The advent of precision oncology has brought about a paradigm shift in the management of cancer, with increased emphasis on personalized treatment approaches. The key aspects of this approach are to identify spatially variable genes, which exhibit significant expression differences across distinct regions of a tumor. These spatially variable genes have emerged as potential therapeutic targets and biomarkers in cancer, as they reflect the inherent heterogeneity within the disease. By capturing the spatial variability of gene expression across a tumor, researchers and clinicians learn important things about the underlying biology and develop more targeted and effective treatment strategies for individual patients. The recent advances in spatial variable genes and the associated methods in oncology are the main topics of this chapter. By understanding how gene expression varies spatially within tumors, we can potentially improve diagnostic accuracy, treatment efficacy, and patient outcomes in oncology.