We'll get started. Welcome and afternoon everyone. I'm Puneet Souda. I cover life science tools and diagnostics here at Leerink. My pleasure to be hosting Everett Cunningham, recently appointed CEO of Quanterix. Also joining is Vandana Sriram, CFO. Also, you know, in audience, we have Investor Relations, Joshua Young as well. Thank you guys, great to have you here.
Good to be here.
Thank you.
Thanks for inviting us.
Yeah.
It's great.
Absolutely. Maybe, Everett, we were just, you know, sort of chatting about baseball, but I know this is the innings have just getting started. Maybe just give us a view of how you think, you know, how many, sort of we're getting started in the innings, how many innings are there?
I appreciate that.
how are you thinking about them, and when should we start to see you know, talk a little bit more about the game?
Put runs on the board? Yeah.
Yeah.
I appreciate the baseball analogy 'cause it's easy for me to do it. Listen, we're in the first inning. I've been here a little bit over a month.
Yeah
At Quanterix, before I got started and, you know, was getting recruited to Quanterix, I really wanted to look at, you know, what is the fit in terms of me coming to Quanterix and helping lead the company, the fit couldn't be better. In terms of the base business, coming off a really good solid fourth quarter. Growth is there in the as we said in the earnings call last week, you know, we'll have growth in that base business. The disease states that we're in now after the acquisition of Akoya, the disease states are disease states that need breakthrough therapies and breakthrough solutions, neurology, Alzheimer's, oncology and immunology, that's good.
We have a good balance sheet, a really good balance sheet. I credit Vandana and team of being disciplined in the way in which we, you know, execute that balance sheet. We have met our $84 million acquisition target, synergy target, which is great. We'll hit it at the end of Q1. Again, good discipline in terms of hitting that. We announced we will be cash flow break even in the second half of this year. We have $100 million in cash, we have no debt, it's a good balance sheet. Coming into that first inning, you know, I feel good about the discipline that we have as an organization in that standpoint. Where we feel really, you know, good about, and again, in the first inning, is the diagnostics opportunity.
You know, we have everything in place from a differentiated blood-based biomarker test in terms of the five markers, which is great. We just submitted our 10-K, I'm sorry, our 510(k) in January, so we should hear back from the FDA six to nine months. We have clinical utility studies that are out there with three really good partners. Those results should release in the second half of this year. We've done a good job of, you know, KOL engagement, making sure that we're having the right discussions at the payer side of things. That fit in terms of me coming in and having a good diagnostics plan based on my past experience, it sets Quanterix up for sustainable growth, and we feel good about that.
As you look at the business, and I know it's just been a few weeks, there's, you know, obviously the, as you pointed out, the core Quanterix core proteomics business, there is the spatial and the diagnostics. Is it fair to say, you know, in your rank ordering, there is emphasis on diagnostics as a growth driver, but there's more work to be done on the other two?
Yeah, I would. I, and again, I, not that I'm ranking.
Yeah.
I love the opportunity and the balance that we have now.
Yeah
With the Akoya acquisition. Before Akoya, we were pretty much a Neurology company. We were 90% Neurology. With Akoya, we're now 60% Neurology, 40% oncology and immunology. The disease states that, you know, that that's in. That balance of where we are.
Mm-hmm.
Coming from Illumina, and, you know, people getting into spatial, it's an attractive market, and so that's what Akoya brings us. It brings us diversification, it brings us, again, good tools, consumables, and other solutions in that spatial business. I don't know if you want to add anything around that.
No, I think that's spot on. We've got, you know, multiple shots on goal, and they're all kind of running in parallel track, and they've all frankly been investments for several years now. Even the diagnostics franchise, while, you know, it's now coming to market, we've been working on this for years, on the science behind it, on getting to multi-market, et cetera. We're in a good spot with a lot of execution still to go.
Got it. That's great. Maybe let's touch briefly on 4Q. Came in ahead of expectations, academic spend, which was positive, surprisingly positive, I think. Maybe just talk a little bit about what drove that academic activity, how sustainable any trends you're seeing here so far in the year that give you confidence that's sustained? Usually we see stronger 4Q and then step down in Q1, but again, the comps might be off this year, and again, academic was impacted heavily last year.
