Personalis, Inc. (PSNL) Earnings Call Transcript & Summary

Good afternoon. Welcome to another afternoon session here at the UBS Healthcare Conference. My name is Dan Brennan. I cover life science tools, diagnostics and pharma services for UBS. Really pleased to be joined with me here virtually on stage with senior executives from Personalis. With me is John West, CEO; and Aaron Tachibana, who is the CFO. Please feel free to -- if you're on the webcast, just pose a question that way, if you'd like. I'm happy to glance at it during the presentation and see if I can get it posed to John and Aaron. But first, I wanted to say, again, welcome, gentlemen. And I think, John, is going to make some opening remarks, maybe give a little perspective on the business for those who aren't as informed or knowledgeable on it, and then we can go through Q&A. So once again, guys, thank you.

Great. Well, thank you very much. I'm happy to tell you about Personalis. Personalis is as a company focused on using next-generation sequencing for genetic profiling, primarily in cancer. And when people hear about next-gen sequencing in cancer, they often think about diagnostics. And that I think that's a good opportunity. But to us, the most important and compelling opportunity upfront was on the therapeutic side because the the cancer drugs we have today have a lot of room for improvement. And in particular, immuno-oncology is a very important trend to enable that. For that, we've developed our ImmunoID NeXT platform, which looks at to all 20,000 human genes, which compares with the standard cancer panel that might be a few hundred genes. So it's enormously more data. And in addition to the number of genes, we also simultaneously capture a complete view of the immune system. And we could talk more about that later on. But this is the first platform of its type in the world. It was introduced in the summer of last year, and we're thrilled with the uptake of that. Personalis also has a business in population sequencing. So this is a very large scale -- both human genome sequencing. Personalis is the sole provider of whole genome sequencing to the veterans administrations, Million Veteran Program, which is the largest population sequencing effort in the United States, now targeting 2 million people being enrolled. Personalis has completed over 60,000 whole genomes for that, including 14,000 genomes just last quarter and is contracted to sequence over 100,000 so far with more than that expected going forward. So these are both very large-scale assays, all leveraging next-gen sequencing. And with that, perhaps I -- best to pause and ask for your questions.

Excellent, John. Thank you. I'm just going -- Great. So maybe since I don't have formal coverage to the stock, you talked about you've been thrilled with the uptake thus far with the ImmunoID. Maybe just walk us through a little bit about -- give some perspective about target audience for this platform? And kind of in terms of the uptake, what's maybe surprised you on the positive end or the negative?

Yes. So this is John again. The platform has designed -- been designed specifically for pharmaceutical companies who are developing advanced cancer therapeutics and particularly in the immuno-oncology space. So I'd say part of what's been really gratifying about that has been the uptake not only by biotech companies, which might tend to be cutting-edge with smaller scale, but also the uptake by large pharmaceutical companies has been very gratifying. We -- these are some of the companies that run the largest clinical trials and largest numbers of clinical trials. And Personalis has worked with a number of them over the years, but that's been broadening up since we introduced the NeXT platform last summer. And I think that's probably been the most exciting part of this has been the uptake in that regard. We have also introduced a diagnostic readout on the platform that's also aimed at -- used by pharmaceutical companies in their clinical trials, at least initially. We think, over time, there will be a larger and larger diagnostic opportunity. But today, the majority of our cancer revenue comes from pharmaceutical companies.

Got it. And maybe just toggling before we dig into the drivers and the opportunity going forward across your product line. Maybe we can just toggle over to COVID for a moment. And maybe just give us a sense of to what extent COVID has been impacting your business thus far? Whether or not there's opportunities, obviously, given all the work that's being done in therapeutics and vaccines right now? How you guys have framed both the drag from COVID and also the opportunity?

