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JP Morgan Healthcare Conference January 12, 2026
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2 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 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
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On a mission to guard wellness and give every person more time free from disease 3
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4 Diagnosed with HR+/HER2- breast cancer Successfully treated with chemotherapy Reveal returned a positive ctDNA result Guardant360 identified multiple actionable mutations, guiding her physician to the next step in her treatment plan Sarah Breast cancer patient 2014 2025 2025 OCTOBEROCTOBER
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Profiling Monitoring Monitoring SurgeryTumor detected Screening MRD Profiling 5 One platform for the entire patient journey PLATFORM
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Strong revenue growth in 2025 61. Approximate preliminary revenue based on unaudited full year and Q4 2025 results provided on January 11, 2026 FY Revenue (M) 2024 2025 $739 $9811 33% YoY Growth Q4 2024 Q4 2025 $202 $2801 Q4 Revenue (M) 39% YoY Growth
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1. Approximate preliminary revenue based on unaudited full year 2025 results provided on January 11, 2026 Expanded product offering coupled with operational excellence is accelerating our revenue growth 7 2021 2022 2023 2024 2025E $374M $450M $564M $739M $981M1 Total Revenue +20% +25% +31% +33%
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ONCOLOGY SCREENING Guardant360 Tissue launch Continued profitability improvement Guardant360 Smart Platform app expansion CRC surveillance reimbursement Positive gross margin Breast publication Therapy monitoring publication Therapy Selection MRD Multi-cancer data ADLT status, improved Medicare pricing Positive gross margin Shield V2 ACS guidelines Delivered key milestones across the continuum of cancer care in 2025 8 BIOPHARMA & DATA Strategic biopharma partnerships Guardant Infinity Smart Liquid Biopsy traction Data partnerships
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9 Multi-Disease ScreeningCancer Screening MRD Therapy Selection We are just at the beginning of our ambition to advance human health $50B $20B $10B $300B
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Sources: Therapy selection TAM is Stage IV patients prevalence, 3rd party consulting, Data from internal modeling that sources information from US Cancer Statistics; SEER, CancerMPact®, NODA data, Treatment Architecture, peer - reviewed literature, and Guardant Health data on file., 3rd party research. Survival data from the Surveillance, Epidemiology, and End Results (SEER) Program; Tonorezos E, Devasia T, Mariotto AB, Mollica MA, Gallicchio L, Green P, Doose M, Brick R, Streck B, Reed C, de Moor JS, Prevalence of Cancer Survivors in the United States, JNCI: Journal of the National Cancer Institute, 2024; https://doi.org/10.1093/jnci/djae135. 10 18M Total U.S. Cancer Patients and Survivors $20B Total U.S. Addressable Market Smart Platform: serving the continuum of cancer care $10B Total U.S. Addressable Market 1M Total U.S. Advanced Cancer Patients Therapy Selection MRD
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Steady cadence of new Smart Platform applications for Guardant360 Liquid Guardant360 y/y growth of 25% in 2025 Reveal continues to be the fastest growing product Strong traction in Guardant360 Tissue following Smart Platform upgrade Oncology volume growth acceleration driven by Smart Platform innovation 111. Approximate preliminary oncology volumes based on unaudited full year 2025 results provided on January 11, 2026 2023 2024 2025 276K1 207K 173K Oncology Volume 20% 34%
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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 12
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13 InfinityAI powers navigation of integrated patient journey NCCN/ASCO Guidelines Biomarker Data Novel Therapeutics Trial Availability Clinical History Guardant Results Guardant Publications
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Partnership with Top Thought Leaders Changing GuidelinesReimbursement NCI-Designated Comprehensive Cancer Centers involved in publication generation 45+ Publications used to obtain Medicare coverage 32 Publications included in successful NCCN submissions 46 As of Jan 7, 2026 Patient Outcomes Publications with patient outcomes involving targeted therapies 270+ 610+ Peer-Reviewed Publications Improving the future of cancer care through research partnerships and 670+ peer-reviewed publications 14 670+
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15 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
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Launched in Q 4 2025 16 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
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Significant progress towards launch of tissue -informed MRD assay with best-in-class sensitivity 17Reveal ULTRA LoD95 estimated from clinical samples processed at representative input levels, data on file, 1. Northcott et al. Oncotarget. 2024;15:200-218, 2. Simulated results based on input levels ranging from 10ng to 80ng Emerging TI-MRD assays1 Higher input easier samples3 Higher input cell lines Lower input challenging samples2 Achieved LOD below 1ppm across broad cohort of patients Assay consistently detected recurrence in challenging tumor types at levels approaching 1ppm with 100% specificity On track for launch in 2026 10 0.1 1 100 500 16 64 256 2,000+ LoD95 (PPM) Number of variants Ultra-sensitive range
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Total CDx approvals in the U.S., Japan, and Europe across biomarker and tumor types 24 Industry-leading global biopharma business with growing long-term partnerships 18 200+ Lifetime biopharma partners including 19 of the top 20 pharma companies Multiple strategic partnerships with global large pharma Fast growing pipeline with 15+ partners signed in China
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Sources: AACR Study, Cancer Prev Res (2020) 120M Average-risk U.S. individuals eligible for CRC screening $50B U.S. Addressable CRC Screening Market Market leader in blood, and just getting started 19
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Shield is a multi- cancer detection platform Multi-cancer Lung Stomach Pancreatic Prostate Esophageal OvarianLiver Bladder CRC Breast CRC 20
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1. Approximate preliminary revenue and volumes based on unaudited Q4 2025 results provided on January 11, 2026 Strong momentum continues for CRC screening 21 Q4 2024 Q1 2025 Q2 2025 Q3 2025 Q4 2025 16K 9K 6K 24K 38K1 Volume +3K +7K +8K +14K
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22 Shield is advancing the fight against cancer FDA - APPROVED BLOOD TEST Routine, high- adherence
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23 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
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Commercial infrastructure is scaling rapidly bolstered by recent strategic collaborations 24 >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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Multi-channel messaging for HCPs and patients helps ensure Shield is top of mind at decision point 25 AWARENESS EDUCATION POINT OF DECISION
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26 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
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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. 27 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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Shield is a platform with the ability to expand beyond cancer Lung Disease Liver Disease Organ Health Cardiovascular Disease Rheumatoid Arthritis Neurodegenerative Disease 28
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FCF Breakeven Q4 20272 $(387)M $(345)M $(275)M 29 1. Preliminary, unaudited free cash flow and year end cash results provided on January 11, 2026. 2. 2025 – 2027 free cash flow and 2028 year end cash exclude any impact from 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. Cash includes cash, cash equivalents, restricted cash and marketable securities. Clear path to cash flow breakeven $(233)M1 20282023 2024 2025 2026 20272022 FCF Positive2 Targeting free cash flow breakeven in Q 4 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: $1.3B1,2
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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 30 BIOPHARMA & DATA CDx approvals, including SERENA-6 Additional strategic biopharma partnerships InfinityAI data partnerships
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32 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