Features and Comparison of Advanced Genomic Tests for Solid Tumors
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Same Biopsy, Five Different Reports: What Comprehensive Genomic Tests Measure, Where, and With What Assurance
In cancer care, the question is no longer "should we order a genetic test?" but "which test, for which patient, to answer which question?" The market offers platforms that look alike but differ considerably in scope, in the layers they measure (DNA, RNA, protein), in regulatory status and in the country where the testing is performed: Caris, Tempus, FoundationOne CDx + RNA, BostonGene and Genekor prime DX. We have previously covered the next-generation sequencing (NGS) technology underlying these tests and the role of RNA sequencing in precision oncology. In this article we compare the five platforms side by side in terms of scope, analytical approach, report content, approval status, turnaround time and the country where the laboratory is located. For the latest regulatory developments we relied on the companies' own announcements (Foundation Medicine, Caris, Tempus).
Quick Answer · Physician Summary
- The key difference is the layer: A test that looks only at DNA and a test that combines DNA + RNA + protein (immunohistochemistry) do not answer the same question. Fusions and splicing alterations in particular are detected more reliably with RNA. RNA sequencing is a standard part of the test at Caris, BostonGene and Genekor; at Foundation Medicine (FoundationOne RNA) and Tempus (xR) it is added to the DNA test and run on the same sample.
- "FDA-approved test" does not mean "the entire report is FDA-approved": FoundationOne CDx, Tempus xT CDx and Caris MI Cancer Seek are FDA-approved companion diagnostics; however, the RNA layer, HRD signatures and many additional analyses are reported as laboratory professional services.
- Laboratory location matters in practice: Caris, Tempus and BostonGene process samples in the United States; Genekor in Greece. Foundation Medicine has laboratories in the United States and Germany. Shipping, customs and block retrieval add to the turnaround time.
- In practice: Choose the test based on the clinical question, not on the number of genes. Results should always be reviewed by a molecular tumor board.
What changed in this update? (October 2026)
- Laboratory country added: For each platform, the country and laboratory where the test is performed have been added to the tables.
- FoundationOne updated: Foundation Medicine now offers its tissue test together with RNA (FoundationOne CDx + FoundationOne RNA). TMB, MSI and the HRD signature (HRDsig) are included in the standard report, and 13 immunohistochemistry tests are offered in the same laboratory.
- Genekor prime DX updated: RNA exome sequencing is now a standard part of the test. Genekor's molecular laboratory is accredited by CAP (College of American Pathologists), and the company also offers a pathology second opinion service in its own pathology laboratory for patients who request it.
- Scope narrowed: How many patients' treatment these tests change in real-world practice (clinical utility) is the subject of a separate article and has been removed from this one; this article focuses on the features of the tests and how they compare.
Why does this matter?
In many solid tumors, particularly lung, colorectal, breast, ovarian, prostate, pancreatic and biliary tract cancers, treatment selection is now guided by the genetic and protein characteristics of the tumor. An ALK fusion, a rare EGFR mutation, a HER2 alteration or a high tumor mutational burden can completely change the drug a patient receives. Even where in the gene a mutation lies can influence response.
However, these tests do not all measure the same thing. Some focus on a targeted gene panel with very high read depth; some read the whole exome and whole transcriptome to draw a broader picture; others combine genomic findings with protein-level biomarkers and pathology services. Because many of these tests are performed abroad for patients in Turkey, the location of the laboratory also directly affects turnaround time and logistics. Choosing the right test means making good use of both the patient's time and what is often a substantial out-of-pocket cost.
Is this the first FDA approval for comprehensive genomic tests?
No. In recent years the field has been shaped less by a race for "more genes" than by regulatory maturation:
November 2017
FoundationOne CDx
The first broad, pan-tumor NGS companion diagnostic to receive FDA approval (324 genes).
2023
Tempus xT CDx
FDA approval of the 648-gene panel; initially, a matched normal sample from the patient (blood or saliva) was required alongside the tumor.
