GRAIL Stock Tumbles Despite EPS Beat After Cancer Trial Miss

Shares of GRAIL, Inc. (Nasdaq: GRAL) cratered nearly 50% in premarket trading on Friday, February 20, 2026, after the biotech company released results from its landmark NHS-Galleri trial that failed to meet its primary clinical endpoint. The stock, which closed at $101.53 on Thursday, plummeted to $53.65 in premarket trading as investors digested the mixed data from the three-year, 142,000-participant study conducted within England’s National Health Service.

The selloff came despite GRAIL reporting a narrower-than-expected quarterly loss, underscoring how heavily the market had been pricing in a successful trial outcome for the company’s flagship Galleri multi-cancer early detection test.

Trial Results Disappoint, Despite Some Secondary Wins

The NHS-Galleri trial, the largest randomized controlled study ever conducted for a multi-cancer early detection test, failed to achieve its primary goal: a statistically significant reduction in combined Stage III and IV cancer diagnoses among participants who received the Galleri test.

Investors had long viewed a successful primary endpoint as a critical catalyst for GRAIL’s FDA premarket approval application and potential adoption by national health systems worldwide.

Despite the miss, GRAIL pointed to several encouraging secondary findings, including a greater than 20% reduction in Stage IV cancer diagnoses in the second and third screening rounds across 12 pre-specified deadly cancer types, and a four-fold improvement in overall cancer detection rates compared to standard care alone.

The company also noted a substantial reduction in cancers detected through emergency presentation, a pathway associated with significantly higher mortality and healthcare costs. CEO Bob Ragusa announced a U.S. sales force expansion on the back of these results and plans to extend the trial’s follow-up period by six to twelve months, with detailed findings expected at ASCO 2026.

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GRAL Stock Brief: Premarket Crash and Key Metrics

As of premarket trading at 7:48 AM EST on February 20, GRAL was quoted at $53.65, down $47.88 or 47.16% from its prior close of $101.53. The stock’s 52-week range of $20.44 to $118.84 illustrates its volatility, having surged over 93% in the past year before this sharp reversal.

Analysts carried an average price target of $114.40 heading into the print, with Baird initiating an Outperform rating at $113 just days earlier on February 17.

On the financial side, GRAIL’s Q4 2025 results were a genuine bright spot. The company reported a net loss of $2.44 per share, beating the consensus estimate of a $4.01 loss, while quarterly revenue reached $43.6 million – up 14% year-over-year.

Full-year U.S. Galleri revenue grew 26% to $136.8 million, more than 185,000 tests were sold in fiscal 2025, and the company ended the year with $904.4 million in cash and marketable securities, providing a financial runway management says extends into 2030.

With the FDA premarket approval application now in final review, how regulators weigh the Galleri test’s secondary benefits against the primary endpoint miss will be the key question hanging over the stock.

Disclaimer: The author does not hold or have a position in any securities discussed in the article. All stock prices were quoted at the time of writing.