Exact Sciences Corp (EXAS) 2022 Q3 法說會逐字稿

Good evening. My name is Colby and I will be your conference operator today. At this time, I would like to welcome everyone to the Exact Sciences Third Quarter 2022 Earnings Call. (Operator Instructions)

晚上好。我叫 Colby，今天我將擔任你們的會議接線員。此時，我想歡迎大家參加 Exact Sciences 2022 年第三季度財報電話會議。 （操作員說明）

I will now turn the call over to Megan Jones.

我現在將把電話轉給梅根·瓊斯。

Thanks, Colby, and I thank all of you for joining us for Exact Sciences Third Quarter 2022 Conference Call. On the call today are Kevin Conroy, the company's Chairman and CEO; and Jeff Elliott, our Chief Financial Officer and Chief Operating Officer. Everett Cunningham, our Chief Commercial Officer, will also be available for questions.

謝謝 Colby，也感謝大家加入我們參加 Exact Sciences 2022 年第三季度電話會議。今天參加電話會議的有公司董事長兼首席執行官凱文·康羅伊 (Kevin Conroy)；和我們的首席財務官兼首席運營官 Jeff Elliott。我們的首席商務官 Everett Cunningham 也將回答問題。

Exact Sciences issued a news release earlier this afternoon detailing our third quarter financial results. This news release and today's presentation are available on our website at exactsciences.com.

Exact Sciences 今天下午早些時候發布了一份新聞稿，詳細介紹了我們第三季度的財務業績。本新聞稿和今天的演示文稿可在我們的網站 exactsciences.com 上獲取。

During today's call, we will make forward-looking statements based on current expectations. Our actual results may have material differences from such statements. Discussions of non-GAAP figures and reconciliations to GAAP figures are available in our earnings press release, and descriptions of the risks and uncertainties associated with Exact Sciences are included in our SEC filings. Both can be accessed through our website.

在今天的電話會議中，我們將根據當前的預期做出前瞻性陳述。我們的實際結果可能與此類陳述存在重大差異。我們的收益新聞稿中提供了非 GAAP 數據的討論以及與 GAAP 數據的調節，我們的 SEC 文件中包含了與 Exact Sciences 相關的風險和不確定性的描述。兩者都可以通過我們的網站訪問。

I'll now turn the call over to Kevin.

我現在將電話轉給凱文。

Our third quarter results demonstrate the strength of our business and the unique platform this team has built to engage patients and physicians. Together, we're working to help fewer people turn into cancer patients and improving care for those who do.

我們第三季度的業績證明了我們的業務實力以及該團隊為吸引患者和醫生而建立的獨特平台。我們一起努力幫助更少的人變成癌症患者，並改善對那些癌症患者的護理。

During the quarter, we had record revenue of $523 million or 20% growth, excluding COVID-19 testing. We're raising our full year revenue guidance by $33 million, while decreasing our operating expense guidance by $113 million. We're also pulling forward adjusted EBITDA profitability to the third quarter of 2023 from our previous target of 2024.

本季度，我們的收入達到創紀錄的 5.23 億美元或 20% 的增長，不包括 COVID-19 測試。我們將全年收入指引提高了 3300 萬美元，同時將運營費用指引降低了 1.13 億美元。我們還將調整後的 EBITDA 盈利能力從之前的 2024 年目標提前到 2023 年第三季度。

We're building an unstoppable engine that will allow us to achieve our vision to help eradicate cancer. Our differentiated approach starts with world-class science and scientists rigorously developing tests to solve real patient needs. When launched, these tests are immediately supported by our sales and marketing teams with broad reach and deep relationships.

我們正在構建一個不可阻擋的引擎，使我們能夠實現幫助根除癌症的願景。我們與眾不同的方法始於世界一流的科學和科學家嚴格開發測試來解決真正的患者需求。推出後，這些測試會立即得到我們具有廣泛影響力和深厚關係的銷售和營銷團隊的支持。

Our well-known test, sophisticated patient navigation, electronic ordering and resulting platform, expansive lab capabilities and deep payer relationships will support new cancer tests with modest incremental investment. This fuels revenue growth and profit generation, which we'll invest in better cancer test and solutions for patients. As we quickly approach profitability, this engine is set to gain momentum with each new test dropped into the platform.

我們眾所周知的測試、複雜的患者導航、電子訂購和結果平台、廣泛的實驗室能力和深厚的付款人關係將通過適度的增量投資支持新的癌症測試。這推動了收入增長和利潤產生，我們將投資於為患者提供更好的癌症測試和解決方案。隨著我們快速接近盈利能力，該引擎將隨著每個新測試進入平台而獲得動力。

Additional highlights from the third quarter include delivering 960,000 total tests, including a record number of Cologuard and Oncotype DX results to patients; improving our adjusted EBITDA loss by more than 70% from last quarter and 86% from the first quarter; launching an innovative Cologuard collection kit to give patients more time to get their samples back to our lab; displaying the power of our multi-cancer early detection approach at the European Society for Medical Oncology Congress; and making our hereditary cancer test, Riskguard, available to oncologists through an early access program.

第三季度的其他亮點包括提供了 960,000 次總測試，包括創紀錄數量的 Cologuard 和 Oncotype DX 結果；調整後的 EBITDA 虧損比上一季度減少了 70% 以上，比第一季度減少了 86%；推出創新的 Cologuard 採集套件，讓患者有更多時間將樣本帶回我們的實驗室；在歐洲腫瘤內科學會大會上展示我們的多癌症早期檢測方法的力量；並通過早期訪問計劃向腫瘤學家提供我們的遺傳性癌症測試 Riskguard。

Jeff will now review our financial results.

Jeff 現在將審查我們的財務結果。

Thanks, Kevin. Good afternoon. Third quarter revenue grew 15% to $523 million or 20%, excluding COVID testing. Screening revenue increased 29% to $361 million, including 3 points of growth from prevention genetics. 10,000 new health care providers ordered Cologuard during the quarter and more than 292,000 have ordered since the launch as of September.

謝謝，凱文。下午好。第三季度收入增長 15% 至 5.23 億美元或 20%，不包括 COVID 測試。篩查收入增長 29% 至 3.61 億美元，其中包括來自預防遺傳學的 3 個增長點。本季度有 10,000 家新的醫療保健提供者訂購了 Cologuard，自 9 月推出以來已經訂購了超過 292,000 家。

Precision Oncology revenue grew 4% to $151 million or 9%, excluding a $2.9 million FX headwind and the sale of our prostate business. COVID testing revenue decreased 64% to $11 million. Third quarter GAAP gross margin was 68%. Non-GAAP gross margin, which excludes amortization of acquired intangibles, was 72%. This was slightly better than expected as the team find ways to partially offset inflation.

Precision Oncology 收入增長 4% 至 1.51 億美元或 9%，不包括 290 萬美元的外匯逆風和我們前列腺業務的出售。 COVID 測試收入下降 64% 至 1100 萬美元。第三季度 GAAP 毛利率為 68%。不包括收購無形資產攤銷的非美國通用會計準則毛利率為 72%。這略好於預期，因為團隊找到了部分抵消通貨膨脹的方法。

Adjusted EBITDA was a loss of $13 million, an improvement of $33 million from last quarter. We ended the quarter with cash and securities of about $670 million. Our total liquidity is about $900 million, including in our available credit facilities. During the quarter, we extended our $150 million revolving credit facility 2 years to 2025. We also have up to $100 million available on our accounts receivable facility.

