How do I read my genomic tumor test report (like FoundationOne)?
The short answer
A genomic report lists the mutations found in your tumor and often links them to therapies or trials. The key skill is telling the actionable findings apart from the rest, and knowing what your oncologist should do with each.
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Who this applies to
Anyone who has had comprehensive genomic profiling (a next-generation sequencing panel such as FoundationOne, Guardant, Tempus, or a hospital panel) and wants to understand what the report means for their treatment.
What is in the report
A genomic report typically lists the genomic alterations found in your tumor (mutations, amplifications, fusions), and often two whole-tumor measures: tumor mutational burden (TMB) and microsatellite instability (MSI), both of which can predict response to immunotherapy. Many reports also flag alterations that are linked to an approved therapy or an open clinical trial.
Actionable findings vs. everything else
Not every alteration matters for treatment. An actionable alteration is one that points to a specific therapy or trial. Many findings are variants of uncertain significance (VUS), real changes whose clinical meaning is not yet known, and they should not drive treatment decisions on their own. The most useful thing to establish is which of your alterations are actionable and what they point to.
Questions to ask your oncologist
- Which alterations on my report are actionable, and which are variants of uncertain significance?
- Do any of my findings point to an approved therapy or a clinical trial?
- What do my TMB and MSI results mean for whether immunotherapy could help me?
- Does anything on this report change your recommended treatment?
Check this against your case
Upload your genomic report and OpenCancer translates it into plain language, separating the actionable findings from the rest and flagging what each one could mean for your options.
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Written by OpenCancer’s science team and grounded in NCCN and NCI guidance. Independent medical review by our clinical team is in progress.
For informational purposes only. This page is grounded in published guidelines and is not medical advice. Always consult your oncologist or care team before making treatment decisions.