Okay, I think we'll kick things off here. My name is Jacob Dodd. I work with Kallum Titchmarsh here on the life science tools and diagnostics team at Morgan Stanley. Thank you all for joining us here this morning. I'm pleased to be joined on stage by Veracyte CEO Marc Stapley and CFO Rebecca Chambers for a fireside chat. Before we jump in, I just want to quickly note that for all relevant disclosures, please see morganstanley.com/researchdisclosures. With that out of the way, yesterday afternoon Veracyte announced the acquisition of Convergent Genomics. Marc, to start us off here, could you tell us a bit about the deal and why it's the right asset at the right time for Veracyte? Yeah, happy to. Before I get into that, maybe I should just remind everybody about our safe harbor statement to the extent we make forward-looking statements. You can find that in its full on our website at www.veracyte.com. Convergent, great acquisition for us. Obviously, we've talked for many years about a strategy of expanding the care continuum in the indications in which we play, adding new indications, like for example, you saw us do that with breast in the U.S., and then expanding across the geographies as well. Convergent fits in perfectly into that strategy of expanding across the care continuum in an indication in which we currently have two tests already, and that is bladder cancer. Bladder cancer is a large and important disease that is being studied a lot more these days. The standard of care needs some diagnostic assistance, and that's where we come in with biomarkers, including the UroAmp that we acquired from Convergent, which importantly is a urine-based biomarker. So now Veracyte has urine, tissue, and blood-based testing in bladder cancer. We can serve the entire care continuum of bladder cancer from that early-stage patient with, for example, Ta disease, non-muscle invasive, all the way up to muscle-invasive bladder cancer with TrueMRD. That, being able to serve the patient at multiple time points and longitudinally follow that patient with our data-driven strategy, is why this makes sense for us. Now, why this time? This is the perfect time because that team over 10 years has done an incredible job studying that analyte and solving a very difficult problem of the signal-to-noise in urine-based testing. They're very close to the point of commercial launch. We're going to launch the first test in late 2028, and they've done all the clinical work, nine publications, 40 abstracts, and so on. So a perfect time for us to come along with our channel, and this is an important one because it's a channel synergy in urology as well, and drive that commercialization. The other added benefit of the timing right now is we have seen more and more data coming out of the Decipher Bladder Genomic Classifier or for the Decipher Bladder Genomic Classifier, which is up front of this test. Our efforts on the Decipher Bladder Genomic Classifier in terms of the commercialization will ramp up over the next couple of years, so that will effectively. We want to own the tissue from the get-go, and that will effectively allow us to do so, and then play nicely into either non-muscle or muscle-invasive pathways that Marc described. I heard you mention a couple Veracyte products with some similarity in indication to the UroAmp. TrueMRD specifically has some superficial similarities in that it's MRD with an indication of bladder cancer. What are you seeing from the clinical data or from where the market is going that makes the multi-sample approach the right way forward versus, for example, investing more in the TrueMRD platform alone? Yeah. There are multiple clinical questions that you need to answer for a patient with bladder cancer. Like I said, from that early stage, and as Rebecca mentioned, you do the TURBT procedure, you've got tissue. It's looking at the subtype and what does that tell you about the prognostic outcomes for that patient to giving them BCG or other IVT treatment, and is that treatment actually working? So monitoring that treatment as you're providing that treatment over the first or multiple cycles to when you finish that treatment, has that treatment actually resulted in elimination of the tumor, or is there residual disease to either other treatment or surgery, cystectomy, for example, monitoring for residual disease in that state as well, which is much more of a blood-based solution. If you think about it now, these tests really don't overlap. You've got in the non-muscle invasive, urine is the best analyte. In muscle invasive, clearly blood is the best analyte, and then you need tissue for the subtyping, as I mentioned. Okay. Makes sense. Maybe one for you, Rebecca. I believe the press release pointed to Convergent's OpEx being absorbed with no impact to Veracyte's 2026 EBITDA guidance. How should we think about the level of investment required over the next couple of years to bring that test to market? And maybe what kind of cost or revenue synergies do you foresee with this platform, whether quantitatively or qualitatively with the rest of the business? Yeah. So on a revenue basis, obviously Marc cited the channel synergies, which are important, as are the back-office operational synergies, whether that be the customer service billing or laboratory. Excuse me, we'll be moving the laboratory into our San Francisco facility, and so there'll be nice synergies there, obviously incredibly qualitative because this isn't a synergy play, this is a revenue growth play, and this is absolutely something