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Guardant Health, Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 19 February 2026: press release. Guidance figures: 9 new. The quarter’s numbers.

Key takeaways

  • Fourth quarter revenue grew 39%: Fourth quarter 2025 revenue was $281.3 million, up 39% from $201.8 million, with Oncology, Screening and Biopharma & Data all contributing to growth. Source
  • Full-year revenue grew 33%: Full-year 2025 revenue was $982.0 million, up 33% from $739.0 million, with Oncology test volume up 34% for the year. Source
  • Oncology revenue up 30% in quarter: Oncology revenue was $189.9 million in the fourth quarter, up 30%, driven mainly by test volume. Full-year Oncology revenue was $683.6 million, up 26%. Source
  • Screening revenue reached $35.1 million: Screening revenue was $35.1 million in the fourth quarter, against $4.1 million a year earlier, and $79.7 million for 2025. Source
  • Operating expenses rose to $302.6 million: Operating expenses were $302.6 million in the fourth quarter, up from $250.2 million. Non-GAAP operating expenses were $260.0 million, up from $214.7 million. Source
  • Oncology volume drove revenue growth: Oncology test volume grew 38% in the quarter to about 79,000 tests, and 34% for the year to about 276,000 tests. Source
  • Cash and securities at $1.3 billion: Cash, cash equivalents, restricted cash and marketable debt securities totalled $1.3 billion at December 31, 2025. Source
  • Fourth quarter free cash flow burn: Free cash flow was $(54.2) million in the fourth quarter and $(233.1) million for 2025, against $(274.9) million for 2024. Source

“We delivered an outstanding end to a great year, with fourth quarter revenue growth of 39% year-over-year,”

Helmy Eltoukhy, co-founder and co-CEO

Guidance

AreaPeriodFigureAgainst last quarter
Total revenue Sourcefull year 2026$1.25 to $1.28 billion, growth of 27% to 30%New
Oncology revenue growth Source202625% to 27%New
Oncology test volume growth Source2026approximately 30%New
Biopharma & Data revenue growth Source2026low double-digit rangeNew
Screening revenue Source2026$162 to $174 millionNew
Screening test volume Source2026210,000 to 225,000 testsNew
Non-GAAP gross margin Sourcefull year 202664% to 65%New
Non-GAAP operating expenses Source2026$1.03 to $1.05 billion, a 14% to 16% increaseNew
Free cash flow burn Source2026 (the document says 2025)$185 to $195 millionNew

What changed from last quarter

  • New guidance: Full-year 2026 guidance was issued with these results. The preliminary release contained no guidance. Source
  • New: A strategic collaboration with Merck was established to develop companion diagnostics and commercialize cancer therapies. Source
  • New: The company bought MetaSight Diagnostics Ltd in December 2025, a health technology company. Source

Results and growth drivers

  • Fourth quarter revenue grew 39%: Fourth quarter 2025 revenue was $281.3 million, up 39% from $201.8 million, with Oncology, Screening and Biopharma & Data all contributing to growth. Source
  • Full-year revenue grew 33%: Full-year 2025 revenue was $982.0 million, up 33% from $739.0 million, with Oncology test volume up 34% for the year. Source
  • Non-GAAP gross margin rose to 66%: Non-GAAP gross margin was 66% in the fourth quarter, against 63% a year earlier. Full-year non-GAAP gross margin was 66%, against 62% for 2024. Source
  • Net loss widened in the quarter: GAAP net loss was $128.5 million in the fourth quarter, against $111.0 million a year earlier. For 2025 it was $416.3 million, against $436.4 million. Source

Segments and revenue mix

  • Oncology revenue up 30% in quarter: Oncology revenue was $189.9 million in the fourth quarter, up 30%, driven mainly by test volume. Full-year Oncology revenue was $683.6 million, up 26%. Source
  • Screening revenue reached $35.1 million: Screening revenue was $35.1 million in the fourth quarter, against $4.1 million a year earlier, and $79.7 million for 2025. Source
  • Biopharma and Data grew 9% in quarter: Biopharma and Data revenue was $54.0 million in the quarter, up 9%. For 2025 it rose 18% to $210.1 million, driven by GuardantINFINITY volume and service milestones. Source
  • Licensing and other revenue declined: Licensing and other revenue was $2.2 million in the quarter, against $2.6 million a year earlier. For 2025 it was $8.6 million, against $13.5 million. Source

“Shield has become one of the most successful diagnostic launches, with meaningful volume and revenue generation in 2025 that exceeded our expectations,”

