Adaptive Biotechnologies: A 2026 Profitability Play in the MRD Gold Rush

The Minimal Residual Disease (MRD) diagnostics market is undergoing a seismic shift, driven by evolving clinical guidelines, reimbursement reforms, and the growing recognition of MRD-guided treatment in oncology. At the forefront of this transformation is Adaptive Biotechnologies, whose clonoSEQ platform has emerged as a gold standard in blood cancer diagnostics. With 2025 financial results underscoring robust revenue growth, improving unit economics, and a clear path to profitability, the company is positioning itself as a compelling long-term investment. This analysis evaluates Adaptive's financial trajectory, competitive advantages, and operational efficiency to assess its viability as a 2026 profitability play.

Financial Performance: Scaling Revenue with Operational Discipline

Adaptive Biotechnologies reported total revenue of $277 million in 2025, a 55% year-over-year increase, with its MRD segment contributing $212 million-accounting for 76% of total revenue. This segment's flagship product, clonoSEQ, delivered 105,600 tests in 2025, a 39% year-over-year surge. The growth is fueled by updated clinical guidelines, such as the National Comprehensive Cancer Network's (NCCN) inclusion of MRD-guided treatment duration in Chronic Lymphocytic Leukemia (CLL), which has expanded the addressable market.

Profitability milestones were also achieved. By Q3 2025, the MRD business generated Adjusted EBITDA of $7.0 million, with cash flow positivity realized ahead of schedule. This reflects disciplined cost management and operational efficiencies, including a transition to NovaSeq sequencing technology, which boosted sequencing gross margins to 66% in Q3 2025.

Unit Economics: Pricing Power and Margin Expansion

Adaptive's unit economics are strengthening, driven by a combination of pricing power and cost optimization. The average selling price (ASP) for clonoSEQ rose to $1,340 in Q3 2025, up from $1,310 in 2025, reflecting expanded reimbursement policies and Medicare's Clinical Laboratory Fee Schedule (CLFS) rate of $2,007 per test. Management has set a long-term ASP target of $1,700–$1,800 by 2029, signaling confidence in sustaining premium pricing as MRD becomes a standard of care.

While the exact cost of goods sold (COGS) per test remains undisclosed, the MRD segment's profitability-evidenced by positive Adjusted EBITDA and gross margins exceeding 70% in 2026-suggests that COGS per test is well-managed. Analysts from Guggenheim and Piper Sandler highlight Adaptive's ability to balance volume growth with margin preservation, a critical factor in sustaining long-term profitability.

Competitive Positioning: Leadership in a High-Growth Market

Adaptive's dominance in the MRD diagnostics sector is underpinned by its first-mover advantage, clinical validation, and payer contracts. The company's market share is expanding rapidly, with analysts projecting a 30% revenue growth rate for multiple quarters. This momentum is further amplified by strategic partnerships and electronic medical record (EMR) integrations, which streamline test ordering and reimbursement.

Competitive threats remain limited. While other players are entering the MRD space, Adaptive's clonoSEQ has established a strong clinical track record, particularly in hematologic malignancies. Its ability to secure favorable reimbursement rates-such as the $2,007 CLFS rate-creates a high barrier to entry for rivals.

Path to 2026 Profitability: Challenges and Opportunities

The road to profitability in 2026 hinges on three key factors: sustaining test volume growth, maintaining pricing power, and controlling operating expenses. Adaptive's full-year 2025 operating expenses are projected at $335–$340 million, a 6% increase from 2024, indicating a focus on cost discipline. However, as the MRD market matures, the company must avoid margin compression from payer negotiations or regulatory shifts.

Opportunities lie in expanding clonoSEQ's indications beyond blood cancers and leveraging AI-driven data analytics to enhance diagnostic precision. Management's guidance for 2026 suggests continued revenue acceleration, with a focus on converting market share gains into durable cash flow.

Conclusion: A Strategic Bet on MRD's Future

Adaptive Biotechnologies is well-positioned to capitalize on the MRD diagnostics gold rush, combining strong revenue growth, improving unit economics, and a defensible market position. While challenges such as reimbursement pressures and competitive dynamics persist, the company's operational discipline and innovation pipeline make it a compelling candidate for 2026 profitability. For investors, the key will be monitoring test volume trends, ASP sustainability, and the pace of new indication approvals-factors that will determine whether Adaptive's MRD ambitions translate into lasting value.