Guardant Health at BofA Conference: Strategic Growth and Challenges

Guardant Health (NASDAQ:GH) took center stage on Wednesday, 14 May 2025, at the BofA Securities 2025 Healthcare Conference. The company shared a comprehensive overview of its strategic initiatives and financial performance. While Guardant Health reported a successful launch of its Shield colorectal cancer screening test, it also acknowledged ongoing challenges in achieving profitability in its screening business.

Key Takeaways

• Guardant Health raised its full-year guidance for the Shield test, projecting 52,000 to 58,000 tests and $40 million to $45 million in revenue.
• The company aims for company-wide breakeven by 2028, with the core business expected to break even by the end of the current year.
• Shield and Reveal gross margins have turned positive, with further improvements expected through automation and increased volume.
• Guardant Health plans to expand its commercial infrastructure significantly, with a target of 700 people.
• The launch of Guardant360 Tissue, which incorporates DNA, RNA, and methylation analysis, is a key addition to its oncology portfolio.

Financial Results

• Shield test volume guidance increased to 52,000-58,000 for the year.
• Shield revenue guidance increased to $40 million - $45 million for the year.
• Shield and Reveal gross margins are now positive.
• Guardant360’s average selling price (ASP) increased from $2,700 to between $3,000 and $3,100.
• Screening net burn is managed at the $200 million level for this year and next year.

Operational Updates

• The Shield commercial team expanded from 50 to 100 representatives, with ongoing hiring and training.
• ADLT status designation for Shield effective April 1, leading to improved Medicare rates.
• Reveal benefits from CRC surveillance reimbursement with ASP over $600.
• Launch of Guardant360 Tissue with advanced analysis capabilities.
• National Cancer Institute selected Shield’s multi-cancer detection technology for trial.

Future Outlook

• Potential Shield V2 launch before year-end, pending FDA approval.
• Submission for breast and IO therapy monitoring reimbursement for Reveal expected next quarter.
• Aims to expand Guardant360 ASP by at least another $200 over the next two to three years.
• Screening business expected to become profitable after next year.
• Exploring Shield application for high-risk oncology patients.

Q&A Highlights

• Emphasis on the synergy between Guardant Health’s screening, MRD, and therapy selection offerings.
• Reinvestment of an additional $10 million gross profit into commercial infrastructure.
• Cost per Shield test reduced to below $600, with a target of $200 per test at a million samples per year.

Guardant Health’s management expressed confidence in their innovative products and market adoption, despite challenges in the screening sector. For a deeper dive into the company’s strategic plans and financial outlook, refer to the full transcript below.

Full transcript - BofA Securities 2025 Healthcare Conference:

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: My name is Mike Riskin. I’m on the Bank of America Life Science Tools and Diagnostics team. And I’m excited to host for our next session, Guardant Health. We’re joined by, we got Helmio Touki, Chairman, Co Founder and CEO. Amir Aliy Talasaz, Co Founder and Co CEO, and Mike Bell, Chief Financial Officer.

Gentlemen, thanks for being

Mike Bell, Chief Financial Officer, Guardant Health: here. Thanks Mike.

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Thanks for

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: having us.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: I mean, maybe to kick things off, I’ll just not my traditional opening question, but Helmi and Amir Ali, you guys had to adjust to travel plans here. Accept an award yesterday. Maybe you could just talk a little bit about what you’ve been up to the last twenty four hours and we can frame that into the conversation.

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: That’s right. Actually, we were honored to be part of the honorary list of Time 100 most influential people in the healthcare class for twenty twenty four, twenty twenty five. And that came following Shields be recognized as one of the top innovation by Time in 2024. So we are very excited.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: That’s a perfect intro. So maybe we’ll just kick it off right there on Shield. You guys just reported 1Q recently, you did 9,000 tests in the quarter ahead of expectations. Maybe you could talk a little bit about what you’ve seen since you’ve rolled it out. So what the feedback’s been, what do you think is driving adoption?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Yeah, I’m more confident than ever about actually what Shield could do for the patient and for Guardant Health. We continue to see physicians use this test in a very meaningful way. The feedback continues to be very solid, very strong. And when the doctors are ordering Shield patients complete the test and do the CRC screening. It’s been amazing when we are looking at higher depth of ordering by the prescribers that have access to Shield now.

