Biodesix (BDSX) 10-Q 1 Nov 24 2024 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2024	Oct. 25, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Entity Central Index Key	0001439725
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-39659
Entity Registrant Name	BIODESIX, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	20-3986492
Entity Address, Address Line One	919 West Dillon Rd
Entity Address, City or Town	Louisville
Entity Address, State or Province	CO
Entity Address, Postal Zip Code	80027
City Area Code	303
Local Phone Number	417-0500
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	BDSX
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		145,467,295

Condensed Balance Sheets

Condensed Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 31,406	$ 26,284
Accounts receivable, net of allowance for credit losses of $246 and $65	8,036	7,679
Other current assets	4,575	5,720
Total current assets	44,017	39,683
Non‑current assets
Property and equipment, net	28,683	27,867
Intangible assets, net	6,438	7,911
Operating lease right-of-use assets	1,918	1,745
Goodwill	15,031	15,031
Other long-term assets	6,656	6,859
Total non‑current assets	58,726	59,413
Total assets	102,743	99,096
Current liabilities
Accounts payable	2,537	2,929
Accrued liabilities	8,553	7,710
Deferred revenue	676	324
Current portion of operating lease liabilities	624	252
Current portion of contingent consideration		21,857
Current portion of notes payable	29	51
Other current liabilities	544	293
Total current liabilities	12,963	33,416
Non‑current liabilities
Long‑term notes payable, net of current portion	36,112	35,225
Long-term operating lease liabilities	25,191	25,163
Other long-term liabilities	620	712
Total non‑current liabilities	61,923	61,100
Total liabilities	74,886	94,516
Commitments and contingencies
Stockholders' equity
Preferred stock, $0.001 par value, 5,000,000 authorized; 0 (2024 and 2023) issued and outstanding
Common stock, $0.001 par value, 200,000,000 authorized; 145,465,941 (2024) and 96,235,883 (2023) shares issued and outstanding	145	96
Additional paid‑in capital	481,958	424,050
Accumulated deficit	(454,246)	(419,566)
Total stockholders' equity	27,857	4,580
Total liabilities and stockholders' equity	$ 102,743	$ 99,096

Condensed Balance Sheets (Paren

Condensed Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Allowance for credit losses	$ 246	$ 65
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, authorized	5,000,000	5,000,000
Preferred stock, issued	0	0
Preferred stock, outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, authorized	200,000,000	200,000,000
Common stock, issued	145,465,941	96,235,883
Common stock, outstanding	145,465,941	96,235,883

Condensed Statements of Operati

Condensed Statements of Operations - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Revenues	$ 18,151	$ 13,491	$ 50,894	$ 34,419
Operating expenses:
Direct costs and expenses	4,179	3,229	11,231	9,636
Research and development	2,547	1,938	7,145	8,099
Sales, marketing, general and administrative	20,016	15,496	60,232	51,136
Impairment loss on intangible assets			135	20
Total operating expenses	26,742	20,663	78,743	68,891
Loss from operations	(8,591)	(7,172)	(27,849)	(34,472)
Other (expense) income:
Interest expense	(2,041)	(2,386)	(6,506)	(7,207)
Loss on extinguishment of liabilities			(248)
Change in fair value of warrant liability, net		(1,393)		(1,332)
Other income (expense), net	374	2	(77)	4
Total other expense	(1,667)	(3,777)	(6,831)	(8,535)
Net loss	$ (10,258)	$ (10,949)	$ (34,680)	$ (43,007)
Net loss per share, basic	$ (0.07)	$ (0.14)	$ (0.28)	$ (0.55)
Net loss per share, diluted	$ (0.07)	$ (0.14)	$ (0.28)	$ (0.55)
Weighted-average shares outstanding, basic	146,296	79,709	123,634	78,672
Weighted-average shares outstanding, diluted	146,296	79,709	123,634	78,672

Condensed Statements of Stockho

Condensed Statements of Stockholders' Equity (Deficit) - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Deficit
Balances at Dec. 31, 2022	$ 20,606	$ 78	$ 387,948	$ (367,420)
Common Stock Balance, Shares at Dec. 31, 2022		77,614
Issuance of common stock, net	(61)		(61)
Issuance of common stock under employee stock purchase plan	420		420
Issuance of common stock under employee stock purchase plan, Shares		270
Exercise of stock options	6		6
Exercise of stock options, shares		9
Release of restricted stock units, shares		86
Share-based compensation	2,281		2,281
Net Income (Loss)	(18,702)			(18,702)
Balances at Mar. 31, 2023	4,550	$ 78	390,594	(386,122)
Common Stock Balance, Shares at Mar. 31, 2023		77,979
Balances at Dec. 31, 2022	20,606	$ 78	387,948	(367,420)
Common Stock Balance, Shares at Dec. 31, 2022		77,614
Net Income (Loss)	(43,007)
Balances at Sep. 30, 2023	(1,446)	$ 88	408,893	(410,427)
Common Stock Balance, Shares at Sep. 30, 2023		88,316
Balances at Mar. 31, 2023	4,550	$ 78	390,594	(386,122)
Common Stock Balance, Shares at Mar. 31, 2023		77,979
Exercise of stock options	81		81
Exercise of stock options, shares		107
Release of restricted stock units	1	$ 1
Release of restricted stock units, shares		525
Issuance of warrants	674		674
Share-based compensation	1,057		1,057
Net Income (Loss)	(13,356)			(13,356)
Balances at Jun. 30, 2023	(6,993)	$ 79	392,406	(399,478)
Common Stock Balance, Shares at Jun. 30, 2023		78,611
Issuance of common stock, net	15,316	$ 9	15,307
Issuance of common stock, net, Shares		9,455
Issuance of common stock under employee stock purchase plan	223		223
Issuance of common stock under employee stock purchase plan, Shares		167
Exercise of stock options	3		3
Exercise of stock options, shares		6
Release of restricted stock units, shares		77
Share-based compensation	954		954
Net Income (Loss)	(10,949)			(10,949)
Balances at Sep. 30, 2023	(1,446)	$ 88	408,893	(410,427)
Common Stock Balance, Shares at Sep. 30, 2023		88,316
Balances at Dec. 31, 2023	4,580	$ 96	424,050	(419,566)
Common Stock Balance, Shares at Dec. 31, 2023		96,236
Issuance of common stock, net	607	$ 1	606
Issuance of common stock, net, Shares		314
Issuance of common stock under employee stock purchase plan	282		282
Issuance of common stock under employee stock purchase plan, Shares		216
Exercise of stock options	3		3
Exercise of stock options, shares		6
Release of restricted stock units, shares		387
Share-based compensation	2,640		2,640
Net Income (Loss)	(13,614)			(13,614)
Balances at Mar. 31, 2024	(5,502)	$ 97	427,581	(433,180)
Common Stock Balance, Shares at Mar. 31, 2024		97,159
Balances at Dec. 31, 2023	$ 4,580	$ 96	424,050	(419,566)
Common Stock Balance, Shares at Dec. 31, 2023		96,236
Exercise of stock options, shares	27
Net Income (Loss)	$ (34,680)
Balances at Sep. 30, 2024	27,857	$ 145	481,958	(454,246)
Common Stock Balance, Shares at Sep. 30, 2024		145,466
Balances at Mar. 31, 2024	(5,502)	$ 97	427,581	(433,180)
Common Stock Balance, Shares at Mar. 31, 2024		97,159
Conversion of preferred stock liabilities to common stock, net	33,150	$ 31	33,119
Conversion of preferred stock liabilities to common stock, net, Shares		30,435
Issuance of common stock, net	18,198	$ 17	18,181
Issuance of common stock, net, Shares		17,392
Exercise of stock options	4		4
Exercise of stock options, shares		8
Release of restricted stock units, shares		156
Share-based compensation	1,218		1,218
Net Income (Loss)	(10,808)			(10,808)
Balances at Jun. 30, 2024	36,260	$ 145	480,103	(443,988)
Common Stock Balance, Shares at Jun. 30, 2024		145,150
Issuance of common stock, net	(15)		(15)
Issuance of common stock under employee stock purchase plan	343		343
Issuance of common stock under employee stock purchase plan, Shares		255
Exercise of stock options	12		12
Exercise of stock options, shares		13
Release of restricted stock units, shares		48
Share-based compensation	1,515		1,515
Net Income (Loss)	(10,258)			(10,258)
Balances at Sep. 30, 2024	$ 27,857	$ 145	$ 481,958	$ (454,246)
Common Stock Balance, Shares at Sep. 30, 2024		145,466