調整後的 EBITDA 虧損 1300 萬美元，比上一季度增加 3300 萬美元。我們在本季度結束時擁有約 6.7 億美元的現金和證券。我們的總流動資金約為 9 億美元，包括我們可用的信貸額度。在本季度，我們將 1.5 億美元的循環信貸額度延長 2 年至 2025 年。我們的應收賬款額度也有高達 1 億美元的可用額度。

We have made significant progress on our goal to generate positive adjusted EBITDA. Thanks to our heightened focus from our team, we now expect to generate positive adjusted EBITDA starting third quarter next year, ahead of our previous target of 2024. The attractive financial profiles of Cologuard and Oncotype DX allow us to continue investing to support growth, drive efficiencies and generate profits sooner than expected while maintaining a strong cash position.

我們在實現正調整後 EBITDA 的目標方面取得了重大進展。由於我們團隊的高度關注，我們現在預計從明年第三季度開始產生積極的調整後 EBITDA，超過我們之前的 2024 年目標。Cologuard 和 Oncotype DX 具有吸引力的財務狀況使我們能夠繼續投資以支持增長，推動效率並比預期更快地產生利潤，同時保持強勁的現金狀況。

Turning to our guidance. We now expect total revenue between $2.025 billion and $2.042 billion for the year. This assumes screening revenue between $1.375 billion and $1.382 billion, including PreventionGenetics revenue between $40 million and $42 million; Precision Oncology revenue between $595 million and $600 million, including a $2.9 million fourth quarter FX headwind based on current rates; and COVID testing revenue between $55 million and $60 million.

轉向我們的指導。我們現在預計全年總收入在 20.25 億美元至 20.42 億美元之間。這假設篩查收入在 13.75 億美元到 13.82 億美元之間，包括 PreventionGenetics 收入在 4000 萬到 4200 萬美元之間； Precision Oncology 收入在 5.95 億美元至 6 億美元之間，包括基於當前匯率的 290 萬美元第四季度外匯逆風； COVID 測試收入在 5500 萬至 6000 萬美元之間。

Moving to annual operating expense guidance. We're lowering sales and marketing expense by $45 million and now expect between $825 million and $845 million. We're seeing significant leverage in total sales and marketing and now expect expense to decrease about 3% year-over-year while delivering more than 25% Cologuard growth. We're also reducing our G&A expense by $30 million and now expect between $740 million and $760 million. We expect R&D expense between $390 million and $405 million, a reduction of $38 million.

轉到年度運營費用指南。我們將銷售和營銷費用減少了 4500 萬美元，現在預計在 8.25 億美元到 8.45 億美元之間。我們看到總銷售和營銷的顯著槓桿作用，現在預計費用將同比下降約 3%，同時實現 Cologuard 超過 25% 的增長。我們還將 G&A 費用減少了 3000 萬美元，現在預計在 7.4 億美元到 7.6 億美元之間。我們預計研發費用在 3.9 億美元至 4.05 億美元之間，減少 3800 萬美元。

The team is becoming more efficient by prioritizing our highest-impact projects and reducing plant hiring. We continue to expect CapEx of about $200 million.

通過優先考慮我們影響最大的項目並減少工廠招聘，該團隊變得更加高效。我們繼續預計資本支出約為 2 億美元。

I'll now turn the call back to Kevin.

我現在將電話轉回凱文。

Thanks, Jeff. Cologuard is becoming synonymous with colorectal cancer screening. It is standard of care because it is accurate, it's a convenient at-home test. It's included in all major guidelines, quality measures and nearly universally covered by insurance with no cost to the patient. Proof points that Cologuard is becoming a preferred screening standard include nearly 10 million people have completed the test.

謝謝，傑夫。 Cologuard 正在成為結直腸癌篩查的代名詞。它是護理標準，因為它準確，是一種方便的在家測試。它包含在所有主要指南、質量措施中，並且幾乎普遍由保險覆蓋，患者無需支付任何費用。 Cologuard 正在成為首選篩查標準的證據包括近 1000 萬人完成了測試。

More than 150,000 health care providers ordered during the third quarter, a new record. We saw a 25% increase in orders from the first week of August to the last week of October, and its Net Promoter Score has nearly doubled since early 2021.

第三季度有超過 150,000 家醫療保健提供者訂購，創下新紀錄。從 8 月的第一周到 10 月的最後一周，我們看到訂單增加了 25%，其淨推薦值自 2021 年初以來幾乎翻了一番。

The longer a health care provider has been ordering Cologuard, the more ingrained it becomes in their practice. Excluding COVID disruption, every cohort of new providers orders more Cologuard tests each year. Since the start of last year, we have added 65,000 new ordering health care providers, and we expect them to follow a similar trend, increasing their order rate every year.

醫療保健提供者訂購 Cologuard 的時間越長，它在他們的實踐中就越根深蒂固。不包括 COVID 中斷，每一組新供應商每年都會訂購更多的 Cologuard 測試。自去年年初以來，我們增加了 65,000 家新的訂購醫療保健提供者，我們預計他們會遵循類似的趨勢，每年增加訂購率。

We pulled forward a major benefit of our next-generation Cologuard by launching an enhanced collection kit in September. Our talented team of scientists developed a new protein preservative to extend sample stability by 33%. This provides patients more time to ship their completed Cologuard kits back to our lab before the sample expires. We expect this to increase completed test by more than 1 percentage point next year, improving Cologuard revenue and margins.

我們在 9 月推出了增強型收集套件，從而推動了下一代 Cologuard 的一項重大優勢。我們才華橫溢的科學家團隊開發了一種新的蛋白質防腐劑，可將樣品穩定性提高 33%。這使患者有更多時間在樣品過期之前將完成的 Cologuard 試劑盒運回我們的實驗室。我們預計這將使明年完成的測試增加 1 個百分點以上，從而提高 Cologuard 的收入和利潤率。

Exact Sciences scale and reach with a 1,000-person primary care sales and marketing team and millions of touch points with patients and providers each year will power our continued leadership in colorectal cancer screening. We'll lead with an intense focus on what is best for each patient.

Exact Sciences 擁有 1,000 人的初級保健銷售和營銷團隊，每年與患者和提供者進行數百萬次接觸，從而擴大規模和影響力，這將推動我們在結直腸癌篩查領域繼續保持領先地位。我們將重點關注最適合每位患者的方法。

Colorectal cancer is the second leading cause of cancer death in the U.S., with more than 151,000 new cases and 53,000 deaths annually. As screening rates increased over the last 20 years, incidents and mortality rates decreased by 35% and 40%, respectively. The most effective screening tools help prevent the disease by detecting pre-cancer before it turns into cancer. Detecting pre-cancers contributes 2/3 of the light years game through screening and early-stage cancer detection provides most of the rest.

