Today in the 21st century, with the progress of tumor molecular biology, the concept of tumor treatment is constantly updated, and antitumor drugs, especially targeted therapeutic drugs, are changing rapidly, thus making precision therapy for tumors attract the attention of scientists and clinical experts. Reviewing the recent development of medical oncology, it is roughly divided into three stages: the traditional cytotoxic drug therapy stage, the emerging molecular targeted therapy stage, and the full of expectations precision therapy stage. I. Cytotoxic drug therapy: insurmountable limitations Cytotoxic drug therapy is the traditional treatment method in medical oncology. With the discovery of more and more anti-tumor drugs, medical oncology has made breakthrough progress in the treatment of various tumors, and even achieved curative efficacy. However, cytotoxic chemotherapeutic drugs have limitations that are difficult to overcome. First of all, it brings toxic side effects in the anti-tumor treatment that many patients can not tolerate, and cytotoxic drugs have a killing effect on normal tissue cells, so its therapeutic efficacy is limited. Furthermore, cytotoxic chemotherapeutic drugs have poor efficacy in treating tumor types that are naturally insensitive to chemotherapeutic drugs. In addition, after a period of application, some tumors will develop drug resistance, which leads to poor therapeutic effect or even tumor recurrence and metastasis. These problems have not been completely overcome until today, and the development of anti-tumor cytotoxic drug therapy has entered a bottleneck stage. Second, molecular targeted therapy: the hope of medical oncology treatment With the progress of tumor molecular biology, scientists have more new knowledge about tumor diseases. Cancer is no longer a single disease, according to the classification of molecular subtypes it can be a variety of. For example, breast cancer can be categorized into four subtypes: hormone receptor-positive, Her2 negative; hormone receptor-positive, Her2 positive; hormone receptor-negative, Her2 positive; triple negative. Based on the different molecular subtypes, clinicians choose appropriate anti-target drugs and treatment regimens to treat breast cancer patients. By subtyping different breast cancer patients, some patients have been spared unnecessary chemotherapy. However, with the application of the above-mentioned EGFR-TKI, the problem of tumor drug resistance has been emerging, and correspondingly, scientists have developed the third-generation EGFR-TKI-AZD9291, and clinical trials have confirmed that AZD9291 has significant efficacy in lung cancer patients with T790M drug-resistant mutations. In short, the emergence of a series of new targeted drugs has given scientists and oncologists a glimpse of the light, and only in 2014 the U.S. FDA approved nine new anti-tumor drugs, and all of them are targeted therapy drugs. It can be seen that targeted therapy brings hope to tumor patients, especially refractory and drug-resistant patients. Precision therapy: a revolutionary change What is precision medicine? Precision medicine is a new medical model based on individualization, with gene and proteomic research as the premise and big data analysis as the main means. Precision medicine is essentially the analysis, identification, validation and application of biomarkers for a large sample of people and specific types of diseases, so as to accurately find the causes of diseases and therapeutic targets, and then formulate individualized optimal therapeutic plans in combination with molecular imaging and big data methods, so as to realize individualized and precise treatments for diseases and specific patients, and ultimately to achieve the goals of high efficiency, low toxicity and low cost. With the continuous progress of genetic technology and the discovery of human genetic map, the latest data show that 90% of tumor patients have gene mutation, copy number change and gene fusion phenomenon, therefore, the future classification of tumor may no longer be based on the tumor type, but on the specific gene type, such as EGFR, HER2 and so on. This will mean that the mainstream trend of tumor treatment in the future will be “different treatment for the same disease” and “different treatment for the same disease”. That is to say, patients with tumors in different organs with the same genetic alterations will receive the same drug treatment. Precision medicine will enable patients to get the right dose of the right drug at the right time, so as to achieve the best therapeutic effect, the smallest toxic side effect and the highest quality of life, and create a revolutionary change in the combination of traditional cytotoxic drugs, molecular-targeted drugs, and immunotherapeutic means. Tumor Precision Therapy: Customized Medical Treatment for Tumor Patients At present, both doctors and patients have pinned hopes on precision medicine. As summarized by our famous oncologist Academician Zhan Qimin, precision medicine of tumor is a kind of “customized” medical model based on tumor patients, which is mainly embodied in precision medical diagnosis and precision treatment. In the future, anti-tumor clinical research will be based on genetic clues to find out the driving genes of tumors and conduct translational research to guide the clinic. For some patients who are resistant to drugs after effective standard treatments, in the case of no drugs available, gene sequencing of tissues or blood will be conducted again to observe whether there is any new genetic variation, so as to find potentially effective drugs. The future of precision medicine research will be based on the patient’s genetic abnormalities as the criteria for enrollment, “umbrella” clinical design refers to the same tumor with different driver genes, the use of the corresponding targeted drug research, the so-called “different treatment for the same disease”; “” The “basket” clinical design refers to the study of the same driver genes in different tumor types using the same targeted drugs, the so-called “different diseases with the same treatment”. Looking ahead, the road to precision anti-tumor therapy is still a long one, as factors affecting cancer treatment are multifaceted, including the disease itself, the patient’s past condition, comorbidities and genetic background, lifestyle and environmental factors. How to conquer tumors has always been a great challenge for scientists and oncology clinicians. In the face of this challenge, we can never ignore the fact that Chinese people have different epigenetics from foreigners, and Chinese tumors are very different from European and American tumors in terms of disease spectrum. Therefore, Chinese people should finally study their own genetic data and come out with a road of anti-tumor precision therapy that is more suitable for Chinese people and has Chinese characteristics. We believe that this day will surely come, and we are looking forward to the early arrival of this day. Tumor precision therapy, has been gradually approaching!