Caris Life Sciences NASDAQ: CAI reported first-quarter 2026 results highlighted by sharp year-over-year revenue growth, improving margins, and continued progress across its pipeline, including a key clinical accuracy readout for its multi-cancer early detection (MCED) test, Caris Detect.
Financial results driven by molecular profiling growth
Vice Chairman and EVP Brian Brilly said the company posted “continued growth, profitability, and cash generation,” which management said supports ongoing investments in MCED, the broader pipeline, and commercial expansion.
Total revenue rose 79% year-over-year to $216 million. Molecular Profiling Services revenue increased 85% to $211 million, which Brilly attributed primarily to clinical profiling performance. The company completed 52,800 cases in the quarter, up 15% year-over-year.
Brilly said revenue growth reflected both higher volume and higher pricing: 15% volume growth and a 61% increase in clinical average selling price (ASP). He added that GAAP gross margin improved to 65% from 47% a year earlier. The quarter produced adjusted EBITDA of $26 million and free cash flow of $22.5 million, marking the fourth consecutive quarter of positive adjusted EBITDA and free cash flow, according to management.
CFO Luke Power said the company’s strong revenue performance continued to translate into profitability despite increased investment. Operating expenses were $136 million, up from $132 million in Q4, and capital expenditures were just over $10 million, up from $5.1 million in Q4. Power noted free cash flow of $23 million for the quarter included annual bonus payments of $30.5 million.
Caris ended the quarter with cash slightly above $825 million, up $23.4 million during the quarter, Brilly said.
Commercial execution: sales realignment, ASP lift, and blood growth
Chief Commercial Officer Bobby Hill said molecular profiling revenue growth was driven by both volume and ASP. He reported tissue ASP increased 70% to more than $4,300, while blood ASP increased 14% to just under $2,500. Hill tied the performance to market access and billing execution and said the company continued to see benefits from the launch of MI Cancer Seek last year.
Hill also detailed sales execution changes made early in 2026, including a sales force realignment in January. Caris expanded its territory structure from 82 to 146 territories to “improve coverage, sharpen accountability, and create a stronger footprint for execution,” he said. Hill described January as a “transition month,” but said activations in February and March grew about 20% year-over-year versus the same period last year, with full-quarter activations up 17%.
Based on February and March completion cadence, Hill said results supported “a quarterly exit run rate of roughly 56,000 completed cases.” For Q1, completed volumes included approximately 43,600 tissue cases and about 9,200 Caris Assure cases. Caris Assure volume grew 58% year-over-year, Hill said.
Management emphasized increasing electronic ordering and workflow integration. Brilly said the company supports more than 6,100 ordering oncologists, with approximately 70% of orders coming through electronic health record (EHR) and portal channels. Hill said more than 70% of orders were submitted electronically and more than 3,000 physicians are using EMR integrations. Caris ended the quarter with more than 270 commercial team members and is “building toward” an approximately 300-person goal, Hill said.
During Q&A, management said the sales realignment contributed to a slower start, but they cited improved monthly trends exiting the quarter as support for full-year expectations. Responding to a question about whether weather affected volumes, management said it did not, and reiterated that cases were coming in and would convert to completed cases in Q2.
Caris Detect ACHIEVE-1 readout and launch preparations
President David Spetzler highlighted what he called an “important milestone” for the quarter: the final readout from the ACHIEVE-1 clinical accuracy study for Caris Detect. He said Caris Detect delivered 60.3% stage 1 and stage 2 sensitivity with 99.2% asymptomatic specificity in a 3,014-subject high-risk cohort.
Spetzler provided additional breakdowns, including stage-specific sensitivity of 56.8% in stage 1, 67.7% in stage 2, 79% in stage 3, and 98.6% in stage 4. He also said Caris reported 96% specificity in “benign tumor and high-risk patient” populations alongside the asymptomatic specificity result, explaining that Caris separated non-cancer patients into groups because false positives can have different implications.
