Adaptive Biotechnologies (NASDAQ:ADPT) used a presentation at the J.P. Morgan healthcare conference to outline growth drivers for its clonoSEQ minimal residual disease (MRD) franchise and to describe a capital-disciplined strategy for its immune medicine (IM) unit, while also reiterating an expectation to reach companywide profitability metrics in 2026.
Company overview and two operating priorities
Chief Executive Officer Chad Robins said the company was founded 16 years ago at the Fred Hutchinson Cancer Research Institute and has been public since 2019. He described Adaptive as having about 620 employees, more than $275 million in revenue, and a cash position of approximately $227 million.
- MRD diagnostics in blood cancers, anchored by the clonoSEQ test.
- Immune medicine, focused on interpreting immune receptor data to generate insights across immunology applications.
MRD: market opportunity and clonoSEQ differentiation
Robins said Adaptive is focused on MRD in lymphoid malignancies, which he put at an estimated total global addressable market of approximately $5.5 billion across clinical and biopharma end markets. In U.S. clinical testing, he cited a roughly $1.8 billion market and argued it can expand as MRD becomes more integrated into clinical decision-making, potentially increasing testing frequency to 2.5 to 3.5 tests per patient per year. He estimated that increased frequency alone could expand the U.S. market by about $700 million.
He emphasized clonoSEQ’s biology-based approach, explaining that in lymphoid malignancies each cancer clone carries a patient-specific immune receptor DNA sequence that functions as a “molecular barcode.” clonoSEQ identifies the sequence at diagnosis and then counts exact matches in later blood or bone marrow samples. Robins argued that this mechanism supports very high sensitivity and specificity, including the ability to detect one cancer cell in one million healthy cells, while largely avoiding false positives that can occur when tests attempt higher sensitivity using signals that may be generated by error.
Robins also highlighted “durable moats” around clonoSEQ, including the test’s FDA clearance in lymphoid malignancies, published evidence and intellectual property, broad coverage and access, and integration into electronic medical record (EMR) workflows.
MRD financial performance, volumes, and pricing outlook
Robins said the MRD business is now profitable, with positive adjusted EBITDA in 2025 followed by positive cash flow. He said MRD revenue has grown at a 34% cumulative average growth rate from 2021 to 2025 and now surpasses $200 million, with clinical revenue growing at a 53% CAGR over the same period. He also pointed to improving gross margins driven by lab efficiencies and a transition to NovaSeq, as well as operating leverage across the commercial organization.
On adoption metrics, Robins said clinical volumes have delivered a 44% CAGR since 2021, and that more than 100,000 patients have been tested with clonoSEQ. He added that in 2025 more than 50% of U.S. hematologist-oncologists used a clonoSEQ test, while penetration remains “relatively early,” citing 35% penetration in acute lymphoblastic leukemia (ALL) and less than 15% in other indications.
Management described several levers intended to drive continued growth, including:
- Blood-based testing (less invasive and more common in community settings); Robins said about 45% of clonoSEQ tests were blood-based and he expects that to exceed 50% by year-end.
- Community expansion; he said about 30% of testing came from community settings and he expects it to exceed 35% over the year.
- Guideline inclusion; Robins said 2025 guideline updates expanded MRD’s role toward clinical decision-making, citing multiple myeloma recommendations that strengthened upfront clonality/ID testing and chronic lymphocytic leukemia (CLL) updates that added more explicit serial testing guidance.
- Data generation; Robins said nearly 90 abstracts featured clonoSEQ data at ASH, with examples including the MITUS study in myeloma (nearly 900 patients) and the NRAD study in pediatric ALL.
- EMR integration; he said integrated accounts in 2025 grew roughly twice as fast as non-integrated accounts and that EMR-integrated sites are expected to contribute more than 50% of 2026 volume.
In the Q&A, MRD business leader Susan Bobulsky said fourth-quarter clonoSEQ volumes were around 30,000 tests, calling it a record sequential step up. She said the company saw 18% quarter-over-quarter growth in community settings and that blood-based testing contributed 47% of tests in Q4, with blood use in multiple myeloma rising to 27%.
On pricing, Robins said the updated Medicare gapfill rate of $2,007 per test (up from $1,700) went into effect at the start of 2025. He said Adaptive’s average selling price reached approximately $1,310 in 2025, a 17% year-over-year increase, and reiterated a long-term path to $1,700 to $1,800 by 2029 driven by coverage expansion, contract renegotiations, recurrence monitoring coverage expansion, and revenue cycle execution.
2026 expectations, biopharma mix, and immune medicine strategy
For fiscal 2026, Robins said Adaptive expects clinical testing volume growth of more than 30% year-over-year, ASP of approximately $1,400, mid-single-digit millions in milestone revenue, and sequencing gross margin exceeding 70% driven by scale and efficiencies, including NovaSeq. He said additional details would be provided with full-year and audited fourth-quarter results in February.
On biopharma MRD, Robins said the portfolio is currently anchored in multiple myeloma, where MRD has formal acceptance as a clinical endpoint and clonoSEQ is included in “most all” pivotal trials. He said that in 2025 about 70% of sequencing revenue and about 60% of backlog came from multiple myeloma studies, while the company is seeing diversification into CLL and diffuse large B-cell lymphoma (DLBCL). He said CLL bookings in 2025 more than tripled year-over-year, and described DLBCL as earlier but with significant pipeline potential tied to registrational activities and demand for a standardized, FDA-validated, globally deployable MRD assay.
Robins also addressed competitive dynamics after noting Natera’s acquisition of Foresight Diagnostics, which he said operates in DLBCL using a circulating tumor DNA approach. He described DLBCL MRD testing as nascent and said Adaptive’s reimbursement and clonoSEQ biology would position it well as data emerge. He added that Adaptive saw 14% quarter-over-quarter and 114% year-over-year growth in DLBCL.
In immune medicine, Robins said the company has expanded its mapped dataset from roughly 2 million T-cell receptors to more than 5 million paired T-cell receptors, spanning over 20,000 antigens and nearly 50 HLA types. He said Adaptive is identifying disease-causative T-cell receptors and antigens in autoimmune diseases including type 1 diabetes, celiac disease, multiple sclerosis, and ankylosing spondylitis. Robins pointed to two recent Pfizer agreements as examples of monetization: a data-licensing agreement for a subset of training data and a target discovery effort in rheumatoid arthritis using Pfizer-provided patient samples.
Robins said immune medicine progress in 2025 was achieved with cash burn of approximately $30 million, and that the company decided not to proceed immediately to IND-enabling studies for its lead TCR-depleting antibody program in ankylosing spondylitis. Instead, Adaptive is prioritizing investment in data generation and predictive modeling, with expected 2026 cash burn of $15 million to $20 million. He closed by stating the company expects to achieve positive adjusted EBITDA and positive free cash flow for the entire company in 2026.
About Adaptive Biotechnologies (NASDAQ:ADPT)
Adaptive Biotechnologies is a clinical-stage biotechnology company that focuses on harnessing the adaptive immune system to transform the diagnosis and treatment of disease. Through proprietary immune receptor sequencing and analysis, the company decodes the genetic information of T-cell and B-cell receptors to identify signatures of immune response. Its core technology platform provides insights into immune-driven conditions, enabling more precise monitoring and targeted therapeutic development.
The company’s flagship product, immunoSEQ, offers high-throughput immune repertoire profiling for researchers and pharmaceutical partners.
