SOPH

Good morning. My name is Vincent, and I'll be your conference operator today. At this time, I would like to welcome everyone to the SOPHiA GENETICS first quarter 2026 earnings conference call. At this time, all lines are in a listen only mode. Following the presentation, we will conduct a question and answer session. If at any time during this call you require immediate assistance, please press star zero for the operator. Kellen Sanger, SOPHiA GENETICS VP of Strategy, you may begin.

Thank you. Good morning, everyone. Welcome to the SOPHiA GENETICS first quarter 2026 earnings conference call. Joining me today to discuss our results are Dr. Jurgi Camblong, our Co-founder and Chief Executive Officer, Ross Muken, our President, and George Cardoza, our Chief Financial Officer. I'd like to remind you that management will make statements during this call that are forward-looking statements within the meanings of federal securities laws. These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated, and you should not place undue reliance on forward-looking statements. Additional information regarding these risks, uncertainties and factors that could cause results to differ appears in the press release issued by SOPHiA GENETICS today and in the documents and reports filed by SOPHiA GENETICS from time to time with the Securities and Exchange Commission.

During this call, we will present both IFRS and non-IFRS financial measures. Reconciliation of IFRS and non-IFRS measures is included in today's earnings press release, which is available on our website. With that, I'll now turn the call over to Jurgi.

Thanks, Kellen, and good morning, everyone. I'm pleased to report that SOPHiA is off to a strong start in 2026. In the first quarter, we delivered revenue growth of 22% year-over-year. We also performed a record 108,000 genomic analysis as demand for SOPHiA DDM accelerates across the globe. In addition to processing more data volume than ever, we also achieved adjusted gross margin of 75.4%, demonstrating the unique scalability of our hyper-efficient analytics platform. Ross and George will walk you through the commercial and financial details in a few minutes. First, let me step back and frame why this quarter matters strategically. The precision medicine landscape is at an inflection point. Sequencing costs are declining, data per patient is exploding, and AI is becoming essential for delivering the highest standard of care.

As a result, hospital and labs around the world are increasingly looking to scale their genomics testing capabilities. With the right partners, turnaround times become faster, economics become profitable, and data generated becomes invaluable for performing research and making new discoveries. SOPHiA DDM was built for this moment. Our platform streamlines testing and allows any institution anywhere in the world to quickly scale their own world-class precision medicine capabilities. SOPHiA DDM provides customers with not just a tool, but an AI-native service that delivers workflow outcomes, generating highly accurate insights and faster speeds, while also unlocking profitable economics for institutions. That's not all. SOPHiA DDM also makes patient care more intelligent by breaking data silos and allowing clinicians to tap into a collective intelligence of the smartest minds in healthcare.

As hospitals use SOPHiA DDM to generate insights and treat patients, they also contribute a stream of data and knowledge back into the platform. As more data flows through the platform, our algorithms become smarter. This in turn enables those same clinicians to get better insights, building trust along the way. Deeper trust, smarter insights, and better outcomes ultimately accelerate new platform adoption, creating a virtuous loop with compounding growth effects. As of Q1, this adoption loop has enabled us to connect 537 institutions across the globe who use SOPHiA DDM every day for genomic analysis. In the quarter, these institutions uploaded real-time, real-world genomic data from 108,000 patients. In March, we set a new company record with more than 40,000 patients analyzed in a single month. This diverse real-time, real-world data stream includes patient data from 75 countries worldwide, creating breadth and global exposure and is unmatched in our space.

Over the past two years, our rich, diverse dataset, which include nearly 2.5 million genomic profiles since inception, has enabled us to build some of the most sophisticated AI in healthcare. New applications in liquid biopsy, solid tumor, MRD for AML, and enhanced exams are impressing our users with their accuracy, flexibility, and AI-powered insights. The good news is we're just getting started. Our top innovation priorities going forward will focus on deepening clinical relationships and getting closer to the patient. To accomplish this, we will expand platform capabilities to new areas as the market evolves. This includes supporting larger, more complex NGS applications like whole transcriptome and methylation, tracking patients longitudinally with MRD, mastering data compute at scale, optimizing the end-to-end workflow, and developing increasingly regulated products.

It also includes expanding capabilities beyond genomics into multimodal to support clinical decision-making and accelerate the future of data-driven medicine. Our planned innovations are also designed to resonate with biopharma. Throughout the year, we will invest in evolving our data sets into durable commercial assets for real-world evidence. In addition, we are working hard to create a global decentralized companion diagnostics offering that brings life-saving therapies to patients across our network. In short, our unique positioning and data set are enabling us to build for the future. We have been a technology company since day one, building real AI to solve the world's most difficult biological challenges. The market is coming to us, and I couldn't be more confident in our ability to deliver products for future growth. As we continue to invest in the future, we also must remain committed to growing in a sustainable way.

Across the organization, our teams are hyper-focused on continuous improvement, efficiency, and operational excellence. We benefit from a young, agile, and tech-centric workforce that has been quick to adopt and deploy emerging productivity tools, including the new AI technologies in the market. Early results from our internal rollout of these AI tools have been overwhelmingly positive. In Q1, we materialized the benefits of recent efficiency gains and took a series of targeted cost actions, which modestly reduced head count and non-labor spend across the business. These actions, which mostly focused on support and operations functions, have allowed us to invest even more in high-growth areas while also ensuring that we meet our profitability commitments going forward. As the year continues, we will look forward to updating you on our progress and showcasing the impressive operating leverage that is innate to our business model.

In closing, Q1 was a strong quarter for SOPHiA. The market is reshaping itself around intelligence, and we are perfectly positioned to accelerate this movement. Our network is compounding, and our data is unmatched. We continue to scale, and our path to profitability is becoming increasingly clear. As I close out my final earnings call as CEO before I transition to Executive Chair in June, I'm happy to transition leadership of the business that is in excellent shape to a capable leader who will propel SOPHiA to its next stage of growth. With that, I will now turn the call over to Ross, who will provide a more detailed update on the business and growth drivers for the year.

Thanks, Jurgi. I certainly share your excitement about the business, and today I'm pleased to share an update on our progress to start the year. In the first quarter, three major themes defined the quarter. First, the U.S. business continues to gain momentum. Decentralized testing has always been a widely accepted characteristic of the European and global market. However, in the last 12 months, demand for decentralized testing has materially increased in the U.S. As reimbursement rates become more established and denial rates improve, hospitals and labs are waking up to the benefits of scaling their own testing capabilities. Central labs have proven that testing is profitable and that genomic data has significant value. Now, U.S. hospitals and labs are making testing part of their core strategy, and those who move are seeing significant benefits.

In the first quarter, we announced an expanded partnership with Mount Sinai, one of the leading academic health systems in the U.S., who is using SOPHiA DDM to bring hemato-oncology and solid tumor testing to the New York market. They join a growing number of New York area institutions to partner with SOPHiA, including NYU Langone Health and Memorial Sloan Kettering Cancer Center. As more institutions adopt SOPHiA DDM, the cost of not having our platform becomes real. Regional density causes patients, providers, and even payers to push testing volumes towards sites which offer the best insights at the lowest cost with the fastest turnaround times. We're proud to work with our partners to bring these positive structural changes to the New York testing market and welcome a decentralization revolution to the New York City area.

The second key theme for the quarter was continued growth of new applications such as the MSK-IMPACT and MSK-ACCESS tests. In Q1, less than two years after decentralizing and deploying these tests globally, we have already reached a total of 100 customers worldwide who have signed on to adopt the applications. A few of these include prestigious Q1 signings such as Maastricht UMC+, a leading Dutch academic medical center, Ospedale Niguarda, one of Italy's leading hospitals in Milan, and Ruhr University Bochum in Germany. These customers, along with half of the 100 signed accounts, are currently implementing SOPHiA DDM, which means they should begin generating revenue over the next 12 months. Among those who have completed implementation, we are pleased to record 3,000 liquid biopsy analysis in Q1, up more than 100% year-over-year.

We look forward to this number continuing to grow as more customers finish their implementation and start using the sophisticated HFCP application. New applications such as liquid biopsy and enhanced exomes help our sales team expand within accounts. As a reminder, we landed a large amount of new customers in 2025 with 124 new signings throughout the year. As we turn to 2026, a major focus will be expanding across these customers by encouraging them to adopt additional applications. I'm proud to say that our expand engine is off to a strong start in the first quarter. Net dollar retention, or in other words, same-store growth, increased to 117%, up from 103% in the prior year period. Moreover, forward-looking indicators show no signs of stopping.

In Q1, we signed many notable expand deals, including three in Europe, that were each valued at over $1 million in annual contract value. This serves as another impressive proof point for the virtuous loop fueling our platform's growth. It also shows that hospitals are excited to consolidate their data strategies with trusted partners in a market where winner-take-most dynamics are forming. The final theme for the quarter was substantial increased momentum with biopharma. In the first quarter, biopharma revenue growth was positive and contributed modestly to overall growth as some of the recent new contracts we signed began to generate revenue. We continue to make progress with a growing number of biopharma partners, and momentum is strong. Coming out of AACR and World Clinical Biomarkers & CDx Summit Europe 2026, it is clear that biopharma customers are looking to develop comprehensive AI investment strategies with trusted partners.

