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Guardant Health, Inc.: Q1 FY2026 earnings call

What management said about Q1 FY2026, from the documents filed with the SEC on 7 May 2026: press release. Guidance figures: 6 raised, 3 kept. The quarter’s numbers.

Key takeaways

  • Revenue rose 48% year over year: Total revenue was $301.7 million, up 48% from $203.5 million. Oncology, Biopharma and Data, and Screening each added to the total, with Screening rising most in percentage terms. Source
  • Screening revenue rose to $41.6 million: Screening revenue was $41.6 million, against $5.7 million, on about 44,000 Shield tests versus about 9,000. Higher reimbursement for Shield tests also contributed. Source
  • Quest collaboration to expand Shield access: A nationwide, multi-year collaboration with Quest was launched to expand access to Shield and accelerate screening adoption. Source
  • Non-GAAP gross margin reached 66%: Non-GAAP gross margin was 66%, compared with 65% a year earlier. GAAP gross margin was 65%, compared with 63%. Source
  • Operating expenses rose on commercial build-out: Non-GAAP operating expenses were $268.1 million, against $199.6 million. The increase was mainly commercial infrastructure and marketing for Shield and Oncology. Source
  • Free cash flow was $(71.2) million: Free cash flow was $(71.2) million, against $(67.1) million a year earlier. Operating cash use was $65.6 million and purchases of property and equipment were $5.6 million. Source

“Our first-quarter revenue increased 48% year over year, reflecting strong momentum across the Guardant portfolio,”

Helmy Eltoukhy, co-founder and co-CEO

Guidance

AreaPeriodFigureAgainst last quarter
Total revenue Sourcefull year 2026$1.30 to $1.32 billion, growth of 32% to 34%Raised from $1.25 to $1.28 billion, growth of 27% to 30%
Oncology revenue growth Sourcefull year 202628% to 29%Raised from 25% to 27%
Oncology test volume growth Sourcefull year 2026greater than 35%Raised from approximately 30%
Biopharma & Data revenue growth Sourcefull year 2026low double-digit rangeKept
Screening revenue Sourcefull year 2026$186 to $198 millionRaised from $162 to $174 million
Shield screening test volume Sourcefull year 2026230,000 to 245,000 testsRaised from 210,000 to 225,000 tests
Non-GAAP gross margin Sourcefull year 202664% to 65%Kept
Total non-GAAP operating expenses Sourcefull year 2026$1.05 to $1.07 billionRaised from $1.03 to $1.05 billion
Free cash flow burn Sourcefull year 2026$185 to $195 millionKept

What changed from last quarter

  • Guidance raised: Full-year 2026 revenue guidance raised to $1.30 to $1.32 billion from $1.25 to $1.28 billion. Source
  • Guidance raised: Oncology revenue growth guidance raised to 28% to 29%, from 25% to 27%. Oncology volume growth guidance raised to greater than 35%. Source
  • Guidance raised: Screening revenue guidance raised to $186 to $198 million, and Shield volume guidance raised to 230,000 to 245,000 tests. Source
  • Guidance raised: Non-GAAP operating expense guidance moved up to $1.05 to $1.07 billion, from $1.03 to $1.05 billion. Source
  • New: Nationwide, multi-year collaboration with Quest launched to expand access to Shield. This was not in the prior quarter's release. Source
  • New: Collaboration with Nuvalent announced to develop companion diagnostics, with initial emphasis on Guardant360 Tissue. Source
  • New: Shield Multi-Cancer Detection launched in Asia through a Manulife partnership. Source

Results and growth drivers

  • Revenue rose 48% year over year: Total revenue was $301.7 million, up 48% from $203.5 million. Oncology, Biopharma and Data, and Screening each added to the total, with Screening rising most in percentage terms. Source
  • GAAP loss widened, non-GAAP loss narrowed: GAAP net loss was $112.1 million, or $0.85 per share, against $95.2 million, or $0.77. Non-GAAP net loss was $58.7 million, or $0.45 per share, against $61.1 million, or $0.49. Source
  • Adjusted EBITDA loss was $58.9 million: Adjusted EBITDA loss was $58.9 million, compared with a $58.5 million loss a year earlier. Source

