Adaptive Biotechnologies Corp (ADPT) 2025 Q1 法說會逐字稿

Good day and thank you for standing by. Welcome to the Adaptive Biotechnologies first-quarter 2025 earnings conference call. (Operator Instructions) Please be advised that today's conference is being recorded.

您好，感謝您的支持。歡迎參加 Adaptive Biotechnologies 2025 年第一季財報電話會議。（操作員指示）請注意，今天的會議正在錄音。

I would now like to hand the conference over to your first speaker today, Karina Calzadilla, Head of Investor Relations. Please go ahead.

現在，我想將會議交給今天的第一位發言者，投資者關係主管卡琳娜·卡爾薩迪拉 (Karina Calzadilla)。請繼續。

Thank you, Antoine, and good afternoon, everyone. I would like to welcome you to Adaptive Biotechnologies first-quarter of 2025 earnings conference call.

謝謝你，安托萬，大家午安。歡迎您參加 Adaptive Biotechnologies 2025 年第一季財報電話會議。

Earlier today, we issued a press release reporting Adaptive financial results for the first quarter of 2025. The press release is available at www.adaptivebiotech.com. We are adopting a live webcast of this call and will be referencing a slide presentation that has been posted to the Investors Section in our corporate website.

今天早些時候，我們發布了一份新聞稿，報告了 Adaptive 2025 年第一季的財務表現。新聞稿可在 www.adaptivebiotech.com 上查閱。我們將以網路直播的方式進行本次電話會議，並將參考已發佈於公司網站「投資者」板塊的幻燈片簡報。

During the call, management will make projections and forward-looking statements within the meaning of federal security laws regarding future events and future financial performance of the company. These statements reflect management's current perspective of the business as of today.

在電話會議中，管理階層將根據聯邦安全法的定義對公司未來事件和未來財務表現做出預測和前瞻性陳述。這些聲明反映了管理層對目前業務的看法。

Actual results may differ materially from today's forward-looking statements depending on a number of factors which are set forth in our public filings with the SEC and listed in this presentation. In addition, non-GAAP financial measures will be discussed during the call and a reconciliation from non-GAAP to GAAP metrics can be found in our earnings release.

實際結果可能與今天的前瞻性陳述有重大差異，這取決於我們向美國證券交易委員會提交的公開文件中所闡述的以及本簡報中列出的許多因素。此外，電話會議期間將討論非公認會計準則 (non-GAAP) 財務指標，非公認會計準則 (non-GAAP) 與公認會計準則 (GAAP) 指標的對帳可在我們的收益報告中找到。

Joining the call today are Chad Robins, our CEO, Co-Founder; and Kyle Piskel, our Chief Financial Officer. Additional members from management will be available for Q&A.

今天參加電話會議的有我們的執行長兼聯合創始人 Chad Robins；以及我們的財務長 Kyle Piskel。其他管理層成員也將參與問答。

With that, I'll turn the call over to Chad. Chad.

說完這些，我會把電話轉給查德。查德.

Thanks, Karina. Good afternoon and thank you for joining us on our first-quarter earnings call.

謝謝，卡琳娜。下午好，感謝您參加我們的第一季財報電話會議。

As highlighted on slide 3, we are off to an excellent start this year, demonstrating strong execution across both top and bottom-line results. In MRD. revenue increased 34% from a year ago. Significant growth was observed in clinical volumes, ASP, and pharma sequencing. This quarter, we also received our first Medicare recurrence monitoring coverage in MCL, a key part of our strategy to grow that lifetime value of each clonoSEQ Medicare patient.

正如幻燈片 3 所強調的，我們今年開局良好，在頂線和底線業績方面都表現出強勁的執行力。在 MRD，收入比一年前增加了 34%。臨床數量、ASP 和製藥定序均顯著成長。本季度，我們還獲得了 MCL 中的第一個 Medicare 復發監測覆蓋，這是我們提高每個 clonoSEQ Medicare 患者終身價值策略的關鍵部分。

In Immune Medicine, we're making progress on our preclinical antibody program in autoimmunity. Sequencing gross margin improved by 17 percentage points year over year to 62%. At the same time, operating expenses decreased by 9%, underscoring our disciplined cost management while driving strong, sustainable growth. As a result, cash burn for the quarter was $23 million, a 38% improvement compared to the same period last year.

在免疫醫學領域，我們在自體免疫方面的臨床前抗體計劃方面取得了進展。定序毛利率年增17個百分點至62%。同時，營運費用下降了 9%，凸顯了我們嚴格的成本管理，同時推動了強勁、可持續的成長。因此，本季現金消耗為 2,300 萬美元，與去年同期相比改善了 38%。

Given the strength of our performance and sustained momentum, we are raising our full-year guidance to reflect, one, a higher MRD-revenue range; two, lower operating expense range; and three, a lower annual cash burn. Kyle will provide more detail during his remarks. Of note, our full-year outlook has minimal exposure to tariffs, trading policy updates, and a funding pressures. Importantly, I want to highlight our solid cash position of $233 million. We believe our cash on hand provides ample runway to achieve our strategic objectives without the need to raise additional capital in the current market environment.

鑑於我們強勁的業績和持續的發展勢頭，我們上調了全年業績預期，以反映以下幾點：第一，更高的 MRD 收入範圍；第二，更低的營運費用範圍；第三，更低的年度現金消耗。凱爾將在講話中提供更多細節。值得注意的是，我們的全年展望受關稅、貿易政策更新和融資壓力的影響很小。重要的是，我想強調一下我們 2.33 億美元的穩固現金狀況。我們相信，在當前市場環境下，我們手邊的現金足以讓我們實現策略目標，而無需籌集額外資金。

Let's now take a closer look at the MRG business on slide 5. Currency clinical revenue, the first quarter grew 55% versus prior year. Tests delivered reached a new record high of over 23,000 in the quarter, representing a 36% increase versus prior year and a 10% increase sequentially. Growth was once again observed in all reimburse indications. Multi-myeloma continues to be the largest contributor of U.S. closing volume at 42%, followed by ALL at 33%, CLL at 10%, DLBCL at 7% and MCL at 5%.

現在讓我們仔細看看幻燈片 5 上的 MRG 業務。貨幣臨床收入，第一季比去年同期成長了 55%。本季的測試次數創下新高，超過 23,000 次，比去年同期成長 36%，比上一季成長 10%。所有報銷指標均再次成長。多發性骨髓瘤仍是美國收盤量最大的貢獻者，佔 42%，其次是急性淋巴性白血病 (ALL) 佔 33%，慢性淋巴球白血病 (CLL) 佔 10%，瀰漫大B細胞淋巴瘤 (DLBCL) 佔 7%，套細胞淋巴瘤 (MCL) 佔 5%。

Looking at other key growth metrics in the quarter, it's encouraging to see the positive trends that align with the successful execution of our strategy. Blood-based testing contributed 44% of MRD test in the US versus 39% a year ago. The increase was primarily driven by strong growth in DLBCL and MCL tests in the community grew 42% versus prior year and 14% sequentially.

縱觀本季的其他關鍵成長指標，令人鼓舞的是，我們看到了與我們策略成功執行一致的正面趨勢。血液檢測占美國 MRD 檢測的 44%，而一年前這一比例為 39%。這一增長主要得益於社區內 DLBCL 和 MCL 檢測的強勁增長，與去年同期相比增長了 42%，與上一季相比增長了 14%。

NHL contribution jumped to 12% from 10% a year ago, driven by continued ramp in MCL and the launch of our enhanced assay and DLBCL. The number of ordering health care providers grew 31% from the prior year is now over 3,400, and our pace of EMR integrations is accelerating. We now have 27 live integrations, including 5 of our top 10 accounts. We expect to add at least 5 more accounts in the next month. We are seeing a notable lift in individual account growth rates, post integration, and growth in integrated accounts is outpacing growth in non-integrated accounts.

受 MCL 持續成長以及我們增強型檢測和 DLBCL 推出的推動，NHL 貢獻從一年前的 10% 躍升至 12%。訂購醫療保健提供者的數量比上一年增長了 31%，現在已超過 3,400 家，而且我們的 EMR 整合步伐正在加快。我們現在有 27 個即時集成，其中包括我們的前 10 個帳戶中的 5 個。我們預計下個月將增加至少 5 個帳戶。我們看到，整合後個人帳戶成長率顯著提升，整合帳戶的成長速度超過了非整合帳戶的成長速度。

In addition, we're making solid progress on our initiatives to increase clonoSEQ ASP. In Q1, ASP was north of 1,220 per test, representing a 14% year-over-year increase. Importantly, we closed and/or renegotiated six key agreements with major national payers, including Aetna, Humana, Anthem, Horizon, and two of the Blue Cross Blue Shield programs.