Yes. So this isn John. So Personalis does not do COVID testing directly. And we have had some impact in the sense that we've had shelter-at-home quarters in our area. As a result, although, our lab is open and has been through this entire period. It's been at a somewhat reduced capacity. And we've also seen some delays in receiving samples from customers, so that will be a delay in terms of revenue. On the other hand, part of what we found is that engaging with pharmaceutical customers during what I would call, normal times, if you wanted to have a meeting with 15 people at a major pharmaceutical company, it could be really challenging to find a day on which all 15 people were going to be in the office. On the other hand, today, that's less of an issue, there's less travel. And we actually find it's been a very productive time in terms of engagement with pharmaceutical customers for them to appreciate the new things we're doing with our NeXT platform. We had record new customer orders in the first quarter and commented that in April, we saw orders again being significantly above revenue. And so I think it's been an encouraging thing from an order standpoint. In our case, we're not involved in -- very little of our business is from prospective clinical trials. So most of it is retrospective trials. So if there's a delay in terms of trials being run today, that itself does not have a large effect on us. It has some effect. We are involved in some prospective trials, but the majority of our business is retrospective trials. So the samples from those already exist, the clinical trials have already been run. The samples are typically stored at biobanks. And so if the biobanks are closed down or if they're operating at reduced capacity, that can lead to delays in samples arriving at Personalis to be processed. But in time, I would expect that since -- once the orders have been placed and the samples exist, that -- those samples are expected to arrive at Personalis. And we do expect to process some as we come out of the backside of this.

Dan, just one thing to -- get back on top of what John just mentioned. So in terms of the -- our guidance, we issued 2020 guidance during our Q3 2019 call, but we did withdraw it on March 25 during our earnings call for year-end, primarily because of the pandemic, and then we did not reissue any guidance on our May 7 call for Q1 as well, primarily because of the the visibility and the uncertainty we have right now. We don't know exactly how long this is going to last. And we are operating with a scale down lab in terms of operations. We are operating, but it's much, much scaled down compared to what we have capacity and utilization for.

Got it. Okay. Maybe just going a little higher level. In terms of ImmunoID NeXT platform. And so when pharma customers are using your platform to help inform their research, what were they previously using? I mean, I know this platform is very different just given the the breadth and the depth of it. But just kind of walk us through a little bit, a typical pharma customer that's adopted, they started to use it? Is it crowding out some of their own internal efforts on using a narrower panel? Is it just opening up something that was never done before? Just walk us over a little bit about the profile of your approach and kind of the category that it fits?

Yes. I think that's a great question. I'd say the the prior generation of tools in this space were often cancer panels, and you've seen those from a variety of companies and also universities that might look at the cancer driver genes. And so these are the genes which when they're mutated, can actually cause the cell to turn cancerous. And it's actually not a huge collection of genes. The ones that have been FDA-approved as companion diagnostics are sort of in the range of 20 to 25 genes. The panels that people have created to try to incorporate them can be 300 or 400 or 500 genes, but relatively limited in scope. What's really different, and we saw this starting back in 2014 with the approval of the first checkpoint inhibitor drug was that it's a completely different set of genetics because now we're looking at the mutations, which can actually provoke the immune system. And these don't have to be mutations that have anything to do with causing the cancer in the first place. But these mutations, if you have mutated DNA, you can create mutated proteins and that's what the immune system will end up detecting or the peptides from those proteins. And so we realized that in order to understand the immune response to a cancer then one needs to see all of those mutations. So instead of looking at a few hundred genes, which is where many of these customers would have been not too many years ago before our platform now there's an interest in moving to see all 20,000 genes and too, at the same time, have a comprehensive view of what the immune system is doing. So I think that need to understand both the cancer and the immune system is part of what's driving the uptake of our platform.

Right. And I believe you've got, what, how many pharma customers? Is it 50-plus customers right now? Or maybe walk through a little bit about like the customers you have today? And I know you've outlined some pretty significant total addressable market estimates. But if you look at a typical customer, do they start initially in one area and then have you seen customers really begin to deepen their relationship with you?

