Guardant Health (GH) Barclays 28th Annual Global Healthcare Conference summary

Key business drivers and clinical advancements

• Three main business drivers: treatment selection, MRD, and screening, all fueling hypergrowth opportunities.

• Guardant360's liquid CGP test is evolving from treatment selection to a monitoring tool, especially with ESR1 mutation detection in breast cancer.

• FDA approval for ESR1 in breast cancer doubled testing volume; upcoming SERENA-6 trial readout could further expand utility.

• New monitoring CDx for Guardant360 will be first of its kind, enabling multiple time-point testing and opening new growth avenues.

• CRC approval for Guardant360 in January is expected to boost physician confidence, payer conversations, and coverage.

Platform strategy and technology innovation

• Large genomic and epigenomic datasets create a strong data moat, enabling new clinical applications and Smart Apps.

• MetaSight acquisition adds complementary technology, expanding beyond ctDNA to multiomics and enhancing product capabilities.

• Reveal, the fastest-growing test, is seeing strong adoption, especially in CRC surveillance, with improved test-per-patient rates.

• Reveal Ultra, a new tumor-informed MRD test, is set to launch later this year, with reimbursement and revenue impact expected post-2026.

• Technology stack for Reveal Ultra remains undisclosed, but innovation focus is on deep sequencing and detection sensitivity.

Market adoption, commercial execution, and growth outlook

• Shield blood test targets unscreened populations, with 90% of tested patients not screened in the past five years.

• 300 sales reps at year-end, with plans to increase and drive productivity; DTC campaigns and Quest partnership expected to accelerate growth.

• Guidance does not include potential upside from ACS guidelines, quality metrics, or Quest rep-driven volume.

• Market segmentation focuses on PCPs experienced with non-invasive CRC screening, with nationwide coverage and significant growth potential.

• Main focus remains on unscreened patient populations, with some adoption in re-screening and interval testing use cases.