結直腸癌是美國癌症死亡的第二大原因，每年有超過 151,000 例新病例和 53,000 例死亡。隨著過去 20 年篩查率的提高，事故率和死亡率分別下降了 35% 和 40%。最有效的篩查工具通過在癌症變成癌症之前檢測癌前病變來幫助預防疾病。通過篩查檢測癌前病變佔光年遊戲的 2/3，其餘大部分由早期癌症檢測提供。

That's why we develop Cologuard, and it's making a difference. Because it detects 42% of all pre-cancers and 69% of advanced pre-cancers and 94% of Stage I and II cancers, we estimate it has helped by nearly 315,000 people with pre-cancer and 46,000 with early-stage cancer. About 90% of people 45 and older see a Cologuard advertisement once a week. Our sales team meets with physicians and their staff a million times per year. We will use each of those touch points to make sure patients and providers understand Cologuard is the superior noninvasive test and the appropriate role blood test should play.

這就是我們開發 Cologuard 的原因，它正在發揮作用。因為它可以檢測出 42% 的癌前病變和 69% 的晚期癌前病變以及 94% 的 I 期和 II 期癌症，我們估計它已經幫助了近 315,000 名癌前病變患者和 46,000 名早期癌症患者。大約 90% 的 45 歲及以上的人每週都會看到一次 Cologuard 廣告。我們的銷售團隊每年與醫生及其員工會面一百萬次。我們將使用這些接觸點中的每一個來確保患者和提供者了解 Cologuard 是卓越的無創測試，並且血液測試應該發揮適當的作用。

Oncotype DX provides the groundwork for Exact Sciences to guide a cancer patient's every step. We're using its powerful brand and our deep oncology relationships to introduce new products like our hereditary cancer test. Riskguard helps people understand their inherited risk of cancer and the genetic makeup of their tumor, arming them with critical information to make better treatment decisions.

Oncotype DX 為 Exact Sciences 指導癌症患者的每一步提供了基礎。我們正在利用其強大的品牌和深厚的腫瘤學關係來推出新產品，例如我們的遺傳性癌症測試。 Riskguard 幫助人們了解他們患癌症的遺傳風險和腫瘤的基因組成，為他們提供關鍵信息以做出更好的治療決策。

Next year, we plan to offer additional genomic test to patients, oncologists and our biopharma and academic partners, including minimum residual disease and enhanced therapy selection with RNA analysis.

明年，我們計劃為患者、腫瘤學家以及我們的生物製藥和學術合作夥伴提供額外的基因組測試，包括最小殘留病和通過 RNA 分析增強治療選擇。

Combining information from our test at different stages of cancer treatment will provide a more complete picture of each patient's disease. Our multi-cancer early detection data presentation at ESMO in September demonstrated meaningful progress toward our goal to bring the best multi-cancer blood test to patients.

結合我們在癌症治療不同階段的測試信息，可以更全面地了解每位患者的疾病。我們 9 月份在 ESMO 上展示的多癌症早期檢測數據展示了我們在為患者提供最佳多癌症血液檢測目標方面取得的重大進展。

Combining 4 biomarker classes and different technologies in a large well-designed case control study, our test detected 61% of cancers at a 98.2% specificity across 15 different organ types, including 11 with no screening option available today. Adding curated DNA mutation markers detected by next-generation sequencing to methylation, aneuploidy and protein markers improved stage 1 and 2 cancer detection by 35%.

在一項精心設計的大型病例對照研究中結合 4 種生物標誌物類別和不同的技術，我們的測試以 98.2% 的特異性檢測了 61% 的癌症，涵蓋 15 種不同的器官類型，其中 11 種目前沒有可用的篩查選項。將下一代測序檢測到的精選 DNA 突變標記添加到甲基化、非整倍體和蛋白質標記中，可將 1 期和 2 期癌症檢測提高 35%。

Next, we plan to complete a larger case-control study to further optimize the test, finalize its design and then start enrolling SOAR, our prospective interventional trial to support FDA approval. Exact Sciences is uniquely positioned to support the 2 biggest patient needs in minimum residual disease and recurrence monitoring in breast and colon cancer. We have relationships with most oncologists in the U.S. and about 170,000 early-stage breast cancer tissue samples are sent to our lab each year. Each sample represents a person who could benefit from a minimum residual disease test.

接下來，我們計劃完成一項更大規模的病例對照研究，以進一步優化測試，完成其設計，然後開始招募 SOAR，這是我們支持 FDA 批准的前瞻性干預試驗。 Exact Sciences 具有獨特的優勢，可以支持患者在乳腺癌和結腸癌的最小殘留病灶和復發監測方面的兩大需求。我們與美國大多數腫瘤學家都有合作關係，每年大約有 170,000 份早期乳腺癌組織樣本被送到我們的實驗室。每個樣本代表一個可以從最小殘留疾病測試中受益的人。

Screening millions of people every year with Cologuard puts Exact Sciences in a leading position to help those likely to develop colorectal cancer and improve outcomes for those patients. We're the only company planning to offer tumor-naive and tumor-informed tests, allowing oncologists to use the best test for each patients with 1 lab partner.

Cologuard 每年對數百萬人進行篩查，使 Exact Sciences 處於領先地位，可以幫助那些可能患結直腸癌的人並改善這些患者的預後。我們是唯一一家計劃提供腫瘤初始和腫瘤知情測試的公司，允許腫瘤學家與 1 個實驗室合作夥伴一起為每位患者使用最佳測試。

We plan to share marker discovery data supporting our tumor-naive approach in breast cancer at the San Antonio Breast Cancer Symposium in December. We also expect to present results of our tumor-informed and tumor-naive approaches for colon cancer at ASCO GI in January.

我們計劃在 12 月的聖安東尼奧乳腺癌研討會上分享標記物發現數據，以支持我們在乳腺癌中的非腫瘤治療方法。我們還希望在 1 月份的 ASCO GI 上展示我們針對結腸癌的腫瘤知情和非腫瘤治療方法的結果。

Exact Sciences has the right team, a unique financial profile and the broadest and strongest foundation in cancer diagnostics. Continued execution from the team, over 70% gross margins, a clear path to profitability next year and a leading presence in cancer screening and precision oncology put us in the best position to eradicate cancer and the suffering it causes.

Exact Sciences 擁有合適的團隊、獨特的財務狀況以及癌症診斷領域最廣泛和最強大的基礎。團隊的持續執行、超過 70% 的毛利率、明年實現盈利的明確途徑以及在癌症篩查和精準腫瘤學方面的領先地位，使我們處於根除癌症及其造成的痛苦的最佳位置。

We're now happy to answer your questions.

我們現在很樂意回答您的問題。

(Operator Instructions) Your first question comes from the line of Brandon Couillard from Jefferies.

（操作員說明）您的第一個問題來自 Jefferies 的 Brandon Couillard。

I'll stick to one question. Kevin, the OpEx cut to the full year outlook pretty substantial. Can you just elaborate on exactly where that's coming from, whether it's headcount or other programs?

我會堅持一個問題。凱文，運營支出對全年前景的削減相當可觀。您能否詳細說明具體的來源，是員工人數還是其他計劃？

Well, I think it's a broad-based continued focus by all of our employees from the front line to the leadership team of making sure that we deliver on our promise that we made several quarters ago of rapidly moving the business to profitability. I believe Jeff will have more color.