Gives us a lot of confidence about the durability of the growth that we can have with Shield. The higher productivity per rep relative to the internal expectation that we have gives us a lot of confidence that actually this year could be a fantastic year and we can have it at very strong launch for Shield.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: And on that point, you can talk about your your updated guide for the year in terms of Shields, sort of what are your new expectations and the road map to get there as you go through the year?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Yes. So we opt actually our volume to 52 to 58,000, and it’s almost like the whole volume we did in Q1. We almost raised our guide for a whole year by that amount, which is kind of indication of how well this launch is going for us. We exited Q1 with a very strong momentum and we continue to see actually good performance and actually that gives us confidence of raising the guidance that we have. Still the guide would be a very thoughtful guide for us.

It’s a very reasonable target to have in mind for the performance of this year. Also, earlier this year, actually we heard about the ADLT status designation and the improved Medicare rates that is in effect actually starting April 1. That additional ASP was also part of increasing our revenue guidance to 40 to 45,000,000 for this year. This test with this revenue could be one of the biggest diagnostic launches ever, and we’ll see maybe if we can make it the biggest launch ever.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Talking about that new the new guide, the at the midpoint 55,000 tests, 40 to 45,000,000. You talked a lot about getting reps more productive, widening sort of the funnel. Can you talk us through the pacing through the year as those reps get productive? When should you really see that flow through?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Yeah, sure. Very good question. So we launched this test last August with about 50 people in the field. We ended the year with 100 people fully deployed in the field, and we are continuing the hiring, onboarding, and the training of the new reps. So when you consider the productivity ramp for these newly hired and this new channel that we built, we are expecting our volume to be second half back loaded.

And that would be some of the trend lines that we are expecting for this year. But so far so good, like in terms of when we look at our Q1 performance, as I mentioned earlier, the productivities that we are seeing from those 50 people that we started the launch with or the ones actually we hired after the launch, their performance has been better than our expectation.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: So you’re assuming in your guide that the the remainder of the Salesforce ramps that same level of productivity on a on a similar lag?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Yes, but with some assumption that as we also adding more reps and we are going after more territories, maybe some of the territories are gonna have less productivity than our highest tier kind of territories. So we are very thoughtful about that reality of going into newer territories. But we see how the whole year would pan out for us. But as I mentioned, there’s a lot of modeling and thoughtfulness that goes into this new guide that we put out there.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Going forward beyond second half of this year, can you talk about maybe need for additional Salesforce expansion, sort of how would you tackle the next level of growth?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Yeah, I think still we believe at steady state in order to really have nationwide coverage on the PCP front and health systems. We need to get to about 700 people in the field, But we are going to get to that in a step by step fashion. The great thing about this sooner than expected ADLT status and higher productivity for the reps that we are seeing, We mentioned that we are expecting now more than, about 10,000,000 additional gross profit than our original estimate, and we are reinvesting that gross profit, additional gross profit into more accelerated commercial infrastructure build out. But we are going to go after this build out to 700 people based on the gross profit that we are going to generate throughout the next few years and meeting some additional milestones that we are going to have in terms of commercial and commercial attraction and the revenues that we are going to have with Shield.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Talking about the gross profit dollars. Can you talk about cost reduction and other factors in the in the gross profit line?

Mike Bell, Chief Financial Officer, Guardant Health: Yeah, on the on the on the Shield side, you know, we’ve made we’ve made very good progress on the on the reduction of the cost cost per test. You know? Before we launched the FDA approved version of the test, you know, cost per test was over a thousand dollars. Now, you know, we’ve reduced that to below $600, and we actually now have in in q one a gross margin positive positive test. There’s still plenty of room for the cost per test to to reduce.

Volume’s gonna be a driver. That’s been the driver to date. But making efficiencies to the workflow is we’re gonna have a step down in cost per test there. That’s more likely in ’26. And we’re also investing a lot on the automation side.

We wanna take out as much labor cost from the from running the test as possible. And, again, when we implement that, it’s probably 2627 timeline. We’ll have another step down there. So I think we feel very confident with all of the initiatives we’re taking in the growing volume that will, you know, eventually by the time we’re at a million samples a year, we’ll have cost per test of of $200.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: 2 hundred dollars. Okay. Maybe we can talk about Shield v two. So just give us your latest thoughts on that. What are you most excited about?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Yeah. Maybe for some of you guys who may be newer to this story, so we got the first generation of Shield. We took it to the finish line, got approval CMS coverage, and we are very excited with its performance. But that wouldn’t be the, best thing that liquid biopsy and shield can do. So we are working on pipeline of activities to make shield a better test.