Condensed Statements of Cash Fl

Condensed Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities
Net loss	$ (34,680)	$ (43,007)
Adjustments to reconcile net loss to net cash, cash equivalents, and restricted cash used in operating activities
Depreciation and amortization	4,324	2,351
(Accretion) amortization of lease right-of-use assets	(266)	1,851
Loss on extinguishment of liabilities	248
Share-based compensation expense	5,373	4,292
Change in fair value of warrant liability, net		1,332
Provision for doubtful accounts	453	467
Accrued interest, amortization of debt issuance costs and other	2,167	3,954
Inventory excess and obsolescence	20	115
Impairment loss on intangible assets	135	20
Changes in operating assets and liabilities:
Accounts receivable	(810)	(1,178)
Other current assets	778	1,798
Other long-term assets	49	(26)
Accounts payable and other accrued liabilities	(57)	(247)
Deferred revenue	273	(395)
Contingent consideration	(23,242)
Tenant improvement allowances received		18,323
Current and long-term operating lease liabilities	682	(237)
Net cash and cash equivalents and restricted cash used in operating activities	(44,553)	(10,587)
Cash flows from investing activities
Purchase of property and equipment	(2,391)	(19,935)
Patent costs and intangible asset acquisition, net	(165)	(126)
Net cash and cash equivalents and restricted cash used in investing activities	(2,556)	(20,061)
Cash flows from financing activities
Proceeds from the issuance of common stock	55,625	15,316
Proceeds from issuance of common stock under employee stock purchase plan	624	643
Proceeds from exercise of stock options	19	90
Payment of contingent consideration		(7,591)
Repayment of term loan and notes payable	(38)	(36)
Payment of debt issuance costs	(38)	(833)
Equity financing costs	(3,685)	(61)
Other	(276)	(127)
Net cash and cash equivalents and restricted cash provided by financing activities	52,231	7,401
Net increase (decrease) in cash and cash equivalents and restricted cash	5,122	(23,247)
Cash, cash equivalents, and restricted cash ‑ beginning of period	26,371	43,174
Cash, cash equivalents, and restricted cash ‑ end of period	31,493	19,927
Supplemental cash flow information:
Issuance of Perceptive Warrants		674
Operating lease right-of-use asset obtained in exchange for lease liabilities	281	867
Finance lease right-of-use assets obtained in exchange for lease liabilities	514	773
Cash paid for interest	4,443	3,241
Purchases of property & equipment included in accounts payable and accrued liabilities	$ 526	$ 824

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (10,258)	$ (10,808)	$ (13,614)	$ (10,949)	$ (13,356)	$ (18,702)	$ (34,680)	$ (43,007)

Insider Trading Arrangements

Insider Trading Arrangements	9 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Rule 10b51 Arr Modified Flag	false