It is also clear that every biopharma company we speak to recognizes that SOPHiA provides differentiated value across the drug continuum. They recognize that our diagnostic network is unmatched in global reach and that the data streaming through our platform has incredible value. They also appreciate our deep AI expertise in the field of biology. Our offering is continuing to resonate as one of the only companies in this space that could support a drug across its entire life cycle, from companion diagnostics to post-launch monitoring with real-world evidence to patient selection and trial design. In the last six months, increasing momentum has materialized in the recent signing of contracts with major biopharmas such as AstraZeneca and Johnson & Johnson, as well as biotechs like Cartos and others.

Moreover, our partnerships with Myriad Genetics in the U.S. and A.D.A.M. Innovations in Japan continue to progress as we work on building out the infrastructure for a hybrid global CDx offering. We look forward to updating you more on these items over the coming weeks and months. Looking ahead to the remainder of 2026, our pipeline across clinical and biopharma remains strong and healthy even after strong bookings conversion. Deal size continues to grow, and the number of opportunities in our pipeline above $1 million are becoming even more numerous. The market is moving in our direction, and we are excited to continue capitalizing on our opportunity. With that, I will now turn it over to George, who will provide a more detailed look at our financial results and the outlook for 2026.

Thank you, Ross. As Jurgi and Ross highlighted, Q1 results were strong and our outlook remains positive. Total revenue for the first quarter was $21.7 million compared to $17.8 million for the first quarter of 2025, representing year-over-year growth of 22%. I will note that year-over-year revenue growth would have been slightly stronger if not for a one-time benefit in the prior year period from a customer true-up. Platform analysis volume was approximately 108,000 in Q1 compared to 93,000 in the first quarter of 2025, representing solid growth of 16%. From a regional perspective, U.S. volumes continue to expand at healthy levels, growing 28% year-over-year in Q1. APAC also outperformed with 31% volume growth.

In EMEA, revenue grew 30% year-over-year, impressively above the company average, mostly driven by great performance in the U.K., Belgium, and Switzerland. In Latin America, revenue remains soft, and we have made changes there to turn around our performance. From an application standpoint, hemonc revenue grew 24% year-over-year. Rare and inherited growth also picked up in the quarter, with volumes growing over 20% as our enhanced exome product begins to come online. As Ross mentioned, liquid biopsy, which carries a higher ASP, continues to ramp and contribute to our revenue growth as well, with more growth expected for the second half of the year. Core genomic customers were 537 as of March 31st, up from 490 in the prior year period. Annualized revenue churn remained world-class at less than 1% in Q1.

As Ross mentioned, net dollar retention for the quarter was 117%, up from 103% in the prior year period. Gross profit was $14.7 million compared to $12.2 million in the prior year period, representing growth of 21%. Gross margin was 68.0% compared to 68.7% for the first quarter of 2025. Adjusted gross profit was $16.4 million, an increase of 22% compared to adjusted gross profit of $13.4 million in the prior year period. Adjusted gross margin was 75.4% compared to 75.7% for the first quarter of 2025. Total operating expenses for Q1 were $32.0 million compared to $28.2 million in the prior year period.

Some specific items temporarily impacted reported operating expenses and are worth calling out directly as they do not reflect the company's underlying operating performance. First, foreign exchange headwinds continued to negatively impact reported results, primarily due to the strengthening of the Swiss Franc. The Swiss Franc strengthened approximately 14% against the U.S. dollar from Q1 2025 to Q1 2026, meaningfully increasing the dollar-translated costs of our Swiss payroll and facilities. This is a pure translation effect, as our underlying cost structure in local currency remains disciplined. As previously disclosed, Guardant Health filed patent infringement claims against us in the U.K. and at the Unified Patent Court in Paris during Q3 last year, alleging that our MSK-ACCESS application infringes their patents. We incurred approximately $1.4 million in related legal expenses during Q1, which is reflected as a litigation adjustment in our adjusted EBITDA reconciliation.

Importantly, in January, the UPC rejected Guardant's request for provisional measures and ordered them to pay us $700,000 in interim costs, $500,000 of which we received in mid-March, and an additional $200,000 which we received in mid-April. Net of this recovery, litigation impact on Q1 operating expenses was approximately $700,000. Operating loss for the first quarter was $17.3 million, compared to $16 million in the prior year period. Adjusted EBITDA was a loss of $9.2 million, compared to the prior year loss of $9.5 million. Lastly, cash burn, which we define as the change in cash and cash equivalents, excluding cash received from borrowings and stock sales, as well as FX impacts, was $19.5 million, compared to $11.7 million in the prior year period. This year-over-year increase reflects two expected dynamics.

First, coming off a strong 2025, annual bonus and commission payouts were meaningfully higher than the prior year, and these were paid in March. Secondly, we also invested in the build-out of a new lab at our Swiss headquarters with increased capacity to support revenue growth for years to come. This impacted our cash burn by approximately $1 million in the quarter. Third, we continue to vigorously defend ourselves against the patent infringement lawsuit filed by Guardant Health, and we paid several bills for expenses incurred in the first quarter of 2025. The $500,000 from Guardant in Q1 and the additional $200,000 received in April only cover a portion of our total litigation costs.

We ended Q1 with cash and cash equivalents of $65.4 million as of March 31st, which includes $14.5 million in ATM proceeds received in the first quarter of 2026. In January, as previously disclosed, we also expanded our credit facility with Perceptive Advisors, increasing total available liquidity by $25 million. We remain confident in our current capital position with respect to the achievement of our long-term goals. I'll now turn to the 2026 outlook. Given the promising revenue growth in Q1, SOPHiA GENETICS is reaffirming our full-year revenue guidance for 2026 of $92 million-$94 million, representing 20%-22% growth on a reported basis.

We still expect 2026 growth to be mostly back-half weighted as new business signed in 2025 comes online in the second half of the year and as more MSK-ACCESS, MSK-IMPACT Flex, and enhanced exome business ramps up to routine usage. We also expect that exchange rates will remain volatile due to macro uncertainties, which may have an impact to reported results. Beyond revenue, we are also reaffirming our full-year adjusted EBITDA loss guidance of $29 million-$32 million, compared to $41.5 million in full year 2025. As demonstrated this quarter, we continue to make targeted investments in our platform to further optimize cloud compute and storage costs and expect gross margins to slightly expand beyond 2025 levels. As a global company, we are monitoring the ongoing conflict in the Middle East closely, particularly with respect to shipping and customer activity in the region.

So far, the conflict has not materially impacted our results, and we do not believe it will have a material impact this year. In Q1, as Jurgi mentioned, we took a series of cost actions and realized benefits of adopting AI across our teams. These actions reinforce our conviction to grow revenue without increasing headcount. They also give us confidence that we will be able to continue holding the line on operating expenses in local currencies and reach our profitability guidance. All said, we continue to believe that we are on track to be approaching adjusted EBITDA break even by the end of 2026 and crossing over to positive adjusted EBITDA in the second half of 2027. With that, I would like to turn the call back over to Jurgi for closing remarks before we take your questions.

Thank you, George. As I wrap up my last earnings call as CEO of SOPHiA GENETICS, I feel confident as ever in our long-term trajectory. Forward-looking indicators remain strong across the business. We continue to see a steady stream of customer signings across new and existing customers. Biopharma interest is growing, and our pipeline is expanding across regions and applications. At the same time, we continue to be laser-focused on optimizing costs and delivering sustainable growth. Thank you to the SOPHiA team, customers, partners, and investors for your continued trust and partnership. 15 years ago, we had an ambitious vision to transform healthcare through data and AI.

Today, we operate the most widely used AI-driven platform in precision medicine, impacting 40,000 patients per month and 2.5 million patients since inception. I'm so proud of what our team has accomplished over the past 15 years, and I know we are just getting started. Operator, you may now open the line for questions.

Your first question comes from the line of Mark Massaro from BTIG.

Hey, guys. congrats on the quarter. Jurgi, appreciate the network that you've built globally, to decentralize this testing and look forward to working with you as you move to the Executive Chairman role.

Thank you, Mark.

Yeah, sure thing. Yeah. Moving into my question, I guess. The adjusted gross margin of 75% was certainly a key highlight of this print. Can you just give us a sense, guys, for your degree of confidence to maintain or, you know, how do you think about this gross margin profile going forward? I know that you are planning to onboard some higher mix applications, so is this something that you think you can build on here, or were there some one-time items that might be lumpy on the gross margin line?

Ross?

Mark, you know, we've really spent quite a lot of effort modernizing the platform over the past 24 months as we've talked about our Gen 2 transition. I think you're seeing the benefits of that. I think there's a lot more scalability left, even as we bring on more complex solutions that require a lot more compute. And so, in general, I'm super happy with how the team has executed here. I think fundamentally as well, we're seeing positive pricing dynamics in our environment. You have both the mix of trade up to more complex solutions as well as more value realized for solutions like ours as a percentage of total cost of diagnostic or as a percentage of revenue.

