精准癌症医学是一个多学科团队的努力，需要包括社会在内的许多利益相关者的参与和承诺。在过去二十年中，基于癌症患者精准治疗的重大进展为未来的发展铺平了道路，未来的发展将受到可扩展的分子诊断技术的改进的显著影响，其中越来越复杂的多层次数据集需要转化为在临床上有用的信息，以指导患者管理，并在快速交付时间内完成。采用考虑癌症在患者治疗过程中的巨大可塑性的组织和液态测定的自适应分析策略，并包括早期检测方法，已经开始应用于临床常规，并将变得至关重要。第二个重要驱动力是智能临床试验和试验设计的发展，辅以真实世界的证据，可迅速扩大治疗选择的范围。在这种情况下，与监管机构和健康技术评估机构的紧密协调至关重要。国内和国际多中心网络在推行临床实践中实施精准肿瘤学，并支持开发和改进为患者带来效益所需的生态系统和框架是关键。本综述提供了实现精准癌症医学所需的诊断工具、创新临床研究和合作努力的综述。©2023作者。由Wiley出版的国际内科杂志发表，代表国际内科杂志出版协会。

Precision cancer medicine is a multidisciplinary team effort that requires involvement and commitment of many stakeholders including the society at large. Building on the success of significant advances in precision therapy for oncological patients over the last two decades, future developments will be significantly shaped by improvements in scalable molecular diagnostics in which increasingly complex multilayered datasets require transformation into clinically useful information guiding patient management at fast turnaround times. Adaptive profiling strategies involving tissue- and liquid-based testing that account for the immense plasticity of cancer during the patient's journey and also include early detection approaches are already finding their way into clinical routine and will become paramount. A second major driver is the development of smart clinical trials and trial concepts which, complemented by real-world evidence, rapidly broaden the spectrum of therapeutic options. Tight coordination with regulatory agencies and health technology assessment bodies is crucial in this context. Multicentric networks operating nationally and internationally are key in implementing precision oncology in clinical practice and support developing and improving the ecosystem and framework needed to turn invocation into benefits for patients. The review provides an overview of the diagnostic tools, innovative clinical studies, and collaborative efforts needed to realize precision cancer medicine.© 2023 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.