Organization and Description of

Organization and Description of Business	9 Months Ended
	Sep. 30, 2024
Organization And Description Of Business [Abstract]
Organization and Description of Business	Note 1 – Organization and Description of Business Biodesix, Inc. (the “Company,” “Biodesix,” “we,” “us” and “our”), formerly Elston Technologies, Inc., was incorporated in Delaware in 2005. The Company’s headquarters are in Colorado and the Company performs its blood-based diagnostic tests in its laboratory facilities which are located in Louisville, Colorado and De Soto, Kansas. The Company conducts all of its operations within a single legal entity. Biodesix is a leading diagnostic solutions company with a focus in lung disease. The Company develops diagnostic tests using a multi-omic approach to harness the strengths of different technologies that are best suited to address important clinical questions. We derive our revenue from two sources: (i) providing diagnostic testing services associated with five blood-based lung tests (Diagnostic Tests) and (ii) providing biopharmaceutical companies with services that include diagnostic research, clinical research, development and testing services generally provided outside the clinical setting and governed by individual contracts with third parties as well as development and commercialization of companion diagnostics. We also recognize revenue from other services, including amounts derived from licensing our technologies (Biopharmaceutical Services and other). Blood-Based Lung Tests The Company offers five Medicare-covered blood-based lung cancer tests across the lung cancer continuum of care to support treatment decisions across all stages of lung cancer: Diagnosis • Nodify CDT ® and Nodify XL2 ® tests, marketed as Nodify Lung® Nodule Risk Assessment, assess a suspicious lung nodule's risk of lung cancer to help identify the most appropriate treatment pathway. The Nodify CDT and XL2 tests have an established average turnaround time of one and five business days, respectively, from receipt of the blood sample, providing physicians with timely results to guide diagnostic planning. The Nodify CDT test is a blood-based test that detects the presence of seven autoantibodies associated with the presence of tumors. Elevated levels of the autoantibodies in patients with lung nodules indicate an increased risk of lung cancer to help identify patients that may benefit from timely intervention. The Nodify XL2 test is a blood-based proteomic test that evaluates the likelihood that a lung nodule is benign to help identify patients that may benefit from surveillance imaging. We believe we are the only company to offer two commercial blood-based tests to help physicians reclassify risk of malignancy in patients with suspicious lung nodules. Treatment & Monitoring • GeneStrat ® ddPCR, GeneStrat NGS ® and VeriStrat ® tests, marketed as part of our IQLung™ testing strategy, are used following diagnosis of lung cancer to detect the presence of mutations in the tumor and the state of the patient’s immune system to help guide treatment decisions. The GeneStrat ddPCR tumor genomic profiling test and the VeriStrat immune profiling test have established an average turnaround time of two business days from receipt of the blood sample, and the GeneStrat NGS test has an established average turnaround time of three business days from receipt of the blood sample, providing physicians with timely results to facilitate treatment decisions. The GeneStrat ddPCR test evaluates the presence of actionable mutations in lung cancer. The test is covered independent of stage and can be used multiple times per patient to monitor changes in mutation status. The GeneStrat NGS test is a broad 52 gene panel, including guideline recommended mutations that help identify advanced stage patients eligible for targeted therapy or clinical trial enrollment. The VeriStrat test is a blood-based proteomic test that provides a personalized view of each patient’s immune response to their lung cancer. In developing the Company's products, we have developed or designed a regulatory strategy resulting in approvals, product development and clinical acumen, biorepositories, proprietary and patented technologies, specimen collection kit manufacturing capabilities, and bioinformatics methods that it believes are important to the development of new targeted therapies, determining clinical trial eligibility, and guiding treatment selection. The Company’s testing services are made available through its clinical laboratories.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Note 2 – Summary of Significant Accounting Policies Basis of Presentation The accompanying unaudited condensed financial statements have been prepared in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X for interim financial information and reflect all adjustments necessary to state fairly the Company’s financial position, results of operations and cash flows for the interim periods presented. All such adjustments are of a normal recurring nature. Results for interim periods are not indicative of the results for the entire fiscal year. The accompanying unaudited condensed financial statements should be read in conjunction with the audited financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023. Certain information and footnote disclosures, including significant accounting policies, normally included in fiscal year financial statements prepared in accordance with accounting principles generally accepted in the U.S. (GAAP) have been condensed or omitted. The condensed balance sheet as of December 31, 2023 was derived from the audited financial statements. Liquidity and Capital Resources As of September 30, 2024, we maintained cash and cash equivalents of $ 31.4 million and we have $ 40.0 million in outstanding aggregate principal amount on our Perceptive Term Loan Facility (see Note 6 – Debt ). We have incurred significant losses since inception and, as a result, we have funded our operations to date primarily through the sale of common stock, the sale of convertible preferred stock, the issuance of notes payable, and from our two primary revenue sources: (i) diagnostic testing, which includes lung diagnostic testing and (ii) providing biopharmaceutical companies with development and testing services and licensing our technologies. In accordance with Accounting Standards Update 2014-15 (ASC Topic 205-40), Presentation of Financial Statements - Going Concern: Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern , the Company is required to evaluate whether there is substantial doubt about its ability to continue as a going concern each reporting period, including interim periods. In evaluating the Company’s ability to continue as a going concern, management projected its cash flow sources and evaluated the conditions and events that could raise substantial doubt about the Company’s ability to continue as a going concern within one year after the date that these financial statements were issued. Management considered the Company’s current projections of future cash flows, our ability to execute our current operating plan, current financial condition, sources of liquidity and debt obligations for at least one year from the date of issuance of this Form 10-Q in considering whether it has the ability to meet its obligations. Our ability to meet our obligations as they come due may be impacted by our ability to remain compliant with financial covenants in our Perceptive Term Loan Facility (see Note 6 – Debt ) or to obtain waivers or amendments that impact the related covenants. As of September 30, 2024, the Company was in compliance with all restrictive and financial covenants associated with its borrowings. Our ability