What Natera (NTRA) Said on Its Q3 Earnings Call

Key Points

• Revenue and test volumes climbed: Q3 revenue rose 34% to $794 million, while total tests increased more than 22% and MRD volumes grew 56%. Natera raised its 2026 revenue forecast to $3.005 billion–$3.035 billion.
• Natera set an ambitious growth target: CEO-designate Solomon Moshkevich aims to double annual revenue to $6 billion by 2029, with profitability expected if the company executes its plan. He said strategy will remain focused on customer service, clinical data and product development.
• Leadership is changing: Steve Chapman is stepping down as CEO, with longtime executive Moshkevich taking over; Chapman will stay on as a consultant and board adviser. The company also cited Medicare coverage for serial Signatera testing in early-stage liver cancer surveillance and accelerating biopharma demand for MRD technology.

Natera NASDAQ: NTRA raised its full-year revenue forecast after reporting a 34% increase in third-quarter revenue, as demand for its cancer-monitoring tests grew and the company announced a change in leadership.

Steve Chapman is stepping down as chief executive officer and handing the role to Solomon Moshkevich, a longtime Natera executive who helped build its oncology business. Chapman said he will remain with the company as a consultant and adviser to the board.

Moshkevich said he does not expect a major shift in strategy. “You are not going to see any big radical change,” he told analysts on the Nov. 5 earnings call, adding that the company will remain focused on customer service, clinical data and product development.

Revenue and Test Volumes Rise

Third-quarter revenue rose to $794 million from $592 million a year earlier. Excluding revenue true-ups, growth was 42%, Moshkevich said. True-ups fell to approximately $32 million from $52 million in the second quarter as Natera incorporated some recent average selling price gains into its revenue accruals, Chief Financial Officer Michael Brophy said.

Natera processed approximately 1.1 million tests during the quarter, up more than 22% from about 894,000 a year earlier. Clinical molecular residual disease, or MRD, volumes reached approximately 316,000 units, an increase of 56%. Those tests include Signatera and Latitude MRD.

Moshkevich said growth reflected new accounts, new patient starts and repeat testing. Colorectal and breast cancer remained the largest indications, although the company also saw growth across other cancer types.

The average selling price for Signatera increased to approximately $1,290 from $1,271 in the second quarter. Natera reported gross margin of about 65%; excluding true-ups, gross margin rose to 63.2%, an increase of roughly 140 basis points from the prior quarter. The company said it generated cash and narrowed its losses but did not provide a loss figure on the call.

Higher Outlook and 2029 Revenue Goal

Natera raised its 2026 revenue guidance to $3.005 billion to $3.035 billion from $2.85 billion to $2.91 billion. The new midpoint is $140 million higher. Brophy said the forecast assumes steady average selling prices and continued volume growth but excludes any fourth-quarter true-ups.

The company maintained its full-year gross margin outlook of 64% to 66%. It also raised the top end of its research and development expense range by $25 million and increased the upper end of its selling, general and administrative expense outlook to $1.3 billion from $1.225 billion. Brophy cited investment in pharma services and clinical trials, along with legal expenses and spending on commercial initiatives.

For 2027, Brophy said preliminary planning assumptions include operating expense growth of 10% to 12% and a gross margin range similar to the 2026 outlook. He said Natera expects to remain cash flow generative while investing in MRD and early cancer detection trials.

Moshkevich also set a goal of doubling annual revenue to $6 billion by 2029, with profitability expected if the company executes its plan. He said the target relies primarily on existing businesses and assumes only a small contribution from emerging cancer screening products. He added that Natera could reach the goal without Signatera’s average selling price rising much beyond $1,450, though management sees potential upside.

Coverage, Japan and Pharma Demand

Medicare has granted coverage for serial Signatera testing in the surveillance of patients with early-stage hepatocellular carcinoma, a form of liver cancer. Moshkevich said the decision followed roughly a year of work with MolDX, the Medicare program that evaluates molecular diagnostic tests.

Brophy said Natera has nine or 10 additional MolDX submissions in progress. Moshkevich said the company could not predict their timing or order.

In Japan, Natera is preparing to launch Signatera for colorectal and muscle-invasive bladder cancer after receiving regulatory approval for the latter indication in the third quarter. The company is discussing reimbursement and pricing for both indications with Japan’s health ministry and expects an update by the JPMorgan Healthcare Conference, if not sooner.

Moshkevich said biopharma demand for MRD technology has accelerated: revenue from the first three quarters of 2026 was roughly 70% higher than pharma revenue for all of 2025. He said the company’s 2029 target would require several hundred million dollars of contribution from pharma and data services.

Clinical Studies and Early Detection

Chief Medical Officer Alex Aleshin said Natera is completing an upgrade to Signatera Genome that incorporates phase and structural variants. The company expects the technology to feature in additional studies and pharma partnerships.

Aleshin highlighted early findings from the ongoing SAGITTARIUS colon cancer trial. Among the first 205 patients in the physician’s choice arm, one in three had an adjuvant treatment plan changed after a negative Signatera result, and 87% of those changes reduced treatment intensity. He noted that the trial’s primary readout is still several years away.

Natera completed enrollment in the third quarter for the premarket approval cohort of its FIND early cancer detection study, with 30,000 patients. Aleshin said the company is working toward a definitive colorectal cancer readout in 2027. Separately, the Food and Drug Administration granted breakthrough device designation in October to Natera’s multi-cancer early detection assay, he said.

About Natera (NASDAQ:NTRA)

Natera, Inc is a diagnostics company that develops and commercializes molecular testing services designed to provide personalized genetic and genomic information. Its tests are used across reproductive health, oncology and organ transplantation, with the company combining next-generation sequencing and bioinformatics to analyze DNA and monitor disease-related signals.

In reproductive health, Natera offers Panorama noninvasive prenatal screening, Horizon carrier screening and Vistara single-gene disorder screening.

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