May 2024
FoundationOne RNA
A 318-gene targeted RNA test launched for clinical use in the United States. Not FDA-approved; a laboratory-developed test (LDT).
November 6, 2024
Caris MI Cancer Seek
The first FDA-approved companion diagnostic based on whole exome + whole transcriptome sequencing; approved reporting is limited to 228 genes and also covers pediatric patients aged 1–22 years.
December 4, 2025
Foundation Medicine: 100 approved indications
FoundationOne CDx and FoundationOne Liquid CDx together reached 100 approved and active companion diagnostic indications (57 in the United States, 43 in Japan).
May 29, 2026
Tempus: tumor-only xT CDx
The test can now retain its approved status even when a normal sample cannot be obtained.
What is a comprehensive genomic profiling test?
Comprehensive genomic profiling (CGP) is a test that examines hundreds of genes simultaneously in a single tumor sample to detect mutations, gene copy number alterations, fusions and genomic signatures such as tumor mutational burden (TMB) and microsatellite instability (MSI). The aim is to identify suitable targeted therapies, immunotherapy options and clinical trials for the patient.
Three layers: what do DNA, RNA and protein tell us?
The easiest way to understand the platforms is to look at which biological layer they read. Each layer answers a different question, and none fully substitutes for another.
Figure 1 · Three different layers of information from a single tumor sample
The layers complement one another; there is no order or hierarchy among them.
Another fundamental distinction is the trade-off between breadth and depth. Targeted panels look at fewer genes but read each region hundreds of times; this is an advantage for detecting a low-frequency mutation in a small biopsy with few tumor cells. The whole exome and whole transcriptome approach, by contrast, sees nearly all genes and has a better chance of finding an unexpected fusion or a rare target, but its average read depth is lower and the report is more complex. This is not a good-versus-bad axis but a balance chosen according to the clinical question.
The five platforms, one by one
Foundation Medicine · FoundationOne CDx + FoundationOne RNA United States · Germany
- ScopeDNA in 324 genes (point mutations, small insertions/deletions, copy number alterations, rearrangements) + targeted RNA sequencing of 318 cancer-related genes with FoundationOne RNA. DNA and RNA are extracted from the same FFPE block, and the results are combined in a single report.
- Genomic signaturesTMB and MSI are in the standard report. The HRD signature (HRDsig), a pan-tumor signature that indicates homologous recombination deficiency independently of gene mutations such as BRCA, is added to the report without a separate order (manufacturer's claim).
- Fusions and RNAApproved DNA-based detection of ALK, ROS1, NTRK1/2/3, FGFR2 and RET fusions and of MET exon 14 skipping; the RNA layer reveals low-level fusions, rare or novel fusion partners and splicing events. It also reports copy number loss in genes such as BRCA1/2, PTEN and MTAP.
- Protein13 immunohistochemistry tests in the same laboratory: PD-L1 (22C3, 28-8, SP142, SP263 clones), HER2 and HER2 ISH, FOLR1 (FRα), CLDN18, MET, MAGE-A4, MMR, PTEN, ER, PR, DLL3, MTAP and TROP2.
- Approval statusFoundationOne CDx has been FDA-approved since 2017 and is CE-IVD certified. According to the company, FoundationOne CDx alone has more than 40 FDA-approved companion diagnostic indications; together with the liquid version, more than 100 in total (United States + Japan). FoundationOne RNA and HRDsig are not FDA-approved; they are reported as laboratory professional services.
- Sample success and turnaroundThe rate of no result due to insufficient sample (QNS) is approximately 1–2%, RNA sequencing success is 92%, and the median turnaround time for DNA + RNA in international markets is 10 days (manufacturer's claim; company data and company-authored publications).
- Liquid optionFoundationOne Liquid CDx: more than 300 genes, FDA-approved companion diagnostic for fusions including ALK, ROS1 and NTRK1/2/3; reports the proportion of tumor DNA in the blood (tumor fraction); median 7 days (manufacturer's claim).
