Guardant Health Inc (GH) 2025 Q1 法說會逐字稿

Hello, everybody, and welcome to the Guardant Health Q1 2025 earnings call. My name is Elliot, and I'll be your coordinator today. (Operator Instructions)

大家好，歡迎參加 Guardant Health 2025 年第一季收益電話會議。我叫艾略特，今天我將擔任您的協調員。（操作員指示）

I would now like to hand over to Zarak Khurshid, Vice President of Investor Relations. Please go ahead.

現在我想把麥克風交給投資人關係副總裁 Zarak Khurshid。請繼續。

Thank you. Earlier today, Guardant Health released financial results for the quarter ended March 31, 2025. Joining me today from Guardant are Helmy Eltoukhy, Co-CEO; AmirAli Talasaz, Co-CEO; and Mike Bell, Chief Financial Officer. Before we begin, I'd like to remind you that during this call, management will make forward-looking statements within the meaning of federal securities laws. These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated.

謝謝。今天早些時候，Guardant Health 發布了截至 2025 年 3 月 31 日的季度財務業績。今天與我一起出席的還有 Guardant 聯合執行長 Helmy Eltoukhy； AmirAli Talasaz，聯合執行長；以及財務長 Mike Bell。在我們開始之前，我想提醒您，在本次電話會議中，管理層將根據聯邦證券法做出前瞻性陳述。這些聲明涉及重大風險和不確定性，可能導致實際結果或事件與預期有重大差異。

This call will also include a discussion of non-GAAP financial measures, which are adjusted to exclude certain specified items. Additional information regarding material risks and uncertainties as well as the non-GAAP financial reconciliation to most directly comparable GAAP financial measures are available in the press release Guardant issued today as well as in our 10-K and other filings with the SEC.

本次電話會議也將討論非公認會計準則財務指標，這些指標經過調整以排除某些特定項目。有關重大風險和不確定性以及非 GAAP 財務與最直接可比的 GAAP 財務指標的調節的更多信息，請參閱 Guardant 今天發布的新聞稿以及我們向美國證券交易委員會 (SEC) 提交的 10-K 和其他文件。

Guardant disclaims any intention or obligation to update or revise financial projections and forward-looking statements, whether because of new information, future events, or otherwise, except as required by law. The information in this conference call is accurate only as of the live broadcast.

除非法律要求，Guardant 不承擔更新或修改財務預測和前瞻性聲明的任何意圖或義務，無論是由於新資訊、未來事件或其他原因。本次電話會議中的資訊僅在現場直播時準確。

With that, I would like to turn the call over to Helmy.

說完這些，我想把電話轉給 Helmy。

Thanks, Zarak, Good afternoon, and thank you for joining our first-quarter 2025 earnings call. Starting on slide 3. We started the year with strong momentum across our portfolio, fueled by groundbreaking product upgrades introduced in 2024, which leverage our Smart Liquid Biopsy platform, as well as the launch of Shield.

謝謝，扎拉克，下午好，感謝您參加我們的 2025 年第一季財報電話會議。從投影片 3 開始。今年伊始，我們的產品組合呈現強勁發展勢頭，這得益於 2024 年推出的突破性產品升級，這些升級利用了我們的智慧液體活檢平台以及 Shield 的推出。

We continue to successfully execute on our long-term vision to support patients throughout their entire cancer journey from early detection, monitoring of recurrence, to treatment selection. By delivering critical insights at every stage of cancer care, we empower clinicians to deliver timely, actionable insights that make a meaningful difference in the lives of patients and their families around the world.

我們繼續成功執行我們的長期願景，為患者在整個癌症治療過程中提供支持，從早期發現、復發監測到治療選擇。透過在癌症治療的每個階段提供關鍵見解，我們使臨床醫生能夠提供及時、可行的見解，為世界各地的患者及其家人的生活帶來有意義的改變。

As we do each quarter, I would like to start our call today by sharing a powerful story that captures the real-world impact of our Guardant Reveal test and the difference it can make in the lives of those we serve. In September 2022, a 55-year-old woman was diagnosed with breast cancer and later identified as having a pathogenic BRCA1 variant. She was prescribed neoadjuvant chemotherapy to help shrink the tumor prior to surgery, and a few months later, the cancer was removed successfully.

就像每個季度一樣，今天我想透過分享一個強大的故事來開始我們的電話會議，這個故事捕捉了我們的 Guardant Reveal 測試在現實世界中的影響，以及它對我們服務對象的生活產生的影響。2022 年 9 月，一名 55 歲的女性被診斷出罹患乳癌，後來被確診為具有致病性 BRCA1 變異。醫生在手術前給她安排了新輔助化療來幫助縮小腫瘤，幾個月後，癌症被成功切除。

In order to monitor for potential recurrence, her oncologist ordered an initial Reveal test shortly after surgery, and six subsequent Reveal tests have been performed over the last two years at three- to six-month intervals. All six Reveal tests have returned negative results. And today, the patient is enjoying life with the peace of mind that she remains cancer-free.

為了監測潛在的復發，她的腫瘤科醫生在手術後不久就安排了初步的 Reveal 測試，並且在過去兩年中每隔三到六個月進行了六次後續的 Reveal 測試。六次 Reveal 測試全部結果均為陰性。如今，患者因沒有罹患癌症而安心享受生活。

Turning to top-line performance on slide 4. We had an excellent start to the year, with Q1 revenue growing 21% year over year to $203 million. As we discussed last quarter, we are now reporting revenue in a way that more closely aligns with how we run the business, and we believe this new reporting structure will help investors and analysts better understand our rapidly evolving business. The four revenue lines are: oncology, which represents clinical therapy selection and MRD testing revenue; biopharma and data, which represents the revenue we generate from our biopharma customers from sample testing, companion diagnostic collaborations, and data services; screening, which represents Shield testing revenue; and finally, licensing and other.

轉向幻燈片 4 上的頂線表現。我們今年有一個良好的開端，第一季營收年增 21%，達到 2.03 億美元。正如我們上個季度所討論的那樣，我們現在以更符合我們業務運作方式的方式報告收入，我們相信這種新的報告結構將幫助投資者和分析師更好地了解我們快速發展的業務。這四條收入線分別是：腫瘤學，代表臨床治療選擇和MRD檢測收入；生物製藥和數據，代表我們從生物製藥客戶那裡通過樣品測試、伴隨診斷合作和數據服務獲得的收入；篩檢，代表 Shield 測試收入；最後，許可和其他。

Starting with our oncology business on slide 5. Q1 represented another quarter of strong oncology performance, with revenue increasing 20% year over year to $151 million. Oncology volumes increased 25% year-over-year to approximately 59,000 tests in the first quarter, with the majority of growth driven by Guardant360, closely followed by strong contribution from Reveal.

從幻燈片 5 上的腫瘤學業務開始。第一季是腫瘤學表現強勁的另一個季度，營收年增 20%，達到 1.51 億美元。第一季腫瘤學檢測量年增 25%，達到約 59,000 次，其中大部分成長由 Guardant360 推動，緊隨其後的是 Reveal 的強勁貢獻。

Looking more closely at some of the recent highlights within our oncology business on slide 6. We experienced continued volume growth across all oncology tests, with notable strength from Guardant360 volume, which accelerated again in the quarter following the major product upgrades leveraging the Smart Liquid Biopsy platform last year.

在第 6 張投影片上更仔細地查看我們腫瘤學業務中的一些近期亮點。所有腫瘤學檢測的銷售量均持續成長，其中 Guardant360 的銷售表現尤為強勁，繼去年利用智慧液體活檢平台進行重大產品升級後，本季銷量再次加速。

In addition to the strengthening product portfolio across both liquid and tissue, we continue to invest in EMR integrations, which are helping to improve depth of ordering per account. I'm pleased to share that Guardant360 ASP improved again this quarter to the range of $3,000 to $3,100, driven by continued improvement in Medicare Advantage and commercial reimbursement.

除了加強液體和組織產品組合外，我們還繼續投資於 EMR 集成，這有助於提高每個帳戶的訂購深度。我很高興地告訴大家，受醫療保險優勢計劃和商業報銷持續改善的推動，Guardant360 ASP 本季度再次提高至 3,000 至 3,100 美元的範圍。

As a reminder, Tissue Medicare pricing increased from $3,140 to $3,500 at the start of the year, and we received Medicare coverage for Reveal in the CRC surveillance setting in January. This reimbursement win for Reveal allows us to more aggressively invest in commercial efforts supporting the test, resulting in greater accessibility for patients and enabling oncologists to make more informed therapeutic decisions.

提醒一下，今年年初，組織醫療保險價格從 3,140 美元上漲到 3,500 美元，我們在 1 月獲得了 CRC 監測環境中 Reveal 的醫療保險覆蓋。Reveal 的這次報銷勝利使我們能夠更積極地投資於支持該測試的商業努力，從而為患者提供更大的可及性，並使腫瘤學家能夠做出更明智的治療決策。

In the first quarter, Reveal was gross margin positive for the first time, driven predominantly by the 50% COGS improvement we achieved exiting 2024. We continue to believe this positive gross margin inflection, along with CRC surveillance reimbursement announced in the quarter, will allow us to unlock volume acceleration while meaningfully improving cash burn.

第一季度，Reveal 的毛利率首次實現正成長，這主要得益於我們在 2024 年後實現的 50% 的 COGS 改善。我們仍然相信，這一積極的毛利率變化，加上本季宣布的 CRC 監控報銷，將使我們能夠實現銷量加速，同時顯著改善現金消耗。

Moving on to slide 7. Now I would like to highlight some of our Infinity Smart Liquid Biopsy application development work in greater depth. We have been quietly developing powerful real-world evidence platform utilizing the nearly 100,000 broad genomic and epigenomic profiles spanning more than 50 cancer types that we have assembled. Moreover, most of these profiles have been combined with rich clinical data.

移至幻燈片 7。現在我想更深入地介紹我們的一些 Infinity Smart 液體活檢應用開發工作。我們一直在悄悄地開發強大的真實世界證據平台，利用我們收集的涵蓋 50 多種癌症類型的近 100,000 個廣泛的基因組和表觀基因組圖譜。此外，這些資料大多已與豐富的臨床數據結合。

And when analyzed with our Infinity AI learning engine, have enabled the development of the groundbreaking clinical applications we have launched and are continuing to launch this year. Specifically, a significant number of the 18 abstracts we are presenting at AACR are highlighting some of these new applications, which enable features such as tumor burden quantification, tumor subtyping, CHIP annotation, HRD detection, immunotherapy prediction, and many, many more to come. We believe these applications will soon set a new standard-of-care in oncology.

