What Are CeGaT Tumor Tests? CancerPrecision, CancerDetect, and CancerNeo – For Whom and When?

Tumor Genetics from Tübingen: The CeGaT Test Family, Which Test for Whom and When?

CeGaT is a diagnostic laboratory founded in 2009 in Tübingen, Germany, that offers genetic analyses of tumor tissue and blood for people with cancer. The tests the company offers under names such as CancerPrecision, CancerEssential, CancerDetect, CancerMRD and CancerNeo form a "test family" designed to answer different clinical questions. In this article, drawing on the company's tumor diagnostics page and its brochure, we look at what each test in the family does, for whom and in which situations it may be considered, how to read the report, its link to the personalized vaccine programs in Tübingen and how it differs from other laboratories' tests, together with the evidence and the limitations. We have covered the general features of comprehensive genomic tests and a comparison of Foundation Medicine, Caris, Tempus, BostonGene and Genekor in our article on advanced genomic tests for solid tumors, and discussed next-generation sequencing (NGS), RNA sequencing and the personalized peptide vaccine used for glioblastoma in Tübingen in separate articles.

Why does this matter?

People with cancer and their families look into genetic tests performed abroad and personalized vaccines, especially when standard treatment options are running out. One of the names they encounter most often in this search is CeGaT, which is also known for the personalized vaccine programs in Tübingen. However, choosing correctly among the company's similarly named tests, and telling apart which test will truly change a treatment decision and which will only provide additional information, is not easy.

For physicians, too, the right test, the right sample and the right timing matter: choosing the wrong test can use up valuable tissue and lead to unnecessary costs and lost time. This article aims to evaluate CeGaT's tests beyond the company's own description, together with the evidence, the limitations and the alternatives.

What are CeGaT tumor tests?

CeGaT tumor tests are genetic analyses that the CeGaT laboratory in Tübingen offers to people with cancer. Using next-generation sequencing of tumor tissue or blood, they look for changes that can guide treatment. Together they form a family that ranges from a narrow organ-specific panel (CancerEssential) to a comprehensive 781-gene panel (CancerPrecision), and from blood-based monitoring tests (CancerDetect, CancerMRD) to neoantigen analysis for personalized vaccine design (CancerNeo).

The test family in one table

Detection threshold: the minimum percentage of DNA in the sample in which a change must be present for it to be reported. Tumor content: the minimum percentage of cells in the sample that must be tumor cells. The information was compiled from the company's website as of October 2026. The company also offers blood-based genetic testing (germline panels) for hereditary cancer syndromes.

The tests one by one

CancerPrecision: the family's comprehensive test

CancerPrecision is the company's most comprehensive tumor panel, presented as the "first choice." It analyzes the coding regions of 781 tumor-related genes and DNA-level structural variants in 38 genes (fusions such as ALK, ROS1, RET, NTRK and MET). With an average read depth of 500–1,000×, changes present in only part of the tumor (subclones) can also be captured. In a high-quality sample containing at least 20% tumor, the company reports a sensitivity above 97.6% and a specificity above 99.9%.

The report includes the following sections:

• Treatment-relevant changes: For each change, the relevant drugs and their FDA or European Medicines Agency (EMA) approval status.
• Immunotherapy biomarkers: Tumor mutational burden (TMB, from a 2.13-megabase panel), microsatellite instability (MSI) calculated by next-generation sequencing and traces of viruses or bacteria (HPV, EBV, MCV, CMV, H. pylori, HBV).
• Homologous recombination deficiency (HRD) score: Calculated for every patient regardless of tumor type; it provides a clue to sensitivity to PARP inhibitors and platinum (PARP inhibitors in ovarian cancer).
• Inherited findings: Because the tumor is compared with blood, disease-related inherited changes are reported separately (hereditary cancers and targeted drugs, ATM gene mutation).
• Pharmacogenetics: Inherited variants in genes such as DPYD, UGT1A1, TPMT, NUDT15 and CYP2D6 that affect the dosing of chemotherapy and other drugs.
• CHIP: Mutations that arise in blood cells with age and do not belong to the tumor; especially important for avoiding misinterpretation of blood tests.
• Additional sections: A copy number profile, a diagram of 9 key signaling pathways and charts comparing the TMB and HRD values with those of other patients.

