Operator
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 SOFIA Genetics 4th Quarter and Full Year 2025 Earnings Conference Call. At this time, all participants are in listen-only mode. Following the presentation, there will be question and answer session. Should you require any operator assistance, you may press star zero. I will now turn the conference call over to Colin Sanger, Sophia Genetics VP of Strategy. You may begin.
Thank you, and good morning, everyone.
Speaker 6
Welcome to the Sophia Genetics fourth quarter and full year 2025 earnings conference call. Joining me today does the results for Dr. Yergi Kambong, our co-founder and chief executive officer, Ross Mukin, our company president, and George Cardosa, 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 meetings 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 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 price leaves, which is available on our website. With that, I'll now turn the call over to Yergi.
Thanks, Kellen, and good morning, everyone. I will start today's call with a brief overview of how exiting 2025, Sophia 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. We re-accelerated revenue growth and 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 SOFIA 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, and like other industries, requires rigorous validation, clinical evidence, and deep institutional trust before change is enacted. At SOFIA, 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 multilayered analyses of genomic and multiomic 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 one petabyte of genomic data in routine usage. To put that in perspective, that's roughly equivalent to one billion books or 30 years of continuous high-definition video streaming. It is also nearly double the amount of data we processed just two 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 analyses, 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 this trend, 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 wall genome analysis can take over 24 hours, we can now complete a wall genome analysis in less than six 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 two of the largest healthcare systems in the U.S. It also has enabled us to expand our adjusted gross margin by 140 base 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%, and annualized revenue churn is below 1%. These metrics underscore the speed, scalability, and thickness of SOFIA 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 World 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 SOFIA 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, 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 SOFIA 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 Muchen to Chief Executive Officer, effective July 1st. Ross, who currently serves as our company president, has been instrumental in SOFIA'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-orientated 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 aid, 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 SOFIA 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 is and how there's truly no other company like it. From our technology to our customers to our employees, Sophia 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 then cover our 2026 growth drivers before handing it over to George 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 is 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 JESA, 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 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 Adam 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 phase. 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 analyses. We looked 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 customer signed in 2025 was up 120% year-over-year. I'll now take a moment to update you on recent major wins across the region. 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 sexome 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 Prodi Lab in Florida's 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's world-class AI and algorithm capabilities to develop TEP, which we can then activate across our customer base. From an expanded 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 in 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 Cytogen 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 Paralopath in Austria, AZ Delta in Belgium, and Circulo Hospital and Machi Foundation 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 sign the Human Genome and Stem Cell Research Center. We also added the National Institute of Genomic Medicine for 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 McCallum Cancer Center, 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. And 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 Atom Innovations in Japan to develop MSK access into a regulated global companion diagnostic offering. Activities are progressing well, and interest from Biopharma in this product is very high, which brings me to our final growth driver for 2026, Biopharma. Biopharma's demand continues to build. At the J.P. Morgan Healthcare Conference in January, I end up with over 20 Biopharma companies exploring partnerships with Sophia. Our value proposition is now well understood, and 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 P10 pathway, and the signing of a multi-year AI-driven evidence generation project for breast cancer, which we mentioned was the largest contract in Sophia'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 five 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. Described 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 expanded 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, and good morning, everyone. As Jurgi and Ross highlighted, 2025 was an exciting year of growth for Sophia Genetics. 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%. Growth 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 continue to negatively impact reported OPEX, primarily due to the strengthening of the Swiss franc. The Swiss franc is appreciated by 14 percent since the start of 2025, which means that our payroll and rent expenses in Switzerland are translating 14 percent higher when viewed in U.S. dollars. In addition, Garden 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. However, in January, the UPC rejected Garden's request for provisional measures and ordered them to pay us 400,000 euros in interim costs, which we expect to receive by mid-March. Last, we also activated an at-the-market or ATM facility with TD Cowan in Q4. We incurred 450,000 of costs associated with the ATM facility in Q4, but 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 of 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 four percent despite the garden 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 percent platform analysis volume was over 391 000 for the full year 2025 compared to 352 000 in 2024 Originomic customers were 528 as of December 31, 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 U.S. 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 U.S. 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-in-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. Now I'll turn to our 2026 outlook. As we announced in January, Sophia Genetics expects full-year reported revenue to be between $92 million and $94 million, representing 20% to 22% growth. Let me provide a few key underlying assumptions relative to our revenue forecast for 2026. First, 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 had. However, 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. Second, we currently contemplate that exchange rates will remain volatile due to macro uncertainties. Since January 1st, 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 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 unidentified 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 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 the closing remarks before we take your questions.