此外，我們在提高 clonoSEQ ASP 的措施上也取得了紮實的進展。第一季度，平均銷售價格 (ASP) 超過每次測試 1,220 美元，較去年同期成長 14%。重要的是，我們與主要的國家付款人達成和/或重新談判了六項重要協議，其中包括 Aetna、Humana、Anthem、Horizo​​n 和兩個 Blue Cross Blue Shield 計劃。

Alongside these payer wins, we've expanded our reimbursement operations team and continue to optimize revenue cycle management. Given this progress, we are confident in achieving an average ASP of $1,300 per test for fiscal year 2025, setting us up for continued future ASP growth.

除了這些付款人的勝利之外，我們還擴大了報銷營運團隊，並繼續優化收入週期管理。鑑於這一進展，我們有信心在 2025 財年實現每次測試 1,300 美元的平均 ASP，為未來 ASP 的持續成長奠定基礎。

Looking at MRD pharma on slide 6, our MRD pharma business had a strong start to the year, with sequencing revenue grew growth of 11% versus prior year. This quarter, we also recognized $4.5 million in regulatory milestones. We continued to see significant momentum following the ODAC recommendation and multi-myeloma last year.

查看幻燈片 6 上的 MRD 製藥，我們的 MRD 製藥業務今年開局強勁，測序收入比上年增長了 11%。本季度，我們也實現了 450 萬美元的監管里程碑。繼去年 ODAC 建議和多發性骨髓瘤之後，我們繼續看到了顯著的勢頭。

As you can see from the chart, over 60% of our portfolio today is a multi-myeloma, including 22 new studies, which closed in the last 12 months. The majority of these studies are using MRD as a primary or secondary endpoints, so they tend to be larger Phase 2 and 3 studies often with large milestones attached.

從圖表中可以看出，我們目前的投資組合中超過 60% 是多發性骨髓瘤，其中包括過去 12 個月內完成的 22 項新研究。這些研究中的大多數都使用 MRD 作為主要或次要終點，因此它們往往是規模較大的第 2 階段和第 3 階段研究，並且通常附有重大里程碑。

We're also seeing a halo effect from this decision in other disease states like CLL, where treatment advances are necessitating more sensitive MRD assessment in clinical trials. Additionally, we see growth opportunities for the pharma business and DLBCL as multiple companies are preparing to advance MRD-directed therapy.

我們也看到這項決定在其他疾病狀態（如 CLL）中產生的光環效應，在這些疾病狀態中，治療的進步需要在臨床試驗中進行更敏感的 MRD 評估。此外，隨著多家公司準備推進 MRD 導向治療，我們看到製藥業務和 DLBCL 的成長機會。

To wrap up on MRD, we achieved strong results for the quarter in both our clinical and pharma businesses. As shown on slide 7, the stage is set to achieve our full-year strategic goals. We are on track to end the year over 45% of clonoSEQ testing done in blood plug. We are on track with EMR integrations, including onco EMR launch with Flatiron in the second half.

總結 MRD，本季我們的臨床和製藥業務均取得了強勁的業績。如第 7 張投影片所示，我們已經準備好實現全年策略目標。我們預計在今年年底完成超過 45% 的 clonoSEQ 測試。我們的 EMR 整合工作進展順利，包括下半年與 Flatiron 合作推出 onco EMR。

We are on track to begin Phase 1 testing with NeoGenomics' in an initial set of accounts in the second half of the year. We're on track to go live with NovaSEQ X in the second half of this year, and we continue to have key data readouts span in multiple indications. Importantly, we are on track to be adjusted EBITDA positive in the second half of this year.

我們計劃在今年下半年與 NeoGenomics 在第一批客戶中開始第一階段測試。我們計劃在今年下半年推出 NovaSEQ X，並且我們將繼續獲得涵蓋多種適應症的關鍵數據讀數。重要的是，我們預計在今年下半年實現調整後 EBITDA 為正。

Now let's turn to Immune Medicine on slide 9. Our Immune Medicine business focus on two differentiated immune-based therapeutic strategies. One is in cancer with our partner, Genentech. The second is in autoimmunity based on our highly targeted precision immunology approach.

現在讓我們翻到第 9 張投影片上的免疫醫學。我們的免疫醫學業務專注於兩種差異化的免疫為基礎的治療策略。其中一個是與我們的合作夥伴 Genentech 合作治療癌症。第二個是基於我們高度針對性的精準免疫學方法的自身免疫。

Our focus this year is on three main goals. First, to generate the size and quality of data to successfully develop a digital TCR-antigen-prediction model that supports a cancer cell therapy program with Genentech. As we successfully scale our data, we're also making good progress in training and improving the performance of our AI and ML models.

我們今年的重點是三個主要目標。首先，產生足夠大小和品質的數據，以成功開發支持與 Genentech 合作的癌細胞治療計劃的數位 TCR 抗原預測模型。隨著我們成功擴展數據，我們在訓練和提高 AI 和 ML 模型效能方面也取得了良好的進展。

We're aiming to replace our TCR discovery cellular assays that digital model that can rapidly and accurately predict TCR antigen binding. This has the potential to meaningfully reduce both time and cost for selecting the best TCRs to include in hand for cell therapy, among other future, your potential high-value therapeutic applications.

我們的目標是用可以快速且準確地預測 TCR 抗原結合的數字模型來取代我們的 TCR 發現細胞分析。這有可能顯著減少選擇最佳 TCR 用於細胞治療以及其他未來潛在的高價值治療應用的時間和成本。

Our second goal is to build a robust preclinical data package for our lead T-cell depletion program in autoimmunity. We're in the process of testing and characterizing a subset of promising antibody candidates in our lead indication.

我們的第二個目標是為我們在自體免疫領域的主要 T 細胞耗竭計畫建立一個強大的臨床前資料包。我們正在對我們的主要適應症中的一組有希望的抗體候選物進行測試和鑑定。

The third goal, as we execute on these two focused therapeutic strategy, we are managing to a target immune medicine cash burn between $25 million and $30 million. We continue to strategically gate our IM R&D investments and grow our pharma business revenue to partially fund the spend.

第三個目標是，當我們執行這兩個重點治療策略時，我們的目標是將免疫藥物的現金消耗控制在 2,500 萬美元到 3,000 萬美元之間。我們將繼續策略性地控制我們的 IM 研發投資，並增加我們的製藥業務收入以部分資助支出。

Now, I'm going to pass it over to Kyle to walk through the financial results and our updated full-year guidance. Kyle.

現在，我將把會議交給凱爾，讓他介紹財務表現和我們最新的全年指引。凱爾。

Thanks, Chad.

謝謝，乍得。

Starting on slide 10, with results for the first quarter. Total revenue was $52.4 million, representing 25% growth from the same period last year. 83% of revenue came from MRD of 17% from the Immune Medicine. MRD revenue grew 34% versus prior year to $43.7 million, with clinical and pharma contributions of 65% and 35%, respectively. clonoSEQ test volume, including international, increased 36% to 23,117 tests delivered versus last year, and ASP in the US grew approximately 14%.

從第 10 張投影片開始，展示第一季的結果。總營收為 5,240 萬美元，比去年同期成長 25%。其中 83% 的收入來自 MRD，17% 來自免疫醫學。MRD 收入較上年增長 34%，達到 4,370 萬美元，其中臨床和製藥貢獻分別為 65% 和 35%。包括國際在內的 clonoSEQ 測試量與去年相比增加了 36%，達到 23,117 次測試，美國的平均售價增加了約 14%。

MRD pharma revenue grew 7% versus prior year to $15.2 million, inclusive of $4.5 million in milestones. On Immune Medicine revenue was $8.7 million, down 6% a year ago, driven by an anticipated 23% decrease in Genentech amortization, partially offset by a 12% increase in IM pharma and academic services.

MRD 製藥公司的營收較上年成長 7%，達到 1,520 萬美元，其中包括 450 萬美元的里程碑收入。免疫醫學收入為 870 萬美元，比去年同期下降 6%，主要由於基因泰克攤銷預計下降 23%，但免疫醫學製藥和學術服務增長 12% 部分抵消了這一影響。

Moving down to P&L. Sequencing gross margin, which excludes milestones and Genentech amortization, was 62% for the quarter. This represents a significant improvement of 17 percentage points versus prior year as we leverage lower overhead costs and stable direct labor supporting increased volumes while improving pricing across both our clinical and pharma revenues.

