• Exact Sciences for liquid biopsy cancer tests. (Focuses on Guardant's pioneering work in non-invasive cancer detection and monitoring from a simple blood draw, akin to Exact Sciences' Cologuard for colon cancer screening.)
• Dexcom for cancer monitoring via blood tests. (Highlights the company's aim to provide ongoing, non-invasive insights into cancer status and treatment response, similar to continuous glucose monitoring for diabetes.)

• Guardant360: A liquid biopsy test that provides comprehensive genomic profiling for patients with advanced cancer, guiding treatment decisions.
• GuardantReveal: A liquid biopsy test used to detect residual disease and monitor recurrence in patients with early-stage cancer.
• GuardantSHIELD: A blood-based test designed for the early detection of multiple cancer types in asymptomatic individuals.

Guardant Health (symbol: GH) primarily sells its advanced liquid biopsy diagnostic tests and related services to other companies, rather than directly to individuals. Its major customer categories include:

1. Pharmaceutical and Biotechnology Companies:

   Guardant Health partners with numerous pharmaceutical and biotechnology companies. These collaborations involve utilizing Guardant Health's liquid biopsy platform for various purposes, including:

   • Clinical Trials: Identifying eligible patients for trials, monitoring treatment response, and assessing resistance mechanisms.
   • Companion Diagnostics: Developing diagnostic tests that determine if a patient is suitable for a specific drug.
   • Drug Discovery and Development: Providing insights that aid in the development of new oncology therapeutics.

   While Guardant Health works with many companies, it is uncommon for a single one to represent a "major customer" (e.g., contributing over 10% of total revenue) that would be individually disclosed in SEC filings. However, the collective revenue from these partnerships is substantial. Examples of such partner companies that are publicly traded include:

   • AstraZeneca (NASDAQ: AZN)
   • Amgen Inc. (NASDAQ: AMGN)
   • Bristol Myers Squibb (NYSE: BMY)
   • Eli Lilly and Company (NYSE: LLY)
   • Johnson & Johnson (NYSE: JNJ) (via its pharmaceutical subsidiary Janssen Biotech)
   • Merck & Co., Inc. (NYSE: MRK)
   • Novartis AG (NYSE: NVS)
   • Pfizer Inc. (NYSE: PFE)
   • Roche Group (SWX: ROG / OTCQX: RHHBY) (often through its subsidiary Genentech)

2. Healthcare Providers and Institutions:

   This category encompasses hospitals, academic medical centers, and community oncology practices. These institutions order Guardant Health's liquid biopsy tests (such as Guardant360 and Guardant Reveal) for their cancer patients to aid in diagnosis, treatment selection, monitoring for recurrence, and, increasingly, for early cancer detection. Due to the decentralized nature of healthcare systems, Guardant Health serves a broad base of these providers, and no single healthcare institution or system typically accounts for a significant enough portion of Guardant Health's revenue to be considered an individually identified "major customer."

• Illumina (ILMN)

Helmy Eltoukhy Co-Chief Executive Officer

Helmy Eltoukhy is the co-founder and co-CEO of Guardant Health, which he established in 2012 with AmirAli Talasaz. Prior to Guardant Health, he co-founded Avantome in 2007 to commercialize semiconductor sequencing, serving as CEO until its acquisition by Illumina in 2008. While at Illumina, he was a senior director of Advanced Technology Research, developing novel chemistries, hardware, and informatics for genetic analysis systems. Eltoukhy received his PhD, MS, and BS degrees in electrical engineering from Stanford University.

AmirAli Talasaz Co-Chief Executive Officer

AmirAli Talasaz is the co-founder and co-CEO of Guardant Health, which he co-founded with Helmy Eltoukhy in 2012. Before Guardant Health, Talasaz was a senior director of Diagnostics Research at Illumina, leading efforts for emerging clinical applications of next-generation genomic analysis. He also founded Auriphex Biosciences, which focused on purification and genetic analysis of circulating tumor cells for cancer management; the technology was acquired by Illumina in 2009. Talasaz holds a PhD in electrical engineering and an MSc in management science from Stanford University.

Michael Bell Chief Financial Officer

Michael Bell is the Chief Financial Officer at Guardant Health, a position he assumed in January 2021. He brings over 30 years of experience in finance, having previously served as CFO for other clinical diagnostic companies including CareDx, Novartis Diagnostics, and Singulex. Bell also worked in public accounting and consulting at Deloitte and Ernst & Young. He holds a Bachelor of Science degree in Mathematics with Computing from the University of Leicester in the United Kingdom.

Craig Eagle Chief Medical Officer

Dr. Craig Eagle serves as Guardant Health's Chief Medical Officer. Before joining Guardant Health, Dr. Eagle was the Vice President of Medical Affairs Oncology for Genentech, where he oversaw medical programs across the oncology portfolio and developed innovative cancer trials. He attended medical school at the University of New South Wales in Sydney, Australia.

Chris Freeman Chief Commercial Officer

Chris Freeman is the Chief Commercial Officer at Guardant Health, responsible for the commercial strategy of the oncology division. Prior to Guardant Health, Freeman was Vice President at Gilead Sciences, where he managed their HIV treatment and prevention business and oversaw the launch of Veklury (remdesivir) for COVID-11. His previous experience also includes commercial leadership roles at Elan Pharmaceuticals and Genentech.

The key risks to Guardant Health's business include its ongoing unprofitability combined with a high market valuation, challenges related to reimbursement and regulatory hurdles, and significant insider selling activity.