that we're investing in for the long-term potential for the benefit of patients and shareholders. So we're excited about that piece. And when it comes down to the guidance statement, obviously we're in the late stages of diligence when we did the earnings call, so we effectively were able to take into account the investment. The investment is, call it, 20-ish people. And so it's not a material investment. They've already done their clinical utility study that needs to be effectively submitted for publication and for the Technology Assessment process. So, I would say this is an incredibly reasonable investment in addition to obviously the M&A purchase price, to allow us to really go after an incredibly large market here. We're calling it roughly around $400 million for the non-muscle invasive portion of disease that UroAmp could potentially address. And there's a ton of optionality that's even larger than that, and we'll get into it, I'm sure, across hematuria, prostate, kidney, UTUC, and other various diseases. So we're pretty excited about this one, I'm not going to lie. And I think the return on the investment will prove out to be quite attractive. Helpful color. Maybe stepping back, I think it's fair to say 2026 has been notable for Veracyte in terms of clinical data and new product introductions overall. Hopefully we'll have a chance to get into more of the specifics as we go here, of course, but at a high level, what is underway at Veracyte that you're most excited about right now? I mean 2026 has been an incredible year for us and it really caps off, at this point, five years of transforming the company from a single product company to a real portfolio of cancer tests in now four indications with the addition of Convergent. Obviously prostate, thyroid, breast, and bladder cancer. Two product launches so far this year, breast and TrueMRD, and an acquisition now. It is very clear that we are extending and expanding our strategy and playing it out the way we talked about five years ago when we really sat down and thought about what could the future of Veracyte be, and we are not done. We are continuing to develop new tests, new indications, always looking at M&A. With the financial profile that we have as a company, that we have also created in that five years, we have got the wherewithal to do what we need to do to continue to grow and scale the business. The whole thing is, as I always say, I think investors are used to hearing me say this, fueling by incredible evidence developments, which is really what drives our business, researching around increasing the understanding of these different disease states, and we always believe in that. The more you understand the disease state, the more you figure out, let the science lead you and figure out where diagnostics has a role to play, and then we are there ready, poised to launch the test for that particular indication, get into guidelines, and drive adoption. Q2 was a solid print overall for Veracyte. Maybe there were some nuances or puts and takes on Decipher volumes. Could you maybe walk us through, again, what went well and what, if anything, differed from your expectations in the quarter and h ow have things been trending in the business, more importantly, now a couple of months into Q3, maybe? Yeah. Q2 was very strong for us with about 20% growth in Decipher and 17%, 18% in Afirma. Just those businesses from a revenue growth standpoint are doing great, and even from a volume growth standpoint are doing great. Everything that came out of the business in the quarter felt strong, with the one exception where we took a small 1,000 test reduction in our expectations for the year in Decipher low-risk disease. So high-risk and intermediate are continuing to grow approximately 20% in volume. Then low risk, we took our expectations down to single digit growth for that. Previously, we had been seeing double-d igit growth as in the last couple of years, low risk expanded nicely. The NCCN guidelines adjusted back in the late part of 2025, and I think we're now starting to see the effects of that on some physicians deciding not to expand low risk as much as they were before or as much as they are intermediate and high. To be very clear, we are still seeing growth in low risk, as I said, single digit, and we're seeing new physicians adopting low risk as well. The growth is driven by new physician adoption here, which is an encouraging sign. As I said before, you need evidence to drive these tests, and we see some important evidence coming out in 2027 and 2028 that were started decades ago or so in active surveillance, and that's the kind of evidence that's going to be needed to drive guideline inclusion for low risk and reverse that last guideline update. Maybe continuing on the Decipher front, I think around a third of U.S. prostate cancer patients today are currently being reached. Could you remind us of Veracyte's market share today and in terms of decomposing the remaining opportunity, how much growth from here comes from incremental utilization from existing physicians versus new, versus maybe layering on new decision points that the test can address? Yeah. You hit on a really important point there, and I think this is worth really punctuating for everybody. Decipher today, at least coming into this year, was about third penetrated in the market. We see the potential to penetrate these markets up to even as far as 80%, maybe even more. We have a lot of opportunity to grow in Decipher, and it's going to come from penetrating more intermediate, which