I think on both of those parameters, you know, this is quite constructive for us. I'll let George comment on what's contemplated going forward. For me, I still think, you know, there's some room to go, but certainly we're very pleased with how we've executed.

Mark, as Ross said, we're very pleased with the performance of our tech team and we were pleased with where gross margin came in for the quarter. We do have some pharma business and if anything could be lumpy on the margin side, it would probably be more the pharma business. Our full year guidance was modest improvement in gross margins, and we're still holding to that, but certainly we were pleased with where Q1 came in at.

Okay, great. It looks like you guys took some cost reduction actions in the month of April. It looks like it's a small action, but can you just speak to which regions were impacted, anything in the U.S. that was material, and how should we think about that in terms of headcount?

You know, couple things, Mark. One, the action was quite small, right? It was a very modest change to the cost structure. You know, we are an organization very focused on continuing improvement. We've also seen some gains in parts of the business from AI, and so we wanted to be able to drop some of that down and then reinvest other parts. I would say in general, again, this was quite isolated and generally, I would say in the G&A functions where we gained efficiency. You know, this was our ability to show that obviously we're an organization very committed to our profitability targets. And also as a software and AI business, we're one that could not only obviously deploy gains to our customers, but also utilize some of that on our own operations, which will help us again as we scale, as growth continues to re-accelerate here. George?

Yeah, no, again, we've, you know, in our guidance for the year, we said, you know, EBITDA, adjusted EBITDA of $29 million-$32 million, and this was an important part is maintaining that cost discipline across the organization. Like Ross said, that's just part of what we're doing and making sure that we continue to have that discipline going forward.

As mentioned, Mark, you know, regionally, you know, most of it was G&A, so I would say, probably a bit more concentrated in the Swiss operations. Honestly, no real geographic bias to it. Actually, the U.S. is where some of the headcount redeployment, particularly on the commercial side, will go; it will be modest, and that's because we're seeing really great characteristics in that business and really are confident in our ability to continue to grow market share in the territory.

Great. Maybe just my last question. You alluded to the fact that you signed a lot of new customers in 2025, many of which are planning to turn onto the DDM platform in the second half. I just wanted to get a sense for, you know, obviously you did reaffirm the revenue guidance, but just wanna get a sense for whether or not you believe that you're tracking to on, you know, initiating the go lives for many of these customers and wanted to test your degree of confidence on these folks coming onto the platform.

Mark, we came in ahead of our plan in the first quarter, so we're very happy with our performance. You know we're conservative, given it's early in the year, despite we're really pleased with the signals and we remain extremely confident in sort of the customer onboarding and progression, you know, we want to make sure that we're well set up for the year. I would say, you know, stay tuned, but ultimately, we're feeling very good around delivering on our commitments and ideally, obviously, outperforming. I would say overall, on the onboarding side, I'm really pleased with our implementation team on our tech side and our bioinformatics group as well as in services. We've seen the pacing of some of the large customers pick up. We have quite a number of them coming online, including some that came on late in March, which helped with that record month that you saw, and helped us have a record quarter.

My expectation is that we'll that cadence will continue to improve. Again, a lot of the AI and other initiatives we have are focused on speeding up that time to revenue. And so, again, as George talks about the back half ramp, a good portion of that is highly visible, and is obviously tied somewhat to some of those customers, particularly some of the large U.S. ones coming online, and we remain super confident on our ability to execute on that. Ideally, if they ramp consistent with what we've seen historically, that may provide some cushion for upside as we tend to initially guide fairly conservatively for the on-ramp of new business. Again, a lot to look forward to on our side as that growth ideally continues to move in a favorable direction.

That sounds great. I'll hop back in the queue.

Thank you, Mark.

Your next question comes from the line of Dan Brennan from TD Cowen. Please go ahead.

Hey, good morning. This is Kyle on for Dan. Thanks for taking the questions. I wanted to jump into your net dollar retention, you know, which accelerated again this quarter to 117%. Can you just discuss some of the drivers a little bit more? I mean, is this more driven by customers expanding into multiple applications, you know, on DDM, or is it more a mix of, you know, the uptake of higher ASP tests like MSK-ACCESS that's driving that performance? Thank you.

Thanks, Kyle. Obviously, we're happy to see that metric get back to, I would say, really high quality standard among software businesses. We're quite pleased with the organic growth. As you mentioned, it's coming from a mix, right? We were very intentional this year versus the last two years of really focusing on the expand. And so, that obviously will benefit the NDR line, and ideally, this will continue into next year. This is a very high ROI acceleration as well as it carries with it very little incremental cost. It helps as we think about our shift to EBITDA profitability. I would also say, you can see it by the strong EMEA results, you know, the underlying growth in our industry, I think has become healthier.

You see it in one of the large equipment vendors' numbers, relative to clinical consumable growth. I think overall, customers are healthy. New technologies are coming online. You know, for us, that would be things like liquid biopsy or exomes. In general, pricing remains, as I mentioned, favorable. I think the component in all of that with incredibly low churn, all of that comes together to give us confidence that the improvement in sort of that organic underlying growth rate will sustain.

Got it. Thank you. Then maybe just on your Latin America business. You know, you noted it was soft in the first quarter. I think in your 6-K, it said it was down over 30%. I believe you had a really tough comp there year-over-year. Can you just dig into some of the trends that you're seeing in Latin America and just expand upon that a bit?

Yeah. Thank you for the question. Obviously, you know, we've been disappointed in that region, albeit it's a small one, but it's strategically important for the last number of quarters. We did make a change there in leadership. I was actually just there myself very recently, as was our CSO in Brazil and in Colombia and Argentina, all three critical countries. I would say Brazil at the moment is where some of that softness is kind of isolated. We've got some ideas and thoughts of how we're going to re-accelerate the territory. I would say I'm quite optimistic on Mexico and Colombia and to a lesser degree, Argentina. I think overall, we expect the region to return to growth.

We think we're gonna make the necessary changes there, and we think the portfolio is also well-positioned. It's also a region that's highly pharma sensitive, sometimes as well, it's dependent on where pharma pipelines are, and there are a few key new drugs coming online that will be highly relevant for Latin America. We would expect that as well to drive an increase in testing in some of the geographies. And so, overall, I would say we're cautiously optimistic, but certainly, we've taken actions to ensure that we get back on track in this strategic territory.

Got it. Thanks, guys.

Your next question comes from the line of Bill Bonello from Craig-Hallum. Please go ahead.

Hey, guys, a couple of questions here. First of all, I wanna follow up on one of the questions that Mark asked just about implementation time, but more specifically, to MSK-ACCESS. I'm just curious what you're seeing these days in terms of typical onboarding time once a customer has said that they want to adopt MSK-ACCESS, and then what you're seeing as a, you know, typical ramp once they're up and running the test.

Bill, it's a great question. Thank you. Obviously, as you know, MSK-ACCESS is incredibly important to us. We're really proud of the 100 accounts that have come online. If you just put that in context, you know, the world didn't really have liquid biopsy testing outside of the U.S., we're really pleased to see it adopted at this great rate. We're also really proud to have great pharma partners in that journey that have helped us in that adoption rate. And so, I would say overall, I wish I could tell you that there's a, you know, a pattern on some of the adoption.

I would say, you know, several accounts have come online and oncologists have really, I would say, you know, understood how to utilize the technology, and we've seen volumes ramp. I think others take more education. And so, again, there's varying degrees of sophistication and understanding on different sort of cancer types, dependent on where we look around the world. At the moment, about half of the accounts are online. I would say they're all ramping. You know, we continue to believe this will be a very material part of the incremental growth. And so, overall, I would say we're pleased, but certainly, you know, you start to see some of that impact the revenue line, but I would say more is to come over the next several quarters and then into 2027. And so far, it's hitting our internal expectations, we'd obviously like to see that inflect more materially.

We think with, again, better doctor education or oncologist education in some of the territories, and then if you see, you know, some of what's gonna be presented at ASCO, as well as at ESMO, our expectation is all of this will help drive with that utilization to much higher levels over time. It's been pretty broadly adopted, right? You know, you should expect to see different adoption curves in each of the different nations.

That's helpful. Thank you. Just a follow-up on the pharma side, and you touched on this just slightly in your response to that question. You know, it's great to see the recovery there. You know, it does seem like typically pharma revenue, you know, might capture a lower multiple just 'cause it's not seen, you know, it is seen as potentially less recurring. Could you maybe talk to us about how you think about the pharma business vis-a-vis the clinical business? In other words, you know, how does pharma drive clinical, and, you know, if it does?

Bill, it's another great question. And it ties frankly into your first question because a product like MSK-ACCESS, which is really a platform for pharma, does have a fantastic flywheel between biopharma and clinical usage, as you alluded to. I would say overall, we're very pleased finally with where our pharma business is performing. We've now gotten back into the green and we're starting to see some nice momentum where I think over the next several quarters you'll see that acceleration play out in the total revenue performance. Certainly, quite a different picture than where we were 24 months ago.

