Financial Data and Key Metrics Changes - Fourth quarter total revenue was $141 million, representing a 19% year-over-year growth driven by a strong core testing business which grew 21% [4] - Full year total revenue reached $517 million, achieving 16% growth [5] - Adjusted EBITDA margin exceeded 27% in 2025, surpassing the 25% target more than a year ahead of plan [6][29] - Cash from operations for Q4 was $52.6 million, ending the quarter with $412.9 million in cash and cash equivalents [26] Business Line Data and Key Metrics Changes - Decipher volume grew 21% in Q4, with approximately 27,200 tests delivered, marking the 15th consecutive quarter of over 20% year-over-year volume growth [11] - Afirma delivered approximately 18,250 tests in Q4, representing 12% volume growth [9] - Total testing volume for Q4 was approximately 48,000 tests, a 16% increase over the same period in 2024 [26] Market Data and Key Metrics Changes - Decipher is recognized as the only gene expression test with high-quality evidence in NCCN guidelines, contributing to its growth [12] - The market penetration for Decipher is approximately 33%, indicating significant room for growth as two-thirds of patients are not yet utilizing the test [53] - The bladder cancer market is transitioning towards more biologically informed evaluations, with Decipher Bladder being integrated into studies to guide treatment decisions [17][85] Company Strategy and Development Direction - The company plans to launch two new products in 2026: TruMRD for muscle-invasive bladder cancer and Prosigna for early-stage breast cancer [8][21] - A phased expansion strategy is in place, focusing on core business momentum and new product launches [7] - The company aims to sustain double-digit growth through its portfolio of tests across prostate, thyroid, bladder, and breast cancer [25] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in sustaining double-digit growth, supported by a strong pipeline and ongoing clinical evidence generation [25][32] - The company is prepared to invest in growth drivers while maintaining profitability, with a focus on clinical evidence and product launches [46][49] - Management highlighted the importance of navigating evolving market dynamics and maintaining a strong operational model [24] Other Important Information - The company achieved significant milestones in 2025, including the launch of Decipher for metastatic patients and the transition of Afirma to a more scalable platform [5][6] - The company is on track to test its 1 millionth patient later this year, reflecting the scale and impact of its platform [5] Q&A Session Summary Question: Has your conviction in the guidance evolved in any way? - Management reiterated strong conviction in guidance, noting seasonal trends and potential drivers for high and low ends of the range [34][35] Question: What readout is required for the OPTIMA study to expand the intended use population? - Management indicated that the OPTIMA study includes enrollment criteria that could allow for expansion, pending positive results [40][42] Question: Can you walk through the push and pulls regarding the margin guidance for 2026? - Management explained that the guidance reflects the need for flexibility to invest in new product launches while maintaining profitability [45][49] Question: How is the competitive landscape for Decipher evolving? - Management noted that Decipher continues to grow despite competition, with strong evidence supporting its use in clinical guidelines [53][55] Question: What is the expected volume growth for Afirma and Decipher in 2026? - Management indicated that Afirma is expected to grow in the mid to high single digits, while Decipher is projected to grow approximately 20% [30][90]