is the most penetrated today and represents the largest share of our market. High and RP is really doing nicely, driven by some evidence around metastatic and high-risk disease. And then as we just talked about, low as well, which is roughly 20%. That's where the growth is going to come from. It's going to come from both new physician adds, we're consistently seeing new physicians coming into the fold. Increasing the frequency of ordering from existing physicians. Sometimes they order, then they don't for a couple of quarters, it's getting them back. Then it's increasing the order rate per physician. Again, each one of those is going to come from evidence development and ultimately guideline inclusion, and that's you're going to need guideline inclusion in metastatic and low risk in order to drive that 80% I talked about previously. Mm-hmm. Speaking of evidence, we saw at ASCO this year, of course, the ENZAMET trial readout, level 1B evidence for metastatic patients who may benefit from triplet therapy. How important was that data for expanding Decipher's reach specifically? Maybe if you could just dive a little deeper on what specifically we should be on the lookout for from the evidence pipeline into 2027. Yeah. Starting with the patient perspective, it's very important in that it helps predict whether patients will benefit from chemotherapy in addition to doublet therapy, and that sort of evidence is really important for so many reasons. I'm happy to get into, but probably don't need to. Where it's also important, as you mentioned, it's level 1B evidence. So it's the kind of evidence that's needed to drive guideline inclusion for metastatic, which is something we don't know when that's going to come, but it's something that we hope will come, and we think that will drive increased adoption. But it's exactly like studies like ENZAMET and of course STAMPEDE as well, that we need for that. As we think about nearer term, we've got ASTRO coming up, and we expect some decent publications at ASTRO, including important ones in intermediate risk, the NRG RTOG 0815 in particular. As I mentioned, we've probably got at least three, if not more, shots on goal in the next couple of years in active surveillance. So lots more evidence to come in the future for Decipher because we've been driving that research with the Decipher test and the GRID. So our strategy is working. Mm-hmm. I believe we saw record orders per physician on Decipher in Q2. Could you maybe speak to how your most engaged physicians are using Decipher today in their practice? What is the path for distributing those best practices across the broader physician base? Your most engaged physicians are the ones who are ordering Decipher for every patient, including low risk up to metastatic. Back to the low risk point, a remarkable number of our physicians, actually more than half are ordering low risk anyway. You have a decent number of physicians who are ordering the test in every indication. You have those who order it more occasionally, right? The way to drive that is we have this very skilled, knowledgeable, effective sales team that are out talking to the physicians, making sure that those KOLs are also out there, making sure that we are doing the right studies as well to drive. Our medical team is making sure we are doing the right studies to drive guideline inclusion, and it is ultimately that that will get what we believe should happen, which is Decipher should be ordered for every patient, ultimately over time, with guideline inclusion. And that is roughly 330,000 patients a year in the U.S. alone. Then, of course, you add international to that. Mm-hmm. We had an uptick in discussions after Q2 around AI and digital pathology potentially competing more with molecular testing. Could you speak to where you see these modalities as complementary versus competitive today? What is an example of how you see an optimal clinical workflow looking longer term as both technologies continue to improve? Yeah, there has been a lot of work done on this over the last few years, and we are letting, as we always do, the science lead us and guide us. The science has demonstrated that these two tests are measuring different elements of biology. From the molecular is actually measuring, in our case, the expression, to the digital pathology AI that is measuring or looking at the phenotype of the underlying biology in a microscopic slide. Those are measuring different things. The science has demonstrated that, and therefore, they are complementary. I think what is really important is that if they are discordant, then the physician is going to rely on the gold standard and the test that is covered in guidelines and has the most evidence, and that is Decipher. That is what we have consistently seen. So I think there is a place for digital pathology. We're enabling the research around it, having scanned hundreds of thousands of patient slides, making that data available through GRID, including the entire transcriptome. We'll let the researchers do the work and figure out where that test should fit into the workflow, and then that will guide us accordingly. As I said before, we'll be poised and ready to do whatever it is we need to do to launch a product. Mm-hmm. Before we move on to discuss some of your other products, maybe one for you, Rebecca. CMS is, of course, contemplating CLFS rate reductions of up to 15% in 2027 for some tests for the first time since 2020. Based on the private payer data that you would have submitted earlier this year, could