好吧，我認為這是我們所有員工從一線到領導團隊的廣泛持續關注，以確保我們兌現幾個季度前做出的迅速將業務轉為盈利的承諾。我相信傑夫會有更多的色彩。

Yes. Thanks, Brandon. The team has just done a really good job of focusing on the highest impact programs across the board. And when you talk about sales and marketing, they're just doing a really nice job making sure we target the right physicians and allocate financials appropriately across all of the various marketing levers we have to pull.

是的。謝謝，布蘭登。該團隊在全面關注最具影響力的項目方面做得非常好。當你談論銷售和營銷時，他們只是做得非常好，確保我們瞄準合適的醫生，並在我們必須拉動的所有各種營銷槓桿上適當地分配財務。

I think what you're really seeing here is a turning point. We've talked for years about the platform that we have built over time. And this has been a significant investment. But now you're really starting to see the part of this platform. As Cologuard grew, we grew 25% in the quarter, sales and marketing was down 5%. Over time, it's clear where this is heading with that foundation in place. And 2 very strong profitable brands on market now and growing, this is going to turn into a cash flow generating machine over time.

我認為你在這裡真正看到的是一個轉折點。多年來，我們一直在談論我們建立的平台。這是一項重大投資。但是現在你真的開始看到這個平台的一部分了。隨著 Cologuard 的增長，我們在本季度增長了 25%，銷售和營銷下降了 5%。隨著時間的推移，有了這個基礎，它的發展方向就很清楚了。現在市場上有 2 個非常強大的盈利品牌，而且還在不斷增長，隨著時間的推移，這將變成一台產生現金流的機器。

Your next question comes from the line of Derik De Bruin from Bank of America.

你的下一個問題來自美國銀行的 Derik De Bruin。

So can you talk a little bit more about physician access and that had been an issue during prior quarters. Can you sort of talk about the metrics, sort of where we are, penetration, access there? And then just anything on sort of what's happening with the Precise Oncology business, OUS, any sort of like slowdowns in demand there? Does macroeconomic issues sort of kick in?

那麼，您能否多談談醫生准入的問題，這在前幾個季度一直是個問題。你能談談指標嗎，我們在哪裡，滲透率，訪問那裡？然後是關於 Precise Oncology 業務 OUS 發生的任何事情，比如那裡的需求放緩？宏觀經濟問題是否開始出現？

Everett, why don't you take the access question. And Jeff, if you would take the precision oncology questions.

Everett，你為什麼不回答訪問問題。傑夫，如果你願意回答精準腫瘤學問題。

Thanks, Kevin. Good afternoon, everyone. Thanks for the access question. We're seeing modest improvements in access, but the access is not back to pre-COVID levels. What I do like about our commercial organization is we're deployed very smartly across all of our geographies. We're deployed at the highest target to drive the largest growth for Cologuard. Our representatives across the board have really good data in terms of knowing where to target, when to target.

謝謝，凱文。大家下午好。感謝您的訪問問題。我們看到訪問權限有所改善，但訪問權限並未恢復到 COVID 之前的水平。我喜歡我們的商業組織的一點是我們在我們所有的地區都非常巧妙地部署。我們部署在最高目標上，以推動 Cologuard 的最大增長。我們的代表在了解目標位置和目標時間方面擁有非常好的數據。

And each month that we're in our revised structure, we get better at making sure that we're making high-quality calls. I look at and my team looks at the calls that we make, just not the quantity of call but the quality of call and quarter-over-quarter, we're getting better. So while the access is just showing modest improvement, the activity of our field force is much more efficient.

每個月我們都在修改結構中，我們會更好地確保我們進行高質量的通話。我看著我的團隊看著我們打的電話，不僅僅是電話的數量，而是電話的質量和季度環比，我們正在變得更好。因此，雖然訪問僅顯示出適度的改善，但我們現場工作人員的活動效率更高。

Derik, this is Jeff. I'll take the PL one. So globally, we had a good quarter in Precision Oncology. If you adjust for FX and the sale of the prostate business, that core growth was about 9%. What we got there was international growth of about 26%, again, adjusted for FX. So really strong growth outside the U.S. You're seeing improved insurance coverage outside the U.S. You're also seeing very strong uptake in the node positive indication.

德里克，這是傑夫。我會拿PL的。因此，在全球範圍內，我們在精密腫瘤學領域取得了不錯的成績。如果你調整外彙和前列腺業務的銷售，核心增長約為 9%。我們得到的是國際增長約 26%，再次針對外匯進行調整。所以美國以外的增長非常強勁。你看到美國以外的保險範圍有所改善。你也看到節點積極跡象的吸收非常強勁。

And then when you look at the next year, I expect that momentum will continue. We're on track to launch in Japan early next year. So good momentum will continue for the international side of the business. In the U.S., another really steady quarter, mid-single-digit growth there with balanced contributions from the Oncotype Breast franchise as well as the therapy selection business, which is becoming a much bigger part of overall Precision Oncology.

然後當你展望明年時，我預計這種勢頭將繼續下去。我們有望在明年初在日本推出。因此，國際業務的良好勢頭將繼續下去。在美國，另一個非常穩定的季度，在 Oncotype Breast 特許經營權和治療選擇業務的平衡貢獻下實現了中等個位數的增長，這在整個精準腫瘤學中所佔的比重要大得多。

Your next question comes from the line of Catherine Schulte from Baird.

您的下一個問題來自 Baird 的 Catherine Schulte。

I think on one of your slides, there was a graphic showing 30 million patients screened by Cologuard by looked like 2027. Did I read that correctly? And can you just talk to what kind of assumptions go into that outlook?

我想在你的一張幻燈片上，有一張圖表顯示 Cologuard 篩查了 2027 年的 3000 萬患者。我沒看錯嗎？你能談談這種前景有什麼樣的假設嗎？

Catherine, you did read that right. It's at least $30 million. And what we did to get there is as we look at the model that we have and all the broad momentum we have that Everett and team are driving across a growing base of providers. Kevin talked about a record number of new order providers in the quarter, over 150,000 ordered during the quarter. We're seeing a deepening of the utilization as Cologuard gets more ingrained in their business. And over time, we expect that growth to continue when you consider the size of this market and the fact that as many as 60 million people remain unscreened today.

凱瑟琳，你沒看錯。至少是3000萬美元。當我們審視我們擁有的模型以及我們擁有的所有廣泛勢頭時，我們所做的就是實現這一目標，即埃弗雷特和團隊正在推動越來越多的供應商基礎。凱文談到本季度新訂單供應商的數量創下歷史新高，本季度訂購了超過 150,000 家。隨著 Cologuard 在他們的業務中越來越根深蒂固，我們看到利用率正在加深。隨著時間的推移，考慮到這個市場的規模以及今天仍有多達 6000 萬人未接受篩查這一事實，我們預計這種增長將持續下去。

Your next question comes from the line of Jack Meehan from Nephron Research.

您的下一個問題來自 Nephron Research 的 Jack Meehan。

Kevin or Jeff, it's that time of year. Everybody is very focused on 2023. Good to see some of the momentum in the quarter and on the order commentary in the year-end. I was just curious if there were any thoughts you could share around kind of positioning into 2023. I caught the profitability comment by the third quarter, but just how are you feeling about the business in the new year?