Caris Life Sciences · MI Profile / MI Cancer Seek United States
- ScopeWhole exome (WES) and whole transcriptome (WTS) sequencing from a single sample, plus immunohistochemistry. Point mutations, copy number alterations, fusions, gene expression and signatures such as MSI, TMB, LOH and HRD are assessed together.
- Distinguishing featureThe ability to integrate additional analyses into the profile, such as MGMT promoter methylation, which is important in glioblastoma.
- Approval statusWith the FDA approval announced on November 6, 2024, MI Cancer Seek became the first WES + WTS-based companion diagnostic. However, approved reporting is limited to 228 genes: "22,000 genes are examined" is not the same as "22,000 genes are reported with FDA approval." The approval covers one pan-cancer and five tumor-specific indications and also includes pediatric patients aged 1–22 years. The rest of the broader MI Profile service is a laboratory-developed test.
- LaboratoryUnited States; company headquarters in Irving (Texas), molecular profiling laboratory in Phoenix (Arizona).
Tempus · xT (DNA) and xR (RNA) United States
- ScopexT is a 648-gene DNA panel; in addition to point mutations, insertions/deletions, copy number alterations and selected fusions, it calculates MSI and TMB. On the RNA side, xR detects fusions of known clinical significance and splicing abnormalities such as MET exon 14 skipping. HLA genotyping is also included in the report.
- Distinguishing featureMatching the tumor with the patient's normal sample (blood or saliva) makes it easier to separate somatic (tumor-specific) from inherited alterations. Its AI-assisted interpretation and clinical trial matching infrastructure stand out.
- Approval statusxT CDx has been FDA-approved since 2023; tumor-only use was also approved on May 29, 2026. This means the test can retain its approved status when a normal sample cannot be obtained, a practical advantage in countries such as Turkey where sample logistics are difficult. The xR RNA test is not FDA-approved.
- LaboratoryUnited States; CAP-accredited and CLIA-certified laboratories in Chicago, Atlanta and Durham.
BostonGene · Tumor Portrait™ United States
- ScopeTumor DNA (whole exome), matched normal DNA and tumor RNA (whole transcriptome) are sequenced together.
- Distinguishing featureIt translates RNA data into an analysis of the tumor microenvironment: the distribution of immune cells within the tumor, T-cell infiltration, inflammation signatures and pathway activation scores. Alongside the question "Which mutation is present?" it adds "What kind of immune environment has this tumor created?"; it is an additional reasoning tool in cases where the immunotherapy decision is difficult.
- Approval statusNot an FDA-approved companion diagnostic; a laboratory-developed test performed in a CLIA-certified and CAP-accredited laboratory. Results should be read not as an approved indication but as supplementary data that require clinical interpretation.
- LaboratoryUnited States; company headquarters in Waltham (Massachusetts). Offered in countries such as Japan through partnerships.
Genekor Medical · prime DX® Greece
- ScopeA 1021-gene DNA panel: all exons are read in 312 genes (point mutations, insertions/deletions, copy number), and part of the coding regions in 709 genes (point mutations, insertions/deletions). There is a DNA design for fusions and rearrangements in 38 genes. RNA exome sequencing is now a standard part of the test: according to the company, more than 20,000 genes and more than 69,000 transcripts; it detects ALK, ROS1, RET, NTRK and FGFR2/3 fusions and splicing events such as EGFRvIII and MET exon 14 skipping.
- BiomarkersTMB, MSI and HLA zygosity; an HRD analysis combining 36 homologous recombination genes and the RediScore® genomic instability score. When clinically indicated, PD-L1, HER2, FRα, CLDN18.2 and c-MET immunohistochemistry can be added to the same report. The report also includes pharmacogenomic information such as DPYD (5-FU toxicity) and UGT1A1 (irinotecan toxicity); this places the question "could this drug be risky for this patient?" alongside "which drug might work?"
- PathologyGenekor has its own pathology laboratory, and the company offers a pathology second opinion service for patients who request it. Because cases that are diagnostically challenging, of unknown primary or with equivocal pathology reports frequently reach tertiary centers, being able to re-evaluate the pathology together with molecular testing is valuable in practice.
