Adaptive Biotechnologies (NASDAQ:ADPT) reported third-quarter net income and raised its full-year revenue outlook for its minimal residual disease business, as demand for its clonoSEQ cancer testing service increased in both clinical care and drug development.
The company reported total revenue of $83.9 million for the third quarter of 2026, up 39% from a year earlier. GAAP net income was $2.8 million, and adjusted earnings before interest, taxes, depreciation and amortization, or EBITDA, were $14.3 million. Chief Financial Officer Kyle Piskel said the company does not currently expect GAAP net income or positive earnings per share in the fourth quarter or for the full year.
Testing Growth Drives Higher Outlook
Revenue from the minimal residual disease, or MRD, business rose 28% to $72.6 million. Excluding $6.5 million in milestone revenue recognized in the prior-year quarter, core MRD revenue increased 44%. Clinical testing accounted for 75% of MRD revenue, while pharmaceutical services contributed the remaining 25%.
Clinical testing volume increased 46% year over year, and clinical revenue rose 41%. Adaptive delivered nearly 40,000 clonoSEQ tests, up 10% sequentially. Robins said every reimbursed indication contributed to growth, with diffuse large B-cell lymphoma, or DLBCL, volume rising 20% from the preceding quarter. Multiple myeloma, which accounted for 45% of testing volume, grew 11% sequentially.
Blood-based testing represented 51% of total clonoSEQ volume, while community practices accounted for 37%, up from 31% a year earlier. Approximately 5,600 clinicians ordered clonoSEQ during the quarter, an increase of 37% year over year, Robins said.
Adaptive raised its full-year MRD revenue guidance to $276 million to $286 million, from $268 million to $278 million. The updated outlook includes $9 million in milestone revenue recognized in the first quarter and assumes no additional MRD milestones for the rest of the year. At the midpoint, the forecast represents 32% growth, or 41% excluding milestones.
The company also lifted its expected full-year clinical volume growth to approximately 42%, from a previous range of 38% to 40%. It expects operating expenses of approximately $350 million, at the low end of its earlier $350 million to $355 million range.
Reimbursement and Pricing in Focus
The U.S. average selling price for clonoSEQ was $1,380 in the third quarter, up 3% from a year earlier and relatively flat sequentially. Robins said Adaptive continues to expect an average of approximately $1,400 for the full year and is pursuing a longer-term goal of $1,700 to $1,800 per test.
Medicare and Medicare Advantage accounted for approximately 45% of the company’s payer mix, up from 39% a year earlier. Robins said the existing Medicare episode rate covers up to four tests over a patient’s lifetime, and that more frequent monitoring is putting pressure on realized prices as patients move beyond that limit.
Adaptive has submitted a technical assessment to MolDX seeking an additional maintenance testing bundle for multiple myeloma. During the question-and-answer session, Robins said the submission requests five additional tests. He described discussions as positive but said the company could not guarantee the number of tests that might be covered or the timing of a decision.
Piskel also addressed preliminary 2027 Medicare pricing, saying Adaptive identified erroneous data submitted for the clonoSEQ proprietary laboratory analysis code. He said the company is working with the Centers for Medicare and Medicaid Services to correct it and does not believe the code’s rate-setting process should affect its Medicare episodic billing framework.
Guidelines and Pharma Demand
Robins said updated National Comprehensive Cancer Network guidelines give MRD testing greater prominence in multiple myeloma, including guidance on testing during maintenance and surveillance. He also pointed to a definition of cure presented on behalf of the International Myeloma Working Group that requires sustained MRD negativity over five years off treatment, demonstrated through at least four negative assessments.
Chief Commercial Officer Susan Bobulsky said the guideline updates could support adoption in community oncology, where clinicians look for direction on how and when to test. She also said DLBCL growth has come from both community and academic accounts and that she expects the indication to remain a leading growth driver over the next few years.
MRD pharmaceutical sequencing revenue, excluding milestones, grew 55% year over year. Adaptive added 27 new or amended studies during the quarter, bringing its total to 191 active global studies. Backlog reached approximately $270 million, up 34% from a year earlier.
Multiple myeloma accounted for approximately 60% of active studies and 65% of backlog. Robins said 19 myeloma studies now use MRD as a primary endpoint, up from 12 a year earlier. Adaptive expects full-year pharma sequencing revenue growth of approximately 25%.
Immune Medicine Separation
Immune Medicine revenue was $11.3 million, primarily reflecting the company’s target discovery agreement with Pfizer. Robins said the business earned a milestone payment after delivering rheumatoid arthritis data under that agreement.
Adaptive is working with Morgan Stanley on the separation of Immune Medicine and remains on track to announce a path forward by year-end, Robins said.
About Adaptive Biotechnologies (NASDAQ:ADPT)
Adaptive Biotechnologies Corporation (NASDAQ: ADPT) is a biotechnology company focused on using the genetics of the adaptive immune system to develop diagnostic and research tools. Based in Seattle, Washington, the company analyzes immune-cell receptors to help identify and measure disease, support drug development and improve understanding of immune responses.
Adaptive’s products include clonoSEQ, a clinical assay used to detect and monitor measurable residual disease in certain blood cancers, including multiple myeloma, acute lymphoblastic leukemia and chronic lymphocytic leukemia.
