Guardant Health (5GH) Q2 2026 Earnings Report

The call conveyed strong operational momentum: broad-based, high-double-digit revenue and volume growth, major FDA approvals (Guardant360 Liquid CDx and a higher-throughput Shield workflow), guideline inclusion and a major payer (UnitedHealth) coverage decision for Shield, record Biopharma results, meaningful margin and cost-per-test improvement initiatives, and expanded commercial reach. Offsetting these positives are elevated operating expenses and investments (S&M and CapEx) to scale Screening, a modest adjusted EBITDA loss and increased free cash flow burn, and outstanding reimbursement/pricing uncertainties (ADLT timing, MolDX/Reveal coverage, USPSTF). On balance, the positive commercial, regulatory and margin trends materially outweigh the near-term cost and reimbursement risks, though execution and payer outcomes remain key near-term sensitivities.

Guardant raised full‑year 2026 revenue guidance to $1.34–$1.36 billion (growth of 36%–38%), with non‑GAAP gross margin expected at 64%–65% and non‑GAAP operating expenses of $1.08–$1.10 billion (up 20%–22% vs. 2025); free cash flow burn is now forecast at $195–$205 million (about $10M above prior outlook) while quarter‑end cash and investments stood at ~ $1.2 billion. By segment, the company expects Oncology revenue to grow ~30% with Oncology volume up ~50%, Biopharma & Data to grow in the low double‑digits, and Screening revenue to be $218–$230 million with Shield tests of 270,000–285,000 (Q2 Shield ASP ≈ $800); Shield cost per test is expected to fall roughly 15% by end of 2026 from ~ $410 (with a $200 target by 2028). Management also reiterated that the rest of the business (ex‑Screening) should generate positive free cash flow in 2026, they remain on track for ADLT designation for Guardant360 Liquid CDx in H1 2027 (supporting a longer‑term ASP uplift toward roughly $5,000), and they are targeting company‑wide cash‑flow breakeven by the end of 2027.