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President and CEO Sam Raha stated the answer is 'both.' He explained that growth will be driven by participating in large, high-growth markets, but the company intends to outperform the market by winning accounts. This will be achieved through a combination of compelling, integrated test offerings, unified reporting that simplifies clinical decisions, and specific product differentiation, such as the ultra-sensitive MRD assay. He also noted that the new Chief Commercial Officer would bring 'stepped up commercial execution'.

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COO Mark Verratti explained that the main point of confusion was the NCCN's mention of 'level 1 evidence' for prostate cancer, a standard not applied to its other 66 cancer guidelines, and that Myriad spent Q1 clarifying this with providers. CEO Samraat Raha added that the Pathomx partnership has been well-received, as it reaffirms Myriad's commitment to prostate cancer and builds anticipation for a novel AI-biomarker test.

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CEO Paul Diaz explained that PATHOMIQ was selected for its deep expertise and established KOL relationships in prostate cancer, a strong and compatible technology platform validated through prior pilots, and its ability to use foundational H&E staining. He emphasized that combining PATHOMIQ's AI with Myriad's commercial channel creates a powerful, unique solution and represents a strategy to accelerate growth through select, deep partnerships.

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President and CEO Paul Diaz admitted they are not clear on what's missing for UnitedHealth but plan to present additional data and stakeholder input. The best-case scenario is a pause on the January 1 effective date. Chief Commercial Officer Mark Verratti confirmed that the United business had been growing at a very similar rate, perhaps slightly more, than the rest of the GeneSight business.

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CFO Frank Stokes described progress with commercial payers as very slow, citing payer self-interest and long review cycles despite compelling data. CEO Derek Maetzold clarified the current Sybase collaboration is focused on a new portable device for atopic dermatitis, not Sybase's existing melanoma test, though future collaboration remains a possibility.

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CFO Frank Stokes clarified the guidance is for adjusted gross margin and accounts for the loss of DecisionDx-SCC reimbursement. CEO Derek Maetzold explained Previse offers a tissue-based methylation test and a non-endoscopic sponge technology, with Frank Stokes adding that meaningful revenue impact is expected to be downstream, not in the current year.

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SVP & CFO Amol Chaubal stated that the market situation is unchanged, with the drug discovery segment (5% of pharma revenue) and biotechs remaining slow, while large pharma and CDMOs show healthy replacement activity. President and CEO Dr. Udit Batra added that regarding India, customers are not seeing any tariff impact and are ramping up capacity for generics opportunities, expressing confidence that the generics industry is unlikely to be a primary tariff target.

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SVP & CFO Amol Chaubal stated that the pharma drug discovery market remains slow, with no replacement cycle kicking in for that segment or biotechs. In contrast, large pharma and CDMOs remain healthy. Regarding India, both Mr. Chaubal and CEO Dr. Udit Batra confirmed that funnel activity is very strong and customers are ramping up capacity, with no fear of tariff impacts. They believe the generics industry is crucial for lowering U.S. healthcare costs and is unlikely to be targeted.

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CEO Udit Batra stated that the U.S. A&G segment is small, at roughly 3% of revenue, and started the year with double-digit growth driven by PFAS testing. However, CFO Amol Chaubal explained that for prudence, the company has assumed a significant 20% decline for this segment for the rest of the year in its updated guidance.

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CEO Masoud Toloue clarified that the fully integrated Simoa ONE platform will offer the best performance specifications compared to using the assays on other systems. Regarding the Accelerator lab, he noted that while customer stickiness and diversity are strong, broader pharma spending dynamics are causing some larger projects to be pushed out. CFO Vandana Sriram detailed that tariff exposure is primarily on certain antibodies and that countermeasures have limited the expected margin impact to 50-100 basis points, with a potential 100 basis point impact on growth from reciprocal tariffs also factored in.

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President and CEO Masoud Toloue clarified that Simoa 1 is designed to expand the company's addressable market into immunology and oncology by offering higher plex capabilities, targeting new customers rather than replacing the existing neurology-focused installed base. CFO Vandana Sriram projected low-double-digit to high-single-digit growth for ex-U.S. markets. Masoud Toloue confirmed that the view of academic market 'paralysis' is based on direct feedback and observations of confusion among customers regarding budgets, hiring, and capital purchases, which he believes is a transient issue.

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President and CEO Masoud Toloue explained that the 2025 diagnostics ramp is directly linked to the uptake of Alzheimer's therapies like LEQEMBI. He detailed that the LucentAD Complete five-marker test reduces the 'intermediate zone' threefold compared to single-marker tests, providing more definitive results for patients. He positioned BD-Tau as a key research marker for staging tau pathology, with future diagnostic potential.

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CEO Marc Stapley stated that the UMBRELLA study is designed to be sufficiently powered to support positive Medicare coverage decisions for the indications studied. CFO Rebecca Chambers explained that the 'project spend' refers to R&D expenses anticipated in Q1 that were shifted to later in the year, and the guidance update reflects this timing adjustment against Q1's outperformance.

