The field of oncology is leading the precision medicine revolution. Heidelberg and Leuven, as two major players in the field world-wide, jointly organized the Health Axis Europe Visionary Seminar on the topic. The event covered some of the most promising novel approaches in research from Flemish and German academia and industry. What are the most important breakthroughs we can expect? Meanwhile, the advancement of precision medicine into routine clinical practice is hindered by the process in meeting requirements of the payer or reimbursement agency for health care.