凱文或傑夫，每年的那個時候。每個人都非常關注 2023 年。很高興看到本季度的一些勢頭和年底的訂單評論。我只是想知道您是否可以就 2023 年的某種定位分享任何想法。我在第三季度收到了盈利評論，但您對新一年的業務感覺如何？

Well, this is Kevin. I am thrilled, first of all, that there is something different about what's going on with Cologuard now than ever before. You've seen our Net Promoter Scores double from the low 20s in the first quarter of '21 to the low 40s this last quarter. Awareness of Cologuard as a brand is at an all-time high among consumers, relevant consumers and health care providers. Reorder rates are at all-time high, number of tests ordered per physician are at an all-time high.

嗯，這是凱文。我很激動，首先，Cologuard 現在的情況與以往有所不同。您已經看到我們的淨推薦值從 20 世紀第一季度的低 20 分翻了一番，到上個季度的低 40 分。 Cologuard 作為品牌的認知度在消費者、相關消費者和醫療保健提供者中處於歷史最高水平。重新訂購率處於歷史最高水平，每位醫生訂購的測試數量處於歷史最高水平。

And so Cologuard is gaining momentum, and it feels that it is being used now much more frequently among physicians, who are very slow to adopt new technologies and change. We've always said that a primary care launch is more like a jumbo jet than a rocket ship. And what you're starting to see is that it's becoming broader. Our Cologuard's utilization is deeper among the physicians who are using it. And the interesting data point is that we continue to add about 10,000 new ordering health care providers per quarter.

因此，Cologuard 正在獲得發展勢頭，並且感覺它現在在醫生中使用得更加頻繁，他們採用新技術和改變的速度非常慢。我們一直說初級保健發射更像是一架大型噴氣式飛機，而不是一艘火箭飛船。你開始看到的是它變得越來越廣泛。我們的 Cologuard 的使用率在使用它的醫生中更為深入。有趣的數據點是，我們每季度繼續增加約 10,000 個新的訂購醫療保健提供者。

And so much of this is driven by 2 incredible teams. One is a marketing team that we think has mastered both television advertising and digital and consumer as well as a sales force that has just continued throughout the pandemic, and now beyond, to continue to educate health care providers, physicians and increasingly now nurse practitioners to order Cologuard and how it should be used in their practice. So something else -- something is changing. Maybe, Jeff, you want to provide a little bit more clarity for the year.

而這其中很大一部分是由 2 個令人難以置信的團隊推動的。一個是我們認為已經掌握了電視廣告、數字和消費者的營銷團隊，以及一個剛剛在整個大流行期間繼續存在的銷售隊伍，現在繼續教育醫療保健提供者、醫生，現在越來越多的護士從業者訂購 Cologuard 以及如何在他們的實踐中使用它。所以還有其他事情——有些事情正在發生變化。也許，傑夫，你想為這一年提供更多的清晰度。

Yes. Typically, we provide guidance on our fourth quarter call in February, and that is our plan now. As you look out to next year, I think I'd say a lot of this momentum that we're seeing both in Q3 and we guided to Q4 should continue into next year. As Kevin said, we're very optimistic in the long term.

是的。通常，我們會在 2 月份的第四季度電話會議上提供指導，這就是我們現在的計劃。當你展望明年時，我想我會說我們在第三季度和第四季度看到的這種勢頭應該會持續到明年。正如凱文所說，從長遠來看，我們非常樂觀。

A few reasons to keep in mind. When you think about physician office access, as Everett said, it's not back to normal. It is still somewhat muted. The team has done a really nice job working around that, but keep that in mind as you think about next year. Also in our rescreen business, it has been a phenomenal growth driver for us. However, when you think about that pool of patients, who become eligible next year, we're certain to lap against COVID years so that the growth in that pool is about flat year-on-year.

有幾個原因要記住。正如埃弗雷特所說，當你想到醫生辦公室的訪問時，它並沒有恢復正常。它仍然有些靜音。該團隊在這方面做得非常好，但在考慮明年時請記住這一點。同樣在我們的重印業務中，它一直是我們驚人的增長動力。但是，當您考慮明年符合條件的患者群體時，我們肯定會趕上 COVID 年，因此該群體的增長與去年同期持平。

I do believe rescreens will grow next year, but that is -- it won't provide as much incremental growth next year as it has. And lastly, next year, you get a full impact of the Medicare sequester, which kicked in midyear. And it does take down Medicare reimbursement across the board, so you get a full year of that next year. So things to keep in mind. We'll provide full guidance on the fourth quarter call. We are very optimistic.

我確實相信明年重新篩選會增長，但也就是說 - 它明年不會提供像現在這樣多的增量增長。最後，明年，您將全面了解年中開始實施的醫療保險自動減支計劃。而且它確實全面取消了 Medicare 報銷，所以明年你可以獲得一整年的報銷。所以要記住的事情。我們將在第四季度電話會議上提供全面指導。我們非常樂觀。

Your next question comes from the line of Andrew Brackmann from William Blair.

你的下一個問題來自 William Blair 的 Andrew Brackmann。

Maybe we could start just given some news that's sort of expected in the next handful of weeks in the space here. Kevin, can you just sort of level set us again sort of on the role pre-cancer detection should be playing in these tests? I think you reiterated some prior commentary about 2/3 of the benefit is coming from pre-cancer. So can you just maybe give us a level set on how you're thinking about that again?

也許我們可以從這裡的空間接下來幾週的一些預期新聞開始。凱文，你能不能讓我們再次了解癌前檢測在這些測試中應該扮演的角色？我認為您重申了一些先前的評論，即 2/3 的益處來自癌前病變。那麼，您能否再給我們一個關於您如何考慮的水平？

Yes, sure. Thanks. So first of all, there is an enormous amount of room to improve screening rates. 60 million out of 110 million Americans in the screening population with ages 45 to 85 remain unscreened today. So there is just an enormous opportunity to get people up to date in their screening. And we believe that our blood test is going to play a role in improving rates. But to date, our test, we haven't shown data, and there is no prospective data showing pre-cancer detection to be that similar to the FIT test, which is 24%.

是的，當然。謝謝。所以首先，提高篩選率的空間很大。在年齡在 45 至 85 歲之間的 1.1 億接受篩查的美國人中，有 6000 萬人今天仍未接受篩查。因此，這是一個巨大的機會，可以讓人們了解最新的篩查情況。我們相信我們的血液測試將在提高比率方面發揮作用。但到目前為止，我們的測試還沒有顯示數據，也沒有前瞻性數據顯示癌前檢測與 FIT 測試相似，即 24%。

And I go back to when we started 13 years ago with Cologuard, one of the most important things we focused on was the detection of precancerous polyps, which take 10 to 15 years to turn into cancer. And with multiple attempts at screening, you can actually prevent the disease. If you look at the drastic drop-off in cervical cancer mortality in the U.S., it's not because the pap smear found cancer. It's because it found the precancerous lesions that lead to cancer. And that's where you've seen mortality drop from 45,000 people -- women a year to 4,500 or thereabouts.