轉到損益表。本季定序毛利率（不包括里程碑和基因泰克攤銷）為 62%。與去年相比，這顯著提高了 17 個百分點，因為我們利用較低的間接成本和穩定的直接勞動力來支持增加的銷量，同時提高臨床和製藥收入的定價。

Total operating expense for the quarter, inclusive of cost of revenue was $82 million, representing a 9% decrease from last year. This decrease was mainly driven by lower R&D spend from both MRD and the Immune Medicine businesses.

本季總營運費用（包括營業成本）為 8,200 萬美元，比去年同期下降 9%。這一下降主要是由於 MRD 和免疫醫學業務的研發支出減少所致。

As you can see from the segment reporting table at the bottom of the slide, MRD adjusted EBITDA is now at a loss of $4.1 million versus a loss of $17.3 million a year ago. This improvement of 76% is driven by both higher revenue and lower operating expense and the Immune Medicine adjusted EBITDA loss was also improved 21% versus Q1 of last year due to reductions in operating expense.

從投影片底部的分部報告表中可以看出，MRD 調整後的 EBITDA 目前虧損 410 萬美元，而去年同期虧損 1,730 萬美元。這一 76% 的成長是由更高的收入和更低的營運費用推動的，由於營運費用的減少，免疫醫學調整後的 EBITDA 虧損也比去年第一季改善了 21%。

Total company adjusted EBITDA was a loss of $12.7 million in first quarter compared to $28.2 million in the prior year. Interest expense from our royalty financing agreement with [our roadmap] was $2.9 million, which was slightly higher than interest income. Net loss for the quarter was $29.8 million.

第一季公司調整後 EBITDA 總虧損 1,270 萬美元，去年同期為 2,820 萬美元。我們與[我們的路線圖]達成的特許權融資協議的利息支出為 290 萬美元，略高於利息收入。本季淨虧損為 2,980 萬美元。

Now let's turn to our full-year 2025 updated guidance on slide 11. We are raising our full-year MRD revenue guidance to a range of $180 million to $190 million, up from our previous range of $175 million to $185 million. This increase is driven by stronger-than-expected clinical volume performance in the first quarter and higher MRT milestone payments anticipated for the year.

現在讓我們來看看第 11 張投影片上的 2025 年全年更新指南。我們將全年 MRD 收入預期從先前的 1.75 億美元至 1.85 億美元上調至 1.8 億美元至 1.9 億美元。這一增長是由於第一季臨床量表現強於預期以及預計今年 MRT 里程碑付款將增加。

Given the strong clonoSEQ test volumes in the quarter and the momentum we are seeing, we now expect approximately 30% growth in 2025 volume versus 2024, and we anticipate sequential growth in the remainder of the quarters. We also expect revenue from MRD milestones to be between $8 million and $9 million, up from our previous guidance of $6 million to $7 million.

鑑於本季強勁的 clonoSEQ 測試量和我們看到的勢頭，我們現在預計 2025 年的測試量將比 2024 年增長約 30%，並且我們預計剩餘季度將連續增長。我們也預期 MRD 里程碑的營收將在 800 萬至 900 萬美元之間，高於我們先前預測的 600 萬至 700 萬美元。

With respect to revenue trends throughout the year, we now expect MRD revenue to be approximately 45, 55 weighted between the first and second half, respectively. We are also lowering our full-year total company operating expense guidance, including cost of revenue, to a range of $335 million to $345 million, down from the previous range of $340 million to $350 million. We continue to expect approximately 69% of the spend to be driven by the MRD business and 23% by the Immune Medicine business with the remainder attributed to unallocated corporate costs.

對於全年的收入趨勢，我們現在預計 MRD 收入在上半年和下半年的權重分別約為 45% 和 55%。我們也將全年公司總營運費用預期（包括收入成本）從先前的 3.4 億美元至 3.5 億美元下調至 3.35 億美元至 3.45 億美元。我們仍預期約 69% 的支出將來自 MRD 業務，23% 來自免疫醫學業務，其餘部分將歸因於未分配的公司成本。

Lastly, if we are also lowering our full-year total company cash burn guidance to a range of $50 million to $60 million, down from the prior range of $60 million to $70 million. This improvement is prime generally driven by higher-than-expected MRD revenue and reduced unallocated corporate burn. We now expect approximately 24% of this year's cash burn to come from the MRD business, still anticipate burn from the Immune Medicine business to be between $25 million and $30 million for the remainder attributed to unallocated corporate costs.

最後，我們也將全年公司現金消耗總額預測從先前的 6,000 萬至 7,000 萬美元下調至 5,000 萬至 6,000 萬美元。這種改善主要是由於高於預期的 MRD 收入和減少的未分配企業消耗所致。我們現在預計今年約 24% 的現金消耗來自 MRD 業務，同時預計免疫醫學業務的消耗將在 2,500 萬美元至 3,000 萬美元之間，其餘部分歸因於未分配的公司成本。

We remain focused on disciplined execution to drive sustainable growth while managing our resources responsibly, and I look forward to providing you with further financial updates throughout the year.

我們將繼續專注於嚴格的執行，以推動永續成長，同時負責任地管理我們的資源，我期待全年為您提供進一步的財務更新。

With that, I'll hand it back over to Chad.

說完這些，我就把權力交還給查德。

Thanks, Kyle.

謝謝，凱爾。

Our strong first-quarter results underscore the focus, agility, and execution of our team for operating from a position of strength and have high confidence in our ability to deliver on our raised full-year guidance. As we look ahead, we remain committed to delivering on our promises and creating lasting value for both patients and our shareholders.

我們強勁的第一季業績凸顯了我們團隊的專注力、敏捷性和執行力，我們對自己實現全年預期的能力充滿信心。展望未來，我們將繼續致力於兌現承諾，為患者和股東創造持久價值。

I'd like now to turn the call back over to operator and open up for questions.

現在我想將電話轉回給接線員並開始回答問題。

Thank you. At this time, we will conduct a question-and-answer session. (Operator Instructions)

謝謝。屆時，我們將進行問答環節。（操作員指示）

Meg Sykes, Goldman Sachs.

高盛的梅格·賽克斯 (Meg Sykes)。

Thanks for taking our questions. You've got Will on for Matt here. Congrats on the quarter and appreciate the color on the 30% volume growth with sequential improvement over the course of the year.

感謝您回答我們的問題。這裡讓威爾取代馬特。恭喜本季取得的成績，並欣賞 30% 的銷量成長以及全年的連續改善。

Just wanted to dig a little deeper there. Are there any specific indications you're seeing gross? And how are you seeing contribution from each of the indications trending over the course of this year?

只是想深入挖掘一下。有沒有具體跡象表明您看到了噁心的東西？您如何看待今年各指標趨勢的貢獻？

Yes. Thanks, Will. I'm going to hand it over to Susan.

是的。謝謝，威爾。我要把它交給蘇珊。

Thanks for the question. Yes, we're seeing sequential growth across all indications. We had particularly strong quarter for our lymphoma indication, DLBCL and mantle cell lymphoma. You'll recall that we've launched the mantle cell indication just in Q4 and two are seeing a nice conversion of the promotional effort over the last two quarters. And then in DLBCL, we launched an enhanced version of our assays and also saw the availability of our assay in New York State under court approval become live in Q1. So a number of factors that contributed there.

謝謝你的提問。是的，我們看到所有跡像都呈現連續成長。我們的淋巴瘤適應症、DLBCL 和套細胞淋巴瘤在本季表現尤為強勁。您會記得，我們​​剛剛在第四季度推出了套細胞指示，並且在過去兩個季度中，促銷活動取得了良好的轉換效果。然後，在 DLBCL 中，我們推出了增強版的檢測方法，並且在第一季度，經法院批准，我們的檢測方法在紐約州可以投入使用。有很多因素導致了這一現象。

In terms of contribution across the indications, over the last, let's say year, quarter by quarter, the contribution has remained relatively stable where we're seeing the uptick in DLBCL and NPL, which now contribute a total of 12%, as Chad noted, versus 10% a year ago, mostly taking from other indications. And we've made, as you know, a concerted effort to move our business further toward our Medicare-covered indications. So that's actually a great shift that we've been able to see.

就各項適應症的貢獻而言，在過去一年中，每個季度的貢獻都保持相對穩定，其中我們看到瀰漫大B細胞淋巴瘤 (DLBCL) 和惡性腫瘤不良反應 (NPL) 的貢獻都有所上升，正如 Chad 指出的那樣，目前這兩種疾病的總貢獻率為 12%，而一年前為 10%，主要來自其他適應症。如您所知，我們已做出一致努力，使我們的業務進一步向醫療保險覆蓋的適應症邁進。所以這其實是我們能夠看到的一個巨大轉變。

That's super helpful. And then just as a follow up, you touched on the EMR integration on the call. I know last we talked about like 30%-plus improvements in the smaller customers and waiting for updates on some of the larger ones. Are we ready to give updates on the larger ones or quantify the uptake you're seeing there?