One is around improvement on colorectal cancer and AA potentially on the other side is adding additional cancer to the same test. So now this Shield V2 is a newly developed algorithm that we have. It’s more sensitive, looks like it can detect colorectal cancers as the levels which are about two times lower than the previous limit of detection that we have. So, we have to see analytically, we know this test is, more sensitive. Clinically still we don’t know.

We during last few months, we had very constructive conversation with FDA. We know what they want to see for validation of this test, and we continue to be on track. We expect to get to the readout of this Shield V2, and if the data is positive submission to agency and hopefully approval and launch of this test before the end of the year. We’ll see how it goes.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: How should we think about how how should we think about expansion of of the indication? What are the criteria you’re looking at in terms of Vortigonax?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: That’s the part that actually I’m even more excited about the future of Shield. When we go back few years ago, we built Shield as a multi cancer detection platform technology. You’re looking at many, many epigenomics features in genome that not only is relevant to looking at colorectal cancer, but they are relevant for a bunch of other cancer types and even potentially other diseases outside cancer, but step at a time. CRC was our lead indication to have, basically a pathway for reimbursement FDA approval. Now that we reached to this milestone, we are envisioning a day not far from today that when a patient is getting tested for CRC screening, the patient can also see if they have any indication of other cancer types.

We are very, excited that we got selected by National Cancer Institute as, one of the technologies that they’re gonna use in their multi cancer detection trial. That trial is actually gonna start very soon, it’s eminent. And once that trial starts, since it’s an interventional study, effectively we are gonna have this multi cancer detection feature of SHIELD be operationally and clinically ready for patient management. So we are very excited to get to that milestone.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: So can you talk about, some of the costs associated with taking it through that stage and how that would, you know, compare to Shield V1?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Yeah, sure. So the beauty is since we’ve developed Shield as multi cancer detection platform, when we are talking about COGS of Shield of today, effectively the Shield, which can also look at multi cancer features, it’s the same cost because it’s the same panel, same sequencing, same data. And when we are looking at that sequencing data, not only we are seeing the signatures associated with colorectal cancer disease, but also we are seeing the signatures associated with other diseases. And since it’s just an algorithm, it’s effective with the same COGS profile.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Let’s move on to REVEAL. You talked about how Formisin 1Q was driven by G360 and Reveal. So you can talk about relative contribution, how Reveal played out in the first quarter. What are your expectations for the rest of 2025?

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: No, they both We were very pleased with the performance of both tests with Reveal. I think we’re very pleased with the reimbursement decision in terms of CRC surveillance for that test that happened very early in the year, which was great. And so really getting the sales team to sort of fire on all cylinders in terms of really pushing out the new patient starts as well as starting to build the adherence and compliance engine around subsequent test orders. So we’re seeing acceleration in volumes in both tests in three sixty and REVEAL. We’re seeing I think really strong momentum in new patient starts after that reimbursement decision.

And now it’s about pull through in terms of just execution, in terms of the subsequent test orders. I can tell you that there’s sort of a latent demand or latent sort of test order that’s out there from the existing patients that would be a huge, huge step up from where we are today. So I think when we look at the back half of the year, we expect to see, I think, a pretty strong inflection in terms of REVEAL volume as those volumes sort of pull through.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: When you talk about the latent demand from existing orders, are you talking about orders you already saw or are you talking about

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: Yeah, if you think about it, we have a bunch of new patients already in the system and we weren’t necessarily pulling through subsequent orders with very high rigor. Now we’re turning all of that machinery on in terms of going to patients, going to physicians, pulling that. And that just takes implementing the right systems, processes, off-site phlebotomy, and so on. So all of that is being put into motion in terms of the last few weeks, a few months. And it’s been good.

We’re seeing returns on that investment and it’s like a snowball that’s beginning to sort of like ramp up and grow.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: And, Mike, maybe for you, you talked about Reveal is also now gross margin positive. Can you talk about the contribution there and similar to your comments on Shield, how you how you expect that to ramp?

Mike Bell, Chief Financial Officer, Guardant Health: Yeah. Again, q one was a great quarter for us in that Reveal flip from being a gross margin negative test to gross margin positive. And in fact, you know, again, last year before we implemented these workflow efficiencies with Reveal, the cost per test was was over a thousand dollars. So so running that running that test with the reimbursement where it was sort of between 400 and $500, you know, it was a it was a it was a cash burn for us, significant cash burn. And now that that’s flipped, you know, we’ve got the CRC surveillance reimbursement.

