Foundation Medicine vs Guardant Health (2026)
Foundation Medicine and Guardant Health both profile advanced cancers in their own laboratories to match patients with therapies. The comparison buyers search for is FoundationOne CDx on tissue against Guardant360 on blood, though each company now sells both kinds of test. FoundationOne CDx is an FDA approved tissue test of 324 genes with microsatellite instability and tumor mutational burden, more than 40 companion diagnostic indications and a median turnaround of eight days, with national Medicare coverage for qualifying patients. Liquid biopsy, hematologic, residual disease and germline tests sit alongside it. HRDsig, a homologous recombination deficiency signature built with machine learning, is reported as a labeled professional service outside the approved assay. Guardant Health's companion diagnostics work from blood. Guardant360 CDx and Guardant360 Liquid CDx, the second approved in May 2026, profile advanced solid tumors from a blood draw, with Guardant360 Tissue, Guardant Reveal for recurrence and a hereditary panel offered as laboratory developed tests. Its tests order and result inside Epic and Flatiron OncoEMR, with order sets and reflex testing triggered by clinical events. Shield, its FDA approved colorectal screening test, sits outside this decision. A practice that wants tissue profiling with the widest set of approved therapy matches fits Foundation Medicine. A practice that starts from a blood draw and wants ordering built into its record system fits Guardant.
- Tissue is available and the team wants profiling from it first.
- Treatment decisions hinge on approved companion diagnostic claims across many cancers.
- A homologous recombination deficiency signature should come with the report.
- Germline testing should come from the same laboratory.
- A blood draw is easier than a new biopsy for the patient.
- Orders and results should run through Epic or Flatiron OncoEMR with reflex testing.
- Recurrence monitoring after treatment is part of the plan.
- The same company should also cover colorectal cancer screening.
This comparison is published by AI Health Index, an independent research platform that compares healthcare AI vendors objectively. Foundation Medicine and Guardant Health are each graded against the same capability taxonomy, from each vendor's own public materials and the regulatory record, under the AI Health Index verification standard. No vendor pays for placement, and no vendor has reviewed this page. How this evidence is graded
Plain facts
| Fact | Foundation Medicine | Guardant Health |
|---|---|---|
| Primary category | Diagnostics & Genomics | Diagnostics & Genomics |
| Founded | 2010 | 2012 |
| Headquarters | Boston, Massachusetts, United States | Palo Alto, California |
| Website | foundationmedicine.com | guardanthealth.com |
Side by Side
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Each vendor in one paragraph
Written to be quoted whole. Each paragraph opens the AI Health Index profile of the vendor: what the product is, who buys it and what it does.
Foundation Medicine, based in Boston and a member of the Roche Group, runs comprehensive genomic profiling for cancer in its own laboratories. FoundationOne CDx is an FDA approved sequencing test of 324 genes with microsatellite instability and tumor mutational burden and more than 40 approved companion diagnostic indications, with a median turnaround of eight days and national Medicare coverage for qualifying patients.
Source: AI Health Index, October 2026
Guardant Health is a publicly traded precision oncology company (Nasdaq: GH), founded in 2012 and based in Palo Alto, California, that runs blood and tissue cancer tests in its own laboratories. Shield, approved by the FDA in July 2024, screens average-risk adults 45 and over for colorectal cancer from a blood draw; its result comes from two methylation classifiers, changed in July 2026 to a methylation-only workflow, and it detects most cancers but few precancerous lesions.
Source: AI Health Index, October 2026
Questions buyers ask
Is Guardant360 or FoundationOne CDx better?
FoundationOne CDx suits a practice with tissue available that wants the widest set of approved therapy matches, with more than 40 companion diagnostic indications on one test. Guardant360 CDx suits a practice that starts from a blood draw and wants ordering built into Epic or Flatiron OncoEMR. Each company now sells both kinds of test. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified October 17, 2026. No vendor pays for placement.
Is Guardant360 a blood test or a tissue test?
Guardant360 CDx and Guardant360 Liquid CDx, the second approved in May 2026, profile advanced solid tumors from a blood draw. Guardant360 Tissue is offered separately as a laboratory developed test. FoundationOne CDx is a tissue test, and Foundation Medicine sells liquid biopsy alongside it. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified October 17, 2026. No vendor pays for placement.
How many genes does FoundationOne CDx cover, and how fast are results?
FoundationOne CDx tests 324 genes along with microsatellite instability and tumor mutational burden. Results come back in a median of eight days, and the test has national Medicare coverage for qualifying patients. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified October 17, 2026. No vendor pays for placement.
Can Guardant360 be ordered inside Epic?
Yes. Guardant's tests order and result inside Epic and Flatiron OncoEMR, with order sets and reflex testing triggered by clinical events. Guardant Reveal adds recurrence monitoring after treatment. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified October 17, 2026. No vendor pays for placement.
Who owns Foundation Medicine and Guardant Health?
Foundation Medicine, based in Boston, is a member of the Roche Group. Guardant Health is an independent public company, listed on Nasdaq as GH and based in Palo Alto. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified October 17, 2026. No vendor pays for placement.
Related comparisons
Other published head to head assessments involving these vendors or their closest peers. The full set for this category is on the Diagnostics & Genomics page.
Foundation Medicine, based in Boston, is a member of the Roche Group. Guardant Health is listed on Nasdaq as GH and based in Palo Alto. Neither holds a SOC 2 report, HITRUST certification or ISO 27001 certificate a buyer can review, and neither has a public price for its therapy selection tests. Both build de identified patient data into products sold to drug developers, FoundationInsights at Foundation Medicine and InfinityAI at Guardant.