這非常有幫助。然後作為後續問題，您在通話中談到了 EMR 整合。我知道上次我們談到小客戶有 30% 以上的改善，並且正在等待一些大客戶的最新情況。我們是否準備好對較大的事件進行更新或量化您在那裡看到的吸收量？

I do have a few more updates and I can share. So we've started to analyze the data across both accounts that have been live for at least one year, and then also now have 5 of our top 10 largest accounts and integrated, several which just went live in Q1, but I can share some data.

我確實還有一些更新可以分享。因此，我們開始分析已上線至少一年的兩個帳戶的數據，現在我們還整合了前 10 個最大帳戶中的 5 個，其中幾個剛剛在第一季度上線，但我可以分享一些數據。

So first, let's start with accounts that have been live for at least a year. Yes, these are generally smaller accounts but there are a couple of larger ones in there as well. Six of those seven accounts exceeded 75% year-over-year growth over the past year since going live. And, in total, the volume in that group of accounts went -- more than doubled over the past year.

首先，讓我們從已運行至少一年的帳戶開始。是的，這些通常都是較小的帳戶，但其中也有幾個較大的帳戶。其中六個帳戶自上線以來，在過去一年中同比增長率超過 75%。總體而言，該組帳戶的交易量在過去一年中增長了一倍多。

Among the newer sites that went live, let's say, went live in the past quarter, which included three of our largest accounts. We saw an average quarter-over-quarter growth of 27%, and that exceeded the 18% we saw in the same sites a quarter immediately preceding integration. So we are seeing -- continuing to see an acceleration, I think particularly in those large accounts, those growth rates are quite -- I'm quite pleased with them.

在上個季度上線的新網站中，包括了我們最大的三個帳戶。我們看到平均季度環比增長率為 27%，超過了整合前一個季度同一站點的 18% 的增長率。因此，我們看到 - 繼續看到加速，我認為特別是在那些大帳戶中，這些增長率相當 - 我對它們非常滿意。

Really impressive results are. Thank you for the color.

結果確實令人印象深刻。謝謝你的顏色。

You bet.

當然。

Mark Massaro, BTIG.

BTIG 的馬克馬薩羅。

Hey, guys, thank you for taking the questions. I wanted to start with the strong performance on the core clonoSEQ volume number. It looks like it was up, I think, 2000 tests sequentially. Other labs in the space have talked about whether I think we're seeing impacts of roughly 100 bps to 150 bps across other reference labs.

嘿，夥計們，感謝你們回答問題。我想從核心 clonoSEQ 卷數的強勁表現開始。我認為，看起來它已經連續進行了 2000 次測試。該領域的其他實驗室已經討論過我是否認為我們在其他參考實驗室中看到了大約 100 bps 到 150 bps 的影響。

So I'm just curious how to do drive the growth. Where did it come from? I know you talked about a larger contribution from clonoSEQ blood, but maybe could you spell out if you had a weather impact in Q1?

所以我只是好奇如何推動成長。它是從哪裡來的？我知道您談到了 clonoSEQ 血液的更大貢獻，但您能否說明第一季是否受到了天氣的影響？

Sure. I can take that. Thanks, Mark.

當然。我可以接受。謝謝，馬克。

We did not see any notable weather impacts this particular quarter. The big growth drivers, one that I noted was non-Hodgkin's lymphoma indications with DLBCL and NPL. We did see an increasing the total contribution of blood. A lot of that was driven by the DLBCL & MPL, which are both blood, entirely blood-based indication.

本季我們沒有發現任何明顯的天氣影響。我注意到，最大的成長動力之一是 DLBCL 和 NPL 等非何杰金氏淋巴瘤適應症。我們確實看到血液總貢獻量增加。這在很大程度上是由 DLBCL 和 MPL 推動的，它們都是血液疾病，完全基於血液的疾病。

Additionally, the acceleration of our EMR integration, we added seven accounts since the end of last year, and several of those three of those are among our top 10. And so the acceleration we're seeing in utilization in those accounts certainly contribute and I am optimistic that as we continue to increase the pace of EMR integrations, we'll continue to see good contribution from those sites.

此外，隨著我們 EMR 整合的加速，自去年年底以來我們增加了 7 個帳戶，其中三個帳戶都位列前十名。因此，我們看到這些帳戶利用率的加速無疑做出了貢獻，我樂觀地認為，隨著我們繼續加快 EMR 整合的步伐，我們將繼續看到這些網站的良好貢獻。

Yes. I'll just kind of add to that, Mark. As we talked about -- it's not any one thing. It's a combination of these strategic factors that I kind of checked off through my prepared remarks. All those things that I've mentioned together are coming together and are executing on the strategy of blood-based testing, increasing community accounts, EMR integrations, et cetera. And obviously, with the launch of the new indications on top of that, those are starting to be a really nice uptake from the clinical community.

是的。我只是想補充一點，馬克。正如我們所說的——這不是任何一件事。這些策略因素的組合是我在準備好的發言中已經核對過的。我提到的所有這些事情都匯集在一起，並正在執行基於血液的測試、增加社區帳戶、EMR 整合等策略。顯然，隨著新適應症的推出，這些適應症開始得到臨床界的正面回應。

Sounds good. Yes, that makes perfect sense. Sorry, Chad?

聽起來不錯。是的，這很有道理。抱歉，查德？

No, I was just saying, you know, we had started off and said we're 25%-plus growth with the emphasis on the plus. And now I think we're quite confident in our 30% growth kind of modified range.

不，我只是說，你知道，我們已經開始了，並且說我們的成長率超過了 25%，而且重點是正數。現在我認為我們對 30% 的成長修正範圍非常有信心。

Okay, perfect. I wanted to ask about the $4.5 million milestone payment in Q1. You are now a little over halfway towards your revised goal. So I'm just curious, is there any change to the funnel? My impression is that maybe the funnel is (technical difficulty) following the big catalysts you had last year with the [odac]. I just wanted to get a sense for how you think about the timing of recognizing these throughout the year.

好的，完美。我想問一下第一季 450 萬美元的里程碑付款。現在，您距離修改後的目標已經過了一半多一點。所以我很好奇，漏斗有什麼改變嗎？我的印像是，也許這個漏斗（技術難度）是繼去年的重大催化劑之後出現的。[odac]。我只是想了解您如何看待在一年中識別這些內容的時間。

Thanks, Mark, for the color. As you know, as it relates to the funnel, I think what's happening is more and more milestones are becoming available to us. Certainly, we're adding more and realizing more from an offsetting factor. But we are having more come earlier and the realization we experienced in Q1 with a couple of milestones coming through, I think just provides us more clarity and confidence in our 2025 outlook and with potential rooms for upside even further from that.

謝謝馬克，謝謝你的顏色。如您所知，由於它與漏斗相關，我認為正在發生的事情是，我們可以實現越來越多的里程碑。當然，我們正在增加更多，並從抵消因素中實現更多。但我們提前取得了更多進展，並且我們在第一季度實現了幾個里程碑，我認為這讓我們對 2025 年的前景更加清晰、更有信心，並且還有進一步上漲的潛在空間。

But we wanted to kind of be prudent with all the stuff that's gone on with the FDA and just hold the dial a little cautious from that perspective. But all that being said, I think we're seeing more and more trials read out in all these things are positive for our business.

但我們希望對 FDA 所做的一切都保持謹慎，從這個角度來看，我們要謹慎行事。但話雖如此，我認為我們看到越來越多的試驗表明，所有這些事情對我們的業務都是有利的。

Okay, great. And last one for me. I'm Chad, you rattled off a number of large health plan, so it's nice to see that positive momentum building there. Can you give us a sense for, you know, to what extent are you contracting or are being disciplined with the higher Medicare rate that you have perhaps as a baseline? I'm just curious how that pricing and contracting discussions are going as it relates to pricing?