As you know, we made some tough decisions in that business, and we really refocused, and we're seeing the benefits now of that play out in the numbers. And so, I would say again, one of the key things we've strategically decided to do is less kind of large one-off project type business that doesn't yield strategic and/or recurring revenue benefits. We're much more confident that the type of business we're bringing online is recurring, can be repeated, and can be scaled. As you think about, again, some of the types of CDx projects even that we do, much of that is done with the intent of not only being able to serve pharma through the CTA and CDx portion, but obviously on the clinical side thereafter.

The idea that you can have one harmonized global solution in all markets, right? Think about that in liquid biopsy, that's, you know, doesn't require large bridging studies, that doesn't require some hybrid mix of, you know, seven or 10 laboratories around the world solving for a geographic or a global picture. I think it's a super compelling offering. It's also different in that for us, we're already embedded in so many of these accounts. Once we flip the switch from some of the pharma work into the clinical market, it's the same solution, right? We can start relatively quickly serving customers in that market post-approval for a drug. I think for us, again, that flywheel is hypercritical. We're really happy with the progress pharma has made.

I would say overall, you can hear from us, our confidence is up. Again, we're not declaring victory. We're just starting to show, kind of the right level of performance here, but it's certainly materially better than where we were, even 12 months ago.

That's great. Thanks so much.

Your next question comes from the line of Subbu Nambi from Guggenheim Securities. Please go ahead.

Good morning, guys. This is Ricki on for Subbu. Thanks for taking our questions. In the slides, you have the average price per analysis ranging from $100-$500. For the first quarter, just some back of the envelope math here, it comes in around $195 per sample analysis or per analysis. What is your expectation for the ASP trend through the remainder of the year, and what are you assuming for this in guidance?

George?

Yeah, if we exclude the pharma business and just look at the clinical business, our price sequentially was up $2. As Ross said, we're building in terms of, you know, selling more higher value tests. Our expectation is to continue to see that lift as the quarters go on during the year, and we continue to see the access clients, the 100 clients that we've booked ramp up. We're optimistic about ASP. Now, there's a balance there because obviously, you know, we are expecting growth now in our Latin America business and some emerging markets like India and Turkey. Still, in terms of modeling, we do expect the ASP to have lift in it for the remaining quarters of the year.

Got it. That's helpful. A lot's been asked on biopharma, but maybe just a slightly different approach of the question. You mentioned how this is a modest positive contributor to growth in the quarter, and there was lots of, you know, positive color on signings and outlook. Did the quarter turn out the way you expected, or was it above your expectations? Did it change what you're expecting for the remainder of the year? Thanks.

Yeah. As I mentioned before, we're quite conservative, Ricki. You know, despite the fact that pharma performed quite well, and I would say we're optimistic for continued sequential improvement and a step up in the second half of the year as well. You know, we did not change our expectation in the guide. I'll let George give some color. I think just fundamentally there, since we're early in that re-acceleration, we wanna remain conservative. What we're trying to convey is if we look at the picture in terms of And even for myself, I was at two large conferences during the quarter.

If we look at the level of interactions we're having with pharma and what we're discussing and the comprehensive nature of that, if we look at the RFPs we're responding to, if we're looking at what's in the pipeline and what's late stage, then what we've now executed on over the last several quarters in terms of new pharma customers as well as new contracts with our existing customers, it's a much better mix than what we've seen in the past, both across, frankly, diagnostics and data. We haven't talked about data or our evidence generation business in a while, but we're actually seeing as well there subtle improvements. I think overall, what we're trying to kind of point to is our increased confidence that that will improve, but we remain conservative, right, George.

Yeah.

In terms of how we factor that into the forecast.

Yeah. We're very pleased with the performance of the pharma business. As Ross said, I mean, it's really been building momentum. It's tangible. We can see it. And again, I think in 2026, it's gonna be an accelerator, but it's really gonna be an accelerator in 2027 and beyond, as that business just continues to build and build.

Operator?

Hello, your line was cut in. If there are no further questions, please continue.

Thank you so much for joining us today and for joining us and me in a journey of 15 years. I'm very happy to basically let the driving seat to a fantastic leader who sits next to me here in Switzerland today, surrounded by a very talented team and with a technology that is better than ever to be able to capture even more opportunities in the market. I'm very, very pleased with what we have achieved, and please continue following us. As you will see, we'll continue to transform precision medicine over the next years. Thank you.

Ladies and gentlemen, this concludes today's conference call. Thank you for participating. You may now disconnect.

Good morning. My name is Angeline, and I will be your conference operator today. At this time, I would like to welcome everyone to the SOPHiA GENETICS S.A. fourth quarter and full year 2025 earnings conference call. At this time, all participants are in listen-only mode. Following the presentation, there will be a question-and-answer session. Should you require any operator assistance, you may press star 0. I will now turn the conference call over to Kellen Sanger, SOPHiA GENETICS S.A. VP of Strategy. You may begin.

Thank you. Good morning, everyone. Welcome to the SOPHiA GENETICS S.A. fourth quarter and full year 2025 earnings conference call. Joining me today to discuss the results are Dr. Jurgi Camblong, our Co-founder and Chief Executive Officer, Ross Muken, our Company President, and George Cardoza, our Chief Financial Officer. I'd like to remind you that management will make statements during this call that are forward-looking statements within the meanings of federal securities laws. These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated, and you should not place undue reliance on forward-looking statements. Additional information regarding those risks, uncertainties and factors that could cause results to differ appears in the press release issued by SOPHiA GENETICS S.A. today and in the documents and reports filed by SOPHiA GENETICS S.A. from time to time with the Securities and Exchange Commission. During this call, we will present both IFRS and non-IFRS financial measures. A reconciliation of IFRS to non-IFRS measures is included in today's earnings press release, which is available on our website. With that, I'll now turn the call over to Jurgi.

Thanks, Kellen. Good morning, everyone. I will start today's call with a brief overview of how exiting 2025 SOPHiA GENETICS S.A. sits at the center of some of the most exciting megatrends in healthcare. I will then turn the call over to Ross, who will provide a detailed update on Q4 performance and what's ahead in 2026. George will close with a review of our financial results and guidance. 2025 was a defining year for SOPHiA GENETICS S.A. We re-accelerated revenue growth, signed several of the largest commercial deals in our company's history. We also continued building one of the most sophisticated AI engines in healthcare. In 2025, our platform broke many records. We analyzed over 391,000 patients with cancer or rare diseases using AI to deliver life-saving insights for diagnosis and treatment. We also reached a total of 993 customers globally. Congratulations to the SOPHiA GENETICS S.A. team on these accomplishments and the incredible impact our platform is having across the world. However, building disruptive AI in healthcare does not happen overnight. Healthcare, unlike other industries, requires rigorous validation, clinical evidence, and deep institutional trust before change is enacted. At SOPHiA GENETICS S.A., we have been pioneering AI in healthcare for over a decade. For 15 years, we have gone from institution to institution slowly and sometimes painfully, bringing their genomic workflows onto a single technology platform. As we've added customers over the years, our network and the collective intelligence behind it has been getting stronger and stronger. Top clinicians across the globe depend on SOPHiA DDM each day to generate insights for their patients. In doing so, they contribute a constant stream of data and knowledge to the platform. The data stream in our platform every day makes up one of the most unique and powerful data assets in healthcare. It includes a real-time, real-world genomic data from over 30,000 patients per month or almost 400,000 patients per year. It is also a diverse, complex, and a match in breadth and global exposure, covering patients from 75 countries across the globe. This rich stream of diverse real-world data has enabled us to build what we believe is some of the most sophisticated AI in healthcare. For over a decade, our R&D team, which includes many of the top AI ML data scientists and mathematicians in the world, have been solely focused on building proprietary AI algorithms on top of this data. These algorithms provide advanced multi-layered analysis of genomic and multi-omic data, enabling clinicians to transform raw data into precise, actionable insights for patients. This AI, housed in SOPHiA DDM, offers our customers an invaluable toolkit of analytical capabilities across a wide range of clinical use cases. Over the last 12 months, demand has been accelerating for these capabilities. We signed a record 124 new customers in 2025 and significantly outperformed all internal booking targets, setting up strong to hit our revenue goals in 2026 and beyond. As more customers adopt the platform, patient volumes have grown substantially. However, volume only tells part of the story. While volumes are growing, the amount of data processed by our platform has increased materially. In 2025, we processed nearly 1 petabyte of genomic data in routine usage. To put that in perspective, that's roughly equivalent to 1 billion books or 30 years of continuous high-definition video streaming. It is also nearly double the amount of data we processed just 2 years ago. The stepwise change in genomic data production reflects a shift in customer demand. Customers are increasingly moving from small targeted panels to large comprehensive tests, multi-omic analysis, longitudinal monitoring, and in general, more sophisticated computational interpretations. All those emerging use cases do not only produce exponentially more data per patient, but they also can only be handled by highly scalable AI-enabled approaches. In response to these trends, we launched a major initiative back in 2022 to drastically modernize our platform. This effort included moving the platform from Java to web and microservices, integrating the latest AI tools into our architecture, and significantly upgrading our compute techniques. I'm proud to share that the new generation of SOPHiA DDM, already adopted by one-third of our customers, now delivers 10 times greater capacity per run than standard systems. As a result, we can double the amount of data we can process per week without impacting margins. Compared to other systems where whole genome analysis can take over 24 hours, we can now complete a whole genome analysis in less than 6 hours. This increased scalability also makes our platform much more cost-efficient than standard systems, enabling us to scale advanced genomics analytics in a sustainable way for institutions across the globe. This faster, scalable, and sustainable approach has been a driving force behind our ability to win larger and larger customers, including the recent signing of 2 of the largest healthcare systems in the US. It also has enabled us to expand our adjusted gross margin by 140 basis points to 74.2% in 2025, despite the huge increase in data compute, which to me is an incredible accomplishment. Beyond scalability and operational excellence, our platform continues to delight customers. Our net promoter score is a remarkable 67. Our customer satisfaction score is over 97%. Annualized revenue churn is below 1%. These metrics underscore the speed, scalability, and stickiness of SOPHiA DDM. In addition, our decentralized approach provides an unparalleled ability to deploy AI models directly into the clinical setting. This enables faster innovation and more efficient launch of new applications. A few examples we will investigate in 2026 are MRD solid tumor and DNA methylation. In addition, we also announced a partnership with MD Anderson in January to leverage our AI algorithms to explore the co-development of the whole transcriptome test. Together, these initiatives reflect the expanding capabilities of our platform and set the stage for the next generation of applications we are bringing to market. Which brings me to my final point. Last quarter, we launched SOPHiA DDM Digital Twins. Digital Twins leverages genomic, clinical, and real-world data to create dynamic AI-driven virtual representations of individual patients. These models allow clinicians and researchers to simulate potential treatment scenarios before decisions are made, helping oncologists select the most effective therapy based on real-world evidence from patients with similar genomic and clinical profiles. I'm proud to announce today that we've already begun onboarding our first lung cancer users. Starting with lung cancer and expanding over time, Digital Twins represent a foundational step towards deploying multimodal AI models, which deliver differentiated care to patients. As we approach the 15th year anniversary since we founded SOPHiA GENETICS S.A., I am more optimistic than ever about our trajectory. We have built a differentiated business with one of the largest, most defensible networks in the world. We also sit at the center of the most exciting trends in healthcare and have more demand than ever among our customers. As SOPHiA GENETICS S.A. continues to grow from a vision into a global business, I recognize that it's the right time to bring in a new leader for the next phase of the company's growth. As announced in January, I am thrilled to promote Ross Muken to Chief Executive Officer effective July first. Ross, who currently serves as our company president, has been instrumental in SOPHiA GENETICS S.A.'s success over the past five years. He led our company through the IPO and helped scale the company from $28 million of revenue to $77 million today. Ross brings a data-driven, commercial-oriented leadership style that is perfect for our next phase of growth and needed for scaling the enterprise. I'm confident he's the right person to lead the company to even greater heights, expand our impact for patients, and create lasting value for our employees and shareholders. As for me, I will transition to the position of Executive Chairman, subject to election at the company's annual general meeting in June 2026. In this new role, I remain 100% committed to SOPHiA GENETICS S.A. as a full-time employee. I will focus my time primarily on science and technology innovation and being a thought leader in precision medicine. With that, I will now turn the call over to Ross, who will provide a more detailed update on each of these areas and make a few new announcements on the new business going into 2026.

