Q4 2019 Earnings Call
consistent with
Our values of putting patients first, I will start our call with a patient story about fifteen years ago a forty forty eight year old woman was diagnosed with hormone receptive her2-negative stage 2 breast cancer following a mastectomy a number of grounds of adjuvant chemotherapy and treatment with aromatase inhibitor for five years or cancer was in remission. She was monitored regularly by her position back in 2017. She presented with pain in her joints and shoulders. Unfortunately, her cancer had returned. It was metastatic and progressing rapidly after failing to respond to chemotherapy from coal just ordered a garden 360 test which quickly identified a Pick 3 c a mutation. She was immediately started on a recently-approved combination therapy for patients with her profile and had a comedian response. We believe this story demonstrates the growing importance of the Precision medicine Paradigm and oncology patients, not just with lung cancer, but across many cancer types.
It is our mission at Garden.
To Conquer Cancer with data to achieve that goal. We are developing products across the Continuum of Cancer Care to inform treatment and Interventional decisions and ultimately transform patient outcomes wage 2019. We experienced incredible growth across our platform and ended the year with $214 in Revenue up 137% from 2018 an advanced cancer setting we have been laser-focused and Shifting the market to a blood first Paradigm for genotyping which we believe will be key to further accelerating the adoption of liquid biopsies early on Thursday focused our efforts with Garden 360 and non-small cell lung cancer where we believe the limitations of tissue created a critical Gap and comprehensive testing through Investments and high-impact clinical studies were able to quickly establish clinical utility and lung cancer, which in turn has helped decrease time to reimbursement improve position conversion efficiency and lead to record clinical adoption.
specifically
Getting of 2019 we published the results from our Nile study that demonstrated hi concordance of tissue testing and faster time to results following the publication of Niall. We saw a significant uplift and clinical volumes over the course of the year. I definitely Nile along with our fifty outcome studies and a hundred fifty Publications led to continued progress on the reimbursement following our Medicare LCD for non-small-cell lung cancer in August of 2018. We made significant Headway with private Pairs and ended 2019 with more than a hundred and seventy million lives were Garden 360 heading into 2019. We also increased our commercial efforts and saw early gains from these Investments over the course of the year as a result of this month is clinical volumes regarding 360 grew 69% in 2019, 240 9926 clinical tests.
At the same time. We also made important progress in our biopharma business. We ended the year with more than fifty biopharma partners with various collaboration projects spanning perspective screening rep active analysis companion diagnostic development and Commercial collaboration opportunities as a result of this progress biopharmaceutical volume through 99% during 2019. 8643 tests during 2019. We also made important progress with our lunar programs initiating our Eclipse study and launching a clear version of our lunar one. I'm I'm very proud of the garden team for the tremendous Headway made throughout the year that said there is still a great deal of work to be done. And we believe we are still at the very beginning of this opportunity with the unfortunate reality. Is that for the seven hundred thousand patients living with metastatic disease of solid tumors. The majority are not receiving guideline recommended genomic testing.
for example
Based on recent studies published in collaboration with Cota less than 8% of lung cancer patients and less than 40% of colorectal cancer patients are in compliance with nccn guidelines for biomarker testing. I'm heading into 2020. We are working to further shift the market toward a blood first Paradigm and increase the number of patients receiving guideline recommended genotyping we expect contributions from the recently finalized pain cancer Medicare LCD expansion to progression testing and upcoming targeted therapy approvals to further Drive demand for comprehensive genomic testing off last December. We were happy to announce a critical milestone for liquid biopsy with the finalization of our pan-cancer medical LTD from Palmetto GBA. We believe this LCD Garden 360 the first and only liquid biopsy to be broadly covered for use across the vast majority of advanced solid tumors in the first line setting similar to our experience following the first LCD pronounce, ma'am.
