As the diagnosis and treatment of diseases including cancer have entered a new era thanks to the molecular and cellular biology, especially related omics research progress since the 21st century, the so-called precision medicine that tailors diagnosis, prognosis, and treatment strategy for the actual needs of different patients based on clinicopathological features combined with molecular expression profile features has emerged. Precision medicine will change the one-size-fits-all model for groups from traditional medicine to help reduce the incidence of misdiagnosis, mistreatment, and over-treatment and improve curative effects. Genome-guided oncology refers to a new therapeutic idea for drug use based on tumor gene characteristics beyond histological disease classification and pathological classification. The relevant new drug development technology and new method of clinical trial design based on this idea provide a new thought to precision oncology. The paper summarizes the research progress of genome-guided precision oncology technology.