Adaptive Biotechnologies (NASDAQ:ADPT) Chief Executive Officer and Co-Founder Chad Robins said the company is focused on expanding its minimal residual disease testing business while pursuing targeted partnerships for its Immune Medicine platform, during a presentation at William Blair’s Growth Stock Conference.
Robins said Adaptive, which was founded 16 years ago out of the Fred Hutch Center in Seattle and has been public since 2019, has more than 620 employees, about $277 million in revenue at the end of 2025 and a cash position of $220 million.
The company operates through two business units: minimal residual disease, or MRD, testing for blood cancer patients, and Immune Medicine, which uses immune receptor data to generate insights across immunological applications.
clonoSEQ Remains Central to MRD Strategy
Robins described clonoSEQ, Adaptive’s flagship MRD product, as the “gold standard” in MRD testing for blood cancer patients and the test of choice for pharmaceutical companies in the field. He said the assay is the only FDA-cleared MRD test in lymphoid cancers and is supported by more than 250 peer-reviewed publications.
According to Robins, clonoSEQ has more than 300 million covered lives and is being used in more than 160 active pharmaceutical trials, with MRD serving as a clinical endpoint in about half of those trials. He said the company recently passed the milestone of more than 100,000 patients using clonoSEQ to monitor disease, and more than 50% of U.S. hem-oncs used and ordered the test as of last year.
Robins emphasized that clonoSEQ’s approach relies on identifying a patient-specific immune receptor DNA sequence, which he described as a “barcode” for that patient’s cancer. That enables the test to track cancer over time and detect one cancer cell among one million healthy cells, he said.
MRD Business Reaches Profitability
Robins said Adaptive’s MRD business has become profitable, achieving positive adjusted EBITDA in 2025, followed by positive cash flow. MRD revenue grew at a 34% compound annual growth rate from 2021 to 2025, surpassing $210 million, he said. Clinical revenue grew at a 53% CAGR over the same period, while pharma revenue grew at a 15% CAGR.
Clinical volumes have also increased, with Robins citing a 42% CAGR since 2021. He pointed to several drivers supporting adoption, including blood-based testing, expansion in the community setting, clinical guideline inclusion, ongoing data generation and electronic medical record integration.
Robins said blood-based testing is particularly important because it makes MRD testing more accessible in community oncology practices. He said community testing now represents 35% of total testing, up from 29% a year earlier, while the number of ordering clinicians grew 43% year-over-year to 5,000 in the first quarter.
Adaptive has integrated clonoSEQ into more than 180 accounts through electronic medical record systems, including Epic in academic medical centers and Flatiron in community settings, Robins said. He added that penetration remains relatively early across indications, with ALL below 35% penetration and other indications, including multiple myeloma, below 16%.
Pricing, Coverage and Pharma Trials Support Growth
Robins said the updated Medicare gap-fill rate of $2,007 per test went into effect at the start of 2025, up from $1,700. He said that supports Adaptive’s long-term average selling price target of $1,700 to $1,800 per test by 2029.
He also cited policy expansion, contract renegotiation, recurrence monitoring and revenue cycle management as factors supporting pricing. In recurrence monitoring, Robins said Adaptive received its first Medicare approval in 2025 for mantle cell lymphoma and sees a path to expansion into CLL in 2026, followed by DLBCL and eventually multiple myeloma.
On the pharma side, Robins said the MRD portfolio is anchored in multiple myeloma, where MRD has achieved formal acceptance as a clinical endpoint. He said clonoSEQ is incorporated into almost every pivotal multiple myeloma trial for biopharma companies developing therapies in the indication.
In 2025, about 70% of sequencing revenue and about 60% of backlog came from myeloma studies, Robins said. He added that Adaptive is seeing diversification into CLL and DLBCL, with bookings in CLL supported by updated NCCN guidelines for fixed-duration regimens and emerging data highlighting the need for higher-sensitivity MRD testing.
Immune Medicine Focuses on Data Partnerships
Robins said Adaptive has spent more than a decade building technology and data to understand how T cell receptors bind to antigens and drive immune responses across cancer, autoimmune diseases and infectious diseases.
The Immune Medicine platform includes more than 6 million functional TCR-antigen pairs, spanning about 50,000 antigens and more than 50 HLA types, which Robins said is sufficient to train predictive models of the adaptive immune response.
He said Adaptive has identified disease-causative T cell receptors and antigens in autoimmune disorders including type 1 diabetes, celiac disease, multiple sclerosis and ankylosing spondylitis. The company’s goal is to monetize its immune receptor data while continuing to scale the dataset and improve prediction models.
Robins also discussed two non-exclusive agreements signed last year with Pfizer. One is a data licensing deal involving a subset of TCR-antigen training data, and the other is a target discovery collaboration in rheumatoid arthritis. He said Adaptive already has 1,000 patient samples and is on track to deliver the rheumatoid arthritis data package in the second half of the year.
Company Targets Positive EBITDA and Free Cash Flow
Robins said Adaptive expects MRD revenue to increase 33% versus the prior year, excluding milestone payments, driven primarily by clinical testing volume growth. He said the company raised its clinical testing volume growth expectation from 30% to 35% and expects average selling price to rise to about $1,400 by year-end.
Sequencing gross margins are expected to exceed 70% for fiscal 2026, with potential upside closer to 75% by year-end, driven by scale, operational efficiencies and the switch to NovaSeq, Robins said.
For Immune Medicine, Robins said Adaptive is maintaining disciplined capital allocation and has “ring-fenced” cash burn to $15 million to $20 million for the year. He said the company expects to achieve positive adjusted EBITDA and positive free cash flow for the entire company by the end of 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.
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