Summary of GRAIL (GRAL) FY Conference Call - August 13, 2025 Company Overview - GRAIL is a company focused on early cancer detection through its multi-cancer early detection (MCED) test, known as the Gallery test [2][3]. Key Financial Highlights - In Q2, GRAIL reported strong demand for its Gallery tests, with U.S. Gallery revenue growing over 20% to $34 million [3][4]. - The number of tests performed increased to 45,000, representing a 29% growth [4]. - The company reiterated its guidance for U.S. Gallery commercial growth of 20% to 30% [4]. - Cash burn was reduced from $320 million to $310 million due to effective restructuring efforts [5]. Product Development and Studies - GRAIL is preparing to present detailed data from its Pathfinder two study at the ESMO conference in October [5]. - The company reported improved positive predictive value (PPV) and cancer detection rates compared to previous studies [6]. - Both Pathfinder two and NHS Gallery studies are expected to provide data for filing a premarket approval (PMA) [7]. Testing and Market Dynamics - The average selling price (ASP) per test was approximately $8,800, slightly lower due to increased repeat testing rates, which rose to 25% from 20% [9][10]. - The cost of goods sold (COGS) per test decreased due to the rollout of the Gallery 2.0, which aimed to automate and optimize the testing process [11][12]. - GRAIL's focus remains on the Gallery test, with limited expansion in biopharma revenue streams due to restructuring [16][17]. Competitive Landscape - GRAIL acknowledges the competitive environment but views it positively, as it raises awareness and support for MCED tests [38][39]. - The company is preparing for the launch of a competitor's MCED test but believes its own test has a significantly lower false positive rate and better cancer signal of origin [37][38]. Regulatory and Legislative Outlook - GRAIL is optimistic about the passage of the Nancy Sue bill, which aims to improve Medicare coverage for cancer screening [49][50]. - The company is actively lobbying for this legislation, which has garnered bipartisan support [50]. - GRAIL anticipates that FDA approval and inclusion in USPSTF guidelines will be critical for broader adoption and reimbursement [53][54]. Future Milestones - Key upcoming milestones include the readout of Pathfinder two and NHS Gallery data, expected in mid-next year [26][27]. - GRAIL is confident in its funding, stating it is funded into 2028, which allows it to focus on upcoming milestones without immediate capital raising needs [65]. Conclusion - GRAIL is currently detecting significant numbers of asymptomatic cancers, emphasizing the real-time impact of its testing capabilities [67][68]. - The company remains focused on its core Gallery test while navigating the competitive landscape and preparing for regulatory approvals.

Financial Data and Key Metrics Changes - Exact Sciences delivered a record 1,300,000 test results, with core revenue growth accelerating to 16% year over year, generating an all-time high of $138,000,000 in adjusted EBITDA [3][4] - Adjusted EBITDA increased by 26%, with a margin expansion of 130 basis points, driven by pricing and productivity gains [5] - GAAP net income was negative $1,000,000, including $15,000,000 in one-time costs related to operational efficiency [5] - Free cash flow reached $47,000,000, bringing year-to-date free cash flow to $46,000,000, an increase of $95,000,000 compared to the same period last year [5][6] Business Line Data and Key Metrics Changes - Screening revenue increased by 18% to $628,000,000, with growth driven by rescreens, CareGAP programs, and improved commercial execution [4] - Precision Oncology revenue grew by 9% to $179,000,000, led by international adoption of Oncotype DX [4][5] - Revenue from sublicensing Twin Strands technology contributed $7,500,000 [5] Market Data and Key Metrics Changes - Cologuard brand awareness reached all-time highs, with top-of-mind awareness matching or exceeding colonoscopy [12] - The colon cancer screening landscape is shifting towards a Cologuard-first approach, as indicated by recent advocacy from the AGA work group [12][13] - Cologuard's momentum is evident, with the company delivering its twenty millionth result, doubling from ten million in just three years [11] Company Strategy and Development Direction - The company is raising total revenue guidance for the year to between $3,130,000,000 and $3,170,000, reflecting a $55,000,000 increase at midpoint [7][8] - A multi-year productivity plan aims for $150,000,000 in annual savings by 2026, focusing on operational efficiencies and AI integration [9][10] - The company reaffirms its long-term target of 15% compounded revenue growth and over 20% adjusted EBITDA margins by 2027 [9] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the growth trajectory, citing strong commercial execution and brand awareness as key drivers [11][12] - The company anticipates increased cash flow in the second half of the year as accounts receivable from Cologuard Plus claims are paid [6] - Management acknowledged challenges in blood-based colorectal cancer screening but remains optimistic about future developments and the potential of the Phrenome acquisition [14][15] Other Important Information - The company has secured Medicare coverage for OncoDetect, enhancing its precision oncology offerings [3][21] - The launch of CancerGuard, a blood-based multi-cancer early detection test, is set for next month, targeting a $25,000,000,000 addressable market [19][20] Q&A Session Summary Question: Strategic fit of the Phrenome agreement - Management highlighted that the agreement adds a blood-based option to their portfolio, complementing existing tests and enhancing market leadership [26][27] Question: Factors contributing to strong growth - Management attributed growth to the successful launch of Cologuard Plus and improvements in commercial execution, with strong performance across all business segments [32][34] Question: Blood test performance and FDA submission timeline - Management stated that the Phrenome test showed promising sensitivity and specificity, with the final module submitted to the FDA, but did not provide a specific timeline for approval [39][40] Question: Concerns about resource allocation and strategic prioritization - Management disagreed with the notion that past acquisitions were unsuccessful, emphasizing the impact of Cologuard and the potential of the blood-based screening market [49][50] Question: Market share expectations for blood-based testing - Management projected that blood-based testing could capture 5% to 10% of the market, depending on future guideline recommendations [88][90]