The emergence of an evolutionary cancer perspective has major implications for cancer biology, patient management and clinical trial design. Through our collective strength in evolutionary biology, statistical genetics, molecular pathology and leadership of the Genomics England 100,000 genome project and the Genomics England Clinical Interpretation Partnership (GeCIP), we are well positioned to profile patients at diagnosis and throughout therapy, linking response to biomarkers and the integration of complex genomics and clinical datasets. The Centre’s collaborative Evolution computational and data resource will support the aims of the programme and enable cancer’s dynamics to be mapped longitudinally during exposure to biological therapies, integrated within the partners’ NHS service.