透過我們的 Infinity AI 學習引擎進行分析，我們得以開發出我們已經推出並將於今年繼續推出的突破性臨床應用程式。具體來說，我們在 AACR 上展示的 18 篇摘要中，有相當一部分重點介紹了其中一些新應用，這些應用實現了腫瘤負擔量化、腫瘤亞型、CHIP 註釋、HRD 檢測、免疫療法預測等功能，以及即將推出的許多其他功能。我們相信這些應用很快就會為腫瘤學的治療樹立新的標準。

Moving on to slide 8. We are pleased to announce that we have launched our upgraded tissue test, which is called Guardant360 Tissue. Guardant360 Tissue represents what we believe to be the first of its kind broad multiomic tissue CGP test to incorporate comprehensive DNA, RNA, AI-powered PD-L1, and broad methylome analysis.

移至幻燈片 8。我們很高興地宣布，我們已經推出了升級版的組織測試，稱為 Guardant360 Tissue。Guardant360 Tissue 代表了我們認為的首個廣泛多組學組織 CGP 測試，它結合了全面的 DNA、RNA、AI 驅動的 PD-L1 和廣泛的甲基化組分析。

This marks the final major product in the oncology portfolio to be upgraded to the Infinity Smart Liquid Biopsy platform, which will enable our tissue product to leverage and accrue many of the groundbreaking epigenomic-powered features we are launching on Guardant360 Liquid. In this way, all of our products spanning our liquid and tissue portfolio will work together synergistically to provide a differentiated physician and patient experience across therapy selection and MRD in pursuit of improved clinical outcomes.

這標誌著腫瘤學產品組合中最後一個主要產品升級到 Infinity Smart Liquid Biopsy 平台，這將使我們的組織產品能夠利用和累積我們在 Guardant360 Liquid 上推出的許多突破性的表觀基因組學功能。透過這種方式，我們涵蓋液體和組織產品組合的所有產品將協同作用，在治療選擇和 MRD 方面提供差異化的醫生和患者體驗，以追求改善的臨床結果。

Finally, since Guardant360 Tissue is built from the ground up utilizing our Smart Liquid Biopsy platform, it can provide results with 40% less tissue required than most of our key competitors, enabling some of the lowest industry-wide sample requirements for next-generation sequencing. We are excited for this next generation of tissue CGP.

最後，由於 Guardant360 Tissue 是利用我們的智慧液體活檢平台從頭開始構建的，因此與我們的大多數主要競爭對手相比，它所需的組織量減少了 40%，從而實現了下一代測序行業範圍內最低的樣本要求。我們對下一代組織 CGP 感到非常興奮。

Now shifting gears to Reveal on slide 9, where we are the leader in tissue-free MRD. We are excited to announce a new breast cancer publication in Clinical Cancer Research, highlighting the performance of Guardant Reveal. Importantly, this is the first publication utilizing Reveal on our Smart Liquid Biopsy platform with early-stage stage II-III triple-negative breast cancer patients. This retrospective study evaluated triple-negative breast cancer patients who are undergoing neoadjuvant chemotherapy.

現在轉到幻燈片 9 上的展示，我們是無組織 MRD 領域的領導者。我們很高興地宣佈在《臨床癌症研究》上發表了一篇新的乳癌出版物，重點介紹了 Guardant Reveal 的表現。重要的是，這是第一篇利用我們的智慧液體活檢平台 Reveal 針對早期 II-III 期三陰性乳癌患者的出版物。這項回顧性研究評估了正在接受新輔助化療的三陰性乳癌患者。

With 83% sensitivity for distant recurrence and 99.5% specificity at the sample level, this data shows that Reveal has the potential to significantly guide postsurgical monitoring and therapeutic decisions. This publication is building our data evidence towards submission for Medicare reimbursement in breast cancer, which is expected this year.

在樣本層面上，遠端復發的敏感性為 83%，特異性為 99.5%，這些數據表明 Reveal 具有顯著指導術後監測和治療決策的潛力。該出版物正在為我們今年提交的乳癌醫療保險報銷申請累積數據證據。

Turning to slide 10. Beyond CRC and breast, we have an extensive pipeline of clinical cohorts to further support clinical utility and analytical validity for Guardant Reveal. We recently submitted data for publications supporting potential Medicare reimbursement for coverage in immuno-oncology therapeutic monitoring, and have a number of ongoing clinical validity studies for additional cancers. We look forward to sharing updates on our progress throughout the year.

翻到第 10 張投影片。除了 CRC 和乳癌之外，我們還有廣泛的臨床隊列，以進一步支持 Guardant Reveal 的臨床實用性和分析有效性。我們最近提交了出版物數據，支持潛在的醫療保險報銷免疫腫瘤治療監測費用，並且正在針對其他癌症進行多項臨床有效性研究。我們期待全年分享我們的進展。

Turning to slide 11. The oncology business is well positioned to continue to experience durable growth, benefiting from organic market growth, ASP tailwinds, and continued international expansion. Guardant360 Liquid and Guardant360 Tissue are further benefiting from recently expanded genomic and epigenomic breadth, which are unlocking greater utility and driving share gain.

翻到第 11 張投影片。由於有機市場成長、平均售價順風以及持續的國際擴張，腫瘤業務已準備好繼續實現持久成長。Guardant360 Liquid 和 Guardant360 Tissue 進一步受益於最近擴大的基因組和表觀基因組廣度，從而釋放出更大的效用並推動市場份額的增長。

In MRD, our redoubled commercial focus following major COGS improvements in Medicare CRC surveillance reimbursement are helping to fuel growth. Guardant Reveal has seen strong uptake in breast cancer already, and we have additional publications of breast data and IO monitoring data this year that will help to further unlock demand in indications beyond CRC.

在 MRD 方面，隨著 Medicare CRC 監測報銷的 COGS 大幅改善，我們加倍重視商業，這有助於推動成長。Guardant Reveal 已在乳癌領域取得了強勁成長，今年我們也將發布更多乳房數據和 IO 監測數據，這將有助於進一步釋放 CRC 以外適應症的需求。

Looking more closely at some of the recent highlights within our biopharma and data business on slide 12. We had another strong quarter for biopharma, with first quarter revenue growing 21% year over year. We continue to see an increasing number of biopharma partnerships and growing mix of volume leveraging methylation analysis from our Smart Liquid Biopsy platform.

在第 12 張投影片上更仔細地查看我們生物製藥和數據業務中的一些近期亮點。我們的生物製藥業務又迎來了一個強勁的季度，第一季營收年增 21%。我們持續看到越來越多的生物製藥合作夥伴和利用我們智慧液體活檢平台的甲基化分析的數量不斷增長。

We recently announced a strategic collaboration agreement with Pfizer, which meaningfully strengthens and expands our long-term partnership where Guardant360 has been a preferred liquid biopsy test in various Pfizer clinical trials. We have also built a robust and growing pipeline of companion diagnostic deals.

我們最近宣布與輝瑞達成戰略合作協議，這將有力地加強和擴大我們的長期合作夥伴關係，其中 Guardant360 已成為輝瑞各項臨床試驗中首選的液體活檢測試。我們也建立了強大且不斷成長的伴隨診斷交易管道。

Lastly, pertaining to our Guardant Inform real-world data business, we continue to expand our presence with large pharma partners such as the recently announced Bayer and ConcertAI collaboration, benefiting from the growing interest in our industry-leading methylation knowledge base and the expanding richness of our EMR-linked data offering.

最後，關於我們的 Guardant Inform 真實世界數據業務，我們繼續擴大與大型製藥合作夥伴的合作，例如最近宣布的拜耳和 ConcertAI 合作，受益於人們對我們行業領先的甲基化知識庫日益增長的興趣以及我們 EMR 鏈接數據產品的不斷豐富。

With that, I will now turn the call over to AmirAli for an update on screening.

說完這些，我現在將電話轉給 AmirAli，詢問其篩選的最新情況。

Thanks, Helmy. Moving on to slide 13. We are pleased to see continued strong traction for Shield in the second full quarter of commercial launch. We delivered $5.7 million of Shield testing revenue in Q1, driven by approximately 9,000 tests, and exited the quarter with positive momentum. We continue to experience outstanding reception from physicians and patients.

謝謝，Helmy。移至幻燈片 13。我們很高興看到 Shield 在商業發布的第二個完整季度繼續保持強勁成長勢頭。我們在第一季實現了 570 萬美元的 Shield 測試收入，其中約有 9,000 次測試，並且在本季結束時我們保持了積極的勢頭。我們繼續受到醫生和患者的熱烈歡迎。

The depth of ordering per account continues to be strong, reaffirming the market opportunity, the product-market fit, and the differentiated physician and patient experience compared to existing modalities. We are particularly encouraged by our sales force productivity ramp.

每個帳戶的訂購深度持續保持強勁，再次證明了市場機會、產品市場契合度以及與現有模式相比差異化的醫生和患者體驗。銷售隊伍生產力的提升令我們特別受鼓舞。

Turning to slide 14. We were very pleased last month with Shield receiving ADLT status, which catalyzed the increase in Medicare price from $920 to $1,495 effective April 1. ADLT status reinforces the value that Shield brings to patients as a more pleasant and convenient option for CRC screening that can help increase the overall screening rate and improve CRC survival outcomes.

翻到第 14 張投影片。上個月，我們非常高興 Shield 獲得了 ADLT 資格，這促使 4 月 1 日起醫療保險價格從 920 美元上漲至 1,495 美元。ADLT 狀態強化了 Shield 為患者帶來的價值，它是一種更愉快、更方便的 CRC 篩檢選擇，有助於提高整體篩檢率並改善 CRC 生存結果。

This more favorable Medicare rate allows us to accelerate the commercial infrastructure buildout to bring Shield to a wider audience.

這項更優惠的醫療保險費率使我們能夠加快商業基礎設施建設，讓 Shield 惠及更廣泛的受眾。

Turning now to slide 15 to take a closer look at our screening highlights for the first quarter of 2025. I'm excited to share that we achieved positive gross margin for Shield in the first quarter, much sooner than we had originally anticipated. This was driven by COGS improvement and a high mix of reimbursable test volume. We received coverage from the VA Community Care Network, which brings Shield access to over 9 million VA beneficiaries with no copay.

