Background <p>Precision medicine has transformed oncology by tailoring treatments to the molecular and genetic characteristics of individual tumors. Stem cell-based strategies hold unique potential to complement these approaches by enabling regenerative support, targeted delivery of therapeutics, and novel models for drug screening.</p> Methods <p>This review synthesizes current evidence on the integration of stem cell biology into precision cancer therapy, highlighting advances in tumor profiling, next-generation sequencing (NGS), and genome editing that enable personalized interventions.</p> Results <p>Emerging applications include engineered stem cells for selective delivery of oncolytic agents, immune modulation through stem cell–derived platforms, and the use of induced pluripotent stem cells (iPSCs) for modeling tumor heterogeneity. Advances in NGS are accelerating tumor-specific profiling, facilitating gene editing of stem cells, and refining patient selection for therapy.</p> Challenges <p>Despite progress, translational barriers remain, including risks of tumorigenicity, ethical concerns, high costs, immune rejection, and limited large-scale clinical validation.</p> Conclusion <p>Stem cell–based precision oncology is a rapidly evolving field with significant promise. Future directions include integrating NGS-driven tumor profiling with engineered stem cells, optimizing safety through gene-editing technologies, and advancing clinical trials to establish efficacy. These efforts could reshape the landscape of individualized cancer care.</p>