Next-generation sequencing and empowering personalised cancer medicine

•Plummeting costs of whole-genome sequencing herald an explosion in the numbers of clinical applications.•Incorporating cancer genomes into clinical trial design will require novel designs.•The regulatory environment for clinical diagnostics involving genomes needs to be built.•Analysis of such high-dimensional data will impose further pressure on healthcare systems.•The promise of genomics is ultimately more effective for personalised medicine.

The announcement earlier this year of the US$1000 genome by Illumina has excited a debate as to when and how genomes will at last transition from the research laboratory to the clinic. Although it is still unclear what the benefit will be to patients, there is sufficient evidence supporting the importance of the genome in driving cancer development, treatment response and drug resistance. Therefore it is reasonable to assume that large-scale stratification of patients using next-generation sequencing technologies will improve patient outcome in at least some common cancer types.