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CEO Marc Stapley confirmed the prognostic and MRD tests are distinct, with the MRD test for muscle invasive bladder cancer being the current priority. He acknowledged the platform's sensitivity could potentially apply to non-muscle invasive cases but stated that is not an immediate focus, as larger opportunities exist in other cancer types where Veracyte has an established commercial channel.

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CEO Marc Stapley explained that while guidelines are not necessary to start, they are key for driving broad, long-term adoption, and studies like STAMPEDE support this effort. He noted the potential for Decipher to guide treatment, whether as a formal CDx or not, and affirmed that global studies like STAMPEDE are relevant in the U.S. CFO Rebecca Chambers added that any hurricane impact was minimal, equating to less than a day of volume.

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CFO Jim Hippel acknowledged that pharma tariff uncertainty contributed to the conservative Q4 guide but noted that pharma companies are well-capitalized and have already undergone pipeline realignments. CEO Kim Kelderman added that Bio-Techne's portfolio is diversified across the entire drug development workflow, mitigating risk from spending shifts. Regarding Spatial Biology, he highlighted the platform's unique, fully automated multi-omic capabilities as a key competitive advantage.

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CEO Kim Kelderman explained that academic performance was strong across product lines and regions, including in the U.S. and Europe, which both faced tough comps. He attributed the strength to funding flows aligning with Bio-Techne's portfolio in areas like cancer and neuroscience. On diagnostics partnerships, Kelderman confirmed the kidney rejection project with Thermo Fisher is progressing but emphasized that the primary focus is now on developing and commercializing its own exosome-based tests, like the upcoming ESR1 breast cancer test, through its Asuragen channel.

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CEO Kim Kelderman described the company's AI-engineered proteins as a 'stepwise change in innovation,' protected by patents and built on a unique combination of historical data and early AI investment. He stated that the COMET's unique multiomic capabilities and user-friendly design should drive rapid adoption, noting the company's existing strength in the clinical spatial biology market is a key differentiator.

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President and COO Patrick Finn reaffirmed the $1.4 billion market opportunity in converting 'DNA makers.' He emphasized that Twist's value proposition of speed and cost-effectiveness resonates strongly in a constrained academic budget environment, allowing researchers to either get more 'shots on goal' or outsource cloning to focus on higher-value research. He concluded that the company remains very bullish on this opportunity.

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CEO Emily Leproust detailed four primary milestones: scaling the silicon chip to the terabyte level, finalizing the enzymatic synthesis chemistry, building the associated hardware, and developing the integrated software. She added that while progress is now directly tied to investment levels, the company is intentionally managing spending in this area to prioritize achieving adjusted EBITDA breakeven for the overall business.

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CEO Dr. Emily Leproust described these advancements as a net positive for Twist. She explained that as the NGS market evolves towards higher quality and performance, it aligns perfectly with Twist's high-quality product offerings. Dr. Leproust emphasized that Twist's rapid R&D cycle is a key advantage that allows the company to adapt and capitalize on new technologies as they emerge.

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CEO Kevin Conroy explained that they see huge leverage with their existing field force and strong interest from large health systems, which see a pressing need to identify cancers earlier. He noted that both the screening and precision oncology sales teams are eager to offer the test, which will be at a price point amenable to out-of-pocket payment.

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CEO Kevin Conroy explained that the launch will leverage the existing screening and precision oncology sales forces. He highlighted strong, proactive interest from large health systems, which see a need to identify cancers earlier and retain patients. He also indicated the test will likely have a differentiated price point that is more accessible for out-of-pocket payment.

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President and CEO Christian Henry projected that the clinical segment could double to 30% or more of total revenue over the next three years. He outlined that growth would be broad-based, coming from whole genome sequencing in rare disease, panel testing using the PureTarget kit for applications like carrier screening, and emerging opportunities in oncology. He expects this to be one of the fastest-growing areas of the business.

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Executive Sharon Benzeno detailed the pipeline, noting upcoming submissions for T-cell ALL and cutaneous T-cell lymphoma (CTCL), as well as efforts to expand the reimbursement framework for mantle cell. Executive Karina Calzadilla and CEO Chad Robins called the NCCN guideline update a positive step that aids commercial payer discussions for DLBCL, for which they already have Medicare coverage.

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CEO Chad Robins estimated that approximately $50 million to $60 million in Genentech amortization would remain after the current year. He also indicated that while formal guidance is pending, the company intends to constrain Immune Medicine spend, suggesting its percentage of total OpEx will be lower next year.

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CEO Jacob Thaysen responded enthusiastically, calling it a great example of the future opportunity in healthcare. He stated that genomics will play a huge role in the project and positioned Illumina as the natural partner for such an initiative, expressing excitement about the possibilities.

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CEO Jacob Thaysen credited Europe's consistent performance to steady execution. He explained that the Americas faced tougher year-over-year comparisons due to a larger number of NovaSeq X placements in the prior year and more intense mid-throughput competitive pressure in the U.S. He expects the U.S. comparisons to ease going forward.

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