Yes, absolutely. We often see customers start by doing a pilot study that can be fairly limited in scale. And then once they get comfortable with the data, they start using the platform in more and more clinical trials. We've also seen a number of customers who approach us who have initially gotten to know us in our -- in cancer. And then come back and say, actually, some of the things you're doing can be useful outside of cancer for the drug developments we have there as well. And so we -- on our last conference call, for example, we talked about a customer that is a large biotechnology company, actually developing a gene therapy for an indication that's outside of cancer. And yet they realize that the genetic engineering they're doing on the patient's own cells before they get transplanted back into the patient. That natural genetic engineering can lead to what are called neoantigens. And we previously only would have thought of neoantigens as being a cancer phenomenon. But now that we're beginning to see there can be other approaches, including in gene therapy that can lead to neoantigens. And it's just an example of the interest from pharma to use our technology, not only in the cancer space, but to go beyond that to other indications.

And I know it's still very early, John. And Aaron, have you found when you're not able to penetrate a pharma customer yet, what are some of the reasons? Why? Is your product just really suited for a -- I mean, even though, you just mentioned, John, obviously, it goes beyond cancer. But is it really, if you're focusing with customers that are focused on immuno-oncology and they're not adopting your platform, is there an issue why? Is it maybe just too much information, too costly, not proven out yet? Just what are some of the factors why someone doesn't adopt to the platform?

With any new technology, there are always earlier adopters and others who take more time. So I think we're just making our way through that. I would say that it is not uncommon when we're in a situation, introducing a customer to what we're doing, that the reaction will be, I had no idea that was even possible. And then the next reaction may be that they are concerned about that would be a fantastic information, but they're worried about what the cost could be. And then when we talk about what the cost actually can be because of the -- we've actually been able to drive the cost down pretty substantially with the technology we have, they're often really surprised at that. We could end up being at similar kind of pricing to what they've been paying for a cancer panel, that's only a few hundred genes. Many of those cancer panels were designed years ago when sequencing was much more expensive. When Illumina introduced their NovaSeq platform in 2017, many labs said, well, maybe we'll get one and we'll try it, but Personalis was a step forward and said, we'll take 10 because we realized that this was a very important step forward. We had been designing assays for several years. In immuno-oncology that would really leverage the large-scale of Illumina's NovaSeq. We didn't know when -- that there would be a NovaSeq, but it in fact came to be. And so it's been a terrific help for us to have that kind of scale. And we look forward to advances in sequencing and taking us even further. I would say that the -- that philosophy has continued. We have a liquid biopsy product that we're introducing later this year. We expect that to also cover all 20,000 human genes. And it's just a dramatically larger scale than others have been pursuing in the liquid biopsy space. Again, many of them are just a few tens of genes or a few hundreds genes, and we're starting at 20,000 genes. So the scale that we have, part of which comes from our population sequencing business really helps us be in a position to take on large-scale opportunities in oncology. And we think those are the future of where oncology therapeutics is going is leveraging that kind of very comprehensive genomic data.

And in terms of the pricing differential, for a customer that may say I only need 300 to 400 or 500 genes and maybe they don't recognize all the value that you provide with the expensive set of information that you give. Is -- can you discuss a little bit, I'm sure pricing varies customer-to-customer, contract-to-contract, but from a high level, how much a customer is paying for your approach versus some of their well or known competing approaches, A? And then B, is there any -- not risk, but is there any pushback ever on data overload where a customer says, I don't need all this, are you able to then tailor like what you give to them, so that you could say, hey, we can give you everything, we give you bits and pieces of it depending on what you need, so maybe pricing? And then how you deliver that information to the customer?

Sure. So I would say on price -- sorry, on pricing, we tend to be about the same range as many of the existing cancer panels. I think in terms of the data amount, it is a lot of data that we deliver, and some customers have been a little surprised at how substantial the scale is. So sometimes they are -- their IT departments to have to go take that on as a homework assignment. But in general, I would say the scientists who're in this product are typically thrilled with the amount of data. And to the extent that there is an issue of the amount of data, sometimes we can be involved in helping to provide analytics so that the answers can be a little bit boiled down so that they're a little bit easier to digest at the customer end, maybe due to a certain amount of this, what I would describe as semi customization on the reporting side, and that can help make the large amount of data more digestible for our customers, and frankly, as a value-add service for them and also provides a certain degree of stickiness for what we do.

