ALS Genetic Testing — tofersen is the first gene-specific ALS therapy, but it only works for SOD1-ALS. Identifying the genetic cause of ALS now determines whether a patient has access to targeted treatment vs. supportive care only.
Whole genome sequencing evaluates all known ALS genes — SOD1, C9orf72, FUS, TARDBP, ANG, OPTN, VCP, and others — including the C9orf72 hexanucleotide repeat expansion that standard sequencing panels miss.
ALS — Motor Neuron Disease Genetic Testing
Amyotrophic lateral sclerosis (ALS, motor neuron disease) causes progressive degeneration of upper and lower motor neurons, producing weakness, atrophy, fasciculations, spasticity, and ultimately respiratory failure. ALS affects approximately 2 per 100,000 people annually. Approximately 5-10% of ALS is familial (fALS) with identifiable genetic causes, and an additional 5-10% of apparently sporadic ALS carries pathogenic variants detectable by genetic testing. The most common genetic causes are C9orf72 hexanucleotide repeat expansion (~40% of fALS, ~7% of sporadic ALS) and SOD1 pathogenic variants (~20% of fALS, ~1-2% of sporadic ALS).
The C9orf72 GGGGCC hexanucleotide repeat expansion in chromosome 9p21.2 is the most common genetic cause of both ALS and frontotemporal dementia (FTD). Normal alleles contain 2-23 repeats; pathogenic expansions contain hundreds to thousands of repeats. C9orf72 expansion causes a combined ALS-FTD spectrum — patients may present with pure ALS, pure FTD, or mixed ALS-FTD. This discovery unified two previously separate neurodegenerative diseases under one genetic etiology. Antisense oligonucleotide (ASO) trials targeting the C9orf72 expansion are underway.
Tofersen (Qalsody), an intrathecal antisense oligonucleotide targeting SOD1 mRNA, received FDA accelerated approval in 2023 — the first gene-specific therapy for any form of ALS. Tofersen reduces SOD1 protein and neurofilament light chain (a biomarker of neuronal damage) in SOD1-ALS patients. The ATLAS trial is evaluating tofersen in presymptomatic SOD1 carriers — potentially the first preventive treatment for ALS. Additional gene-specific therapies in development include ASOs for C9orf72 and FUS-ALS. Genetic testing is now standard of care for all ALS patients, not just those with family history.
Tofersen (Qalsody, FDA 2023) is the first gene-specific ALS therapy — but it only works for SOD1-ALS (~2% of all ALS). Without SOD1 molecular confirmation, patients cannot access this treatment. Genetic testing of ALL ALS patients is now recommended.
ALS genetic testing is now standard of care — not just for family history cases. Gene-specific therapies (tofersen for SOD1, ASOs for C9orf72 in trials) require molecular confirmation. WGS is the only test that evaluates all ALS genes including repeat expansions.
Tofersen for SOD1-ALS and the ATLAS presymptomatic prevention trial — molecular SOD1 confirmation required
Tofersen specifically targets SOD1 mRNA and is only effective in SOD1-ALS. The ATLAS trial is enrolling presymptomatic SOD1 carriers to determine whether early tofersen prevents ALS onset — potentially the first preventive therapy for any neurodegenerative disease. Family members of SOD1-ALS patients who carry the variant can enroll in ATLAS before symptom onset. Without molecular SOD1 testing of the proband, at-risk family members remain unidentified and cannot access presymptomatic intervention.
C9orf72 repeat expansion causes both ALS and FTD — explaining 'ALS-dementia' families that standard ALS panels miss
The C9orf72 hexanucleotide repeat expansion is the single most common genetic cause of both familial ALS and familial FTD. Families may show ALS in some members and FTD in others — a pattern that was unexplained before C9orf72 discovery. Standard ALS gene panels may not detect repeat expansions (which require specialized assays). WGS detects both sequence variants and repeat expansions across the entire genome, identifying the C9orf72 expansion alongside all other ALS genes in a single comprehensive test.
Your full DNA (not just a part of it)
Traditional genetic testing looks at narrow sets of genes, missing most parts of your genome. We sequence your full genome — every gene and every region between genes.
Comprehensive insights and specialized reports
Easy to read and with answers you and your doctor can act on. Not a file to interpret — 200+ clinical reports, organized by category.
Your test becomes more valuable every year
Your DNA does not change, but genome science is accelerating. Every month, new variant-disease associations are discovered. We validate these findings and update your reports automatically. Your test becomes more valuable every year.
The results doctors bring to their hardest cases.
Forty years of uncertainty. One test.
A patient had spent decades in the UK healthcare system without a diagnosis. Dante data, accepted by NHS clinical teams at Queen Elizabeth University Hospital Glasgow, identified Noonan Syndrome and a RUNX1 leukemia-associated variant that had gone undetected. After 40 years, they finally had an answer.
