We see a future where cancer patients receive personalised treatment from the day of diagnosis, based on their genetic make-up and that of their tumour. Such ‘precision' or 'personalised' medicine involves considering all treatment options, including chemotherapy, surgery, radiotherapy, immunotherapy and targeted therapies, alone or in combination, in order to find the most appropriate and effective. Recent advances have meant that this vision is within reach for some, but more research is needed to make it a reality for all cancer patients.