我回到 13 年前我們開始使用 Cologuard 時，我們關注的最重要的事情之一是檢測癌前息肉，它需要 10 到 15 年才能變成癌症。通過多次嘗試篩查，您實際上可以預防這種疾病。如果你看看美國宮頸癌死亡率的急劇下降，這並不是因為子宮頸抹片檢查發現了癌症。因為它發現了導致癌症的癌前病變。這就是你看到死亡率從每年 45,000 人——女性下降到 4,500 人左右的地方。

And so the goal of any screening test should be to find pre-cancers and then detect Stage I or II cancers at a high rate. And we know that colonoscopy is good at finding Stage I and II cancers. Cologuard detects 94% of Stage I and II cancers. Blood tests aren't going to detect 94% of Stage I and II cancers. So if you look at that population wise, if you see 100 people screened with Cologuard and a blood test, there may be, I don't know, 10 people who Cologuard would find but a blood test wouldn't. And so that's why finding those stage 1 and 2 cancers is critical.

因此，任何篩查測試的目標都應該是發現癌前病變，然後以高比率檢測出 I 期或 II 期癌症。我們知道結腸鏡檢查擅長發現 I 期和 II 期癌症。 Cologuard 檢測出 94% 的 I 期和 II 期癌症。驗血無法檢測出 94% 的 I 期和 II 期癌症。因此，如果你明智地看待人口，如果你看到 100 人接受了 Cologuard 篩查和血液測試，我不知道，可能會有 10 人 Cologuard 會發現但血液測試不會。因此，這就是為什麼發現那些 1 期和 2 期癌症至關重要的原因。

And so blood test will have a role. Now there may be a challenge in getting blood test into the guidelines because, again, they look at modeling and the modeling that is done, 2/3 of the life years gained, comes from pre-cancer detection. So there's going to be some challenges here. And without getting into the guidelines, you don't get into HEDIS or Stars quality measures. And without that, it's really difficult to launch a test. There's going to be a number of years before all of this plays out. And we plan to share data that we have generated, including more recent data on our blood-based CRC test.

因此，驗血將發揮作用。現在，將血液測試納入指南可能存在挑戰，因為他們再次關注建模，而完成的建模，即獲得的 2/3 生命年，來自癌前檢測。所以這裡會有一些挑戰。如果不了解指南，您就不會了解 HEDIS 或 Stars 質量措施。沒有它，就很難啟動測試。還需要很多年才能完成所有這一切。我們計劃分享我們生成的數據，包括我們基於血液的 CRC 測試的最新數據。

And I just want to remind people that the huge investment that is required to participate as a serious player and as a serious provider of colon cancer screening tools. We have invested about $4 billion today in our patient engagement engine, in our commercial team, in our 320,000 square feet of lab space and, really importantly, in the 250 health system connections using Epic to be able to electronically order Cologuard and get results.

我只是想提醒人們，作為一個認真的參與者和一個認真的結腸癌篩查工具提供者參與需要巨大的投資。我們今天已經投資了大約 40 億美元用於我們的患者參與引擎、我們的商業團隊、我們 320,000 平方英尺的實驗室空間，而且非常重要的是，我們使用 Epic 的 250 個健康系統連接能夠以電子方式訂購 Cologuard 並獲得結果。

So this is a really important goal is to get more people screened. And I wanted -- one other comment is that we've recently gotten feedback from the FDA on our blood test. And they have been clear, like they were clear with Cologuard, that there is an expectation around pre-cancer detection. So they have said there's a certain expectation around the sensitivity for detecting cancer, for detecting pre-cancer and also for specificity or the false positive rate.

所以這是一個非常重要的目標是讓更多的人接受篩查。我想——另一條評論是我們最近從 FDA 那裡得到了關於我們血液測試的反饋。他們已經很清楚，就像他們對 Cologuard 很清楚一樣，人們對癌前檢測抱有期望。因此他們表示，對於檢測癌症、檢測癌前病變以及特異性或假陽性率的敏感性存在一定的期望。

Those are 3 critically important metrics that will come out of our blood CRC study. And these are serious scientific things that still need to be established, and we look forward to sharing our data with you at the completion of our study.

這些是我們血液 CRC 研究中將產生的 3 個至關重要的指標。這些都是仍然需要建立的嚴肅的科學事物，我們期待在完成研究後與您分享我們的數據。

Your next question comes from the line of Matt Sykes from Goldman Sachs.

你的下一個問題來自高盛的 Matt Sykes。

This is Dave on for Matt Sykes. Can you tell us more about what drove the Oncotype outperformance in the quarter?

這是馬特賽克斯的戴夫。你能告訴我們更多關於是什麼推動了本季度 Oncotype 的出色表現嗎？

Yes, this is Jeff. I'll take that one. I talked before about having really strong growth outside the U.S., up 26% adjusted for FX. So I would say that's part of it. We're also seeing continued very strong momentum in the node positive indication. Recall this is the newer indication thanks to the responder data that came out a couple of years ago, continue to see really good uptake there.

是的，這是傑夫。我會拿那個。我之前談到過美國以外的增長非常強勁，經匯率調整後增長了 26%。所以我會說這是其中的一部分。我們還看到節點積極跡象的持續強勁勢頭。回想一下，由於幾年前發布的響應者數據，這是較新的跡象，繼續看到那裡的吸收率非常高。

And lastly, I think this doesn't get enough attention, but we do have a pretty sizable therapy selection business that continues to gain momentum. We'll have an additional product launch there early next year. I think it's -- I would say it's a broad-based good quarter from that team.

最後，我認為這沒有得到足夠的重視，但我們確實有一個相當大的治療選擇業務，並且繼續獲得發展勢頭。我們將在明年初在那裡推出其他產品。我認為這是 - 我會說這是該團隊的一個基礎廣泛的好季度。

Your next question comes from the line of Vijay Kumar from Evercore.

你的下一個問題來自 Evercore 的 Vijay Kumar。

Your next question comes from the line of Thomas Stevens from Cowen and Company.

你的下一個問題來自 Cowen and Company 的 Thomas Stevens。

I'll dissect my question, so just kind of 2-parter here. On those power users you kind of discussed you've seen some headwinds, just an update on your kind of previously high order in Cologuard doctors. And the kind of second one is an offshoot of those question. I guess in looking at 2027 in blood, in Medicare, what kind of opportunity do you see for a kind of 2-year test there? And what kind of population do you see to tap into with your test?

我將剖析我的問題，所以這裡只有兩個人。在你討論過的那些超級用戶身上，你看到了一些不利因素，只是對你之前在 Cologuard 醫生中的高訂單的更新。第二個問題是這些問題的一個分支。我想看看 2027 年的血液，在 Medicare 中，你認為在那裡進行為期 2 年的測試有什麼樣的機會？你認為你的測試適合什麼樣的人群？

Thanks, Tom. This is Jeff. I'll start on the -- I think your comment on the power users, and maybe Everett can fill in here, too. We had previously talked about different cohorts. I think the results here really show that we've seen broad-based improvements in utilization. Whether you look at different cohorts based on when doctors first ordered, there's some data in the deck that people are seeing for the first time.

