SOPHiA GENETICS SA Q1 FY2024 Earnings Call

Good day, everyone. My name is Jamie, and I'll be your conference operator today. At this time, I'd like to welcome everyone to the SOPHiA GENETICS First Quarter 2024 Earnings Conference Call. Please note this event is being recorded. At this time, I'd like to turn the floor over to Kellen Sanger, SOPHiA GENETICS' Head of Strategy and Investor Relations. You may begin.

Thank you, and good morning, everyone. Welcome to the SOPHiA GENETICS First Quarter 2024 Earnings Conference Call. Joining me today to discuss our results are Dr. Jurgi Camblong, our Co-Founder and Chief Executive Officer; and Ross Muken, our Chief Financial Officer and Chief Operating Officer. I'd like to remind you that management will make statements during this call that are forward-looking statements within the meaning 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 risks, uncertainties, and factors that could cause results to differ appears in the press release of SOPHiA GENETICS issued 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. 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, and good morning, everyone. I will start off the call today by providing an update on our progress in Q1, including details on the performance of our clinical and biopharma businesses. I will then turn the call over to Ross, who will provide a closer look at our Q1 financials and our outlook for 2024. In Q1, the performance of the business was marked by strong forward-looking indicators such as bookings and new logos, but lighter than expected revenue. Total revenue for the quarter was $15.8 million, up 13% from $14 million in Q1 2023, and analysis volume was approximately 84,000, up 9% from the prior year period. The lighter-than-expected start for the year can be attributed to three primary drivers. First, as with any consumption-based business, we expect to see volatility from time to time. In this case, we saw lower-than-expected analysis volume in January across nearly all applications, but particularly within EMEA, which can likely be attributed to exaggerated seasonal consumption trends. Second, and as mentioned during our last earnings call, setup times for business have been slightly longer than expected as more and more customers adopt new sequencer types and adopt increasingly sophisticated applications, which require them to spend a bit more time on proficiency testing and validation before they can begin implementing our platform. Third, the signing of one of our data projects in biopharma was unexpectedly delayed during the quarter, and we are seeing some elongated sales cycles for larger deals. Let me take a moment to address each of these items. On the first point with respect to usage in January, I'm pleased to report that consumption picked up considerably in March, and this momentum continues now into April and early May. For example, volume in March reached approximately 30,000 analyses as compared to the approximately 84,000 analyses for the quarter. As a company that maintains close relationships with customers, conversations from the field further indicate that the change in consumption was temporary. Additionally, many customers also reconfirmed their volume assumptions for the full year, and we'll continue to monitor their usage closely. In addition to consumption returning to more normalized levels in March, bookings for new clinical business grew over 30% year-over-year in the quarter, nicely above our internal expectations. We also signed an impressive 27 new logos in Q1, up from 18 new logos in the prior year period. This marks a second consecutive quarter of strong new business growth as the 27 new logos signed in Q1 joined the 35 new logos signed in Q4 2023 to set us nicely for a strong back-end ramp for the year. On the second point regarding longer-than-expected setup times, we have now fully ramped up a team of best-in-class subject matter experts with a deep experience in setting up and validating genomic workflows. These specialists, whom we call our master team, are laser-focused on partnering with customers to often complete their proficiency testing quicker so that they enter routine usage and begin generating revenue faster. This team is well-prepared to manage the existing influx of new customers we have experienced over the last two quarters. In Q1, we have brought 19 new customers into routine usage, up from 14 in the prior year period, and we are excited to see this positive trend continue. On the final point regarding biopharma delays, we have developed an action plan to recover the revenue and capitalize on growing demand in biopharma during the back half of the year. While our biopharma pipeline has more than doubled in the past year, the business is