So kind of in your deck, you walked through this kind of early on, I think, the TAM of the $5 billion petition in liquid biopsy analysis, diagnostics, which I think is around $40 billion in personalized therapeutics -- $40 billion. And then I guess, right now, you're in the first phase, if you will. What's -- when you think about going to each of the next 2 phases, even though clearly there's a lot of whip and to top in the first phase, what's the timing of diagnostics and personalized therapeutics that you've laid out?

Okay. Sure. So the -- from a diagnostic standpoint, we introduced a diagnostic readout on our platform in January of this year. So that product already exists. That's being marketed to start with to our pharmaceutical customers who not only want to have this large-scale translational research data, but also want to be able to have a truly clinical report that they can deliver to the oncologists who are treating patients in their clinical trials. We expect that to expand over time. So we're beginning that process now. And then I would say in terms of the personalized therapeutics area, this is an area that was a lot of excitement about a few years ago with literally drugs that are designed and chemically synthesized separately for each patient. And there's a whole group of companies that are pursuing that, and perhaps not surprisingly for something that's so advanced there's been some delay in having success in clinical trials. But what many people don't realize is that actually the genetic analysis inside of those clinical trials and the majority of the companies in that space, is actually provided by Personalis. And we developed a technology in that space early on. We wanted to be a leader in that area. We think it may take some time for there to be success. But ultimately, you can imagine that a drug that is synthesized for each patient has the best opportunity of being successful for that patient. We have to learn how to do that and the field is working on that personnel's plans to continue to be the front end, the genomics front end to a large number of those efforts. Today, it's not a very large part of our business, and it's difficult to put a timeline on it because it has to do with success in a whole new category of cancer therapeutics that -- none of which have been fully successful in clinical trials yet. But we do think it's a very promising area for the future. And should that happen eventually, we think that becomes an overwhelming trend in the cancer therapeutic space and Personalis is likely to be the engine that's helping to drive that. So we don't control those timelines, but we expect to be an important part of that whole ecosystem if those clinical trials end up being successful.

Got it. Right. Because I know in the past, I know we met -- I mean I know that was clearly something that was really differentiated, and you guys had a real -- seemed like a real stranglehold on that opportunity. Just on the diagnostics front, so you're providing the readout today, is there a plan or a pathway for you in the next 12, 24, 36 months to actually begin to use -- have hospitals begin to use this? Whether it's just similar to what some of the other players are doing, just kind of matching metastasic patients to the drug trial or maybe it's already being done? Just how do you envision the diagnostics part of the business playing out?

Yes. So I'd say that the people who are likely to adopt what we're doing from a diagnostic standpoint, are likely to be people who see real advantage in the large-scale data along with it. The diagnostic readout that we could provide today would be similar to what others are doing in terms of selecting between existing therapies and that would tend to use the cancer driver genes. Our platform is one that actually can achieve over 1,000x coverage in the cancer driver gene. So we're actually very sensitive to those mutations and can do a great job of that. But again, the real power of our platform is the huge amount of additional data that it provides. And so at cancer centers, which are providing both patient care and are involved in research. That's a natural fit for us to get started, whether that's in collaborations or whether that's in clinical trials or ultimately just as a reimbursed diagnostic. We have designed our platform so that it, in fact, covers the kind of content that is required for one of the national coverage decisions that CMS issued a couple of years ago. So we believe that there's a pathway to the product being reversed and that the dollar amount that's being reimbursed for tests under that coverage decision today would be a level that would actually be reasonably attractive for us financially going forward. So that's a direction that we're interested in. We don't have anything to announce on that specifically today, but it is -- so you see an idea of the road map, in fact, the platform has been designed with that in mind.

And then just within your existing pharma business, typical -- what's like the typical contract look like when a pharma -- is it build on a per sample basis? They're pharma sending new samples, you're running it on your platform? Volume discount sounds like that, you like a month...

