Guardant Health (GH) Q4 2025 earnings summary

Executive summary

• Achieved breakout year in 2025 with Q4 revenue up 39% and full-year revenue up 33%, driven by innovation, new product launches, and strong adoption across oncology, screening, and biopharma segments.

• Oncology segment saw 30% revenue growth and 38% volume growth in Q4, supported by Guardant360 upgrades, expanded reimbursement, and new therapy monitoring applications.

• Screening segment experienced significant momentum, with Shield test volumes rising from 6,000 in Q4 2024 to 38,000 in Q4 2025 and revenue increasing from $4M to $35M.

• Expanded product offerings and commercial partnerships, including launches of Shield multi-cancer detection, new applications for Guardant360, and collaborations with Quest, PathGroup, and Merck.

• Secured Medicare and TRICARE coverage for Reveal and Shield, and demonstrated real-world impact with improved screening adherence and early cancer detection.

Financial highlights

• Q4 2025 revenue reached $281.3M, up 39% year-over-year; full-year revenue was $982M, up 33% from $739M in 2024.

• Oncology revenue grew 30% in Q4 to $189.9M, with 79,000 tests (up 38%); full-year oncology revenue was $683.6M, up 26% year-over-year.

• Screening revenue totaled $35.1M in Q4 from 38,000 Shield tests; full-year screening revenue was $79.7M from 87,000 tests.

• Biopharma and data revenue was $54M in Q4 (up 9%) and $210.1M for the year (up 18%).

• Non-GAAP gross margin improved to 66% in Q4 and for the year, up from 63% and 62% in 2024, respectively.

• Adjusted EBITDA loss improved to $64.9M in Q4 and $220.9M for the year; free cash flow burn was $233M for 2025, improving by $42M.

• Ended 2025 with $1.3B in cash after MetaSyte/MetaSight acquisition and equity/debt financing.

Outlook and guidance

• 2026 revenue expected at $1.25B–$1.28B (27%–30% growth), targeting $2.2B by 2028.

• Oncology revenue projected to grow 25%–27% in 2026, with ~30% volume growth; screening revenue guidance: $162M–$174M from 210,000–225,000 Shield tests.

• Non-GAAP gross margin expected at 64%–65% in 2026; operating expenses to grow 14%–16%.

• Free cash flow burn for 2026 forecasted at $185M–$195M; core business to remain free cash flow positive.

• Guidance excludes potential upside from Quest co-promotion, ACS guideline inclusion, and new product launches.

• Targeting free cash flow breakeven in Q4 2027.