still in its nascent stages and the timing of biopharma revenue remains difficult to predict. In conclusion, consumption has returned to more normalized levels and new business remains strong. We have taken actions to reduce setup times and accelerate new customers into routine usage. Lastly, we have a plan in place to advance the growing number of biopharma opportunities we're seeing in the market. Given these factors, we remain confident in a strong back-end ramp in 2024 and are reaffirming our revenue guidance for the year. Before moving on to a more robust update on our commercial business, I want to highlight that we continue to manage costs well in the quarter as adjusted operating loss improved 13% year-over-year to $14.1 million compared to $16.2 million in Q1 2023. During the quarter, we remained obsessed with capital efficiency by continuing to take actions to optimize our operations and focus on increasingly high ROI projects. We also continued to work closely with partners such as Microsoft and NVIDIA to manage gross margins, and our adjusted gross margins remained above 70% during the quarter despite the temporary softness in clinical volume and biopharma demand. We are proud of our cash management to date and therefore, are also reiterating our full-year guidance for 2024 with respect to our adjusted gross margin and adjusted operating loss while remaining deeply focused on our goal of achieving profitability in the next two-plus years with an acceptable level of cash cushion. As we progress on our path to profitability, revenue growth continues to be the primary driver towards this objective. At SOPHiA, we grow our clinical revenue by landing new customers and expanding within those customers over time as they adopt more applications. As of March 31, we had 463 core genomics customers who have used SOPHiA DDM in the past 12 months to analyze cancers and broad diseases, up sequentially by 13 customers and up annually by 26 customers. Our focus will be to continue to expand within these existing accounts by encouraging them to adopt more applications. Our proven ability to expand within existing customers is demonstrated by our continued high net dollar retention, which was 123% in Q1, up materially from 107% at the end of Q1 2023. Our ability to expand within existing customers also exemplifies the importance of landing new customers. As mentioned, Q1 was a strong quarter in terms of landing new customers with 27 new logos signed. For these customers as well as the 35 new customers signed in Q4, our market care team will be laser-focused on reducing their time to routine so that they begin generating revenue faster. I will now take a moment to provide more detail on some of our major new land and expand achievements during Q1, and in doing so, we'll also touch upon three primary factors driving our growth in 2024: the U.S. market, our world-class solid tumor applications, and our new liquid biopsy offering. First, we continue to see compelling momentum in the U.S. market. Analysis volume in the U.S. grew 34% in Q1 compared to the prior year period, and revenue grew 27%. We continue to win major new logos in the U.S., and today, I'm proud to announce the signing of Mayo Clinic, one of the top-ranked academic medical centers in the world, which will be adopting SOPHiA DDM's capabilities in oncology, starting with immune applications. Welcome, Mayo Clinic, to the SOPHiA community. Beyond the U.S., we achieved major recent wins in the Asia-Pacific market as well. In India, we continued our strong momentum from Q4 and signed a partnership with Strand Life Sciences in Bangalore, encompassing a broad-based collaboration that aims to bring SOPHiA DDM's oncology applications to patients across the country. Strand is an established partner of biopharma companies in India, and we are excited to partner with them to improve patient health outcomes. The addition of Strand, along with recently announced partners in India such as Karkinos and Tata, positions us very well in a country that is not only the most populated in the world but also developing very quickly in terms of precision medicine. Outside of India, I'm also proud to announce today for the first time that Samsung Medical Center in Seoul, South Korea, went live on SOPHiA DDM this month using our world-class solid tumor application for HRD. With the addition of Samsung Medical Center, we now work directly with four of the top five oncology hospitals in the world. This list now includes Samsung, Mayo Clinic, Gustave Roussy, and MSK. It's rewarding to see these leading healthcare institutions continue to recognize SOPHiA DDM's best-in-class analytical capabilities as well as the platform's ability to save customers' valuable time and resources. In