Yeah. Maybe talking about Q4 first and then-
Yeah
You know, maybe we can dive deep in Q1.
Yeah. Absolutely.
Yeah.
For the fourth quarter, I think it was a testament to a couple of things. One, of course, execution, given that this was only our second quarter after a transformative acquisition. We've already started to operate as one company. The second piece really is the stickiness of our portfolio. You know, the fact that a lot of our recurring revenue came back. If you recall, in the third quarter, we saw a slight dip in consumables, and while we knew that academic funding was tight, you know, that was something that we studied very extensively. What we saw in the fourth quarter was really kind of the staying power of consumables, if you will. Almost all of our sequential increase came from consumables. As funding came loose, customers started to release all of the pent-up demands.
At this point now, as a company, we're about 75% recurring revenue, you know, taking all of our consumables and a portion of our Accelerator. We feel really good about that getting into 2026. Now, the start of Q1 generally for us is a little bit slower with, you know, budgets getting loosened up and, you know, companies going through their regular cycles, et cetera. We had, you know, planned for the first quarter to be a little bit lighter from a revenue perspective simply because of the seasonality. We do know from a cash perspective this will be a heavier cash usage quarter, which is also typical for us just given our seasonality. Maybe anything to add, John?
Yeah, no, I'll just add. I mean, I have the benefit of just walking the halls, getting to know the team and what the team went through with the Akoya acquisition and kind of how we're coming into the 2026. The positive thing that I see is, yes, we were focused on hitting synergy targets, now we're focused on growth. I, you know, love our 2026 plan. People are getting enthusiastic about the diagnostics opportunity. The diagnostics opportunity that we have in terms of the five biomarker tests, we'll put our plans in place this year. Most of the impact will be 2027 beyond, but that kind of on our, you know, on the offense, so to speak, of the company, you can feel that in the hallway.
Yeah, I wanna come back to you know, guide. For just a second, I mean, when should. You know, you talked about the 2026 plan, a lot of it depends on what, where, which areas you're gonna be investing more into, where you'll have cost-cutting.
Yep.
When should we expect to hear about more about that from you?
Yeah. first inning.
Yes.
Now just, you know.
Yes
A little bit more over a month. You know, I think we're gonna well, we're gonna hear the end-to-end diagnostics plan in the second half of this year. You know, I'm taking advantage of talking to a lot of people that have been in diagnostics on the Quanterix side that have given me a lot of good feedback. I'm going to go on a barnstorming to stay in the baseball theme. Barnstorming tour in terms of, you know, talking to key opinion leaders, Neurology centers. Does the diagnostics opportunity sit in the primary care space too? I'll be talking to a lot of people there. I'm using my Rolodex with my experience of, you know, being in diagnostics in prior companies. I'll talk to people that helped build that diagnostics plan with me and get ideas and input, so.
We'll have a good, solid diagnostics plan in the second half of this year to be ready for 2027.
Got it. Okay. Look forward to that. Maybe just coming back then to the 2026 guide, 0%-3%, no end market recovery assumed in that. How much of that is more, you know-- Look, in this market, a number of companies are being conservative. How much of that is sort of conservatism, prudent approach versus, you know, any other, anything else that you're seeing in market that's giving you a pause?
Yeah, maybe I'll start.
Yeah, go ahead. No.
Look, we always guide to what we can see. You know, it's based on all of the facts we have at that point in time. It is relatively early in the year. Based on what we can see, we do have a slightly tough comp coming, especially in the first quarter, just based on how Q1 of 2025's kind of played out. Keeping that in mind, keeping in mind the fact that we haven't seen hard data that suggests that the market is going to turn, you know, that's kind of how we informed our guide. We do think there's growth to be had. You know, we're very excited about the new assays that we put out, both on the Simoa and the spatial side. We do think that'll add a layer of revenue, even if markets didn't get better.
We're excited about the uptick we're seeing from our diagnostics partners. They're starting to buy more consumables, which to us is a sign that there's more testing happening. All of those indicators are positive, but without some end market tailwind, we didn't want to bake in, you know, more upside than that. If end markets get better, that would be great. You know, we'd be ready for that. For now, we are guiding to what we can see.