Our CRC, Reveal ASP now is over $600, Reveal COGS around 500. And so it’s gross margin positive. And there’s room for that cost per test and gross margin to continue to improve. Cost per test going forward is really going to be driven the reduction is going to be driven by continued volume. There is the opportunity for us to take the automation that we’re building for Shield and also put that onto Reveal.

So, you know, in a couple of year time, there could be another step down in in Reveal cost per test. And, of course, you know, we’re focused on additional reimbursement for Reveal. We’re pursuing the ADLT route for CRC, and hopefully we’ll be able to submit to MolDX for breast reimbursement. So we see potential increases in ASP, continued improvement in Cospertes, so gross margins continue to expand from now onwards.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Can you talk a little more about the timelines for those reimbursement decisions and potential ASP uplift?

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: Yeah, so I think most likely within the next quarter, we should be ready to submit for breast and potentially IO therapy monitoring. And then sometime maybe end of the year is when we would at their earliest potentially be over the finish line from a Medicare reimbursement decision, hopefully a positive one. Then same thing, and that might move into the beginning of next year. But yeah, we’re very encouraged by the data, by performance we’re seeing from the tests. When you think about those three indications, CRC, breast and IO monitoring, those three make up the largest of the MRD indications and would then provide a very strong base for that franchise for us.

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: Okay.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: And you touched on some of your ongoing studies. You’ve got some longer term studies in progress as well. Can you give us an update on how we should think about data readouts and that as a catalyst path?

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: Yeah, so those are the three that are nearest term, but we have something like 10 or 11 other indications we’re working on. We have something like twenty thousand patients and eighty thousand samples that are acute on MRD over the next few years. Some of the biggest studies we have are the TRAC C study which is a interventional clinical utility study in colorectal. That’ll take a couple more years to read out. I think we should have some other readouts potentially in the coming quarters as well and some smaller clinical utility studies.

It’s gonna be a steady drumbeat in the coming quarters and years in terms of additional data readouts on REVEAL. But like I said, those three sort of give us a solid base and everything else would just be additional ASP over time. Maybe let’s pivot to therapy selection, G360.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: You talked about accelerated growth again in the first quarter. I think it was the second or third consecutive quarter of accelerating growth. Can you talk about the factors that are driving that? Sort of what did you see in that business?

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: Yeah. So third quarter of accelerating growth, but who’s counting? It’s one that is very exciting. When you look at the volume for three sixty and you break that out over the last four or five years in our business, we’re seeing one of the fastest ramp rates we’ve seen in March in that time period over the last three or four quarters, really coincident with the launch of our smart liquid biopsy platform. And so it’s really telling us there’s a market preference, there’s a product market fit that we’ve unlocked with this new test and it’s very exciting because we really haven’t sort of unleashed all of the power and promise of this platform yet.

We have major launch of many new applications that will be added in the coming months and quarters to this platform that’ll be even more exciting. We’re essentially creating all these features that provide additional clinical utility around IO therapy, around PARP inhibitors, around tumor biology, around transitions of disease, subtyping of disease, essentially seeing cancer at its fundamental level at much higher resolution than has been possible through either tissue or liquid. So it’s very exciting as we start launching these features. Essentially we’re creating a whole new visual language by which to essentially understand disease, understand a specific patient’s disease. And that is going to carry through to all of our products on the oncology side.

Our tissue products with this new launch that we have will have all of those featured as well over time. And the ones that apply will also apply to Reveal as well. And so it’s going be a really exciting ecosystem that is all sort of buoyed up by this epigenetic backbone that is this common string across our portfolio.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Okay. You mentioned g three sixty Tisha. I won’t touch on that in a sec, but briefly on G360 ASPs, you saw a little bit of an uptick this quarter. Can you talk about conversations you’re having with payers? How much more progress do you think you can have there?

Mike Bell, Chief Financial Officer, Guardant Health: Yeah. I I think there’s still room to continue to grow that Garmin three sixty ASP. We made significant improvements last year, taking it from something like $2,700 to $3,000 And then in Q1, we’re in this range now, 3,000 to $3,100 And there’s been a few things. One was getting the Medicare LDT rate to $5,000 at the start of ’24. Then we’ve seen the pull through with Medicare Advantage payers.

