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DATE

Wednesday, Feb. 25, 2026 at 4:30 p.m. ET

CALL PARTICIPANTS

  • Chief Executive Officer — Marc Stapley
  • Chief Financial Officer — Rebecca Chambers
  • Chief Commercial Officer — Dr. John Leite
  • Chief Medical and Scientific Officer — Dr. Phillip G. Febbo

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TAKEAWAYS

  • Total Revenue -- $140.6 million for the quarter, up 19% year over year, driven by continued momentum in the core testing business.
  • Testing Revenue -- $135.8 million for the quarter, a 21% increase year over year, with Decipher revenue up 27% and Afirma revenue up 16%.
  • Testing Volume -- Approximately 45,500 tests in the quarter, reflecting 16% growth, with Decipher and Afirma volumes growing 21% and 12% respectively.
  • Testing ASP -- Average selling price was approximately $2,984 for the quarter, 4% higher year over year, with normalized ASP at $2,875, up 1% after $5 million in prior period collections (PPCs).
  • Non-GAAP Gross Margin -- 75.1%, expanding 580 basis points over the prior year, with testing gross margin at 76.1%, up 380 basis points due to v2 transcriptome transition and PPCs.
  • Adjusted EBITDA -- $42.3 million for the quarter, a 30.1% margin; for the full year, adjusted EBITDA margin was 27.6%, exceeding the 25% target more than a year ahead of plan.
  • Cash Flow and Balance -- Generated $52.6 million in operating cash flow in the quarter, ending with $412.9 million in cash and cash equivalents.
  • Operational Transition -- Completed the full transition of Afirma to the v2 transcriptome platform, resulting in lower costs and a 2% reduction in no-result rate compared to the previous quarter.
  • Decipher Provider Growth -- Number of ordering physicians increased 18% year over year, with combined high-risk RP and metastatic categories up more than 30% in the quarter.
  • 2026 Financial Guidance -- Total revenue guidance is $570 million to $582 million (10%-13% growth), testing revenue is expected to grow 14%-16%, with Afirma in the mid- to high-single digits and Decipher at approximately 20%; adjusted EBITDA margin is guided at approximately 25%.
  • Product Launch Plans -- Two major launches are planned by summer: TRUE MRD for muscle-invasive bladder cancer and Prosigna as a laboratory developed test (LDT) for early-stage breast cancer in the U.S.
  • Market Penetration -- Decipher market penetration at approximately 33%, Afirma at approximately 38%, and company expects further penetration in both core segments.
  • Research Output -- More than 50 abstracts to be presented at ASCO GU across prostate and bladder cancer; more than 100 publications for Decipher and an additional 100 using the GRID platform.
  • Capital Allocation -- Company cited continued focus on organic growth, product development, and supporting MRD platform following prior acquisition of C2i; no announced change in overall capital strategy.

SUMMARY

Veracyte (VCYT 5.21%) reported double-digit revenue, test volume, and gross margin growth, supported by high utilization of its Decipher and Afirma diagnostic products. The company reiterated fiscal 2026 guidance, which excludes contributions from planned 2026 product launches, and outlined expectations for continued double-digit growth, targeted investments, and margin sustainability. Two major product launches—TRUE MRD and Prosigna LDT—are due by summer, with management emphasizing a phased commercial rollout and a strategy of sustained evidence-building to support longer-term adoption.

  • Management stated, "Adjusted EBITDA margin exceeded 27% in 2025, not only reaching but surpassing our 25% target more than a year ahead of plan."
  • Rebecca Chambers asserted that fiscal Q1 adjusted EBITDA margin is expected to be lower than both Q4 and annual guide due to seasonality and removal of $10 million in prior period collections.
  • CEO Stapley confirmed, "we are not guiding for the new product launches." in 2026, expecting revenue impact to occur in future years.
  • Development pipeline includes continued expansion of signatures and tests for additional cancer indications, with leadership noting multiple studies underway in bladder, lung, breast, and colorectal cancer.
  • The company completed enrollment for the Nightingale trial of the Percepta nasal swab, with milestone timing dependent upon patient follow-up and subsequent publication and reimbursement discussions.

INDUSTRY GLOSSARY

  • Afirma GRID: A research-use-only genomic platform generating data for thyroid nodule research and new biomarker signatures.
  • Prior Period Collections (PPCs): Revenue recognized from payments received for services performed in prior periods, not included in forward guidance.
  • TRUE MRD: Veracyte’s tumor-informed, whole-genome sequencing test for minimal residual disease (MRD) monitoring post-cancer therapy.
  • Decipher GRID: A research-use-only data analysis platform in urology for deriving new molecular signatures and supporting publications.
  • v2 Transcriptome: Veracyte’s second-generation, scalable transcriptome analysis platform, lowering costs and improving result accuracy.
  • PAM50: A gene expression signature used by Prosigna to subtype breast cancer and estimate recurrence risk.
  • LDT (Laboratory Developed Test): A diagnostic test developed and performed by a single laboratory that is not distributed as a kit.
  • MolDX: A program, primarily through Medicare, that assesses, reimburses, and sets policy for molecular diagnostics.

Full Conference Call Transcript

Marc Stapley, Veracyte, Inc.'s Chief Executive Officer, and Rebecca Chambers, our Chief Financial Officer. Dr. John Leite, our Chief Commercial Officer, and Dr. Phillip G. Febbo, our Chief Medical and Scientific Officer, will join us for Q&A. Veracyte, Inc. issued a press release earlier this afternoon detailing our fourth quarter and full-year 2025 financial results. This release and a copy of the presentation we will review during the call today are available in the Investors section of our website at veracyte.com. Before we begin, I would like to remind you that statements we make during this call will include forward-looking statements as defined under applicable securities laws.

Forward-looking statements are subject to risks and uncertainties and the company can give no assurance they will prove to be correct. Additionally, we are not under any obligation to provide further updates on our business trends or our performance during the quarter. To better understand the risks and uncertainties that could cause actual results to differ, we refer you to the documents that Veracyte, Inc. files with the Securities and Exchange Commission, including the most recent Forms 10-Q and 10-K. In addition, this call will include certain non-GAAP financial measures. Reconciliations of these measures to the most directly comparable GAAP financial measures are included in today's earnings release accessible from the Investors section of Veracyte, Inc.'s website.

I will now turn the call over to Marc Stapley, Veracyte, Inc.'s CEO.

Marc Stapley: Thank you, Shayla, and thank you all for joining us today. Q4 capped off another outstanding year of strong execution for Veracyte, Inc., with performance across our core businesses that reinforces both the durability of our growth model and the opportunities ahead. I will review our fourth quarter results, reflect briefly on 2025, and then focus on the growth drivers that give us confidence as we move into 2026. Fourth quarter total revenue was $141,000,000, representing 19% growth year over year. This performance was driven by continued strength in our core testing business, which grew 21% on strong volume and ASP. Decipher volume grew 21% and Afirma grew 12%, together contributing to 16% total testing volume growth.