Yeah. Got it. Okay. You know, I wanted to switch to clinical diagnostics opportunity, obviously, and, you know, as you said, strength was in Neurology. Obviously, you have Lucent capabilities. As you talked about FDA approval, 6-9 month timeframe, you know, is that, can you elaborate a little bit on sort of, is that just a general assumption that you have? I mean, when we look at this entire market, there have been Breakthrough designations for a number of assays, but we're yet to see, you know, approvals on them. Maybe you can talk about sort of, you know, what's your thinking in that 6-9 months?
FDA engagement, if you can talk a little bit about that, what's been the engagement there?
Yeah. Yeah. Our thinking is we have a lot of work to do before we think about FDA approval in six to nine months, before we think about our clinical utility studies reading out.
Mm-hmm.
That work needs to be done on the payer side. When the clinical utility studies data reads out, the conversations with payers are gonna be easier because we'll have, you know, we'll have data, we'll have information. We're not gonna wait. We're having those discussions now. As a matter of fact, Quanterix had those discussions before I got there. That framework is gonna be good. Another big thing that I'm going to do is making sure that I get customer back feedback. Blood-based biomarkers, it's nascent. It's early in terms of, you know, Alzheimer's diagnostics. I wanna make sure that we have a blood-based biomarker test that first differentiates, which we're confident it will, and Vandana can talk more on that. Second, it fits in the workflow, easy to order.
Our order to cash process back in our lab is easy, that we make it an easy process. you know, the last thing I'll say is, what I'm just excited about.
Mm-hmm
I've done it before, right? Is how do we change the way that Alzheimer's is treated today? Right now, if you think of Alzheimer's, and everybody's been impacted by it, you think of it as someone's cognitively impaired, right? They go to the neurologist, and there's not many answers, right? To changing it now to earlier in the journey of Alzheimer's, early detection. With that early detection, there's pharmaceutical now, partnerships, there's diet and exercise, there's lifestyle changes, and there's tests that give you answers. You're, you're moving it earlier in the treatment continuum, which helps everyone out. That's what we wanna be involved in. We gotta tell those testimonial stories. We gotta make sure that our key opinion leaders are along the ride. I've done that in other companies. I'm looking forward to building that out.
Got it. On the, you know, on the competitive front for, the, you know, diagnostics, there is an existing test that is FDA approved. There were some challenges that it had in the market in terms of, quality. Then there's obviously a mass spec-based test as well. There are other developments even including a larger company that has talked about, you know, potential multi-marker test. They have a p-Tau 217 approved in the market. When you look at the competitive landscape, how are you thinking about so far? I know it's a little bit early still, but how are you thinking about the positioning and obviously, you know, the sales force and the commercial build-out?
Yeah.
You know, yeah.
Let me maybe talk about.
Yeah
You know, the specifics that you mentioned.
Yeah
We can talk a little philosophically on how we think about competition. You know, in terms of the test, we've always talked about the fact that our test is differentiated, and it's the best test in the market, and some of that has played out. As you said, some of our competition has had challenges in actually getting patients to an answer. The distinction between our test and some of our competitors' test is, in our case, we have only a 10% indeterminate zone. What that means is 90% of patients that come in will get an answer and will also actually get a risk score. Over time, they can also monitor their progression. You know, five years from now, they can refer back to that risk score and say, "Okay, have things gotten better? Have things gotten worse," et cetera.
That is unique to us, and that is something that our competition doesn't offer. We do believe that the value of the test really is in the sensitivity and specificity and in ease of use, and that's going to where we differentiate ourselves. You know, with one of our competitors, as you mentioned, that intermediate zone is now about 30%-40%, which has been very frustrating for clinicians. In the case of our other competitor, while, you know, the test still has an intermediate zone, that workflow is relatively difficult, samples need to be sent back, et cetera. Scalability is also going to be a large question.
I'm just gonna talk about the philosophy of competition
Sure.
Only because.
Yeah
You know, it's how I was raised in terms of my last 30-plus years in healthcare. I'm not talking about how Quanterix was before I got there. I'm talking about how we're gonna be moving forward. We're gonna embrace competition. I actually think competition in this space defines the attractiveness of this market, and that's why people are getting in. It also defines the disease state of, you know, neurological impairment and Alzheimer's and everything. There's a need for solutions that are out there. That's number one in terms of embracing competition. I think competition's gonna make us better. I think it's gonna make us come to work every single day and move faster, make better and smarter decisions, be out in front more. I.