And I think we’ve sort of got through to the end of that pull through now. So we’ve reached a nice steady state on Medicare Advantage. And so the opportunity for us to further expand the ASP really now comes on commercial side. And whilst we’ve got very wide coverage for Guardant360, there are still gaps and there’s gaps with a lot of the national payers who maybe cover LDT and not the CDX version or they cover certain indications like lung and breast. And so I think we a very strong team.

They’re continuing all the time to talk to those payers, and we’re looking, you know, to push as hard as we can to expand coverage. You know, we think there’s at least another couple of hundred dollars over the next, you know, two or three years that we can further expand the the ASP. Okay.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: On G360 tissue, what’s been the response to that so far, little bit more recent launch?

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: Yeah. Look, we’ve had a lot of success with our tissue product over the years. We’ve essentially had tissue next. We saw when we expanded it to 500 genes, we saw a really nice uptick in terms of volumes. What we started seeing was a lot of physicians coming to us, especially when we had those 500 genes, and only ordering tissue from us.

Physicians that weren’t ordering liquid products were starting to order tissue from us. So we call these standalone orders. And there was a really nice kind of response from the market. And what we’ve been hearing from some of our liquid customers was add RNA to your tissue tests and we’ll switch our volume over to you. And so we knew there were a lot of buying signals out there.

And so when we built this new product Tissue two point zero, we really took all the market feedback, everything that was sort of a pain point with tissue today, and everything that we knew that could enhance the clinical actionability of these tissue tests. That is essentially what our Tissue two point zero, our TissueGuardant360 Tissue represents is all of that feedback put into one product. And so we can use essentially much smaller samples than the other products out there, 40% less tissue which is one of the pain points that are there. It’s fast turnaround time which is another pain point. But more importantly we scour essentially that piece of tissue across a trifecta of biomarkers, DNA, RNA and methylation, essentially genome wide signals where we can essentially make sure that no biomarker is sort of unturned in terms of being able to find a potential option for patients.

And so much broader DNA analysis, RNA analysis. And then with methylation we bring all of the features of smart liquid biopsy to the tissue platform seeing potentially PARP inhibitors, IO options. There are many clinical trials now that require promoter methylation for instance and no other test out there today on the tissue side provides that information. And so I can tell you that when we launched this now just nine, ten days ago, our sales team has never been more excited for any product we’ve ever launched than this launch here. So it’s a really important sort of final piece of the oncology portfolio, at least in terms of the major product categories.

Okay.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: You just walked through a lot of it, Helmy, but I want to kind of wrap it On the tissue side, it feels like it’s a little bit more of a competitive marketplace. You’ve got a number of players that have been established there for a while. You touched on the epigenomics, you touched on the faster turnaround time, the 40% less tissue. Do you think those differentiators are enough to let you really gain share here versus Jaris, Foundation Medicine, Tempus?

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: Yeah, when we look at it, there are entrenched incumbents there and we know the bar is very high in terms of being able to switch patients from one provider to another. I think one of the advantages we have going for us over sort of a new entrant of the space is that we’ve built a lot of trust with oncologists already. We have something like 10,000 oncologists that have ordered our products over the last twelve months. And so there’s built in trust on the liquid side. They know what it’s like to work with Guardant.

They know that, you know, we give them white glove service. They know the quality of our medical affairs personnel and and so on. And so I don’t think the bar is very high for Guardant specifically in terms of, you know, driving that switch. But that being said, we are very confident with this sort of product profile that for every 100 patients a physician tests that we would provide more actionable insights than the next test out there.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: I wanna talk a little bit about the breadth of the portfolio and again, bring it all together. When we talk to docs or KOLs in the space, they all tend to identify sort of one leader in blood, one leader in MRD, one leader in tissue. And there really hasn’t been a player out there that’s really managed to sort of, you know, reemerge that that brings it all together into one umbrella. As you look at Shield, Reveal, you know, G three sixty, G three sixty tissue, Do you think that having all that under one roof can really change the conversation with oncologists in terms of Guardant’s positioning in the market?

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: Look, I think I’ll speak for the oncology side where, that’s a single call point. It’s attended 12,000 or 14,000 oncologists that are out there. And yeah, absolutely that’s increasingly becoming an important selection criteria. Can I simplify my life? Can I simplify my ordering process?

Can I use one portal, one EMR to order all of the products that I need for making diagnostic decisions on a patient? And so, yeah, I think that is where the bar is moving. And we are, I think one of the first companies to really populate the whole portfolio across the board. I think longer term, I think you’re going to see crossover between the primary care channel and oncology channel. The fact that MRD patients, cancer survivors, twelve million of them are more than five years out from surgery.

