Authorship note: mz and mk contributed equally to this work. met, mm, srv, and gh jointly supervised this work. conflict of interest: adc has received honoraria from onclive, bayer, targeted oncology, aptitude health, journal of clinical pathways, cancer network, clinical care options, great debates & updates, pfizer, and springer healthcare; consulted for blackstone; served on the advisory boards of clovis, dendreon, bayer, eli lilly, astrazeneca, astellas, blue earth, janssen, and tolmar; and received research funding from bayer. emva has served as an advisor or consultant to tango therapeutics, genome medical, invitae, enara bio, janssen, manifold bio, and monte rosa; has received research support from novartis and bristol myers squibb; holds equity in tango therapeutics, genome medical, syapse, enara bio, manifold bio, microsoft, and monte rosa; has received travel reimbursement from roche/ genentech; has filed institutional patents on chromatin mutations and immunotherapy response and on methods for clinical interpretation (wo2015013191a1, us20170115291a1, us20170081724a1, wo2019132287a1, us20190338370a1); and has provided intermittent legal consulting on patents for foley hoag. met has served on the advisory boards of janssen, pfizer, astrazeneca, and bayer. mlf has served as a consultant to and holds equity in nuscan diagnostics; this activity is outside of the scope of this article. mm has consulted for bayer, interline, and isobl; is an inventor on patents licensed to labcorp (us10669589b2, us10000815b2, us9035036b2, us8465916b2, us8105769b2, us7964349b2, us7294468b2) and bayer (us20200369633a1, us11339157b1, us11207320b2, us11142522b2, us10966986b2, us9890127b2); and receives research funding from bayer, janssen, and ono pharmaceuticals. rb consults for and owns equity in scorpion therapeutics, and receives grant funding from novartis and merck. psn has served as a consultant to bristol myers squibb, janssen, and pfizer in work