The test can also be performed on blood, but the tumor DNA fraction in the blood must be at least 20%. This level cannot be reached in many patients, especially when the disease burden is low. In that case, the company's more sensitive blood test, CancerDetect, comes into play.

Why does comparing the tumor with blood matter?

In tests that sequence only the tumor, computer algorithms try to filter out the thousands of harmless variants the patient was born with. This approach is error-prone and can lead to tumor mutational burden being overestimated; in one study, this problem was particularly pronounced in patients of non-European ancestry. A tumor–normal comparison also makes it possible to detect an inherited predisposition in about 17.5% of patients with advanced cancer; more than half of these may be missed by classic family history criteria. CeGaT performs this comparison as standard in its comprehensive tests, whereas many widely used tests analyze only the tumor.

Sample report: BRCA2 in breast cancer

In the sample report in the company brochure, the results of a patient with breast cancer are summarized in boxes on the first page. Boxes that matter for treatment are highlighted in color:

This example shows the value of the tumor–normal comparison well: the same test reveals both a treatment target (BRCA2 and HRD) and an inherited risk that concerns the patient's children and siblings (risk-reducing approaches in BRCA carriers).

CancerEssential: organ-specific, fast and more economical

CancerEssential is a narrow panel developed together with oncologists and pathologists that analyzes the genes most often affecting treatment decisions in each tumor type. The read depth is about 1,000×, the sensitivity is above 99.8% and the turnaround time is 2–3 weeks. TMB, HRD and copy number analyses are not performed; MSI is ordered separately by PCR and also requires a blood sample. For example, the lung set includes EGFR, KRAS, BRAF, MET and ERBB2 as well as ALK, RET and ROS1 fusions; the prostate set includes 24 DNA repair genes, among them BRCA1/2, ATM and CDK12; and the glioma set includes the IDH1/2, ATRX, TERT and H3 genes.

In early-stage disease, or when a single target question needs to be answered (for example EGFR, KRAS G12C and fusions in lung adenocarcinoma, or RAS and BRAF in colorectal cancer), this panel may be sufficient. In rare tumors, when standard treatments have been exhausted, or when immunotherapy biomarkers and inherited risk are also of interest, the comprehensive panel is more appropriate.

CancerFusionRx and CancerIFP: the RNA and protein layers

Gene fusions are among the targets that respond best to treatment (such as ALK, ROS1, RET, NTRK, FGFR2 and NRG1). CancerFusionRx analyzes more than 200 genes and more than 130 regions targeting known breakpoints in tumor RNA, looking for both known and novel fusion partners; it also detects treatment-relevant transcript changes such as MET exon 14 skipping and EGFRvIII. The company states that this method is superior to DNA-based and whole-transcriptome methods, but comparative data supporting this claim have not been published on its website. It is, however, generally accepted that adding RNA analysis to DNA testing increases fusion detection.

CancerIFP, in turn, is a method that stains nine proteins simultaneously on a single tissue section (multiplex immunofluorescence): immune cells (CD45), immune checkpoints (PD-L1, LAG3), signaling pathways (p-mTOR, p-ERK), p16, p53, HER2 and TROP2, the target of antibody–drug conjugates. It is a laboratory-developed test, and the company itself notes that results may differ from standard immunohistochemistry. For this reason, for biomarkers tied to drug approval, such as PD-L1 and HER2, the approved standard immunohistochemistry test should be the basis for decisions.

CancerDetect: target search and resistance tracking from blood

CancerDetect reads the tumor DNA in blood 50,000–100,000 times using duplex molecular barcoding (duplex UMI), so it can capture mutations at a frequency of 0.25% even in samples with a tumor DNA fraction as low as 1%. It analyzes treatment-relevant hotspots in 31 genes (such as EGFR T790M and L858R, KRAS G12/G13/Q61, BRAF V600 and PIK3CA), the entire TP53, PTEN and CDKN2A genes, and fusions in 6 genes. Besides blood, abdominal fluid (ascites), cerebrospinal fluid and pancreatic cyst fluid are also accepted; this can be valuable in brain tumors and in spread to the lining of the brain (other uses of liquid biopsy).