Thank you, Jurgi. I'm grateful for your continued involvement as Executive Chairman and excited for the future. Over the past five years, I've come to recognize how unique SOPHiA GENETICS S.A. is and how there is truly no other company like it. From our technology to our customers to our employees, SOPHiA GENETICS S.A. is a category-defining company that is reshaping precision medicine, and I couldn't be more excited to lead this next chapter. Today, I'll begin with an update on our fourth quarter performance as we close 2025 with sustained commercial strength across the business. I'll cover our 2026 growth drivers before handing it over to George Cardoza for a detailed look at the financials. First, we delivered 22% revenue growth in the fourth quarter, re-accelerating the business toward historical levels. Excluding biopharma, clinical revenue grew an impressive 31% year-over-year, reinforcing the strength of our core business. I'm looking forward to this continuing throughout 2026 and for biopharma to pick up after the major recent signings which we saw over the second half of the year. From a regional perspective, EMEA grew 22% in the fourth quarter. Excluding biopharma, EMEA clinical revenue was up a robust 35% year-over-year. Belgium and Germany contributed significantly as the countries grew 93% and 66% respectively, as major recent wins such as GESA came online. North America analysis volumes were exceptional in the fourth quarter, growing 45% year-over-year. On a reported basis, you may notice that revenue growth is lower as we booked a one-time large vendor payment in the fourth quarter of 2024, which created a challenging prior year comp. Excluding this, underlying regional growth remains strong. Asia Pacific also continued to outperform in the fourth quarter, with 44% revenue growth in the period, driven primarily by India and Australia. We also saw revenue from Japan begin to ramp as our new partnership with A.D.A.M. Innovations is now underway and gaining traction. In Latin America, we were happy to see recovery in the fourth quarter with 49% revenue growth. Mexico and Brazil contributed significantly as the countries grew 95% and 48% respectively. From an application standpoint, we continue to establish ourselves as a global leader in hemato-oncology testing. Hemonc volumes grew 27% year-over-year in the fourth quarter, off an increasingly large base. Beyond hemonc, liquid biopsy continues to grow as more MSK-ACCESS customers come online. In the fourth quarter, we recorded just over 2,400 liquid biopsy analysis. We look to 2026 for new higher ASP products like MSK-ACCESS, MSK-IMPACT, and Enhanced Exomes to meaningfully drive overall growth. Moving to new business on the clinical side, I'm happy to share that we continued to book new business at record levels. We landed 30 new customers in the fourth quarter, bringing total new customers signed in 2025 to 124. Average contract value of the new customers signed in 2025 was up 120% year-over-year. I'll now take a moment to update you on recent major wins across the regions. Starting in North America, last month, we announced the signing of two of the largest integrated health systems in the United States, one based on the West Coast and another in the Midwest. The two networks are adopting SOPHiA DDM to support genomic testing for up to 60,000 patients annually with their communities. Both customers are initially adopting SOPHiA DDM for rare disorders utilizing a 20,000 gene Enhanced Exome application. We expect these clients to be what we call routine usage by the fourth quarter of 2026. It's also worth noting that together, the two systems serve nearly 1 million oncology and rare disease patients each year, creating meaningful long-term expansion potential as we integrate our solutions into their workflows. Beyond these two large wins, we also landed NYU Langone Health in New York City and Protlab in Florida as new customers. As Jurgi mentioned, we announced a strategic collaboration with MD Anderson. Through this alliance, we will bring together MD Anderson's world-class oncology research arm and SOPHiA GENETICS S.A.'s world-class AI and algorithm capabilities to develop tests which we can then activate across our customer base. From an expand perspective in North America, many customers signed to adopt additional applications in the fourth quarter, including Vanderbilt University School of Medicine, the Icahn School of Medicine at Mount Sinai, and Memorial Healthcare System in Florida, which is adding MSK-ACCESS. In EMEA, MSK-ACCESS also continued to attract major interest. In the fourth quarter, we signed Labpoint Medical Lab in Switzerland, the Royal Infirmary of Edinburgh in Scotland, and Citogen in Spain to the application, among others. We also saw a large amount of interest in our newly launched solid tumor application, MSK-IMPACT Flex, signing Parapath in Austria, AZ Delta in Belgium, and Ospedale di Circolo e Fondazione Macchi in Italy, among others. In total, we have now signed 21 customers to MSK-IMPACT. In Latin America, we continue to see new business in Brazil and signed the Human Genome and Stem Cell Research Center. We also added the National Institute of Genomic Medicine from Mexico for our MSK-ACCESS test. In Asia Pacific, we signed the National Taiwan University Hospital, who is adopting multiple applications for solid tumor testing, including MSK-IMPACT. We also expanded our footprint in Peter MacCallum Cancer Centre, one of the top hospitals in Australia. Congratulations to the team on these wins. I could not be more pleased with the momentum we're carrying into 2026. I look forward to seeing the new customers complete implementation and begin generating revenue over the coming months. Speaking of implementation, we implemented a record 102 new customers in 2025, including 29 in the fourth quarter, who are now moving to routine usage. This reflects the impact of the actions we took to expand and strengthen our implementation capabilities and shorten time to revenue. While we have made meaningful progress, we continue to optimize this function throughout the year. Looking ahead to 2026, we expect to continue accelerating growth within these three growth drivers. First, continuing to execute and grow in the United States. Second, continuing to expand our liquid biopsy application, MSK-ACCESS. Third, capitalizing on the renewed momentum in our biopharma offering. Starting with our first driver, U.S. analysis volume grew at nearly 50% year-over-year in the fourth quarter. Recent large wins and a strong and growing pipeline give us confidence that this will continue to grow into 2026. Our U.S. commercial team continues to perform at a very high level and with a robust pipeline, we are well-positioned to repeat our record bookings performance this year. Liquid biopsy offers a second meaningful driver for growth, as we have now signed 70 customers for MSK-ACCESS across 29 countries to the application. Of these customers, only about half have completed implementation and begun to ramp usage, giving us a large base to grow in 2026. We also continue to develop our partnerships with Myriad Genetics in the U.S. and A.D.A.M. Innovations in Japan to develop MSK-ACCESS into a regulated global companion diagnostic offering. Activities are progressing well. Interest from biopharma in this product is very high, which brings me to our final growth driver for 2026, biopharma. Biopharma demand continues to build. At the J.P. Morgan Healthcare Conference in January, I met with over 20 biopharma companies exploring partnerships with SOPHiA GENETICS S.A. Our value proposition is now well understood. We believe we're approaching an inflection point as biopharma recognizes the value of a decentralized partner, our massive global network, and the rich data and AI ecosystem it fuels. I'm excited to announce today that we recently renewed our global commercial agreement with AstraZeneca. As you know, AZ has been a major collaborator with us, as in 2025 alone, we signed several new contracts. These include AZ-sponsored deployment of MSK-ACCESS across 30 sites globally, the development of an AI-driven NGS solution for the PTEN pathway, and the signing of a multiyear AI-driven evidence generation project for breast cancer, which we mentioned was the largest contract in SOPHiA GENETICS S.A.'s history. Today, I'm also proud to announce that beyond AZ, we recently signed for the first time ever, a global commercial agreement with a new top 5 global pharmaceutical company. Congrats to the team on this advancement, and I look forward to updating you as details progress. As we enter 2026, we are fueled with substantial new wins across clinical and biopharma. Despite strong bookings conversion, our pipeline remains incredibly strong and is at record levels. Deal size continues to grow, and the number of opportunities in our pipeline above $1 million is expanding materially. Overall, we're pleased with the business's trajectory and look forward to updating you throughout the year. With that, I will now turn it over to George, who will provide a more detailed look at our financial results and outlook for 2026.