For the full year, we delivered total revenue of $517,000,000, at the high end of our preliminary range and representing 16% growth. During the year, we provided clinically actionable information to nearly 170,000 patients with over 800,000 patients served to date. We remain on track to testing our one millionth patient later this year, an important milestone for the company and our team that reflects both the scale and impact of our platform. In addition to our strong revenue and volume growth, we executed against all of the key milestones we set for 2025.

We drove continued penetration and share gains, launched Decipher for metastatic patients expanding our presence in advanced disease, and generated meaningful new clinical evidence across endocrinology and urology. We advanced our pipeline with positive Prosigna outcomes data from the OPTIMA prelim study, submitted the technical assessment for TRUE MRD, and completed enrollment for our Nightingale lung cancer study. Together, these accomplishments position us well for multiple product launches, beginning in 2026. Importantly, we achieved this while delivering industry-leading profitability and cash generation. Adjusted EBITDA margin exceeded 27% in 2025, not only reaching but surpassing our 25% target more than a year ahead of plan.

We also completed key operational priorities, including the restructuring of Veracyte SAS and the full transition of all Afirma volume to the more scalable, lower-cost v2 transcriptome platform, improving our operational efficiency and launching new transcriptome-based tests. These actions support the sustainability of our financial profile, as we continue to invest in growth. I am extremely proud of our team's focus on execution and innovation, which enabled us to deliver an outstanding year and reach more patients than ever before. The foundation we have built through the Veracyte, Inc. Diagnostics platform supports a clear, phased expansion strategy anchored by a focused set of drivers contributing to near-, mid-, and long-term growth.

First is the ongoing durable expansion in our core business, Decipher and Afirma, which we believe will support double-digit revenue growth for the foreseeable future. The second phase is our 2026 product expansions, with two product launches planned by this summer. We are preparing to launch our inaugural TRUE MRD test for patients recovering from muscle-invasive bladder cancer, followed by the U.S. launch of Prosigna as an LDT to address early-stage breast cancer patients. The third phase represents our longer-term commitments, including geographic expansion through our IVD strategy, and addressing new cancer challenges across the care continuum. Today, I will focus on the first two phases: our core business momentum and the opportunities ahead with our 2026 launches.

Starting with Afirma, we delivered approximately 18,250 tests in the fourth quarter, representing 12% volume growth. Throughout the year, we saw a steady pipeline of new account wins and increased utilization per account, with the fourth quarter continuing this trend. As of year end, we believe we have grown Afirma approximately 38% market share with continued opportunity for further penetration. Importantly, as previously mentioned, we completed the full transition to our v2 transcriptome in the lab during the fourth quarter. Besides being more scalable and cost effective, this new platform enables us to deliver results in challenging cases where we were previously unable due to low RNA.

In the fourth quarter, our no-result rate was 2% lower than in the prior quarter, directly contributing to more patients and physicians receiving actionable results to support clinical decision-making. We also saw a steady drumbeat of new publications leveraging data generated from our research-use-only Afirma GRID, which further builds on our extensive body of clinical evidence. The majority of Afirma-related abstracts and publications in 2025 were GRID-related, reinforcing Afirma's position as not only the standard of care in clinical testing, but also what we believe is becoming the primary research platform advancing understanding of thyroid nodules and cancer.

This year, we plan to build on this momentum with an updated version of GRID that includes additional signatures designed to support ongoing thyroid nodule research. Given our recent progress, we are confident in Afirma's ability to sustain healthy growth in 2026 and beyond. Turning to Decipher, we delivered approximately 27,200 tests in Q4, marking our fifteenth consecutive quarter of more than 20% year-over-year volume growth. We reached another record for both the number of quarterly ordering providers and orders per physician. In fact, the number of ordering physicians increased 18% year over year in Q4, reflecting Decipher's expanding adoption and its role in supporting treatment decision-making. This momentum has been building throughout the year.

Of the more than 300,000 prostate cancer patients tested with Decipher since launch, more than 100,000 were tested in 2025 alone. Decipher is recognized as the only gene expression test with high-quality evidence in NCCN guidelines, which we believe has been an important contributor to this impressive growth. Looking ahead, with the market now penetrated by Decipher at approximately 33%, we remain extremely confident in its ability to sustain strong double-digit growth in 2026 and beyond. This growth outlook is supported by several key drivers. As GRID-enabled research establishes clinical utility for new prostate signatures, we plan to expand our clinical reporting to incorporate these insights.

Our first examples are three new predictive signatures—ATRX loss, PTEN, and PAM50—that are now widely recognized by key opinion leaders as having utility based on recently published studies. Patients with higher ATRX loss scores have been shown to benefit from higher doses of radiation in both post-biopsy and post-RP salvage settings. PTEN, used alongside the Decipher score, showed promise in the STAMPEDE study for identifying which metastatic patients would benefit from adding chemotherapy. And the BALANCE trial, whose results were presented at ASTRO last fall, found that the PAM50 molecular signature confidently predicts which patients with recurrent prostate cancer may benefit from hormone therapy with apalutamide in addition to salvage radiation therapy.

We are working to add these molecular features to the Decipher report as optional insights, providing additional information for men with high-risk biopsy and RP disease, including those with biochemical recurrence. As a reminder, this patient population has been underserved to date, a trend that we have been focused on improving with augmented clinical evidence supporting Decipher in advanced disease, where its predictive power has been shown to improve patient outcomes. This focus, paired with the launch of Decipher Metastatic, has led to another quarter of more than 30% growth in the combined high-risk RP and metastatic categories, and we believe there remains significant opportunity to expand Decipher's use in advanced disease.

Additionally, we view digital pathology and AI-powered analysis as complementary to molecular analysis, with the potential for additional data points to provide a more comprehensive assessment of tumor histology. To support further research, we made our digital pathology and associated AI models available to collaborators last year, and have implemented slide scanning as a standard production workflow. We have now scanned over 210,000 slides from over 150,000 patients with outcomes data, representing the majority of our historical dataset on Decipher.

We plan to leverage this extensive database in combination with whole transcriptomes in an expanding number of collaborations with top academic centers to understand the complementary nature of these two data types in order to continue to evolve our clinical offerings. Generating clinical evidence is a core pillar of our Veracyte, Inc. Diagnostics platform, and we continue to fuel this flywheel. Decipher Prostate now has more than 100 publications demonstrating its clinical utility and validity across the prostate cancer risk spectrum, and an additional 100 publications leveraging our research-use-only GRID platform. At ASCO GU, data to be presented—including more than 50 abstracts across prostate and bladder cancer—highlight how our platform is contributing to advances in urologic oncology.