In the company's case example, a 42-year-old patient with EGFR-mutant lung cancer whose disease progressed after afatinib and who could not undergo a biopsy had a negative result on a standard blood panel, whereas CancerDetect detected the EGFR T790M resistance mutation in a sample containing only 2% tumor DNA, and treatment was switched to osimertinib (EGFR-mutant lung cancer). This single case illustrates the test's sensitivity; it is not a comparative study.

Limitation: Because the test looks only at selected hotspots, it cannot see TMB, copy number or mutations outside these regions. A negative blood test does not mean the tumor has no target; tissue testing should be considered.

CancerMRD: residual disease tracking with a whole-genome fingerprint

CancerMRD first performs whole-genome sequencing on the tumor and a blood sample to create a "fingerprint" made up of many mutations specific to the patient's tumor, and then searches for this fingerprint in each subsequent blood sample. The company reports that it can detect tumor DNA in blood at a level of 0.02% (200 per million). The whole-genome approach allows more mutations to be tracked than panel-based tests and thus higher sensitivity; we discussed similar approaches in our articles on whole-genome-based ctDNA tests and ultrasensitive residual disease tests.

CancerNeo and the personalized vaccines in Tübingen

CancerNeo generates the data needed to design a personalized cancer vaccine: whole-exome sequencing of the tumor and blood (which also includes the CancerPrecision analyses), whole RNA sequencing of the tumor, typing of the patient's tissue type (HLA) and neoantigen prediction from these data. The up to 12 selected neoantigens consist of both short (8–12 amino acids) and long (about 17 amino acids) peptides, so as to stimulate helper (CD4) and cytotoxic (CD8) T cells together. The selected peptides are presented in a separate report for vaccine formulation. MGMT promoter methylation, PD-L1 and HLA staining can be added on request.

An important distinction: CancerNeo is not a vaccine but an analysis that produces the vaccine's "recipe." Manufacturing and administering the vaccine is a separate process; in Tübingen, CeCaVa (Centre for Cancer Vaccines), the joint venture of CeGaT and B. Braun, works in this field. In Germany, these vaccines are given under the physician's responsibility as an "individual treatment attempt"; they are not an approved drug.

Real-world data on 173 glioblastoma patients vaccinated with this approach were published in Nature Communications in 2024:

• Patients: 70 were vaccinated after initial treatment without progression, and 103 after progression.
• Safety: Side effects were infrequent and mostly mild (grade 1–2).
• Immune response: Of the 97 patients monitored, 87 (90%) developed a response to at least one vaccine peptide; in most patients the responses were durable.
• Survival: Median overall survival from diagnosis was 31.9 months; 53 months in those who developed a multiple T-cell response and 27 months in those who did not.

These results should be read with caution: there is no comparison group; because vaccine manufacturing takes time, only patients who remain in good condition during this period can be vaccinated, and calculating survival from diagnosis may make the effect look better than it is. Whether patients with strong immune responses live longer because of the vaccine or because these patients already had a more favorable disease course is unknown (reading research correctly). Randomized trials are needed to prove efficacy. In glioblastoma, standard treatment with surgery, radiotherapy and temozolomide remains in place; the vaccine can be considered only in addition to it, at specialized centers (the latest in glioblastoma treatment, molecular diagnosis and individualized treatment in glioblastoma, new treatments for high-grade gliomas). Currently, the strongest evidence for personalized neoantigen therapies comes from melanoma: in October 2026, a personalized mRNA therapy (intismeran) reduced the risk of relapse in a phase 3 trial for the first time (cancer vaccines, mRNA vaccine trials in lung cancer).

CancerAdvice: from test result to treatment recommendation

CancerAdvice is a consulting report that combines CeGaT test results with the patient's treatment history, pathology and immunohistochemistry findings to list approved, off-label and clinical trial options. For off-label options, trial data are provided in tables, and the report can be used as a scientific rationale in insurance applications. This requires detailed information such as recent clinical reports, medication history, ECOG performance status, sites of metastasis and planned procedures. The clinical trial search is limited to a maximum of five countries. This report can be a valuable resource; however, it does not replace the assessment of the local team that knows the patient and of the molecular tumor board.

How do CeGaT tests compare with other laboratories?