Thanks, Ross, good morning, everyone. As Jurgi and Ross highlighted, 2025 was an exciting year of growth for SOPHiA GENETICS S.A. Before I discuss our outlook for 2026, I will start by providing a brief overview of our fourth quarter financial results. Total revenue for the fourth quarter was $21.7 million, compared to $17.7 million in the fourth quarter of 2024, representing year-over-year growth of 22%. Platform analysis volume was over 105,000 in Q4, compared to 91,000 in the fourth quarter of 2024, representing growth of 16%. Gross profit was $14.7 million in Q4, compared to $12.1 million in the prior year period, representing year-over-year growth of 21%. Gross margin was 67.7%, compared with 68.2% for the fourth quarter of 2024. Adjusted gross profit was $16 million in Q4, an increase of 22% compared to adjusted gross profit of $13.2 million in the prior year period. Adjusted gross margin was 73.9%, decreasing slightly by 30 basis points year-over-year. Total operating expenses for Q4 were $33.2 million, compared to $29.5 million in the prior year period. It is worth pointing out that our Q4 results were adversely impacted by certain items which temporarily impacted results but do not reflect the company's underlying operating performance. For example, adverse foreign exchange movements continued to negatively impact reported OpEx, primarily due to the strengthening of the Swiss franc. The Swiss franc has appreciated by 14% since the start of 2025, which means that our payroll and rent expenses in Switzerland are translating 14% higher when viewed in US dollars. Guardant Health filed patent infringement claims in the United Kingdom and at the Unified Patent Court in Paris during Q3, alleging that our MSK-ACCESS application infringes their patents. This litigation resulted in legal expenses of approximately $1.8 million, which is reflected as an adjustment for litigation in our adjusted EBITDA table. In January, the UPC rejected Guardant's request for provisional measures and ordered them to pay us €400,000 in interim costs, which we expect to receive by mid-March. We also activated an at-the-market or ATM facility with TD Cowen in Q4. We incurred $450,000 of costs associated with the ATM facility in Q4. I am pleased to announce that we have raised $15.5 million in net proceeds, including $1.1 million raised in Q4 2025 and $14.4 million raised in Q1 2026, executed at a weighted average price of $5.12 per share. Operating loss for the fourth quarter of 2025 was $18.5 million, compared to $17.4 million in the prior year period. EBITDA loss for the fourth quarter was $16.1 million, compared to $15.2 million in the prior year. Adjusted EBITDA was a loss of $9.9 million compared to a prior year loss of $9.1 million. Lastly, total cash burn, which we define as the change in cash and cash equivalents, excluding cash received from borrowings and stock sales as well as FX impacts, was $12.3 million compared to $12.8 million in the prior year quarter, representing a year-over-year improvement of 4% despite the Guardant litigation cost impact that we discussed. Now turning to the 2025 full year results. Total revenue for the full year 2025 was $77.3 million, representing year-over-year growth of 19%. Platform analysis volume was over 391,000 for the full year 2025 compared to 352,000 in 2024. Our genomic customers were 528 as of December 31st, 2025, up from 472 in the prior year period and up sequentially by 17 customers relative to Q3. Annualized revenue churn was at a record low of less than 1% for 2025. Net dollar retention for the year increased to 115% in 2025, up from 104% in 2024. This impressive same-store growth demonstrates the stickiness of the platform, as well as our continued ability to expand within accounts by encouraging them to adopt additional applications. Gross profit for the full year 2025 was $52.1 million compared to $43.9 million in 2024, up 19% year-over-year. Gross margin was 67.4% for the full year 2025 and flat to prior year. Adjusted gross profit was $57.3 million, an increase of 21% compared to adjusted gross profit of $47.5 million in the full year 2024. Adjusted gross margin was 74.2% for the full year 2025 compared to 72.8% for 2024, increasing 140 basis points due to ongoing compute optimizations. As Jurgi mentioned, targeted platform improvements by our tech team have driven cloud compute and storage costs lower throughout 2025, an achievement we remain proud of and expect to continue into 2026, despite the increase in data processed with larger panels being run. Beyond cloud compute, we also had a significant reduction in our scrap costs related to bundles, which helped drive gross margin improvements. Total operating expenses for the full year 2025 were $123 million compared to $110.5 million in 2024 as reported in US dollars. While constant currency costs have remained fairly flat year-over-year, the appreciation of the Swiss franc and euro have resulted in higher expenses when reported in US dollars. These foreign exchange movements has significantly and adversely impacted our reported results throughout the year as our expenses still exceed our revenue. Beyond foreign exchange rates, we also made a target investment in our sales and marketing team in 2025. We have seen the results of this in accelerated growth, which is reflected in our 2026 guidance. We continue to be very focused on our expenses and operating as efficiently as possible while still making strategic long-term investments in R&D and continuously improving our platform. Operating loss for the full year was $70.9 million compared to $66.6 million in 2024. EBITDA loss for the year was $61.4 million compared to $58 million in 2024. Adjusted EBITDA loss for the year was $41.5 million compared to $40.2 million in 2024. Lastly, total cash burn for 2025 was $50.4 million compared to $53.7 million in the prior year, improving 6% year-over-year. These numbers exclude cash received from borrowings and stock sales as well as FX impacts. We finished the year with cash and cash equivalents of $70.3 million as of December 31st. Note that this does not include the Q1 2026 proceeds from the ATM of $14.4 million to date, and this will be affected in our Q1 update. In January, we also expanded our credit facility with Perceptive Advisors, increasing total available liquidity by $25 million. We remain confident in our current capital position with respect to the achievement of our long-term goals. I'll turn to our 2026 outlook. As we announced in January, SOPHiA GENETICS S.A. expects full year reported revenue to be between $92 million and $94 million, representing 20%-22% growth. Let me provide a few key underlying assumptions relative to our revenue forecast for 2026. With respect to seasonality, we expect 2026 growth to be mostly back-half weighted as new business signed in 2025 comes online in the second half of the year and as more MSK-ACCESS business continues ramping up to routine usage. We mentioned the two large U.S. wins that we have. These clients will not produce meaningful revenue in the first half of the year. As a reminder, Q1 tends to be seasonally softer from a revenue standpoint, where Q4 is seasonably stronger. We currently contemplate that exchange rates will remain volatile due to macro uncertainties. Since January first, we've seen the U.S. dollar sink further against the Swiss franc and euro, which has had the impact of increasing both our sales and operating expenses when reported in U.S. dollars. The company expects adjusted EBITDA loss to be between $29 million and $32 million, compared to $41.5 million in 2025. This guidance is based on the following expectations. We continue to make targeted investments in our platform, which should further optimize cloud compute and storage costs, and therefore expect gross margins to expand slightly in 2026. We also expect to hold the line on operating expenses in local currency and excluding social charges, as we currently have the correct team size to support our medium-term growth objectives. In addition, we are looking at targeted opportunities to flatten our organization structure and reduce our headcount in certain areas. Lastly, we will continue to revisit our discretionary expenses and execute on identified savings in systems, professional services, and certain public company costs throughout 2026. Overall, in 2026, we expect to drop 60% of every incremental revenue dollar down to the bottom line and demonstrate improved operating leverage throughout the year. We continue to believe that we are on track to be approaching adjusted EBITDA breakeven by the end of 2026 and crossing over to positive adjusted EBITDA in the second half of 2027. With that, I would like to turn the call back over to Jurgi for the closing remarks before we take your questions.

