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TEM vs. GH: Which AI in Precision Oncology Stock Has More Upside Now?

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Key Takeaways

  • GH raised 2025 revenue guidance to $880-$890M, driven by rising test volume and ASPs.
  • TEM posted 75% revenue growth and a $200M foundation model deal but remains unprofitable.
  • GH expects breakeven for non-screening ops by Q4 2025, with lower cash burn excluding Shield.

Tempus AI (TEM - Free Report) and Guardant Health (GH - Free Report) are two dominant players in the field of AI-powered precision oncology. Tempus, newly public and rapidly scaling, reported a 75% year-over-year revenue growth in the first quarter of 2025, fueled by surging demand in genomics testing and a landmark $200 million data licensing deal with AstraZeneca (AZN - Free Report) and Pathos to build a foundational AI model in oncology. Meanwhile, Guardant Health continues to strengthen its liquid biopsy and early cancer detection foothold with its core oncology products and screening test Shield, achieving positive gross margins for the first time in the first quarter.

Year to date, shares of Tempus AI and Guardant Health have surged 102.4% and 60.9%, respectively, handily outperforming the broader Medical sector’s 4.4% dip and the S&P 500’s 1.4% rise. This outsized growth reflects investor confidence in their differentiated value propositions and long-term potential in a rapidly digitizing healthcare environment.

Share Price Comparison

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With both companies showing promise, the question arises: which stock is the better buy at this moment? Let's delve deeper.

Reasons to Be Bullish on Tempus AI

Explosive Growth With Strengthening Operating Leverage: Tempus AI is scaling at an impressive pace, reporting a 75.4% year-over-year increase in first-quarter revenues, driven by 89% growth in genomics revenues, including strong gains across both oncology and hereditary testing. At the same time, TEM is exhibiting meaningful operating leverage, with gross profit nearly doubling (up 99.8% year over year) and adjusted EBITDA improving by $27.8 million year over year. This performance led management to raise full-year guidance to $1.25 billion, implying around 80% annual growth.

Strategic Biopharma Alliances and Scalable Data Licensing Model: Tempus AI is rapidly evolving from a clinical testing provider into a data-driven platform company. As stated earlier, its $200 million, three-year data licensing and foundation model development deal with AstraZeneca and Pathos brings the company’s total remaining contract value to over $1 billion, positioning Tempus AI at the forefront of AI-powered oncology R&D. Complementing this, the company’s Data and Services revenues grew 43% year over year, driven by a 58% surge in its high-margin Insights business. This highlights TEM’s ability to monetize its vast multimodal datasets, creating a recurring, scalable revenue stream with long-term growth potential.

However, despite strong revenue growth and strategic wins, Tempus AI remains unprofitable, posting a Q1 adjusted EBITDA loss of $16.2 million. Its high-profile foundation model deal with AstraZeneca and Pathos also involves complex accounting and sizable compute costs. Meanwhile, the hereditary testing segment, though growing, operates in a competitive, potentially commoditizing market.

Reasons to Be Bullish on Guardant Health

Raised Guidance and Reveal’s Breakthrough Bolster Growth Outlook: Guardant Health raised its full-year 2025 revenue guidance to $880-$890 million (up from $850-$860 million), driven by stronger-than-expected test volume and average selling prices (ASPs), particularly in its core oncology business. Oncology revenues are now projected to grow 18%, with test volumes expected to rise more than 25% year over year, underscoring robust demand for Guardant360 and Reveal.

Critically, Reveal turned gross margin positive in the first quarter after a more than 50% reduction in cost per test and improved reimbursement (>$600 ASP) following Medicare coverage for CRC surveillance. With strong uptake already in breast cancer and upcoming data to support immuno-oncology use, Reveal is poised to become a high-growth, high-margin MRD franchise, solidifying Guardant Health’s leadership in minimal residual disease detection.

Disciplined Cash Management: GH maintained its target of company-wide cash flow breakeven by 2028, but critically, expects to reach breakeven for all non-screening operations in the fourth quarter of 2025. Excluding Shield, projected cash burn is just $25-$35 million for the year, a significant improvement. While $200 million in burn is allocated to scaling Shield, management sees this as an intentional investment to cement a first-mover advantage in early cancer detection.

Despite strong first-quarter 2025 momentum, Guardant Health remains unprofitable, with a projected $225-$235 million cash burn in 2025, driven by heavy Shield-related investments. While Shield and Reveal are now gross margin positive, their profitability depends on continued reimbursement and volume growth.

Comparing Valuation: GH is Attractively Valued Than TEM

Tempus AI is trading at a forward 12-month price-to-sales (P/S) ratio of 8.48, above its median of 8.16 over the last year. Guardant Health’s forward sales multiple sits at 6.22, above its last one-year median of 5.32. Meanwhile, TEM appears relatively more expensive than GH compared with the S&P 500 average of 5.06X.

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Average Target Price for GH Suggests a Strong Upside

Based on short-term price targets offered by 10 analysts, TEM’s average price target represents a decline of 5.2% from the last closing price of $69.10.

 

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Based on short-term price targets offered by 22 analysts, GH’s average price target represents an increase of 16.1% from the last closing price of $50.57.

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Which Stock is a Better Buy Now?

While both Tempus AI and Guardant Health are compelling long-term plays in AI-powered precision oncology, GH appears comparatively better positioned at this moment. Tempus AI, carrying a Zacks Rank #3 (Hold), offers strong growth potential with its AI-driven platform and high-profile biopharma partnerships like AstraZeneca. However, its premium valuation and ongoing losses may limit near-term upside compared to Guardant Health. GH, also a Zacks Rank #3 stock, pairs strong revenue growth with improving gross margins and disciplined cash management, with non-screening operations expected to reach breakeven by year-end. Reveal’s accelerating adoption and favorable reimbursement trends enhance its long-term potential. You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.


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