Natera Morgan Stanley 24th Annual Global Healthcare Conference

Yeah. Cheers. Thank you. Thanks for having us in.

Yeah. I'd say obviously, very strong quarter and year to date. We've had multiple revenue raises. We've seen acceleration in Signatera volume and really just strength across the business overall. I think in Q2, we had 34,000 quarter-over-quarter growth, which was just an all-time record for Signatera. Super exciting. I would say, the area that I think is maybe most underappreciated is just how big the MRD market opportunity is. When we start to look, drilling into the numbers, looking at territory by territory, each sales rep, and just understanding how much additional opportunity there is, it's really remarkable, and I think we're going to be in this period of very strong growth for a very long time.

Yeah. A couple of years ago, we'd go speak to doctors, and they'd really be focused on, "Well, hmm, not sure how the test should be used," or, "I'm not really sure what I should do if I get a positive result. Maybe we may consider using it. We're just sort of waiting for the evidence." I would say now we really don't hear that anymore. We've just had so much peer-reviewed evidence and prospective data, overall survival data, disease-free survival data, that's read out, that doctors, I think now have come to the appreciation that MRD testing and Signatera particularly, has been thoroughly validated, thoroughly proven in the peer-reviewed evidence.

Now it's really about, "Well who do I use it on?" Not "Should I use it?" But, "Who do I use it on and how often?" The discussions now center around putting protocols in place, EMR connectivity, expansion within the practice from, say, CRC and breast to other indications, which is exciting. I think that really means that we've crossed this threshold and are gearing up for a period of very deep growth.

Yeah. So we've published several hundred peer-reviewed papers at this point. As I just mentioned, there's a sense that we've sort of crossed the evidence threshold, especially now with the FDA approval and so forth. But we're not done there. We're continuing to invest in peer-reviewed evidence, really across histologies. So that's going to continue. We have some great readouts coming in the second half of this year and into 2027. Just to give you kind of a flavor, I think there's continued exciting data in CRC, continued exciting data in breast. We've got a big readout in head and neck, gastroesophageal, in lung, several pan-cancer readouts. So we've got a lot to keep the team busy and we're excited about these new readouts coming.

Yeah. So achieving FDA approval and then getting NCCN guidelines has really, I think, changed the way doctors think about the test. Now they really are required to have an MRD strategy in their practice. I think that that has sort of put us on a new trajectory. Again, kind of thinking about, "Okay, how do I use the test? Which patient should I use it on?" Versus, "Whether I should use it." There's also some exciting things in the protocol. If you look at the IMvigor protocol, just how the testing is used every 6 weeks, versus maybe traditionally once a quarter or say, twice a year. We're now looking at sort of a 6-week protocol in the IMvigor study, and under the approval. I think that's an exciting opportunity as well. So overall, on the right path.

We now have multiple NCCN guidelines for MRD, not just muscle-invasive bladder, but also lymphoma, Merkel cell. I think that kind of starts this sort of flywheel effect of where we're on this path to, in the future, sort of be deeply penetrated into guidelines, and that will continue to help accelerate volume growth.

Yeah. So we're doing exceptionally well in biopharma. That's an area that we've seen very significant increases in interest, really driven by a couple of factors. I think one is this shift towards an MRD-guided strategy for new phase III clinical trials, particularly this concept of ToMR or treatment on molecular recurrence, where big pharma companies are now saying, "We want to be able to move our drugs up in the care paradigm. Rather than waiting for somebody to have a clinical relapse on a scan before we can administer the drug, we want to be able to administer the treatment directly on the molecular relapse itself. Prior to the cancer expanding within the body and becoming stronger, we want to treat on MRD." That's what ToMR stands for, treatment on molecular recurrence or treatment on MRD.