to maintain our financial covenants under our Perceptive Term Loan Facility during the next twelve months is, in part, dependent upon executing our current operating plan. If we do not execute our current operating plan and maintain our financial covenants, this could result in an Event of Default (as defined in the Perceptive Term Loan Facility), causing an acceleration and repayment of the outstanding balances. The Perceptive Term Loan Facility requires the Company to meet certain minimum net revenue threshold amounts agreed to between the Company and Perceptive as of the last day of each fiscal quarter, which commenced with the fiscal quarter ending March 31, 2023. During 2023, the Company entered into various amendments to the Perceptive Term Loan Facility to reduce the relevant Minimum Net Revenue thresholds. On February 29, 2024, the Company entered into a third amendment to the Perceptive Term Loan Facility, whereby, subject to the terms and conditions of the third amendment, the Minimum Net Revenue Covenant was amended to reduce the relevant threshold through the fiscal quarter ended December 31, 2025 (see Note 6 – Debt ). During the three months ended June 30, 2024 , the Company completed an underwritten offering of common stock and a concurrent private placement (the April 2024 Offering). Collectively, the Company raised net proceeds of approximately $ 51.3 million (see Note 8 – Equity ). We have taken steps to improve our liquidity through raising debt and equity capital and have also undertaken several proactive measures including, among other things, the reduction of planned capital expenditures and certain operating expenses as previously disclosed. If we do not execute our current operating plan, we may need to consider further measures to reduce our operating expenses. These measures would limit or reduce our operations and could include a hiring freeze, reductions in our workforce, reduction in cash compensation, deferring capital expenditures, and reducing other operating costs. If we do not execute our current operating plan we may need to continue to raise additional funds from external sources, such as through the issuance of debt or equity securities. We may also raise additional capital to restructure our existing debt or for general working capital purposes, or both. If we raise additional capital through debt financing, we may be subject to covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends. If we do raise additional capital through equity offerings, the ownership interest of our existing stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect our existing stockholders’ rights. There can be no assurance that additional capital will be available to us or, if available, will be available in sufficient amounts or on terms acceptable to us or on a timely basis. We expect to continue to incur operating losses in the near term while we make investments to support our anticipated growth. Our ability to maintain our financial covenants is, in part, dependent upon executing our current operating plan and, along with the items noted above, raises substantial doubt about the Company’s ability to continue as a going concern within one year after the date the financial statements are issued. Our unaudited financial statements have been prepared assuming we will continue as a going concern and do not include any adjustments that might be necessary should we be unable to continue as a going concern. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the balance sheet date and the reported amounts of revenue and expenses during the reporting periods. Actual results could differ from those estimates. Concentrations of Credit Risk and Other Uncertainties Substantially all of the Company’s cash and cash equivalents are deposited with one major financial institution in the United States. The Company continually monitors its positions with, and the credit quality of, the financial institution with which it holds cash. Periodically throughout the year, the Company has maintained balances in various operating and money market accounts in excess of federally insured limits. The Company has not experienced any losses on its deposits of cash and cash equivalents. Several of the components for certain of the Company's sample collection kits, test reagents, and test systems are obtained from single-source suppliers. If these single-source suppliers fail to satisfy the Company's requirements on a timely basis, the Company could suffer delays in being able to deliver its diagnostic solutions, a possible loss of revenue, or incur higher costs, any of which could adversely affect its operating results. For a discussion of credit risk concentration of accounts receivable as of September 30, 2024 and December 31, 2023, see Note 9 – Revenue and Accounts Receivable Credit Concentration . Restricted Cash Restricted cash consists of deposits related to the Company’s corporate credit card. For both of the periods ended September 30, 2024 and December 31, 2023 , the Company had $ 0.1 million restricted cash, respectively, which was included in ‘ Other current assets ’ in the accompanying condensed balance sheets. Inventory Inventory consists primarily of material supplies, which are consumed in the performance of testing services and charged to ‘Direct costs and expenses’. Inventory is stated at cost and reported within ‘Other current assets’ in the condensed balance s heets and was $ 1.2 million and $ 1.4 million as of September 30, 2024 and December 31, 2023 , respectively. The Company recorded a reserve for excess inventory of zero and $ 0.1 million as of September 30, 2024 and December 31, 2023, respectively. During the nine months ended September 30, 2024 and 2023, the Company record ed an insignificant amount and $ 0.1 million, respectively , to the condensed statements of operations for excess and obsolete inventory. Other Assets The Company has a $ 5.0 million cash refundable deposit to secure the performance of the Company’s obligations associated with the operating lease agreement with Centennial Valley Properties I, LLC and subsequently assigned to CVP I Owner LLC (see Note 7 – Leases ). As of September 30, 2024 and December 31, 2023 , the $ 5.0 million refundable deposit is reported within 'Other long-term assets' in the condensed balance sheets. Fair Value of Financial Instruments U.S. GAAP for fair value establishes a hierarchy that prioritizes fair value measurements based on the types of inputs used for the various valuation techniques (market approach, income approach and cost approach). We utilize a combination of market and income approaches to value our financial instruments. Our financial assets and liabilities are measured using inputs from the three levels of the fair value hierarchy. Fair value measurements are categorized within the fair value hierarchy based upon the lowest level of the most significant inputs used to determine fair value. The three levels of the hierarchy and the related inputs are as follows: Level Inputs 1 Unadjusted quoted prices in active markets for identical assets and liabilities. 2 Unadjusted quoted prices in active markets for similar assets and liabilities; Unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active; or Inputs other than quoted prices that are observable for the asset or liability. 3 Unobservable inputs for the asset or liability. The carrying amounts of certain financial instruments including cash and cash equivalents, accounts receivable, prepaid expenses and other current assets, other long-term assets, accounts payable and accrued liabilities approximate fair value due to their relatively short maturities. See Note 4 — Fair Value for further discussion related to estimated fair value measurements.