AmirAli Talasaz, co-founder and co-CEO

Products, customers and approvals

  • First Guardant360 CDx approval in colorectal: The company received the first Guardant360 CDx companion diagnostic approval in colorectal cancer during the period. Source
  • Reveal monitoring extended to late-stage: Guardant Reveal, a tissue-free test, was expanded to include late-stage therapy response monitoring. Source
  • Shield gains TRICARE coverage: Shield CRC received TRICARE coverage for active-duty service members and their families, with no copay for average-risk individuals ages 45+. Source
  • Health system team set up for Shield: A dedicated health systems team for Shield was launched, and the first enterprise integrations with large health systems were deployed in West Virginia and Georgia. Source

Costs, margins and operating expenses

  • Operating expenses rose to $302.6 million: Operating expenses were $302.6 million in the fourth quarter, up from $250.2 million. Non-GAAP operating expenses were $260.0 million, up from $214.7 million. Source
  • Commercial spending drove cost increase: Management attributed the increase to commercial team expansion and marketing for the Shield launch and existing products. Source
  • Full-year non-GAAP expenses reached $903.7 million: Full-year non-GAAP operating expenses were $903.7 million, up from $757.3 million. Management also cited higher information technology infrastructure costs for the year. Source
  • GAAP gross margin rose to 65%: GAAP gross margin was 65% in the fourth quarter, against 62% a year earlier, and 64% for full-year 2025, against 61%. Source

“We are uniquely positioned with scaled offerings spanning both therapy selection and monitoring, and the recent launch of Reveal for therapy response monitoring further strengthens our competitive moat.”

Helmy Eltoukhy, co-founder and co-CEO

Demand and test volumes

  • Oncology volume drove revenue growth: Oncology test volume grew 38% in the quarter to about 79,000 tests, and 34% for the year to about 276,000 tests. Source
  • Shield screening volume reached 38,000: Shield screening tests were about 38,000 in the fourth quarter, against 6,400 a year earlier, and about 87,000 for 2025. Source

Capital, cash and financing

  • Cash and securities at $1.3 billion: Cash, cash equivalents, restricted cash and marketable debt securities totalled $1.3 billion at December 31, 2025. Source
  • Fourth quarter free cash flow burn: Free cash flow was $(54.2) million in the fourth quarter and $(233.1) million for 2025, against $(274.9) million for 2024. Source
  • Equity offering raised $327.3 million: In November 2025 the company sold 2,856,981 new shares and reissued 976,351 treasury shares at $90.00 each, for net proceeds of $327.3 million. Source
  • $402.5 million convertible notes issued: In November 2025 the company issued $402.5 million principal of 0% convertible senior notes due 2033. Source

Strategy, deals and acquisitions

  • MetaSight acquired for upfront cash: The MetaSight purchase carried $59.0 million of upfront cash consideration, paid at closing in December 2025. Source
  • Merck collaboration on companion diagnostics: The Merck collaboration covers companion diagnostics and commercializing new cancer therapies on the Guardant Infinity platform. Source
  • In-house testing launched in Italy: An in-house testing service launched in Italy at Policlinico Gemelli, based on Guardant360 CDx technology. Source

Preliminary and final figures

  • Final revenue above preliminary estimates: The January preliminary release estimated fourth quarter revenue at about $280 million and full-year revenue at about $981 million. Final figures are $281.3 million and $982.0 million.
  • Preliminary figures were unaudited: The January release stated that revenue, test volumes and free cash flow were preliminary and unaudited, and could change at year-end close.

Coming up, as management said on 19 February 2026

  • Reveal reimbursement submission pending: A Reveal chemotherapy monitoring data package was submitted for Medicare reimbursement. The document gives no decision timing. Source
  • MetaSight contingent payments tied to approvals: Up to $90.0 million more is payable depending on commercial performance and regulatory approvals of the MetaSight technology. Source
  • Shield growth expected in 2026: Management expects another year of significant growth in 2026, supported by commercial infrastructure and a pipeline of growth drivers. Source
  • Oncology launches expected through 2026: Management expected Oncology momentum to continue through the year, with several product launches.

Figures management reported

FigureReported
Patient volumes Sourceabout 79,000 oncology tests in Q4 (+38%); about 276,000 for 2025 (+34%)
Patient volumes Sourceabout 38,000 Shield screening tests in Q4 (vs 6,400); about 87,000 for 2025

Earlier plans management reported on

  • Not stated: The January release said the audited fourth quarter and full-year 2025 results would be reported on the February 2026 call. The February release followed.

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.