Malignant neoplasms have possible specific genetic characteristics that may determine the effectiveness of various treatments. Pharmacogenomics in oncology represents an advanced approach aimed at identifying the genetic features of tumors to select the most optimal therapeutic strategies. This review focuses on the role of pharmacogenomic approaches in the implementation of personalized treatment for oncological diseases. Pharmacogenomics is a cutting-edge field that relies not only on advances in next-generation sequencing but also on modern methods and algorithms for processing large volumes of data. This review discusses the relationship between pharmacogenomics and next-generation sequencing technologies, machine learning, and artificial intelligence. It emphasizes the importance of accumulating real-world data to enable the proper interpretation of identified genetic mutations and the use of this information in treatment personalization. The review also covers existing pharmacogenomic platforms and characterizes a domestically developed pharmacogenomic platform for making clinical decisions in oncology. © 2023, Media Sphera Publishing Group. All rights reserved.