1. Unprofitability and High Valuation with Execution Risks: Guardant Health is currently unprofitable and is not projected to achieve profitability within the next three years. Despite this, the company trades at a high valuation, with its forward enterprise value-to-sales multiple significantly above the industry average. This high valuation implies elevated expectations for substantial future growth and successful execution, which leaves limited room for operational missteps or delays in product development, market expansion, and the realization of anticipated financial performance.
2. Reimbursement and Regulatory Challenges: A critical risk for Guardant Health is securing and maintaining favorable reimbursement for its advanced liquid biopsy tests. Reimbursement is crucial for the widespread adoption and commercial success of its diagnostic products. Additionally, the company faces inherent regulatory risks, including the need for ongoing approvals for its tests and potential delays in product launch timelines, which could hinder market entry and revenue generation.
3. Significant Insider Selling: Guardant Health has experienced significant insider selling of its stock over the past three months. This considerable selling by key executives and insiders can be perceived by investors as a negative indicator regarding the company's internal outlook and future prospects.

There are clear emerging threats to Guardant Health, primarily from strong competition in key growth markets:

• Competition in Minimal Residual Disease (MRD) testing: Natera's Signatera test has gained significant clinical traction and market share in the MRD space, particularly for colorectal cancer, directly challenging Guardant's Reveal product. Natera continues to publish strong clinical data and expand its commercial footprint, posing a direct threat to Guardant's growth in this segment.
• Competition in Multi-Cancer Early Detection (MCED) testing: GRAIL's Galleri test is an established product in the emerging MCED market, which is a major future growth area for Guardant Health's developing Shield product. If GRAIL (or another strong competitor like Exact Sciences with its own MCED development) establishes market leadership and broad reimbursement for their MCED tests, it could significantly limit the market opportunity for Guardant's own MCED offering once it launches.

Guardant Health targets significant addressable markets with its main products and services:

• For colorectal cancer (CRC) screening, Guardant Health estimates a $20 billion market opportunity globally. Specifically in the U.S., there are over 50 million eligible Americans who do not currently receive recommended screenings. This market is addressed by their Shield blood test, which received FDA approval in July 2024.
• For the broader cancer screening market, which includes colorectal, lung, and other cancer types, the company projects a total addressable market of over $50 billion globally.
• In precision oncology, which includes products like Guardant360, GuardantOMNI, and Guardant Reveal for advanced cancer patients, the company holds a leadership position in liquid biopsy testing. Guardant360 CDx is an FDA-approved liquid biopsy for comprehensive genomic profiling in advanced solid cancers.

1. Expansion and Adoption of the Shield Screening Test: Guardant Health anticipates significant revenue growth from the continued launch and increasing adoption of its Shield colorectal cancer screening test. The company has seen strong market demand and plans to expand its sales force to over 250 representatives by year-end to further penetrate the market. Efforts to enhance product sensitivity with Shield V2 data and anticipated inclusion in ACS guidelines are also expected to drive volume. For example, Shield screening test revenue guidance was raised to $71 million to $73 million for 2025, with anticipated volume of 80,000 to 82,000 tests.
2. Growth in Precision Oncology Portfolio, including Guardant360 Liquid and Tissue: The precision oncology segment, particularly the Guardant360 suite (Liquid and Tissue), is a consistent driver of revenue growth. The company reported a 31% increase in oncology revenue for Q3 2025, with approximately 74,000 oncology tests performed. The launch of upgraded Guardant360 LVT and smart liquid biopsy platforms, which expand the number of genes tested and improve sensitivity, is expected to continue opening broader market opportunities and higher reimbursement potentials.
3. Market Expansion and Reimbursement for Reveal MRD: The Reveal MRD (Minimal Residual Disease) product is Guardant Health's fastest-growing product in the portfolio. Securing new reimbursement applications, such as for breast cancer, is expected to open up a larger market for the Reveal MRD business, thereby driving future revenue growth. Surveillance reimbursement for colorectal cancer was already received earlier in 2025.
4. Strategic Partnerships and Regulatory Approvals: Guardant Health is actively pursuing strategic collaborations, such as those with Quest Diagnostics and PathGroup, to accelerate nationwide access to Shield. FDA approvals for its products, like the Guardant Shield for colorectal cancer screening, have provided significant market expansion opportunities. A submitted PMA application for Guardant360 Liquid to the FDA could streamline the product offering and further strengthen its leadership in therapy selection.

Share Repurchases

• Guardant Health plans to repurchase approximately $45 million of its common stock in connection with debt exchange transactions in February 2025.

Share Issuance

• In November 2020, Guardant Health conducted a Post IPO funding round, raising $1 billion.
• In November 2025, the company announced an underwritten public offering of $250 million of common stock, with an option for underwriters to purchase up to an additional $37.5 million in shares.
• In February 2025, Guardant Health issued $600 million aggregate principal amount of 1.25% Convertible Senior Notes due 2031 in exchange for approximately $659.3 million principal amount of 0% Convertible Senior Notes due 2027.

Inbound Investments

• Guardant Health raised $360 million in a Series F funding round in May 2024, achieving a valuation of $12 billion. This round was led by SoftBank Vision Fund.

Outbound Investments

• In June 2022, Guardant Health acquired the remaining equity interest in Guardant Health AMEA, Inc. from SoftBank and its affiliates for approximately $177.8 million, gaining full control of operations in Asia, the Middle East, and Africa.
• The company makes equity investments in private companies to advance business and strategic objectives.

Capital Expenditures

• Guardant Health's capital expenditures were -$39.33 million in the last 12 months.
• Planned capital expenditures are projected to increase from $116 million in 2025 to $200 million in 2029.
• The anticipated increase in capital expenditure requirements is primarily to support additional laboratory capacity due to expected growth in demand for their tests.