Recently Issued Accounting Stan

Recently Issued Accounting Standards	9 Months Ended
	Sep. 30, 2024
Accounting Standards Update and Change in Accounting Principle [Abstract]
Recently Issued Accounting Standards	Note 3 - Recently Issued Accounting Standards Standards Being Evaluated In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting: Improvements to Reportable Segment Disclosures (ASC Topic 280). This ASU requires all public entities to provide additional disclosures about the entity's reportable segments and more detailed information about a reportable segment's expenses. This guidance will become effective for the Company for the annual period beginning on January 1, 2024, and interim periods beginning on January 1, 2025. The Company is currently evaluating this guidance and assessing the overall impact on its financial statements. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures . This ASU improves the transparency of income tax disclosures by requiring consistent categories and greater disaggregation of information in the rate reconciliation and income taxes paid by jurisdiction. This guidance will become effective for the Company beginning January 1, 2025, with early adoption permitted. The Company is currently evaluating this guidance and assessing the overall impact on its financial statements.

Fair Value

Fair Value	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Fair Value	Note 4 - Fair Value Recurring Fair Value Measurements Our borrowing instruments are recorded at their carrying values in the condensed balance sheets, which may differ from their respective fair values. The fair value of borrowings as of September 30, 2024 is primarily associated with the Perceptive Term Loan Facility entered into with Perceptive Credit Holdings IV, LP, in November 2022 and was determined using a discounted cash flow analysis, excluding the fair value of the Perceptive Warrant (as defined below) issued in conjunction with the transaction. The carrying value of outstanding borrowings approximates the fair value as of September 30, 2024 and December 31, 2023 . The table below presents the carryi ng and fair values of outstanding borrowings, which are classified as Level 2, as of the dates indicated (in thousands): As of September 30, 2024 December 31, 2023 Carrying Value Fair Value Carrying Value Fair Value Borrowings $ 36,141 $ 36,550 $ 35,276 $ 35,506 The financial liabilities that are measured and recorded at estimated fair value on a recurring basis consist of our contingent consideration associated with our previous acquisition of Indi, the warrant liabilities granted as consideration for the Perceptive Term Loan Facility (see Note 6 - Debt ), and contingent value rights granted to certain holders of our previously converted Series F Preferred Stock, which were accounted for as liabilities and remeasured through our condensed statements of operations. The table below presents the reported fair values of contingent consideration and warrant liabilities, which are classified as Level 3 in the fair value hierarchy, as of the dates indicated (in thousands): As of Description September 30, 2024 December 31, 2023 Contingent consideration $ — $ 21,857 Warrant liabilities $ — $ — Contingent value rights $ — $ — The following table presents the changes in contingent consideration for the dates indicated (in thousands): For the nine months ended Level 3 Rollforward Contingent Consideration Balance - January 1, 2024 $ 21,857 Interest expense 1,137 Loss on extinguishment of liabilities 248 Payments ( 23,242 ) Balance - September 30, 2024 $ — The following table presents the changes in contingent consideration and warrant liabilities for the dates indicated (in thousands): For the nine months ended Level 3 Rollforward Contingent Consideration Warrant Liabilities Beginning balances - January 1, 2023 $ 28,986 $ 61 Changes in fair value, net — 1,332 Interest expense 3,094 — Payments ( 7,591 ) — Ending balances - September 30, 2023 $ 24,489 $ 1,393 Contingent Consideration In connection with the acquisition of Indi in 2018, the Company recorded contingent consideration for amounts contingently payable to Indi's selling shareholders pursuant to the terms of the asset purchase agreement (the Indi APA). The contingent consideration arrangement requires additional consideration to be paid by the Company to such shareholders upon attainment of a three-consecutive month gross margin target of $ 2.0 million within the seven-year period after the acquisition date, which was achieved during the three months ended June 30, 2021. Under the terms of the original agreement, when the gross margin target was achieved, the Company was required to issue 2,520,108 shares of common stock. For the six months following the achievement of the gross margin target, Indi had the option to require the Company to redeem these common shares for $ 37.0 million in cash over eight equal quarterly installments. If Indi elected to not exercise its option, the Company had 12 months to repurchase the common stock in two equal and consecutive quarterly cash installments totaling $ 37.0 million. In August 2021, the Company entered into an amendment to the original agreement in which all parties agreed to forgo the issuance of common stock and agreed that the Company would, in lieu thereof, make six quarterly installments of approximately $ 4.6 million each beginning in January 2022 and a final payment of approximately $ 9.3 million in July 2023 for a total of $ 37.0 million (the Milestone Payments and each individually a Milestone Payment). The aggregate amount of payments owed by the Company under this amendment is the same as if Indi had exercised the put right or the Company had exercised the call right provided for in the original agreement. On April 7, 2022, the Company entered into Amendment No. 3 to the Indi APA, in which the parties agreed to restructure the Milestone Payments. The Company made five quarterly installments of $ 2.0 million each beginning in April 2022, three quarterly installments of $ 3.0 million which began in July 2023, one installment of $ 5.0 million in April 2024, and one installment of $ 8.4 million in July 2024. In addition, the Company agreed to an exit fee of approximately $ 6.1 million to be paid in October 2024. Interest shall accrue on the difference between the payment schedule as agreed in the August 2021 amendment and the April 2022 amended payment schedule, at an aggregate per annum rate equal to 10 %, with such interest to be payable quarterly on the following installment payment date. Our ability to make these payments was subject to ongoing compliance under the Perceptive Term Loan Facility. On September 30, 2024, the Company obtained consent from Perceptive and prepaid the October 1, 2024 exit fee of $ 6.1 million to Indi. The contingent consideration liability was accounted for at fair value and subject to certain unobservable inputs. The significant unobservable inputs used in the measurement of the fair value included the probability of successful achievement of the specified product gross margin targets, the period in which the targets were expected to be achieved, and discount rates which ranged from 11 % to 16 %. As a result of the achievement of the gross margin target, the only remaining significant unobservable input used in the measurement of fair value included the discount rate since all other inputs became fixed and determinable. Subsequent changes to the contingent consideration following the achievement of the gross margin target were recorded as ‘Interest expense’ in the condensed statements of operations resulting from the passage of time and fixed payment schedule. During the three and nine months ended September 30, 2024, the Company recorded $ 0.2 million and $ 1.1 million, respectively, compared to $ 1.0 million and $ 3.1 million during the three and nine months ended September 30, 2023, respectively, in interest expense due to the passage of time and fixed payment schedule. In accordance with ASC 230, Statement of Cash Flows , cash paid to settle the contingent consideration liability recognized at fair value as of the acquisition date (including measurement-period adjustments) should be reflected as a cash outflow for financing activities while the remaining portion of the amount paid should be reflected as a cash outflow from operating activities in the statements of cash flows. All 2024 Milestone Payments are classified as cash outflows from operating activities in the Company's statements of cash flows. Warrant Liabilities On November 21, 2022, as consideration for the Perceptive Term Loan Facility (see Note 6 - Debt ), the Company issued Perceptive a warrant to purchase up to 5,000,000 shares of the Company's common stock (the Perceptive Warrant), including Initial Warrants (as defined in Note 8 - Equity below) and Tranche B and C Warrants. The Initial Warrants are equity classified (see Note 8 - Equity ) while the Tranche B and C Warrants were initially classified as liabilities and recognized at fair value. On December 15, 2023 (the Tranche B Borrowing Date), the Company exercised its ability to draw the Tranche B loan (see Note 6 – Debt ). In connection with the Tranche B draw, the Company remeasured the Tranche B Warrants through the Tranche B Borrowing Date and recorded the change in fair value through the statements of operations and, subsequently, reclassified the fair value to additional paid-in capital (see Note 8 – Equity ). The fair value of the Tranche C Warrants was determined using a Black-Scholes model and subject to certain unobservable inputs. The significant unobservable inputs used in the measurement of the fair value included the fair value of the Company's common stock, risk-free rate, the volatility of common stock, and the probability of the expected borrowing. The Tranche C loan had a commitment date through September 30, 2024 and, as of that date, the Company did not exercise its ability to draw the Tranche C loan. Therefore, the associated Tranche C Warrants expired and are no longer exercisable. During the three and nine months ended September 30, 2024 , the Company recorded zero as a change in fair value through the condensed statements of operations. During the three and nine months ended September 30, 2023 , the Company recorded a $ 1.4 million and $ 1.3 million loss, respectively, as a change in fair value through the condensed statements of operations due to changes in unobservable inputs. This is a result of changes in the probability of our ability to draw on Tranche B and C loans. Contingent Value Rights In January 2016, the Company issued shares of Series F Preferred Stock (the Series F Offering) that were subsequently converted into common stock in connection with the Company's initial public offering in October 2020. In connection with the Series F Offering, investors who purchased more than their pro-rata amount in the financing received a calculated number of contingent value rights (CVRs). One CVR represents 0.00375 % of the Company’s interest in the drug ficlatuzumab, which began a Phase 3 clinical trial in January 2024 (see Note 13 - Commitments and Contingencies below). In January 2016, the Company issued 3,999 CVRs, or 15 % interest in the drug ficlatuzumab, originally valued at $ 0.5 million. The initial estimated value of the CVRs were recorded as a liability and as a reduction to the Series F proceeds. Subsequent to recoupment of our initial co-development costs, upon receipt of a milestone, royalty, or any other type of payment from the Company’s ownership rights in the drug, the Company is required to make a cash payment to the CVR holders equal to 15 % of net proceeds, as defined. During the three and nine months ended September 30, 2024 and 2023 , the Company recorded zero as a change in fair value through the condensed statements of operations due to the probability of receiving net proceeds in excess of our initial co-development costs.

