Changes in technology, with decreases in the cost of molecular profiling, has expanded the interest in creating institution-wide personalized medicine platforms to allow selective assessment of a given patient's tumor in real time, with the ability to utilize that information for patient-care decisions. In order for this approach to function adequately, a multidisciplinary team must be created in an environment with dedicated support at an institutional level. J. Surg. Oncol. 2015 111:3–8. © 2014 Wiley Periodicals, Inc.