Guardant Health, Inc. · NASDAQ:GH
Guardant Health — Q4 2025 Earnings Presentation
26 slides from Guardant Health's earnings presentation, Feb 19, 2026
Slide 1: Conquering Cancer with Data
Conquering Cancer with Data Q4 2025 & Full Year 2025 Earnings Call February 19, 2026
Slide 2: Safe harbor and non-GAAP disclosures
Safe harbor and non-GAAP disclosures Certain statements in this presentation and the accompanying oral commentary are forward-looking presentation are made only as of the date hereof. For a further description of the risks and uncertainties statements within the meaning of federal securities laws. T
Slide 3: One platform for the entire patient journey
One platform for the entire patient journey Profiling PLATFORM Monitoring Monitoring Screening Tumor Surgery MRD detected Profiling 3
Slide 4: Strong revenue growth in 2025
Strong revenue growth in 2025 Q4 Revenue FY Revenue $982M $281M $739M $202M 39% YoY Growth 33% YoY Growth Q4 2024 Q4 2025 2024 2025 Oncology Biopharma & Data Screening Licensing & Other 4
Slide 5: Oncology revenue growth driven by robust performance across all products
Oncology revenue growth driven by robust performance across all products Oncology Revenue Oncology Volume 79K $190M 57K $146M 30% YoY Growth 38% YoY Growth Q4 2024 Q4 2025 Q4 2024 Q4 2025 5
Slide 6: Oncology volume growth driven by product upgrades and reimbursement coverage
Oncology volume growth driven by product upgrades and reimbursement coverage Oncology Volume Y/Y 14% 21% 24% 25% 30% 40% 38% Growth Steady cadence of new Smart Platform applications to Guardant360 Liquid Upgrade 79K CRC Surveillance Wave 3 Upgraded Guardant360 Tissue leveraging Wave 2 Reimbursement
Slide 7: InfinityAI is accelerating innovation across the business
InfinityAI is accelerating innovation across the business Fueling a rich data ecosystem >1,000,000 PATIENT SAMPLES Product innovation + Smart App launches >400,000 Clinical insights EPIGENETIC PROFILES Biopharma applications >100 TUMOR TYPES 7
Slide 8: Q4 Oncology highlights
Q4 Oncology highlights Oncology y/y volume growth 38% driven by strong performance across all products Guardant360 y/y volume growth of nearly 30% Reveal continues to be the fastest growing Oncology product Expanded tissue-free Reveal test to include late-stage therapy response monitoring Submitted
Slide 9: Reveal data pipeline driving reimbursement momentum
Reveal data pipeline driving reimbursement momentum Indication Specific Studies 1H 2024 2H 2024 1H 2025 2H 2025 1H 2026 2H 2026 CRC Surveillance COSMOS Covered by Medicare Elliot et al, Breast Surveillance Ademuyiwa et al RADIOHEAD, IO Monitoring Liang et al Chemo Monitoring RWE CDK4/6 Monitoring Mu
Slide 10: Unlocking new paradigms in therapy monitoring
Unlocking new paradigms in therapy monitoring Launched in Q4 2025 SERENA-6 Trial1 Tissue-free solution to monitor Liquid biopsy directed switch to a new treatment response and detect early treatment upon emergence of ESR1 disease progression with best-in-class resistance mutation speed and sensitivi
Slide 11: Biopharma & Data growth supported by strategic partnerships
Biopharma & Data growth supported by strategic partnerships Biopharma & Data FY Revenue 5 new CDx approvals in the last 6 months 18% Strong SERENA-6 readout at ASCO 2025 $210M $178M Collaboration with Merck to develop companion diagnostics and commercialize new therapies Multiple strategic data coll
Slide 12: Strong momentum continues for CRC screening
Strong momentum continues for CRC screening +14K Shield Volume 38K +8K $35M 24K +7K 16K +3K 9K Q4 ‘25 Revenue 6K Q4 2024 Q1 2025 Q2 2025 Q3 2025 Q4 2025 12
Slide 13: Q4 Screening highlights
Q4 Screening highlights Strong Q4 volume with +14,000 test sequential growth Shield continues to demonstrate a high adherence rate Continued scaling commercial team, exiting Q4 with ~300 sales reps Shield received coverage for active-duty service members and their families through TRICARE, the U.S.