Yes. So sometimes the contracts cover just a single clinical trial, sometimes they can be blank orders, which would then allow multiple clinical trials to be run under the same contract. And then as the pharma convinces [indiscernible] we're kind of running on money on the contract, they just put more money under the same blanket and then individual clinical trials can run under that. So we have a couple of different arrangements that way, but revenue is recognized as we process individual -- as we process samples that come to us. Again, many of those are in large batches that come from retrospective analysis of trials that have already completed. Aaron, I can hear you. I don't hear UBS.

Dan are you there?

This is Danny. He might have dropped. Let me message my team.

Sure.

This is Dan. John, sorry about that. I don't know what happened. I was on, not muted. No idea what happened. I just stopped putting my voice. Sorry about that.

You were sounding good, too.

I guess the question was on public, what can you speak to publications using your platform pharma? Is that an important part of the story to kind of get the story out there and get it validated further?

I'm sorry, I didn't fully understand the beginning part of the question.

Just in terms of publications, like pharma, [indiscernible] data, whether it be as you're doing research using your platform, what they're finding that's unique or different in that? Is that part of the story to get publications out there?

Absolutely. We do have a scientific group that is actually working on a number of publications. I would say for us, the peer-reviewed publication process is important, but it's a pretty slow process from a calendar standpoint. And there's an alternative method of getting our message out to pharma customers, which is through conference presentations and conference poster sessions. And so for example, at this time of year, typically, we would have the conference of the American Association for Cancer Research, AACR and then typically in early June, the ASCO conference in clinical oncology. Those 2 conferences are both being held in a virtual basis this year online. Personalis has had 10 different abstracts approved for those 2 conferences together. They are being held online, and we will be presenting those. And so I would say that, that's a mechanism that a lot of pharma customers have -- I'm to appreciate that if they really want to see what's happening on the cutting edge, they pay attention to the posters and then the publications come sometime later, recapitulating something that's similar. So there's a lot of connection at the level of the posters and we have quite a few that we'll be being presented. I think there are 2 sessions, one in late May and one in June for those 2 conferences, which have now gone online. So you'll see a lot of new exciting stuff from Personalis at those meetings.

And is that -- when you think about just, again, the breadth and depth of your platform and what you offer versus some of the other much, much narrower approaches? Is the idea -- it obviously makes sense you're going to find a lot more stuff. Is the idea, though, that other seminal papers or obvious examples of just how elucidating or differentiated your platform is for a pharma customer doing immuno-oncology? Can you point to references, case studies that kind of exemplify that why immuno-oncology customers should be using the ImmunoID NeXT platform?

Yes. Absolutely. So I think one of the examples that you'll see in the set of posters that we'll be talking about involves what's called a loss of heterozygosity of HLA. So HLA is the key elements of the immune system. And in many tumors, loss of that HLA is something that leads to the tumor being able to escape from the treatment. And so it's something that people would really like to see Personalis has a leading capability in terms of being able to detect that. And so that would be an example of 1 of the things you'll see, we've had a number of presentations about that kind of thing. And it has raised a lot of interest in what we do. We're also, as I've mentioned that in before, planning on launching 20,000 gene liquid biopsy test for later this year. So we're already presenting data on what that looks like. So people can begin to get an idea of what they can anticipate when that comes. And we'll have questions on a topic like that as well.

In terms of -- given, I presume the depth of sequencing that you're doing and all the targets you're looking at. From an MRD basis, is that something at all that your platform ultimately could be used for whether for therapeutic drug development, or ultimately, diagnostics, I don't know if that's something that's already being useful, but I'm just wondering if that's a case -- if that could be a use case?