- Approval and accreditationThe molecular biology and genetics laboratory is CAP-accredited; ISO 15189:2022 accreditation (for selected genes and biomarkers). Reagents and software are CE-IVD; the test is not an FDA-approved companion diagnostic.
- Turnaround and sample15 business days; a recent FFPE block with more than 20% tumor content is recommended, and a liquid version (prime DX Liquid) is available if tissue is insufficient (manufacturer's claim).
- LaboratoryGreece; headquarters and molecular laboratory in Athens (Gerakas), pathology laboratory in Thessaloniki.
Comparison table: scope
| Platform | Country where tested | DNA scope | RNA | Additional biomarkers | Distinguishing feature |
|---|---|---|---|---|---|
| FoundationOne CDx + RNA | United States (Massachusetts, North Carolina); Germany (Penzberg) | 324 genes | FoundationOne RNA: 318 genes, targeted | TMB, MSI, HRDsig standard; 13 IHC tests (PD-L1 4 clones, HER2, FRα, CLDN18, MET, TROP2, DLL3, etc.) | Most approved companion diagnostic indications |
| Caris MI Profile / MI Cancer Seek | United States (Phoenix, Arizona) | Whole exome | Whole transcriptome | MSI, TMB, LOH, HRD, MGMT methylation, IHC | DNA + RNA + protein in a single workflow; approved reporting 228 genes |
| Tempus xT + xR | United States (Chicago, Atlanta, Durham) | 648 genes | xR: transcriptome; fusions and exon skipping | MSI, TMB, HLA genotype | Matched normal or tumor-only; AI-assisted interpretation |
| BostonGene Tumor Portrait™ | United States (Massachusetts) | Whole exome + matched normal | Whole transcriptome | MSI, TMB, tumor microenvironment, immune cell distribution, pathway scores | Focus on functional immune biology |
| Genekor prime DX® | Greece (Athens; pathology in Thessaloniki) | 1021 genes (312 with all exons) | RNA exome, standard | MSI, TMB, HLA zygosity, HRD (RediScore®), PD-L1/HER2/CLDN18.2/FRα/c-MET IHC, pharmacogenomics | Broad biomarker package + pathology second opinion |
Comparison table: approval status, turnaround and report
| Platform | Country where tested | Regulatory status | Stated turnaround time* | Report style | Clinical question where it is strongest |
|---|---|---|---|---|---|
| FoundationOne CDx + RNA | United States; Germany | DNA test FDA-approved (2017) and CE-IVD; RNA and HRDsig laboratory services | Median 10 days (DNA + RNA) | Concise; actionable findings on the first page | "I need an approved result tied to a drug label" |
| Caris | United States | MI Cancer Seek FDA-approved (November 2024); the rest of the profiling services are laboratory-developed | Approximately 10–14 days | Rich; expression-based recommendations | "I don't want to miss a rare target or fusion outside the panel" |
| Tempus | United States | xT CDx FDA-approved (2023; tumor-only May 2026); xR laboratory-developed | Approximately 10–14 days | Digital portal; combined DNA + RNA summary | "I want a clear somatic–germline distinction and strong clinical trial matching" |
| BostonGene | United States | CLIA/CAP laboratory-developed test; not FDA-approved | Approximately 2–3 weeks | Multilayered, graphics-heavy, long | "The immunotherapy decision is difficult; I want to see the tumor's immune environment" |
| Genekor prime DX® | Greece | CAP-accredited laboratory; CE-IVD reagents and software; not FDA-approved | 15 business days | Interactive PDF; expandable gene-level information | "HRD, immune markers, IHC and pharmacogenomics in one go; pathology second opinion if needed" |
*Turnaround times are those measured by the companies in their own laboratories, from sample receipt to report. For samples sent from Turkey, time for block retrieval, shipping and customs must be added.