Supplementary Balance Sheet Inf

Supplementary Balance Sheet Information	9 Months Ended
	Sep. 30, 2024
Balance Sheet Related Disclosures [Abstract]
Supplementary Balance Sheet Information	Note 5 – Supplementary Balance Sheet Information Property and equipment consist of the following (in thousands): As of September 30, 2024 December 31, 2023 Lab equipment $ 5,877 $ 6,089 Leasehold improvements 28,165 24,713 Computer equipment 1,307 1,221 Furniture and fixtures 1,073 1,034 Software 325 325 Vehicles 97 97 Construction in process 88 — 36,932 33,479 Less accumulated depreciation ( 8,249 ) ( 5,612 ) Total property and equipment, net $ 28,683 $ 27,867 Depreciation expense for the three and nine months ended September 30, 2024 was $ 1.0 million and $ 2.8 million, respectively, compared to $ 0.3 million and $ 0.9 million for the three and nine months ended September 30, 2023, respectively. Intangible assets, excluding goodwill, consist of the following (in thousands): September 30, 2024 December 31, 2023 Cost Accumulated Net Carrying Value Cost Accumulated Net Carrying Value Intangible assets subject to amortization Patents $ 2,000 $ ( 843 ) $ 1,157 $ 1,975 $ ( 752 ) $ 1,223 Purchased technology 16,900 ( 11,736 ) 5,164 16,900 ( 10,328 ) 6,572 Intangible assets not subject to Trademarks 117 — 117 116 — 116 Total $ 19,017 $ ( 12,579 ) $ 6,438 $ 18,991 $ ( 11,080 ) $ 7,911 Amortization expense related to definite-lived intangible assets was $ 0.5 million and $ 1.5 million for both the three and nine months ended September 30, 2024 and 2023, respectively. Future estimated amortization expense of intangible assets is (in thousands): As of Remainder of 2024 $ 501 2025 2,000 2026 1,979 2027 1,021 2028 73 2029 and thereafter 747 Total $ 6,321 Accrued liabilities consist of the following (in thousands): As of September 30, 2024 December 31, 2023 Compensation related accruals $ 4,958 $ 3,855 Accrued clinical trial expense 940 983 Other expenses 2,655 2,872 Total accrued liabilities $ 8,553 $ 7,710