colon cancer we expect the
Expanded policy to result in a significant step up and test furthermore we expect this Milestone will Usher in a new tail winds to further expand our current and future private payer coverage Beyond lung cancer. Importantly. The Medicare will be X LCD decision also covers repeat testing for patients progressing in their disease after initial treatment to help identify with their treatment options based on newly acquired tumor mutations. Finally. We also expect that upcoming targeted therapy approvals and lung prostate and colorectal cancers long will further Drive demand for comprehensive genomic testing and the research setting we are encouraged by the increasing demand for our products from our biopolymer partners, especially Garden Omni, which is increasingly become the Workhorse for many clinical-stage programs. Overall. I have never been more excited about the opportunity ahead of us at gardened as we look to the year ahead. We expect Revenue phone number.
Thousand twenty to be in the range of $275 to $285 million lastly as announced in a press release this afternoon. Derek is planning to
Retire in the second quarter of this year a search for a new Chief Financial Officer is already underway Derek plans to remain at Garden until a successor is hired and support the company during this transition. I would like to take a moment to thank Derek for his leadership and contributions for over almost four years, which have been instrumental to the company's growth with that. I will now turn the call over your alley for more detail on our biopharma Partnerships and lunar program.
Thanks, help me just as tissue poses a challenge for genotyping clinical care. It also poses a challenge to buy a market-driven clinical trial enrollment. We believed liquid biopsies can address this Challenge and significantly actually the identification of eligible patients. In fact recent data from our Priscilla study presented at home. You must traded plasma genotyping with Guardian 360 was associated with a higher clinical trial enrollment rates in advanced GI cancer.
In this one.
103 patient umbrella basket study Garden 360 down the same proportion of patient with targetable alteration as tissue genotyping three times as quickly as a traitor more by removing barriers associated with tissue biopsy Garden 360 double the rate of enrollment.
Crucially patients enrolled with liquid biopsy demonstrated comparable overall response rate to those enrolled with tissue.
Liquid biopsy testing can also identify more patients for whom they are approved therapies available. We believe that overcoming tissue limitations together with our rapid turnaround time and Broad commercial reach is increasing interest in gardens as a companion diagnostic partner.
In early January we announced his strategy collaboration with Amgen to develop companion diagnostic claims for garden 364 inhibitor AMG 5 or 10 in non-small cell lung cancer.
We believed.
Did they have a little bit of garden 360 CDX with ultimately increase the number of patients who are identified as eligible for a AMG 510 as a Target therapy thus improving access to this potentially life-changing treatment for the 13% of the lung cancer patients with this biomarker.
We expect to work with engine to support filing in the United States Europe and Japan.
Now turning to our lunar program and starting with lunar one. When where we are developing and a safe or excellent therapy decision-making and recurrence monitoring committed to generating evidence based on Interventional studies to establish clinical utility of residual disease testing, which will be a critical component to drive sustained long-term adoption the space as for our clinical development and Commercial path for garden 360 where we started with lung cancer. We are taking a similar approach with our loaner programs which as the lead indication.
in early January we were very pleased to announce the initiation of
Incorporated city which we launched in collaboration with energy oncology We Believe Cobra to be a first-of-its-kind randomized control study aiming to establish clinical utility for the detection of ctdna in adjuvant setting in colon cancer, the C prospective study that will enroll over 1400 stage 2 colon cancer patients to systemically. That's our my if detection of ctdna post-surgery followed by a treatment can lead to better outcomes than active surveillance alone.
We are all so excited to announce our collaboration with standup2cancer MGH and Dana-Farber Cancer Institute. And I have a prospective intervention study to manage adjuvant treatment in stage 3 colon cancer patients based on detection of ctdna post-surgery if successful we expect these studies will validate the clinical utility of residual disease based on as a biomarker to manage adjuvant chemotherapy. We are excited to be partnering a potentially groundbreaking doing everyone studies.
now moving to
Doing there to diligently at matzinger colorectal cancer screening program and are continuing to make important progress in our Eclipse study with more than Thursday many sites are ready enrolling patients eclipse is a prospective multi-site registration study designed to play a pivotal role in a potential FDA submission and South part for coverage by CMS of our lunar to a safe for use in colorectal cancer screening in average risk adults.