Spetzler also cited early-stage sensitivity by cancer type in the stage 1 and 2 dataset, including 53.7% in breast, 74.1% in prostate, 73.4% in lung, 60.6% in uterus, 61.8% in bowel, 81.3% in head and neck, and 70% in pancreatic cancer. He said the results were generated using “only 1 of 9 potential pillars,” and suggested performance could improve as additional pillars are incorporated.
Spetzler said the company had been conducting a beta launch “the last few weeks” and continued to anticipate a commercial launch with Everlywell. Power later said the company planned to launch Caris Detect in Q2 and would assess contribution in the second half of the year.
Pipeline and product launches: ChromoSeq and MI Clarity; MRD development
Management highlighted two recent product launches. Brilly said Caris launched Caris ChromoSeq on April 1 as a therapy selection assay for hematological cancers using whole genome technology. Spetzler added ChromoSeq launched with MolDX coverage and is designed for AML, MDS, MPN, and suspected myeloid malignancies. He described the assay as providing greater than 200X coverage across the whole genome, with approximately 1.6 billion reads per patient, to detect a broad range of clinically relevant genomic alterations.
The company also launched Caris MI Clarity, which Brilly described as a prognostic breast cancer test using digital pathology to provide insight into early and late distant recurrence risk. Spetzler said the “digital AI-only version” is designed for post-menopausal patients with HR-positive, HER2-negative, node-negative early-stage breast cancer at diagnosis, and is intended to support decision-making and reduce unnecessary therapy.
Caris also discussed minimal residual disease (MRD) efforts. Spetzler said MRD tumor-naive development remains focused on colorectal cancer and uses the Caris Assure platform, with additional data being compiled for a MolDX technical assessment. He said MRD tumor-informed development and launch planning had also progressed for a pan-tumor opportunity in stage 1-3 disease, using tumor-normal whole genome sequencing and a proprietary tracker approach designed to improve sensitivity.
In Q&A, management said MRD is the “next priority” now that other product launches are “done and behind” the company.
Guidance reaffirmed; reimbursement and refinancing updates
Power said Caris reaffirmed its guidance from February, citing confidence in full-year volume expectations based on February and March trends. He said the company continued to expect tissue growth in the low teens and blood growth in the high 50s to low 60s. For Q2, he said Caris expects over 58,000 cases, representing 10% sequential volume growth from Q1, and provided a rough split expectation of about 47,500 tissue cases and “approaching over” 10,000 blood cases.
Power also addressed reimbursement topics raised by investors, emphasizing that both MI Cancer Seek and Caris Assure are CDLTs and not ADLTs, and therefore are reported under PAMA. He said the 2026 PAMA reporting window runs from May 1 through July 31 based on data from Jan. 1 through June 30, 2025, with any related fee schedule updates effective Jan. 1, 2027. Power said the company submitted its PAMA data May 1 and “do[es] not expect any downward adjustments from that.”
Brilly also said Caris refinanced its credit facility with a new $400 million debt facility led by Blue Owl and Blackstone, citing lower costs (approximately $6 million in annual interest savings), a maturity extension to April 2031, and a $300 million delayed draw term loan for potential strategic acquisition flexibility. In response to a question on capital allocation, Brilly said the company did not see gaps requiring acquisitions but described Caris as “flexible and tactical” given its financial profile.
About Caris Life Sciences NASDAQ: CAI
Caris Life Sciences NASDAQ: CAI is a molecular science company focused on advancing precision medicine in oncology. The company develops and delivers comprehensive molecular profiling services designed to identify actionable biomarkers across DNA, RNA and protein modalities. Its clinical services are intended to support oncologists in treatment decision-making by matching patients to targeted therapies, immunotherapies and relevant clinical trials based on tumor biology.
Caris provides laboratory-based diagnostic testing and related interpretive reports, combining high-throughput sequencing and other molecular technologies with bioinformatic analysis.
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