you speak to what the error bounds might be in terms of effect, if any, on rate reductions for Decipher or Afirma in the next three years? Maybe as part of that, could you speak to your level of overall Medicare versus commercial exposure? Yeah, happy to do so. By test, Decipher effectively is 2/3 Medicare Advantage, and then 1/3 commercial, and then Afirma is the inverse. It's relatively easy to remember that way. When it comes down to PAMA, every year, we've looked at the distribution of our payment received by test and effectively, if we were to have to submit to PAMA, what that would be. Obviously, we did just submit to CMS for PAMA in the last couple of weeks. When it comes down to it, all of our calculations are that we do not expect a material change in rates for either test. A reminder, Afirma is $3,600, Decipher is $3,800. To date, the data, we've been pretty proactive in managing our payer contracts accordingly and making sure for anything we contract is at a relatively reasonable rate for Medicare. Both for the prostate test and the Afirma test, we don't expect a meaningful change. The one place we do expect a change, just because the testing volume has been quite low, is on the bladder test, because we haven't necessarily gone through the same process. That might be reflected, but the volume at this point in time is so low, and as we move forward, we'll work on that contracting as volume increases. That situation will effectively resolve itself over time as we apply the same practices and standards that we have on the prostate and Afirma test to the bladder test. I'm talking Decipher Bladder. We're going to have to start clarifying. Sure. Since the Medicare rates are determined ultimately by commercial, to some extent, are there any large commercial contracts coming up for renewal that could change your expectations in this respect or more the status quo you'd expect? Yeah, I would say, it's less about contracts coming up for renewal, and it's more about us trying to get new payers under the covered lives umbrella, if you will. I don't foresee anything there really impacting us in terms of contracts coming up for renewal. With Decipher, we're only at 215 million covered lives, and so there's plenty of room to go to gain price over a multi-year period. We are seeing price this year augment volume growth, and so we would expect to see that continuously over the next three to five years, albeit in any given year, we're not able to call that magnitude. I think overall, price is a good news story for Veracyte and for the Decipher prostate test. Okay. Makes sense. Maybe one more on Afirma here. It's a more mature product in some ways, but continues to grow nicely, double- digits. How should investors think about the market forces underpinning that growth, and what's your level of confidence or visibility in the trajectory from here? Yeah, we're very proud of Afirma and the Afirma team as well, and that product has just proven to be an absolute superstar over time. We're now more than a decade in, and it's continuing to grow. There are some nuances this year. Rebecca can talk about the financial effect, but one of the things that we did was we launched our new universal transcriptome assay on the latest sequencing technology. From a patient perspective, that's just been fantastic because what it's enabled us to do is to make sure more and more patients are getting a result that previously we wouldn't have been able to call a result. That's actually helped bolster the growth rate this year. We lap that next year, and Rebecca, as I said, can cover what the effect of that is on the numbers. But even in spite of that, the volume is growing nicely, and it is really fueled by the fact that it is a market-leading test. We have continued to drive even more and more research and evidence. We launched GRID a couple of years ago now, and the new research is coming out all the time using that data. So it is just the same story that we have done that I think has created a nice resurgence in Afirma over the last few years. And the comp that Marc mentioned, given the benefit of the new transcriptome, is about 300 basis points of benefit to this year in top-line growth. Then the other one to take into account is on ASP. We have had a goodness on the ASP front this year as we resolve some of the challenges with LBM last year. So those are two different comps to take into consideration for 2027. I think about the Afirma growth algorithm in any given year as a comp as really incidence growth of low single digits. A couple of hundred basis points of share growth is the base, and then anything we can incrementally penetrate in three and four, albeit that is incredibly penetrated at this point in time. Then over a longer-term duration, as GRID signatures move from the RUO report into the clinical report, we hopefully will be able to penetrate more in the five and six category as utility improves. Great. I want to make sure we have some time to talk about some of your new products as well. So maybe switching gears to Prosigna. Now several months into launch of the LDT version, how has the feedback been, and what have you learned about what it takes to ramp Prosigna into system-wide use at the target institutions, especially with competitive incumbents in the space? Yeah. So in case anybody missed the exciting news at ASCO, the OPTIMA study read out and demonstrated, and this is such an important headline, that 2/3 of patients don't actually need chemo. What's important about that headline is the patients