Latin America, I'm excited to announce that in Mexico, we expanded our relationship with INMG, the Instituto Nacional de Medicina Genómica, one of Mexico's national institutes and a top research center in the country. An existing customer of ours in Latin America is now adopting a related cancer application in addition to the solid tumor applications they already use. In Latin America, these applications are estimated to be used to perform approximately 8,000 analyses per year. The last market I will highlight is EMEA. Q1 performance in EMEA was representative of our company's overall performance, with forward-looking indicators such as bookings and new logos outperforming internal expectations, but revenue falling slightly short. Modest revenue growth in EMEA can be primarily attributed to exaggerated seasonal consumption trends in Italy, Spain, and France as January had lower consumption levels than expected. Based on recent trends and customer discussions, we expect revenue performance to return to previously expected growth levels as consumption picks up and new business won in Q4 and Q1 is onboarded over the course of the year. On that note, I will take a moment to highlight some of our major new business wins in EMEA, which were again ahead of our internal expectations. First, in the U.K., I'm proud to announce today the signing of Synnovis, a London-based lab providing services to the NHS, which will be adopting our new liquid biopsy application, MSK-ACCESS® powered with SOPHiA DDM™. Synnovis provides lab services to Synlab as well as NHS institutions such as Guy's and St. Thomas' and King's College Hospital. Furthermore, they joined the Royal Marsden Hospital as yet another NHS-related provider to recently adopt SOPHiA DDM. I'm excited to keep you updated on our progress with the NHS in the coming quarters. Speaking of major European healthcare institutions, I'm also proud of the recent announcement we made with Unilab, one of the largest diagnostic labs in Europe, who went live on SOPHiA DDM in April. Unilabs, which conducts more than 221 million tests annually, is the latest of many central labs to have adopted SOPHiA DDM's world-class HRD application. Beyond the U.K., I'm excited to announce today that we deployed SOPHiA DDM in a resounding three new countries in EMEA during Q1. This includes Romania, Norway, and our first customer in Africa, Nigeria. In Romania, Personnel Genetics, a major central lab located in Bucharest and a member of the largest private medical network in Romania, recently adopted SOPHiA DDM's world-class solid tumor and immune classifications. In Norway, Stavanger University Hospital, one of Norway's largest hospitals, adopted our new liquid biopsy application, MSK-ACCESS® powered with SOPHiA DDM™. Lastly, Syndicate Bio, a precision medicine lab in Nigeria, aims to provide cancer testing to over one million cancer patients in Africa each year and also adopted MSK-ACCESS® powered with SOPHiA DDM™. Syndicate Bio joins the SOPHiA DDM community as part of our collaboration with MSK and AstraZeneca, which aims to advance health equity on a global scale by expanding access to cancer testing worldwide. The deployment of MSK-ACCESS® powered with SOPHiA DDM™ in Africa also represents a significant breakthrough on the MSK initiative started more than 15 years ago to improve outcomes for people with cancer in low- and middle-income countries in Sub-Saharan Africa. I'm incredibly proud of this important step towards our mission. All of the progress I've spoken about today regarding SOPHiA DDM liquid biopsy applications and especially MSK-ACCESS® powered with SOPHiA DDM™ has been increasingly impressive, especially when you consider that the application's official commercial launch was only last week. For pre-launch activities, numerous customers have already adopted MSK-ACCESS® powered with SOPHiA DDM™, including BioReference® and Telesioncology in the U.S., Oncolyt in Canada, Dasa in Brazil, Syndicate Bio in Nigeria, Synnovis in the U.K., Stavanger University Hospital in Norway, unnamed customers in France, and SOPHiA GENOMICS in Taiwan. Customers are attracted to MSK-ACCESS® powered with SOPHiA DDM™ for three primary reasons. First, the application leverages our proprietary CUMIN™ and PEPPER™ algorithms to accurately detect variants in blood samples with low input materials and maintain the high level of accuracy of the MSK-access test when deploying it in a decentralized manner. Second, we utilize a tumor-normal approach that removes biological false positives and enables customers to confidently identify relevant alterations while also saving valuable time and resources. Third, MSK-ACCESS® powered with SOPHiA DDM™ allows customers to retain ownership of their samples and data and