現在翻到第 15 張投影片來仔細看看我們 2025 年第一季的篩選亮點。我很高興地告訴大家，我們在第一季實現了 Shield 的正毛利率，這比我們最初預期的要快得多。這是由 COGS 改進和可報銷測試量的高組合推動的。我們獲得了 VA 社區護理網絡的保障，該網絡為超過 900 萬 VA 受益人提供了 Shield 保險，且無需自付費用。

Importantly, the VA will cover Shield for all eligible individuals between 45 and 84 years old, which marks Shield's first coverage of patients below the Medicare age. And last week, the American Gastroenterological Association, or AGA, the leading professional organization representing top leaders in the GI space, released a Clinical Practice Update. This update mentioned the potential for Shield to improve adherence to cancer screening and recognized that programmatic screening every three years with this blood test is valuable for currently unscreened individuals.

重要的是，退伍軍人事務部將為所有年齡在 45 歲至 84 歲之間的符合條件的個人提供 Shield 保險，這標誌著 Shield 首次為低於醫療保險年齡的患者提供保險。上週，代表胃腸領域頂尖領導者的領先專業組織美國胃腸病學協會（AGA）發布了一份臨床實踐更新。此次更新提到了 Shield 提高癌症篩檢依從性的潛力，並認識到每三年進行一次血液測試的程序性篩檢對於目前未接受篩檢的個體非常有價值。

Lastly, a recent Harris Poll survey shows that 92% of patients would be more satisfied with their wellness visit if their provider offered an FDA-approved blood test as an option for a CRC screening. And 93% of primary care providers believe patients are less likely to avoid screening if presented with an FDA-approved blood test option.

最後，哈里斯民意調查最近的一項調查顯示，如果醫療服務提供者提供 FDA 批准的血液檢查作為 CRC 篩檢的一種選擇，92% 的患者會對他們的健康訪問更加滿意。93% 的初級保健提供者認為，如果向患者提供 FDA 批准的血液檢測選項，患者不太可能避免篩檢。

Turning to slide 16. Our goal has always been to identify and catch many cancer types early when they are most treatable. We developed our Shield assay as a platform capable of multi-cancer detection or MCD. CRC screening is the first indication for our Shield test, and we are excited to see Shield CRC is gaining strong traction. We are even more excited about expanding the impact of Shield beyond single cancer screening.

翻到第 16 張投影片。我們的目標一直是及早發現並發現多種類型的癌症，因為它們最容易治療。我們開發了 Shield 檢測作為能夠進行多種癌症檢測或 MCD 的平台。CRC 篩檢是我們 Shield 測試的第一個適應症，我們很高興看到 Shield CRC 正在獲得強大的吸引力。我們更興奮的是，Shield 的影響力將擴展到單一的癌症篩檢之外。

Moving on to slide 17. In early January, we announced Shield selection for inclusion in the National Cancer Institute's Vanguard Study. The Vanguard Study is a 24,000-patient pilot study to evaluate the use of MCD test. Shield was one of the only two technologies selected through a highly competitive process and inclusion not only represented validation of our platform by NCI, but we believe establishes Guardant as a leader in the field of MCD. We are pleased that FDA has completed the review of our Shield MCD device in their approval of the Investigational Device Exemption, or IDE, supporting the Vanguard Study, which is expected to start in the very near future.

移至投影片 17。1 月初，我們宣布 Shield 被選入美國國家癌症研究所的先鋒研究。Vanguard 研究是一項涉及 24,000 名患者的試驗研究，旨在評估 MCD 測試的使用情況。Shield 是透過高度競爭流程選出的僅有的兩項技術之一，其入選不僅代表了 NCI 對我們平台的認可，而且我們相信這也確立了 Guardant 在 MCD 領域的領先地位。我們很高興 FDA 已完成對我們的 Shield MCD 設備的審查，並批准了研究設備豁免 (IDE)，以支持預計在不久的將來進行的 Vanguard 研究。

And this week at AACR, we are excited to present the validation performance data from Shield MCD that was the basis for its selection by NCI. Overall sensitivity for 10 cancers was 60%, with 35% sensitivity in Stage I-II and 84% sensitivity in Stage III-IV cancers at a specificity of 98.5%.

本週在 AACR，我們很高興展示 Shield MCD 的驗證效能數據，這是 NCI 選擇它的基礎。10 種癌症的整體敏感性為 60%，其中 I-II 期癌症的敏感性為 35%，III-IV 期癌症的敏感性為 84%，特異性為 98.5%。

While Shield can operate at a specificity level of 99.5%, the NCI preferred 98.5% specificity to optimize for early-stage sensitivity. Primary or secondary cancer site of origin, or CSO, accuracy was 89%. As a reminder, cancer site of origin refers to the prediction made by the test about the likely organ where a cancer signal originates. CSO accuracy was an important factor in the NCI evaluation process, and our diligence suggests it is critically important to the commercial success of MCD test.

雖然 Shield 的特異性可以達到 99.5%，但 NCI 更傾向於 98.5% 的特異性，以優化早期敏感性。原發性或繼發性癌症起源部位（CSO）的準確率為 89%。提醒一下，癌症原發部位是指透過測試對癌症訊號可能起源的器官所做的預測。CSO 準確性是 NCI 評估過程中的一個重要因素，我們的勤勉表明它對於 MCD 測試的商業成功至關重要。

Turning to slide 18 to take a closer look at the data. Sensitivity in the six most aggressive cancers with the shortest survival rates, including esophageal, lung, liver, pancreatic, ovarian, and gastric was 74%, ranging from 67% in lung cancer to 96% in esophageal and gastric cancers. This test has the opportunity to save many lives. And following the commencement of the NCI Vanguard Study this year, multi-cancer detection analysis capabilities of the Shield test will be ready to be clinically offered.

翻到第 18 張投影片來仔細檢視數據。對食道癌、肺癌、肝癌、胰腺癌、卵巢癌和胃癌這六種最具侵襲性和生存期最短的癌症的敏感性為 74%，範圍從肺癌的 67% 到食道癌和胃癌的 96%。這次測試有機會挽救許多人的生命。隨著今年 NCI Vanguard 研究的開始，Shield 測試的多癌症檢測分析功能將準備好在臨床上應用。

Looking ahead, we are excited about our upcoming milestones in 2025, including the potential inclusion of Shield in American Cancer Society, or ACS guidelines, Shield CRC V2 data and potentially launching Shield V2 later this year. With that, I will now turn the call over to Mike for more detail on our financials.

展望未來，我們對 2025 年即將到來的里程碑感到興奮，包括可能將 Shield 納入美國癌症協會或 ACS 指南、Shield CRC V2 數據以及今年稍後可能推出 Shield V2。說完這些，我現在將把電話轉給麥克，以了解有關我們財務狀況的更多詳細資訊。

Thanks, AmirAli. Turning to slide 19. I'll now discuss some select financial highlights for the quarter ended March 31, 2025. I'll refer to year-over-year growth rates, unless otherwise noted. As previously mentioned, going forward, we will present new revenue categories. To help with modeling and analysis, we've included supplemental information on our Investor Relations website that breaks out historical 2024 quarterly revenue into the new categories.

謝謝，AmirAli。翻到第 19 張投影片。我現在將討論截至 2025 年 3 月 31 日的季度的一些財務亮點。我將參考年成長率，除非另有說明。如前所述，未來我們將推出新的收入類別。為了幫助建模和分析，我們在投資者關係網站上添加了補充信息，將 2024 年曆史季度收入細分為新的類別。

First-quarter total revenue grew 21% to $203.5 million and was largely driven by oncology revenue, which grew 20% to $150.6 million. Oncology volume grew 25% to approximately 59,000 tests in Q1, with the majority of unit growth driven by Guardant360, closely followed by a strong contribution from Reveal. Year-over-year Guardant360 growth accelerated again in Q1, marking the third consecutive quarter of accelerated growth. Reveal continued to represent our fastest-growing product on a year-over-year basis.

第一季總營收成長 21% 至 2.035 億美元，主要得益於腫瘤學收入成長 20% 至 1.506 億美元。第一季腫瘤學檢測量成長了 25%，達到約 59,000 次，其中大部分單位成長由 Guardant360 推動，緊隨其後的是 Reveal 的強勁貢獻。Guardant360 第一季同比成長再次加速，這是其連續第三個季度實現加速成長。與去年同期相比，Reveal 繼續成為我們成長最快的產品。

Guardant360 ASP was in the range of $3,000 to $3,100 in the first quarter of 2025 compared to approximately $3,000 in Q4 2024. This increased Guardant360 ASP was a function of continued improved reimbursement from Medicare Advantage and commercial payers. First-quarter oncology revenue also benefited from an out-of-period upside of approximately $5 million above our normal expected level. This compares to an $8 million out-of-period upside that we recognized in Q1 2024.

2025 年第一季度，Guardant360 的平均售價在 3,000 美元至 3,100 美元之間，而 2024 年第四季約為 3,000 美元。Guardant360 平均售價的上漲得益於 Medicare Advantage 和商業付款人的報銷持續增加。第一季腫瘤學收入也受惠於期外成長，比我們正常預期水準高出約 500 萬美元。相較之下，我們在 2024 年第一季確認了 800 萬美元的期外上漲。

Our biopharma and data business performed incredibly well again in the first quarter with revenue totaling $45.4 million, an increase of 21%. Our biopharma pipeline continues to shape up solidly, driven by Guardant Infinity on our Smart Liquid Biopsy platform, and the recently announced multiyear strategic collaboration with Pfizer further adds to our confidence in both the short-term and long-term business.

我們的生物製藥和數據業務在第一季再次表現優異，總收入達 4,540 萬美元，成長 21%。在智慧液體活檢平台上的 Guardant Infinity 的推動下，我們的生物製藥產品線繼續穩步發展，最近宣布的與輝瑞的多年戰略合作進一步增強了我們對短期和長期業務的信心。

Screening revenue totaled $5.7 million in Q1 2025, generated from the 9,000 Shield tests that we reported in the quarter. And finally, licensing and other revenue was $1.9 million compared to $5.2 million in the prior year period.

2025 年第一季篩檢收入總計 570 萬美元，來自我們本季報告的 9,000 次 Shield 測試。最後，許可證和其他收入為 190 萬美元，而去年同期為 520 萬美元。

Turning to slide 20. We're extremely pleased to be able to report that both Reveal and Shield became gross margin positive in the first quarter of 2025.

