NEW YORK, February 20, 2026, 12:32 EST — Regular session
Grail shares plunged 49.5% to $51.26 by midday Friday, hitting a session low of $45.51 earlier on. Volume shot past 10 million shares by noon.
Selling picked up after a new readout from the NHS-Galleri trial in England. Grail reported that the three-year study didn’t hit its primary endpoint—a statistically significant reduction in combined stage III-IV cancers. Still, the trial noted fewer stage IV diagnoses and a four-fold jump in cancer detection rates when Galleri was added to standard screenings, within a pre-specified group of 12 high-risk cancers among roughly 142,000 participants ages 50 to 77. Grail says it’s planning to extend follow-up by another 6 to 12 months and will put more detailed results forward at ASCO. Trial investigator Charles Swanton remarked he “see[s] how profound the difference is between Stage III and Stage IV disease.” CEO Bob Ragusa added that Grail is “expanding our field-based sales and medical teams.” SEC
The NHS study isn’t just about validation—it’s a big commercial play, too. Grail, in a separate statement, pitched Galleri as a prescription-only blood test that picks up signals from over 50 types of cancer, though it hasn’t landed FDA clearance or approval yet. The company wrapped up the final piece of its premarket approval application in January—“Our teams completed Galleri’s PMA submission to the FDA in January,” CEO Ragusa said. For 2025, Grail posted revenue of $147.2 million and ended the year with $904.4 million in cash, cash equivalents, and short-term marketable securities. SEC
Canaccord Genuity’s Kyle Mikson doesn’t see much real risk to FDA approval, though he points to lingering questions over coverage. “We believe it is relatively likely that CMS will emphasize U.S.-based studies,” Mikson said, noting the Centers for Medicare and Medicaid Services’ role. Earlier this month, Reuters reported President Donald Trump signed a bill paving the way for Medicare to cover multi-cancer early detection tests starting in 2028, age-dependent. Reuters
The technical term here is “primary endpoint”—basically, the main outcome researchers target from the start. Falling short on that front tends to make both regulators and insurers think twice, regardless of solid secondary results.
With screening tests, it’s not enough just to spot cancer — the bigger issue is whether catching it sooner actually changes what happens next. Stage IV means the cancer’s already spread. Pushing diagnoses earlier could mean more ways to treat, but it also complicates follow-up steps and brings new questions about how quickly patients move through care.
There’s a chance the NHS could determine the data fall short for a national screening rollout. On the U.S. side, payers might opt to hold off and watch. Uptake could drag—FDA review or not.
Traders are eyeing how fast Grail addresses the miss—and if deeper data actually back up the claim that stage-shift gets better with each screening round. Right now, the stock’s behaving like a binary event.
Coming up, the ASCO annual meeting hits Chicago from May 29 to June 2—a period when oncology data can quickly shift sentiment. Investors are eyeing potential updates on when and how the FDA will move forward with its PMA review.