therefore enables them to develop their own expertise and become lighthouses for precision medicine. As you can tell by the strong progress we've made pre-launch, this unique value proposition is resonating with customers, and our liquid biopsy offering is driving significant demand in the market. This demand was evident during the liquid biopsy launch event we hosted at our offices last week in Rolle, Switzerland, which included attendees from MSK, numerous friends and potential MSK access adopters from around the world, and over 35 key opinion leaders across Europe as well as our biopharma partners. Thanks to those who joined us. We're excited to work together to expand access to world-class cancer testing in the liquid biopsy space. On that note, I want to highlight that the benefits of MSK-ACCESS® powered with SOPHiA DDM™ resonate not only with clinical customers but also with our biopharma customers. Biopharma companies are mutually interested in expanding access to cancer testing worldwide and have demonstrated this by sponsoring the deployment of SOPHiA DDM in several instances. More equitable and accurate diagnosis improves market access broadly. Additionally, more accessible cancer testing enables better identification of patients for clinical trials, which can accelerate the development cycles of targeted therapies. As announced previously, we recently entered a major collaboration with AstraZeneca to sponsor the deployment of MSK-access globally. The contract was finalized last month with a plan to sign numerous institutions across the globe to MSK-access in 2024. MSK-ACCESS® powered with SOPHiA DDM™ offers AstraZeneca a unique platform to accelerate drug deployment and development. For institutions signed as part of this collaboration, AstraZeneca will fund the setup programs and evidence-generation activities. Besides the sponsored deployment of our platform, biopharma companies are also eager to gain access to the genomic and multimodal data produced by our platform as well as the advanced multimodal algorithms that we've developed on this data. Our multimodal data offering provides biopharma companies with critical insights for their Phase II trial and market access needs as our sophisticated algorithms can be used to identify specific characteristics of populations that are failing to respond to current standards of care. Last quarter, I provided an update on a recent project with one of our biopharma partners, where SOPHiA identified a signature in a small population of lung cancer patients, which could indicate different treatment effects of the drug. This has the potential to be valuable to the biopharma customer for both market access and trial design. Beyond our learning capabilities, I'm excited to announce today that we recently signed our first breast cancer pilot. The project will follow a similar approach as taken for the lung project, and we will leverage SOPHiA's multimodal capabilities to identify novel multimodal biomarkers and develop advanced personalized treatment for stage four hormone-positive breast cancer patients. The collaboration will be a proof of concept for applying machine learning approaches to breast cancer patients and verifying that such approaches can identify multimodal predictive signatures of response to therapy. More to come on this topic in the future. Beyond lung and breast, we recently expanded our multimodal offering to kidney cancer as well. In Q1, we announced the publication in Nature's Precision Oncology Journal of a multiyear study between us and the French Kidney Cancer Research Network, UroCCR, in which we analyzed 3,300 kidney patient cases. This helped us develop algorithms to predict postoperative outcomes and validate immuno-oncology pathways facing renal cell carcinoma. Going forward, we're excited to bring our multimodal analytics capability for lung, breast, and kidney cancer, among others, to even more biopharma companies across the globe and capitalize on the large pipeline we have in this area. Along the lines of fueling our future growth, I'm also proud today to make one final important announcement. In light of some of the recent market trends, we believe we are in a position to accelerate our growth through organic and/or inorganic initiatives. We have therefore entered into an agreement with Perceptive Advisors for up to $50 million in debt financing to provide additional capital flexibility to pursue our growth strategy. I'm pleased to further reinforce our already strong balance sheet while providing us with increased buffer and flexibility on our path to profitability. With that, I will now turn the call over to Ross, who will provide more details about our financial performance in Q1 and an outlook for the rest of the year.