Going back to the baseball analogy, the Yankees wouldn't be the Yankees without the Red Sox, right? Listen, I welcome competition 'cause I want that to motivate our internal company to be better.
Yeah. That's great. Then on the reimbursement front, what was attractive is that you received $897 pricing, their ongoing, obviously, clinical utility studies. You know, maybe just in terms of, when do you expect that sort of MAC coverage, and are you thinking about, might be early, but are you thinking about ADLT process here?
Building all that as you talk about it right now. We feel that the $897 price crosswalk speaks to exactly what Vandana said in terms of it's a differentiated test. I think they priced it accordingly. You know, based on the space that we're in, it'll mostly be a Medicare type reimbursement.
Yeah
We'll focus on that. We feel we're in a good spot. We feel we're ahead of the game, you know, when it comes to that, I'm laying out exactly the payers that we need to talk to moving forward. It's gonna be a lot easier in the second half when we have that clinical utility.
Wonderful
Utility information.
Good. Yeah.
Yeah.
Great. Maybe shifting gears, and talking about the core business. You know, one of the questions that we, you know, we've been getting and obviously something that we've been looking at as well is the competitive landscape of Simoa. When Simoa entered the market, it, you know, a high-sensitivity tool, a little bit lower on the plex side, but it had great utility in the research as well as the clinical translational market, and it's continued to grow into clinical trials and translational.
Maybe just give a sense of sort of, you know, as so far, and I know it's still a bit early, but as you have looked at that positioning of that product, what are some of the things that come to your mind earliest that you need to do in order to strengthen the positioning of that product?
Yeah. I'll give you my-
Is it more market mostly?
Yeah. I'll give you my 30 days, and Vandana can tell you a little bit more. In the low-plex business, Simoa ONE is still a differentiator. It just is. What I like about this, I'm taking advantage of, you know, me being new, is next-generation. What do we do to continue to, you know, build on and make things even more, you know, better in terms of sensitivity. We have a really good pipeline. Really good pipeline. On the Simoa side, our job is going to be there's many opportunities that we can go forward with, Simoa ONE being an option.
I'm gonna take advantage of, you know, taking a holistic review of our pipeline and then work with Vandana to say, you know, which direction are we gonna go that gives us a, you know, the fastest return on investment, you know, into our business? To me, I look at that as a, as a really good challenge to have on the Simoa side. I don't know if you wanna mention anything.
No, I think that's right. You know, you mentioned before about competition really making us better. We do take that to heart. We do believe we still have a bit of an advantage on the low-plex space because everybody talks about low-plex at sensitivity, but a lot of times when you dig deep, they're really talking about high-plex, not low-plex. There's a little bit of a differentiation there. The other things that add strength to our portfolio is we have a very large install base and, you know, we've been embedded for a long time with our researchers. As we add menu, we see a lot of stickiness. You know, we had two tau markers that came out last year. Those are getting a lot of good interest.
The addition of menu also helps us maintain our position on the instrument side.
Got it. In 2025, obviously the market challenges existed. We're expecting Neurology to be flat to slightly better this year, which is positive, but again, funds will start flowing as we go through the rest of the year. As you look, you know, the overall consumables pull-through for Simoa has been under pressure. I mean, correct me if I'm wrong, but our estimate was about its pull-through was down about 17% or so, to $57, and we're modeling about flat in this year. Maybe just tell us more about the utilization.
Mm-hmm.
Where the install base is, and there is a competitor in the market with multiple, you know, in terms of overall plexing as well as higher sensitivity. How much of impact could we continue to see from sort of that competitor? How much was a factor in 2025, and how much should we see in 2026?
Yeah. We look at it really as the total consumables revenue change because, you know, the pull-through does tend to be a little bit lumpy. We've seen that 'cause it depends on the use in a particular lab. Total consumables on the Simoa side for the year were down about 7%, which to us correlated more to how the external market was behaving. You know, we do hear about competition more from the perspective of share of wallet than from, you know, consumables truly moving away. You know, this is something that we've got to weather through, especially in the academic side. You know, our expectation is as menu continues to improve, pull-through will continue to get better.