翻到第 20 張投影片。我們非常高興地報告，Reveal 和 Shield 在 2025 年第一季均實現了毛利率為正。

For Reveal, we saw the full impact of the workflow changes made towards the end of last year, which have resulted in a significant reduction in cost per test. From an average cost of more than $1,000 in 2024, we've achieved a reduction of more than 50% with the cost per test now less than $500. This, together with an improved Reveal CRC ASP of more than $600 following Medicare coverage, means that we can now unlock Reveal volume acceleration while meaningfully improving cash burn.

對於 Reveal，我們看到了去年年底進行的工作流程變革的全部影響，這些變革顯著降低了每次測試的成本。從 2024 年的平均成本超過 1,000 美元，到現在每次測試的成本已減少 50% 以上，不到 500 美元。這與醫療保險覆蓋後 Reveal CRC ASP 提高至 600 多美元一起，這意味著我們現在可以釋放 Reveal 銷售加速，同時顯著改善現金消耗。

For Shield, we also saw a continued reduction in cost per test, driven by increased volume and by tight cost control and efficiencies across our screening operations. In the first quarter of 2025, Shield cost per test was approximately $500.

對於 Shield，我們還看到每次測試的成本持續降低，這得益於測試量的增加以及整個篩檢操作的嚴格成本控制和效率。2025 年第一季度，Shield 每次測試的成本約為 500 美元。

With an ASP of approximately $600, Shield is also now gross margin positive. We expect the gross margin to further expand in Q2 due to the increase in ASP we'll get from ADLT status, which was effective April 1 and from continued volume-related cost reductions.

Shield 的平均銷售價格約為 600 美元，目前毛利率也為正。我們預計，由於 4 月 1 日生效的 ADLT 狀態將帶來平均售價的上漲，並且與產量相關的成本將持續降低，因此第二季的毛利率將進一步擴大。

Moving on to slide 21. Our non-GAAP gross margin of 65% was above our expectations in the first quarter of 2025 and was an improvement compared to 63% in the first quarter of 2024. The strong gross margin was primarily a result of the improved oncology ASPs as well as the significant Reveal and Shield COGS reductions.

翻到第 21 張投影片。2025 年第一季度，我們的非 GAAP 毛利率為 65%，高於我們的預期，與 2024 年第一季的 63% 相比有所提高。強勁的毛利率主要得益於腫瘤學平均售價的提高以及 Reveal 和 Shield COGS 的大幅降低。

Non-GAAP operating expenses were $199.6 million in the first quarter of 2025, an increase of 13% and in line with our expectations. Both non-GAAP R&D and G&A expenses in the quarter were approximately flat compared to prior year, which reflects the operating leverage that we are achieving throughout the business.

2025 年第一季非公認會計準則營運費用為 1.996 億美元，成長 13%，符合我們的預期。本季非公認會計準則研發費用和一般及行政費用與去年同期相比基本持平，這反映了我們在整個業務中實現的營運槓桿。

As expected, non-GAAP sales and marketing expense increased 29% to $94.1 million in the first quarter of 2025. This increase was due to the ongoing screening commercial buildout as well as continued investment in oncology sales and marketing. Adjusted EBITDA loss was $58.5 million for Q1 2025, an improvement of $2.6 million compared to a loss of $61.1 million in Q1 2024.

正如預期的那樣，2025 年第一季非 GAAP 銷售和行銷費用成長 29%，達到 9,410 萬美元。這一增長歸因於正在進行的篩檢商業建設以及對腫瘤學銷售和行銷的持續投資。2025 年第一季調整後 EBITDA 虧損為 5,850 萬美元，較 2024 年第一季 6,110 萬美元的虧損改善 260 萬美元。

We continue to be focused on cash management and reducing our burn in 2025 versus 2024. Q1 2025 free cash flow burn was $67 million, compared to $37 million in the prior year period. The year-over-year increase was entirely due to the timing of the company's annual bonus payout, which this year was made in Q1 and which in previous years has been made in Q2. Adjusting for this timing difference, free cash flow burn in the quarter decreased year over year.

我們將繼續專注於現金管理，並減少 2025 年和 2024 年的現金消耗。2025 年第一季自由現金流消耗為 6,700 萬美元，去年同期為 3,700 萬美元。年比成長完全是由於公司年度獎金發放的時間，今年是在第一季度，而往年是在第二季度。調整此時間差異後，本季自由現金流消耗較去年同期有所下降。

We ended the quarter with approximately $804 million in cash, cash equivalents, and restricted cash. We continue to expect that we will reach cash flow breakeven in 2028, with cumulative free cash outflow of $450 million to $550 million over the next three years.

本季末，我們擁有約 8.04 億美元的現金、現金等價物和受限現金。我們仍然預計，我們將在 2028 年實現現金流收支平衡，未來三年累計自由現金流出將達到 4.5 億至 5.5 億美元。

Moving to slide 22 for our outlook and assumptions for the full-year 2025. We're increasing our full-year 2025 revenue to be in the range of $880 million to $890 million, representing growth of approximately 19% to 20% compared to 2024 and an increase of $30 million compared to our prior range of $850 million to $860 million.

前往投影片 22，查看我們對 2025 年全年的展望和假設。我們將 2025 年全年營收提高至 8.8 億美元至 8.9 億美元之間，與 2024 年相比成長約 19% 至 20%，與先前的 8.5 億美元至 8.6 億美元相比增加 3,000 萬美元。

We now expect oncology revenue to grow approximately 18% year over year in 2025 compared to our prior guidance of 15%. The increase is based on stronger-than-expected volumes and reimbursement experienced in Q1 2025 and improved Guardant360 ASPs and oncology volume now projected for the remainder of the year.

我們現在預計，到 2025 年，腫瘤學收入將年增約 18%，而我們先前的預測是 15%。此次成長是基於 2025 年第一季強於預期的銷售和報銷情況，以及預計今年剩餘時間內 Guardant360 ASP 和腫瘤學銷量的提高。

Given the continued positive traction we're seeing from Guardant360 LDT on Smart Liquid Biopsy, the Medicare CRC surveillance coverage for Reveal, and the recent upgrade to Guardant360 Tissue, we continue to expect volumes across all oncology products to accelerate in 2025, and we now expect total oncology volume to grow greater than 25%.

鑑於我們看到 Guardant360 LDT 在智慧液體活檢、Medicare CRC 監測覆蓋 Reveal 以及最近對 Guardant360 Tissue 的升級方面持續取得積極進展，我們繼續預計所有腫瘤產品的數量將在 2025 年加速增長，我們現在預計腫瘤總產量將增長 25% 以上。

We expect our biopharma business to perform well throughout 2025 and continue to expect low-double-digit growth for biopharma and data revenue. We are raising our full=year 2025 Shield revenue guidance forecast to $40 million to $45 million from our prior guidance of $25 million to $30 million.

我們預計我們的生物製藥業務將在 2025 年表現良好，並繼續預計生物製藥和數據收入將實現低兩位數成長。我們將 2025 年全年 Shield 收入預測從先前的 2,500 萬至 3,000 萬美元上調至 4,000 萬至 4,500 萬美元。

Approximately $10 million of this increase is the result of obtaining ADLT status for Shield, which increased ASP to approximately $800 per test starting April 1. The remaining $5 million increase in Shield revenue guidance is a result of higher volume, where we now expect 52,000 to 58,000 tests versus our prior guidance of 45,000 to 50,000 tests.

其中約 1000 萬美元的增長是由於 Shield 獲得了 ADLT 資格，從 4 月 1 日起，ASP 增加到每次測試約 800 美元。Shield 收入預期中剩餘的 500 萬美元增長是由於測試量增加，我們現在預計測試量將達到 52,000 至 58,000 次，而我們​​之前的預期是 45,000 至 50,000 次。

We continue to expect full-year volume to be more back-end loaded due to the time required for recently hired sales reps to ramp productivity. With both Reveal and Shield becoming gross margin positive in Q1 2025 and with the progress we're seeing with oncology and Shield ASPs, we're confident that we can deliver full-year non-GAAP gross margins in the range of 62% to 63%. We continue to monitor the tariff news closely. And as a reminder, we do not source any of our assay inputs directly from China.

由於新聘用的銷售代表需要時間來提高生產力，我們仍然預計全年銷售量將更集中在後端。隨著 Reveal 和 Shield 的毛利率在 2025 年第一季均變為正值，並且隨著腫瘤學和 Shield ASP 的進展，我們有信心實現全年非 GAAP 毛利率在 62% 至 63% 之間。我們將繼續密切關注關稅新聞。需要提醒的是，我們的任何檢測投入都不直接從中國採購。

We've completed a thorough materials analysis in concert with our third-party vendors. And based on what we know today, any tariff impact is likely to be minimal. Given the higher 2025 Shield revenue on the heels of ADLT pricing and increased volume, we plan to reinvest the incremental screening gross profit back into the business to accelerate our commercial infrastructure buildout.

我們與第三方供應商合作完成了徹底的材料分析。根據我們目前所知，任何關稅的影響都可能是微乎其微的。鑑於 2025 年 Shield 收入隨著 ADLT 定價和銷量增加而增加，我們計劃將增量篩選毛利重新投資於業務，以加速我們的商業基礎設施建設。

As a result, we now expect 2025 non-GAAP operating expenses to be in the range of $830 million to $840 million, representing a 10% to 11% increase compared to 2024. We continue to expect full-year R&D and G&A expenses to be relatively flat compared to 2024, with the full-year increase in operating expenses coming mainly from investments in sales and marketing activities as we continue to drive top-line growth. Lastly, our commitment to reduction in cash burn each year in order to reach company-wide cash flow breakeven in 2028 is unchanged.

因此，我們現在預計 2025 年非 GAAP 營運費用將在 8.3 億至 8.4 億美元之間，與 2024 年相比成長 10% 至 11%。我們仍預期全年研發和一般行政費用與 2024 年相比將相對持平，全年營運費用的成長主要來自對銷售和行銷活動的投資，因為我們將繼續推動營收成長。最後，我們每年減少現金消耗以在 2028 年實現全公司現金流量收支平衡的承諾保持不變。

For full-year 2025, we still expect free cash flow burn to be in the range of $225 million to $235 million, an improvement compared to $275 million for 2024. We continue to expect our cash burn in 2025 to consist of approximately $200 million related to screening as we scale our Shield business and maximize our first-mover advantage. Significantly, excluding screening, we expect the remainder of the business to burn approximately $25 million to $35 million during the year and to reach cash flow breakeven in the fourth quarter of 2025.

