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Conquering Cancer with Data Q4 2025 & Full Year 2025 Earnings Call February 19, 2026
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Certain statements in this presentation and the accompanying oral commentary are forward-looking statements within the meaning of federal securities laws. These statements relate to future events or Guardant Health, Inc. (the “Company”)’s future results and involve known and unknown risks, uncertainties and other factors that may cause the actual results, levels of activity, performance or achievements of the Company or its industry to be materially different from those expressed or implied by any forward-looking statements. In some cases, forward-looking statements can be identified by terminology such as “may,” “will,” “could,” “would,” “should,” “to,” “target,” “expect,” “plan,” “anticipate,” “intend,” “believe,” “estimate,” “predict,” “potential” or other comparable terminology. All statements other than statements of historical fact could be deemed forward-looking, including any expectations regarding the Company's commercial engine as a force multiplier for research and development initiatives; any projections of market opportunities; statements about the Company’s ability to assess potential market opportunities or any statements about the Company’s ability to successfully develop new products and services; any statements regarding expectations for future reimbursement opportunities; any statements regarding the Company’s long-term expectations, including with respect to oncology, liquid biopsy, and other aspects of the Company’s industry; any statements about launching planned new products and additional laboratories, including with respect to Guardant Shield, CGP tissue assay, and laboratories outside the United States; any statements about the Company’s ECLIPSE study; any statements regarding expectations for future regulatory approvals; any statements about historical results that may suggest trends for the Company’s business; any statements of the plans, strategies, and objectives of management for future operations and directions; any statements of expectation or belief regarding future events, opportunities to drive future growth, potential markets or market size, or technology developments; and any statements of assumptions underlying any of the items mentioned. The Company has based these forward-looking statements on its current expectations, assumptions, estimates and projections. While the Company believes these expectations, assumptions, estimates and projections are reasonable, such forward-looking statements are only predictions and involve known and unknown risks and uncertainties, many of which are beyond the Company's control. These and other important factors may cause actual results, performance or achievements to differ materially from those expressed or implied by these forward-looking statements. The forward-looking statements in this presentation are made only as of the date hereof. For a further description of the risks and uncertainties that could cause actual results to differ from those expressed in these forward-looking statements, as well as risks relating to the business of the Company in general, see the Company's periodic filings with the Securities and Exchange Commission, including its most recently filed Annual Report on Form 10 -K, and in its other reports filed with or furnished to the Securities and Exchange Commission. Except as required by law, the Company assumes no obligation and does not intend to update these forward- looking statements or to conform these statements to actual results or to changes in the Company's expectations. This presentation also contains estimates and other statistical data made by independent parties and by the Company relating to market size, penetration and growth and other data about the Company's industry, which involve a number of assumptions and limitations, and you are cautioned not to give undue weight to such estimates. In addition, projections, assumptions, and estimates of the Company's future performance and the future performance of the markets in which the Company operates are necessarily subject to a high degree of uncertainty and risk. In light of the foregoing, investors are urged not to rely on any forward-looking statement or third-party data in reaching any conclusion or making any investment decision about any securities of the Company. This presentation includes references to certain financial measures that