Got it. Maybe just thinking about the platform, the Simoa platform itself, Simoa ONE, maybe just tell us your expectations for, you know, sort of Simoa ONE placements, you know, given the still very much capital-constrained environment that we're in. I think there were some enhancements to the platform. Maybe just tell us about that. Like, is that going to change?
Yeah. I'll
the trajectory of
I'll maybe touch on, we hit a, you know, key milestone. We had a early access customer that we re-released to at the end of last year. We're now working with that customer in terms of that partner to get feedback on Simoa ONE. As I said, I'm gonna take a holistic review of our entire, what I would call next generation Simoa, which Simoa ONE will be part of that, and we'll use that early access information to help us make decisions. The challenge that I love, and again, my first 30 days, and I've probably been in 10 what I would say, you know, technology meetings, right? The challenge that I love is we have many shots on goal. Our job is gonna be how do we prioritize?
We cannot do everything underneath the sun. We can't. I'm not saying that that's what Quanterix's theme was before I got there, but moving forward, we're being intentional about, hey, what few things do we focus on that we know will bring us immediate sustainable growth, of which Simoa ONE will take a hard look at that, see if that'll be a player.
Okay. great. Switching gears to maybe spatial, Vandana, can you talk a little bit about the program? There was a program cancellation that you saw.
Sure.
How much does that impact, and how should we think about it, you know, going forward?
Yeah. This was a companion diagnostics program that we had studied extensively during diligence as well. You know, as soon as the acquisition closed, we started to get to work on it. You know, this is one of those items, as Everett talked about, you know, just having focus. This program was upside down for us from a profitability perspective. We came to a mutually agreeable solution with our customer, working with our customer to make sure that we could transfer the CDX back to them. Now, having said that, you know, we do believe that the spatial instruments, especially the HD-X Imager instrument that we got from Akoya, is actually really good in the clinical space.
We already have a couple of customers that are working their own LDTs on this, and we do think there is a large CDX market. As Everett said, we're gonna prioritize and, you know, chase the ones that make the most sense. We do see a large clinical opportunity for spatial.
Just to add, looking at that contract that we got out of, we will use companion diagnostics as a growth strategy for us. We just need to make sure that our contracts are mutually profitable for the pharma side and our side. We're gonna make sure we, you know, make sure we do that due diligence.
Got it. Before I go into Accelerator and a bit more on pharma, maybe just on the spatial side, just thinking about the overall competitive landscape, there's the research, there's translational, where Akoya is positioned, and maybe just talk to us sort of where the positioning is and if anything that you wanna do in the near term in terms of enhancing that or, you know, making any changes.
What we really liked about the Akoya portfolio was the fact that they had a research tool as well as a translational tool. On the research side, the PhenoCycler-Fusion is great from a discovery perspective and is used by, you know, most of the key players in the discovery market. Then on the clinical side, you know, we talked about the HD-X, which is now starting to make that transition into the clinical space. The research tool is more, you know, 100+ markers. The HD-X is a little more targeted and specific and is more downstream, and is starting to see a lot more from a clinical application perspective. You know, as we did our diligence on Akoya, we got a lot of voice of customer, we spoke to a lot of customers and users.
You know, there's definitely some low-hanging fruit there that we're working on. We got a lot of feedback on things like ease of use, conjugation of antibodies, menu, et cetera. As we looked at all of those, we were like, "Oh yeah, that's fixable. You know, we know how to do this." Some of the things that you'll see us put out, starting from the fourth quarter and going into this year, really will be specifically addressing some of those feedback items to make these instruments a lot more competitive.
I'll just add, in the near future, we've done a good job of maintaining legacy Quanterix tech expertise and Akoya expertise. Walking around the hallways, I feel very comfortable that we have walking around our hallway and at the same time operating as one Quanterix. You know, feel good about the expertise. Even though the diagnostics, Alzheimer's diagnostics will be our focus, we have a diagnostics opportunity on this, on the, on the Akoya side too. I wanna make sure that again, we prioritize and don't try to do too many things.
Yeah. Makes sense. On the pharma side, you're not expecting any pharma recovery in 2026. When we look at the broader market, pharma has been the relatively stable market, and biotech, maybe you could say small and emerging biotech has been more weaker. Obviously academic challenges are ongoing, but pharma is relatively stable. Maybe just tell us, you know, sort of what's your read on the demand trends there for the Accelerator business, and maybe just give us a view as to sort of how Accelerator did in 2025 as well.
