Over the years, the field of oncology has moved toward standardized treatment using evidence-based approaches to improve treatment outcomes and reduce the cost of cancer treatment. Now, the most widely discussed topic in the medical industry is precision medicine, which uses detailed genetic information about a patient’s cancer to achieve precise treatment of the disease and effective targeted therapy for the tumor. A very important question has emerged: Are precision medicine and evidence-based approaches compatible? Target Comparison: Precision Medicine vs. Evidence-Based Medicine On the surface, precision medicine and evidence-based approaches seem to be in conflict with each other. After all, it seems counterintuitive for doctors to develop “individualized” treatments based on a patient’s genetic information, yet also follow standardized treatment guidelines based on an evidence-based approach. A closer look at the goals and approaches of these two treatment modalities reveals that not only are precision therapy and evidence-based approaches compatible, but that they are also, in some ways, similar and most complementary. Due to advances in research and drug development, the number of drugs used to treat cancer has increased significantly. Treatment modalities are also diverse, and there is growing evidence that some treatments are more effective and/or less toxic than others. Both precision medicine and evidence-based approaches help identify appropriate diagnostic methods, procedures, and effective treatments. Evidence-based approaches were invented and utilized by oncologists to narrow treatment choices using clinical guidelines supported by a large body of evidence as a foundation. Clinical guidelines were originally developed as a standard of care approach with the primary goal of improving the quality of patient care. Treatment guidelines limit variability in treatment without compromising clinical outcomes. The goal of an evidence-based approach is to apply the right treatment to the right patient. Sounds familiar doesn’t it? Take another look at precision medicine and you’ll see that they have similar goals. By understanding the biology of a tumor in greater detail, drug developers focus on mutations that can be targeted to trigger tumors or tumor growth. Precision medicine is not a new concept; it has been around for a long time and confirms that the growing knowledge of the human genome and its impact on cancer and other diseases has had a profound impact on how we assess risk and make treatment decisions. Perhaps the best known example is the identification of HER2/neu protein expression. This important discovery in the mid-1980s dramatically changed the way we identify women at elevated risk due to HER2 protein overexpression and also changed how we treat women with HER2-positive breast cancer. Another example is the EGFR mutation, which is present in a subset of patients with non-small cell lung cancer (NSCLC). In 2011, ASCO issued a tentative clinical recommendation to use EGFR testing to help predict the benefit of EGFR tyrosine kinase inhibitor (TKI) therapy in patients with advanced NSCLC.ASCO made this recommendation because study data showed that lung cancer patients carrying EGFR mutations were more likely to benefit from targeted therapy than those who did not carry the mutation. Identifying such mutations in NSCLC patients can help guide oncologists in choosing the most effective treatment for their patients. The guideline’s recommended first-line treatment option for patients with NSCLC carrying the mutation is an EGFR TKI, replacing the traditional chemotherapy combination approach for patients who do not carry the EGFR mutation. These examples highlight that there is an important link between precision medicine and evidence-based approaches. In both examples, identifying the mutation is key to providing the treatment that is most likely to benefit the patient. In addition, evidence-based approaches developed from retrospective studies, best clinical practices, and expected outcomes point physicians to the impact of proven lines of treatment on the quality of patient care and lead to improved outcomes. The Future of Precision Medicine and Evidence-Based Medicine Since President Barack Obama announced the launch of the Precision Medicine Initiative earlier this year, precision medicine has received a lot of attention. There has been much discussion about how the future of precision medicine will play a role in how doctors diagnose and treat patients. Most experts believe that precision medicine will have an important impact on the future of healthcare, as doctors will be able to target patients’ diseases in a more targeted manner. The NIH’s investment in precision medicine will translate into accelerating the growth of knowledge about many diseases. As this knowledge grows, this initiative will result in physicians needing to identify which patients should be tested for which mutations and when. For most new diagnostic tests, technologies and treatments, genetic testing is expensive and is not necessary or recommended for every patient. Not only will evidence-based approaches continue to be used as a way to reduce variation in care and improve treatment outcomes, but evidence-based approaches will be an important tool for clinical guidelines to guide physicians on how and when to use tests.