Thank you, Jurgi, and good morning, everyone. As Jurgi highlighted, Q1 featured mixed results with strong forward-looking indicators such as bookings, but revenues for the quarter came in a touch lighter than expected. Total revenue for the first quarter of 2024 was $15.8 million compared to $14 million for the first quarter of 2023, representing year-over-year growth of 13%. Constant currency revenue growth was 12%. Platform analysis volume was approximately 84,000 for the first quarter of 2024 compared to approximately 77,000 for the first quarter of 2023. Year-over-year growth in analysis volume was 9% or 11% when excluding COVID-related volume. EMEA and Latin America experienced the softest growth during Q1, partially offset by significant strength in North America and Asia-Pacific, which grew at 44% and 39%, respectively. From an application standpoint, oncology outperformed rare and inherited disorders driven by strength in solid tumor testing. I will take a moment to provide a bit more detail behind the modestly lighter-than-expected volume and revenue for the quarter. I will also share a few more metrics and data points than we traditionally would on leading indicators to provide context for our continued confidence in the underlying health of demand within the business. As Jurgi mentioned, this year got off to a lighter start than expected. As a business that is extra sensitive to working days and weeks, January of 2024 had holidays which extended well into the first week, notably in EMEA. After speaking with many customers, we can surmise that this was at least partially to blame for the soft volumes at the start of the year. In addition, setup times associated with new business have been slightly longer than expected as we see more customers adopting new sequencers and more sophisticated applications. We currently believe this may add up to three months to setup timelines, meaning that we will likely see a larger impact from recent key wins in late 2024 and more notably in 2025. Lastly, we did see one biopharma project unexpectedly delayed as sales cycles appear to be elongating for larger deals, and we have noted prior fluctuations in deal timing that have outsized impacts on our quarterly cadence of reported revenue. Beyond these factors, we are seeing many positive trends in the business. For existing customers, consumption picked up considerably in March, and this momentum continues now into April and May. In addition, many customers have also reconfirmed their volume assumptions for the full year despite the light start. Furthermore, reaction shipments for our bundled solutions were strong in Q1, up 26% year-over-year with even further acceleration exhibited in April. These shipments of partner lab components are typically a reliable indicator of future platform usage. This trend leads us to believe that the usage of the platform should sustain at normalized levels going forward. With respect to new business, forward-looking indicators remain strong. Clinical bookings grew 32% year-over-year in the quarter, nicely above our internal expectations. We also signed 27 new logos in Q1, adding to the 35 new customers we signed in Q4 2023. Lastly, the pipeline for the clinical business grew over 50% year-over-year in Q1, and the pipeline for the biopharma business more than doubled, indicating a healthy and growing end market. Specifically, we are seeing interest around MSK-ACCESS® powered with SOPHiA DDM™ in both clinical and biopharma markets. This marks the second consecutive quarter of strong forward-looking indicators, which in combination with the return to expected consumption levels, actions we are taking to reduce implementation times, and address biopharma delays gives us confidence for a strong back half of 2024. Moving on to an update on other key business metrics, core genomic customers were 463 as of March 31, 2024, up from 437 in the prior year period and up sequentially by 13 customers relative to Q4 of 2023. Our annualized revenue churn rate was approximately 4.5% for Q1 2024, slightly higher than our expectations due to the loss of one customer via acquisition in Latin America. Net dollar retention, which is net of revenue churn for the year improved to 123%, up 1,600 basis points from 107% in Q1 2023. Constant currency net dollar retention, excluding COVID-related revenue, was 122% compared to 121% in Q1 2023. Gross profit for the first quarter of 2024 was $10.4 million compared to gross profit of $9.7 million in the first quarter of 2023, representing year-over-year growth of 7%. Gross margin was 65.9% for the first quarter of 2024 compared with 69.4% for the first quarter of 2023. Adjusted gross profit was $11.1 million, an improvement of 9.9% compared to adjusted gross profit of $10.1 million for the first quarter of 2023. Adjusted gross margin was 70.5% for the first quarter of 2024 compared to 72.5% for the first quarter of 2023. Despite the modest softness in revenue this quarter, we are proud of our ability to manage costs and still compute accordingly to maintain adjusted gross margins above 70%. The comparison for this quarter was also tougher as we recognized the remainder of a one-time benefit to computational storage-related costs from our Microsoft partnership in the first quarter of 2023, which previously benefited gross margins