<p>The comprehensive understanding of the molecular basis of malignant diseases and the development of new targeted therapeutics has permanently changed the treatment reality for many types of cancer. While numerous molecularly targeted substances are now the approved standard of care, the increasing use of advanced molecular diagnostics using high-throughput methods such as next-generation sequencing is leading to the identification of molecular target structures beyond the limits of approval. In this situation, molecular tumor boards attempt to provide clinically meaningful support in the classification of therapeutic value and to document treatment successes as well as ineffective treatment strategies. Since the care of cancer patients in Germany is predominantly decentralized and takes place across sector boundaries, cooperation between the various stakeholders is of crucial importance to enable optimal clinical care, the collection of real-world data and translational research.</p>