are not calculated in accordance with GAAP. Reconciliation to the most directly comparable GAAP financial measure may be found in the earnings release furnished to the SEC. We define our non-GAAP measures as the applicable GAAP measure adjusted for the impacts of stock-based compensation and related employer payroll tax payments, contingent consideration, amortization of intangible assets, unrealized and realized gains and losses on marketable equity securities, impairment of non-marketable equity securities, gain on extinguishment of convertible notes, and other non-recurring items. Free cash flow is defined as net cash used in operating activities in the period less purchases of property and equipment in the period. Safe harbor and non- GAAP disclosures 2
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Profiling Monitoring Monitoring SurgeryTumor detected Screening MRD Profiling 3 One platform for the entire patient journey PLATFORM
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Strong revenue growth in 2025 4 FY Revenue Q4 2024 Q4 2025 $202M $281M Q4 Revenue 39% YoY Growth Oncology Biopharma & Data Screening Licensing & Other 2024 2025 33% YoY Growth $739M $982M
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Q4 2025Q4 2024 Oncology Revenue $190M $146M 30% YoY Growth Q4 2025Q4 2024 79K 57K 38% YoY Growth Oncology Volume Oncology revenue growth driven by robust performance across all products 5
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Q2 '24 Q3 '24 Q4 '24 Q1 '25 Q2 '25 Q3 '25 Q4 '25 79K Steady cadence of new Smart Platform applications to Guardant360 Liquid Upgraded Guardant360 Tissue leveraging the Smart Platform and RNA comprehensive analysis Received Medicare reimbursement for Reveal CRC Surveillance Oncology Volume Oncology volume growth driven by product upgrades and reimbursement coverage Upgrade Wave 2 CRC Surveillance Reimbursement Smart Apps Launch Wave 1 Wave 3 14% 21% 24% 25% 30% 38%Y/Y Growth 40% 6
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Clinical insights Product innovation + Smart App launches Fueling a rich data ecosystem > 1,000,000 PATIENT SAMPLES >100 TUMOR TYPES EPIGENETIC PROFILES Biopharma applications >400,000 InfinityAI is accelerating innovation across the business 7
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Q4 Oncology highlights 8 Oncology y/y volume growth 38% driven by strong performance across all products Guardant360 y/y volume growth of nearly 30% Reveal continues to be the fastest growing Oncology product Expanded tissue-free Reveal test to include late-stage therapy response monitoring Submitted Reveal chemo monitoring data package to MolDx for Medicare reimbursement Publication manuscript under review for Reveal CDK4/6 monitoring Launched in-house testing service at Policlinico Gemelli based on Guardant360 CDx technology
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Reveal data pipeline driving reimbursement momentum Indication Specific Studies 1H 2024 2H 2024 1H 2025 2H 2025 1H 2026 2H 2026 CRC Surveillance COSMOS Breast Surveillance Elliot et al, Ademuyiwa et al IO Monitoring RADIOHEAD, Liang et al Chemo Monitoring RWE CDK4/6 Monitoring Multiple MRD/Surveillance Multiple Submitted for publication MolDx is the Molecular Diagnostic Services Program to identify and establish Federal coverage reimbursement for molecular diagnostic tests Covered by Medicare 5+ Tumor Types Published and submitted to MolDx 9
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Launched in Q4 2025 Unlocking new paradigms in therapy monitoring SERENA-6 Trial 1 Tissue-free solution to monitor treatment response and detect early disease progression with best-in-class speed and sensitivity Liquid biopsy directed switch to a new treatment upon emergence of ESR1 resistance mutation First monitoring (~3x per year) application for Guardant360 with ~40,000 patient prevalence in the U.S. 1. SERENA-6 opportunity is contingent on approval of Camizestrant for emerging ESR1-mutated advanced breast cancer 10
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Biopharma & Data growth supported by strategic partnerships 2024 2025 $210M $178M Biopharma & Data FY Revenue 5 new CDx approvals in the last 6 months Strong SERENA-6 readout at ASCO 2025 Collaboration with Merck to develop companion diagnostics and commercialize new therapies Multiple strategic data collaborations 11 18%
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Strong momentum continues for CRC screening 12 Q4 2024 Q1 2025 Q2 2025 Q3 2025 Q4 2025 16K 9K 6K 24K 38KShield Volume +3K +7K +8K +14K $35M Q4 ‘25 Revenue
