Personalis (PSNL) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue was $15.5 million, down 25% year-over-year, mainly due to declines in pharma, enterprise, and population sequencing, partially offset by a 365% increase in clinical diagnostic revenue following new Medicare coverage for breast and lung cancer tests.

• Clinical test volumes rose 258% year-over-year and 26% sequentially to over 7,800 tests, reflecting strong MRD demand and physician adoption.

• Net loss for Q1 2026 was $30.0 million, compared to $15.8 million in Q1 2025, reflecting higher costs and investments in clinical diagnostics and R&D.

• Key milestones included Medicare coverage for lung and breast cancer surveillance, the launch of Real-Time Variant Tracker, and new clinical data supporting the NeXT Personal platform.

• Over 1,000 physicians ordered tests in the quarter, with retention rates above 98%.

Financial highlights

• Q1 2026 revenue was $15.5 million, down from $20.6 million year-over-year due to planned decline in non-core revenue.

• Clinical revenue grew to $1.4 million from $0.3 million year-over-year, with clinical test volumes up 258%.

• Pharma testing services revenue was $10.7 million–$11.2 million, down from $13.6 million a year ago, mainly due to Moderna trial completion.

• Gross margin compressed to 1.8% from 35% year-over-year, expected to remain low in H1 2026 before improving.

• Ended Q1 with $233.2 million in cash and short-term investments, including $21.0 million from ATM sales, and no significant debt.

Outlook and guidance

• 2026 revenue guidance reaffirmed at $78–$80 million, representing 26% growth over 2025 (excluding non-strategic and one-time items).

• Clinical test volume expected to reach 43,000–45,000, a 171% year-over-year increase at midpoint.

• Clinical revenue projected at $10–$11 million, biopharma MRD at $20–$21 million, and pharma/enterprise at $55–$56 million.

• Gross margin projected at 15–20% for the year, with improvement in H2 as reimbursement expands.

• Net loss for 2026 expected to be ~$105 million; cash usage projected at ~$100 million.