by about 180 basis points. Total operating expenses for the first quarter of 2024 were $29.2 million compared to $29 million for the first quarter of 2023. Across the functions, we continue to benefit from lower headcount on a year-over-year basis. Additionally, I remain pleased with our progress in G&A, where we also continue to benefit from lower professional service fees and the optimization of our public company costs. R&D expenses remained flat this quarter as we continue to focus on increasingly high ROI projects. Sales and marketing expenses were up slightly, primarily due to higher commission payouts on new business wins. Operating loss for the quarter was $18.8 million compared to $19.3 million in the first quarter of 2023. Adjusted operating loss for the first quarter of 2024 was $14.1 million compared to $16.2 million for the first quarter of 2023. We continue to be pleased with our trajectory towards profitability and believe the additional headcount actions we took in the second half of 2023, and incremental discretionary expense controls implemented were necessary to sustain the positive momentum across the balance of 2024. Of note, below the line in this quarter, we did have a significant favorable unrealized foreign exchange gain that benefited net income. Lastly, the total cash burn for the first quarter of 2024 was $19.5 million compared to $16.8 million in the prior year quarter, representing 16.3% year-over-year growth. The increase in cash burn could be attributed to unfavorable foreign exchange translation on cash of approximately $3 million. Excluding this unfavorable FX impact, operating cash burn was down slightly year-over-year in Q1. We remain happy with our cash utilization trend and are on track with respect to our medium-term liquidity trajectory. Cash and cash equivalents were approximately $103.7 million as of March 31, 2024. Turning to our 2024 outlook, given the return to expected consumption levels in March, healthy observed growth in reaction shipments, strong bookings and new logos in Q1, and actions taken to accelerate setup times, we believe we will be able to mitigate the modest revenue shortfall experienced in January over the course of the year. Therefore, SOPHiA GENETICS is reaffirming our full-year revenue guidance for 2024 of $78 million to $81 million or revenue growth of 25% to 30% year-on-year. With respect to seasonality, we now expect revenue to be notably second-half weighted in 2024, with underlying utilization following a typical quarterly cadence while new business will be skewing revenue towards the third and fourth quarters. Additionally, we expect pharma-related revenue to be stronger in the second half, given the recognition requirements of recently signed awards as well as elongated new business timelines. We would also note FX has weakened modestly from our original expectation, creating an incremental headwind in the second quarter of a few hundred basis points. Following our solid cost performance in Q1 2024, SOPHiA GENETICS also reaffirms our adjusted gross margin guidance in the range of 72.5% to 72.7% as well as our adjusted operating loss guidance of between $45 million and $50 million loss. Furthermore, we remain confident in our medium-term path to adjusted operating profitability. We have taken the necessary cost actions to expedite that goal and continue to be focused on capital efficiency. This requires sustaining medium-term revenue momentum at our previously communicated targeted levels while ensuring a reasonable time frame to cash flow generation. To achieve this in 2024, we will continue to revisit our discretionary expenditures and identify savings in systems, professional services, and certain public company costs. The combination of these items and the natural operating leverage in the business resulting from strong revenue growth will further our path to adjusted operating profitability in the next two-plus years. Lastly, I'm pleased to share that we have recently entered into an agreement with Perceptive Advisors for up to $50 million in debt financing to provide additional capital flexibility to pursue our growth strategy. This may include both organic and inorganic growth efforts. As part of the agreement, we will be drawing $50 million immediately with an additional tranche of $35 million available through March 2026 for us to pursue the right opportunities. The interest on the loan is payable in cash on the outstanding principal amount at a per annual rate equal to the sum of the higher of the applicable secured overnight financing rate or the minimum floor rate of 4% plus 6.25%. Under the terms of the agreement, Perceptive has been issued warrants to purchase 400,000 shares of the company's stock as of the closing date with an exercise price equal to the 10-day volume-weighted average price preceding the closing date. Warrants to purchase 200,000 shares will be issued immediately and warrants to purchase an additional 200,000 shares will be issued upon drawing of the subsequent tranche. In addition, this transaction further reinforces our already strong balance sheet, and we're pleased to have the support of Perceptive, a recognized leader in growth capital financing. With that, I would like to turn the call back over to Jurgi for the closing remarks before we take your questions.

