In lung cancer, clinically relevant prognostic information is provided by staging. Staging forms the basis for the treatment options and this is briefly summarized in the introduction. Epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase are biomarkers used for prediction of chemotherapy and prediction of targeted treatment. Other driver biomarkers in lung cancer (point mutations and rearrangements in specific genes including Her2, BRAF, NUT, MET, ROS1, DDR2, FGFR1, KRAS, and PTEN) might potentially provide additional information for clinical decision making. Owing to the low prevalence of mutations in predictive markers, patient numbers in studies are usually small, with the exception of EGFR. These mutations increase our understanding of the biology of lung cancer. Mutation analysis as a basis for treatment choice can have an impressive clinical impact with dramatic responses. However, as yet the impact of these approaches to overall survival is less striking.