好的，太好了。對我來說這是最後一個。我是查德，你剛剛列舉了許多大型健康計劃，很高興看到那裡正在形成積極的勢頭。您能否告訴我們，您在多大程度上受到了約束，或者受到了以更高的醫療保險費率為基準的約束？我只是好奇定價和簽約討論進展如何，與定價有關？

You know, is a great question, Mark. We inject a significant amount of discipline in our pricing, meaning we will not accept a contracted rate unless it's at or very close to the Medicare rate. We have (technical difficulty)

你知道，這是一個很好的問題，馬克。我們在定價中註入了相當嚴格的紀律，這意味著我們不會接受合約價格，除非它等於或非常接近醫療保險價格。我們有（技術難度）

Okay, great. Thanks, guys.

好的，太好了。謝謝大家。

You bet.

當然。

David Westenberg, Piper Sandler.

大衛‧韋斯滕伯格、派珀‧桑德勒。

Thanks for taking my question. So I wanted to ask on your so many different multiple myeloma trials. I'm guessing at a lot of times with drugs, you might see tighter testing intervals. Is there kind of a way to show better outcomes through tighter testing intervals? And I'm just like maybe thinking about that as multiple myeloma and all the clinical trial as you're in. But you know, maybe some of the other indications as well could benefit from tighter intervals.

感謝您回答我的問題。所以我想問你參加過這麼多不同的多發性骨髓瘤試驗的情況。我猜很多時候，對於藥物，你可能會看到更嚴格的檢測間隔。有沒有辦法透過更緊密的測試間隔來顯示更好的結果？我可能只是將其視為多發性骨髓瘤以及您所參加的所有臨床試驗。但您知道，也許其他一些跡像也可能因更緊密的間隔而受益。

Yes. That's an interesting question, David. I mean, I think what you mean by tighter, of course, is more frequent testing, if I'm correct on.

是的。這是一個有趣的問題，大衛。我的意思是，如果我沒記錯的話，你所說的更嚴格當然是指更頻繁的測驗。

Yes.

是的。

And so there's clearly a balance here, but in general, because, of course, the increases across the study. But in general, we are seeing greater interest in increased frequency of testing. In some indications, in particular, the kinetics of disease can be indicative of the patient's performance over time and so on. Additionally, because the FDA has -- in myeloma, they specified a certain range within which have primary endpoint can be defined. It's generally served within the 9 to 15 months of the start of therapy.

因此這裡顯然存在平衡，但總的來說，當然，因為整個研究都在增加。但總體而言，我們看到人們對增加測試頻率的興趣越來越大。在某些適應症中，特別是疾病動力學可以指示患者隨時間的表現等等。此外，由於 FDA 在骨髓瘤方面指定了可以定義主要終點的某個範圍。通常在治療開始後的 9 至 15 個月內進行。

And so for that those studies, we do see people utilizing multiple time points stability, give themselves some optionality. And additionally, I think over time, we'll see that in the leukemia in DLBCL, which are increasingly blood-based indications. The frequency of the testing is certainly a conversation topic in many of these trial designs.

因此，對於這些研究，我們確實看到人們利用多個時間點的穩定性，給自己一些選擇權。此外，我認為隨著時間的推移，我們會看到 DLBCL 白血病越來越多地成為基於血液的適應症。在許多此類試驗設計中，測試頻率無疑是一個討論主題。

Got it. Very helpful. And then I just wanted to ask about technology or addressing market and adjacencies. Don't get me wrong. I mean, you just recently got into DLBCL and that's a very large market. So you definitely have a large market that itself. But is there any technology or any kind of way to address other maybe blood malignancies. And then or you know, maybe that and improvements in terms of the technology in terms of getting to greater sensitivity? I mean, I'm guessing 10 to the minus eights probably really difficult to do, but maybe you can improve like the confidence interval where the --.

知道了。非常有幫助。然後我只想問一下有關技術或解決市場和鄰接問題。別誤會我的意思。我的意思是，您最近才進入 DLBCL 領域，這是一個非常大的市場。所以你肯定擁有一個巨大的市場。但是有沒有什麼技術或方法可以治療其他血液惡性腫瘤呢？然後或者你知道，也許是在技術方面有所改進，從而獲得更高的靈敏度？我的意思是，我猜 10 的負 8 次方可能真的很難做到，但也許你可以改進置信區間，--.

Yes. I mean, I think the way I can answer that, as I say that we are absolutely at all times looking at ways that we can continue to enhance our technology and improving the sensitivity. And to some extent, the sensitivity, the assay is simply limited by the amount of input material, right? We're also balancing that with what's practical in the queue clinic or hospital for our clinical trial.

是的。我的意思是，我認為我可以這樣回答，正如我所說，我們絕對一直在尋找能夠繼續增強我們的技術和提高靈敏度的方法。並且從某種程度上來說，靈敏度、分析僅僅受到輸入材料數量的限制，對嗎？我們也在平衡排隊診所或醫院臨床試驗的實際情況。

And so we are actively looking at a number of strategies that could allow us to continue to extend the sensitivity in practical settings as well as ways that we might enhance the technology or even new technological approaches we could bring on to solve some of the problems that continue to exist on in this space.

因此，我們正在積極研究多種策略，這些策略可以讓我們繼續提高實際環境中的靈敏度，以及我們可以增強技術的方法，甚至可以採用新的技術方法來解決這個領域中仍然存在的一些問題。

For example, at the very strong desire in the clinic for up an entirely blood-based approach to MRD, monitoring in multiple myeloma, which is something we can support, but that there may still be ways to improve upon.

例如，臨床上非常希望採用完全基於血液的方法來監測多發性骨髓瘤的 MRD，這是我們可以支持的，但仍有改進的地方。

Got it. Thank you very much for taking the questions and congrats on the quarter.

知道了。非常感謝您回答這些問題，並祝賀本季度取得的成績。

Thank you.

謝謝。

Thanks, David.

謝謝，大衛。

Tejas Savant, Morgan Stanley.

摩根士丹利的 Tejas Savant。

Hello. This is Yuko on the call for Tejas. Thank you for taking my questions. Just regarding the FX integration, in addition to the volume lift from the EMR integrate accounts are also realizing associated cost savings, productivity gains as a result? If so, what can I mean in the context of your goal to have 50% of your ordering volume coming from EMR integration by year end? And is that factored into your updated OpEx guide as well?

你好。我是 Yuko，正在為 Tejas 打電話。感謝您回答我的問題。僅就 FX 整合而言，除了 EMR 整合帳戶的交易量提升之外，是否還能實現相關的成本節約和生產力提高？如果是這樣，那麼在您設定的到年底 50% 的訂購量來自 EMR 整合的目標背景下，我的意思是什麼？這也考慮到了您更新的 OpEx 指南中嗎？

Yes. Thanks for the question, Yuko. So it's an interesting one because, of course, most of the volume that we have going through integration is really only been going through integration for the past one to two quarters at most. But I think that where you're headed is a fair. The idea that there are potentially operational efficiency to be gained in the medium to long term as more and more of our volume goes through these integrations.

是的。謝謝你的提問，Yuko。所以這是一個有趣的問題，因為，當然，我們經歷整合的大部分業務實際上最多只是在過去一到兩個季度內經歷了整合。但我認為你要去的地方是公平的。隨著我們業務量不斷增加，透過這些整合，中長期內有可能提高營運效率。

I can tell you just as an anecdote that the largest account -- our number one largest account integrated in October, and they have told us that under their measurement, they have achieved a 90% decrease in callbacks from our staff to address order discrepancies since integration.

我可以告訴你一個軼事，最大的帳戶——我們最大的帳戶在十月份進行了整合，他們告訴我們，根據他們的衡量標準，自整合以來，我們員工為解決訂單差異而提出的回電次數減少了 90%。

As you can imagine, that's also not just saving them time, which is fantastic, also saving up time on that particular account. If we can achieve even half that improvement in callbacks, that other accounts and over at a scale, you can imagine that can help us either redirect our staff time or save staff time entirely. But I don't -- we have not incorporated any operational savings into our guide in 2025 at this time and we'll be continuing to monitor that. There are a number of ways by the way beyond just reducing callbacks on orders that we can leverage EMR to reduce total operational time. But those gains will be probably achieved over the next couple of years.

你可以想像，這不僅節省了他們的時間，這非常棒，也節省了那個特定帳戶的時間。如果我們能夠在回撥方面實現哪怕是一半的改進，那麼其他帳戶和規模都可以，你可以想像這可以幫助我們重新安排員工的時間或完全節省員工的時間。但我不知道——我們目前還沒有將任何營運節省納入到 2025 年的指南中，我們將繼續監控這一點。順便說一下，除了減少訂單回調之外，我們還可以利用 EMR 來減少整體營運時間。但這些收益可能會在未來幾年內實現。

And then one other area of potential upside is looking at revenue cycle management and being able to leverage our EMR integrations to kind of reduce have time for time to cash.

