Guardant Health (GH) TD Cowen 46th Annual Health Care Conference summary

Business performance and growth outlook

• Achieved exceptional growth in 2025, with continued momentum expected in 2026 across all product lines.

• Guardant360 saw 25% volume growth in 2025, with 30% in the second half; 2026 guidance is for 20% growth.

• Reveal volumes grew over 80% in late 2025, with strong expectations for 2026, especially pending Medicare coverage for breast cancer.

• SHIELD is projected to more than double 2025 volumes in 2026, supported by expanded sales force and Quest partnership.

• All business segments are described as performing strongly, with further market penetration and product launches anticipated.

Product innovation and portfolio strategy

• Transitioned Guardant360 to a smart liquid biopsy platform with broad epigenetic profiling, driving adoption.

• Reveal Ultra will launch in 2026, expanding into tumor-informed MRD testing.

• The portfolio is evolving from individual tests to an integrated platform, enhancing patient management and customer retention.

• Over 15 applications launched, with more powerful ones in the pipeline to drive clinical utility and physician engagement.

• Therapy monitoring protocols and serial testing are expected to increase test utilization per patient.

Regulatory and reimbursement developments

• Confident in FDA approval for flagship liquid biopsy in the second half of 2026, which will simplify the portfolio and boost both liquid and tissue test volumes.

• FDA approval will enable a new ADLT rate in 2027, potentially increasing revenue and profitability.

• Medicare coverage for Reveal breast cancer is anticipated to be a major catalyst for volume growth.

• ACS guideline endorsement for SHIELD is expected soon, likely increasing awareness, commercial payment, and access in key states.