謝謝，湯姆。這是傑夫。我將從 - 我認為您對高級用戶的評論開始，也許 Everett 也可以在這裡填寫。我們之前討論過不同的隊列。我認為這裡的結果確實表明我們已經看到了利用率方面的廣泛改進。無論您是根據醫生首次下單的時間來查看不同的隊列，甲板上都有一些人們第一次看到的數據。

No matter when you first ordered, the order rate continues to climb higher which is really powerful to see, especially when you consider all the new doctors that we're adding. If you segment doctors based on their level of ordering, kind of broadly also there, whether you're kind of towards the top or newer to Cologuard, we're seeing continued strong uptick in utilization. So those are the overall trends. I don't know, Everett, anything to add there?

無論您什麼時候第一次訂購，訂購率都會繼續攀升，這真的很強大，尤其是當您考慮到我們正在添加的所有新醫生時。如果你根據醫生的訂購水平對醫生進行細分，那麼無論你是 Cologuard 的頂級還是新手，我們都會看到利用率持續強勁上升。這些就是總體趨勢。我不知道，Everett，有什麼要補充的嗎？

Yes. I will add a little bit. I spent a lot of time out in the field in the past few quarters. And the way our commercial organization looked at it, Thomas, is a little bit more simple. What they do is they look at, where is the growth opportunity for Cologuard. And we have targets, we have priorities that we focus on like rescreen opportunities, 45 to 49 opportunities. And where those opportunities are, we go and we make the call.

是的。我會補充一點。在過去的幾個季度裡，我在這個領域花了很多時間。 Thomas，我們的商業組織看待它的方式要簡單一些。他們所做的就是看 Cologuard 的增長機會在哪裡。我們有目標，我們有我們關注的優先事項，比如重新篩選機會，45 到 49 次機會。哪裡有機會，我們就去哪裡，我們就打電話。

And we have boiled it down to the more quality calls that we make with those targets, the more that, that PCP writes Cologuard. And so we incent our representatives to go out every single day, focus on the priorities, focus on the opportunities and grow Cologuard. And I think that, that's the reason why we're continuing to have good quarter-over-quarter growth.

我們將其歸結為我們對這些目標進行的質量調用越多，PCP 編寫 Cologuard 的質量就越高。因此，我們每天都鼓勵我們的代表出去，專注於優先事項，關注機會並發展 Cologuard。我認為，這就是我們繼續保持良好的季度環比增長的原因。

Tom, I'll take the second question, which was on the blood opportunity in 2027. Look, as Kevin talked about, he talked about the broader framing. I would just add to that, that this is going to take time. When you think of the obstacles you've got to get through, whether it's first developing the test, get into the guidelines, quality measures, FDA, Medicare, there's a whole series of things that have to happen. And if you look back at Cologuard, right, it takes about 4 to 5 years after launch for all those things to come into play.

湯姆，我會回答第二個問題，這是關於 2027 年的血液機會。看，正如凱文所說，他談到了更廣泛的框架。我只想補充一點，這需要時間。當你想到你必須克服的障礙時，無論是首先開發測試、進入指南、質量措施、FDA、醫療保險，都有一系列的事情必鬚髮生。如果你回顧一下 Cologuard，對吧，所有這些東西在發布後大約需要 4 到 5 年的時間才能發揮作用。

So I think in the 2027 time frame, which is what you asked, I think the opportunity there is still relatively minimal. Potentially, you could see blood being positioned for specific niches of the market. One that stands out to us is somebody who, say, over the age of 75, where perhaps at that age, pre-cancer detection may be less important, but -- and they're likely on Medicare.

所以我認為在 2027 年的時間框架內，也就是你問的，我認為那裡的機會仍然相對較小。潛在地，您可能會看到血液被定位到特定的市場細分市場。一個對我們來說很突出的人是 75 歲以上的人，在那個年齡段，癌前檢測可能不那麼重要，但是 - 他們可能正在享受醫療保險。

Commercial insurance, broad adoption is going to take longer than that. For that, you need to be in USPSTF guidelines, you need to be in the quality measures. And I don't see that coming together in 2027.

商業保險，廣泛採用需要比這更長的時間。為此，您需要遵守 USPSTF 指南，需要遵守質量措施。而且我認為這不會在 2027 年實現。

Your next question comes from the line of Patrick Donnelly from Citigroup.

你的下一個問題來自花旗集團的 Patrick Donnelly。

You've got Jason on for Patrick. Maybe just one. I know you're not giving '23 guidance right now, but just at a high level, thinking about the goal of being adjusted EBITDA positive in the third quarter next year. How should we be thinking about gross margins next year, some of the moving pieces there, like inflation, FX and then kind of where automation and rescreens fit into that?

你讓傑森代替帕特里克。也許只有一個。我知道你現在不是在給出 23 年的指導，而是在高水平上考慮明年第三季度調整後的 EBITDA 為正的目標。我們應該如何考慮明年的毛利率，那裡的一些變動因素，如通貨膨脹、外匯，以及自動化和重新篩選適合的地方？

We'll give more color on this on our fourth quarter call, but it helps -- it starts with a really strong growth drivers in both Cologuard and Oncotype. Both are profitable today. We expect continued momentum into next year. From a gross margin standpoint, obviously, there are headwinds out there. There are headwinds out there, they're not unique to us, with inflation, with fuel, supply chain, complexities with COVID. So there's a lot of pressures there. The team did a really nice job of offsetting that.

我們將在第四季度的電話會議上對此提供更多的顏色，但這有幫助——它始於 Cologuard 和 Oncotype 的真正強勁增長動力。兩者今天都盈利。我們預計明年將繼續保持增長勢頭。從毛利率的角度來看，顯然存在不利因素。那裡有逆風，它們並不是我們獨有的，包括通貨膨脹、燃料、供應鏈、COVID 的複雜性。所以那裡有很大的壓力。該團隊在抵消這一點方面做得非常好。

I think when I look at Q4 and the near term here, I think margin is pretty similar to Q3, maybe down a hair just based on the seasonal trends with revenue into next year, inflation is still the wild card. So we'll talk more about that. Longer term, gross margin, we're very optimistic there because again, the team has done a really nice job building the foundation that we can scale. So we expect nice margin improvement over time.

我認為當我看第四季度和這裡的近期時，我認為利潤率與第三季度非常相似，也許只是基於明年收入的季節性趨勢，通脹仍然是未知數。所以我們會更多地討論這個。從長遠來看，毛利率，我們在那裡非常樂觀，因為再次，團隊在建立我們可以擴展的基礎方面做得非常好。因此，我們預計隨著時間的推移會有不錯的利潤率改善。

From an operating expense standpoint, again, I think a hallmark of what you saw in the third quarter, the team has done a nice job finding efficiencies throughout the business. I think that will continue throughout next year. Next year, we do have the STORE study started for multi-cancer, that will be some additional R&D. Otherwise, we expect continued efficiencies throughout the P&L.

從運營費用的角度來看，我認為你在第三季度看到的一個標誌是，團隊在提高整個企業的效率方面做得很好。我認為這將持續到明年。明年，我們確實開始了針對多種癌症的 STORE 研究，這將是一些額外的研發。否則，我們預計整個損益表的效率會持續提高。

Your next question comes from the line of Vijay Kumar from Evercore.

