Personalis, Inc. Q4 FY2025 earnings call

• Chris Hall highlighted 2025 as the year they validated their MRD strategy, with Clinical growth and 2 Medicare coverage decisions. Fourth-quarter Clinical tests grew 41% sequentially and 329% year-over-year. Full-year 2025 Clinical tests were over 16,000, growing 394% year-over-year. • They announced the next evolution of NeXT Personal MRD test, the real-time variant tracker report, with early access program starting in January 2026. • Pillars of Win-in-MRD strategy: Clinical adoptions with over 900 oncologists ordering, scaling commercial footprint with 10+ reps; building Clinical evidence with 3 dossiers submitted to Medicare, achieving coverage for breast and lung cancer; leading in biopharma sector with MRD biopharma revenue growing nearly 240% in 2025. • 2026 Clinical volume guidance 43,000 to 45,000 tests, ~170% growth year-over-year. Aaron Tachibana discussed revenue rotation, gross margin compression as intentional and temporary, operating expenses, balance sheet, and 2026 guidance including revenue ranges, margin expectations, and cash usage.

In the fourth quarter of 2025, Personalis delivered 6,183 Clinical tests, a 41% sequential growth over Q3 2025 and 329% year-over-year. Full-year 2025 Clinical tests were over 16,000, growing 394% year-over-year. Fourth-quarter revenue was $17.3 million, full-year revenue $69.6 million. Biopharma MRD revenue grew nearly 240% in 2025. Clinical revenue was $0.9 million in Q4 2025 and $2 million for full-year 2025. Gross margin was 11% in Q4 2025 and 22.7% for full-year 2025. For 2026, total revenue is expected to be $78 million to $80 million, with Clinical revenue $10 million to $11 million, pharma test and services revenue $55 million to $56 million, MRD revenue $20 million to $21 million, and population sequencing plus enterprise customers $13 million. Gross margin expected 15% to 20%, net loss approximately $105 million, cash usage ~$100 million.

• Total company revenue expected $78 million to $80 million in 2026. • Clinical revenue expected $10 million to $11 million, pharma test and services revenue $55 million to $56 million, MRD revenue $20 million to $21 million, population sequencing plus enterprise customers $13 million. • Gross margin expected 15% to 20%, first quarter potentially lowest. • Net loss approximately $105 million. • Cash usage ~$100 million in 2026 as they invest in Win-in-MRD strategy.

Q: Moving in a short period of time from no reimbursement to now 2 indications, potentially more here early in 2026, how does that affect the focus of reps internally, externally with Tempus for Clinical and also your eye for still building the pharma business longer term?

A: Chris Hall said they're starting to ungate the business, guiding $43 million to $45 million, and continuing to push hard on biopharma companies as that's a big growth driver.

Q: How has reimbursement changed receptivity from clinicians compared to other competitors in the field? Have you seen an acceleration in ordering since the reimbursement announcement?

A: Chris Hall said getting reimbursement gives legitimacy in conversations, being able to say they pass through Medicare process gives legitimacy with physicians and key opinion leaders, and helps reinforce the power of what they're doing.

Q: Are you seeing pushouts or cancellations of contracts in biopharma? And just how material do you think MRD side of biopharma is versus other areas that you've done historically like PCV is longer term?

A: Chris Hall said they're seeing the sector stabilize, haven't seen pushouts or big jolts, and MRD side of biopharma is growing with nearly 240% year-over-year growth.

Q: Can you share any details on the mix of volumes you expect to run in '26? In your reimbursed indications versus your not reimbursed indications?

A: Aaron Tachibana said roughly 20% coming from breast, 15% to 20% from lung, IO somewhere between 20% and 25%, CRC around 20% and all other remaining 20% or so, with a fair amount of tests running with zeros.

Q: Should I read that as having cash to break even? Or should I not read that far into it?

A: Aaron Tachibana said they haven't said anything about cash to breakeven or cash profitability, just that they have $240 million of cash at end of year and $100 million cash usage in 2026, plenty of capital to drive to go get market share.

Q: Are people ordering the real-time variant tracker? I mean, of the physicians you went out to with the early access program, are they ordering it? Do they literally have to click a box? Or just mechanically, how does that work? And how do you drive the stickiness on that?

A: Christopher Hall said it's an opt-in module, Rich Chen said they're gearing up for early access program and expect physicians will opt in.

Q: Of the Clinical volume you're expecting this year, you mentioned that you had 900 oncologists ordering last year. Do you have a sense of how many docs are going to be responsible for that 43,000 to 45,000? Just again, big ranges are fine. I'm just curious about depth versus breadth.

A: Christopher Hall said they'll keep focusing on driving deeper within existing accounts, with 900 doctors ordering from them continuing to grow, and focusing on going deeper as well as broader.

Q: How should we think about the Q-over-Q Clinical volume growth? You delivered 6,200 Clinical tests in the fourth quarter. Is that a good jumping off point for you guys, from what you guys could grow 24%, 25% Q-over-Q to get to the midpoint of your volume guide?

A: Aaron Tachibana said they haven't given quarterly guidance, but linearizing 6183 exiting 2025 in Q4 probably gets close, with some seasonality.

Q: There's a lot of new entrants in the MRD space, and there's been some consolidation in the space as well with one of the large MRD players recently making a large acquisition of another large MRD player in December and potentially integrating their IP to enhance the sensitivity of their assay. So could you just share your thoughts on the current competitive landscape and why you think you can gain share against arguably larger players with deeper pockets?

A: Christopher Hall said they've proven they can execute, been focused on pioneering the story, aligned with Tempus providing commercial infrastructure, have traction with 30-plus ongoing studies, and are investing heavily in R&D.

Q: The volume expectations, obviously looked great, well above, I think, what people have been expecting. The Tempus comments last night were incredibly bullish. I think what might surprise people is sort of where you're ending up on the Clinical revenue, the gross margin and the cash flow guide. And you kind of talked about your philosophy, but maybe you can just give a little bit more color on what's prompting that.

A: Aaron Tachibana said exiting 2024, they meter things a bit due to no coverage and balance sheet, but now with coverage for breast and lung cancer and healthy price, they can step on the gas as market is growing. Christopher Hall said they see strong demand, investments now will pay dividends, and guide hits good cadence of investment versus expansion.

Q: Have you sort of given Tempus also the green light, maybe not to go full throttle, but do they have a little more freedom in what they can do with sales as well?

A: Christopher Hall said they're focused on going deeper within accounts and added more reps, in good position.

Q: Just a quick one on adjuvant reimbursement. So, have you outlined any expectations over the next couple of years in breast and lung on the potential for adjuvant reimbursement? And kind of what's the pushback from MolDX there? Any color would be helpful. And then kind of secondarily, on the neoadjuvant opportunity, I mean, could you lay out broad strokes where pharma is applying them in trials today, neoadjuvant feels like an easier use case and maybe some initial market sizing on the neoadjuvant opportunity, if you could also spare that.

A: Richard Chen said they're focused on adjuvant breast and lung, pursuing that, and in neoadjuvant, there's interest as drugs are being brought earlier, with data showing ultrasensitive approach's power, but initial market sizing not estimated yet.