I would like to Welcome, North Korea as Gardens new Chief Information officer.
A monkey's responsibilities commode will lead our Enterprise application and software development information technology and security teams. I'm confident in our ability to lead our digital Innovation and to scale up our data infrastructure as we prepare for the next phase of our growth with that. I will now turn the call over to the record. She took more detail on our financials Derek. Thank you and me really
Revenue
The fourth quarter of 2019 totaled 62.9 million up 91% from 32.9 million in the prior-year quarter.
Fourth-quarter Revenue included 1.3 million of cash payments received from successful appeals of payers denials reimbursement for samples processed in 2018, Given the age of the samples associated with these successful appeals. You do not believe this appeals revenue is indicative of our ordinary course of operations.
Total Precision oncology testing revenue for the fourth quarter was 57.4 Million up 104% from 28.1 million in the prior year.
Precision oncology revenue from Clinical tests in the fourth quarter total 31.3 million up 81% from 17.3 million with the prior-year quarter past due primarily to an increase in test volume this included the 1.3 million of revenue from successful appeals for samples process in 2018, fourth-quarter. Clinical Precision, oncology volume total 15270 tests up 78% from 8596 tests in the prior-year quarter off.
Precision oncology revenue from biopharmaceutical tests in the fourth quarter total 26.2 million up 142% from 10.8 million for the prior-year quarter due to an increase in test volume for both Garden 360 and Garden on me.
Fourth-quarter biopharmaceutical Precision oncology volume totaled 6316 tests up 108% from 3433 tests with the prior-year quarter.
Average revenue recognized for biopharmaceutical test in the fourth quarter was $4,142 up 16% from $3,571 in the prior-year quarter.
The increase was primarily driven by selling a greater proportion of garden to Omni tests, which have a higher selling price and garden 360 tests compared to the same period of the prior year.
Development services Revenue in the fourth quarter totaled five point five million up 15% from the prior-year quarter. The increase was primarily driven by an increase in projects from a pharmaceutical customers active in 2019, mainly for companion diagnostic development and regular and related regulatory services.
Gross profit is total revenue less cost of precision oncology testing and cost of development services gross profit for the fourth quarter of 2019 was 41.1 Million month compared to a gross profit of 18.9 million in the same period of the prior year.
The gross margin in the fourth quarter was 65% as compared to 58% during the fourth quarter of 2018.
These results are inclusive the benefits of the 1.3 million of appeals Revenue.
Gross margin Improvement was primarily due to due to reduction in the cost of precision oncology testing during by production efficiencies as well as the increase in average revenue per biopharmaceutical test due to the greater proportion of garden only tests.
As a reminder effective January 1 2019. We adopted the new Revenue accounting standard ASC 606 using the modified retrospective method which means that Revenue reported for 2018 is not restated in our 2019 financial statements instead the accumulate a difference resulting from applying the new Revenue standard wage to all contracts that were not completed. As of adoption was recorded to opening accumulated deficit as of January one 2019. The effect of the adoption of Life 606 was to increase Revenue by 1.3 million compared to the revenue that would have been reported without adoption of a sec. 606
effect this change
disclosed in our Q4 results press release
Total operating expenses for the fourth quarter of 2019 or 67 million a 45% increase from 46.3 million in the fourth quarter of 2018.
R&D expenses for the fourth quarter of 2019 with 25.9 million compared to sixteen point seven million in the fourth quarter of 2018.
Increase was primarily attributable to work performed for preparing regarding 360 submission to the FDA development and clinical studies for the lunar program and additional clinical studies and improvements to processes and products.
