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Grail, Inc.: Q4 FY2025 earnings call

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

Key takeaways

  • Fourth-quarter revenue rose 14%: Fourth-quarter total revenue was $43.6 million, up $5.3 million or 14% from the prior-year quarter. Source
  • Full-year revenue rose 17%: Full-year total revenue was $147.2 million, up 17%, while U.S. Galleri revenue grew 26% to $136.8 million. Source
  • Full-year adjusted EBITDA improved $163 million: Full-year non-GAAP adjusted EBITDA was $(320.6) million, compared with $(483.5) million in 2024. Source
  • NHS-Galleri primary endpoint not met: NHS-Galleri showed fewer Stage IV diagnoses and a four-fold higher detection rate than standard of care alone, but did not meet its primary endpoint of a statistically significant reduction in combined Stage III and IV. Source
  • Full PATHFINDER 2 analysis completed: Analysis of the 35,000-participant PATHFINDER 2 study matched the earlier 25,000-participant analysis, and the release describes a safety profile as well. Source
  • PMA submission completed in January: The final module of the Premarket Approval application for Galleri was submitted to the FDA in January. The PMA draws on PATHFINDER 2 and NHS-Galleri data. Source
  • Cash and securities of $904.4 million: Cash, cash equivalents, and short-term marketable securities totaled $904.4 million as of December 31, 2025. Source

“2025 was a year of significant commercial growth for GRAIL, and we’re excited by the building momentum for multi-cancer early detection”

Bob Ragusa, Chief Executive Officer at GRAIL

Guidance

AreaPeriodFigureAgainst last quarter
Total Galleri revenue growth202622 - 32% growth
Cash burn2026<$300M

What changed from last quarter

  • New: NHS-Galleri topline results were announced, which the January presentation had listed as a future readout. Source
  • New: Analysis of the full 35,000-participant PATHFINDER 2 study was completed, which the January presentation had listed as a future readout. Source
  • New: The final module of the Galleri PMA application was submitted to the FDA in January. Source
  • New: The Medicare multi-cancer early detection coverage act became federal law, creating a Medicare coverage pathway for these tests. Source
  • New: Galleri became available through the Hims & Hers digital health platform. Source

Results and growth drivers

  • Fourth-quarter revenue rose 14%: Fourth-quarter total revenue was $43.6 million, up $5.3 million or 14% from the prior-year quarter. Source
  • Full-year revenue rose 17%: Full-year total revenue was $147.2 million, up 17%, while U.S. Galleri revenue grew 26% to $136.8 million. Source
  • U.S. Galleri revenue rose 31%: U.S. Galleri revenue for the fourth quarter was $41.3 million, up 31% year over year. Source
  • Screening revenue made up most growth: Screening revenue was $42.3 million in the quarter versus $31.6 million, and $138.6 million for the year versus $108.6 million. Development services revenue fell to $1.3 million in the quarter from $6.7 million. Source
  • Full-year net loss narrowed: Full-year net loss was $408.4 million, including $138.3 million of Illumina acquisition-related intangible amortization and a $28.0 million impairment. Source

Products, partners and customers

  • Hims & Hers adds Galleri access: Galleri is now offered through the Hims & Hers Multi-Cancer Test, which the release describes as expanding digital access. Source
  • Hims & Hers adds to other platforms: Access through Hims & Hers Labs is described as additive to access through Function Health and Everlywell and other digital health and wellness platforms. Source

“We remain on track for continued commercial growth in 2026 with new and expanding partnerships in digital health and further integration into health systems”

Bob Ragusa, Chief Executive Officer at GRAIL

Costs, gross profit and margins

  • Fourth-quarter gross loss narrowed: Fourth-quarter gross loss was $11.1 million, compared with $16.0 million a year earlier, after excluding amortization of intangible assets. Source
  • Adjusted gross profit rose 29%: Non-GAAP adjusted gross profit for the quarter was $23.1 million, compared with $17.9 million in the prior-year quarter. Source
  • Full-year adjusted EBITDA improved $163 million: Full-year non-GAAP adjusted EBITDA was $(320.6) million, compared with $(483.5) million in 2024. Source
  • Research and sales spending declined: Full-year research and development expense was $195.8 million versus $322.4 million, and sales and marketing expense was $116.7 million versus $154.0 million. Source

Clinical and regulatory progress

  • NHS-Galleri primary endpoint not met: NHS-Galleri showed fewer Stage IV diagnoses and a four-fold higher detection rate than standard of care alone, but did not meet its primary endpoint of a statistically significant reduction in combined Stage III and IV. Source
  • Full PATHFINDER 2 analysis completed: Analysis of the 35,000-participant PATHFINDER 2 study matched the earlier 25,000-participant analysis, and the release describes a safety profile as well. Source
  • PMA submission completed in January: The final module of the Premarket Approval application for Galleri was submitted to the FDA in January. The PMA draws on PATHFINDER 2 and NHS-Galleri data. Source
  • Medicare multi-cancer coverage act enacted: The release reports that the act became federal law, establishing a Medicare coverage pathway for multi-cancer early detection tests. Source

Capital, cash and funding

  • Cash and securities of $904.4 million: Cash, cash equivalents, and short-term marketable securities totaled $904.4 million as of December 31, 2025. Source
  • Raised more than $435 million: Management said the company subsequently raised more than $435 million, which it described as providing financial flexibility. Source
  • Operating cash use fell in 2025: Net cash used by operating activities was $299.0 million for 2025 versus $577.2 million in 2024. Net cash used by investing activities was $85.0 million versus $551.0 million. Source

Plans for 2026

  • 2026 Galleri revenue growth target: The January presentation gave a 2026 total Galleri revenue growth range of 22 - 32%. The February release does not restate it.
  • 2026 cash burn target: The January presentation gave 2026 cash burn guidance of less than $300M. The February release does not restate it.
  • Commercial growth expected on track: Management said it remains on track for continued commercial growth in 2026, citing partnerships in digital health and further integration into health systems. Source

Coming up, as management said on 19 February 2026

  • Detailed trial results due mid-2026: Management anticipates presenting detailed results from PATHFINDER 2 and the NHS-Galleri trial in mid-2026. Source
  • Full PATHFINDER 2 data for conference: Full data from the 35,000-participant PATHFINDER 2 study will be submitted for presentation at a conference later in 2026. Source

Figures management reported

FigureReported
Galleri tests sold, 2025 Sourcemore than 185,000

Risks management discussed

  • Regulatory: The NHS-Galleri trial did not meet its primary endpoint of a statistically significant reduction in combined Stage III and IV cancers. Source
  • Regulatory: The release states that Galleri has not been cleared or approved by the FDA, while the PMA application is under review. Source
  • Financial: Fourth-quarter net loss rose $2.1 million to $99.2 million, including $34.6 million of Illumina acquisition-related intangible amortization. Source

Earlier plans management reported on

  • On track: Management said the company is on track for continued commercial growth in 2026. Source
  • Met: The January presentation planned to complete the modular PMA submission in Q1 2026. The release says the final module was submitted in January. Source
  • Not stated: The January presentation planned full PATHFINDER 2 and NHS-Galleri results for mid-2026. The release reiterates that timing without stating progress. 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.