Guardant Health (GH) Q4 2025 earnings summary

Executive summary

• Achieved 2025 revenue of $982M, up 33% year-over-year, with Q4 revenue up 39% to $281M, driven by innovation and strong adoption in oncology, screening, and biopharma segments.

• Oncology business led growth with Guardant360 and Reveal, while Shield screening test saw rapid adoption and high adherence rates.

• Biopharma & Data revenue grew 18% year-over-year, supported by new CDx approvals and strategic partnerships.

• Expanded commercial infrastructure, R&D, and strategic collaborations, including new product launches and acquisitions.

Financial highlights

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

• Oncology revenue grew 30% in Q4 to $189.9M; volumes up 38% to 79,000 tests.

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

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

• Adjusted EBITDA loss improved to $64.9M in Q4 and $220.9M for the year.

Outlook and guidance

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

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

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

• Free cash flow burn projected at $185M–$195M in 2026, with core business (excluding screening) free cash flow positive.

• Targeting free cash flow breakeven in Q4 2027.