Strong Top-Line Revenue Growth and Raised Guidance
Q1 revenue of $302 million, up 48% year-over-year; company surpassed $1 billion trailing 12-month revenue. Raised full-year 2026 revenue guidance to $1.30B–$1.32B (32%–34% growth).
Oncology Momentum — Volume and Revenue Expansion
Oncology revenue $205 million, up 36% YoY; oncology test volumes ~86,000, up 47% YoY. Guardant360 Liquid volumes +30% YoY; Guardant360 Tissue is the second-fastest growing product; Reveal volumes >100% YoY. Company expects oncology revenue growth of 28%–29% and oncology volume growth >35% for 2026.
Breakout Screening (Shield) Performance
Shield revenue $42 million vs $6 million in Q1 2025 with ~44,000 tests (prior ~9,000). Strong March momentum following nationwide Quest launch and DTC/HCP campaigns. Shield guidance increased to $186M–$198M for 2026, implying ~230k–245k Shield tests.
Material Improvement in Screening Economics
Screening non-GAAP gross margin improved from 18% (Q1 2025) to 56% (Q1 2026). Shield non-GAAP cost per test declined from $520 to $420 YoY; Medicare fee-for-service rate established at $1,495 (effective 2026–2027). Company expects Shield cost per test to fall to ~ $200 at scale (targeted for 2027).
Biopharma & Data Growth and Strategic Partnerships
Biopharma & Data revenue $53 million, up 17% YoY. Expanded CDx footprint with 26 approvals across U.S., Japan and Europe (recent approvals with Pfizer/Arvinas); multiyear agreement with Merck and collaboration with Nuvalent; InfinityAI-generated RWE contributed to a tumor-agnostic approval in Japan.
Improved Margins Driven by Sequencing Cost Reduction
Non-GAAP gross margin of 66% in Q1 2026 (vs 65% prior year), primarily due to NovaSeq X transition lowering Guardant360 Liquid sequencing cost per test by nearly $200 vs Q1 2025. Company expects FY non-GAAP gross margin of 64%–65%.
Data Treasury and AI Platform Progress
Data repository exceeds 1 million patient samples and 500,000 epigenetic profiles across >100 tumor types; InfinityAI powering 25 of 38 AACR abstracts and multiple Smart Apps; ongoing smart app pipeline and Reveal data submissions to MolDx.
Operational Strength and Cash Position
Adjusted EBITDA loss of $59 million (flat YoY). Free cash flow burn $71 million in Q1 (vs $67M prior year); excluding increased bonus impact, FCF burn decreased by ~$12 million YoY. Ended Q1 with ~ $1.2 billion in cash and investments and reiterated plan to reduce full-year 2026 FCF burn and achieve company-wide cash flow breakeven by end of 2027.
Commercial and Patient Engagement Catalysts
Nationwide Quest collaboration launched, EMR connectivity expanded (fast-tracked to >650,000 HCPs), DTC campaign including Patrick Dempsey generated >1 billion impressions, and Shield adherence >90%. FDA approved reduction of Shield kit from 4 blood tubes to 2, improving patient experience.