對於 2025 年全年，我們仍預期自由現金流消耗將在 2.25 億美元至 2.35 億美元之間，與 2024 年的 2.75 億美元相比有所改善。隨著我們擴大 Shield 業務規模並最大限度地發揮先發優勢，我們預計 2025 年與篩檢相關的現金消耗將達到約 2 億美元。值得注意的是，除篩選外，我們預計其餘業務今年將消耗約 2,500 萬至 3,500 萬美元，並在 2025 年第四季實現現金流收支平衡。

Finally, turning to slide 23. We've already reached key milestones across each of our business segments, and we continue to have a rich pipeline of catalysts for the remainder of the year.

最後，翻到第 23 張投影片。我們已經在各個業務領域達到了關鍵的里程碑，並且在今年剩餘時間內我們將繼續擁有豐富的催化劑管道。

With that, we'll now open the call to questions.

現在，我們開始回答問題。

(Operator Instructions) Mark Massaro, BTIG.

（操作員指示）Mark Massaro，BTIG。

Congrats on the quarter. Maybe the first one for you, Helmy. You've had Guardant360 in the market now for, I think this is year number 11, and yet you're raising the oncology volume to accelerate to over 25% growth. As this is accelerating, I was wondering if you could help us perhaps rank-order what these opportunities are.

恭喜本季取得佳績。或許對你來說這是第一個，Helmy。我認為今年是 Guardant360 上市第 11 年了，而您的腫瘤治療量卻在加速成長，達到 25% 以上。隨著這一進程的加速，我想知道您是否可以幫助我們對這些機會進行排序。

To what extent is this Epic? To what extent is this potentially competitive takeaways? And then to what extent could this be some boost from attachment to the Guardant360 Tissue?

這是 Epic 到什麼程度？這種外賣在多大程度上具有潛在的競爭力？那麼，附著在 Guardant360 紙巾上能起到多大程度的促進作用呢？

Yes. No, thanks for the question, Mark. We're very pleased in terms of the progress that we're making. I was looking at where we were with 360 over the last couple of years and with the recent Smart Liquid Biopsy upgrade, we're actually seeing some of the strongest growth we've seen in a number of years. This is the third quarter of sequential accelerating growth for that product.

是的。不，謝謝你的提問，馬克。我們對所取得的進展感到非常高興。我回顧了過去幾年 360 的發展情況，隨著最近智慧液體活檢的升級，我們實際上看到了多年來最強勁的增長。這是該產品連續第三季加速成長。

And so, we really know we've achieved product-market fit with respect to the liquid biopsy market and therapy selection. So that's going to continue to be a really nice growth driver. Obviously, Reveal is growing nicely. We're seeing accelerating growth there for the last two quarters as well, and we're going to really lean into that now that we're gross margin positive on that product.

因此，我們確實知道我們已經在液體活檢市場和治療選擇方面實現了產品與市場的契合。所以這將繼續成為一個非常好的成長動力。顯然，Reveal 正在順利發展中。我們也看到過去兩個季度那裡的成長正在加速，而且由於該產品的毛利率為正，我們現在將真正傾向於這一點。

And then last but not least, this massive upgrade we've done on Tissue, where we're really taking everything that has worked so well in liquid for us, especially the last few quarters and essentially putting all of that into the Tissue product. And then everything else you mentioned that increases depth, that simplifies the ordering experience in terms of EMR and digital and so on is sort of gravy on top of all of that. So it's a really nice setup in '25 for us, and we're really excited for this next chapter.

最後但同樣重要的一點是，我們對 Tissue 進行了大規模升級，我們將液體中所有運作良好的功能（尤其是過去幾季的功能）都融入了 Tissue 產品中。然後，您提到的所有其他增加深度、簡化 EMR 和數位等方面的訂購體驗的功能都是額外的好處。所以這對我們來說是 25 年的一個非常好的設置，我們對下一章感到非常興奮。

And then maybe a two-parter on the screening business. Nice to see the raised guide. Can you walk us through the components of that? Obviously, you signed VA and Abu Dhabi. I'm curious what you're seeing on the business development side as well.

然後也許還有關於篩選業務的兩部分內容。很高興看到這個升起的指南。您能向我們介紹一下它的各個組成部分嗎？顯然，你與 VA 和阿布扎比簽署了協議。我也很好奇您在業務發展上看到了什麼。

Any other potential similar type systems that you're engaged with? And then as we think about the ASP assumptions of the raised guide, it's somewhere in the $770 range per test. Why is that the right number when your ADLT price is $1,495, and you're focusing on the Medicare population? And just curious what that Medicare mix was in Q1.

您正在參與的還有其他潛在的類似類型的系統嗎？然後，當我們考慮上調指南的 ASP 假設時，它會在每次測試 770 美元左右。當您的 ADLT 價格為 1,495 美元並且您關注的是醫療保險人群時，為什麼這是正確的數字？我只是好奇第一季的醫療保險組合是怎麼樣的。

Yeah, sure. So maybe I'll start on the commercial side and ask Mike to maybe comment on the ASP front. So we are very excited and pleased with what we are seeing in terms of the productivity of the reps in the field. And this improved productivity is giving us more confidence that maybe we can achieve more than what we originally anticipated.

是的，當然。因此，也許我會從商業方面開始，並請 Mike 對 ASP 方面發表評論。因此，我們對現場代表的生產力感到非常興奮和高興。生產力的提升讓我們更有信心，也許我們可以取得比最初預期更多的成就。

On the Abu Dhabi side, Q1 for them was really to get to the setup of the program. So we have to see really how quickly that program is going to set up. We have limited visibility at this time. As a result, we continue to just assume a fraction of that 10,000 samples that we are contracted for this year would be part of our guide. So really the guide change had no impact by the upside that potentially we are going to have from Abu Dhabi.

在阿布達比方面，Q1 實際上是為了完成該計劃。因此我們必須真正了解該計劃的建立速度有多快。目前我們的能見度有限。因此，我們繼續假設我們今年簽約的 10,000 個樣本中的一小部分將作為我們指南的一部分。因此，指南的改變實際上並沒有對我們從阿布達比獲得的潛在好處產生影響。

We are very excited about this VA. There are millions of people at age 45 and 64 who are going to also get access to this test. We kind of fine-tuned some of our targeting to even have kind of more presence in some of the areas that they have more concentration of these VA families and VA members to really extend the offering to them. And I ask Mike to talk about the ASP.

我們對這次 VA 感到非常興奮。數百萬 45 歲至 64 歲的人也將有機會接受這項測試。我們對我們的一些目標進行了微調，以便在這些 VA 家庭和 VA 成員較為集中的某些地區有更多存在，從而真正為他們提供服務。我請 Mike 談談 ASP。

Yes, on the ASP, of course, we received the ADLT status in Q1, and that goes effective -- or went effective April 1. So the Medicare rate went from $920 to $1,495. And so, yes, that's going to have a nice positive impact on our ASP. For Q1, it was just north of $600. And we expect for the remainder of the year, Q2 to Q4, the ASP to be around $800.

是的，關於 ASP，我們在第一季獲得了 ADLT 狀態，並且將於 4 月 1 日生效。因此醫療保險費率從 920 美元漲到了 1,495 美元。是的，這將對我們的 ASP 產生正面的影響。對於第一季來說，這一價格略高於 600 美元。我們預計今年剩餘時間（第二季至第四季）的平均售價將在 800 美元左右。

So we'll get an uplift from the ADLT. You asked, Mark, around the proportion that's Medicare. There are basically three elements to the ASP. There's obviously the Medicare fee-for-service portion. There's Medicare Advantage, and we're starting to get paid by Medicare Advantage payers.

因此，我們將從 ADLT 獲得提升。馬克，你問的是醫療保險的比例。ASP 基本上有三個要素。顯然，這其中有醫療保險按服務收費的部分。有醫療保險優勢計劃，我們開始從醫療保險優勢計劃的付款人那裡獲得報酬。

But the way that we're recognizing the revenue and the ASP that we're using for that is, I'd say it's conservative at the moment, and there's room for that to improve over time as we see the collections come through. And then there is a portion. It's a relatively small portion, but there is a portion of commercial pays in that. And, of course, at the moment, we're getting paid zero. So you put them all together, we expect ASP again for the remainder of the year to be about $800.

但我認為，我們確認收入和平均售價的方式目前是保守的，而且隨著我們看到收款的增加，還有改進的空間。然後還有一部分。這是相對較小的份額，但其中一部分是商業報酬。當然，目前我們的報酬為零。所以綜合起來，我們預計今年剩餘時間的平均售價將再次達到 800 美元左右。

And overall, getting this ADLT status from April 1, that's roughly a $10 million increase from our original guidance at the start of the year, and that's part of the $30 million uplift in guidance that we've just announced today.

總體而言，從 4 月 1 日起獲得 ADLT 地位，比我們年初的原始指導金額增加了約 1000 萬美元，這也是我們今天剛剛宣布的 3000 萬美元指導金額上調的一部分。

Tycho Peterson, Jefferies.

傑富瑞 (Jefferies) 的 Tycho Peterson。

Maybe just sticking with the guidance theme, there still seems like a lot of that you're not fully baking in here. But can you give us a sense, G360 ASPs, you guided flat previously. What you're baking in for G360 TissueNext? And then Reveal adoption in the surveillance setting, where do you ultimately think you end the year on test per patient?

也許只是堅持指導主題，似乎還有很多內容你沒有完全融入其中。但您能否為我們介紹一下，您之前指導的 G360 ASP 是否平穩。您為 G360 TissueNext 準備了什麼？然後揭示在監測環境中的採用情況，您最終認為今年每位患者的檢測結果會如何？

Yes, Tycho, I can answer the ASP on Guardant360. At the start of the year, we were guiding to $3,000. We saw a nice uplift in Q1, mainly coming again from Medicare Advantage and commercial reimbursement being stronger than expected, and we're in this new range now of $3,000 to $3,100. So we expect that to continue for the remainder of the year. And so that's helped us raise our guide again.

是的，Tycho，我可以回答 Guardant360 上的 ASP。年初，我們的指導價為 3,000 美元。我們在第一季看到了不錯的成長，這主要得益於醫療保險優勢計劃和商業報銷比預期更強勁，現在我們處於 3,000 美元至 3,100 美元的新範圍內。因此我們預計這種情況將在今年剩餘時間內持續下去。這有助於我們再次提高我們的指南。

And for TissueNext, current ASP is around $1,700, $1,800. And so we're effectively assuming a similar rate for the remainder of the year. And we got a nice uplift at the start of the year for Tissue with the Medicare rate going from $3,140 to $3,500.