Sales and marketing expenses for the fourth quarter of 2019 with 22.3 million compared to 17.1 million in the fourth quarter of 2018. The increase was due to age increase Personnel costs related to expansion of our commercial programs to drive increases in Revenue.
General and administrative expenses for the fourth quarter were eighteen point nine million compared to twelve point five million in the fourth quarter of 2018.
this in
Increase was primarily due to increases in Personnel Professional Services, including legal and accounting in additional compliance costs required to support transition to a large x-rated filer.
Net loss attributable to Garden Health common stockholders was 25.2 million unchanged compared to the fourth quarter of 2018 includes a charge of 3 + 1 million in the fourth quarter of 2019 compared to a benefit of 0.1 million in the fourth quarter of 2018 for change in the fair value of SoftBank softbank's ownership in order to Adventure.
Mazda Tribute able to Garden Health common stockholders was $0.27 in the fourth quarter of 2019 as compared to Thirty cents in the corresponding period of the prior year off.
Turning to the full year 2019 revenues were two hundred fourteen point four million a 137% increase from 90.6 million and 2018 Prestige oncology Revenue increased 130% 180.5 million.
Volume for the year grew to 49926 tests up 69% year-over-year from 29592 tests.
The average revenue recognized protest in 2019 Rose 38% from the prior year as a result of Revenue earned from tests reimbursed by Medicare for lung cancer patients charting in the fourth quarter of 2018 increases in commercial payer payments that were been officially affected by the protecting access to Medicare act 2014 month and 6.8 million of revenue from successful appeals for samples processed in 2018.
Clinical testing Revenue in 2019 totaled 101 million which includes the 6.8 million of revenue from appeals of 2018 samples given the age of the Samsung associated with the successful appeals. We do not believe this appeals revenue is indicative of our ordinary course of operations.
biopharmaceutical volume grew 99% year-over-year is 20643 tests due to an increase in the number of biopharmaceutical customers off in their contracted projects particularly for Garden on the
Precision oncology testing revenue for biopharmaceutical customers increased one hundred and 29% in 2019 to 79.5 million from 34.7 million and 2018 due to the increase in test Volume Plus the higher price charge for Garden on me.
Average revenue recognized biopharmaceutical test in 2019 was $3,850 up 15% from $3,347 in the prior-year due to a greater proportion of tests being Garden Omni tests, which has a higher selling price than guardant360 tests.
Phillip in Services Revenue
177 percent is 33.9 million in 2019 who may need two new companion diagnostic development projects biopharmaceutical companies.
Gross profit for 2019 was 143.7 Million compared to a gross profit of 47.4 million in the prior year.
The gross margin in 2019 was 67% as compared to 52% during the prior-year.
Gross margin Improvement is primarily due to the increase in average revenue per clinical and biopharmaceutical Test Plus reductions in the cost of precision oncology testing.
Total operating expenses in 2019 were 226 million a 61% increase from 140.4 million in 2018.
Expense drivers are the same as noted earlier for the increase related to the fourth quarter.
Net loss attributable attributable to Garden Health common stockholders was 75.7 Million compared to 85.1 million in 2018.
Includes charges of 7.8 million in 2019 and 0.8 million in 2018 for increases in the fair value softbank's ownership in our life.
That last for sure attributable to Garden Health common stockholders was $0.84 in 2019 as compared to $2.80 in 2018.
We ended the fourth quarter of 2019 with 791.6 million in cash cash equivalents and marketable securities.
Now turning to our outlook for the full year 2020.
Tell me mentioned we expect Revenue to be in the range of $275 to $285 million representing growth of approximately 31% over 2019 at the midpoint range.
We expect clinical sample volume to be in the range of $65,000 to 67,000 test which represents growth of approximately 30% to 34% over 2019.
Expect net loss for the full year 2020 to be in the range of $155 billion to $160 billion as we increase investment in our lunar programs.
embedded in our Outlook or a few key assumptions
First during the fourth quarter of 2019 increased activity from a number of our biopharmaceutical programs resulted in our highest-ever Collective Revenue recognition from development services and related biopharmaceutical tasks in any given quarter so far.