included in that study included premenopausal, and it also included those with high nodal involvement, above three nodes. So to be able to tell that many patients that you don't actually need chemo is such an important clinical outcome. We've got some real-life examples of patients who were days away from having their chemotherapy sessions commenced, and they were able to get the Prosigna test, and in many cases were told, "You actually don't need to go on chemo" and were able to cancel that and continue with their lives. That's just so heartening from a patient perspective, and it's wonderful to see Prosigna, with that data, by the way, we launched our Prosigna test a week after that data came out. That data was very well-received. It was the most talked about diagnostic test or study publication at ASCO. So it's great to have that launched. The feedback so far has been fantastic. We've spoken to well over 100 institutions, and we're hearing feedback from, "I'm going to start adopting this in my premenopausal and my high-risk patients," to, "I want to adopt Prosigna broadly across the board." I think I won't get into the competitive dynamics there, but the evidence always speaks for itself, and OPTIMA is just such a great pivotal study. The next steps is get that published, peer-reviewed, get the reimbursement resolved for Medicare. We're already largely covered on commercial side. Then EMR integrations and other things like that to drive the test. We've actually recently doubled our expectations around our sales force growth because of the excitement that we've seen around it. You just alluded to the Medicare unlock that could be coming. Could you provide any updates on your conversations with MolDX to date? I think you mentioned that assuming favorable coverage, pricing is most likely to fall somewhere between the IVDs, $2,500 and Afirma at $3,600. Of course, it's hard to get in Medicare's head, but what might be the rationale for landing closer to one end versus the other there? Yeah, I am happy to take that. Effectively, our conversations with Medicare have been positive in nature. We have gone through numerous rounds at this point in time, and recently submitted again. We are now down to the long tail of small questions that they have. Hopefully, by the end of the year or shortly thereafter, we will have Medicare coverage. We do expect that $2,500 price point at the time of getting the Technology Assessment. Obviously, we think it should be paid more, but effectively, I think the baseline assumption should be that $2,500. We have a path to the $3,600, and we are relatively confident in that path. That path will include going through the crosswalk on the CLFS next year. The reason why Afirma is a reasonable code is because it is effectively the exact same workflow. We are hopeful that the $2,500 will be just through December 31st, 2027, and we will get to move to the $3,600 as of January 1, 2028. I would say, the publication conversations, because that is obviously critical for guidelines. I know we have not gotten the guidelines yet. But the publication conversations are going positively, the reimbursement conversations are going positively, and the customer conversations are going positively. It is going to take quarters to get all of this to converge and really augment growth in a meaningful way, at least volume growth. Revenue is going to be a different conversation, just given rev rec and all that fun estimation that is hard to do in early stages of a launch. But we are excited about this product. We are excited about the impact it is having on breast cancer patients' lives, and we feel optimistic that we will be able to make some real inroads into this market and augment our growth accordingly. Helpful. In terms of TrueMRD, obviously MRD is a quite competitive space. Could you speak to what gives TrueMRD a right to win in that category? Maybe as part of that, how does the whole genome sequencing approach that you have selected play into that in terms of incremental value to physicians and patients? Yeah. Our first launch of TrueMRD was in muscle-invasive bladder cancer, and as you can see from our previous conversation about conversion, it really does fill out the cancer care continuum in bladder cancer, and that's a significant market. The whole genome approach is really important. If you think about now how we're able to longitudinally follow a patient, including having a whole genome in their MRD test when it's muscle invasive, you can imagine the research that can be done to look at how that tumor's evolving over time. We think it's really important to help fuel further understanding of disease at a molecular level. That will lead to better diagnostics, and it will lead to more biopharma engagement as well because there's a lot of work in bladder. Our MRD test is a platform. It's a whole genome-based platform, but you do need to go indication by indication. Our expectation over time is that we will continue to launch MRD tests on a whole genome basis because that's what we believe is differentiating and important, using our TrueMRD assay in multiple indications to come. You can imagine those indications being ones where we participate. As you've seen us now do with bladder, having the diagnostic test, the tissue-based test, the blood-based test, other analytes, it is such an important part of our strategy. You can imagine us to round off these indications with MRD over time where it makes sense. You alluded to just now the pharma relationships or the potential there at