Yes. Absolutely. We do expect there to be use of our -- particularly our 20,000 gene liquid biopsy product when that's released. We expect that to be used for monitoring patients, both patients who are already diagnosed or undergoing treatment. Today, the treatments are often successful enough that, that can become a fairly lengthy period of time. So it's good for the patients but it can be lengthy, but it means there's more and more monitoring of those patients. And often, it's not just a question of what's the scale of the tumor, is it getting bigger or smaller? Because you can see that on a medical X-ray. But this -- an interesting understanding in detail, how is the tumor changing? What are the -- not only what's happening with the mutations that previously existed, but we know that tumors evolve over time that mutations that can help the tumor escape from the therapy, in particular, tend to show up. And so by looking at the whole -- essentially the whole exome with our liquid biopsy, the goal is to be able to see new mutations that are occurring. Obviously, we can track those mutations that were already known. But the goal is to also be able to see new mutations that are coming out of the tumor, which will give us an idea of what the future of the tumor is and where it's headed, not just seeing tracking the things that we already saw from the past. So that will be absolutely part of the positioning. I would say in terms of recurrence detection, we have a pretty big platform here. But part of what's an advantage is if -- because the platform is so large, we will often see a much, much larger number of mutations than people who have much smaller platforms. And so that likely will make us more sensitive at being able to see tumors that may be coming back because we have so many different places in the genome that we can be looking for signals of the tumor recurring.

Right. And is it possible down the line for the platform to be used for initial screening in different cancers?

I think that's possible. The -- some of the applications that you're mentioning are ones where customers may be fairly price sensitive. And so we want to be careful about that. Our sense is we tend to be very aligned with Illumina's long-term outlook. When Illumina talks about heading towards the $100 genome, one of the companies that will most benefit from that is Personalis because we've been designing products that will leverage that scale of sequencing when it comes along the way. And so absolutely, in general, having a larger assay where you look at more content is more valuable. And then if the cost of getting to that comes down so it becomes more affordable, then we expect that used to become broader and broader. And so the applications that we will tend to start in tend to be the really high-value applications where you have a late-stage cancer patient and the disease is extremely serious and really rich data is needed to understand that. On the other hand, some of these other cases where we talk about residual disease or screening patients, these are actually really important as well and could be much larger market opportunities. And so by building a product that should be 1 of the most sensitive products around we expect to be in a position that ultimately, as those costs come down, that will be the most attractive opportunity in that space. So yes, we're interested in those areas as well.

So presumably, given that you've got -- given your history with Illumina or Illumina's history with you and the way you've designed the company to benefit from a scale basis, what -- I mean, can you say anything about like what BGI is trying to do in terms to introduce a price point that could be as much as 80% lower than who knows, maybe it's not that much lower for yourselves, do you likely give volume discounts? But how does BGI factor in what you're doing? Is it just something that could accelerate Illumina's price point? Are you seeing pricing come down? Any comment on BGI and how that impacts your business?

Yes. So happy to see efforts to try to have new kinds of sequencing technologies come forward and lower the cost. I think we anticipate that there will be improvements in the cost of sequencing from Illumina over time. They've already said they're headed in that direction. I would say, looking at Illumina's newest platform, the NextSeq 2000, it's not a sequence that we would use because it's only medium throughput sequencer, and we only use the high end. But it is a place where they've introduced some new technology with the new platform they introduced in January with the Blue Green chemistry. And in particular, the use of the term Super Resolution to the extent of fairly specialized technical term in optics, and it does give the potential for dramatically larger output from the size of the flow cell. And so if that technology, which may be being essentially piloted on Illumina's mid-throughput sequencers, if that technology eventually could be applied to the high-end sequencers, we think the throughput of the high-end sequencers could take the next big leap and that could be an important aspect of bringing the cost down. So we don't know whether Illumina will take that approach or not. Other people certainly have speculated on that. I think our expectation is that Illumina is not going to sit still. We anticipate there's a lot of room for continuing to improve the throughput in the sequencers. We could have a very detailed technical the question of that at some point, if you'd like. I think the more important thing for us has been -- since we're pretty confident that's where things are headed. The question is who's going to be able to benefit from it? And if you have a small cancer panel with a few hundred genes, it's probably not very helpful for you because sequencing may not already be your -- may already not be your dominant cost. On the other hand, the kinds of things Personalis is doing, where we've embraced looking at 20,000 genes and looking at DNA and RNA and the immune system all at one-time, we use a lot of sequencing capacity. And so as those costs come down, they make our platform more and more favorable. So to the extent that there are people in your investor audience who are optimistic about the future of sequencing and want to see who's going to benefit from that? I would say, Personalis is one of the companies that's likely to benefit from that.