As we have discussed Peaks and troughs in activity can result in lumpy revenue from our private pharmaceutical customers in 2020. We expect contributions from our bioferment biopharma business to be lighter in the first-quarter demand from our biopharmaceutical customers remain strong and we continue to expect significant growth over the long term.
II
Can is that we expect Revenue to benefit to begin to benefit from the expanded Medicare LCD in the second quarter of 2020 with more full benefit in the third quarter Beyond.
This timing is based on our forecast for Meridian the Mac that adjudicates our Medicare claims to timely finalize its expanded lck LCD and begin wage a reimbursement there under
At this point I would like to turn the call back to help me with closing comments.
Thank you Derek. I'm very proud of our team for such an incredible year during 2019. We made rapid progress across our platform in twenty-twenty We believe We Are well-positioned to make great strides against her ambitious goals and look forward to updating you on our progress with that. We will now open it up to questions operator. Thank you, sir. As a reminder to ask a question. You would need to press star one on your telephone to withdraw your question, press the pound key. Please stand by while we compiled the Q&A roster.
Our first question comes from from SV be wearing please go ahead. Yeah. Hi Derek. First of all great working with you and good luck with the retirement age then uh, welcome in the CIO rural wanted to first ask you a helmet in terms of the guide. I recognize the guide implies a 31% growth at midpoint 537% last year. I mean, I appreciate 2019 was the first impactful year for lung with Medicare and biopharma was also strong, but when we look at 2012 that you have pain cancer LCD, you have a pre-approval potentially for g360 biopharma adoption ramping and and lunar one. So just trying to understand what what them in the guide here at 31% growth. And then if you could also touch on the net loss number is that where are some of those Investments growing is it down?
lunar two or lunar one
I'd appreciate some details on that. Thank you. Yeah, thanks many start off and then let others chimed in here. So, you know in terms of you know, thinking about 2019 and the the incredible year we had last year there a number of components to that. Obviously. We were beneficiaries of the large increase we had from the added wrong in that regard both from Medicare and the private payers there. And so we you know, really saw this kind of double whammy of both, you know growth and the clinical side obviously very good clinical volume growth and on the biopharma side, we had significant growth as well because that was really the major swing in terms of uptake and shift to Omni from garden 360 which has a choice, you know higher and and so those those inflection points are kind of behind us in terms of major growth on the clinical and biopharma side. And and so what we see in in 2020 is dead.
Much more of the organic growth in.
You know our businesses and so we're you know, I think it's still very excited about the year ahead of us were very much in the early innings in terms of adoption in this space. And so we see, you know, kind of continued wage growth for many years to come in terms of you know, the spend side of things, you know, a lot of the Investments were making around our lunar program in terms of the acceleration of those Investments. If you remember we said that, you know, we would dedicate about seventy to a hundred million dollars in terms of our Eclipse trial and some of the surrounding infrastructure that were both obviously it's not you know inexpensive to be doing some of these Interventional studies that are doing on the lunar one side of things with Cobra and stand up to cancer and so, you know, we're typically investing in that space But it's because we're going to open up significant Market opportunities as a result over the medium to longer-term
Okay. Thanks and and on.
SB question that I have here that have been getting from investors just help help us understand. What are you baking in for the Improvement? If you could remind us first of all, the pain cancer with the pain cancer LCD in in in place. What is the Medicare rate and should we expect what the size of volume that should we expect to get reimbursed Now versus before and and my understanding is the LCD was effective on February 3rd. So how much of that contribution should we expect in the first quarter here?
Yeah, so, you know, I think if you remember under a current LCD, we're currently reimbursed for about a third of our Medicare volume. We expect conservatively that it would suck double under the spam cancer LCD to at least two-thirds of the volume being reimbursed our list. Our reimbursement price is $3,500 in terms of medical and you know, there are still some I think administrative.
and
Teachers that are required before we start actually getting paid on these on these claims. We're very confident it will happen, but it'll likely be into the third quarter before we full the, you know are paid on most of the claims or at least most of the coverage plans.