Yeah. Let me maybe start with how Accelerator-
Yeah
did in 2025, and we'll talk about 2026 then. You know, Accelerator continues to be really unique for us. For those who are not familiar with Accelerator, that is our CLIA-certified lab in Boston where we're located. The reason that's really important to us is that lab is really where we get insights into what's most important for our customers, what are the assets that they're working on, what are, you know, the fields that they're working on. That, you know, provides a lot more insight back into the company. 2024 for Accelerator was a banner year where we saw, you know, about 40% growth over there, mostly coming from very large projects. We had a large project with Lilly that was close to $5 million, as well as a couple of other large pharma projects.
Those projects did not repeat in 2025. We saw a lot more projects, but smaller ticket sizes. Our expectation going into 2026 is more of a 2025 profile, you know, absent having line of sight to specific projects. If those projects were to develop and move faster, again, that would be tailwind to our guide, but we're not counting on that for this year.
Moving forward, I've had a chance to review the Accelerator lab, the people that work there. It's just, it's a, it's a high margin, great opportunity for us. We need bigger projects. I'll just put it that way. Easier said than done, but, you know, I'll take my two decades plus of pharma experiences and relationships. I'm looking at a colleague I've worked with at Pfizer that, you know, we're gonna make sure we just build on that opportunity to just drive more bigger relationships.
You know, in terms of the Neurology pharma demand dynamics, I mean, obviously there was quite a bit action happening here over the last five years in terms of the clinical trials. What's your sense right now in terms of the opportunity base?
I think the opportunity is still strong. You know, you've obviously got large pharma, which we know is spending a lot of money on multiple disease states in Neurology. We're also in the Accelerator seeing earlier stage smaller companies. That's why the ticket size is still small, because they're much earlier stage and, you know, it's a much smaller company than, say, a Lilly. The fact that we're seeing so much interest with these smaller companies and projects, numbers have remained the same, tells us that there's a lot of activity going on there. Our objective is to be partnering with customers early in their journey so that we can be with them throughout that journey.
All right. Maybe just one in the last few minutes we have here, just on gross margins. What are the levers for recovery in 2026? Obviously, you know, top line growth being an important one, but just how are you thinking about overall things that you can do to drive gross margin? Maybe I'll just ask this as well, just given the time maybe. On the OpEx reduction side, you're targeting $85 million in OpEx. Maybe just tell us a little bit more about that and where there's more room to reduce OpEx and drive-
Sure
profitability.
Sure. The $85 million is both OpEx as well as in gross margin, it's basically a total cost structure. You saw some of that come through in the third and fourth quarter where we saw our gross margins kind of go back up, and we exited the fourth quarter back at 50% on gross margins. Moving forward, we think our cost structure is right-sized. You know, that was a lot of the work that we did in the synergy realization. We have one lab now, one manufacturing facility. The cost structure is solid. Volume is really the key driver. We are now highly indexed to volume and, you know, every incremental dollar of volume is, you know, Most of it goes to the bottom line.
We'll be very focused on kind of, that 0%-3% of growth, but we feel like the cost structure is right-sized. Same on the OpEx side. You know, most of the actions related to our synergies are done. There's a little bit of like system enhancements and stuff that'll keep going on. That's almost regular. You'll see in our reporting, we'll start, you know, all of this will start to come together, and we feel like we've positioned the company well for, as Everett says, "Now it's return to growth. It's not about cost anymore.
Yeah. I'll say this, I'm not linking this to any OpEx savings, but I think it'll generate OpEx savings, and that is when I say prioritization, not only will that help us from a balance sheet standpoint, it's gonna help us from an execution standpoint. My early observations are we're doing a lot of things, which is commendable 'cause we're doing a lot of things in a disease state that warrants it. We have to make sure that we focus on those things that are really gonna drive our overall strategy, drive our overall, you know, making sure we hit growth this year and set us up for sustainable growth.
Okay. That's all the time we have, but I look forward to more updates on prioritization as you finalize that.
Looking forward to it.
We'll talk more later. Thank you again.
Give me till the fifth inning, at least.
Okay. All right. Not giving you that. All right.
Thank you.
Great. Thanks, Puneet.