Eric Klein, MD from the Glickman Urology & Kidney Institute, Cleveland, OH discusses biopsy-based genomic testing in men with early-stage prostate cancer. It has been recognised that many men with with early-stage have indolent tumors that do not need to be treated. Tests have been developed that determine how aggressive a specific tumor is and whether or not the patient requires treatment, or how frequently they need to be followed. It is hoped that these tests may be used to help physicians make an informed decision about what is best for each individual patient a precision-medicine approach applied to early-stage disease. Dr Klein presented new data at the American Society of Clinical Oncology (ASCO) 2016 Annual Meeting, which shows that these tests can stratify outcomes in patients with similar histology, tumor grade or risk categorization when you add the genomic data. Dr Klein also discusses some of the challenges of biopsy-based genomic testing in the clinic.