Multiple abstracts will showcase the power of Decipher GRID to enable novel research, including studies demonstrating how signatures derived from GRID predict adverse outcomes in men on active surveillance. Additionally, several abstracts will be presented leveraging real-world data on the usage of the Decipher Prostate score in our patient population, including those with metastatic prostate cancer. Moving to bladder cancer, our Decipher Bladder classifier and associated research-use-only GRID data are increasingly being integrated into studies that aim to help researchers identify critical signatures to guide the future of bladder cancer treatment. We are seeing strong momentum generating new clinical evidence for this indication, with five abstracts highlighting Decipher Bladder at ASCO GU.

We are particularly excited about the findings from the SHURE-02 trial, which underscore the importance of molecular subtyping in muscle-invasive bladder cancer, or MIBC, and support integrating genomic classifiers like Decipher Bladder into clinical trial design and treatment planning. As the field transitions towards more biologically informed evaluation of novel treatment strategies in bladder cancer, we plan to continue investing in this indication to drive future growth. Collectively, these studies highlight how our Decipher tests are increasingly helping guide clinical decision-making, advance biological understanding, and accelerate innovation in urologic cancer care. This momentum in bladder cancer extends to our TRUE MRD platform, our whole-genome sequencing approach to MRD.

We remain on track to launch our first indication for MIBC in the first half of this year, after completing our technology assessment with MolDX to receive reimbursement, which is in progress. We intend to leverage our strong Decipher brand and channel to serve patients that are treated in the urology and radiation oncology setting, which we believe reaches approximately 70% of MIBC cases. Our initial focus will be on recurrence monitoring in those patients who have completed their initial therapy for MIBC and are not undergoing adjuvant chemotherapy, which we believe is a majority of MIBC patients treated in this setting. We are building a strong and growing body of clinical evidence around our MRD platform.

At ASCO GU, TRUE MRD will be featured in an oral presentation on a phase 2 trial evaluating pembrolizumab combined with serial ctDNA monitoring in patients with MIBC that did not undergo radical cystectomy. In this trial, TRUE MRD's whole-genome sequencing was used during neoadjuvant therapy, at restaging, and during surveillance to monitor for residual disease, providing more confidence that the cancer was responding to therapy. The results demonstrate that many patients with MIBC may be successfully treated without bladder removal and maintain very low risk of metastatic recurrence. These findings highlight how molecular monitoring may support bladder-sparing treatment strategies while maintaining confidence in managing disease.

This therapeutic strategy is being prospectively evaluated in the actively accruing NEO-BLADE study conducted at the University of British Columbia. In addition, there are several other studies that have already been completed across bladder, colorectal, and lung cancer, as well as other indications. We have a deep pipeline of additional studies underway, with 10 in testing or analysis, 13 in contracting, and 17 in active planning, spanning MIBC as well as non-muscle-invasive bladder cancer, breast, lung, colorectal, and immunotherapy treatment response. TRUE MRD is a platform that is extensible into other cancer types, and we plan to launch additional indications each year going forward.

Our MIBC launch addresses a clinically important market and will serve, we believe, as a foundational proof point that Veracyte, Inc. is a credible player in this large and expanding space. With strong engagement from leading institutions and encouraging early results, we believe TRUE MRD's differentiated approach positions us well to capture meaningful share in the MRD market. Turning now to Prosigna, our second major product launch planned for 2026. Prosigna is based on the well-established and scientifically validated PAM50 signature, which provides physicians and patients with deeper insights into the biological classification of their cancer and the risk of recurrence, to help inform treatment decisions.

The opportunity in the U.S. breast cancer market is significant, with over 300,000 patients diagnosed each year. Approximately 75% of these patients have early-stage hormone receptor-positive disease and would be eligible for Prosigna testing. Clinical data will be an important driver of adoption, and we look forward to the full OPTIMA trial readout, which we expect to be presented at ASCO in June. We believe this data will further strengthen the clinical evidence supporting Prosigna, differentiating it as the next standard in breast cancer prognosis, and that numerous ongoing studies will further demonstrate differentiation of Prosigna in this setting, building on the OPTIMA results.

We believe this body of evidence supports the opportunity for Prosigna to capture meaningful share in this market over the next five years. We remain on track to launch our LDT for Prosigna over the summer on our new transcriptome lab workflow, the same analytical platform we have built and fully launched for Afirma. To prepare for this, we have begun building out our commercial team, starting with appointing a strong leader for the salesforce, while also growing our medical science liaison team and engaging KOLs. Meanwhile, our talented marketing team is busy working on all of our prelaunch activities, while our fantastic market access team is working on the Medicare and commercial reimbursement coverage.

I could not be more excited about our two major product launches this year. The foundation we have built over the last five years, including our track record of meeting or exceeding our expectations while expanding our leadership across the cancer care continuum, reinforces the durability of our growth outlook. Our execution across Decipher and Afirma, combined with our ability to navigate through evolving market dynamics, reflects the strength and resilience of our operating model. We are entering 2026 with a clear path to sustain double-digit growth, served by a portfolio of tests in prostate, thyroid, bladder, and breast.

This momentum positions us to deliver lasting value for the patients we serve, the employees who power our mission, and our shareholders. I will now turn the call over to Rebecca to review our financial results for the fourth quarter and full year as well as our outlook for 2026.

Rebecca Chambers: Thanks, Marc. Q4 was another exceptional quarter with $140,600,000 in revenue, an increase of 19% over the prior-year period. We grew total volume to approximately 48,000 tests, a 16% increase over the same period in 2024, and generated $52,600,000 of cash from operations to end the quarter with $412,900,000 of cash and cash equivalents on hand. Testing revenue during the quarter was $135,800,000, an increase of 21% year over year, driven by Decipher and Afirma revenue growth of 27% and 16%, respectively. Total testing volume was approximately 45,500 tests, an increase of 16% over the prior-year period.

Testing ASP was approximately $2,984, an increase of 4% compared to the prior year, driven primarily by the impact of higher prior period collections, or PPCs. Normalized ASP was also higher at $2,875, a 1% increase compared to the prior-year period after adjusting for the approximate impact of $5,000,000 of PPCs in the quarter. Moving to gross margin and operating expenses, I will discuss our non-GAAP results. Non-GAAP gross margin was 75.1%, up 580 basis points compared to the prior-year period. Testing gross margin increased 380 basis points compared to the prior year, to 76.1%, driven by operational efficiencies from our v2 transcriptome and higher PPCs.

Non-GAAP operating expenses were up 12% year over year to $5,100,000 compared to the prior year. Research and development expenses increased by $1,600,000 to $19,000,000, driven primarily by clinical investments. Sales and marketing expenses increased slightly to $23,900,000 given higher travel expense. G&A expenses were up $4,700,000 to $22,300,000, primarily due to hiring and expenses in our customer service function to support revenue growth and software teams to support new product development. Moving to profitability, we recorded quarterly GAAP net income of $41,100,000 and $66,400,000 for the full year of 2025. Adjusted EBITDA for the quarter was $42,300,000, or 30.1% of revenue, well above our expectations given the benefit of prior period collections.