Thank you, Ross. While our performance this quarter was mixed, we remain quite optimistic about our path forward. SOPHiA's success stands on our ability to expand access to data-driven medicines by using AI to deliver broad care to patients across the globe. In closing, thank you to our SOPHiA colleagues, partners, customers, and investors for joining us on our journey. Without you, none of this would be possible. Please note, we are presenting at the RBC Healthcare Conference next Tuesday in New York City. I look forward to continuing to update you on SOPHiA's future success in democratizing data-driven medicine. Operator, you may now open the line for questions.

Our first question today comes from Conor Noel McNamara from RBC Capital Markets.

Ross, thanks for some of the clarity on the quarterly results. But can you just talk a little bit more about the revenue rate this year and your confidence in hitting full-year guidance? How much is from trends you saw in March and April with existing customers? And how much impact are you expecting from your new logo wins, which have been very strong in the last two quarters?

Yes. Thank you, Conor. This is Jurgi. As you may remember, most of the revenue we do in a given year is with customers we have signed in the previous year. Now said that, this year, we expect a strong back-end given the number of new logos we signed in Q4 2023 as well as in Q1 2024. As we highlighted in the call, in Q1 2024, we signed 27 new logos, and in Q4 2023, we signed 35 new logos, compared to a historical average of 17 to 18 new logos per quarter. We expect the utilization to continue to grow. We mentioned that we had a weak January for diverse reasons, but March was already much better, near 30,000 analyses per month, and we saw this trend continue into April. In terms of utilization, we're very confident that this will continue to fuel our growth for the next quarters. We mentioned that the conversion from bookings to routine usage has been weaker than expected, but we have taken actions now, and we have a full team of professional services executing MaxCure. So we expect these delays not to be extended. The very strong performance we had in bookings highlights that the second part of the year will be strong in terms of utilization and revenue.

I would add that if you think about what I noted in the script on reaction shipments, which is an indicator from our customers on forward utilization or future analysis volume, that was running in the high 20s. The exit velocity of the quarter was quite good. When we had originally guided, we had already contemplated in the guidance a relatively back-half weighting to the revenue forecast. Excluding the volume weakness in January, Q1 played out generally as we had expected. Obviously, that seasonal weakness we saw was pronounced. With the exit velocity and comments that Jurgi shared on forward indicators, we feel good about the continued ramp back of the business to more normalized growth rates. And again, Jurgi mentioned other mitigation efforts, so we maintained the guidance.

All right. Very helpful. And just one question on testing. Do you anticipate any impact on testing volumes as a result of the recently proposed LDT regulations by the FDA?

Yes. Thank you, Conor. That's something we and many others are following closely. At SOPHiA, we have always strived for high standards because we believe that this is what is required to create trust in our industry. We welcome the recent developments in the U.S. It is similar in Europe with IVDR. We believe that standardization will make the market larger because it becomes more comprehensive for a broader audience and potentially a wider set of patients that will benefit. I would add that our customers in the U.S., which would be the first ones impacted, are large academic centers and large reference labs, which are very well equipped for the new legislation and should benefit from this legislation with increased demand for sample testing.

Conor, we saw very strong volume growth in North America and particularly in the U.S. all quarter. While we experienced some seasonality in EMEA, the U.S. business was across all applications quite healthy. Therefore, you're not seeing any change in behavior regarding the LDT legislation. As Jurgi mentioned, there are still elements of that legislation that need to be sorted and firmed. However, we see this as a long-term positive for us.

Our next question comes from Tejas Savant from Morgan Stanley.

This is Yuko on the call for TJ. For the lab setups that you have undertaken that involve sequencing platforms from emerging vendors, you noted that these setups take approximately three months longer. Approximately what proportion of new logos are incorporating emerging sequencing platforms? And do you expect this dynamic to be more pronounced in one region versus another?

Yes, very good question. The sample data we have today is not yet large enough to give precise numbers. However, while Illumina sequencers dominate, we observe more customers adopting alternative types of sequencing technologies. In particular, MGI and Element are gaining traction, and we hear a bit more about PacBio's recent developments. Regarding regions, the U.S. still prefers Illumina, but we see increasing competition in other regions. Our view is that this will likely expand the market and create healthy competition between vendors, providing more data for us to compute.

Great. With the new debt providing up to $50 million in financing, does M&A optionality come into focus for you? Could you remind us how you decide what to build in-house versus to acquire?

Yes, Yuko, I'll start and then let Ross recap some specific details of the financing. At SOPHiA, we've proven to be eager to develop capabilities externally. We apply the principle of open innovation at different levels. Historically, we acquired a company called Interactive Biosoftware, which brought us technology now widely utilized globally. We applied similar strategies for multimodality and developed technology from a renowned French institute. Regarding the MSK Access technology, it was developed by an academic center and embedded within our platform. To directly answer your question, there are specific technologies, especially tech-related ones, that we prefer to develop internally such as microservices and algorithms. Beyond that, we are eager to accelerate our growth by potentially acquiring other companies that enhance our journey in specific applications or market segments. Ross, do you have more information on the debt financing?

Yes, so to address also the nature of your question, our focus is on creating shareholder value sustainably. Consequently, as we evaluate organic versus inorganic initiatives, we remain sensitive to dilution and our cash burn as well as our path to profitability. Therefore, any initiative must align with our strategic plan, and we will not deviate from the path to generating cash flow and becoming self-sustainable. We are seeking high ROI transactions. In the current climate, many businesses are struggling with capital access, which presents an opportunity for us to find value-enhancing acquisitions that align with our profitability goals. But we will remain disciplined and happy with our current level of R&D investment and pipeline.