Many of them are in the primary care channel and that’s where it’s easier to access them. And so having access to a primary care channel is going to be a huge strength. I think there are high risk patients in the oncology channel where having a sort of version of Shield, for instance, that can address that population is gonna be really important. So yeah, we see that together we can serve the entire market in terms of the cancer care continuum much more effectively than companies that are sort of piecemeal or only in one segment.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Talking about the cancer care continuum, you’ve talked about this a number of times in the past where you sort of do see it as a journey with a patient where there is a G360 test, then there’s a therapy, and then there’s a MRD, and then there’s repeat screening. Again, you’re now sort of getting to that point where you’re able to provide all of that. Can you talk about potentially the uplift that could get from just having that patient travel through that journey? Whether you want to talk about it in terms of tests per patient, however you want to

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: address it? Yeah, you’re seeing that kind of the all roads are leading to sort of more and more tests per patient. We have things like the Serena six trial we’re doing with AstraZeneca where you’re seeing the emergence of this new paradigm in terms of molecular progression, essentially testing the patient at multiple time points and looking for the earliest signs of emergence of a resistance marker. So you can switch that therapy when the cancer is as small as possible and as easy to fight as possible. And that is going to be the future of all of sort of disease intervention is finding it as early as possible and intervening as quickly as possible.

And that’s where I think having a continuum of testing where you can have one data stream that allows you to track that patient from beginning to end is going to be really important. That’s why I think one of the sort of hidden important features of our portfolio is the fact that it’s all built on the same technology stack. The fact that I can essentially take a patient, I can understand exactly what tumor level, what disease markers are there, whether they’re in the screening segment, MRD segment, therapy selection segment. We haven’t built a Frankenstein portfolio of pieces we’ve sort of inorganically acquired and stuck together. These are all built from the ground up with the intention of spanning this continuum from essentially when we started the company.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Okay. That’s a good point. Mike, I want to make sure I touch on the financial profile and profitability. Talked a little bit about some of the individual products this year, but could you bring it all together in terms of, you know, ramp and profitability, EBITDA margin positive, free cash flow positive?

Mike Bell, Chief Financial Officer, Guardant Health: Yeah. You know? And I think I think we sort of look at the business in in two sections. You know? One is is screening.

And, you know, if you look at that, obviously, that’s not profitable now. And that’s because we’re ramping up the commercial infrastructure. And we’re sort of committed to this managing the net burn on screening at the 200,000,000 level for this year and next year. But we we envisage some point soon after that, we’ll start to get to a level of scale that that burn will start to come down significantly, significantly quickly. And so that that’s screening.

The rest of the business, I think the profile is very strong there. Therapy selection, Garnet three sixty, that’s already profitable. Our biopharma business is a profitable business. We’re significantly reducing the cash burn on Reveal now that it’s gross margin positive. And if you take all of the rest of the business excluding screening together, that’s heading for being breakeven by the end of this year, and we’re absolutely committed to that.

And so I think then if you put the two together with a screening business that’ll burn 200,000,000 over the next couple of years, but then quickly get to breakeven and a profitable business excluding screening over the next couple of years, we, you know, we’re on track to hit our target of company wide breakeven. By 2028, that was our target. Potentially earlier, we’ve seen a lot of tailwinds across the business. And so I think the path that we’re on to that profitability is a very strong course.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Okay. We’re out of time, but I’ll squeeze in our last closing question, Whoever wants to take it. What do you feel is most underappreciated or misunderstood about Guardant?

Helmio Touki, Chairman, Co-Founder and CEO, Guardant Health: I think maybe there are several point too. Like, you know, earlier, what Helvi mentioned, Guardant is truly the only company right now who has great offerings across screening, MRD, and treatment selection. When you see MRD companies are trying to get to screening, or screening companies are trying to get to MRDs, Like this is also an indication that other people are trying to catch up since they see that strategic value of being a player at the Continuum of Care. Since this was our vision from the beginning, we got there much earlier. And I think the value of this over time would just show itself more and more in the quarters and years to come.

Mike Riskin, Host, Bank of America Life Science Tools and Diagnostics team: Great. Thank you. No, thanks, everyone. Thanks for joining.

Amir Aliy Talasaz, Co-Founder and Co-CEO, Guardant Health: Thank you. Thanks.

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