Debt

Debt	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Debt	Note 6 – Debt Our long-term debt primarily consists of notes payable associated with our Perceptive Term Loan Facility which is described in further detail below. Long-term notes payable were as follows (in thousands): As of September 30, 2024 December 31, 2023 Perceptive Term Loan Facility $ 40,000 $ 40,000 Other 40 78 Unamortized debt discount and debt issuance costs ( 3,899 ) ( 4,802 ) 36,141 35,276 Less: current maturities 29 51 Long-term notes payable $ 36,112 $ 35,225 Perceptive Term Loan Facility On November 16, 2022 (the Closing Date), the Company entered into a Credit Agreement and Guaranty (the Credit Agreement) with Perceptive Credit Holdings IV, LP as lender and administrative agent (the Lender). The Credit Agreement provides for a senior secured delayed draw term loan facility with Perceptive Advisors LLC (Perceptive) (the Perceptive Term Loan Facility). The Tranche A Loan, in an aggregate amount of up to $ 30.0 million (the Tranche A Loan), was funded under the Perceptive Term Loan Facility on November 21, 2022 (the Funding Date). The Company's net proceeds from the Tranche A Loan were approximately $ 27.9 million, after deducting debt issuance costs and expenses. In addition to the Tranche A Loan, the Perceptive Term Loan Facility included an additional Tranche B Loan, in an aggregate amount of up to $ 10.0 million, and an additional Tranche C Loan, in an aggregate amount of up to $ 10.0 million, which were accessible by the Company so long as the Company satisfied certain customary conditions precedent, including revenue milestones. On December 15, 2023, the Company exercised its ability to draw the Tranche B loan for $ 10.0 million. The Tranche C loan had a commitment date through September 30, 2024 and, as of that date, the Company did no t exercise its ability to draw the Tranche C loan . The Perceptive Term Loan Facility has a maturity date of November 21, 2027 (the Maturity Date) and provides for an interest-only period during the term of the loan with principal due at the Maturity Date. Interest Rate The Perceptive Term Loan Facility will accrue interest at an annual rate equal to the greater of (a) forward-looking one-month term SOFR as posted by CME Group Inc. and (b) 3.0 % per annum, plus an applicable margin of 9.0 %. As of September 30, 2024, the stated interest rate was approxima tely 13.9 %. Amortization and Prepayment On the Maturity Date, the Company is required to pay the Lender the aggregate outstanding principal amount underlying the Perceptive Term Loan Facility and any accrued and unpaid interest thereon. Prior to the Maturity Date, there will be no scheduled principal payments under the Perceptive Term Loan Facility. The Perceptive Term Loan Facility may be prepaid at any time, subject to a prepayment premium equal to 2 % to 10 % of the aggregate outstanding principal amount being prepaid, depending on the date of prepayment. Security Instruments and Warrants Pursuant to a Security Agreement, dated as of the Funding Date (the Security Agreement), between the Company and the Lender, substantially all of the Company’s obligations under the Credit Agreement are secured by a first lien perfected security interest on all of the Company’s assets, subject to customary exceptions. As consideration for the Credit Agreement, the Company has issued, on the Funding Date, the Perceptive Warrant of up to 5,000,000 shares of the Company's common stock, including the Initial Warrants which are equity classified at a per share exercise price equal to $ 1.0648 which is equal to the 10-day volume weighted average price (VWAP) of the Company’s common stock, on the business day immediately prior to the Closing Date of the Tranche A Loan. In connection with the Tranche B borrowing, additional warrants became exercisable into 1,000,000 shares of common stock with a per share exercise price equal to $ 1.0648 , which is equal to the Initial Warrant exercise price and expire on December 15, 2033 (the Tranche B Warrants). In addition to the Initial and Tranche B Warrants, additional warrants would become exercisable into 1,000,000 shares of common stock concurrently with the borrowing date of the Tranche C Loan (the Tranche C Warrants).The Company accounted for the Tranche C Warrants as liabilities as the Tranche C Warrants did not meet the criteria for equity treatment (see Note 4 – Fair Value ). The Tranche C loan was not drawn by the loan commitment date and the associated Tranche C Warrants expired and are no longer exercisable. Representations, Warranties, Covenants, and Events of Default The Credit Agreement contains certain representations and warranties, affirmative covenants, negative covenants, financial covenants, and conditions that are customarily required for similar financings. The affirmative covenants, among other things, require the Company to undertake various reporting and notice requirements, maintain insurance and maintain in full force and effect all Regulatory Approvals, Material Agreements, Material Intellectual Property (each as defined in the Credit Agreement) and other rights, interests or assets (whether tangible or intangible) reasonably necessary for the operations of the Company’s business. The negative covenants restrict or limit the ability of the Company to, among other things and subject to certain exceptions contained in the Credit Agreement, incur new indebtedness; create liens on assets; engage in certain fundamental corporate changes, such as mergers or acquisitions, or changes to the Company’s business activities; make certain Investments or Restricted Payments (each as defined in the Credit Agreement); change its fiscal year; pay dividends; repay other certain indebtedness; engage in certain affiliate transactions; or enter into, amend or terminate any other agreements that has the impact of restricting the Company’s ability to make loan repayments under the Credit Agreement. In addition, the Company must (i) at all times prior to the Maturity Date maintain a minimum cash balance of $ 2.5 million; and (ii) as of the last day of each fiscal quarter commencing on the fiscal quarter ending March 31, 2023, meet certain minimum net revenue threshold amounts agreed to between the Company and Perceptive. On May 10, 2023, the Company entered into the First Amendment with the Lender, whereby subject to the terms and conditions of the First Amendment, the Minimum Net Revenue Covenant (as defined in the Credit Agreement) was amended to reduce the relevant threshold of each fiscal quarter commencing on the fiscal quarter ending June 30, 2023 through and including the fiscal quarter ending March 31, 2024. As consideration for the First Amendment, the Company agreed to issue to Perceptive a warrant to purchase up to 500,000 shares of the Company’s common stock (the First Amendment Warrants) which are equity classified at a per share exercise price equal to $ 1.6254 (see Note 8 - Equity ). On August 4, 2023 (the Second Amendment Effective Date), the Company entered into the Second Amendment to the Credit Agreement and Guaranty (the Second Amendment) with Perceptive as lender and administrative agent and the Company, as borrower, whereby subject to the terms and conditions of the Second Amendment, the Minimum Net Revenue Covenant (as defined in the Credit Agreement) was amended to reduce the relevant threshold as of the last day of each fiscal quarter commencing on the fiscal quarter ending June 30, 2024 through and including the fiscal quarter ending December 31, 2025. Under the terms of the Second Amendment, the conditions precedent for drawing on the Tranche B Loan were amended to (i) reduce the trailing twelve-month revenue milestone and (ii) add the receipt of aggregate cash proceeds of at least $ 27.5 million from an equity offering of the Company's common stock. During the three months ended December 31, 2023, the amended conditions precedent were met and on December 15, 2023, the Company exercised its ability to draw the Tranche B loan for $ 10.0 million. On February 29, 2024 (the Third Amendment Effective Date), the Company entered into the Third Amendment to the Credit Agreement and Guaranty (the Third Amendment) with Perceptive as lender and administrative agent and the Company, as borrower, whereby subject to the terms and conditions of the Third Amendment, the Minimum Net Revenue Covenant (as defined in the Credit Agreement) was amended to reduce the relevant threshold as of the last day of each fiscal quarter commencing on the fiscal quarter ending March 31, 2024 through and including the fiscal quarter ending December 31, 2025. The Credit Agreement also contains certain customary Events of Default which include, among others, non-payment of principal, interest, or fees, violation of covenants, inaccuracy of representations and warranties, bankruptcy and insolvency events, material judgments, cross-defaults to material contracts, certain regulatory-related events and events constituting a change of control. As of September 30, 2024, the Company was in compliance with all restrictive and financial covenants associated with its borrowings. The occurrence of an Event of Default could result in, among other things, the declaration that all outstanding principal and interest under the Perceptive Term Loan Facility are immediately due and payable in whole or in part. On the Closing Date, the Initial Warrants and Additional Warrants were valued at $ 2.9 million and $ 0.1 million, res pectively, using the Black-Scholes option-pricing model, estimated settlement probabilities and estimated exercise prices. As a result of the fees paid to Perceptive and the value of the Perceptive Warrant, the Company recognized a discount on the Perceptive Term Loan in the amount of $ 5.2 million . The First Amendment Warrants were valued at $ 0.7 million using the Black-Scholes option-pricing model which the recognized as a discount on the Perceptive Term Loan Facility. The Company recorded the debt discount as a reduction to the principal amount of the debt and is amortized as interest expense over the life of the debt. Scheduled principal repayments (maturities) of long-term obligations were as follows (in thousands): As of Remainder of 2024 $ 13 2025 21 2026 6 2027 and thereafter 40,000 Total $ 40,040