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Q4 Screening highlights 13 Strong Q4 volume with +14,000 test sequential growth Shield continues to demonstrate a high adherence rate Continued scaling commercial team, exiting Q4 with ~300 sales reps Shield received coverage for active-duty service members and their families through TRICARE, the U.S. military’s health insurance coverage, with no copay for average-risk individuals ages 45+ Launched dedicated Health Systems team for Shield and deployed our first enterprise integrations with large health systems in West Virginia and Georgia Expanded Shield to include multi-cancer detection (MCD) result report with strong interest by patients to be part of the MCD data collection initiative
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93% Adherence rate for first 100,000 patients1 25-71% Shield real-world patient adherence far surpasses other screening modalities Adherence rate2 Colonoscopy or stool-based tests 1. Guardant Health internal data; 2. See appendix for sources 14
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Screening commercial infrastructure is scaling rapidly bolstered by recent strategic collaborations 15 >8,000 National patient access points >650K EMR connected HCPs and hospitals Access to Quest national sales team Launching in Q1 2026 Launched
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Shield is a multi-cancer detection platform Multi-cancer Lung Stomach Pancreatic Prostate Esophageal OvarianLiver Bladder CRC Breast CRC 16
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The Shield MCD results report is not a part of the FDA approved Shield IVD and has not been cleared or approved by FDA. 17 Physician opts in to receive MCD results report Patient authorizes release of medical data Multi-cancer detection When Shield is ordered for CRC screening Scalable platform for clinical data generation
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2025 2026 … Major 2025 achievements lay the groundwork for strong Shield growth in 2026 and beyond ADLT Status: $1,495 Rate Product-Market Fit Commercial Excellence NCCN Guidelines EMR Integrations Field Force Scale-Up ACS Guidelines Targeted DTC Campaigns OUS Self-Pay Expansion 18
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+ PLATFORM Multi-disease detection Multi-cancer detection CRC screening 19 Announcing acquisition of MetaSight Diagnostics
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Q4’25 Q4’24 % Growth FY’25 FY’24 % Growth Total Revenue $281M $202M 39% $982M $739M 33% Oncology $190M $146M 30% $684M $543M 26% Biopharma & Data $54M $50M 9% $210M $178M 18% Screening $35M $4M -- $80M $5M -- Licensing & Other $2M $3M -- $9M $13M -- Significant revenue growth in 2025 20
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Non-GAAP Measures Q4’25 Q4’24 FY’25 FY’24 Gross Profit $185M $126M $645M $460M Gross Margin1 66% 63% 66% 62% Total Operating Expenses $260M $215M $904M $757M R&D $86M $81M $309M $296M S&M $131M $96M $448M $328M G&A $44M $38M $146M $133M Adjusted EBITDA2 $(65M) $(78M) $(221M) $(258M) 1. Gross margin is defined as gross profit divided by total revenue. 2. Adjusted EBITDA is defined as net loss adjusted for interest income; interest expense; other income (expense), net; provision for (benefit from) income taxes; depreciation and amortization expense; stock- based compensation expense and related employer payroll tax payments; contingent consideration; and other non-recurring items. Q4 and full year 2025 non-GAAP financial highlights 21
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FCF Breakeven Q4 20271 $(387)M $(345)M $(275)M 1. 2026 – 2028 free cash flow forecast excludes any impact from future mergers, acquisitions, legal matters, mergers, acquisitions and financing. Free cash flow is defined as net cash used in operating activities in the period less purchase of property and equipment in the period. 2. Cash includes cash, cash equivalents, restricted cash and marketable debt securities. Clear path to cash flow breakeven $(233)M 20282023 2024 2025 2026 20272022 FCF Positive1 Targeting free cash flow breakeven in Q4 2027 Excluding Screening, generated positive free cash flow in Q3 and Q4 2025 Strong balance sheet following recent financing and convertible restructuring Cash at year end 2025: $1.3B2 22
