Nature, Published online: 05 February 2025; doi:10.1038/d41586-025-00335-5Electronic health records and tumour-genome profiling offer promising real-world data with which to model cancer outcomes. Models built by using artificial intelligence (AI) to annotate clinical reports from more than 20,000 individuals with cancer can predict survival, as well as identify genomic features associated with metastasis and response to immunotherapy.