.Attribute Medicine, Published online: 16 September 2024 doi:10.1038/ s41591-024-03244-8In the observational SCRUM-Japan GOZILA research, after an average follow-up of 11 months, clients with metastatic gastrointestinal cysts that obtained biomarker-matched treatments based on circulating cyst DNA profiling showed a more significant clinical benefit than those obtaining incomparable therapy.