Okay. Thank you. Last one if I could squeeze in on g360 what's been the feedback or any questions from FDA and what's your timeline or expectation for a g360 approved? Thank you. Turn over Jimmy Riley. Yeah sure. So actually we've been active discussion on conversation with them and you know as we expected, you know, this is a first-of-its-kind submission. So, you know, the process is a bit unpredictable and we reject actually submitted some additional data package and information based on the questions and requests that we had from the agency and tools active discussion with agencies continuing. So I feel very confident that conversations are going in the right direction. Now in terms of timing is they you know
you're dealing with you know, first-of-its-kind submission and
Right through the advice that we are developing some event framework how these kind of devices needs to get reviewed and go to approval process.
Okay, great. Thank you.
Thank you. My next question comes from Doug schenkel from Calvin, please go ahead.
Hey, good afternoon. And thank you for taking my questions first off congrats on your retirement. Thanks for all your help. That's the past couple of years. So so maybe just starting on Meridian and following up on puneet question. So the the expanded LCD to our understanding hasn't been finalised. Like you just described the comment period ended month of July. So I I think it's fair to say this taking a little bit longer than expected based on your what you've embedded into guidance for the year the assumption that this becomes effective and cute. Mm. I just want to make sure that there is no concern at all regarding the outlook for this getting completed at some point this year. And in your guidance. Are you assuming that there are any thoughts up payment for past that are done in line with the expanded LCD before this becomes effective?
Yes.
So maybe I'll start you know, we're very confident that you know, in terms of the, you know, eventual being able to collect payments under this LCD. There's this year is a little bit different than prior years because of the 21st century is correct and there are a few administrative kind of logistics that are required in behalf of Meridian as a result. But you know, we have we have full confidence that you know, this will be finalized and we'll be able to collect under this LCD.
And then the second part about catch up payments.
Yeah, that's always something that I think is it remains to be seen, you know, I think it depends on the specifics, but I would direct maybe China.
Yeah. The the catch up payments, you know to the extent that are any would be something we can't predict at this point and it it's ultimately something that Joe Million will have to make a decision and they finalized their LCD as to whether or not there are catch up payments we've as as you saw we've had some but God it's you know, it's it's not predictable for us. So from a guidance standpoint. We're assuming that there are not any
Okay.
That's super helpful and all all sounds good, you know, if you need also have to ask the question about guiding philosophy. I mean simply put you know as we look back at 2019 you bumped up guidance wage order and ultimately I think you'd be your initial Revenue guidance for the Year by over eighty two million dollars if I'm doing the math, right, you know, I I know there were some a series of things that took away last year, but just at a high level it doesn't sound like there's really any major change and guidance philosophy entering this year. No, no, no effort to get more aggressive than you were, you know heading into last name.
Yeah, I mean we're we we continue to try and provide, you know, we believed to be accurate and reliable guidance and you know that that's that's our goal continue to do that. Okay got it. And and then last one, you know given the the pending expanded LCD. How do you think about the importance of the FDA approval and and d and and maybe very specifically do you believe that moving forward successfully with the FDA would lead to expand and coverage in commercial payers beyond the hundred seventy Million Lives you already have off and then even within that 170 to move Beyond just long in some of those um coverage decisions. Yeah, so. I would say that the pain cancer.
it's
Self will give us some Tailwinds in terms of potential expansion from just long to pan cancer and the private payer side of things in terms of you know, FDA and fax being able to Leverage The D as a result, you know, we think that will give us maybe marginal Improvement in terms of a Espeon and reimbursement over this pan-cancer LCD wage really getting the bull is of upside from my point of view and reimbursement point of view from this pain cancer LCD. We think over the medium to longer-term though FDA, you know, I think it'll certainly help in terms of conversations with private payers and especially some of the the laggers that are there but I think even more so it'll help with the, you know, middle majority and late majority in the market in terms of really being that stamp of quality where you know, they can essentially see that you know, this is a test they can you know order and you know has been validated and so on so, yep.