TissueNext 的當前平均售價約為 1,700 美元至 1,800 美元。因此，我們實際上假設今年剩餘時間的成長率與此類似。今年年初，紙巾的醫療保險費率從 3,140 美元上漲至 3,500 美元，並取得了不錯的成長。

Yes. No, obviously, that's something we're very focused on in terms of increasing the number of tests per patient. As you saw from the patient story, there's huge potential there in terms of increasing that. And it's a metric that's been improving across our portfolio in terms of number of Guardant tests per patient quarter over quarter.

是的。不，顯然，我們非常注重增加每位患者的檢測次數。正如您從患者的故事中看到的，在增加這一點方面有巨大的潛力。就每位患者接受的 Guardant 測試次數而言，我們的整個產品組合的這項指標一直在逐季提高。

And there's a lot of, I would say, work being done by the teams to make that as simple as possible in terms of the compliance and adherence with each additional test. And so we expect that to see that grow considerably throughout the year.

我想說的是，團隊正在做大量工作，以盡可能簡化每項附加測試的合規性和遵守性。因此，我們預計全年這一數字將大幅成長。

And then a follow-up on MCED. Obviously, it was a big topic at AACR. Good to see the data from you guys. I guess maybe talk a little bit about roadmap from here, what you need to do to get ready for payer discussions? What are you able to do to kind of get them comfortable? Historically, obviously they've balked at multicancer. So talk about some of the steps you need to take going forward.

然後是 MCED 的後續行動。顯然，這是 AACR 的熱門話題。很高興看到你們的數據。我想也許可以從這裡談論一下路線圖，您需要做些什麼來為付款人討論做好準備？您能做些什麼讓他們感到舒服呢？從歷史上看，他們顯然對多發性癌症猶豫不決。那麼，請談談您下一步需要採取的一些措施。

Yes. It's a very exciting moment for us. We had this vision that Shield would be a multi-cancer screening detection kind of a technology. We built it that way. We went through this route of CRC approval for reimbursability pathway and like approval pathway.

是的。對我們來說這是一個非常令人興奮的時刻。我們的願景是，Shield 將成為一種多癌症篩檢檢測技術。我們就是這樣建造的。我們通過了 CRC 批准的報銷途徑和類似的批准途徑。

I think over time, we are going to figure out that this Shield platform that can detect not only CRC, but that can have some kind of secondary analysis for other cancer type detection would have a very strong product-market fit. So we are excited with the data that we showed in AACR. Technology works, platform works.

我認為隨著時間的推移，我們會發現這個 Shield 平台不僅可以檢測 CRC，還可以對其他癌症類型的檢測進行某種二次分析，具有非常強的產品市場契合度。因此，我們對在 AACR 上展示的數據感到非常興奮。技術有效，平台有效。

We are doing some additional data generation. I'm excited that for about 20,000, 25,000 patients that we tested with Shield, right now, we correlated -- actually, we gathered the clinical outcome of those patients in real world, have they been diagnosed with other cancers or not. And we are in the process of now running this MCED algorithm on those patients to see, in a cohort of tens of thousands of patients, what are we going to see in terms of sensitivity and specificity.

我們正在進行一些額外的數據生成。我很高興，對於我們用 Shield 測試的大約 20,000 到 25,000 名患者，我們現在建立了相關性——實際上，我們收集了這些患者在現實世界中的臨床結果，他們是否被診斷出患有其他癌症。我們現在正在對這些患者運行 MCED 演算法，以便在數萬名患者中觀察其敏感性和特異性。

Definitely very exciting days for us. I'm looking forward to having more conversation about this throughout the year.

對我們來說這絕對是非常激動的日子。我期待全年就此進行更多討論。

Bill Bonello, Craig-Hallum.

比爾·博尼洛、克雷格·哈勒姆。

I wanted to circle back a little bit on the tissue test, and the commentary about needing 40% less tissue seemed really important. But maybe just if you could elaborate a little bit based on discussions you're having with existing accounts, sort of how you expect this to play out over time? I mean, presumably, we're talking about taking share maybe with your existing customers for liquid biopsy who are sending tissue to somebody else.

我想稍微回顧一下組織測試，關於需要減少 40% 組織的評論似乎非常重要。但是，您是否可以根據與現有帳戶的討論來詳細說明一下，您預計這種情況會如何發展？我的意思是，大概我們正在談論與現有的液體活檢客戶分享份額，這些客戶正在將組織發送給其他人。

But are there particular cancers where you think the advantages of your new product are going to be most distinctive? Do you think it's more about just the ease of working with one provider rather than sending tests to multiple providers, maybe the ability to reflex to blood, et cetera? Just how are you sort of expecting to compete there?

但是，您認為您的新產品在哪些特定的癌症上會發揮出最顯著的優勢呢？您是否認為這更多的是為了方便與一個提供者合作，而不是將測試發送給多個提供者，也許是反射血液的能力等等？您打算如何參加那裡的比賽？

You answered the question in some way. We're very excited about this product because we have a lot of customers who love the sort of white-glove service that we're able to provide them. And just in terms of the quality of our sales reps and really the knowledge base we have around our medical affairs team and so on. And many of them have said, if you simply add RNA to your Tissue product, we're going to switch to you. And so, we did way more than that with this product.

您以某種方式回答了這個問題。我們對這款產品感到非常興奮，因為我們有很多客戶喜歡我們為他們提供的那種白手套服務。就我們的銷售代表的素質以及我們醫療事務團隊的知識基礎而言等等。他們中的許多人說，如果你們只是在組織產品中添加 RNA，我們就會轉向你們。所以，我們對這個產品所做的遠不止這些。

We really built it from the ground up, where we can use very limited samples. That continues to be one of the issues that many providers have is not being able to get sort of actionable results out of the limited tissue biopsy samples. We've been able to sort of solve that issue, but it's well more than that. The fact that we're going deep into epigenomics, it's really the first tissue product that has a broad-based methylation backbone to it.

我們確實是從頭開始建立它的，我們可以使用非常有限的樣本。這仍然是許多提供者面臨的問題之一，即無法從有限的組織活檢樣本中獲得可操作的結果。我們已經能夠解決這個問題，但遠不止於此。事實上，我們正​​在深入研究表觀基因組學，它確實是第一個具有廣泛甲基化骨架的組織產品。

And you see really kind of the richness of what we've been able to present at AACR and the fact that all of our products now will work together essentially with these applications, all embedded in them, and this continuity of information that we believe will provide a lot more actionability than any other product in the market from a clinical outcomes point of view, from a clinical decision-making. And that is our North Star is can we help provide actionable decisions for every patient more so than other tools in the market.

您可以看到我們在 AACR 上展示的內容非常豐富，而且我們所有的產品現在基本上都可以與這些應用程式協同工作，所有產品都嵌入其中，我們相信這種資訊的連續性將比市場上任何其他產品從臨床結果的角度和臨床決策的角度提供更多的可操作性。這就是我們的北極星，與市場上的其他工具相比，我們能否更好地幫助每位患者做出可行的決策。

And we believe this product absolutely does that. So we're very excited by it. We had great reception at AACR in terms of unveiling the specifics around it. And I can tell you, our sales team has been chomping at the bit to get access to this, too, to tell the world about it.

我們相信這款產品絕對能夠做到這一點。所以我們對此感到非常興奮。我們在 AACR 上公佈的具體細節受到了熱烈歡迎。我可以告訴你們，我們的銷售團隊也一直迫不及待地想要獲得這個訊息，並向全世界公佈。

And ultimately, is your strategy to try and push for a world in where doctors are ordering both tissue and blood-based testing? Or is that just not a realistic scenario anytime in the next several years?

最終，您的策略是否是嘗試推動醫生同時進行組織和血液檢測的世界？或者這只是未來幾年內不切實際的情況？

No. I mean, the guidelines are already almost there. We have a growing number of payers who believe in that. When you think about the fact that neither modality is perfect, neither modality has 100% sensitivity, whether it's liquid or tissue, and when you think about that decision that could be so imperative and could be the difference between life and death for a patient, isn't a patient's life worth searching both liquid and tissue for a potential life-saving outcome? We think so.

不。我的意思是，指導方針已經差不多完成了。越來越多的付款人相信這一點。當您考慮到兩種檢查方式都不完美，兩種檢查方式都不具備 100% 的靈敏度（無論是液體還是組織）時，當您考慮到這個決定可能如此重要並且可能決定患者的生死時，難道患者的生命不值得同時尋找液體和組織以尋求潛在的救命結果嗎？我們是這樣認為的。

I think the guidelines believe it to be the case. So we believe, eventually, it will be the standard-of-care to have both for every patient.

我認為指導方針認為情況確實如此。因此我們相信，最終，對每位患者來說，這兩種治療方法都將成為標準的治療方法。

And then just one final one, and I'll hop off. But I have to ask, is there any risk at all of sort of cannibalization of the higher-priced blood-based tests? Just people saying, hey, if we can get tissue, we want to do tissue. And now we can use 40% less tissue, we're more likely to be able to get a result in cancers where we might have just jumped right to blood.

再說最後一個，我就下車了。但我不得不問，價格較高的血液檢測是否有被蠶食的風險？人們只是說，嘿，如果我們能得到紙巾，我們就想做紙巾。現在，我們可以使用少 40% 的組織，我們更有可能在癌症治療中獲得原本可以直接使用血液的治療結果。

No. The way we look at it is there are going to be many shots on goal with liquid, whether it's in screening, MRD or therapy selection. And then, obviously, we're the one company that really has a continuum of testing across the board. So if we can also provide what we believe to be a leading modality and product on the tissue side, we think that ultimately just grows the pie for us.

不。我們的看法是，無論是在篩檢、MRD 或治療選擇方面，液體治療都會有很多應用。顯然，我們是唯一一家真正進行全面連續測試的公司。因此，如果我們還能提供我們認為在組織方面領先的模式和產品，我們認為這最終只會為我們帶來更大的利益。

(Operator Instructions) Subbu Nambi, Guggenheim Partners.

（操作說明）Subbu Nambi，Guggenheim Partners。

AmirAli, what are the potential drivers or catalysts to drive upside or downside to your Shield volume guidance of 52,000 to 58,000?

AmirAli，有哪些潛在驅動因素或催化劑會推動您指導的 Shield 交易量從 52,000 到 58,000 上漲或下跌？

So in terms of upside, if we continue to outperform the productivity of our reps in the field, that could be upside of what we are assuming right now. The other upside could be the inclusion in the ACS guidelines, any kind of guideline inclusion definitely has some kind of impact on the commercial adoption of the test. And although we are very optimistic about the timing for that guideline inclusion for some time this year, since we don't know when, we are not assuming that in our volume guidance.