Thank you, George. I am confident as ever in our long-term trajectory. I am excited for the year ahead as the momentum in our business continues to build. As we enter 2026 and approach the 15th-year anniversary of our founding, SOPHiA GENETICS S.A. is entering its next phase of scale, one that positions us to reach important milestones in the years ahead. Our forward-looking indicators remain strong across the business. We continue to see a steady stream of new customer signings, expanding biopharma interest, rising average contract size, and a healthy expansion in pipeline across regions and applications. At the same time, we continue to be laser-focused on optimizing costs and delivering sustainable growth. Thank you to the SOPHiA GENETICS S.A. team, customers, partners, and investors for your continued trust and partnership. 15 years ago, we had an ambitious vision to transform healthcare through data and AI. Today, we operate the most widely used AI-driven platform in precision medicine, impacting 391,000 patients in 2025 and over 2.3 million patients since inception. I'm so proud of what we've accomplished over the past 15 years, and I know we are just getting started. Please note we are presenting at the TD Cowen Health Care Conference tomorrow in Boston. We all look forward to continuing to update you on SOPHiA GENETICS S.A.'s future success. Operator, you may now open the line for questions.

Thank you. In a moment, we will open the call to questions. If you would like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing any keys. Please be advised that the questions are limited to two questions, and then you can rejoin the queue. Thank you. One moment, please, while we poll for questions. The first questions come from Subhalaxmi T. Nambi with Guggenheim. Please go ahead.

Hey, guys. Thank you for taking my question. Good morning. Your guidance is for 21% growth at the midpoint. Can you walk us through what contributions you're expecting from key growth drivers such as MSK-ACCESS IMPACT and from rare disease?

Hi, Subbu. Good morning. Yeah, absolutely. We will drag you through that. First, to recap, we ended up the year very strong with a 31% revenue growth year-over-year on Q4, with as well signings for the ACV as being very, very strong. 120% better in 2025 versus 2024 full year. This is now well positioning us for basically a 2026 performance. I know, Ross or George, if you want to comment on the guide.

Maybe just specifically, you know, to the point you made, the ramping of MSK-ACCESS continues to be a really nice driver for us. Sequentially, we had some sizable customers start to come online in the fourth quarter, and you'll see that ramp continue in Q1 and beyond. We've only seen roughly half of the total cohort start to contribute. Even those that come online, the volumes are relatively modest as it does take time to ramp and liquid. I would say that is certainly a really nice area of expansion for us. You know, you mentioned impacts of CGP. We've had some really material wins, both in ex U.S. as well, as in our native markets. I feel quite confident, we're gaining share, in that vertical. I think in general, you're seeing a shift again to kind of larger and larger panels. In solid tumor, we're well-positioned for that, particularly with our flex product, which I think has some really unique characteristics. Outside of that, I would say overall, as to Jurgi's point, the entire platform has had really nice growth across almost all of the application sets, right? It's really been quite balanced. Those, you know, points you made are obviously some of the true highlights. You know, even on the rare and inherited side, we're seeing really great uptake in our Enhanced Exomes product. And that, you know, was one of the key drivers behind the 2 big U.S. wins we called out several weeks ago. I would say in general, it's really balanced. We've got quite a number of drivers, and I would say we're really levered to a number of the key, I would say, mega trends you're seeing across oncology, diagnostics and NGS that you see with many of the other, you know, key players that you cover. Certainly a balanced and exciting period for us on the growth side.

Thank you both. I feel like you probably answered my second question and smidge. The net dollar retention was up meaningfully to 115%. Can you speak to a bit to what drove the cross-selling strength here, and if you expect this to continue in 2026? Thank you so much.

We're super pleased, Subbu, with the re-acceleration in NDR. You know, this is really a metric quite critical to us and to any other software company where you're obviously looking at same-store organic growth. First part that we're incredibly proud of, the churn is now actually under 1%. I mean, this is like 99 percentile performance for software. It just really shows how sticky the platform has become and really how hard it would be to sort of move to other opportunities just because again, the uniqueness of what we're able to do from a compute and scalability and cost perspective and efficiency perspective is really unmatched. I'd say above and beyond that, you know, and you've seen this in general, there is a re-acceleration of volumes within sort of NGS, oncology, and rare disease. We're benefiting from that. I would say as well, we've done a much better job on the expand, right? Which is really where this is also a key metric to make sure that, you know, we're enabling our customers to scale not just with the data computes or higher ASPs, but also with bigger volumes and then moving to more applications, right? I would say overall you'll see that continue into 2026 and beyond, particularly given the great number of new logos or new accounts we've brought online, you know, north of 200 over the last 2 years. There's just huge expansion potential, which you'll see come through on the NDR.

Thank you so much for that, George.

Thanks, Subbu.

Thank you. The next question comes from William Bonello with Craig-Hallum. Please go ahead.

Hey, thanks for taking my question. A couple here. On the pharma side, obviously, exciting to see the number of contracts that you're signing. I'm just wondering, you know, when you sort of add them all up, beginning with the stuff that you, the expansion that you did with AZ and then the new contracts that you've added, can you give us any kind of sense of the potential annual contribution from those contracts and then maybe sort of the time period over which we would see that revenue begin to roll in?

Thank you, Bill. I would say, you know, obviously considering, you know, we had obviously challenging performance in the pharma business going back to 2024. We're really pleased to see improved momentum in terms of new contracts and new logos coming online. You know, coming off of J.P. Morgan, you know, I spent quite a bit of time with very senior members of many of the top 20 pharma, and I would say finally our story is really resonating. I think there's really, I would say, you know, specific areas of repeatable business where we can scale. I think on the product market fit and on the, you know, sort of ability to have a much more material contribution to our overall revenue and growth, we're moving in the right direction. That being said, you know, pharma business, as you know, does take time, right, to sort of come online and ramp and also decide. You know, it is long cycle business. We are trending in the right direction. I do think, you know, obviously the contribution into 2026 will be a net positive for biopharma, which is important. Certainly, you know, we're not in a position yet where we're looking for a hockey stick, right? Obviously we're, you know, we're doing all of the right, I would say, strategic steps to lay the groundwork for a pretty nice re-acceleration in later 2026, 2027 and beyond. We're not yet kind of at a point where I would say the critical mass is enough to where I can declare this will be X% of revenue. Aspirationally, you know, we think pharma could be a much higher percentage of total revenue, certainly much greater than where it is today. I wouldn't say we're at a point yet where we can exactly point to that. Certainly as we see more and more evidence of kind of that momentum continuing and building, we'll be happy to share more specific figures to allow you guys to model better that business, which I know has been a bit challenged over the last two years.

Sure. Thanks. Just on the 2 large health systems that you added, thanks for talking about what indication it is that they're using. You know, how do you sort of assess the potential for those, you know, based on your discussions with those health systems, the potential that those customers may want to eventually, expand into additional, indications and sort of what the, you know, what the key components would be to influence their decision one way or another?

Sure. It's a great question, Bill, and I appreciate you pointing this out because obviously we're incredibly excited to be able to serve two of the four largest health systems in the United States. You know, this is starting with just one application, right? If you look at the growth we had in the period, particularly in volume in the US, nearly 50%, this isn't even, you know, sort of, I would say, contemplating any of that volume starting to contribute. Again, we're really excited about just the size and magnitude that this can bring just again with one application. Give you a sense, we actually have already an expand opportunity in the pipeline from one of these two parties, and it's also fairly significant. I'm super, I would say, optimistic that we'll be able to, you know, grow these accounts materially over time where we're looking and we'll share in the investor deck, and some of the cohort analysis over time. I think what you'll see is our ability to really over multiple periods to grow that initial land by multiples, right? So 2x, 3x, 4x, 5x through the volume uptick, through the increased ASP and through application expand. I mean, these are both accounts that, you know, if we were to fully penetrate them, could be certainly, you know, in the 8-figure range. These are very, very sizable initial, I would say, starts for us, and we're really optimistic we'll be able to convert them on the platform as that remains, I would say, a really attractive opportunity. If you think coming off of last week at AGBT, particularly with all of the new platforms coming online on the sequencing side and the complexity of the chemistry and all of the new applications, MRD, transcriptomics, et cetera. The ability to do all of that in one platform at massive scalability at a cost that makes sense with sort of the labor savings these institutes can see, given where reimbursement's been attractive, this is a very favorable medium to near-term trend for us, and we would expect this to accelerate to others.

Thanks very much.

Thank you. The next question comes from Daniel Brennan with TD Cowen. Please go ahead.

Great. Thanks, thanks for the questions. Congrats, Jurgi and Ross. Maybe first one just on volume price mix for the 2026 guide. Volumes, I think, grew, what, 16% in Q4, up low double digits in 2025. What does the guide contemplate for volumes and price mix in 2026? Given the push with MSK and liquid biopsy, should we expect price mix growth to accelerate as we go forward from here?