For the full year 2025, our adjusted EBITDA margin was 27.6%, ahead of our target of 25%, which was achieved more than a year ahead of our projections. We increased our cash balance by more than $120,000,000 over the course of the year. These results give us the flexibility to invest in our growth drivers and are a testament to our differentiated financial profile. Turning now to our 2026 outlook. We are reiterating our 2026 total revenue guidance of $570,000,000 to $582,000,000, or 10% to 13% year-over-year growth. This reflects testing revenue growth of 14% to 16% for the year, with Afirma growth expected to be in the mid- to high-single digits and Decipher growth to be approximately 20%.

As always, we have not included PPCs in our guidance, and we do have a headwind of approximately $10,000,000 of PPC we recognized in 2025. We expect adjusted EBITDA margin to be approximately 25% in 2026 and in future years, barring any bespoke investments we decide to make, which, of course, we would communicate as appropriate. We expect Q1 adjusted EBITDA margin to be lower given typical seasonality of expenses, including increased compensation, benefits, and payroll tax. As always, we plan our expenses on an annual rather than quarterly basis. In closing, I am thrilled with our progress over the course of 2025.

As Marc shared, we delivered on or exceeded all of our 2025 goals, including the Decipher launch and the transition of Afirma to the v2 transcriptome. With a number of exciting catalysts on the horizon for 2026 and beyond, paired with our differentiated financial position, I am more confident than ever in Veracyte, Inc.'s future and proud to be serving more patients at pivotal points in their cancer journey. We will now open for questions. Operator, please open the lines.

Operator: Thank you.

Operator: At this time, we will conduct the question-and-answer session. As a reminder, to ask a question, you will need to press 11 on your telephone and wait for your name to be announced. To withdraw your question, please press 11 again. We please ask that you limit your questions to one question and one follow-up question. Please standby while we compile the Q&A roster. Our first question comes from the line of Subbu Nambi of Guggenheim. Your line is now open.

Subbu Nambi: Hey, guys. Thank you for the question. I have two topics, starting with the guidance question. As we sit here eight weeks into the year, has your conviction in the guidance evolved in any way? What are the assumptions that drive the high end or low end of the range? And maybe some details on the quarterly cadence.

Marc Stapley: Yeah. Thanks, Subbu. I will start. I mean, obviously, you know, we are eight weeks into the quarter, but only eight weeks into the year. We have reiterated our guidance that we gave earlier in the year, so you can see from that our conviction in our guidance to be strong. I will ask Rebecca to talk a little bit about the seasonality and the potential drivers of the high and low end range.

Rebecca Chambers: Happy to do so. Thanks, Marc, and thanks, Subbu. Great to hear your voice. So I think the first thing to be aware of is for the first quarter sequentially, this is a quarter where we do see seasonal trends. We had, obviously, an incredibly large prior period collection quarter in the fourth quarter, and historically, if you use last year as a guide, that does not typically tend to repeat in the first quarter. Last year, it was around $500,000. So that is one thing to be aware of from a sequential trend perspective.

From a volume perspective, Afirma is typically the lowest in the first quarter and followed by the third quarter, with the second and fourth quarter being stronger. And with Decipher, it is highly dependent in the first quarter on weather. If you use last year, we were up maybe 100 samples or so sequentially and had a pretty big weather impact the first quarter of last year. This year, tracking to date is around the same from a weather impact, and so, you know, obviously, we will catch that up throughout the course of the year, but that is something to be aware of on a go-forward basis.

What would get us to the high end of the range would be a couple of different things. The first, you know, we do have a no-result rate assumption for Afirma in guidance. At the low end, we would assume little to no benefit from the no-result rate. At the high end, we would assume about the same level we saw in the fourth quarter. So that would be one thing to take into account. If we do get prior period collections that is not baked in, that could bias us to the high end. And then, obviously, volume outperformance.

Specifically, you know, I think Decipher has more—the error bars are wider on Decipher than Afirma given the nature of the portion of the adoption curve of where we are at. And so from a Decipher perspective, if we were to see more penetration or more share gains, that would obviously lend itself to the high end of the guide as well. Hopefully, that helps. Anything else to add, Marc?

Marc Stapley: No. Just a reminder that, you know, in our guide for revenue, we are not guiding for the new product launches. For the very simple reason that we expect those to be more of a driver in 2027, but those, of course, are not included in the guidance either.

Rebecca Chambers: Thanks for the reminder.

Subbu Nambi: Super helpful, both. Thank you for that. One of the goals of the OPTIMA study is to expand the intended use population. What readout is required for this to occur? And if successful, how big would this market be? Thank you so much, guys.

Marc Stapley: Yeah. So I will start, then I will hand over to John to talk about the market opportunity here. But the way we describe this is the patients, the 300,000 patients a year with breast cancer. There is about 75% of them, or 225,000 of them, that are addressed by what we believe will be a Prosigna indication there. Our first and foremost goal is to penetrate that market as it currently stands. And then obviously, you can expand from there. And so you can expand, you know, into, for example, premenopausal. You can expand into all the different risk categories within that 225.

But, John, maybe you can just give a little bit more commentary on how OPTIMA is going to address this.

John Leite: Yeah. So thanks, Subbu. OPTIMA has included in their enrollment criteria up to nine nodes. Currently, Oncotype is approved up to three. You know, we will have to see what the performance of the test ultimately will be with the OPTIMA trial results before we can provide very directed commentary on how we expect to leverage that data.

Marc Stapley: Okay. And remember, OPTIMA is really expected to read out—we hope at ASCO. Of course, we are hoping and expecting that the results are positive and it reads out when we are looking for it to, and we are ready to launch when that happens. Thanks for that question, Subbu.

Subbu Nambi: Thank you.

Operator: Our next question comes from the line of Puneet Souda of Leerink Partners. Your line is now open.

Carlos (for Puneet Souda): Hey, folks. This is Carlos on for Puneet. I have got two questions. So the first one is you had a really healthy beat of your 25% margin target. You were at, I think, 27.6% for the year, but you are guiding to go back down to the long-term target of 25% in 2026. If you could just walk through some of the push and pulls there, is that just conservatism? Is it true-ups? Is there an increase in OpEx that we should be looking out for? Anything there would be helpful. Thank you.

Marc Stapley: Yes. Thanks for the question. At a high level, we have got two product launches coming this year. And the way I think about it is, as we launch those products, if we see an opportunity to invest to go faster, we will absolutely want to be able to take that. And so that is one. Obviously, building clinical evidence and clinical studies and so on, especially in MRD as we expand more indications, is important. So I think for us it is really important to have the flexibility to be able to do that while remaining, you know, extremely profitable relative to the industry.