Interesting. Okay. And then maybe we didn't really spend much time on we didn't want to talk about the liquid biopsy platform, which you know is a really important future growth driver. But I do want to touch upon top seat briefly on that front since today is a nice opportunity for the company, steady -- nice contractual revenue with nice economics? What's happening today, obviously, with COVID, it slowed things down? Like what's -- I guess, there's a lot of bank samples or maybe it's new patients? Is there -- are the samples ready to go and it just you haven't been able to get to the lab to run them? Or what's been the slowdown in terms of sequencing this year with the Million Veterans?

So actually, the Million Veterans has not slowed down. We had record revenue from the Million Veterans in the first quarter. We have seen the Million Veterans actually is way ahead in terms of collecting samples. They have blood samples now from 825,000 veterans. They're getting so close to hitting the 1 million level that they've -- the program to now target billion veterans. And in April, we received the largest shipment of samples from the VA that we've ever received from them. So that now gives us enough samples already received at Personalis already under contract to keep us busy with that business for most of the rest of this year. So it puts us in a great position. It's -- the only thing that limits us there is our own capacity. And obviously, with COVID, that's -- as I've mentioned, the capacity of the lab is down somewhat from where we've been. But April was probably the low point on that. In May, we've been working on steps that allow us to bring additional employees back into the lab. I expect in June, that will continue. And so if we can bring the capacity back up, we actually expect that to be a great business this year. If we could match the kind of throughput that we had in the first quarter, we would actually sequence our 100,000th full human genome before the end of this year. And I believe we would be the first full profit company in the United States to actually do that in the United States. So that's going to be a sort of an exciting milestone for us and look forward to continuing to take it up from there. We do anticipate the population sequencing we'll be heading more and more towards becoming part of the health care system. At this point, 2 million veterans would be a little over 20% of the population of veterans who receive their health care from VA. If those numbers increase over time, you can imagine a day when it could be that all veterans would be -- have their genome sequenced is a routine part of clinical care. And certainly, as we head towards the $100 genome, I think that's a sensible direction to look. And one of the companies that will be in the best position to be part of that is Personalis because we will have sequenced more genomes than almost anyone in the United States.

Is that something, John, that you -- and I know Helix has a business to do with their exome and Geisinger and Intermountain are some of the bigger networks that are trying to push ahead. How do you -- you've got a great contract and set up with the government, are you actively going out and trying to seek other relationships? Or is it -- is this sufficient given the whole ImmunoDX business or given your whole therapeutics platform opportunity that you have?

Yes. We're interested in growing both parts of our business. And we'll be exploring additional opportunities in terms of population sequencing. Some of the other people you mentioned have done a lot of work with exome sequencing. I think the large-scale work we've done here has been full genome. And I think the field will probably increasingly move forward with time. The -- I would say that we see also an increasing amount of cross-pollination between the 2 businesses because, for example, we began doing the largest amount of whole genome sequencing, we have in the biopsy part of our business. And when we were going public last year, we said that at some point in the future, we anticipated that cancer sequencing would also move in that direction as well. We've actually then had customers who have encouraged us to go that direction. So we announced cancer whole genome sequencing. Late last year, we now had our first customer samples in that regard. And as mentioned on our last conference call that we've now sequenced whole genome sequenced over a thousand samples from cancer patients, and that's continuing to grow. So I think there's a cross-pollination between the whole genome work we've been doing from a population sequencing standpoint and also where we're headed from an oncology standpoint.

Got it. Great. Well, we're at the bottom of the hour. Thanks for bearing with my gap there in the middle. But a great conversation, John and Aaron, thank you for joining us. Hopefully, the day was productive, and thanks for everyone participating on the webcast as well. So hopefully, I can see you guys soon as opposed to having to do it virtually next time. But thanks again.

Thank you, Dan.

That's sound good. Thank you so much for your time today. Thank you. Bye.

Okay. Take care.