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In this study, we report the feasibility analysis of the first 55 patients enrolled in the multicentric, randomized controlled EXALT\u20102 trial (NCT04470947) comparing treatment recommendations of gPM, fPM, and physicians' choice (PC) head to head. In 54 patients (98%), the diagnostic workflow was successfully implemented, resulting in treatment recommendations for 42 patients (76%), of whom 29 (69%) received the suggested individualized treatments. Actionable targets were identified in 65% by gPM and 80% by fPM (64% microscopy\u2010based, 86% flow cytometry\u2010based fPM). The median time to report was shorter for fPM than for gPM testing. The two strategies revealed overlapping drug targets in 60% of cases. Both, gPM and fPM can efficiently be integrated into the clinical routine to guide therapy decisions for the majority of patients.<\/jats:p>","DOI":"10.1002\/hem3.70129","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T09:16:37Z","timestamp":1745486197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparing functional and genomic\u2010based precision medicine in blood cancer patients"],"prefix":"10.1002","volume":"9","author":[{"given":"Lukas","family":"Kazianka","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, Division of Hematology and Hemostaseology Medical University of Vienna Vienna Austria"},{"name":"Ludwig Boltzmann Institute for Hematology and Oncology Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Pichler","sequence":"additional","affiliation":[{"name":"Department of Internal 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