Snapshot
Guardant Health, Inc. reported $232M of revenue in Q2 2025, up 30.9% year over year, with diluted EPS of $-0.80 and an operating margin of -45.9%.
- Revenue
- $232M
- YoY growth
- +30.9%
- Diluted EPS
- $-0.80
- Operating margin
- -45.9%
What management said
- •We continued to build momentum across Oncology, Biopharma, and Screening business lines, including accelerating therapy selection and MRD volume growth, record Biopharma sales, and quickly scaling Shield volumes and revenues.
- •Q2 revenue grew 31% year-over-year to $232 million, with strong performance across our Oncology, Screening, and Biopharma & Data businesses.
- •Roughly 1/2 of the overall year-over-year revenue growth in Q2 came from the Oncology business, with revenue increasing 22% to $159 million.
- •Oncology volumes increased 30% year-over-year to approximately 64,000 tests in the second quarter, with the majority of growth driven by Guardant360 Liquid, again closely followed by strong contribution from Reveal.
- •We saw continued volume growth across all oncology tests this quarter, with particularly strong performance from Guardant360 Liquid, where year-over-year growth accelerated for the fourth consecutive quarter and was over 20% in Q2.
- •We continue to believe that the steady cadence of new app introductions powered by Smart Liquid Biopsy has been instrumental to the accelerating growth profile of Guardant360 Liquid.
- •With a prevalent pool of approximately 40,000 patients in the U.S., this new application of Guardant360 has the potential to drive significant incremental Guardant360 revenue in 2026 and beyond.
- •Since July of last year, Guardant360 has delivered accelerating growth each quarter, fueled by our Guardant Infinity Smart Liquid Biopsy platform.
- •Our Oncology business is well-positioned for durable growth, supported by continued CGP penetration, favorable ASP dynamics, and international expansion.
- •With our redoubled commercial focus on Reveal following major COGS improvements in Medicare CRC surveillance reimbursement earlier this year, the business is primed for strong growth in MRD.
- •We delivered a record quarter for our Biopharma business, achieving all-time highs in both volume and revenue, with second quarter revenue growing 28% year-over-year.
- •We continue to have a robust and growing pipeline of partnerships, and near-term revenue visibility remains high.
What went well
- •Q2 revenue grew 31% year-over-year to $232.1 million, with strong performance across the Oncology, Screening, and Biopharma & Data businesses.
- •Oncology revenue grew 22% to $158.7 million on 30% volume growth to approximately 64,000 tests, with Guardant360 Liquid year-over-year volume growth accelerating for a fourth consecutive quarter and exceeding 20%.
- •Guardant360 Tissue ASP reached approximately $2,000 in Q2, hitting the company's 2028 ASP target three years ahead of schedule.
- •The Biopharma & Data business delivered a record quarter with revenue of $56 million, up 28%, including two new companion diagnostic deals signed in the quarter.
- •Shield generated $15 million (later cited as $14.8 million) of screening revenue on approximately 16,000 tests, with Shield non-GAAP gross margin improving to 48% from 18% in Q1 and 2% in Q4 2024, ASP over $900, and cost per test below $500.
- •Non-GAAP gross margin reached 66%, above expectations and up from 60% a year ago, and Shield was added to NCCN CRC screening guidelines in Category 2A, the first national guideline recommendation for the test.
What went wrong
- •Adjusted EBITDA was a loss of $51.9 million in Q2 2025, though improved by $10 million versus the prior-year loss of $61.9 million.
- •Q2 2025 free cash flow burn was $65.9 million, an improvement from $99.1 million a year ago but still a meaningful cash outflow.
- •Non-GAAP sales and marketing expense increased 45% to $107.8 million due to the ongoing screening commercial build-out and continued oncology investment.
- •Shield V2 data was expected by some investors by now and has not yet been released, with management declining to commit to firm timing.
