Guardant Health, Inc.

Second-quarter revenue was $335 million, up 44% year over year. Oncology revenue was $219 million, up 38%, with test volume up 63% to approximately 104,000 tests. Biopharma & Data revenue was a record $61 million, up 9%, and Screening revenue was $53 million versus $15 million a year ago, with Shield volume at about 66,000 tests versus about 16,000 last year. Non-GAAP gross margin was 67%, compared with 66% a year ago; adjusted EBITDA loss was $56 million versus a loss of $52 million in Q2 2025; quarter-end cash and investments were approximately $1.2 billion; and free cash flow burn was $70 million versus $66 million a year ago. For 2026, management raised revenue guidance to $1.34 billion to $1.36 billion, expects Oncology revenue growth of about 30% and volume growth of about 50%, Biopharma & Data low-double-digit growth, Screening revenue of $218 million to $230 million and 270,000 to 285,000 Shield tests, non-GAAP gross margin of 64% to 65%, operating expenses of $1.08 billion to $1.1 billion, and free cash flow burn of $195 million to $205 million. The company also said Shield cost per test should fall by roughly 15% by the end of 2026 from the current level of about $410, with a $200 cost-per-test target in 2028.

Helmy Eltoukhy framed the quarter as a major step in advancing Guardant’s platform strategy across therapy selection, recurrence monitoring, screening, and eventually multi-disease screening. He emphasized that FDA approval of Guardant360 Liquid CDx, higher-throughput/lower-COGS Shield workflow approval, ACS guideline inclusion, and UnitedHealthcare coverage together show the company is turning its platform vision into clinical impact and growth. His tone was notably upbeat, especially on the breadth of Oncology momentum, the data asset behind InfinityAI, and the long runway for Reveal and Shield.

Michael Bell focused on the financial execution and the updated outlook. He cited the 67% non-GAAP gross margin, the approximately $200 per-test cost reduction from the NovaSeq X transition, and said the new Shield workflow should lower Shield cost per test by roughly 15% by year-end 2026 from about $410. He also noted Q2 free cash flow burn of $70 million and quarter-end cash and investments of about $1.2 billion, then raised full-year free cash flow burn guidance to $195 million to $205 million because of added CapEx for Shield lab capacity. On capital allocation, he said Guardant plans to reinvest some incremental gross profit into commercialization and innovation while still aiming for company-wide cash flow breakeven by the end of 2027.

Analysts focused heavily on Shield coverage, pricing, and whether UnitedHealthcare and ACS could pull forward broader payer adoption before USPSTF. Management said United’s move was earlier than expected, that ASP effects will take time, and that they do not expect major additional payer wins in the near term, though conversations are improving. Questions also centered on Guardant360 ADLT pricing and margin leverage; management said the expected ADLT price is $8,455, that realized pricing should flow through over 12 to 24 months, and that some of the higher gross profit would likely be reinvested while some drops to the bottom line. Analysts asked about Reveal therapy monitoring and reimbursement timing, and management said uptake is strong, especially from G360 physicians, but MolDX decisions for IO and breast are still pending and could come by year-end.