And I am proud of the fact that we got there about a year earlier than we anticipated, and we set a well-run business in this 25% and sustainably remain there.

Rebecca Chambers: Yeah. I would just say specifically to the 27.6% over the course of 2025. Recall, we did have $10,000,000 of prior period collections over the course of 2025. And given we do not apply that in the guide, we would not include that in our OpEx guide either. But we do have significant investments per Marc's point that all have an incredibly high ROI associated with them. And given, you know, our goal here is to serve as many cancer patients as we can with high-value, quality products, we are going to invest in those things.

And while they are not necessarily going to be impactful and are not included in our guide in 2026, they are absolutely critical for the long-term performance of this organization, and we feel very positively about the benefit they will have to all of our stakeholders, including patients. And so, you know, when it comes down to it, that is what we are focused on—driving revenue growth, driving patient adoption, and really serving as many folks as we can—and everything we are investing in here is very high ROI. So that is what I would add.

I would just say, you know, what we are investing in specifically are those new product introductions, the software and bioinformatics resources required, the commercial resources required, the revenue growth support through our customer service, billing, and lab operations team. And, again, remember last year, we did invest in the back half more so than the first half, and so, obviously, you have the full-year annualization of that impact as well.

So I think you can see the opportunity breadth of what we have in front of us is so high, it would almost be foolish not to do our best to invest these dollars in things like further Decipher penetration, bolstering Afirma for the long term, the MRD platform as well as Prosigna, and then, obviously, the long-term growth drivers, which are a much smaller percentage of the pie vis-à-vis IVD-enabled product at this point in time.

Carlos (for Puneet Souda): Okay. Thanks. That is really helpful. And then just as one other question. So when we are looking at the Decipher market, you know, you have had really great momentum, 27% growth in the fourth quarter. Still plenty of penetration to go with the market only 40% penetrated, but the penetration is growing quickly, and we are seeing competitors invest a lot more into their competing assays. You know, one of them that had struggled a bit managed to return to double-digit volume growth that they announced earlier this week, for example. If you could just give a little update on the competitive space that Decipher operates in, what you are seeing, that would be very helpful. Appreciate it.

Marc Stapley: Yeah. Happy to. A couple of kind of macro-level things. I mean, the way we see the market growing is from an incidence standpoint, it was about 6%. Decipher represents, based on our math now coming out of the year 2025, about 33% market penetration. So as you can see, you know, one third of patients are getting Decipher, but more importantly, two thirds are not. We have not seen any change in the competitive dynamics or competitive environment at all.

In fact, you know, if you look at the way Decipher grew in 2025, and our guide going forward, you know, it is continuing to represent very strong growth, and that is driven by the masses of evidence that we talk about regularly, the NCCN guidelines that we have, and where Decipher sits in that. And so, you know, we remain extremely confident in Decipher's ongoing growth trajectory, and, you know, we are very encouraged when we see how that—even coming into this quarter—how that is progressing in the marketplace.

Rebecca Chambers: And just one thing to add. I mean, we grew 22,000 tests in 2025 versus 2024. If you look at the other players in the market and do an extrapolation of what you think their total-year volumes were, they are not that far off of what our pure growth was. And so, you know, that is just an exclamation point to Marc's point that we really are not seeing a difference in competitive dynamics. And recall, there are three players in this market, and at least in the preannouncement, I do believe, you know, we are seeing kind of maybe share move from one to the other in any given quarter.

But, again, our competitive dynamics are such that are so strong that we do not necessarily even see that noise.

Marc Stapley: Maybe just to—Rebecca, remind me—just punctuate one other point. As you look across the NCCN risk spectrum, you know, Decipher is doing, and always has done, extremely well in the intermediate and low. Low has been, I would say, our second highest, and high has probably been the lowest. And I think we mentioned a few times over the last couple of quarters how we are seeing since the launch of—30% range—it is actually really exciting to see further penetration across the care continuum, which has always been our strategy with all of our tests and particularly with the type of evidence that we generate.

Carlos (for Puneet Souda): Thanks. Really appreciate it, and congrats again on the quarter.

Operator: Our next question comes from the line of Bill Ponello of Craig-Hallum Capital Group.

Bill Ponello: Hey. Yeah. Two things. So I will start with—I might come also at the margin question, but probably from the opposite point of view. I mean, just sort of back-of-the-envelope math, it looks like you are giving yourself, you know, $10,000,000 to $15,000,000 of incremental investment to launch two products. And at some point, you have to, you know, put together an entirely new salesforce, I would imagine, for breast cancer. So, you know, help us understand why that is enough spend to allow you to be competitive with those two products.

Rebecca Chambers: Love your question, Bill. Marc is going to answer it, but—

Marc Stapley: —anything, I would say, you know, when you talk about the room, you know, that might be room for us to add incremental spend if we need it. Remember what I said: if we see an opportunity to go faster, we have the room to go faster. The baseline assumption might even be a little bit less than that. And the reason for that is, you know, as we launch these new products, if you think about how 2026 shapes out, we need to add maybe a dozen sales reps at the beginning for the Prosigna side and then, of course, MRD into our existing channel in urology, where the majority of patients are served in that setting.

And so there is not a significant amount of incremental investment there. So beyond the sales team and the market development activities, you know, the bulk of actually launching a new product is in clinical evidence development, and that has been ongoing and is already in the run-rate for us and has been for years. And, you know, again, it is playing the similar formula to Decipher: many of the studies that are actually going to drive these products are the studies that, you know, others will do over time. So I would say, Bill, the answer to the question is we are confident we can do it with that.

And if we need to spend more, we will spend more, and we will go faster.

Rebecca Chambers: Yeah. I absolutely agree with Marc. And, Bill, you had—let us take the math offline because the amount we will be spending year over year versus 2025 is significantly higher than the $10,000,000 you cited. So Marc is absolutely right on the drivers of that investment. But, yes, the investment, given the gross margin expansion that we expect from the v2 transcriptome transition, allows the math to be much—to be decently higher than that $10,000,000 cited.

Bill Ponello: Excellent. Thanks. I have never been good at math. Then the follow-up, which is sort of cheating, because it is really a different question. But can you just talk about how you are thinking about capital allocation? I mean, you are sitting with a lot of cash and generating really strong cash flow, and it looks like you will continue to do that.

Marc Stapley: Yeah. No. Absolutely. Happy to do that. There is no change in our philosophy around capital allocation. You know, we have been generating cash for a while now. We have had a strong balance sheet. We have made some important decisions, including, you know, acquiring C2i in order to drive our MRD platform. And we are continuing to look at our opportunities in the marketplace, but our philosophy and our bar has not changed one bit. Other than that, you can see—and we just talked about—those investments in our ongoing business, with, you know, obviously spending money as you would expect us to on, you know, organic discovery-type activities and building infrastructure—things like software development and so on.

