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Grail, Inc.: Q1 FY2026 earnings call

What management said about Q1 FY2026, from the documents filed with the SEC on 5 May 2026: press release. The quarter’s numbers.

Key takeaways

  • Revenue grew 28 percent: Total revenue was $40.8 million, up from $31.8 million a year earlier. Galleri revenue was $39.8 million, up 37% year over year. Source
  • Adjusted EBITDA loss narrowed: Adjusted EBITDA was $(79.9) million, compared with $(98.7) million in the first quarter of 2025. Source
  • Galleri test volume rose 50 percent: Galleri tests delivered in the quarter exceeded 56,000, up 50% year over year. Source
  • Epic integration reaches point of care: Under the planned integration, health systems and their providers would order the Galleri test at the point of care, receive structured results, and manage patient follow-up within their native EHR. Source
  • Adjusted gross profit rose 38 percent: Adjusted gross profit was $19.7 million, up from $14.3 million. Management defines it as gross profit excluding amortization of intangible assets and stock-based compensation in cost of revenue. Source
  • Cash and securities total $823.1 million: Cash, cash equivalents and short-term marketable securities were $823.1 million at March 31, 2026, down from $904.4 million at December 31, 2025. Source
  • PMA data covers 25,000 participants: The PMA draws on PATHFINDER 2 with one year of follow-up and the first-year prevalent round of NHS-Galleri, plus a bridging analysis comparing trial and submitted test versions. Source

“We continue to build new partnerships to support demand and were pleased to announce our collaboration with Epic, which will expand access to Galleri for physicians and patients,”

Bob Ragusa, Chief Executive Officer at GRAIL

What changed from last quarter

  • New: Management announced a planned integration of the Galleri test into Epic's EHR platform, with broad availability expected by the end of 2026. Source
  • New: Compared with the fourth quarter 2025 release, which reported the PMA submission as completed in January, the first quarter release reports that FDA accepted the application for review. Source

Results and growth drivers

  • Revenue grew 28 percent: Total revenue was $40.8 million, up from $31.8 million a year earlier. Galleri revenue was $39.8 million, up 37% year over year. Source
  • Net loss narrowed to $93.2 million: Net loss was $93.2 million, down $13.0 million from $106.2 million a year earlier. Net loss per share was $(2.29), against $(3.10). Source
  • Adjusted EBITDA loss narrowed: Adjusted EBITDA was $(79.9) million, compared with $(98.7) million in the first quarter of 2025. Source
  • Interest income was $8.0 million: Interest income was $7,986 thousand, against $7,779 thousand a year earlier. Total other income, net was $8,242 thousand. Source

Revenue mix and development services

  • Screening revenue made up most sales: Screening revenue was $39,832 thousand, against $29,133 thousand. Development services revenue was $953 thousand, against $2,704 thousand. Source
  • Development services revenue declined: Cost of development services revenue was $376 thousand, against $1,171 thousand. Cost of revenue amortization of intangible assets was $33,472 thousand in both periods. Source
  • Sequential revenue was lower: Fourth quarter 2025 total revenue was $43.6 million and U.S. Galleri revenue was $41.3 million, compared with first quarter total revenue of $40.8 million.

“We are looking forward to our upcoming presentations of detailed results from our 35,000 PATHFINDER 2 study and the 140,000 NHS-Galleri trial, which were accepted for presentation at the 2026 ASCO Annual Meeting in late May.”

Bob Ragusa, Chief Executive Officer at GRAIL

Products, customers and data

  • Galleri test volume rose 50 percent: Galleri tests delivered in the quarter exceeded 56,000, up 50% year over year. Source
  • Epic integration reaches point of care: Under the planned integration, health systems and their providers would order the Galleri test at the point of care, receive structured results, and manage patient follow-up within their native EHR. Source
  • Mammography adherence data at AACR: AACR data showed women with a negative MCED result kept mammography adherence above 80% in the 24 months after testing. Source

Costs and margins

  • Gross loss narrowed: Gross loss was $14.3 million, compared with $19.9 million in the first quarter of 2025. Source
  • Adjusted gross profit rose 38 percent: Adjusted gross profit was $19.7 million, up from $14.3 million. Management defines it as gross profit excluding amortization of intangible assets and stock-based compensation in cost of revenue. Source
  • Screening cost rose year over year: Cost of screening revenue, excluding amortization, was $21.2 million, against $17.1 million a year earlier. Source
  • Operating expenses fell year over year: Research and development was $48.0 million, against $53.6 million. Sales and marketing was $30.7 million, against $35.0 million. General and administrative was $42.8 million, against $45.1 million. Source

Cash and capital

  • Cash and securities total $823.1 million: Cash, cash equivalents and short-term marketable securities were $823.1 million at March 31, 2026, down from $904.4 million at December 31, 2025. Source
  • Cash moved into short-term securities: Cash and cash equivalents were $69.3 million, against $249.7 million at December 31, 2025. Short-term marketable securities were $753.8 million, against $654.7 million. Source
  • Shares outstanding increased: Shares issued and outstanding were 41.1 million at March 31, 2026, against 40.3 million at December 31, 2025. Source

Clinical and regulatory data

  • PMA data covers 25,000 participants: The PMA draws on PATHFINDER 2 with one year of follow-up and the first-year prevalent round of NHS-Galleri, plus a bridging analysis comparing trial and submitted test versions. Source
  • Emergency department involvement and survival: An AACR analysis of Medicare patients found emergency department involvement at diagnosis associated with a significant fraction of overall mortality in cancer patients. Source
  • 174,000 participants across two studies: More than 174,000 participants enrolled across the NHS-Galleri trial and PATHFINDER 2 study combined. Source

Coming up, as management said on 5 May 2026

  • Epic broad availability by end-2026: Management expects broad availability of the Galleri test in the Epic EHR platform by the end of 2026. Source
  • NHS-Galleri oral presentation May 30: Detailed NHS-Galleri trial results are scheduled as a late-breaking oral presentation at ASCO on Saturday, May 30, 2026. Source
  • PATHFINDER 2 oral presentation May 31: Final PATHFINDER 2 study results are scheduled as a late-breaking oral presentation at ASCO on Sunday, May 31, 2026. Source

Figures management reported

FigureReported
Patient volumes Sourcemore than 56,000 Galleri tests in the quarter, up 50% year over year

Risks management discussed

  • Regulatory: The Galleri test has not been cleared or approved by the FDA, and the PMA application remains under FDA review. Source

Earlier plans management reported on

  • On track: In the fourth quarter 2025 release, management said it remained on track for continued commercial growth in 2026.
  • Not stated: The fourth quarter 2025 release anticipated presenting detailed results in mid-2026. The first quarter release sets ASCO presentations in late May.

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.