Three pitfalls when reading the tables
- Gene counts do not measure the same thing: "1021 genes" and "324 genes" are reported at different depths, for different types of alterations and with different levels of regulatory assurance. A gene may appear "covered" by a panel while only some of its regions are actually read. In prime DX, for example, all exons are examined in 312 of the 1021 genes, and only part of the coding regions in 709.
- Turnaround times are not directly comparable: Some laboratories give calendar days, some business days, some a median time. When giving a patient a time frame, quote the average actually achieved at your own center, not the figure in the brochure.
- Company data and independent data do not carry the same weight: Sample success rates, sensitivity and statements such as "rate of actionable findings" mostly come from the manufacturer's own data or from company-authored publications. Independent head-to-head comparisons of the platforms remain limited.
Common claims and what is closer to the truth
Commonly heard"A test that looks at more genes is better."
Closer to the truthGene count is a trade-off; as breadth increases, depth and report clarity may decrease. The right test is the one that best answers the clinical question.
Commonly heard"This test is FDA-approved, so the entire report is approved."
Closer to the truthApproval is limited to specific gene–drug pairings. The RNA layer, HRD signatures and many additional analyses are laboratory professional services and require interpretation.
Commonly heard"The test found a targetable mutation, so now I have a treatment."
Closer to the truthSome findings carry only weak evidence; variants of uncertain significance (VUS) are not a basis for treatment. Decisions depend on the level of evidence for the finding, the patient's condition and access to the drug.
Which test for which patient?
Figure 2 · Test selection by clinical question
A simplified framework; more than one platform may answer the same question. The decision is made by the team that knows the patient.
- If a definitive result tied to the label of an approved drug is needed: FoundationOne CDx, which has the broadest companion diagnostic basis, followed by Tempus xT CDx and Caris MI Cancer Seek.
- If no driver mutation has been found and a fusion or exon skipping is suspected (as in a young never-smoker with lung cancer): a test that includes RNA is essential. Caris and BostonGene read the whole transcriptome; in prime DX, RNA exome sequencing is standard; with FoundationOne, RNA is ordered together with CDx.
- If the immunotherapy decision is in a gray zone: BostonGene if tumor microenvironment data beyond TMB and MSI are wanted; prime DX or FoundationOne's IHC panel if HLA zygosity, TMB, MSI and PD-L1 are wanted together.
- If HRD is needed for a PARP inhibitor or platinum decision (ovarian, breast, prostate, pancreatic): FoundationOne (HRDsig), prime DX (RediScore®) or Caris. HRD definitions and thresholds differ between platforms.
- If a protein biomarker is needed for an antibody–drug conjugate: for markers such as pan-tumor HER2, FRα or CLDN18.2, platforms that offer IHC in the same laboratory as the genomic test (FoundationOne, Genekor, Caris) simplify the workflow. These tests can also be performed in pathology laboratories in Turkey.
- If the pathology diagnosis is disputed: in cases of unknown primary, uncertain subtype or an equivocal pathology report, a pathology second opinion should be considered before or together with molecular testing. Genekor offers this service in its own pathology laboratory; experienced pathology centers in Turkey are also an option.
- If tissue is insufficient or a biopsy is risky: liquid biopsy options (FoundationOne Liquid CDx, prime DX Liquid, others) come into consideration. However, a negative result on liquid biopsy does not mean there is no alteration; the tumor may not be shedding enough DNA into the blood. If the tumor fraction is low, a return to tissue testing is needed. The use of circulating tumor DNA for postoperative recurrence monitoring is a separate area of application.
- If the patient is deteriorating rapidly: the most comprehensive test is not the right test if its result arrives later than the patient can wait. In this situation, rapid targeted tests that can be performed in Turkey (single-gene or small panels) may be the more sensible choice.
Four questions to ask before testing
- Can the result of this test actually change the treatment decision for this patient?
- Is the patient's general condition suitable for waiting for the result and starting a new treatment?
- Is there access (marketing authorization, reimbursement, clinical trial) to the targeted drug that might be identified?