And those are kind of the main ways we think about allocating capital. And so, you know, we will continue to be very deliberate about that.

Bill Ponello: Great. Thank you.

Operator: Thank you. Our next question comes from the line of Doug Schenkel of Wolfe Research. Your line is now open.

Doug Schenkel: Hey. Good afternoon, guys, and thank you for taking my question. The first topic I wanted to dig in on is gross margin, which stepped up by about 200 basis points in the fourth quarter. How much of that can be directly attributed to the v2 transcriptome? And then just one clarification also on gross margin. Rebecca, in your prepared remarks on Q1 adjusted EBITDA margin being lower, is that an expectation of being, you know, lower than the target guidance number for the year or down sequentially from Q4?

Rebecca Chambers: Yeah. Let me take the back part of that first. So, yes, we would expect Q1 to be below the guide for the year and definitely lower sequentially. You have to remove the PPCs, and obviously, the start-of-the-year costs—whether it is benefits, comp, taxes, healthcare, et cetera—will impact that. So absolute, and then obviously, PPC. So, yes, absolutely, Q1 should be down sequentially for sure. Vis-à-vis your question on gross margin in Q4, that really is the two things that you—those thing you cited and the thing I cited. So together, we have the perfect answer, Doug: no-result-rate benefit and the cost benefit from the v2 transcriptome, as well as the PPCs.

And the PPCs is the larger impact of the two; the no-result rate is the larger impact of the two.

Marc Stapley: Okay.

Doug Schenkel: Thank you for that. Second topic is Decipher Bladder. Data coming out of ASCO GU looks pretty impressive. You know, our understanding is most of your Decipher volume is still in prostate today. Can you comment on roughly what percentage of Decipher is bladder and then how you expect that to trend over time? And, you know, I guess, on the bladder-sparing data being presented at ASCO GU, it does seem like that could support increased use of Decipher into earlier stage or potentially neoadjuvant chemo decision-making workflows. And that could actually support multiple Decipher-informed decision points across the bladder care continuum over time.

So if that is the case, I could see where this could, you know, turn into a much bigger growth driver over time, if I am thinking about it the right way. So any help there would be appreciated. Thank you.

Marc Stapley: Yeah. Doug, I think your question is spot on. And so, you know, the way to think about the bladder and the numbers today: it is a very small portion of the total Decipher number that we talk about. And, you know, I think we have been relatively consistent in describing how we think about the bladder classifier. We need more evidence—exactly the type of evidence that is coming out at ASCO GU—in order to drive the clinical utility of that test and in, for example, the neoadjuvant setting that you just described. And then what I really love about it is then you have got this, you know, Decipher classifier that can be used at that very early stage.

And I have always said, you know, as you move the patient through the care continuum, you have patients who need MRD as well. We will have the TRUE MRD test as well for those patients. So I love that we are filling out the care continuum, and I think it is important to be part of the diagnostic and prognostic and predictive workflow as well. Do you want to talk a little bit about some of the interesting things that we are going to see at ASCO GU?

John Leite: Yeah. And thanks for the question. So I would say the GU ASCO abstracts in aggregate really demonstrate how understanding the different subtypes of earlier-stage bladder cancer is increasingly becoming a part of care because bladder cancer is in this transition where we are really looking at how to maximize response to neoadjuvant therapy to move patients to a bladder-sparing approach. And the studies we will be presenting show how our Decipher Bladder can inform those decisions and where we see higher proportion responses in luminal versus non-luminal subtypes.

And so not only managing that, additionally, we see—you are seeing how Decipher Bladder also pairs nicely with the follow-on with our muscle-invasive bladder cancer MRD, again, identifying how patients are doing when patients are working towards a bladder-sparing approach. So the bottom line is our portfolio of studies showing that understanding the subtypes of bladder cancer helps inform that neoadjuvant therapy just increases the interest, and we are getting a lot of interest on that bladder test.

Operator: Our next question comes from the line of Kyle Mikson of Canaccord Genuity. Your line is now open.

Kyle Mikson: Congrats on a strong year. I want to start on the 2026 guidance. I think, Rebecca, in response to Subbu's question, you parsed out Afirma and Decipher expectations for the year with respect to revenue. I think you said mid-single digit, high-single digit for Afirma and then Decipher 20% growth. You kind of left. So could you just talk about the volume expectations for both of those products for '26? And then any, you know, puts and takes for each of those, like, Afirma, you know, maybe some volume shifts because of v2 or Decipher if you have a lot of digital pathology stuff going on. So we would love to hear that. Thank you.

Rebecca Chambers: Yeah. Happy to do so, Kyle. Thanks for the question. Effectively, given the prior period collections in 2025, you can assume that the volume growth number embedded in the guide is higher than the revenue growth guide because of the $10,000,000 of prior period collection impact. So that is the easiest way to think about it. And remind me what the second part of your question was?

Kyle Mikson: I mean, it was just kind of, like, puts and takes for volume growth for the year. There is a lot of kind of exciting stuff. Kicking, especially. So I want to know—

Rebecca Chambers: Yeah. So on the new transcriptome, at the low end of the Afirma guide, we would assume no benefit. At the high end, we would assume kind of what we saw in the fourth quarter. And then on Decipher, there is a lot of different things that we are working on. Obviously, the continuous drumbeat of publications and podium presentations. Obviously, the ASCO GU showing was incredibly strong. We would expect, you know, just that flywheel to continue throughout the year. The other thing on the Decipher front is we are working on our new signatures that Marc cited in his prepared remarks.

Those may not be necessarily additive to 2026 but will be important as we think about looking to '27 and beyond and continued competitive differentiation. And then the last one I would cite is really kind of on the high-risk biochemical recurrence/metastatic side. We have seen a lot of traction there since the ASTRO presentations back in Q3, and I would suspect that trend continues, if not becomes even stronger, as we go throughout the course of 2026 and beyond.

Kyle Mikson: Perfect. I had a follow-up on MRD. I was curious what you are doing now to feed the market for the launch for MRD in MIBC in the first half of the year. Like there is a lot going on in bladder cancer, whether it is on the therapeutic approval side or, you know, trials in MRD. So how are you going to make sure that your voice is heard other than the data and things like that in presentations?

Marc Stapley: Yeah. I think that is a great question. There are a couple of layers to it. I mean, first and foremost, as you know, our initial test in TRUE MRD, which is a platform, is going to be in muscle-invasive bladder cancer. And for that, you know, we really already have a lot of the voice of the customer in that we are visiting those customers because of Decipher. And so at the appropriate time—and remember, we do not want to, obviously, distract from our very well-run Decipher business on the prostate side—at the appropriate time and the appropriate accounts, we will be spending time with those customers.

