Sebastian Sandler

Sebastian Sandler inquired about potential upside drivers for the clonoSEQ volume guide in 2026, specifically asking about community volume growth, NEO genomics contribution, guidelines, and incremental recurrence monitoring coverage. He also asked about the 2026 ASP guide of $1,400, its dependence on two called-out contracts, execution risk, and the pacing of ASP growth throughout the year.

Answer

Susan Bobulsky, Chief Commercial Officer of MRD, identified potential upside from EMR integration, particularly the pull-through on serial testing with Flatiron, and optimizing already integrated sites. She also pointed to continued focus on blood-based testing and community penetration. Chad Robins, CEO and Co-Founder, reiterated the five key drivers (blood-based testing, community, data readouts, guidelines, and EMR integrations) as areas of reinvestment and confidence. Kyle Piskel, CFO, and Chad Robins, CEO, expressed confidence in the ASP guide, noting multiple levers to achieve it despite some execution risk with key payer contracts, with pacing likely more weighted to the second half.

Sebastian Sandler asked about potential upside drivers for the clonoSEQ volume guide in the current year, specifically mentioning contributions from NeoGenomics, guidelines, and incremental recurrence monitoring coverage. He also inquired about the execution risk associated with the two key payer contracts influencing the 2026 ASP guide of $1,400, asking for quantification of potential ASP impact if contracts are less favorable and the pacing of ASP dynamics throughout the year.

Answer

Susan Bobulsky, Chief Commercial Officer of MRD, Adaptive Biotechnologies, identified EMR integration, particularly Flatiron, and serial testing pull-through as key areas for potential volume upside. She also mentioned optimizing integrated sites and continued focus on blood-based and community testing. Chad Robins, CEO and Co-Founder, Adaptive Biotechnologies, reiterated the five core growth drivers. Kyle Piskel, CFO, Adaptive Biotechnologies, acknowledged some execution risk with the payer contracts but expressed confidence in achieving long-term rates, noting that ASP dynamics would likely be more weighted to the second half of the year. Chad Robins added that multiple levers provide confidence in the ASP guide.

Sebastian Sandler, on behalf of JPMorgan Chase & Co., asked about the impact of the recent NCCN guideline update on multiple myeloma ordering patterns and how unique patient IDs translate to future MRD testing. He also inquired about the MRD Pharma backlog conversion to revenue and any changes in pharma customer behavior.

Answer

CCO Susan Bobulsky stated the NCCN update is a supportive tailwind, reinforcing their message in the community, but it's too early to attribute specific volume increases to it. CFO Kyle Piskel noted the pharma backlog conversion profile is largely unchanged. CEO Chad Robins added that global regulatory support for MRD as an endpoint (ODAC, CHMP) is growing, making them bullish on the pharma opportunity with minimal impact from other macro factors.

Sebastian Sandler, on behalf of Rachel Vatnsdal from JPMorgan Chase & Co., questioned if the strong sequential increase in clonoSEQ volume is a sustainable run-rate and asked if community setting growth is from new or existing accounts.

Answer

Executive Susan Bobulsky expressed confidence in continued sequential growth for the year but remained prudent about the exact magnitude each quarter due to new initiatives launching in the second half. She confirmed that growth in the community setting was driven by both acquiring new accounts and achieving deeper penetration within existing ones.

Sebastian Sandler, on for Casey Woodring of JPMorgan Chase & Co., asked about ICON's role in licensing deals between large pharma and Chinese biotechs, and what percentage of ICON's revenue comes from China.

Answer

CEO Steve Cutler stated that revenue from China is approximately 3%. He explained that while Chinese biotechs use local CROs for domestic trials, they rely on global organizations like ICON for international trials aimed at US and European registration. He views this as a 'medium to longer-term fuel' for the business as Chinese innovation grows.