How do I read my Tempus report?
Read a Tempus report in four passes: the variants called clinically significant, the biomarker summary covering TMB, MSI and relevant expression, the therapy and trial sections, and finally the quality metrics such as tumor purity and coverage. Most of the report is reference material; the decisions live in the first two pages read against your clinical situation.
The four passes
Reports are long because they are written for documentation as much as for decisions. Reading them in a fixed order keeps the important part from being buried.
- Pass one: variants listed as clinically relevant, with their tier and the gene involved
- Pass two: biomarkers such as tumor mutational burden, microsatellite instability, and any expression results
- Pass three: listed therapies and trials, which are generated from rules and always need clinical filtering
- Pass four: assay metrics, including tumor purity and sequencing coverage, which decide how much weight the rest deserves
What the tiers mean, and what they do not
Variant classification describes evidence, not certainty about your case. A variant can be well characterized in one cancer type and essentially uninformative in yours. Variants of unknown significance are common and usually should not drive treatment, though a few deserve a second look when they fall in a gene central to your disease.
The therapy list is also not a ranked recommendation. It reflects what a rules engine associates with the variants found. Line of therapy, prior exposure, organ function, and disease sidedness are not in that calculation.
The parts people miss
Low tumor purity can produce false-negative calls, meaning an absent variant is not always truly absent. DNA results and RNA fusion results appear in different sections and can disagree. Germline findings, when reported, carry implications for family members that are easy to overlook in a treatment-focused reading.
Related questions
Does a Tempus report tell me which treatment to take?
No. It lists options associated with your findings. Choosing among them requires your full clinical history, and that judgment belongs with your oncology team informed by a careful read of the molecular data.
What if my report says no actionable alterations?
That is a real result, and it still carries information: it can rule options out, support standard therapy, and point to whether different testing, such as RNA sequencing or a liquid biopsy, would add anything.
Should I get a second read of my report?
It is worth it when the report is complex, when the trial list is long, or when nobody has walked you through it line by line. That is what the Clarity Report and Molecular Strategy engagements exist for.
Reviewed 2026-09-22 by Kim Lockheimer, PhD, DFM.