We will be describing the clinical studies that have already been done in that setting, and we will be helping those customers to understand what our TRUE MRD offering is and how they are able to use it. John, do you want to add anything with respect to that?

John Leite: No. I think you answered it well. I mean, the only thing that I would add is we have a standing policy that we would only pursue tests commercially once they are reimbursed. I think what you are hearing here is prudence, not conservatism. We are confident in the performance of the test as we have seen, as we have published. It addresses a meaningful clinical question that physicians are asking, which is how many are going to recur post-surgery that, after neoadjuvant treatment and after surgery, are intended to be curative. Beyond that, we have lots of studies in the hopper that continue to pull the Decipher play on, which is to continue to expand clinical utility through evidence.

Marc Stapley: Yeah. And it is a good time to remind everybody why our test is differentiated. You know, a TRUE MRD test is a whole-genome-based approach. And so, you know, to John’s point, the whole-genome data that we are going to generate for every single patient at every single incidence of care during their treatment journey and the recovery journey, more importantly, is going to be valuable data and valuable information that will drive future clinical studies. So over time, you see the Decipher playbook play out over and over again in MRD as well as it does in our whole transcriptome business.

Kyle Mikson: Perfect. Thanks, guys.

Operator: Thanks. Thank you. Our next question comes from the line of Andrew Brackmann of William Blair. Your line is now open.

Andrew Brackmann: Hi, good afternoon. Thanks for taking the questions. Maybe we can actually just pick up where you left off there, Marc, and sort of using the Decipher playbook for TRUE MRD as well. I think in the past, you talked about sort of driving some collaborations through GRID on TRUE MRD. Can you just remind us sort of how you can replicate some of the learnings on using that GRID platform from other tests like Decipher into TRUE MRD? And any similarities or differences as you move from Decipher to TRUE MRD data? Thanks.

Marc Stapley: Yeah. I mean, it is a great question. I do not think there are a ton of lessons learned other than the high-level one that, you know, making that GRID information available is certainly driving—and has driven over the years—a lot of research. You know, that research is on the existing test, but also, importantly, as you heard when we talk about ATRX loss, PTEN, and PAM50, it actually drives research around other biomarkers as well. And, you know, we can expand those by adding them to the report—the clinical report—over time.

So you have got this great workflow of research: find the most interesting outcomes and clinical information that can be deployed as a test, and then it is very simple for us to just add that without even changing the nature of our test at all. And that is why we have this kind of uniform platform that we use across all of our tests. Do you want to add something?

John Leite: Yeah. So with respect to specifically our MRD, as Marc mentioned, it is whole genome on the tumor; it is also whole genome on the germline, whole genome on the cell-free DNA. That whole genome across lets us really track the tumor. So we use the whole genome to provide a clinically validated MRD test that says tumor detected/not detected. If it is detected, it gives a tumor fraction. Because we are doing whole genome, the GRID approach is that we will leverage that additional data through collaborations, through research, to look at things like tumor heterogeneity, clonal evolution, the emergence of genome-wide signatures associated with resistance to platinum or other therapies used.

That is how our MRD really aligns well with what we have done with Decipher and what we are doing with Afirma, where we get paid for a transcription signature, but we use a whole transcriptome through research to look at the biology and develop new biomarkers.

Marc Stapley: And what I love about this, Andrew, is you start in one indication or one risk category, and then you expand from there. You start in prognostic, you expand into predictive, and so on. And so you fill out the care continuum and you fill out the clinical uses of the test across that care continuum. And I do not see it being any different in MRD than we have demonstrated already in transcriptome.

Andrew Brackmann: Okay. All that is great color here. I will stick on TRUE MRD. This is more sort of housekeeping. Can you just sort of remind us on the reimbursement strategy here? I think you are going after two codes versus sort of the bundle. So can you just level set us on expectations there? And as you sort of think about dollar amounts, I do not know if you are willing to share sort of what defines success for you there, but anything qualitatively you can share with respect to sort of where your mind is at on sort of levels of reimbursement there. Thanks.

Marc Stapley: Yeah. Too early on the dollars, but I will ask John to talk a little bit about the process we are going through.

John Leite: Yeah. On the reimbursement side, Andrew, as I mentioned, we are looking to pursue recurrence detection post patients who have been treated either with or without neoadjuvant therapy and have undergone a radical cystectomy. Those are management decisions that are made with curative intent. And so, as such, it is presumed that the patient is cancer free, and as such, it does not conform to the NCD 90.2 limitation of having to bundle testing for MRD. And so those will be coded and billed individually. So we will have two main codes. One is the initial landmark-setting test that determines the MRD signature, as Phil described earlier, as well as then each sequential plasma test, which is also billed independently.

As it relates to pricing, that is something that we are still negotiating through the MolDX process.

Marc Stapley: And then the population that John laid out—based on our own research—we believe is about 70% of the patients that are seen in our channel.

John Leite: Thank you.

Marc Stapley: Thank you.

Operator: Our next question comes from the line of Lu Li of UBS. Your line is now open.

Lu Li: First one on the new product revenue contribution—understand that it is not included in the guide. I wonder whether you guys have, like, kind of, like, internal target that you wanted to hit. And then, secondly, on the MRD new indication, you have CRC one on the slide. I wonder if it is fair to assume that those will be the next indications. Let me start with the second one and then—

Marc Stapley: —Rebecca, you can talk about the first one. But I would not assume, no. What I do not want to do yet—because it is so dependent on a couple of things, including cohorts—is put out a roadmap for exactly what is coming when. It is why we have said we have a new indication every year. We will want to flex and adjust that and have agility to be able to do so on an ongoing basis based on, you know, the channel, the clinical evidence, the cohorts, the publications of that evidence, the reimbursement, and so on. So we are not going to be more specific about the indications at this point.

We have said you should expect us to focus first and foremost on indications where we have, you know, some channel reach or we are building channel, and, you know, that will certainly be a factor over time.

Rebecca Chambers: Yeah. And on your new product introductions, of course, we have our internal goals. I would highlight them on the MRD front as being more around the customer experience and less around the revenue contribution over the course of 2026. That will obviously become more of a factor in '27 and beyond. But this year, we are really working on ensuring a great customer experience for MRD and various other critical deliverables that we are citing internally.

On Prosigna, that is expected to be launched here over the summer, and the benefit of that and the expectations for that are going to be highly tied to, you know, the OPTIMA readout and the timing of the OPTIMA readout and how that all goes. We have a range of outcomes internally. But, again, we are seeding the market, and we are not going for volume from the get-go. What we are really focused on is KOL engagement and spreading the word and really kind of taking the approach of a top-down KOL engagement and ensuring that is where we are really focusing on volume growth from the get-go.

Over, you know, a five-year timeframe, we do believe this will translate into strong share across the entirety of that market. But, again, in 2026, we are looking to build the foundation more so than really amp revenue from Prosigna and MRD.