- Is the available tissue sufficient and of adequate quality (tumor cell content, block age, biopsy type)?
If the answer to even one of these questions is "no," the priority and type of testing should be reconsidered.
The situation in Turkey
- The sample goes abroad: None of these five platforms performs the test in Turkey; samples are sent to laboratories in the United States, Germany or Greece. Confirm with the company's representative in Turkey which laboratory will process a sample sent from Turkey. Distance directly affects shipping and customs time.
- Consent and data: Because the sample and health data are sent abroad, the patient must be informed about this and written consent must be obtained.
- Cost: In most cases, comprehensive genomic tests are not covered by SGK (the Turkish Social Security Institution) and are paid out of pocket. For this reason, the expected benefit and the cost should be discussed openly with the patient before the test is ordered. A targeted drug matched to a finding may not be licensed or reimbursed in Turkey; importing the drug from abroad must be planned separately.
- Tissue quality: Insufficient tumor cell content or old FFPE blocks can lead to technical failure. Talk to pathology in advance when planning the test, and select the most recent block with the highest tumor content.
- Inherited findings may emerge: Particularly with tests that use a matched normal sample, and in genes such as BRCA, an inherited alteration relevant to the family may be found. This possibility should be discussed before testing, and genetic counseling should follow if it occurs.
- The report alone is not a treatment plan: Results should be reviewed by a molecular tumor board. Abandoning a proven treatment on the basis of a weakly supported finding is one of the most common mistakes.
For patients and families
- What are these tests? They produce a genetic "ID card" of your tumor and look for immunotherapy or targeted therapy options that may work specifically for you. In some patients they change treatment from the outset; in others no clear target is found. That is also a normal result and does not mean you have no treatment options.
- What to keep in mind? "The test that looks at the most genes is the best" is not true. Not every finding in the report means there is a drug.
- What can you ask? "Can this test change my treatment?", "Which country will my sample go to, how long will the result take, and what will we do in the meantime?", "What does it cost?" and "Could a finding be relevant to my family?"
Frequently asked questions
- In which country are the FoundationOne, Caris, Tempus and Genekor tests performed?
- Caris, Tempus and BostonGene tests are performed in the United States, and Genekor prime DX in Greece. Foundation Medicine has laboratories in the United States and Germany. Which laboratory a sample sent from Turkey will go to should be confirmed with the company's representative.
- Why is RNA sequencing important in genomic testing?
- Fusions and splicing alterations, for example ALK, ROS1, RET and NTRK fusions or MET exon 14 skipping, can be missed by DNA testing. RNA sequencing detects these alterations more reliably; it is especially important in patients in whom no driver mutation has been found.
- What does an FDA-approved test mean?
- It means the test has been approved as a companion diagnostic for specific gene–drug pairings. The entire report is not approved; the RNA layer, HRD signatures and many additional analyses are reported as laboratory professional services and require interpretation.
- Which genomic test is better?
- There is no single "best" test. Different platforms stand out depending on the clinical question, such as an approved drug match, a search for fusions, HRD, immunotherapy or a pathology second opinion. The choice should be made by considering cancer type, tissue availability, turnaround time and cost together.
Glossary
- Comprehensive genomic profiling (CGP)
- A genetic test that examines hundreds of genes simultaneously in a single sample.
- Companion diagnostic (CDx)
- A test formally approved to determine which patients should receive a particular drug.
- Fusion
- The joining of two different genes to produce an abnormal protein; ALK and ROS1 fusions are examples.
- TMB
- Tumor mutational burden; a measure of the number of mutations in a tumor, used in immunotherapy decisions.
- MSI
- Microsatellite instability; an indicator of defective DNA repair, associated with response to immunotherapy.
- HRD
- Homologous recombination deficiency; a DNA repair defect associated with sensitivity to PARP inhibitors and platinum.
- Immunohistochemistry (IHC)
- The visualization of specific proteins in tissue using special stains; PD-L1 and HER2 tests are examples.