We we see FDA approval really as that kind of catalyst for kind of the the middle to latter stage of Market it up.
Okay, super helpful. Thanks guys.
Thank you.
Thank you. Next question comes from Brian Weinstein from William Blake, please go ahead.
Hey guys. Thanks for taking my question. I just wanted to go through catalysts for 20 20 in follow-up to an earlier question is your expectation still for FDA approval to be sometime in the next few months here. I think you would talk about a 6 months approval time frame and you had submitted that I believe in late October early November. So can you just talk more specifically about the timing expectations? And if that is still your expectation and then other catalysts for 2020 on the pipeline in particular anything else that we should be looking forward to in terms of data releases or or other pieces of information to give us some incremental information on how some of these pipeline projects are progressing wage.
So maybe I start so on the FDA site based on all the conversation that we had with agency and back and Ford. We don't seem to resent the time frames that you mentioned would not work still but you know, as we are going through this this process we are going to know more and there's still some unpredictability aspect of it. But the time frame that you mentioned, you know or realistic if you haven't heard anything which would guide us against those timelines in terms of additional data off, you know, like there are a bunch of other clinical studies or for the advance cancerous type card entry sixty that continuously. They're getting rid of Publications are coming out as long as I mentioned during script. You have hundred fifty. Review publication. You could expect more Pops are going to get added in 20 20 more important for your around maybe doing their programs and wage.
in major Congress, especially Congress is around and cancer related conferences off your
Tennessee some data contribution by Gardens in those congress's as you've seen before. So this year we would be this Thursday. Okay, and then I'm hoping to get just some information from you on the ordering patterns that you guys are seeing kind of my cohorts of clinicians off what you typically see as far as progression of ordering for g360 any kind of the qualitative or quantitative information that can give us some idea about how things are progressing on a on a utilization basis any information that you can provide as far as the number of clinicians that are now ordering it today versus maybe a year ago. Just just anything help us dig into some of those utilization metrics.
Yeah, so, you know the data continues to look very robust in terms of you know, the types of metrics that we Monitor and and would like to see move in the right direction. For instance. Not only are we spending, you know, the number of oncologists, you know have ordered the test where you know now in the vast majority of the 10,000 in college just you know have ordered, you know, Garden 360 but more importantly we're going much deeper. And so we're seeing you know, almost a doubling from a year ago of the number of clinicians that are regularly ordering Garden 316 ordered me on a Thursday pretty pretty continuous basis. And so we're really seeing those same store sells sales and and depth of penetration grow in the right direction and we're also seeing an increase utilization not just in lung cancer, but in breast cancer and prostate cancer and colorectal cancers as well. And so we're seeing, you know, very robust growth across an almost wage.
every metric and you know, I think we think that the the pain cancer Medicare LCD will you know help with the
Meaning of usage and really remove some of the you know, Financial barriers to adoption of of 360.
Thank you. My next question comes from Derek deburring from Bank of America, please go ahead. Hi. This is Heidi for there today. Thank you for taking my question. So first of all, I wanted to focus on luna-1 wanted to see you know, as the cancer monitoring monitoring Market getting more competitive. Wanted to see if we can get an updated view on the timeline of the one key timelines for clinical adoption and other time life as well as updated view or a competitive landscape at this point. Thanks. So this is for a recurrence monitoring or digital disease detection month. Yeah. So, you know, I think as you see we're really focused on trying to establish clinical utility and trying to release show that you know, this type of testing can make a difference in patient outcomes.
I think that's why you know, we've announced these, you know fairly significant undertakings.
cobra in terms of working with energy on