Guardant Health, Inc. Q4 FY2025 earnings call

• Oncology: Introduced groundbreaking applications for Guardant360 Liquid, upgraded Guardant360 tissue, expanded Reveal. Saw exceptional growth, with Guardant360 volume growth, Reveal as fastest-growing product, and global access expansion. - Screening: Shield delivered extraordinary growth, expanded to include multi-cancer detection results report, had strong sequential growth in Q4, achieved ADLT status, and made strategic collaborations. - Biopharma and data: Leader in companion diagnostics with 25 approvals, biopharma partner base over 200 companies, and made progress in data set expansion through partnerships.

In Q4 2025, total revenue was $281 million, up 39% YOY, and full-year revenue was $982 million, up 33% YOY. Oncology revenue in Q4 was $190 million, up 30%, with volumes growing 38% to ~79,000 tests. Biopharma and data revenue was $54.0 million, up 9%. Screening revenue was $35.1 million from ~38,000 Shield tests. Full-year oncology revenue was $683.6 million, up 26%, biopharma and data revenue was $210.1 million, up 18%, and screening revenue was $79.7 million from ~87,000 tests. Non-GAAP gross margin improved to 66% in Q4 and 66% for the full year. Shield's non-GAAP gross margin improved from negative levels at launch to 52% in Q4 2025.

For 2026, expect total revenue $1.25 billion to $1.28 billion (27%-30% growth). Oncology revenue growth 25%-27% with ~30% volume growth, including potential upsides from SERENA-6, FDA approval, and Reveal Ultra. Biopharma and data forecast low double-digit revenue growth. Screening revenue $162 million to $174 million from 210,000 to 225,000 tests. Non-GAAP gross margin 64%-65%. Non-GAAP operating expenses $1.03 billion to $1.05 billion. Free cash flow burn $185 million to $195 million, with rest of business free cash flow positive.

Q: Talk about Reveal therapeutic monitoring.

A: Excited about it, bridges to next Guardant360 test, with unique platform allowing tests to work together.

Q: Elaborate on oncology volume growth.

A: Bullish on 2026, 360 volume growth at least 20%, Reveal fastest-growing, tissue accelerating.

Q: Shield specific burn and rep hiring.

A: Screening burn ~$220 million in 2026, continue building commercial infrastructure.

Q: ADLT pricing and oncology conservatism.

A: ADLT for 360 not baked in 2026, oncology guide 30% volume growth.

Q: Shield guide and Quest/PathGroup.

A: Guide thoughtful, Quest and PathGroup have minor contribution.

Q: Reveal Ultra.

A: Excited, on track to launch, best-in-class sensitivity.

Q: MCED legislation and Shield.

A: Encouraged but not near-term driver.

Q: Opt-in rate for MCED Shield.

A: Good adoption rate, trending up.

Q: Shield guide and seasonality.

A: Q1 seasonality, ACS guideline near.

Q: MetaSight acquisition.

A: Excited about acquisition, details to come.

Q: Shield demand and growth.

A: Demand from unscreened patients, focus on care gap.

Q: Oncology sales force and NovaSeq X.

A: Healthy oncology sales force, NovaSeq X transition mid-year, expected gross margin improvement.

Q: FDA approval and tests.

A: FDA approval could be catalyst for tissue business, enabling concurrent ordering.