Guidance changes
| Metric | Period | Previous | Current | Change |
|---|---|---|---|---|
| Total revenue | FY2025 | $880M-$890M | $915M-$925M (approximately 24%-25% growth) | Raised (+$35M) |
| Oncology revenue growth | FY2025 | 18% | approximately 20% | Raised |
| Total Oncology volume growth | FY2025 | >25% | >27% | Raised |
| Biopharma & Data revenue growth | FY2025 | Low double-digit | Mid-teens | Raised |
| Shield revenue | FY2025 | $40M-$45M | $55M-$60M | Raised |
| Shield tests | FY2025 | 52,000-58,000 | 68,000-73,000 | Raised |
| Non-GAAP gross margin | FY2025 | 62%-63% | 63%-64% | Raised |
| Non-GAAP operating expenses | FY2025 | — | $840M-$850M (11%-12% increase) | Updated |
| Free cash flow burn | FY2025 | — | $225M-$235M (improvement from $275M in 2024) | Reaffirmed |
| Shield ASP | H2 2025 | — | approximately $800 (slightly below Q2's $900+) | New |
Performance breakdown
| Metric | YoY change | Reason |
|---|---|---|
| Total revenue | +31% to $232.1M | Strong performance across Oncology, Biopharma & Data, and Screening. |
| Oncology revenue | +22% to $158.7M | Accelerated volume growth led by Guardant360 Liquid, closely followed by Reveal. |
| Biopharma & Data revenue | +28% to $56M | Guardant Infinity and additional companion diagnostic partnerships signed in the quarter. |
| Non-GAAP gross margin | +6 pts to 66% | Improved Oncology ASP and turnaround in Reveal and Shield gross margins, both of which moved from negative to positive. |
| Shield gross margin | 48% (vs 2% in Q4 2024) | ADLT-driven Medicare rate increase to $1,495, strong Medicare Advantage reimbursement, and cost per test below $500. |
| Guardant360 Tissue ASP | approximately $2,000 | Medicare pricing increase from $3,140 to $3,500, commercial payer progress, and incremental reimbursement from the new tissue RNA feature. |
Earnings call themes & trends
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Smart Liquid Biopsy / Infinity platform | Driving accelerating Guardant360 growth since mid-2024 | Nearly a dozen new apps launched at ASCO 2025, expanding clinical utility and driving share gains; over 100,000 genomic profiles across 50+ cancer types | Expanding |
| SERENA-6 / breast cancer monitoring | — | Guardant360 was the exclusive companion liquid biopsy in the trial; a prevalent pool of ~40,000 U.S. patients represents significant incremental revenue opportunity in 2026 and beyond | Emerging tailwind |
| Shield CRC screening | Earlier commercial launch quarters | ~16,000 tests, adherence over 90%, NCCN Category 2A inclusion, sales force to surpass 250 reps by year-end | Scaling |
| Shield multi-cancer detection (MCD) | Clinical validation presented at AACR/ASCO | FDA breakthrough device designation received; NCI Vanguard Study commenced with MCD results being delivered to physicians | Advancing |
| Reveal MRD | Cost per test over $1,000 in 2024 | Fastest-growing oncology product; cost per test below $500; breast reimbursement submitted to MolDX; ASP $600-$700; ADLT submitted and pending | Accelerating |
| Path to profitability | 2028 breakeven target set at prior Investor Day | Reaffirmed 2028 company-wide breakeven; non-Screening business to reach free cash flow breakeven in Q4 2025; ~$200M annual Screening burn | On track |
Q&A summary
Did Guardant360 benefit from the New England Journal of Medicine SERENA-6 publication in Q2, and can you keep driving the testing interval in breast cancer?
Eltoukhy said any SERENA-6 impact was very minimal in Q2 and the majority would come once the drug is approved; over 20% Guardant360 growth reflects strong product-market fit from the Infinity platform, with the monitoring paradigm representing years of growth ahead as the CGP liquid biopsy market is converted.
What is driving Shield growth, what is the ASP trajectory, and any update on Shield V2 data?
Talasaz attributed growth to strong market pull and sales rep productivity. Bell said Shield ASP rose from just over $600 in Q1 to over $900 in Q2 driven by ADLT status (Medicare rate up from $920 to $1,495) and strong Medicare Advantage reimbursement, with H2 ASP expected around $800 on mix shift; V2 remains a very active program without committed timing.
Where is Guardant360 growth coming from, and are the Smart Liquid Biopsy features resonating with oncologists?
Eltoukhy said growth is broad-based, with more oncologists ordering each month, higher depth per account, and significant share gains; the features resonate at both academic and community levels by detecting biology tissue cannot, identifying drug eligibility, and tracking tumor evolution, with an even more exciting app pipeline ahead.
What are the next steps to market Shield as an MCD test, and what is the view on inducement and USPSTF risk?
Talasaz said Shield MCD is clinically validated and operationally ready, with Vanguard Study samples being run and clinical reports delivered, so no pivotal readout is required before broadening access; the company operates within the law and views the USPSTF panel changes as something to monitor while building the business in a large greenfield opportunity.
Why are you confident Reveal breast Medicare reimbursement will be faster than CRC, and is NCCN inclusion affecting Shield volumes?
Eltoukhy said the second CRC surveillance coverage came quickly (about four-to-six months) and the company now better understands Medicare requirements, giving high confidence on breast and good confidence on IO. Talasaz said NCCN inclusion is hard to isolate within the strong ramp but the company remains confident about ACS and USPSTF inclusion over time.
What is the path to real profitability while continuing to reinvest screening gross profit rather than chasing near-term profitability?
Bell reaffirmed the 2028 breakeven target set at the prior Investor Day, with cash burn reducing every year and the ~$200 million Screening burn funding commercial scale-up without exceeding the annual target; excluding Screening, the rest of the business is on track for free cash flow breakeven before year-end, supporting confidence in the balance sheet and path to profitability.