least. How big of a factor was that pharma potential in terms of your choice to go with WGS, and what's an example of what a relationship like that could look like, at least in theory? It's a good question. It wasn't a primary factor, quite frankly. The key driver for us going to whole genome as we've been whole transcriptome as well is to drive the research to better understand the disease, to drive better diagnostics and adoption of diagnostics, and so that is the primary goal. You're right, there is a secondary benefit in that whole genome data will be, I think, very important for biopharma researchers as well, thinking about what the next lines of therapies are and should be. We do expect some interest there. That isn't a big revenue driver in our spreadsheet. If it comes and when it comes, it's upside. I actually think in bladder cancer and breast cancer, those are probably two of the most important opportunities and two that we are clearly now participating in more strongly. Could you speak a bit more to the trajectory for expansions outside of MIBC for TrueMRD and with respect to that, what is the bar for performance in MIBC or the bar for early uptake that you will use to set the appropriate level for continued investment in the platform? Well, in any MRD test, you have to demonstrate superior performance to the standard of care, and that is what we were able to do with our TrueMRD. That is the bar for performance. To the extent we have the clinical data and the publications to be able to demonstrate that, to drive reimbursement and adoption in other indications, for example, breast cancer, we will do that. We are also working in lung cancer, and we have already had data published from our C2i team that we acquired on that, and then multiple other cancers as well. As you think about it, we prioritize based on filling out that care continuum, our existing channels, and then we let the way the clinical studies go drive our roadmap. Some will read out faster than others. Not always will they read out positively, and then you have to pivot. You have to take all that into account. It is a constant dynamic assessment of what is the right products to develop and to launch at the appropriate time. Maybe sticking with the theme of reinvestment. Rebecca, we have seen impressive 30%-ish EBITDA margins for several quarters in a row now. Is this reflective of the right level of reinvestment for Veracyte going forward? Yeah, we've been pretty forthcoming that we think the right level of profitability for a business like ours is 25% adjusted EBITDA. We've outperformed that year- to- date, but we manage it more on an annual basis. Our guide for this year is actually around 26%, so slightly outperforming, primarily driven by the better than expected UTA transcriptome benefit as well as prior period collections. But we have a lot of areas to invest, and all that investment obviously has a high ROI and is augmenting revenue growth to the benefit of shareholders and patients. So that's effectively what we are trying to continuously balance. The beauty of the 30% is it demonstrated what our business can do if we were to just let it flow, if you will. But when it comes down to it, we have a lot of different portfolio options to invest in, and we're here to build a durable revenue growth business that's attractive to investors with profitability and cash flow accordingly. So, I think 30%'s too high, if I'm being honest about it. We're hiring, and we'll get to that over 26% for the full year, and we're pretty confident. Obviously, we're able to absorb the Convergent spend into that as well. So I think you're seeing the power of the business, if you will, but at the same time, not necessarily starving for growth given all the growth opportunities that we have in the future. So I think it's a nice balance. Our philosophy is effectively to invest to augment revenue growth and the profitability that follows. Marc, with Veracyte's offering spanning more and more of the cancer care continuum, from diagnosis to risk stratification, treatment selection, et cetera, how do these different businesses reinforce one another and make for a stronger overall Veracyte, whether from a commercial or a clinical standpoint? Well, I think they reinforce the power of our platform. Our data-driven approach, our approach to enabling research and better understanding of disease through that approach. Then, of course, with GRID and then the success and capability of our team driving the market-leading tests in ultimately, over time, hopefully every indication. We're getting close to serving our one millionth customer. Actually, if I think about how many customers or patients we serve a year, between Decipher, as I mentioned, is roughly 330,000, 225,000 breast cancer patients. With our bladder portfolio, we could serve roughly 250,000 tests. That's multiple tests per patient. And then, Afirma are around 180,000, something like that. That's close to a potential market of 1 million tests a year. To the extent we can continue to penetrate that, I think that will just drive even more research and more understanding of disease and more adoption. That's even before we go OUS, right? Yes, OUS. A growth factor that we haven't necessarily spent a lot of time on today, which is completely fine because it's longer-term in nature. Yeah. But I think, just to augment Marc's point, we have nothing but opportunity ahead of us. Great. I think we'll end it there. But Marc, Rebecca, thank you very much. Thank you. Thank you. Thank you for joining us