Our next question comes from Dan Brennan from TD Cowen.

This is Kyle on for Dan. I hope you're feeling better. I had a clarifying question on the customer setups. You mentioned that some are taking longer than anticipated. Is that incremental to the commentary provided in the last quarter or is this in line with your thoughts from the past few months?

Yes, thank you, Kyle. I do feel better. This situation is consistent with what we thought last quarter. The type of new applications like MSK Access require proficiency testing with more sophisticated samples, especially with the new FDA regulation. This has led to some delays, but it's not about the technology readiness. It's more about the customer process needing more hand-holding to smoothly navigate the proficiency testing.

Got it. Regarding volume, could you speak to which applications are performing the strongest currently?

Nearly all applications have been growing year-on-year. The strongest growth has been in solid tumor HRD testing, which has seen strong double-digit growth. Overall, solid tumors have exhibited strong double-digit growth as well. Inherited cancer testing has also seen strong single-digit growth, with expectations of further growth due to consolidations potentially benefiting sample access and utilization for SOPHiA DDM. Liquid biopsy is still in its early stages, given we just launched the MSK Access application last week. Despite that, we signed a total of 13 new customers for liquid biopsy and 9 specifically for MSK Access across various regions, showing strong pipeline growth.

On top of the volume growth, if I analyze Q1 bookings, which we don't often discuss, it is relevant this quarter due to the disconnect between the consumption seen versus the new business coming online benefiting us later in this year and into 2025. We observed a balanced contribution across regions as well as applications. Each application set is seeing healthy growth in their booking contributions that are balanced, including rare and inherited categories. Overall, while some short-term headwinds were experienced, we have a very healthy and balanced pipeline across our major application sets.

Our next question comes from Mark Massaro from BTIG.

This is Vidyun on for Mark. Just curious, you called out a tougher macro environment for biopharma. How should we interpret that contribution throughout the year, either by revenue or in terms of customer count? And how should we size that headwind?

Indeed, one factor we highlighted during our earnings was biopharma and particularly large deals. Various companies in this space have noted the need to implement cost control measures, leading to elongated contracting times due to complex MSAs. Despite the challenges, our data offering pipeline has grown significantly over the last quarter. Catalysts beyond lung data offerings include breast, where we initiated a pilot with a partner. We announced new capabilities and will generate demand at ASCO. While biopharma deal complexities may extend timelines, we believe our MSK Access will be a critical element for biopharma in compound development.

We had a very robust 23% growth in biopharma last year. We began this year aware of the tough comparisons, especially in the first half. This segment remains somewhat volatile, predominantly due to the size of contracts. Delays in clinical business can mean a $100,000 or $200,000 variance while biopharma deals have larger financial impacts. We're committed to monitoring this area, mitigating our challenges, and aligning with our guidance for the year, although we need developments on the biopharma side for this forecast.

Perfect. That makes sense. Regarding MSK-Access, what does the early feedback look like, and how should we size the pipeline for that offering? Could you also remind us of its ASP profile?

The early feedback on MSK Access has been overwhelmingly positive. We hosted an event last week with 30 key opinion leaders from various institutions and biopharma partners. Initial data presented showed incredibly high sensitivity and specificity from two of our customers. They were very impressed with the application, and MSK itself is actively advocating for its decentralized adoption, which helps accelerate patient recruitment for clinical trials. Notably, we've already signed 9 customers for MSK Access globally, and its average selling price is significantly higher due to its sophisticated nature, positively impacting our overall ASP once utilization ramps up around Q3 and Q4 this year.

And ladies and gentlemen, with that, we're showing no additional questions. We'll end today's question-and-answer session. I'd like to turn the floor back over to management for any closing remarks.

Thank you all for joining us today. Next week, we will be in New York for the RBC conference. To recap, although revenue was lighter than expected, business momentum is strong in terms of pipeline and bookings. Our cost and loss performance have also significantly improved. As Ross mentioned, we remain committed to sustainable growth with a path to profitability in the next two-plus years. Thank you very much, and have a good day.

Ladies and gentlemen, with that, we'll be concluding today's conference call and presentation. We do thank you for joining. You may now disconnect your lines.