We've recommended that people do continue to assume that our ASPs are going to increase. We're concentrating on selling higher priced tests like MSK-ACCESS, MSK-IMPACT and the MSK-IMPACT Flex product that we have. We do expect lift from those. You know, these ASPs are much higher, in some cases 2x, what our average ASP is. You should model some increases. Realize too, though, we're also going to be putting on volumes in areas like Latin America, India, Turkey, that do have a little bit of lower ASP, that sort of tempers it out a bit. Generally speaking, I think you saw the 16% in the fourth quarter. I think we feel good about that in terms of the volume growth. Figure the rest of that revenue growth is going to be coming from the ASP lift.

Okay. Maybe second one for Ross. As new CEO of the company, can you just speak to a little bit about your approach philosophy? I assume given the trajectory of the business, it's probably going to continue on what you've been doing. If we look out a year or 2 and then we're looking back at what's transpired, do you think we'll see any potentially meaningful changes? Kind of what type of how will your approach possibly be similar to Jurgi and/or maybe different? Thank you.

Thanks, Dan. You know, I've still got a few months before I take over, I'm super excited, also, I would say to have Jurgi remain involved in an executive chairman function. I think the two of us will make a very good partnership going forward, being able to really help scale this business. Look, I would say in general, I'm fortunate in that the transition's happening in a period of great strength for the business, right? We have a ton of momentum at the moment. I think the real focus is, all right, you know, obviously we're very focused on getting to the $100 million barrier of revenue, you know, whether that's on an ARR or full year basis. You know, how do we scale materially from there, right? A lot of the effort, a lot of the focus of myself is preparing the organization for that next level of substantial growth and expansion. I would say we have a lot of the pieces in place, but certainly, you know, as you get bigger, you need to put systems and people and technology in place to allow that to continue in a way where the return on that capital is quite appealing, and we create shareholder value. I would say that is a good part of it. You know, the other side I would say is we're still not fully tapping the full value of the platform and the network and the ability to have, again, nearly, Dan, 1,000 institutions connected around the world, right? What we're starting to see as we get to the scale is, you know, one, labs of all sizes really see us as someone, they will need to continue to compete in the future, but not just in sort of the traditional business in precision medicine. You know, you look at again where AI is going with Software as a Medical Device or with, you know, multimodal algorithms. Think about, you know, what's happening in the ABC category with computational pathology and digital biomarkers. You look at, you know, the desire to create, again, these more complex algorithms for patient stratification or patient segmentation in clinical trials. There's just a lot more areas where I would say AI and having a network of the size and the data that we touch becomes really unique on a global basis, given its diversity. We need to figure out how to obviously unlock and scale that. You know, one of the things in the interim that I would say has limited us somewhat is, you know, obviously, as we're trying to get to be profitable, right? You have to be very disciplined on the investments you make. I would say with our confidence in that crossover to profitability in the near medium term, you start to get a lot more capital freed up to make some of those investments and bets. I would expect to see us take products like the digital twins and others and really use that to scale into some of those multimodal and other data related capabilities and really truly build this kind of intelligence layer for healthcare that I think could be incredibly differentiated on a global basis.

Great, Ross. Thank you.

Thanks, Dan.

Thank you. The next question comes from Mark Massaro with BTIG. Please go ahead.

Hey, guys. Thank you for taking the questions and congrats on all the momentum. One of the key levers to your business, I think, over the years has been your ability to turn on customers. Can you just give us a sense for where you are now with your go live implementation timelines? Can you speak to maybe the infrastructure or boots on the ground that you have, perhaps any metrics you could share about, you know, taking all these customers you've signed on to to make them go live in 2026?

Yes. Good morning, Mark. Absolutely right. Turning customers in routine has always been part of our business model. As you know, we're being paid on usage. First we land customers, we sign them, then we implement the platform on the customer side, and then we start seeing revenue coming up, right? As you understand, most of the bookings we've been doing in 2025 are going to contribute in our revenue story from mid to end of 2026. The KPI you're highlighting in terms of implementation is obviously something we scrutinize a lot, and it's very important. Ross will share with you where we stand on the momentum and remind you maybe what were some of the actions we had taken last year as well to speed it up the implementation.

Yeah. Mark, if you look, we're able to complete north of 100 implementations this year, and that was up pretty materially year-over-year. If you look at the sequential cadence of what we did in the second half, it was materially above the first half, right? The actions we took starting in kind of the first part of this year, particularly in the second quarter, really started to pay off. We'll see that momentum continue into 2026. We're starting to see, essentially the amount of revenue released per month similar to the amount of bookings signed per month, which is more ideal, right? We had a period where more was coming into the funnel than was coming out just because we were sort of at this material acceleration period. It doesn't mean that growth isn't continuing to sequentially improve. It is, but we're getting much better at handling the volume, and optimizing a number of steps in that process and essentially managing the customer to a quicker time to revenue and routine. We're also getting better, I would say, at enabling customers to choose products, that are in, from a long-term perspective, you know, future-proofed and things that are more standard for us. You think about, again, MSK-IMPACT, MSK-ACCESS, Enhanced Exomes, et cetera. These are products or our comprehensive hematology product that we can bring online faster, that we're doing multiple of at the same time, and it's allowing again for that quicker speed to revenue. I won't declare victory. I think we still have plenty of places to get more efficient and improve, but I think the trend is favorable and that will help again in terms of that sequential revenue acceleration that we're obviously implying in the guidance over the balance of this year as well, similar to what we saw last year, in terms of the cadence.

Okay, that's really helpful. You know, you guys have been driving really strong growth in the U.S. market with analysis volume up 50% in Q4. You indicated you expect it to continue in 2026. You know, since U.S. is still a relatively small portion of your business, do you think you can build off of the 50%? Related to that, you guys do compete with some other send out labs in the U.S. market, some of which have really juiced up their commercial teams, some of which in 2025, others are doing it now this year. How do you think about the right size of your U.S. sales operation, and could that be an area where you look to expand?

Yeah, absolutely, Mark, right. Actually the U.S. clinical market should be our biggest market. As you remember, we started in Europe, developing the technology there and really penetrated the U.S., from 2022, post-COVID. Yes, to your point, the U.S. market should be significantly bigger with our model. Given that there is more and more data, more and more complexity on the data, we expect to make inroads into many, more new customers and grow those volumes. Ross?

You know, Mark, I'm really proud of our performance here, in the U.S. I think obviously it's taken some time, for our model to really scale and resonate. I think there's also a bunch of other favorable trends happening, in the space with reimbursement getting more asserted on many of these tests, as well as, you know, the sequencing equipment and consumables getting, more affordable, right? I think with a platform like ours, the ability to generate precision medicine data at scale close to the patient, has never been easier, right? We're seeing a lot of large institutions start to see the benefits of that and really move in that direction outside even just the traditional academics that have done so in the past. In that vein, Mark, again, just to remind you, we don't necessarily view ourselves competing, right, with the send outs because in general some of them actually use us as well, right? It's really our customers that are competing with each other. For example, those two large entities we talked about in the U.S., right? I guess you can say they are going to compete for exome volumes with others in the space, but we don't really see ourselves as necessarily that competitor, right? We're happy to also work with large laboratories doing exomes as well, right? For us, our belief is ultimately with our scale and cost advantage and with the size of our network and the size of just the compute we're doing based on the number of patients, you know, we'll at some point be the largest sort of precision medicine, you know, platform and laboratory in the world, right. Just 'cause we're serving an entire globe, not just regions of the U.S., et cetera. I think with that, it gives us a lot of flexibility. I will say, Mark, you know, last 12 months you're really seeing an inflection in the U.S., right. We're proud of that growth number. To me, there's no reason why that can't even accelerate at some point in 2026 as some of these large customers come online. I'll tell you, and we were meeting yesterday as an executive team, and this is one of the questions. It was, you know, with the performance of that business, do we need to add, you know, headcount? I think we probably will, is the answer. You know, when I look at what others are doing versus us, it's a very different sale, right? For us, if I add 2 FTEs to the U.S. business, right? That's pretty material for us because they're, you know, they're not calling on clinicians, right? They're not calling on oncologists. We're signing entire health systems, right? You know, we pick up 1 million patients, or in this case, you know, in the 2 institutions, 60,000 patients, that's 1 salesperson, right? To do that at a send out laboratory, you'd need many, right? 'Cause you'd be calling on the clinicians. We get much better operating leverage on that. I would say it's astute of you. We're certainly going to be adding, and it's one of the only few places in the entire organization we're adding headcount. Again, if you're thinking of quantum, I don't think we're going to be adding 100 feet on the street. It's, you know, I think in our model, we're pretty well scaled, and we can add incrementally and that new salesperson and productivity adds quite a bit of revenue, right, per salesperson. We're excited about that from an efficiency standpoint as well.

Sounds good. Thanks for the time, guys.

Thank you, Mark.

Thank you. We have reached the end of the question and answer session. Let me transfer the call over to Jurgi Camblong, Co-founder and CEO for closing remarks. Please go ahead, sir.

Thank you so much for joining us today. Thank you to all the Sofians for the great work in 2025 and Q4 2025. We're very much looking forward to your impact in 2026. To remind you, tomorrow we are attending the TD Cowen Healthcare Conference in Boston, and we will be happy to see you there and take your questions. Have a good day.

This concludes today's conference, and you may now disconnect your lines at this time. Thank you for your participation.