然後，另一個具有潛在優勢的領域是專注於收入週期管理，並能夠利用我們的 EMR 整合來減少兌現時間。

All right. That's super helpful. And then second unrelated question. With a number of headlines around cost cutting at pharma, is it possible to see more back-end loaded or milestone-based agreements with pharma versus pay-as-you-go type of contract? Have you seen any shifts and types of MRD agreements with pharma over the last six months or so?

好的。這非常有幫助。然後是第二個不相關的問題。隨著有關製藥公司成本削減的新聞不斷出現，是否有可能看到製藥公司簽訂更多後端加載或基於里程碑的協議，而不是現收現付類型的合約？在過去六個月左右的時間裡，您是否看到與製藥公司的 MRD 協議有任何變化和類型？

Well, actually, I've mentioned this on a couple of investor conferences. We're actually trying to, over time when contracts come up for renewal, do the opposite of that, which is to move more to recurring revenue-model business to kind of front-loaded of could have, well I'll say the fee for services sequencing component of that and move away from some of the kind of lumpy or hard to predict from a time perspective kind of milestones.

嗯，實際上，我在幾次投資者會議上都提到過這一點。實際上，隨著時間的推移，當合約需要續約時，我們試圖做相反的事情，即將更多的業務轉向經常性收入模式，這種模式可以預先加載，好吧，我會說服務費的排序部分，並擺脫一些從時間角度難以預測的里程碑。

So you know, it really depends on the focus of pharma companies and indications that they're doing. But we have not seen that and don't anticipate being impacted by it.

所以你知道，這實際上取決於製藥公司的重點和他們正在做的事情的跡象。但我們尚未看到這種情況，並且預計不會受到其影響。

Got it. Thank you so much.

知道了。太感謝了。

You bet.

當然。

Rachel Vatnsdal, JPMorgan.

摩根大通的 Rachel Vatnsdal。

Hi, this is Sebastian Sandler on for Rachel, thanks for taking the questions. I'd like to turn back to the strong sequential growth in quantity volumes. I think it was one of the best step-ups in terms of absolute test since 4Q '23 against slides the [ground] 2000.

大家好，我是 Sebastian Sandler，代表 Rachel 回答問題。謝謝您的提問。我想回顧一下數量連續強勁增長的情況。我認為，就絕對測試而言，這是自 2023 年第四季以來針對 2000 年滑坡進行的最好的升級之一。

So just looking ahead to the rest of the year, I'm wondering if the surround 2000 test step-up is appropriate. And then I'm curious if there's any further upside to the acceleration based on the number of drivers you laid out in the call.

因此，展望今年剩餘的時間，我想知道環繞 2000 測試升級是否合適。然後我很好奇，根據您在電話中列出的驅動程式數量，加速度是否還有進一步的上升空間。

Sure, thanks for the question, Sebastian. I mean, I am very pleased to see the volume growth in Q1 step-up only strengthens my confidence in our potential for the remainder of the year. As you know, when we started the year, we talked about there being an upside. And I think some of that materialize in Q1.

當然，謝謝你的提問，賽巴斯蒂安。我的意思是，我很高興看到第一季銷量的成長，這只會增強我對我們今年剩餘時間的潛力的信心。正如你所知，當我們今年年初時，我們談論的是其好處。我認為其中一些將在第一季實現。

With this updated guidance, we still see room for upside and we do still anticipate sequential growth quarter-over-quarter, although I won't speculate on whether that the magnitude of the step-up will look the same in every single quarter. I think the reason for us being prudent on that is simply that we have a number of strategic initiatives that we are pursuing this year and that will go live in the second half. And these are just things that we haven't done before.

憑藉這一更新後的指引，我們仍然看到了上漲的空間，我們仍然預計季度環比將出現連續增長，儘管我不會猜測每個季度的增長幅度是否都相同。我認為我們對此持謹慎態度的原因很簡單，因為我們今年正在推行一些策略性舉措，這些舉措將在下半年實施。這些都是我們以前沒有做過的事。

So we're kind of erring on the side of owned under-promise and over-deliver right now versus speculating too much about how much upside to how fast that upside can be realized. EMR is a big driver, particularly in the second half, but you know, we have to see how Flatiron launch goes. Those are in accounts that are new or emerging for us. So we are going to wait and see how quickly we can leverage that to help us with our adoption of community count.

因此，我們現在傾向於少承諾多兌現，而不是過多猜測上漲空間有多大以及上漲速度有多快。EMR 是一個重要的驅動力，尤其是在下半年，但你知道，我們必須看看 Flatiron 的發布進度如何。這些對我們來說都是新的或正在出現的帳戶。因此，我們將拭​​目以待，看看我們能多快利用它來幫助我們採用社區計數。

The Epic integrations. We have a long sleeve of those plans, but not fully in our control when they get done is we need to rely on account side IT resource. So we are eager to provide further updates. But when we feel very confident, we don't see any material headwinds at this point. But it's still early in the year.

Epic 整合。我們有很多計劃，但無法完全控制它們何時完成，我們需要依賴帳戶方面的 IT 資源。因此我們渴望提供進一步的更新。但當我們感到非常有信心時，我們目前沒有看到任何實質的阻力。但現在還只是年初。

Understood. Thank you for the color. And then turning to the community settings called out and 40%-plus growth there. So curious if this was driven mostly by adding new accounts or deeper penetration into existing accounts? And then just curious on the outlook and the community setting for the rest of the year. Thank you.

明白了。謝謝你的顏色。然後轉向社區設置，那裡的成長率超過了 40%。所以很好奇這是否主要是透過增加新帳戶或更深入地滲透現有帳戶來推動的？然後我只是對今年剩餘時間的前景和社區環境感到好奇。謝謝。

Yes, you know, both we and we still we have a number of community accounts where we now have some significant volume. What we have now an account in our top 10 that is a community accounts, which by the way was one of the ones that just went live recently with an integration. In fact, our first ever non-Epic point-to-point integration, although they haven't had time to drive volume yet it just happened in April. I am as bullish about the opportunity there.

是的，你知道，我們和我們都仍然擁有一些社群帳戶，現在我們的帳戶數量相當可觀。我們現在在前十名中有一個社區帳戶，順便說一下，它是最近剛剛上線並進行了整合的帳戶之一。事實上，這是我們首次非 Epic 點對點集成，儘管他們還沒有時間推動規模，但它在 4 月就完成了。我對那裡的機會同樣充滿信心。

And so we do have accounts where we have significant penetration and where it's really about continuing to drive that depth. We also have accounts that are -- not have not ordered or are just getting started and so both contributed in Q1 to the continued growth. I'm really pleased with the work that our community-focused field team is doing.

因此，我們確實擁有具有顯著滲透力的帳戶，而我們真正要做的就是繼續推動這種深度。我們還有一些帳戶——不是沒有訂購，就是剛開始，因此兩者都為第一季的持續成長做出了貢獻。我對我們的以社區為中心的實地團隊所做的工作感到非常滿意。

I'm excited about the potential of not only our Flatiron integration to help us with the community business in the later part of the year, but also work we're doing with NeoGenomics', which albeit we will only launch in a selected group of Phase 1 accounts in the second half of this year. But in 2026 and beyond, that will be an important driver for our community footprint and our community growth pace.

我很高興看到 Flatiron 的整合不僅有潛力幫助我們在今年下半年開展社區業務，而且還有與 NeoGenomics 合作的潛力，儘管我們只會在今年下半年在部分選定的第一階段帳戶中推出這項服務。但在 2026 年及以後，這將成為我們社區足跡和社區成長步伐的重要驅動力。

Great. Thank you so much.

偉大的。太感謝了。

Tom Stevens, TD Cowen.

湯姆·史蒂文斯（Tom Stevens），TD Cowen。

Hi, guys. Thanks for taking my question and congratulations on a really strong operating quarter.

嗨，大家好。感謝您回答我的問題，並祝賀本季營運表現非常強勁。

My first one is just on the contribution of mantle cell into this year and also more broadly, just the level of new patient adds that is the number of new clonoSEQ IDs in this quarter versus 4Q. Also maybe comment on, A, the number of MCLs you expect in guidance this year and, B, the number of new patient adds as it were?

我的第一個問題只是關於套細胞對今年的貢獻，更廣泛地說，只是新患者的增加水平，即本季度與第四季度相比新的 clonoSEQ ID 的數量。另外也許可以評論一下，A，您預計今年指導中的 MCL 數量，以及，B，新增患者的數量？

I think what I can say, Tom, is that in Q1, we were very pleased with the growth. We saw a 28% quarter-over-quarter growth in the contribution of MCL was 5%, which is up from about 3.5% a year ago. That indication and you know, is the smaller indication. I think one was a significant unmet need that is well suited to the value proposition of clonoSEQ.