Lu Li: Yeah. That is very helpful. Maybe a quick question on the Decipher Q4 volume. If you look at it sequentially, I think that is only up by 500 units. I wonder if there were anything to call out or just, like, why it is slightly lower than, like, Q4 2024 number.

Rebecca Chambers: Yeah. I am happy to take that one. Effectively, in any given quarter, you can have a day or two of volume that falls on either side of the quarter. In Q4 of '24, that was a good guy. In Q4 of '25, it was—you know, we had a day that did not get out, or day-plus, actually, that did not get out. So, you know, I think that all makes itself up, and that is typical quarterly impact and quarterly volatility, and it is not any underlying trend. Over the course of the fourth quarter, we had across every single metric we track just an outstanding quarter.

And so I definitely would not—500 samples does not make me flinch one way or the other, 600, 700, whatever the case may be. But, you know, I think that is—I would not get overly wrapped around that axle. We have had many quarters like this before that fall on one side, and folks tend to get a little excited about it. And, you know, a quarter or two or three later, it all normalizes. So I would not read into it.

Lu Li: Got it. Thank you.

Rebecca Chambers: Thanks for asking that question.

Operator: Thank you. Our next question comes from the line of Thomas DeBourcy of Nephron Research. Your line is now open.

Thomas DeBourcy: Hi. Thanks for taking the question. I actually wanted to ask, I guess, the non-testing revenue, or I think you are guiding to $10,000,000 to $12,000,000. And it seems like, I guess, in Q4, you still had biopharma revenue. What I would expect in 2026—while maybe not from the same source—you may also have IVD revenue whether it is from MRD or other clinical trials. And so just how to think about product versus biopharma revenue as we, you know, I guess there are IVD launches. Or just, I guess, biopharma one-time revenue?

Rebecca Chambers: Yeah. Happy to answer that, Tom. Implied in the guide is less than $1,000,000 of biopharma revenue, call it zero at the low end and one at the high end. That is an incredibly specific range. And the reason why it is that specific is because unless something is signed and booked, we do not include it. That is just our philosophy. So, you know, obviously, with shutting down the French entity, that was where the vast majority of the biopharma revenue came from. And so we will, obviously, with the Decipher franchise and the MRD franchise, continue to go after biopharma. But this, again, is less about a revenue strategy, and it is much more about an evidence strategy.

And that is really where we are focused. And so that is not necessarily the driving force. On the product front, we have implied, you know, something closer to that around $10,000,000 that you cited. And that is down year over year. That is down year over year for two reasons. One is we have a new contract manufacturer, and, obviously, the variable of their ability to produce, we wanted to give ourselves just some wiggle room around. And then the second is, you know, we are not selling to U.S. customers ahead of the LDT launch. Let me be very clear.

We are not selling the IVD to U.S. customers ahead of the LDT launch, and therefore, that contribution, which was quite small in nature, is not included in the guide.

Marc Stapley: Thank you.

Operator: Our next question comes from the line of Keith Hinton of Freedom Capital Markets. Your line is now open.

Keith Hinton: Great. Thanks. Just wanted to follow up quickly on Decipher and bladder. Just to make sure that I sort of understood the comment. So based on the exciting data at ASCO GU, is investing additional commercial resources there becoming a near-term priority just based on what you have seen, or do you feel like you need to see more data? And if so, is there more data that you are aware of in the near term? And then, you know, if you do decide to invest commercially there, how much synergy is there with the existing Decipher franchise and the MRD franchise as well?

John Leite: Yeah. I can take that one. Thank you for the question. No. The answer is no. The rate-limiting step in the growth of Decipher Bladder is not tied to commercial investments per se. As Marc mentioned earlier, there is a very high degree of overlap between bladder cancer patients who are currently managed by the physicians that we call on for Decipher Prostate. We feel we can manage that and have the bandwidth and capacity to manage that through our current channel and sales personnel and our systems. I think the parts that are rate limiting are all this great evidence that you are seeing at ASCO GU still needs to be completed, still needs to be published.

And those are, in general, what allows us then to update our own clinical reports and to essentially leverage that great data to seed and create more demand.

Marc Stapley: And then just broadly, you know, our investment in commercial this year will be mostly on the Prosigna LDT U.S. side and then on MRD, to your question. Because of the overlap in urology, I think about the MRD investment being in future years as we broaden into other indications.

Marc Stapley: Thank you.

Operator: Our next question comes from the line of Michael Stephen Matson of Needham & Company. Your line is now open.

Michael Stephen Matson: Yes, thanks. I really just have two questions. Not to pile on the TRUE MRD, but I was wondering if you could just tell us the annual number of patients that you think are candidates and then the number of tests per year you would expect to be used on those patients on a given patient. And then the second question is really just on tax rate. So are you—do you expect to start paying taxes in 2026? And what would be the appropriate rate to model?

Rebecca Chambers: I will take the latter because it is fast and easy. So we always have to pay some state taxes. We have flown through our NOLs, but that is in the run-rate. So I would not think too hard about that. But, effectively, we are expecting our GAAP and non-GAAP tax to be around the mid-single digits this year. So we still have a decent chunk of NOLs to get through.

You know, one thing that we will be talking about over the course of this year as we look at the profitability profile going forward is our valuation allowance, but more to come on that in the back half of the year if we are looking like that might be something that gets released.

John Leite: Yeah. And on the available market, we are estimating just around 20,000 patients for a SAM. You also have to assume that there is going to be some serial repeat testing on a per-patient, per-episode-of-care basis. The details of that are still under discussion through our tech assessment with MolDX.

Operator: Thank you. Our next question comes from the line of Colm Titchmarsh of Morgan Stanley. Please go ahead.

Jason (for Colm Titchmarsh): Hi. This is Jason on for Colm. Thank you for taking our questions. A lot has been asked, I will just keep it to one. Maybe on Percepta nasal swab, you recently completed enrollment for the Nightingale trial. Can you just provide some color on what are the next milestones we should be looking at? Any color you can share on timeline for trial completion, data readouts, commercialization, and just any milestones we could track. Thank you.

Marc Stapley: Yeah. That was one of our key accomplishments in 2025, getting the final enrolled through that study. And now it is a question of, I think, a couple of milestones. One is the follow-up. And, of course, you have to wait for at least a year, if not two, for those patients to be followed up to confirm, you know, benign. And then it is getting that publication ready, getting it published, which can take time, and then it is a serial conversation with MolDX and payers in order to get it reimbursed. And so this is why this one is very clearly not in our, you know, five-year, three-to-five-year plan. It is more in our five-to-ten-year plan.

Marc Stapley: Thank you.

Operator: This concludes the question-and-answer session. I would like to thank you for your participation in today's conference. This does conclude the program, and you may now disconnect.