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$1.25B – $1.28B 27% - 30% y/y growth Total Revenue Oncology Screening driven by ~30% y/y volume growth driven by 210K – 225K Shield volume Initiating full year 2026 guidance 23 Non-GAAP Operating Expenses $1.03B – $1.05B Non-GAAP Gross Margin 64%-65% range Free Cash Flow $(185M) – $(195M) $162M - $174M 25% - 27% revenue growth Biopharma & Data Low double digit revenue growth
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ONCOLOGY SCREENING Guardant360 Liquid FDA approval and launch Transition to NovaSeq X ESR1 monitoring launch Guardant360 Smart Platform app expansion MolDx coverage for Reveal Breast MRD MolDx coverage for Reveal therapy monitoring MolDx submissions in additional tumor types and indications Reveal Ultra launch Therapy Selection MRD ACS guidelines Quest collaboration launch OUS self-pay expansion Upcoming key catalysts across the continuum of cancer care in 2026 24 BIOPHARMA & DATA CDx approvals, including SERENA-6 Additional strategic biopharma partnerships InfinityAI data partnerships
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References Sources for adherence for colonoscopy: • Bretthauer M, Løberg M, Wieszczy P, et al. NordICC Study Group. Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med. 2022;387(17):1547-1556. doi:10.1056/NEJMoa2208375 • Lin JS, Perdue LA, Henrikson NB, Bean SI, Blasi PR. Screening for Colorectal Cancer: An Evidence Update for the U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality; 2021. Evidence Synthesis No. 202. AHRQ Publication No. 20-05271-EF-1. Sources for adherence for stool-based tests: • Quintero E, Castells A, Bujanda L. Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening. N Engl J Med. 2012;366(8):697-706. doi:10.1056/NEJMoa1108895 • Jensen CD, Corley DA, Quinn VP, et al. Fecal immunochemical test program performance over 4 rounds of annual screening: a retrospective cohort study. Ann Intern Med. 2016;164(7):456-463. doi:10.7326/M15-0983 • Oluloro A, Petrik AF, Turner A, et al. Timeliness of colonoscopy after abnormal fecal test results in a safety net practice. J Community Health. 2016;41(4):864-870. doi:10.1007/s10900-016-0165-y • Binefa G, Garcia M, Milà N, et al. Colorectal cancer screening programme in Spain: Results of key performance indicators after five rounds (2000-2012). Sci Rep. 2016;6:19532. doi:10.1038/srep19532 • Idigoras I, Arrospide A, Portillo I, et al. Evaluation of the colorectal cancer screening programme in the Basque Country (Spain) and its effectiveness based on the Miscan-colon model. BMC Public Health. 2017;18(1):78. doi:10.1186/s12889-017-4639-3 • Bretagne JF, Piette C, Cosson M, Durand G, Lièvre A. Switching from guaiac to immunochemical faecal occult blood test increases participation and diagnostic yield of colorectal cancer screening. Dig Liver Dis. 2019;51(10):1461-1469. doi:10.1016/j.dld.2019.05.004 • Akram A, Juang D, Bustamante R, et al. Replacing the guaiac fecal occult blood test with the fecal immunochemical test increases proportion of individuals screened in a large healthcare setting. Clin Gastroenterol Hepatol. 2017;15(8):1265-1270.e1. doi:10.1016/j.cgh.2017.01.025 • Singal AG, Gupta S, Sugg Skinner C, et al. Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial. JAMA. 2017;318(9):806- 815. doi:10.1001/jama.2017.11389 • Nielson CM, Vollmer WM, Petrik AF, Keast EM, Green BB, Coronado GD. Factors affecting adherence in a pragmatic trial of annual fecal immunochemical testing for colorectal cancer. J Gen Intern Med. 2019;34(6):978-985. doi:10.1007/s11606-018-4820-0 • Forsberg A, Westerberg M, Metcalfe C, et al. SCREESCO Investigators. Once-only colonoscopy or two rounds of faecal immunochemical testing 2 years apart for colorectal cancer screening (SCREESCO): Preliminary report of a randomised controlled trial. Lancet Gastroenterol Hepatol. 2022;7(6):513-521. doi:10.1016/S2468-1253(21)00473-8 • Conroy K. Exact Sciences. 36th Annual JP Morgan Healthcare Conference; January 9, 2018; San Francisco, California 2018. • Weiser E, Parks PD, Swartz RK, et al. Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening: Real-world data from a large cohort of older adults. J Med Screen. 2021;28(1):18-24. doi:10.1177/0969141320903756 • Miller-Wilson L, Finney Rutten LJ, Van Thomme J, Ozbay B, Limburg PJ. Cross-sectional adherence with the multitarget stool DNA test for colorectal cancer screening in a large, national study of insured patients. Abstract presented at: 2021 Gastrointestinal Cancers Symposium; January 22, 2021. • Inadomi JM, Vijan S, Janz NK, et al. Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Arch Intern Med. 2012;172(7):575-582. doi:10.1001/archinternmed.2012.332 26