A complete read delivers a complete picture.
A patient came to Dante to investigate periodic paralysis. Reading the complete genome identified a concurrent hereditary cardiac finding — Brugada syndrome — that their doctor confirmed with an ECG. The result also explained a family member's unresolved cardiac history. One test. Every answer in it.
Sequenced in 2019. The data worked in 2021.
Jennifer sequenced her genome with Dante two years before her breast cancer diagnosis. When treatment began, Dante's pharmacogenomics data showed her prescribed chemotherapy would cause serious adverse effects. Her doctor selected an alternative — and she started effective treatment from day one.
Every genetic question deserves a complete answer.
Whether you are searching for answers today or protecting your health for tomorrow, a complete read of your entire genome is the only place to start.
It runs in your family. Now you can know if it runs in your genes.
Your genome contains inherited variants associated with medical conditions like cardiac, cancer, and neurological. We read all of them — with the clinical depth to give the result meaning.
Learn more →When traditional lab tests say you're fine. And you know you're not.
Standard diagnostic tests check for a pre-selected set of answers. We sequence your full DNA — including parts that no test was designed to check. If the answer is in your genome, we will help you find it.
Learn more →Your diagnosis may be right. Your treatment plan may be incomplete.
Your genes determine which treatments are most likely to work — and which are not. We give your doctor the tools and insights to inform your treatment plan.
Learn more →You want to know before something forces the question.
Some people don't wait for a diagnosis or a family history to act. Whole genome sequencing gives you the complete genetic picture now — so you and your doctor can make informed decisions before anything becomes urgent.
Learn more →You already took a DNA test. Here's what it couldn't tell you.
Most consumer DNA tests read less than 0.1% of your genome. We read all of it.
Learn more →Clinical-grade results. Chosen by individuals, trusted by doctors for their most complex cases.
Dante Genome Test helped specialists at a UK national acute hospital in the identification of Noonan Syndrome and a rare leukemia-associated genetic variant that had gone undetected. That result changed the medical care of the patient.
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Common questions about whole genome sequencing.
What is the difference between whole genome sequencing and a targeted genetic test?
Targeted genetic tests — including standard hereditary cancer panels — read a pre-defined list of known variants in a specific set of genes. They are designed to find what they already know to look for. Whole genome sequencing reads your entire genome: all 6 billion base pairs, every gene, every region between genes. A Mayo Clinic study published in JAMA Oncology found that standard testing guidelines missed more than half of patients with inherited cancer mutations. Genome Test does not have a fixed list.
What will I receive when my results are ready?
Your Dante Genome delivers 200+ physician-ready reports organized by clinical category — hereditary cancer, cardiac conditions, rare diseases, pharmacogenomics, carrier status, and more. Reports are delivered to your secure Genome Manager and are formatted for direct clinical use. Your genome data is permanently retained and re-analyzed automatically as science advances.
What happens if a clinically significant variant is found?
If a pathogenic or likely-pathogenic variant is identified, it will be clearly flagged in your physician-ready report with clinical context, published evidence, and recommended next steps. We recommend sharing any clinically significant finding with your physician or a genetic counselor, who can guide decisions about surveillance, risk reduction, or cascade testing for family members.
How is this different from a consumer DNA test like 23andMe or AncestryDNA?
Consumer DNA tests use genotyping chips that read less than 0.1% of your genome — a tiny pre-selected set of common variants. They are optimized for ancestry and population-level traits, not clinical genetic findings. The Dante Genome Test sequences 100% of your genome at 30X coverage, the same standard used in clinical diagnostic settings. The two tests are not comparable in scope, methodology, or clinical utility.
How long does it take to get results, and how are they delivered?
Your collection kit ships within 48 hours of ordering. Once your sample arrives at our CLIA-certified laboratory, sequencing and analysis takes 6–8 weeks. Results are delivered securely to your Genome Manager, where you can access your reports, share them with your physician, and receive automatic updates as new findings are validated against your genome.
We work with patient advocacy groups worldwide.
Dante Labs works with patient advocacy groups of any size — for ALS — Motor Neuron Disease Genetic Testing and other conditions, rare and common. We support groups in any country, including virtual patient advocacy groups.
We can provide customized reports, group discounts, and packages tailored for your members. Please reach out using the form and we'll be in touch within two business days.
- Custom genomic reports for your members
- Group discounts and tailored packages
- Any country — including virtual groups
- Rare and common conditions covered
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We'll be in touch within 2 business days. To follow up directly: hello@dantelabs.com
One test.
A lifetime of answers.
One kit, sent to your home. Your entire genome sequenced at the clinical standard used for diagnostic decisions. 200+ physician-ready reports delivered to your Genome Manager in 6–8 weeks — permanent and updated as science advances.
Ships within 48 hours · Results in 6–8 weeks