因此，從好的方面來說，如果我們繼續超越現場代表的生產力，那麼這可能比我們現在假設的更有優勢。另一個好處可能是將其納入 ACS 指南，任何類型的指南納入肯定會對測試的商業化採用產生某種影響。儘管我們對今年某個時候納入該指南的時間非常樂觀，但由於我們不知道具體時間，所以我們不會在我們的數量指導中假設這一點。

The other potential upside could be on this Abu Dhabi contract. It's kind of a sizable contract. We're just assuming a small fraction of it in our numbers.

另一個潛在的好處可能是這份阿布達比合約。這是一份數額相當大的合約。我們只是在我們的數字中假設了其中的一小部分。

And lastly is, as we talked about it in our prepared remarks, there are additional positive gross profit that we are getting because of this sooner-than-expected ADLT pricing. We are reinvesting it back in building more commercial infrastructure, a lot more kind of reps in the field. We are just going through that process right now. It would help us to have more reps deployed very late this year.

最後，正如我們在準備好的評論中所討論的那樣，由於 ADLT 定價快於預期，我們獲得了額外的正毛利。我們正在將其重新投資於建立更多的商業基礎設施，以及在該領域招募更多的代表。我們現在正經歷這個過程。這將有助於我們在今年稍後部署更多的代表。

It's mainly a 2026 kind of upside for us. But if we can bring the reps and deploy them to the field sooner than the current plan, maybe there would be some upside there, too. Downside, I think we'll see. So it's hard to say.

對我們來說，這主要是一種 2026 年的優勢。但如果我們能夠比目前計劃更快地將代表們派往現場，也許也會有一些好處。缺點，我想我們會看到。所以很難說。

Hopefully, there aren't any downside. Can I quickly squeeze a short question? How much TissueNext is assumed in the guidance?

希望不會有任何不利情況。我可以快速擠出一個簡短的問題嗎？指南中假設了多少個 TissueNext？

Well, without specifically breaking out, I mean, it's relatively a small portion of the oncology guidance. The main drivers of oncology in that guide are obviously Guardant360 and Reveal.

嗯，沒有具體細分，我的意思是，這只是腫瘤學指導中相對較小的一部分。該指南中腫瘤學的主要驅動因素顯然是 Guardant360 和 Reveal。

Puneet Souda, Leerink Partners.

Puneet Souda，Leerink 合夥人。

First one, if I could, on the screening side, Guardant is obviously, all of your products in a unique way, they're working to the top right now. But just wanted to understand from the Shield side, how are you thinking about in this multimodal market, where you're -- would love to know where you're getting the most traction, the type of patients, the type of practices. And now with ADLT and better margins, how are you thinking about the size of the sales force? And I have a follow-up for Helmy.

首先，如果可以的話，在篩選方面，Guardant 顯然以獨特的方式將您的所有產品推向頂峰。但只是想從 Shield 方面了解，您如何看待這個多式聯運市場，您在哪裡——很想知道您在哪裡獲得最大的吸引力，患者類型，實踐類型。現在有了 ADLT 和更好的利潤率，您如何考慮銷售團隊的規模？我還有關於 Helmy 的後續報導。

Okay. Yes. So it's definitely exciting days for us. When we look at the market, we talked about it before, and we are now just experiencing it, there are a lot of unscreened patient population out there, 50 million unscreened. We are seeing very good traction on the PCPs that we onboarded.

好的。是的。所以對我們來說這絕對是個令人興奮的日子。當我們觀察市場時，我們之前討論過這個問題，現在我們正在經歷這個問題，有很多未篩檢的患者群體，有 5000 萬人未接受篩檢。我們看到，我們所加入的 PCP 取得了非常好的進展。

The depth of ordering continues to be very favorable, which is an endorsement that there are many unscreened patients in the practices that we are going through in general, everywhere. So that's actually pretty good. In our steady state in terms of commercial infrastructure continues to be the same.

訂購的深度仍然非常有利，這證明在我們普遍進行的實踐中，各地都存在許多未經篩檢的患者。這實際上非常好。就商業基礎設施而言，我們的穩定狀態保持不變。

We are planning to get to the 700 reps at some point. This additional gross profit helps us to accelerate to some extent. We probably are going to have in terms of fully trained, deployed sales force, probably are going to have about 200 people by end of the year. That's where we are targeting, and we continue from there.

我們計劃在某個時候達到 700 次重複。這額外的毛利在某種程度上幫助我們加速發展。我們可能將擁有經過全面培訓、部署到位的銷售隊伍，到今年年底大概會有 200 人左右。這就是我們的目標，我們將以此為起點繼續前進。

And then on the Reveal side, Helmy, could you talk a little bit about where you're getting the best product fit for Reveal? Because you're coming into this market much later versus some of the tissue-inform tests out there. Can you just talk to us in terms of the adoption you're seeing today in CRC surveillance, the way the product could grow in breast, and then beyond that, other indications where tissue might be a little bit challenged? Could you talk to us about that and the sort of the growth expectations potentially for Reveal?

然後，在 Reveal 方面，Helmy，您能否談談哪裡可以找到最適合 Reveal 的產品？因為與現有的一些組織資訊測試相比，你們進入這個市場的時間要晚得多。您能否簡單談談目前在 CRC 監測中看到的採用情況、該產品在乳房中生長的方式，以及除此之外，組織可能受到一些挑戰的其他適應症？您能否與我們談談這一點以及對 Reveal 的潛在成長預期？

Yes. We see the product is sort of being adopted in a pretty broad-based way. I think there are just -- the reality is that the anxiety of waiting three, four, five, six, seven weeks in the adjuvant setting is just too much to bear for many patients. And we believe that our product profile in terms of the performance and so on is one that I think matches up favorably in that market and in that setting. And so yes, we're seeing a lot of physicians in the adjuvant setting prefer Guardant Reveal.

是的。我們看到該產品正被廣泛採用。我認為，現實情況是，在輔助治療中等待三、四、五、六、七週的焦慮對許多患者來說是難以承受的。我們相信，我們的產品在性能等方面的配置在該市場和環境中是具有優勢的。是的，我們看到很多輔助治療的醫生都喜歡 Guardant Reveal。

We're averaging less than seven days in terms of turnaround time for that product. So it's really exciting to see the operational efficiency the team has kind of built up to. And then clearly, in the surveillance setting, as the patient is negative for a year or two, there's a big chance that what comes back may not be the same as what was taken out.

該產品的平均週轉時間不到七天。因此，看到團隊所建立的營運效率確實令人興奮。顯然，在監測環境中，由於患者在一兩年內都處於陰性狀態，因此返回的結果很可能與取出的結果不一樣。

And there's a greater confidence in something like Reveal that can have a much larger catchment in terms of catching a disease that might be slightly different that comes back. And so we're feeling very confident in terms of the trajectory in terms of the growth that Reveal has ahead of it, especially with surveillance reimbursement and then, clearly, some of the other indications that we're building towards.

人們對 Reveal 之類的技術更有信心，因為它在檢測與復發疾病略有不同的疾病方面可以涵蓋更大的範圍。因此，我們對 Reveal 未來的成長軌跡非常有信心，特別是在監控報銷方面，以及我們正在努力實現的一些其他跡象。

Obviously, breast is a huge, huge opportunity and when we're -- having the kind of profile we have in the surveillance setting, I think, is really going to be nice.

顯然，乳房研究是一個巨大的機遇，當我們在監測環境中擁有這樣的地位時，我認為，這將是一件非常好的事情。

Dan Leonard, UBS.

瑞銀的丹·倫納德（Dan Leonard）。

I'll ask a two-parter on the tissue launch. For starters, I'm trying to put some context around the launch and wonder how would you frame your market share today in tissue versus what you view as your long-term entitlement in that market? So that's the first part.

我將就紙巾的發布提出兩個問題。首先，我想介紹一下此次發布的一些背景信息，並想知道您如何看待目前您在衛生紙領域的市場份額以及您認為在該市場的長期權益？這是第一部分。

And then the second part, and I'll keep this to one question. Are there any ASP implications of the new tissue product? Is there potentially a different Medicare rate than that $3,500 that might be attainable long term?

然後是第二部分，我將把它保留為一個問題。新的紙巾產品對平均售價有何影響？是否存在可能與長期可實現的 3,500 美元不同的醫療保險費率？

Yes. Maybe I'll start with the second one. It's a product that I think we're eventually going to take through FDA approval, and then we'll have the opportunity to qualify for ADLT status. And I think there's an opportunity to have higher price at that point, which we've seen for our other products here at the company. I don't want to get into specifics in terms of market share and where we think we can be.

是的。也許我會從第二個開始。我認為我們最終將透過 FDA 批准該產品，然後我們將有機會獲得 ADLT 資格。我認為那時有機會提高價格，我們已經在公司的其他產品中看到了這一點。我不想談論市場份額的具體細節以及我們認為我們能達到的水平。

But certainly, we think we can take a much greater share of the market than we have today on the tissue side. We believe we have a product now that compares favorably in terms of product-market fit to a lot of the products that are on the market today. And ultimately, that's going to do a lot of good for patients. And when you have that kind of profile, I would say there's no ceiling in terms of where you can reach in the market. So we think there's no reason why we can't catch up to where we are on the liquid side over time.

但可以肯定的是，我們認為我們可以在紙巾市場佔據比現在更大的份額。我們相信，我們現在的產品在產品市場契合度方面與當今市場上的許多產品相比具有優勢。最終，這將為患者帶來許多好處。當你擁有這樣的形象時，我想說，你在市場上能達到的高度是沒有上限的。因此我們認為，隨著時間的推移，我們沒有理由無法趕上我們在流動性方面的現狀。

Dan Brennan, TD Cowen.

丹布倫南 (Dan Brennan)，TD Cowen。

Maybe just starting on Reveal, a two-parter. Mike, did I hear you say realized price above $600? Sorry, you went through the prepared remarks. So just any color on pricing that you shared there.

也許剛開始《揭示》，分成兩部分。麥克，我聽到你說實際價格超過 600 美元了嗎？抱歉，您已經看過準備好的演講稿了。因此，您在那裡分享的定價只是任何顏色。

And then if there's -- I know there was a question asked earlier, but any additional color you can provide about just how the first quarter kind of played out in surveillance and kind of what we should think about for the rest of the year in terms of the accelerant to that business now that you've got that approval?