Thank you, George. I am confident as ever in our long-term trajectory, and 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 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 Bioforma 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 SOFIA team, customers, partners, and investors for your continued trust and partnership. Fifteen 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 TDK1 Healthcare Conference tomorrow in Boston. We all look forward to continuing to update you on Sophia's future success. Operator, you may now open the line for questions.
Operator
Thank you. In a moment, we will open the call to questions. If you would like to ask a question, please press star 1 on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star 2 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 Subbu Nambi with Guggenheim. Please go ahead.
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?
We ended up the year very strong with 31% revenue growth year-on-year on Q4. and with, as well, signings where the ACV has been very, very strong, 120% battery in 2025 versus 2024 full year. And so this is now well-positioning us for basically a 2026 performance.
So I know, Ross or George, if you want to comment on the guide. Yeah, so maybe just specific to the point you made, so the ramping of MSK access continues to be a really nice driver. You mentioned impacts of CGP. we've had some really material wins, both in XUS as well as in our native markets. And so I feel quite confident we're gaining share in that vertical. And I think in general, you're seeing a shift again to kind of larger and larger panels in solid tumor. And 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 Yergi's point, the entire platform has had really nice growth across almost all of the application sets, right? So it's really been quite balanced. Those points you made are obviously some of the true highlights. But, you know, even on the rare and inherited side, we're seeing really great uptake in our enhanced exome product. And that, you know, was one of the key drivers behind the two big U.S. wins. we called out several weeks ago. So 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, megatrends you're seeing across oncology diagnostics and NGS that you see with many of the other key players that you cover. So 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, but the net dollar retention was up meaningfully to 115%. Can you speak to a bit to what drove the gross selling strength here and if you expect this to continue in 2026? Thank you so much.
Yeah, so we're super pleased, Subu, with the reacceleration 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. And so, first part that we're incredibly proud of, the churn is now actually under 1%. I mean, this is like 99th percentile performance for software. And so, 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 reacceleration of volumes within sort of NGS oncology and rare disease. Getting from that, and then I would say it's 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? And so, of new logos or new accounts we've brought online, you know, north of 200 over the last two years. So there's just huge expansion of potential, which you'll see come through on the end.
Thank you so much for that, guys.
Operator
Thank you. The next question comes from Bill Bonello with Craig Howlum. Please go ahead.
Hey, thanks for taking my question. So 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?
During, 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, a bit of time with many of the top 20 pharma. And I would say finally, our story is really resonating. And I think there's really a whole business where we can scale. So I think on the product market fit, you know, sort of that being said, you know, so it is long cycle business. We are trending in the right direction. I do think, you know, obviously the contribution into 26 will be a net positive for biopharma, which is important. But certainly, you know, we're not in a position yet where we're looking for a hockey stick, right? So obviously, we're, you know, we're doing all of the right for a pretty nice reacceleration in later 26, 27 and beyond. But 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 percent of revenue. You know, aspirationally, you know, we think pharma could be a much higher percentage of total revenue, certainly much greater than where it is today. We're at a point yet where we can exactly point to that. But 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. And then just on the two large health systems that you added, and thanks for talking about what indication it is that they're using, potential that those customers may want to eventually expand into additional indications and sort of what the, you know, what the decision one way or another. there?
Sure. So 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. But this is starting with just one application, right? So if you look at the growth we had in the period, particularly volume in the U.S., any of that volume starting, we're really excited about just the magnitude that this can bring just, again, with one application. So 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. And I'm super, I would say, optimistic that we'll be able to, you know, grow these accounts materially over time. We were looking and we'll share in the investor deck and some of the cohort analysis over time. And I think what you'll see is our ability to really over multiple periods to grow that initial volume uptick through the increased ASP vacation expand. I mean, these are both accounts that, you know, if we were to fully penetrate them, could be certainly, you know, in the eight-figure range. So 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, you know, I would say, really attractive. If you think coming off of last week at AGPT, for new platforms coming online on the sequencing side and the complexity of the chemistry and all of the new applications, MRD, transcriptomics, et cetera, you know, the ability to do all of that in one platform at, you know, where reimbursement's been attractive, this is a very near-term trend for us, and we would expect this to accelerate to others.
Operator
Thank you. The next question comes from Daniel Brennan with TITICO, and please go ahead.
Great. thanks for the questions. Congrats, Jurgi and Ross. Maybe first one, just on volume price mix for the 26 guide. So volumes, I think, grew, what, 16% in Q4, up low double digits in 25. What does the guide contemplate for volumes and price mix in 26? And given the push with MSK and liquid biopsy, should we expect price mix growth to accelerate as we go forward from here.