湯姆，我想我可以說的是，我們對第一季的成長感到非常滿意。我們看到 MCL 的貢獻較上季成長了 28%，達到 5%，高於一年前的 3.5% 左右。你知道，那個跡像是較小的跡象。我認為其中一個重要未滿足需求非常適合 clonoSEQ 的價值主張。

And certainly, we're encouraged by the recurrence monitoring coverage that we achieved earlier in Q1, which while it will change our promotional strategy, we've been promoting the importance of our serial monitoring of patients off therapy on since launch. And it certainly as strengthens our resolve to make sure we drive as we drive testing in that space because we can now get paid for a larger number of these tests, which I think our clinical very, very valuable to patients.

當然，我們對第一季早期實現的複發監測覆蓋率感到鼓舞，雖然這會改變我們的促銷策略，但自推出以來，我們一直在宣傳對接受治療的患者進行連續監測的重要性。這無疑增強了我們確保在該領域繼續推進測試的決心，因為我們現在可以因進行大量此類測試而獲得報酬，我認為這對患者的臨床測試非常非常有價值。

And yes, in terms of MCL growth over time, we haven't commented specifically on the contribution of any one indication, but I do think that is possible to have higher single-digit contribution over the course of the next year or so. That is an indication, again that we believe we can penetrate quickly because of the treatment paradigm, they're being so conducive to the use of MRP.

是的，就 MCL 隨時間的增長而言，我們還沒有具體評論任何一種適應症的貢獻，但我確實認為，在未來一年左右的時間裡，有可能出現更高的個位數貢獻。這再次表明我們相信我們可以快速滲透，因為治療模式非常有利於使用 MRP。

Thank you. And just on clonoSEQ ID. I'm not sure I got that in your response.

謝謝。並且僅在 clonoSEQ ID 上。我不確定我是否從你的回覆中理解了這一點。

Right, sorry. So more generally the contribution of clonoSEQ ID, I mean, we are starting to see an increased contribution of repeat patients. This is beyond MCL for some time at the business overall. This point, it's about a third, maybe a little less 30% of our tests are IT test and then another 20%, our first MRD's and about half of the tests are repeat MRD's. That's kind of how the business breaks out right now.

好的，抱歉。因此，更普遍地說，clonoSEQ ID 的貢獻，我的意思是，我們開始看到重複患者的貢獻增加。這已經超出了 MCL 一段時間以來的業務總體水平。就這一點而言，我們的測試中大約有三分之一（可能略少於 30%）是 IT 測試，另外 20% 是我們的第一次 MRD，大約有一半的測試是重複 MRD。這就是目前業務爆發的方式。

Cool. And then just one more follow-up on just kind of how you think about gross margins for the year. 62% sequencing is obviously very impressive. I know you have lots of spinning plates with our EMR initiatives into the back half. But just wondering what the public on a fee-for-service contribution to ASPs well in the quarter.

涼爽的。然後再問一個關於您對今年毛利率的看法。 62% 的排序顯然非常令人印象深刻。我知道你們在後半段為我們的 EMR 計劃做了很多忙碌的事情。但只是想知道大眾對本季收費服務對 ASP 的貢獻如何。

And I'm just to make sure that the MSC index transition is don't charge for Q3 and maybe why not raise the cash burn -- or reduce the cash burn guidance more than the [beat] in Q1?

我只是想確保 MSC 指數轉換不會對第三季度收費，也許為什麼不提高現金消耗 - 或者將現金消耗指導降低到比第一季更低的水平？

Yes. Thanks for the question, Tom. As it relates to progress on gross margins, first quarter with great. We're seeing improving -- our cost structure, improving the lab and the volume is certainly helping that. NovaSEQ is still on track for the second half of the year, and we reiterate the 5 to 8 percentage point improvement from that in the first 12 months post launch on.

是的。謝謝你的提問，湯姆。就毛利率的進展而言，第一季表現非常好。我們看到了改進——我們的成本結構、實驗室的改進和產量無疑對此有所幫助。NovaSEQ 下半年的業績仍保持在正軌，我們重申，與推出後的前 12 個月相比，業績將提高 5 至 8 個百分點。

So everything's kind of coming along with gross margin. So I don't have any concerns there and expect to see it continue to grow especially as we get more on the pricing favorability from both our clinical and pharma businesses.

所以一切都與毛利率有關。所以我對此沒有任何擔憂，並希望看到它繼續成長，特別是當我們從臨床和製藥業務中獲得更多定價優惠時。

Yes. And if you recall, Tom, we talked about 70%-plus gross margins at scale. And you know, we're a little bit ahead of pace based on strong, really strong quarter.

是的。湯姆，如果你還記得的話，我們討論過規模化毛利率超過 70% 的情況。你知道，基於強勁的季度表現，我們的步伐略有領先。

And on your question on cash burn, I think, yes, opportunity there to beat the number we put a guide. But again, we're just early. The exact timing of NovaSEQ launch, all those types of things, but certainly an opportunity for some additional upside and reducing our burn further, given the strong performance in Q1.

關於您關於現金消耗的問題，我認為是的，有機會超過我們設定的數字。但話說回來，我們來得還早。NovaSEQ 推出的確切時間，所有這些事情，但鑑於第一季的強勁表現，無疑是一個獲得額外收益並進一步減少我們燒錢的機會。

Right. So now is that like to add incremental investment in your salesforce or anything that we should be aware of?

正確的。那麼現在這是否意味著要對銷售人員增加增量投資，或者我們應該注意什麼？

Nothing currently planned. We did make some investments in our revenue cycle management are reimbursed from operations team, and we believe those are paying off accretively. But no major expansions from there.

目前尚無計劃。我們確實在收入週期管理方面進行了一些投資，並從營運團隊獲得了補償，我們相信這些投資正在獲得增值回報。但此後並沒有出現重大擴張。

Awesome. Thank you, guys.

驚人的。謝謝你們。

Thanks, Tom.

謝謝，湯姆。

Sung Ji Nam, Scotiabank.

加拿大豐業銀行的 Sung Ji Nam。

Hey, this is Corey Rosenbaum on for Sung Ji. Thanks for taking my questions and congrats on the quarter.

嘿，我是 Corey Rosenbaum，取代 Sung Ji。感謝您回答我的問題並祝賀本季取得佳績。

So first on DLBCL, do you expect the upgraded assay with the seven-fold increase in sensitivity to meaningfully change the trajectory of adoption and the indication? And could you talk about the potential use case expansion with this significant improvement in sensitivity?

那麼首先關於 DLBCL，您是否預期升級後的檢測方法靈敏度將提高七倍，從而顯著改變其採用軌跡和適應症？您能否談談靈敏度顯著提高後的潛在用例擴充？

Sure. Thanks for the question, Corey. So first off, I think that primary opportunity to leverage the enhanced assay to drive adoption. I think it's in the pharma setting rising. We've faced somewhat increased competition in recent years. And I think there is a strong desire to have a very sensitive assay [premium] in the frontline into therapy setting where a number of companies are going after study design in which patients essentially receive additional treatment of varying classes based on the fact that they are MRD in a positive, even though they've achieved conventional coal complete response by PET/CT.

當然。謝謝你的提問，科里。因此首先，我認為主要機會是利用增強的檢測方法來推動採用。我認為它在製藥業正在興起。近年來，我們面臨的競爭有所加劇。我認為，人們強烈希望在治療環境的第一線開展一種非常靈敏的檢測方法 [premium]，許多公司正在追求這樣的研究設計：患者根據 MRD 呈陽性這一事實，基本上接受不同類型的額外治療，即使他們已經通過 PET/CT 獲得了常規的煤炭完全緩解。

So that detecting disease at those levels where imaging isn't revealing anything there requires that particular degree of sensitivity compared to other use cases. And so in the pharma setting, that's where the enhanced assay has really been an important part of our messaging in our data generation.

因此，與其他用例相比，在成像無法揭示任何資訊的層面上檢測疾病需要特定的靈敏度。因此，在製藥業中，增強檢測確實是我們資料生成過程中傳遞訊息的重要組成部分。

Now, of course, in the clinic, this is important broadly as well. And we are increasing our focus on that endotherapy use case. It has a, frankly, a synergy with what's going on in clinical trials. We anticipate that over time, these clinical trials will read out. They'll be successful the opportunities for patients to be treated with additional therapy when they don't achieve MRD negativity by the end of the standard round of, let's say, R-CHOP.