We compared laboratories offering comprehensive genomic tests in detail in a separate article. The table below places CeGaT CancerPrecision side by side with the tests from that article using the same criteria:

Values are based on the companies' own statements and our earlier comparison article; they may change over time. The table is not a ranking.

When does CeGaT stand out, and when is another test more suitable?

• Where it stands out: When a standard comparison of tumor and blood is wanted (inherited risk, accurate TMB), when pharmacogenetic and CHIP information is wanted in the same report, when a personalized vaccine is planned (CancerNeo), or when analysis of fluids other than blood, such as cerebrospinal fluid, is needed (CancerDetect).
• Where another test may be more suitable: When a specific FDA-approved companion diagnostic is required for a drug's approval or reimbursement; when a very fast result is needed; when the tumor cell content is below 20% and a new sample cannot be obtained; or when a targeted test available at a local center is enough to answer the clinical question.
• Common ground: Whichever laboratory is chosen, the result should be interpreted by a molecular tumor board, taking levels of evidence into account.

For patients and their families: questions to ask before ordering a test

• Which CeGaT test is right for me, and why? A narrow panel, a comprehensive panel or a blood test?
• Could the result change my treatment? Which options might come into consideration?
• Is my existing pathology sample adequate? Is the tumor content above 20%, or will a new biopsy be needed?
• What happens if an inherited finding turns up? How does it affect my family, and will I be able to receive genetic counseling?
• What are the total cost and time? What happens if the sample turns out to be inadequate?
• If a personalized vaccine is being considered: Have the vaccine's level of evidence, manufacturing time, cost and how it will be combined with my standard treatment been discussed?

At the decision stage, getting a second opinion can be helpful, especially when evaluating testing and vaccine options abroad.

Frequently asked questions

What is the CeGaT CancerPrecision test?

CancerPrecision is the comprehensive tumor test of the CeGaT laboratory in Tübingen, analyzing 781 genes. The tumor is compared with the normal DNA in the patient's blood; mutations, fusions, TMB, MSI, HRD, inherited findings and pharmacogenetic variants are provided in a single report. Results take about 2–3 weeks, and a sample containing at least 20% tumor cells is required.

What is the difference between CancerPrecision and CancerEssential?

CancerEssential is a narrow, organ-specific panel of 6–24 genes for each tumor type; it searches for common, approved targets quickly and at lower cost. CancerPrecision shows all options with 781 genes, TMB, HRD, copy number and a tumor–normal comparison; it is more suitable for advanced, rare or heavily pretreated tumors.

When are CeGaT's blood tests used?

CancerDetect is used to search for targets when tissue cannot be obtained and to monitor resistance mutations during treatment; it can detect mutations at a frequency of 0.25%. CancerMRD monitors minimal residual disease and early relapse after treatment using a tumor-specific whole-genome fingerprint; its clinical benefit is still being investigated in many cancers.

Can a personalized vaccine be made with CancerNeo?

CancerNeo provides data for vaccine design by selecting up to 12 neoantigens through whole-exome and RNA sequencing; it is not the vaccine itself. In Tübingen, such peptide vaccines are given as individual treatment attempts. Observational data on 173 patients with glioblastoma are encouraging, but efficacy has not yet been proven in randomized trials.

Glossary

Tumor–normal (matched normal) comparison

Sequencing tumor DNA together with the normal DNA in the patient's blood to identify tumor-specific changes with certainty.

Detection threshold (NAF)

The lowest fraction of DNA in the sample in which a mutation must be present for it to be reported.

Tumor mutational burden (TMB)

The number of mutations per megabase of tumor DNA; a high value is associated with response to immunotherapy.

Homologous recombination deficiency (HRD)

A defect in the DNA double-strand repair system; associated with sensitivity to PARP inhibitors.

Pharmacogenetics

The study of inherited differences that affect how drugs are broken down in the body and their side effects.

CHIP

Mutations that arise in blood cells with age and are unrelated to the cancer; they can lead to misinterpretation of blood tests.

Minimal residual disease (MRD)

Disease that cannot be seen on imaging after treatment but can be detected through tumor DNA in the blood.

Neoantigen

A new protein fragment arising from tumor mutations that the immune system can recognize as "foreign."

Individual treatment attempt

An experimental treatment given to a single patient, under the physician's responsibility and with the patient's consent, when no approved treatment is available.