Guardant Health pays $59M for MetaSight to add metabolomics

Guardant Health has acquired Israel-based MetaSight Diagnostics for $59 million in upfront cash, with up to $90 million in additional payments tied to regulatory approvals and commercial performance, the company said. The purchase brings mass-spectrometry multi-omics capabilities in metabolomics, lipidomics and proteomics into Guardant’s diagnostics portfolio as it moves beyond oncology screening.

The transaction is structured as a $59 million immediate payment plus contingent milestone payments that could raise the total to $149 million if targets are met. The milestone payments are explicitly tied to regulatory approvals and sales thresholds, a structure that aligns vendor incentives with product commercialization and reimbursement milestones in regulated markets.

Guardant enters the deal with momentum. The company reported $982 million in total revenue for 2025, a 33 percent increase from $739 million the prior year, and a fourth quarter revenue figure of $281.3 million, up 39 percent year over year. Oncology revenues accounted for $683.6 million in 2025, while screening revenue totaled $79.7 million and biopharma and data offerings generated $210.1 million. Company executives have publicly signaled an appetite to expand beyond cancer diagnostics into broader multi-disease detection.

MetaSight, founded in 2020 through a partnership between the healthtech fund aMoon and Israel’s Technion, is based in Rehovot and raised $8 million in 2024. MetaSight said its goal was to develop accurate, affordable and accessible disease diagnostics and monitoring. Its platform uses mass spectrometry to identify disease-specific biomarkers in serum samples rather than relying on next-generation sequencing approaches that many liquid biopsy developers employ.

That technical difference matters for regulatory and clinical strategy. MetaSight’s stated approach focuses on disease-specific signatures and validation pathways, with the company’s two most advanced programs targeting colorectal cancer and liver disease-associated fibrosis and other programs addressing myocardial infarction, diabetic kidney disease, and tumors of the pancreas and lungs. Observers have contrasted MetaSight’s disease-specific, mass-spec strategy with broad multi-cancer early detection efforts that search for dozens of cancer types via NGS, an area that has faced recent study setbacks.

For Guardant, the acquisition offers complementary capabilities to its NGS-based Shield test for colorectal cancer screening, which the company runs in labs in Palo Alto and Redwood City, California. Combining NGS-derived epigenomic signatures with metabolomics and proteomics could broaden the company’s ability to detect non-oncologic conditions and refine population-level screening tools, though it raises questions about regulatory harmonization, payer coverage, and clinical utility demonstration across different disease areas.

MetaSight’s low-cost testing claim also introduces public health implications; Globes reported the company had developed tests that could cost only a few dollars. If realized at scale, such cost points would affect screening strategy, reimbursement models and health system adoption.

Several details remain unclear. Guardant has not disclosed integration plans, whether MetaSight executives will join the combined organization, or specific timelines for the contingent milestones. Regulators and payers will play central roles in determining whether the mass-spec assays move from development to routine use, and how Guardant recognizes contingent consideration in its financial reporting will bear watching as the company pursues broader multi-disease detection.