We recommended that people do continue to assume that our ASPs are going to increase again. We're concentrating on selling higher price tests like MSK Access, MSK Impact, and the Impact Flex product that we have. So we do expect lift from those higher, you know, these ASPs are much higher, in some cases 2X. S2, 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. So that sort of tempers it out a bit. But 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. So I figured the rest of that revenue growth is going to be coming from the ASP lift.
Okay. Maybe second one for Ross. So 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 But if we look out a year or two, and then we're looking back at what transpired, do you think we'll see any potentially meaningful changes? Kind of what type of, not stamp, but how will your approach possibly be similar to Yergi and or maybe different? Thank you.
Thanks, Dan. And, you know, I've still got a few months before I take over. And so I would say to have Yurgy 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. So, look, I would say in general, I'm fortunate in that the transition is happening in a period of great strength for the business, right? And so we have a ton of momentum at the moment. I think the real focus is all right. So, 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 a full-year basis. You know, how do we then scale materially from there, right? And so 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 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. And so 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, a thousand institutions connected around the world. And so 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, not just in sort of the traditional business in precision medicine, but, 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 ADC category with computational pathology and digital biomarkers. Or you look at, you know, the desire to create, again, these more complex algorithms for patient stratification or patient segmentation and 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. And so 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 with the investments you make. I would say with our confidence in that crossover to profitability in the near to medium term, you start to get a lot more capital freed up to make some of those investments in bets. And so, it's 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.
Operator
Thank you. The next question comes from Mark Massaro with BTI. 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. So can you just give us a sense for where you are now with your go-live implementation timelines? And 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 make them go live in 2026?
Good morning, Mark. And absolutely, right. Turning customers in routine has always been part of our business model. As you know, we're being paid on usage. So first we land customers, we sign them, then we implement the platform on the customer side. And then we start seeing revenue coming up. So 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. And so the KPI you're highlighting in terms of implementation is obviously something we scrutinize a lot and it's very important. And 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 to the implementation. Yeah.
So, Mark, if you look, we were able to complete north of 100 implementations this year, and that was up pretty materially year on year. But if you look at the sequential cadence of all we did in the second half, it was materially above the first half, right? of the actions we took starting in kind of the first part of this year, particularly in the second quarter, really started to pay off. And we'll see that momentum continue into 2026. So we're starting to see essentially the amount of revenue released per month, similar to the amount of booking 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. So 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, from a long-term perspective, future-proofed and things that are more standard for us. So you think about, again, MSK Impact, MSK Access, Enhanced Exome, et cetera. These are products or a 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. So 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. And then, 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 expected 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%? And then 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? the US clinical market should be our biggest market. As you remember, we started in Europe, developing technology there, and really penetrated the US from 2022 post-COVID. But yes, to your point, the US market should be significantly bigger with our model. And 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 growing those podiums, Ross?
So 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? So 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? And so 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. And so in that vein, Mark, again, just to remind you, we don't necessarily view ourselves competing, right, with the sendouts because in general, some of them actually use us as well, right? So it's really our customers that are competing with each other. So for example, those two large entities these we talked about in the U.S., with large laboratories doing 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, will at some point be the largest sort of precision medicine, you know, platform and laboratory in the world, right? Just because we're serving an entire globe, not just regions of the U.S., et cetera. So I think with that, it gives us a lot of flexibility. But I will say, Mark, You know, last 12 months, you're really seeing an inflection in the U.S., right? So 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. But 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? And I think we probably will is the answer. But, you know, when I look at what others are doing versus us, it's a very different sale, right? So for us, if I add two FTEs to the calling on clinicians, right, they're not calling on oncologists, we're signing entire health systems. Take up a million patients, or in this case, you know, in the two institutions, 60,000 patients. At a send-out laboratory, you'd need many, right, because you'd be calling on the clinicians. And so we get much better operating leverage on that. And so I would say it's astute of you. So we're certainly going to be adding, and I think it's one of the only few places in the entire organization we're adding headcount. But, again, if you're thinking of quantum, I don't think we're going to be adding 100 feet on the street. I think in our model, we're pretty well scaled, and we can add incrementally. And that new salesperson at productivity adds quite a bit of revenue per salesperson. And so we're excited about that from an efficiency standpoint.
But thanks for the time, guys. Thank you, Mark.
Operator
Thank you. We have reached the end of the question and answer session. Let me transfer the call over to Juriji Kambla, 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. And to remind you, tomorrow we are attending the TD K1 Health Care Conference in Boston, and we will be happy to see you there and take your questions.
Operator
This concludes today's conference, and you may now disconnect your lines at this time. Thank you for your participation.