當然，在臨床上，這一點也同樣重要。我們正在加大對內視鏡治療用例的關注。坦白說，它與臨床試驗中正在進行的事情有協同作用。我們預計，隨著時間的推移，這些臨床試驗將會顯現出來。當患者在標準療程（如 R-CHOP）結束時未達到 MRD 陰性時，他們將有機會接受額外治療。

And even now there are opportunities for patients to enroll and clinical trials. And so it's two-patients benefit for us to be able to provide the most sensitive at the possible in the clinical setting as well.

即使現在，患者仍有機會參加臨床試驗。因此，我們能夠在臨床環境中提供盡可能最靈敏的服務，這對兩位患者都有好處。

Great. Thank you for that insight, and I appreciate the pharma commentary throughout the call. But can you discuss the current split between later-stage clinical trials versus earlier-stage trials for the active trials underway with the MRD pharma partners?

偉大的。感謝您的見解，也欣賞整個通話過程中製藥業的評論。但是，您能否討論一下目前與 MRD 製藥合作夥伴進行的活躍試驗中後期臨床試驗與早期試驗之間的劃分情況？

The majority of our studies are in later-stage study, a later stage trial from multiple myeoloma, which is as you know, sort of [60%] of our business in the most well-developed indication. And in some of our earlier stage indications, for example, in lymphoma, we have a smaller portion of our business. The mix 10 more towards earlier-phase studies.

我們的研究大多處於後期研究，即多發性骨髓瘤的後期試驗，如你所知，這占我們業務中最成熟的適應症的 [60%]。而對於我們一些早期的適應症，例如淋巴瘤，我們的業務比例較小。該混合物更接近早期階段​​的研究。

But in general, the use of MRD is really evolving toward registrational uses, whether primary-endpoint or secondary-endpoints status and increasingly toward the utilization of MRD as a means to direct therapy, stratify patients. And so that by nature, is helping the business evolve toward a later phase, more heavily weighted mix.

但總體而言，MRD 的使用實際上正在向註冊用途發展，無論是主要終點還是次要終點狀態，並且越來越多地利用 MRD 作為指導治療、分層患者的手段。因此，從本質上來說，這有助於業務向後期更重要的組合發展。

Appreciate it. Thank you.

非常感謝。謝謝。

(Operator Instructions)

（操作員指示）

Andrew Brackmann, William Blair.

安德魯布拉克曼、威廉布萊爾。

Hey, everyone. This is Maggie [Bouie] on for Andrew. Thanks for taking our question.

嘿，大家好。我是 Maggie [Bouie]，代替 Andrew 發言。感謝您回答我們的問題。

Maybe just to start, it's nice to see a reduction in the OpEx guide for the full year. On MRD side, can you talk about any areas in particular you're seeing leverage from? And then just what other areas you think you that you could see leverage from building out from there? And then just looking further out over the next few years, where do you plan to prioritize your investment? Thank you.

也許只是開始，很高興看到全年營運支出指南的減少。在 MRD 方面，您能談談您看到哪些特別有影響力的領域嗎？那麼，您認為還有哪些領域可以從中獲益？那麼展望未來幾年，您計劃優先投資哪些領域？謝謝。

Yes. Thanks for the question. As it relates to leverage, I think we're seeing a ton of leverage across both first and foremost in the lab. Again, increasing volumes, some of the assay consolidation initiatives we put in place last year, and we're seeing the fruits of that labor payoff.

是的。謝謝你的提問。至於槓桿作用，我認為我們首先在實驗室中看到了大量的槓桿作用。再次，隨著數量的增加，我們去年實施了一些檢測整合舉措，我們看到了這些勞動成果。

Secondarily, you know, we're seeing a ton of leverage through our volumes increasing in our field force as well. So that's, you know, all of those things are driving improvements. And while we're making investments in our reimbursement operations, at least early days from those investments seem to be paying off and gaining leverage. But we'll continue to kind of monitor that. So I think all those things are pointing to a healthy profile for this business longer term.

其次，您知道，我們的現場力量也透過業務量的增加獲得了巨大的槓桿作用。所以，你知道，所有這些都在推動改進。雖然我們正在對報銷業務進行投資，但至少在早期階段，這些投資似乎正在獲得回報並產生效益。但我們會繼續監控這一點。所以我認為，從長遠來看，所有這些都表明該業務的狀況良好。

In terms of prioritizing our investments, I think some of this has been discussed previously in terms of what we do with our assay going forward. But we'll provide more color into that as things progress.

就我們投資的優先順序而言，我認為我們之前已經討論過一些關於我們未來如何進行分析的問題。但隨著事情的進展，我們會提供更多詳細資訊。

I'm sure I can just add perhaps that now a couple of things that we've talked about throughout this call will potentially be areas will be we'll see where we want to continue to invest in may ramp up investment over time. Revenue Cycle Management is the one that kind of alluded to EMR integration and related sort of technology investments that can help us increase the stickiness of our business increase our access to data that will support our ability to operate effectively. There are some potential investments we're diving there. Data generation will remain a priority for the foreseeable future in addition to some earlier stage R&D investments that we're assessing.

我確信我可以補充一點，我們在整個電話會議中討論的幾個事情可能會成為我們想要繼續投資的領域，並且隨著時間的推移可能會增加投資。收入週期管理是指 EMR 整合和相關技術投資，它可以幫助我們提高業務黏性，增加我們對數據的訪問，從而支持我們有效運營的能力。我們正在那裡進行一些潛在的投資。除了我們正在評估的一些早期研發投資外，資料生成在可預見的未來仍將是優先事項。

And then lastly, you might wonder, I didn't mention commercial field for us. We don't have any interim plans. We looked at the investment we've made and we're very comfortable with how we're covering 90% of the relevant patient population. We have reasonably sized balanced territories and reasonable numbers of HCP and account targets per rep. So we're pretty happy there. But we will evaluate whether there are additional or new deployment strategies that we might want to implement over time in response to the evolution of the market dynamics.

最後，您可能想知道，我沒有提到商業領域。我們沒有任何中期計劃。我們審視了我們所做的投資，並且對如何涵蓋 90% 的相關患者群體感到非常滿意。我們擁有合理規模的均衡區域以及每個代表合理數量的 HCP 和帳戶目標。所以我們在那裡很開心。但我們將評估是否有額外的或新的部署策略，我們可能希望隨著時間的推移實施這些策略以應對市場動態的變化。

Got it. Thank you. That was super helpful.

知道了。謝謝。這非常有幫助。

And then maybe just one on the NeoGenomics' partnership. Can you just update us on the progress you're making there and talk about what work is being done to ensure readiness for the early pilot launch and the second half of the year? And then just how you're thinking about how that will inform your full launch down the line. Thank you.

然後也許只談一個關於 NeoGenomics 的合作關係。您能否向我們介紹目前的進展，並談談為確保早期試點啟動和下半年做好準備所做的工作？然後你會思考這將如何影響你未來的全面發布。謝謝。

Sure. I'm really pleased with how that partnership has been progressing and very grateful to be working with great partners on the neo side. And the work we've been doing up until this point was to select the Phase 1 account that we wanted to target based on a variety of criteria that will allow us to gain insight to ensure that we optimize the broader national launch the beginning of next year.

當然。我對這種合作關係的進展感到非常高興，並且非常感激能夠與 Neo 方面的優秀合作夥伴一起工作。到目前為止，我們一直在做的工作是根據各種標準來選擇我們想要瞄準的第一階段帳戶，這將使我們能夠獲得洞察力，以確保我們優化明年年初更廣泛的全國發布。

We've been finalizing the TRS design and test acquisition form design. We've been designing and are creating a few direction and designing accompanying training.

我們一直在完成 TRS 設計和測試採集表設計。我們一直在設計並正在創建一些方向並設計配套培訓。

And we've been in determining how samples will actually flow between the companies, how orders and reimbursement data will flow between the companies. And we've been firming up how we will manage the handoff between various members of our cross-functional teams that face our customers. So all that work will inform the second half our Phase 1 launch and will directly benefit on the longer-term national launch.

我們一直在確定樣品在公司之間如何流動，訂單和報銷數據在公司之間如何流動。我們一直在確定如何管理面向客戶的跨職能團隊各個成員之間的交接。因此，所有這些工作都將為我們第一階段的下半年發布提供信息，並將直接有利於長期的全國發布。

Great. Thank you.

偉大的。謝謝。

I am showing no further questions at this time. Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.

我目前沒有其他問題。感謝大家參加今天的會議。該計劃確實就此結束。您現在可以斷開連線。