Personalis Q1 Earnings Call Highlights

Key Points

• Personalis posted Q1 2026 revenue of $15.5 million and said it is intentionally shifting toward higher-growth clinical MRD and biopharma MRD testing, while reducing reliance on lower-margin legacy revenue. The company reaffirmed full-year revenue guidance of $78 million to $80 million.
• Clinical test volume surged to more than 7,800 tests in the quarter, up 26% sequentially and 258% year over year, with over 1,000 physicians ordering the test. Management said retention among oncologists using NeXT Personal remains above 98% and that the rollout is being supported through its partnership with Tempus.
• Margins were heavily pressured by unreimbursed testing, with gross margin falling to 1.8% from 35% a year earlier, but management called the compression temporary. Personalis ended the quarter with $233.2 million in cash, no meaningful debt, and said reimbursement coverage and additional clinical evidence remain key growth drivers.

Personalis NASDAQ: PSNL reported first-quarter 2026 revenue of $15.5 million as management said the company is prioritizing growth in its clinical minimal residual disease, or MRD, testing business and biopharma MRD programs over lower-margin legacy enterprise revenue.

Chief Executive Officer Chris Hall said the company delivered more than 7,800 clinical tests in the quarter, up 26% sequentially from the fourth quarter and 258% year over year. He said the company remains focused on scaling NeXT Personal, its tumor-informed blood test for detecting and monitoring cancer recurrence.

“Since we launched NeXT Personal, we haven't just validated our Win in MRD strategy, we have disrupted the market,” Hall said. “Last year in 2025, we established the power of our platform, and this year in 2026, we are scaling it.”

Hall said Personalis continues to expect 43,000 to 45,000 clinical tests in 2026. The company also reaffirmed full-year revenue guidance of $78 million to $80 million, including strategic revenue of $30 million to $32 million.

Clinical test volume rises as physician base expands

Hall said more than 1,000 physicians ordered Personalis tests during the first quarter. He also said the company has seen retention of more than 98% “over the past several quarters” among oncologists who have integrated NeXT Personal into routine workflows.

In response to an analyst question, Hall said the 1,000-physician figure referred to ordering physicians in the quarter, not a cumulative total. He said most physicians ordering the test have some experience with MRD testing, though Personalis is also targeting physicians who are newer to the category.

“We’re seeing the market just continue to grow,” Hall said, citing interest in blood tests that monitor cancer progression and recurrence. He said the company believes its ultra-sensitive approach gives physicians and patients more confidence in negative results.

Personalis is commercializing NeXT Personal in partnership with Tempus. Hall said the company is working with Tempus in a coordinated way rather than competing in the field. Aaron Tachibana, the company’s chief financial and chief operating officer, said Tempus accounted for a little more than 80% of volume in the quarter, while Personalis’ internal commercial team was “flattish” sequentially.

Revenue mix shifts toward MRD

Tachibana said total revenue declined 25% from the year-earlier period, but characterized the decrease as part of an intentional transition from lower-margin legacy enterprise revenue to higher-growth clinical and biopharma MRD revenue. He also said revenue from Moderna decreased as expected following the conclusion of enrollment in a large Phase III trial last year. Personalis expects a baseline of $2 million to $3 million per quarter from Moderna for the rest of 2026.

Biopharma testing services revenue was $11.2 million in the first quarter, down from $13.6 million a year earlier. Tachibana said the decline was entirely due to the expected decrease in Moderna revenue.

Clinical revenue was $1.4 million, compared with $0.3 million in the prior-year quarter. Tachibana said revenue is now being generated from Medicare reimbursement coverage for breast and lung cancer surveillance, with breast cancer covered in November 2025 and lung cancer in February 2026.

Personalis reported $3.1 million of biopharma MRD revenue in the first quarter. Management said it still expects full-year biopharma MRD revenue of $20 million to $21 million, with most of that revenue expected in the second half of the year as larger projects ramp.

Margins pressured by unreimbursed testing

Gross margin was 1.8% in the first quarter, compared with 35% in the prior-year period. Tachibana said the margin compression was “both intentional and temporary,” driven by the growth of NeXT Personal testing ahead of reimbursed revenue. He said unreimbursed test costs diluted margins by more than 2,000 basis points in the quarter.

Operating expenses rose to $32.4 million from $24.9 million a year earlier, as the company invested in commercial resources, reimbursement-supporting studies and technology development. Research and development expense was $14.5 million, while selling, general and administrative expense was $17.9 million.

Net loss widened to $30 million from $15.8 million in the prior-year quarter. The company ended the quarter with $233.2 million in cash and short-term investments and no debt other than small equipment loans. Tachibana said cash usage was approximately $28 million in the quarter, including about $5 million of incentive compensation that will not repeat during the rest of the year.

Reimbursement and evidence remain key priorities

Hall said Personalis submitted a neoadjuvant breast cancer coverage request during the quarter, and that both the neoadjuvant breast cancer submission and a pan-cancer immunotherapy monitoring submission are under review. He said timing remains subject to MolDX review.

The company highlighted data presented at the AACR conference, including NEOPRISM-CRC colorectal cancer data that Hall said showed a 100% negative predictive value for disease relapse following surgery in a group of patients. He also cited real-world NeXT Personal testing of 10,000 patients, which found that 40% of positive detections occurred in the “ultrasensitive range” below 100 parts per million across 14 cancer types and stages.

Hall also discussed the DARWIN 2 study, saying collaborators found NeXT Personal was a predictor of long-term immunotherapy success in lung cancer patients, with patients who cleared DNA early during treatment five times more likely to remain progression-free at three years.

Looking ahead to ASCO, Rich Chen, president and chief medical officer, said Personalis expects to present more colorectal cancer data and data in two additional cancer types. Chen said there is increasing recognition in the oncology community that ultra-sensitivity in MRD testing is “not just a nice to have, but a must-have.”

Full-year outlook unchanged

Personalis reaffirmed its 2026 guidance. The company expects:

• Total revenue of $78 million to $80 million.
• Clinical revenue of $10 million to $11 million from covered breast and lung cancer surveillance tests.
• Revenue from pharma tests, services and other customers of $55 million to $56 million.
• Biopharma MRD revenue of $20 million to $21 million.
• Population sequencing plus enterprise customer revenue of approximately $13 million.
• Gross margin of 15% to 20%, with the first two quarters expected to be the lowest points of the year.
• Net loss of approximately $105 million and cash usage of approximately $100 million.

Tachibana said the company’s guidance only assumes paid tests from reimbursement coverage decisions already received. He said potential upside could come from faster coverage expansion, accelerated payer adoption, additional clinical test volume growth and stronger biopharma MRD demand.

About Personalis NASDAQ: PSNL

Personalis, Inc NASDAQ: PSNL is a clinical‐stage genomics company that develops and markets advanced next‐generation sequencing (NGS) services and assays designed to accelerate precision medicine. The Company's core offering is the ImmunoID NeXT™ Platform, which combines comprehensive tumor profiling—including whole exome, transcriptome, and T‐cell receptor sequencing—with proprietary bioinformatics to identify biomarkers and guide immuno‐oncology research. Personalis serves biopharmaceutical companies, academic institutions, and clinical research organizations seeking in‐depth insights into cancer, autoimmune diseases and other complex conditions.

In addition to its flagship ImmunoID NeXT™ Platform, Personalis offers a suite of customizable sequencing assays for biomarker discovery, clinical trial support and companion diagnostic development.

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