Segments and regions

  • Oncology revenue grew 36%: Oncology revenue was $205.0 million, up from $150.6 million. The release attributes the growth mainly to test volume, up 47%, and higher reimbursement for oncology tests. Source
  • Biopharma and Data revenue grew 17%: Biopharma and Data revenue was $53.0 million, up from $45.4 million. Licensing and other revenue was $2.1 million, against $1.9 million a year earlier. Source
  • Screening revenue rose to $41.6 million: Screening revenue was $41.6 million, against $5.7 million, on about 44,000 Shield tests versus about 9,000. Higher reimbursement for Shield tests also contributed. Source

“We are pleased with our progress with Shield, including strong volume momentum exiting the first quarter,”

AmirAli Talasaz, co-founder and co-CEO

Products and customers

  • Quest collaboration to expand Shield access: A nationwide, multi-year collaboration with Quest was launched to expand access to Shield and accelerate screening adoption. Source
  • Nuvalent companion diagnostics collaboration: The company announced a collaboration with Nuvalent on companion diagnostics in targeted cancer therapy, with initial emphasis on Guardant360 Tissue. Source
  • FDA approval for Guardant360 CDx: The FDA approved Guardant360 CDx as a companion diagnostic for Arvinas and Pfizer's VEPPANU in ER+/HER2- ESR1 mutated advanced breast cancer. Source
  • Shield MCD launched in Asia: Shield Multi-Cancer Detection launched in Asia through a partnership with Manulife. Source
  • Tissue test adds transcriptome profiling: Guardant360 Tissue gained whole transcriptome profiling, which the company says expands its clinical utility. Source

Costs, operating expenses and margins

  • Non-GAAP gross margin reached 66%: Non-GAAP gross margin was 66%, compared with 65% a year earlier. GAAP gross margin was 65%, compared with 63%. Source
  • Operating expenses rose on commercial build-out: Non-GAAP operating expenses were $268.1 million, against $199.6 million. The increase was mainly commercial infrastructure and marketing for Shield and Oncology. Source

“With a disciplined focus on execution as we scale, we are well positioned to broaden our reach in cancer screening and drive long-term value creation.”

AmirAli Talasaz, co-founder and co-CEO

Demand and awareness activity

  • Awareness campaigns during colorectal month: Direct-to-consumer and influencer campaigns ran during Colorectal Cancer Awareness Month to build awareness and demand. Source

Capital, cash and cash flow

  • Cash and securities were $1.2 billion: Cash, cash equivalents, restricted cash and marketable securities were $1.2 billion at March 31, 2026, against $1.3 billion at December 31, 2025. Source
  • Free cash flow was $(71.2) million: Free cash flow was $(71.2) million, against $(67.1) million a year earlier. Operating cash use was $65.6 million and purchases of property and equipment were $5.6 million. Source

Strategy and investment

  • Smart platform and InfinityAI cited: Eltoukhy linked oncology trends to the Smart platform and InfinityAI offerings, which he said position the company for sustained growth and leadership in precision oncology. Source
  • Reveal receptivity for therapy monitoring: Management reported strong receptivity to the expansion of Guardant Reveal into therapy response monitoring. Source
  • AACR abstracts and ENHERTU support: The company presented 38 abstracts at the 2026 AACR Annual Meeting and used InfinityAI real-world evidence to support an ENHERTU approval. Source

Coming up, as management said on 7 May 2026

  • Shield growth via Quest and partners: Management expects sustained Shield volume growth as it builds commercial infrastructure and expands collaborations with Quest and other partners. Source

Figures management reported

FigureReported
Oncology test volume Sourceapproximately 86,000 tests, an increase of 47%
Shield screening tests Sourceapproximately 44,000 tests, against approximately 9,000 a year earlier

Earlier plans management reported on

  • Not stated: Management continues to expect Biopharma and Data revenue growth in the low double-digit range for 2026. Source
  • Not stated: Management continues to expect free cash flow burn of $185 to $195 million for 2026. Source

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.