- CAP / CLIA / CE-IVD
- CAP: laboratory accreditation by the College of American Pathologists; CLIA: US clinical laboratory certification; CE-IVD: conformity marking for diagnostic use in Europe.
DROZDOGAN Academy Commentary
When comparing comprehensive genomic tests, the real question is not "which one looks at more genes?" but "which one answers my patient's question in time and reliably?"
⚡ Why it matters
The differences between platforms are not technical brochure details: which layer is read (DNA, RNA, protein), which finding carries regulatory assurance, in which country the sample is processed and when the result arrives all directly affect the treatment decision.
✅ What we know
The field is maturing rapidly: RNA sequencing is now either standard or available as an add-on to the DNA test on all five platforms. FoundationOne CDx, Tempus xT CDx and Caris MI Cancer Seek are FDA-approved companion diagnostics, and there is a growing trend toward bringing genomic testing, protein biomarkers and pathology services under one roof.
⚠️ Limitations
Independent head-to-head data comparing the platforms are very limited; much of the technical information is manufacturer's claims. Turnaround times are in-laboratory measurements and are longer for samples shipped from Turkey. HRD definitions and thresholds differ between platforms, so results are not interchangeable.
🩺 In practice
Choose the test according to the clinical question. If an approved gene–drug match is needed, prefer the platform with a strong companion diagnostic basis; when a fusion is suspected, a test that includes RNA; when HRD, immune markers and pharmacogenomics are needed together, one that brings them into a single report. In diagnostically challenging or equivocal cases, which frequently reach tertiary centers, planning a pathology second opinion together with molecular testing saves time. Always discuss the result at a molecular tumor board.
❓ Open questions
Does the breadth of whole exome and whole transcriptome sequencing provide a measurable advantage in clinical outcomes over panel-based approaches? How concordant are the platform-specific HRD signatures? Will AI-assisted interpretation layers reduce or increase weakly supported recommendations? And will some of these tests become available within Turkey with the same quality assurance?
Bottom line: None of the five platforms is "the best" on its own. The right test is the one chosen according to the clinical question, tissue availability, turnaround time, cost and, where needed, pathology support.
Transparency note
- This article was prepared in August 2026 and updated in October 2026.
- Regulatory information is based on the companies' official announcements. Gene counts, sample success rates, turnaround times and laboratory locations are largely taken from the manufacturers' own documents and websites; independent verification is limited, and this information may change over time.
- Information on FoundationOne CDx + RNA was taken from Foundation Medicine's Turkish-language product information document and the company's announcements. Information on Genekor's pathology second opinion service was obtained from the company.
- This article was prepared without regard to any commercial relationship with any company and is not a product recommendation. The diagrams are derived from the text and contain no new data. The Academy commentary is our own.
References
- Foundation Medicine. Foundation Medicine achieves 100 approved and active companion diagnostic indications (December 4, 2025). foundationmedicine.com
- Foundation Medicine. FoundationOne RNA U.S. launch (May 21, 2024). foundationmedicine.com
- Foundation Medicine. Introducing the HRDsig biomarker. foundationmedicine.com
- Foundation Medicine. FoundationOne CDx + RNA Turkish-language product information document (2026; company data).
- Foundation Medicine. Inside our Germany location (Penzberg laboratory). careers.foundationmedicine.com
- Caris Life Sciences. Caris Life Sciences receives FDA approval for MI Cancer Seek (November 6, 2024). carislifesciences.com · Clinical and analytical validation: PubMed 40804002
- Tempus. Tempus receives FDA approval for xT CDx (2023). tempus.com
- Tempus. Tempus receives FDA approval for tumor-only xT CDx (May 29, 2026). businesswire.com
- Tempus. Tempus sequencing labs overview. tempus.com
- BostonGene. Fujita Health University and BostonGene expand access to genomic cancer testing with Tumor Portrait (October 2024). biospace.com
- Genekor Medical. prime DX® product page. genekor.com · Corporate information and accreditations: genekor.com
- Genekor Medical. prime DX® Combo sample report. genekor.com
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