The heterogeneous nature of lung cancer has become increasingly apparent since introduction of molecularclassification. In general, advanced lung cancer is an aggressive malignancy with a poor prognosis. Activatingalterations in several potential driver oncogenic genes have been identified, including EGFR, ROS1 and ALKand understanding of their molecular mechanisms underlying development, progression, and survival of lungcancer has led to the design of personalized treatments that have produced superior clinical outcomes in tumoursharbouring these mutations. In light of the tsunami of new biomarkers and targeted agents, next generationsequencing testing strategies will be more appropriate in identifying the patients for each therapy and enablingpersonalized patients care. The challenge now is how best to interpret the results of these genomic tests, in thecontext of other clinical data, to optimize treatment choices. In genomic era of cancer treatment, the traditionalone-size-fits-all paradigm is being replaced with more effective, personalized oncologic care. This review providesan overview of lung cancer genomics and personalized treatment.