.Attributes Medicine, Posted online: 16 September 2024 doi:10.1038/ s41591-024-03244-8In the empirical SCRUM-Japan GOZILA study, after an average follow-up of 11 months, individuals with metastatic gastrointestinal tumors who obtained biomarker-matched treatments based on spreading cyst DNA profiling revealed a greater clinical benefit than those receiving incomparable therapy.