Cancer Genomic Medicine (CGM) optimizes therapeutic intervention based on the cancer genomic profiling (CGP) tests. To discuss a necessary platform to actualize CGM under the national health insurance system in Japan, The Ministry of Health, Labour and Welfare (MHLW) defined the network of CGM hospitals, and also set a central datacenter, Center for Cancer Genomics and Advanced Therapeutics (C-CAT), to aggregate genomic as well as clinical information for the cancer patients. CGM officially started in 2019 with two CGP tests, and, as of July 2022, Japan has a total of 233 CGM hospitals, and C-CAT has already collected the genomic/clinical information of over 38,000 patients. Also, from 2021, Japan has started a large-scale whole genome sequencing (WGS) research project for cancer. About ten thousands of cancer specimens are expected to be analyzed with WGS/RNA-sequencing every year, and Japan is seeking an adequate way to bring such WGS results to the patients. I would like to overview how CGM has been constructed in Japan and where it heads.