然後如果有——我知道之前有人問過一個問題，但是您能否提供一些額外的信息，說明第一季度監控業務的進展情況，以及既然您已經獲得批准，我們應該如何考慮在今年剩餘時間內推動該業務的發展？

Yes. I mean, I can address the ASP. We said in the prepared remarks, and it's in the deck that we also shared, that our Reveal CRC ASP now is over $600. And, of course, that puts Reveal now in a gross margin positive position. So it's allowing us to push on the volumes.

是的。我的意思是，我可以解決 ASP。我們在準備好的演講中說過，並且在我們分享的簡報中，我們的 Reveal CRC ASP 現在已超過 600 美元。當然，這使得 Reveal 現在的毛利率處於正值狀態。因此，它使我們能夠提高產量。

And I don't know, Helmy, if you want to --

我不知道，Helmy，你是否想--

Yes. No, as I said, I think maybe in response to one of the other questions, we've seen accelerating growth over the last few quarters with Reveal. And certainly, there's a lot of opportunity now in terms of pushing the surveillance testing that we're starting to pursue. So we've been very pleased at the start of the year. It's been really nice, and we believe that it will continue to be our fastest-growing product on the oncology side as it was in Q1.

是的。不，正如我所說，我想也許可以回答另一個問題，我們在過去幾季中看到 Reveal 的成長加速。當然，就推動我們開始進行的監測測試而言，現在有很多機會。因此，我們對今年年初感到非常高興。它真的很棒，我們相信它將繼續成為我們腫瘤學領域成長最快的產品，就像第一季一樣。

Great. And then maybe, AmirAli, just kind of back to Shield. So you took the volumes up 7,000 or so. Obviously, the unscreened opportunity is pretty massive. I think you're at 55,000 tests this year. But can you just -- back to Puneet's question, can you spend a little more time on just what you're seeing in the field, maybe what's surprising you on the positive, anything on the negative?

偉大的。然後也許，阿米爾阿里就回到了 Shield。因此，您的銷量增加了 7,000 左右。顯然，未經篩選的機會是相當巨大的。我認為今年的測試次數將達到 55,000 次。但您能否－回到 Puneet 的問題，您能否多花一點時間談談您在實地看到的情況，有哪些積極方面令您感到驚訝，有哪些消極方面令您感到驚訝？

Exact talks about the frequency of doctor visits is when they start to see an uptake, maybe 6 or 7 times visiting the doctor before they see someone do a test. Is the same thing playing out on the blood side? Or just any color you could share in terms of what informs the modest raise and kind of how the launch is going versus expectations?

確切地說，當他們開始看到接受度增加時，可能需要 6 或 7 次就診才能看到有人做檢查。血液方面也發生著同樣的事情嗎？或者您能否分享一下此次適度加薪的具體原因以及發布會的進展與預期相比如何？

Yes. As I mentioned, we continue to hear a lot of positive feedback from the market on PCP side. We are a blood draw modality. So we are going in terms of integration of blood workflows into the practice and stuff. It takes some more energy from us probably than just dropping off a stoke kit in accounts in terms of activating accounts, but the depth of ordering we are hearing and seeing are very positive.

是的。正如我所提到的，我們繼續聽到 PCP 市場的許多正面回饋。我們是一種抽血方式。因此，我們正在將血液工作流程整合到實踐和其他方面。就啟動帳戶而言，這可能比僅僅在帳戶中放入一個激勵套件需要我們投入更多的精力，但我們聽到和看到的訂購深度非常積極。

I cannot point to any specific thing that we are hearing that we did not expect it and consider it negative. Maybe if I want to highlight something, but we knew it, we expected it is the reality of the importance of quality scores, that's very important.

我無法指出我們所聽到的任何具體的事情，我們沒有預料到它會是負面的。也許如果我想強調一些事情，但我們知道，我們預期這是品質分數重要性的現實，這非常重要。

Once we get into HEDIS score, it's going to be a huge catalyst for us. But there is a lot of business for us to mine that we are focused on it, and we are growing comfortably so far. And we are excited of, like the rest of this year.

一旦我們獲得 HEDIS 分數，它將成為我們的巨大催化劑。但是，我們有很多業務可以挖掘，我們專注於此，而且到目前為止，我們的成長情況良好。我們對今年剩餘的時間感到興奮。

Still, we are in very, very early innings of this, right? I don't want to get ahead of our skis. But so far, better than what we thought. We'll see how it goes.

不過，我們才剛進入這個階段，對吧？我不想超越我們的滑雪板。但到目前為止，情況比我們想像的還要好。我們將拭目以待。

Rachel Vatnsdal, JPMorgan.

摩根大通的 Rachel Vatnsdal。

I wanted to ask another follow-up just on Shield and some of the volumes that you're seeing. You increased volumes by 2,600 sequentially, roughly. So if we apply that same sequential increase for the rest of the year, that really gets us near that low end of the guidance range for Shield volumes. So I wanted to dig into a few questions around that.

我想就 Shield 和您看到的一些卷問另一個後續問題。您連續增加了約 2,600 個交易量。因此，如果我們在今年剩餘時間內採用相同的連續成長，那麼我們實際上就會接近 Shield 產量指導範圍的低端。所以我想深入探討這方面的幾個問題。

First, as we look specifically to the second quarter, should we see a sequential step-up above that 2,600 sequential and volume increase? Or could it kind of be the same level that you guys saw this quarter? And then if we were to get towards that high end of the Shield volume range, at what point in the year would you expect a larger step-up in the sequential given what you're seeing in the field so far?

首先，當我們特別關注第二季時，我們是否應該看到連續 2,600 以上的成長和銷售的成長？或者它可能與你們本季看到的水平相同？那麼，如果我們要達到 Shield 產量範圍的高端，那麼根據您目前在該領域看到的情況，您預計在今年什麼時候會出現更大的連續成長？

Yes. I think maybe I reiterate what we mentioned in the prepared remarks. We continue to expect it to be second half loaded. And the reason for it is there are a bunch of new reps that we have, the productivity ramp of those people need to be considered when you're modeling sequential Q-over-Q growth. And we are continuing to hire.

是的。我想也許我應該重申我們在準備好的發言中提到的內容。我們仍然預計它將在下半年滿載。原因是我們擁有一批新銷售代表，在對連續 Q 環比成長進行建模時，需要考慮這些人的生產力提升。我們也將繼續招募。

So we are going to end the year with more reps than the year the number of reps that, for instance, we deployed in the field in Q1. So when you consider all this, I think, you need to consider that as a result, it should be biased towards second half growth.

因此，我們今年年底的代表數量將比今年第一季我們部署在現場的代表數量還要多。因此，當你考慮所有這些時，我認為，你需要考慮，結果應該偏向下半年的成長。

Maybe just digging deeper on that, though, specifically on 2Q. Should we be modeling a step-up sequentially relative to this 2,600 you did in the first quarter? Or at this point, given the reps are still kind of getting deeper ingrained into their territories, should we assume a similar step-up to what you had?

也許只是對此進行更深入的挖掘，特別是第二季。我們是否應該根據第一季的 2,600 來模擬連續的成長？或者在這一點上，考慮到代表們仍然在他們的領域中根深蒂固，我們是否應該假設與你所採取的類似的措施？

Yes, I think maybe what I can comment is like we exited Q1 with just marginally a little bit more reps than the number of reps that we started with Q1. I don't want to get into like a lot more details of the exact number of reps and what we are seeing. But I think you should consider that and the reality of diagnostics, it takes 12 to 18 months to get to the full productivity.

是的，我想也許我可以評論的是，我們退出 Q1 時的代表數量比 Q1 開始時的代表數量略多一點。我不想談論更多有關確切次數和我們所看到的情況的細節。但我認為你應該考慮到這一點以及診斷的現實情況，需要 12 到 18 個月才能達到完全生產力。

When you add the reps within the first three months, you shouldn't expect anything really, six months, maybe some material contribution. So I think if you consider all this, you are going to get to some reasonable numbers.

當你在前三個月內增加代表時，你不應該真正期待任何東西，六個月，也許會有一些物質貢獻。所以我認為如果你考慮所有這些，你就會得到一些合理的數字。

Luke Sergott, Barclays.

巴克萊銀行的盧克‧塞戈特 (Luke Sergott)。

I just wanted to ask about the SERENA-6 trial with Astra and kind of how that's ramping and how we can think about those volumes as it goes through and as that trial keeps progressing.

我只是想問一下與阿斯特拉合作的 SERENA-6 試驗的情況，以及該試驗的進展情況，以及我們如何考慮在試驗過程中和試驗不斷進展時這些數量。

Yeah, obviously it hasn't gotten approved yet. It's still something that we're waiting for. The trial is done in terms of enrollment and so on. And I believe some of that data may be presented later this year. That's up to our pharma partner in terms of their timelines.

是的，顯然它尚未獲得批准。這仍然是我們正在等待的事情。試驗是在招生等方面進行的。我相信部分數據可能會在今年稍後公佈。這取決於我們的製藥合作夥伴的時間表。

We're not going to comment on that. But it's something we're very excited about in terms of the paradigm that it means in terms of being able to test patients, look for essentially molecular changes in a patient's genotype. We think this is really the way of the future in terms of where many drugs will start being developed really at the first sign of molecular progression, being able to switch therapies. And so it's something that we're coordinating, I think, very closely on, and we're very excited for it in terms of the potential that it means for uptake in terms of our liquid biopsy volume, Guardant360 volume in the future.

我們不會對此發表評論。但就範式而言，我們對此感到非常興奮，這意味著我們能夠對患者進行測試，尋找患者基因型中本質上的分子變化。我們認為這確實是未來的發展方向，許多藥物將在分子進展的第一個跡像出現時開始開發，並能夠轉換治療方法。所以我認為，這是我們正在密切協調的事情，我們對此感到非常興奮，因為它意味著我們未來液體活檢量、Guardant360 量的吸收潛力。

And so, yes, I would just say maybe stay tuned over the remainder of the year. But yes, certainly, we think it could present some nice upside for testing -- for liquid biopsy testing and Guardant360 testing in the future.

所以，是的，我只想說，也許在今年剩餘的時間裡，請繼續關注。但是的，我們當然認為它可以為測試帶來一些好處——未來的液體活檢測試和 Guardant360 測試。

Operator, I think we're out of time.

接線員，我想我們已經沒時間了。

Ladies and gentlemen, that concludes our Q&A and today's conference call. We'd like to thank you for your participation. You may now disconnect your lines.

女士們、先生們，我們的問答和今天的電話會議到此結束。我們感謝您的參與。現在您可以斷開線路了。