你的下一個問題來自 Evercore 的 Vijay Kumar。

Congrats on the steady execution here. Maybe my question here on the cash flows, Jeff. This is a pretty impressive quarter in terms of cash burn rate. Are we now looking at the Exact Sciences exiting fiscal '23 perhaps being cash flow neutral to positive? How should we think about operating expenses? And maybe just give us some color, Jeff, on what changed. Is this a function of Exact holding back expenses? And is that going to come at the cost of revenue growth or are these structural changes which are sustainable?

祝賀這裡的穩定執行。傑夫，也許我的問題是關於現金流量的。就現金消耗率而言，這是一個令人印象深刻的季度。我們現在是否正在考慮退出 23 財年的 Exact Sciences 現金流可能從中性到正值？我們應該如何考慮運營費用？也許只是給我們一些顏色，傑夫，關於發生了什麼變化。這是 Exact 抑制費用的功能嗎？這是否會以收入增長為代價，或者這些結構性變化是否可持續？

Thanks, Vijay. As Kevin talked about, it's not either or, it's growth with efficiencies and a focus on profitability. I don't think this is a shift or change in the business. We've been talking for years about building the foundation that will not only get us to profitability, but allow us to punch through and continue to generate improving margins, steady cash flow generation for years and years to come. And you're now -- I think we're at that turning point now, we're at that turning point where you're really starting to see that fall through.

謝謝，維杰。正如凱文所說，它既不是，也不是，它是以效率和對盈利能力為重點的增長。我不認為這是業務的轉變或變化。多年來，我們一直在談論建立不僅能讓我們盈利的基礎，還能讓我們突破並繼續提高利潤率，在未來幾年穩定產生現金流。而你現在 - 我認為我們現在正處於那個轉折點，我們正處於那個你真正開始看到失敗的轉折點。

As far as next year, we're excited to pull ahead the EBITDA profitability on a free cash basis, likely lags that a little bit. What's helping recently is that we've had some really nice improvement in working capital management. You see DSOs down 16 days year-on-year. Inventory turns continue to improve. So the team has done a really nice job with a heightened focus on profitability and cash flow.

就明年而言，我們很高興能夠在自由現金基礎上提前實現 EBITDA 盈利能力，可能會落後一點。最近有幫助的是我們在營運資金管理方面有了一些非常好的改進。您會看到 DSO 同比下降 16 天。庫存周轉繼續改善。因此，該團隊在高度關注盈利能力和現金流方面做得非常好。

So our next question comes from the line of Kyle Mikson from Canaccord.

所以我們的下一個問題來自 Canaccord 的 Kyle Mikson。

Alex Vukasin online for Kyle Mikson. Congratulations on the quarter. And one brief question for you. So there's probably little value baked into the stock really for multi-cancer, MRD and liquid biopsy test. Why don't you think investors are taking these assets seriously? And what are you going to do to reinvigorate excitement in these promising potential long-term growth drivers?

Alex Vukasin 在線為 Kyle Mikson。祝賀這個季度。還有一個簡短的問題要問你。因此，對於多癌症、MRD 和液體活檢測試來說，股票的實際價值可能很小。你認為投資者為什麼不認真對待這些資產？您打算如何重振這些有前途的潛在長期增長動力？

This is Jeff. I'll take that one and maybe Kevin can jump in. Look, we're focused on executing on the business, starting with Cologuard and Oncotype, making sure the foundation is there. And we're in the middle of this period where it's an intense data readout period for our pipeline. We started this year with really strong data on Cologuard 2, we shared some additional data on our MRD program at ASCO and then just in September, shared the data on NSABP, we thought it was all really good data.

這是傑夫。我會接受那個，也許 Kevin 可以加入。看，我們專注於執行業務，從 Cologuard 和 Oncotype 開始，確保基礎在那裡。我們正處於這個時期的中間，這是我們管道的密集數據讀取期。我們從今年開始在 Cologuard 2 上獲得了非常強大的數據，我們在 ASCO 上分享了我們 MRD 計劃的一些額外數據，然後就在 9 月，分享了 NSABP 上的數據，我們認為這些數據都是非常好的數據。

Looking ahead, this robust period of pipeline data continues. When you look ahead to -- in this month, there's additional data coming out on our NSABP program. Next year, as Kevin talked about, our top line readout starting with BLUE-C, data on our colon cancer blood program. And over time, I think as investors fully appreciate this, look, we're optimistic here. Not only we can continue delivering on the core on-market programs, but we have a really robust growth in store throughout the pipeline.

展望未來，這一強勁的管道數據時期仍在繼續。當你展望未來時——在本月，我們的 NSABP 計劃將發布更多數據。明年，正如凱文所說，我們的頂線讀數從 BLUE-C 開始，是我們結腸癌血液計劃的數據。隨著時間的推移，我認為隨著投資者充分意識到這一點，看，我們在這裡很樂觀。我們不僅可以繼續提供核心的市場計劃，而且我們在整個管道中的商店都有非常強勁的增長。

Your next question comes from the line of Alex Nowak from Craig-Hallum Capital Group.

你的下一個問題來自 Craig-Hallum Capital Group 的 Alex Nowak。

A couple of calls this evening, so apologies if you already addressed this. But I was just hoping if we can get your latest ideas on M&A in the genomics space. We've seen the valuations come down across the sector. Does that make it more appealing to slot some of these names into this Exact Sciences commercial engine? What are you looking for? Is it new capabilities? Or would you rather add established products in the bag?

今晚打了幾個電話，如果您已經解決了這個問題，我們深表歉意。但我只是希望我們能得到你關於基因組學領域併購的最新想法。我們已經看到整個行業的估值都在下降。這是否會使將其中一些名稱插入此 Exact Sciences 商業引擎更具吸引力？你要買什麼？是新的能力嗎？或者您更願意在包中添加既定產品？

Well, our primary focus is on Cologuard, Oncotype and then 3 pretty remarkable opportunities in colon cancer screening, both stool and blood, multi-cancer screening, which probably has the biggest potential for impact in human health of any diagnostic ever developed. And then also minimum residual disease testing.

好吧，我們的主要重點是 Cologuard、Oncotype，然後是結腸癌篩查中的 3 個非常重要的機會，包括糞便和血液、多癌症篩查，這可能是迄今為止開發的任何診斷方法中對人類健康影響最大的潛力。然後還有最小殘留病檢測。

Our philosophy on M&A hasn't changed. We'll consider it if 3 conditions are met. Number one, it contributes to our long-term strategy. Two, the company is a good culture fit. And three, it creates shareholder value. So no changes there in our focus. I'd point out that we added a prevention genetics team. It's an amazing talented team. It's added over $40 million of profitable revenue in a new product line, Riskguard. And so it's all about quality and strategic fit.

我們的併購理念沒有改變。如果滿足3個條件，我們會考慮它。第一，它有助於我們的長期戰略。第二，公司文化契合度高。第三，它創造了股東價值。所以我們的重點沒有改變。我要指出的是，我們增加了一個預防遺傳學小組。這是一個了不起的天才團隊。它在新產品線 Riskguard 中增加了超過 4000 萬美元的盈利收入。因此，這一切都與質量和戰略契合有關。

There are no further questions at this time. This concludes today's conference call. You may now disconnect.

目前沒有其他問題。今天的電話會議到此結束。您現在可以斷開連接。