the development of cost-effective and robust clinical next-generation sequencing (NGS) assays, somatic mutation profiling has been broadly integrated into clinical practice for patients with hematologic malignancies and advanced solid tumors. The long-term clinical benefit of comprehensive mutation profiling remains to be defined.Despite the widespread application of tumor mutation profiling in practice, interpretation of the results and therapeutic decision making remains challenging. Institutional resources and/or publicly available decision tools should be consulted to help guide providers and patients.Large-scale studies such as the NCI-MATCH study and the MD Anderson IMPACT study, provide a critical framework for matching patients with biomarker-driven clinical trials, which is a hallmark of precision oncology.