Slide 14: Shield real-world patient adherence far surpasses other screening modalities
Shield real-world patient adherence far surpasses other screening modalities Colonoscopy or stool-based tests 93% Adherence rate for first 25-71% Adherence rate2 100,000 patients1 1. Guardant Health internal data; 2. See appendix for sources 14
Slide 15: Screening commercial infrastructure is scaling rapidly bolstered by recent strategic collaborations
Screening commercial infrastructure is scaling rapidly bolstered by recent strategic collaborations >650K >8,000 Launching in EMR connected National patient Q1 2026 HCPs and hospitals access points Access to Quest national sales team Launched 15
Slide 16: Shield is a multi-cancer detection platform
CRC CRC Lung Shield is a Bladder multi-cancer Liver Ovarian detection Multi-cancer platform Stomach Esophageal Pancreatic Prostate Breast 16
Slide 17: Multi-cancer detection
Scalable platform for clinical data generation Multi-cancer detection When Shield is ordered for CRC screening Physician opts in to receive MCD results report Patient authorizes release of medical data The Shield MCD results report is not a part of the FDA approved Shield IVD and has not been cleare
Slide 18: Major 2025 achievements lay the groundwork for strong Shield growth in 2026 and beyond
Major 2025 achievements lay the groundwork for strong Shield growth in 2026 and beyond Field Force Scale-Up OUS Self-Pay Expansion 2025 ACS Guidelines Targeted DTC Campaigns … 2026 ADLT Status: $1,495 Rate NCCN Guidelines Product-Market Fit EMR Integrations Commercial Excellence 18
Slide 19: Announcing acquisition of MetaSight Diagnostics
Announcing acquisition of MetaSight Diagnostics CRC screening PLATFORM Multi-cancer detection + Multi-disease detection 19
Slide 20: Significant revenue growth in 2025
Significant revenue growth in 2025 Q4’25 Q4’24 % Growth FY’25 FY’24 % Growth Total Revenue $281M $202M 39% $982M $739M 33% Oncology $190M $146M 30% $684M $543M 26% Biopharma & Data $54M $50M 9% $210M $178M 18% Screening $35M $4M -- $80M $5M -- Licensing & Other $2M $3M -- $9M $13M -- 20
Slide 21: Q4 and full year 2025 non-GAAP financial highlights
Q4 and full year 2025 non-GAAP financial highlights Non-GAAP Measures Q4’25 Q4’24 FY’25 FY’24 Gross Profit $185M $126M $645M $460M Gross Margin1 66% 63% 66% 62% Total Operating Expenses $260M $215M $904M $757M R&D $86M $81M $309M $296M S&M $131M $96M $448M $328M G&A $44M $38M $146M $133M Adjusted EB
Slide 22: Clear path to cash flow breakeven
Clear path to cash flow breakeven 2022 2023 2024 2025 2026 2027 2028 FCF Breakeven FCF Positive1 Targeting free cash flow Q4 20271 breakeven in Q4 2027 Excluding Screening, generated positive free cash flow in Q3 and Q4 2025 $(233)M $(275)M Strong balance sheet following recent financing and convert
Slide 23: Initiating full year 2026 guidance
Initiating full year 2026 guidance Total Revenue $1.25B – $1.28B Non-GAAP Gross Margin 27% - 30% y/y growth 64%-65% range 25% - 27% revenue growth Oncology driven by ~30% y/y volume growth Non-GAAP Operating Expenses Low double digit $1.03B – $1.05B Biopharma & Data revenue growth $162M - $174M Free
Slide 24: Upcoming key catalysts across the continuum of cancer care in 2026
Upcoming key catalysts across the continuum of cancer care in 2026 ONCOLOGY BIOPHARMA & DATA SCREENING Therapy Selection MRD Guardant360 Liquid FDA MolDx coverage for Reveal CDx approvals, including ACS guidelines approval and launch Breast MRD SERENA-6 Transition to NovaSeq X MolDx coverage for Rev
Slide 25: Guardant Health
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Slide 26: References
References Sources for adherence for colonoscopy: • Bretthauer M, Løberg M, Wieszczy P, et al. NordICC Study Group. Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med. 2022;387(17):1547-1556. doi:10.1056/NEJMoa2208375 • Lin JS, Perdue LA, Henrikson NB, Bean