Personalis (PSNL) Q4 2025 earnings summary

Executive summary

• Achieved explosive clinical growth in 2025, validating the Win-in-MRD strategy and building momentum for 2026.

• Delivered 6,183 clinical tests in Q4 2025, up 41% sequentially and 329% year-over-year; full year clinical test volume rose nearly 400% to over 16,000, reflecting rapid MRD adoption.

• Secured two Medicare coverage decisions for breast and lung cancer surveillance, expected to drive significant clinical revenue growth.

• Strong cash position of approximately $240 million at year-end supports commercial expansion and investment in MRD strategy.

• Expanded commercial partnership with Tempus and increased field reps to drive adoption.

Financial highlights

• Q4 2025 revenue was $17.3 million, a 3% year-over-year increase; full year 2025 revenue was $69.6 million, down from $84.6 million in 2024.

• Clinical test revenue for 2025 was $2.0 million, more than double the prior year; Q4 clinical revenue was $0.9 million.

• Biopharma MRD revenue grew 239% year-over-year despite a $19.5 million decline from Natera and $10 million from Moderna trial conclusion.

• Gross margin was 11% in Q4 and 22.7% for the full year, reflecting intentional margin compression due to unreimbursed test volume.

• Net loss for 2025 was $81.3 million, flat year-over-year; ended 2025 with $240 million in cash and short-term investments, no significant debt.

Outlook and guidance

• 2026 revenue guidance: $78–$80 million, with clinical revenue of $10–$11 million and biopharma MRD revenue of $20–$21 million.

• Clinical test volume guidance for 2026: 43,000–45,000 tests, representing ~170% year-over-year growth.

• Gross margin expected at 15–20% for 2026, with Q1 as the lowest point.

• Net loss projected at ~$105 million; cash usage expected to be ~$100 million.