Guardant Health Inc Q1 2025 Earnings Call Transcript

The following is excerpted from the question-and-answer section of the transcript.

Question: Mark Massaro - BTIG - Analyst : Congrats on the quarter. Maybe the first one for you, Helmy. You've had Guardant360 in the market now for, I think this is year number 11, and yet you're raising the oncology volume to accelerate to over 25% growth. As this is accelerating, I was wondering if you could help us perhaps rank-order what these opportunities are. To what extent is this Epic? To what extent is this potentially competitive takeaways? And then to what extent could this be some boost from attachment to the Guardant360 Tissue?

Question: Mark Massaro - BTIG - Analyst : And then maybe a two-parter on the screening business. Nice to see the raised guide. Can you walk us through the components of that? Obviously, you signed VA and Abu Dhabi. I'm curious what you're seeing on the business development side as well. Any other potential similar type systems that you're engaged with? And then as we think about the ASP assumptions of the raised guide, it's somewhere in the $770 range per test. Why is that the right number when your ADLT price is $1,495, and you're focusing on the Medicare population? And just curious what that Medicare mix was in Q1.

Question: Tycho Peterson - Jefferies - Analyst : Maybe just sticking with the guidance theme, there still seems like a lot of that you're not fully baking in here. But can you give us a sense, G360 ASPs, you guided flat previously. What you're baking in for G360 TissueNext? And then Reveal adoption in the surveillance setting, where do you ultimately think you end the year on test per patient?

Question: Tycho Peterson - Jefferies - Analyst : And then a follow-up on MCED. Obviously, it was a big topic at AACR. Good to see the data from you guys. I guess maybe talk a little bit about roadmap from here, what you need to do to get ready for payer discussions? What are you able to do to kind of get them comfortable? Historically, obviously they've balked at multicancer. So talk about some of the steps you need to take going forward.

Question: William Bonello - Craig-Hallum - Analyst : I wanted to circle back a little bit on the tissue test, and the commentary about needing 40% less tissue seemed really important. But maybe just if you could elaborate a little bit based on discussions you're having with existing accounts, sort of how you expect this to play out over time? I mean, presumably, we're talking about taking share maybe with your existing customers for liquid biopsy who are sending tissue to somebody else. But are there particular cancers where you think the advantages of your new product are going to be most distinctive? Do you think it's more about just the ease of working with one provider rather than sending tests to multiple providers, maybe the ability to reflex to blood, et cetera? Just how are you sort of expecting to compete there?

Question: William Bonello - Craig-Hallum - Analyst : And ultimately, is your strategy to try and push for a world in where doctors are ordering both tissue and blood-based testing? Or is that just not a realistic scenario anytime in the next several years?

Question: William Bonello - Craig-Hallum - Analyst : And then just one final one, and I'll hop off. But I have to ask, is there any risk at all of sort of cannibalization of the higher-priced blood-based tests? Just people saying, hey, if we can get tissue, we want to do tissue. And now we can use 40% less tissue, we're more likely to be able to get a result in cancers where we might have just jumped right to blood.

Question: Subhalaxmi Nambi - Guggenheim Partners - Analyst : AmirAli, what are the potential drivers or catalysts to drive upside or downside to your Shield volume guidance of 52,000 to 58,000?

Question: Subhalaxmi Nambi - Guggenheim Partners - Analyst : Hopefully, there aren't any downside. Can I quickly squeeze a short question? How much TissueNext is assumed in the guidance?

Question: Puneet Souda - Leerink Partners - Analyst : First one, if I could, on the screening side, Guardant is obviously, all of your products in a unique way, they're working to the top right now. But just wanted to understand from the Shield side, how are you thinking about in this multimodal market, where you're -- would love to know where you're getting the most traction, the type of patients, the type of practices. And now with ADLT and better margins, how are you thinking about the size of the sales force? And I have a follow-up for Helmy.

Question: Puneet Souda - Leerink Partners - Analyst : And then on the Reveal side, Helmy, could you talk a little bit about where you're getting the best product fit for Reveal? Because you're coming into this market much later versus some of the tissue-inform tests out there. Can you just talk to us in terms of the adoption you're seeing today in CRC surveillance, the way the product could grow in breast, and then beyond that, other indications where tissue might be a little bit challenged? Could you talk to us about that and the sort of the growth expectations potentially for Reveal?

Question: Daniel Leonard - UBS - Analyst : I'll ask a two-parter on the tissue launch. For starters, I'm trying to put some context around the launch and wonder how would you frame your market share today in tissue versus what you view as your long-term entitlement in that market? So that's the first part. And then the second part, and I'll keep this to one question. Are there any ASP implications of the new tissue product? Is there potentially a different Medicare rate than that $3,500 that might be attainable long term?

Question: Daniel Brennan - TD Cowen - Analyst : Maybe just starting on Reveal, a two-parter. Mike, did I hear you say realized price above $600? Sorry, you went through the prepared remarks. So just any color on pricing that you shared there. And then if there's -- I know there was a question asked earlier, but any additional color you can provide about just how the first quarter kind of played out in surveillance and kind of what we should think about for the rest of the year in terms of the accelerant to that business now that you've got that approval?

Question: Daniel Brennan - TD Cowen - Analyst : Great. And then maybe, AmirAli, just kind of back to Shield. So you took the volumes up 7,000 or so. Obviously, the unscreened opportunity is pretty massive. I think you're at 55,000 tests this year. But can you just -- back to Puneet's question, can you spend a little more time on just what you're seeing in the field, maybe what's surprising you on the positive, anything on the negative? Exact talks about the frequency of doctor visits is when they start to see an uptake, maybe 6 or 7 times visiting the doctor before they see someone do a test. Is the same thing playing out on the blood side? Or just any color you could share in terms of what informs the modest raise and kind of how the launch is going versus expectations?

Question: Rachel Olson - JPMorgan - Analyst : I wanted to ask another follow-up just on Shield and some of the volumes that you're seeing. You increased volumes by 2,600 sequentially, roughly. So if we apply that same sequential increase for the rest of the year, that really gets us near that low end of the guidance range for Shield volumes. So I wanted to dig into a few questions around that. First, as we look specifically to the second quarter, should we see a sequential step-up above that 2,600 sequential and volume increase? Or could it kind of be the same level that you guys saw this quarter? And then if we were to get towards that high end of the Shield volume range, at what point in the year would you expect a larger step-up in the sequential given what you're seeing in the field so far? REFINITIV STREETEVENTS | www.refinitiv.com | Contact Us consent of Refinitiv. 'Refinitiv' and the Refinitiv logo are registered trademarks of Refinitiv and its affiliated companies. APRIL 30, 2025 / 8:30PM, GH.OQ - Q1 2025 Guardant Health Inc Earnings Call

Question: Rachel Olson - JPMorgan - Analyst : Maybe just digging deeper on that, though, specifically on 2Q. Should we be modeling a step-up sequentially relative to this 2,600 you did in the first quarter? Or at this point, given the reps are still kind of getting deeper ingrained into their territories, should we assume a similar step-up to what you had?

Question: Luke Sergott - Barclays - Analyst : I just wanted to ask about the SERENA-6 trial with Astra and kind of how that's ramping and how we can think about those volumes as it goes through and as that trial keeps progressing.