Leases

Leases	9 Months Ended
	Sep. 30, 2024
Leases [Abstract]
Leases	Note 7 – Leases Operating Leases The Company acts as a lessee under all its lease agreements. In January 2024 the Company relocated its corporate headquarters and laboratory facilities to Louisville, Colorado. The Company also leases laboratory and office space in De Soto, Kansas, under a non-cancelable lease agreement for approximately 9,066 square feet that is set to expire in October 2026. The Company De Soto lease agreement was amended on April 12, 2024 to include an additional 1,772 square feet of office space. The Company also holds various copier and equipment leases under non-cancelable lease agreements that expire in th e next one to three years . Centennial Valley Properties I, LLC Lease Agreement On March 11, 2022, the Company entered into a Lease Agreement (the Lease) with Centennial Valley Properties I, LLC and subsequently assigned to CVP I Owner LLC, a Colorado limited liability company (the Landlord) for office and laboratory space in Louisville, Colorado (the Leased Premises). The initial term of the Lease is twelve years (the Initial Term) from the commencement date, which was April 1, 2023 (the Commencement Date). The Company has two renewal options to extend the term of the Lease for an additional seven- or ten-year terms for each renewal. Under the Lease, the Company is leasing approximately 79,980 square feet at the Leased Premises. The Company will pay base rent over the life of the Lease beginning at approximately $ 227,000 per month and escalating, based on fixed escalation provisions, to approximately $ 326,000 per month, plus certain operating expenses and taxes. The Company's obligation to pay base rent shall be abated, commencing as of the Commencement Date and ending on March 31, 2024 (the Abated Rent Period). Further, the Company's obligation to pay base rent with respect to a portion of the area of the Lease Premises equal to 19,980 square feet shall be abated (the Partial Abated Rent), commencing as of April 1, 2024 and ending on March 31, 2025 (the Partial Abated Rent Period). Pursuant to a work letter entered by the parties in connection with the Lease, the Landlord contributed an aggregate of $ 18.8 million toward the cost of construction and improvements for the Leased Premises and the Company exercised its option for an additional tenant improvement allowance of $ 2.0 million (the Extra Allowance Amount). The Company will repay the Extra Allowance Amount actually funded by the Landlord in equal monthly payments with an interest rate of 6 % per year over the Initial Term excluding any part of the Abated Rent Period or Partial Abated Rent Period, which shall start to accrue on the date that the Landlord first disburses the Extra Allowance Amount. The Company made an accounting policy election to reduce the right-of-use asset and lease liability at lease commencement because the Lease specifies a maximum level of reimbursement for tenant improvements which are probable of being incurred and within the Company's control. Due to the tenant improvement allowances at the accounting lease commencement date and rent abatement periods described above, the Company expects the lease liability to accrete to approximately $ 25.5 million by March 2025. The Company utilized the total $ 20.8 million in tenant improvement allowances for capital expenditures for leasehold improvements throughout the year ended December 31, 2023. The Lease includes various covenants, indemnities, defaults, termination rights, and other provisions customary for lease transactions of this nature. During the three months ended September 30, 2022, a $ 5.0 million cash collateralized letter of credit under the operating lease agreement was released and the funds were subsequently transferred to the Landlord as a refundable deposit (subject to contingent reduction over the term of the lease) to secure the performance of the Company’s obligations. The $ 5.0 million refundable deposit is included within ' Other long-term assets ' in the condensed balance sheet as of September 30, 2024. Operating lease expense for all operating lease s was $ 0.6 million and $ 1.7 million for the three and nine months ended September 30, 2024 , respectively, compared to $ 1.1 million and $ 3.3 million for the three and nine months ended September 30, 2023, respectively. As of September 30, 2024, th e weighted-average remaining lease term and discount rate associated with our operating leases were 10.3 years and 11.4 %, respectively. Future minimum lease payments associated with our operating leases were as follows (in thousands): As of Remainder of 2024 $ 696 2025 3,909 2026 4,171 2027 4,063 2028 4,151 2029 and thereafter 28,113 Total future minimum lease payments 45,103 Less amount representing interest ( 19,288 ) Total lease liabilities $ 25,815

Equity

Equity	9 Months Ended
	Sep. 30, 2024
Stockholders' Equity Note [Abstract]
Equity	Note 8 – Equity Equity Financing Programs The Company maintains two facilities that enable equity financing on an ongoing basis at the Company’s discretion, our at-the-market (ATM) offering and our common stock purchase agreement with Lincoln Park Capital Fund, LLC (Lincoln Park). In November 2021, the Company entered into a sales agreement with a financial institution, pursuant to which the Company may issue and sell, from time to time, shares of its common stock having an aggregate offering price of up to $ 50.0 million (the ATM Shares), subject to terms and conditions. The ATM Shares will be offered and sold by the Company pursuant to its previously filed and currently effective registration statement on Form S-3, and sales of common stock, if any, will be made at market prices by methods deemed to be an “at-the-market offering” as defined in Rule 415 promulgated under the Securities Act of 1933, as amended, including sales made directly on the NASDAQ Global Market, or any other existing trading market for our common stock. On March 7, 2022 (the LPC Effective Date), the Company entered into a purchase agreement with Lincoln Park Capital Fund, LLC (the Purchase Agreement), pursuant to which Lincoln Park has committed to purchase up to $ 50.0 million of the Company's common stock (the LPC Facility). Under the terms and subject to the conditions of the Purchase Agreement, the Company has the right, but not the obligation, to sell to Lincoln Park, and Lincoln Park is obligated to purchase up to $ 50.0 million of the Company’s common stock. Such sales of common stock by the Company, if any, will be subject to certain limitations, and may occur from time to time, at the Company’s sole discretion, over the 36-month period commencing on the LPC Effective Date. The Purchase Agreement may be terminated by the Company at any time, at its sole discretion, without any cost or penalty, by giving one business day notice to Lincoln Park to terminate the Purchase Agreement. Lincoln Park has covenanted not to cause or engage in any manner whatsoever, any direct or indirect short selling or hedging of the common stock. On the LPC Effective Date, the Company issued 184,275 shares of common stock to Lincoln Park as a commitment fee (the Initial Commitment Shares) for which the Company did not receive consideration and, upon the available amount being reduced to an amount equal to or less than $ 20.0 million, the Company will be required to issue 61,425 shares (the Additional Commitment Shares and together with the Initial Commitment Shares, collectively, the Commitment Shares). The Initial Commitment Shares issued were valued at $ 0.6 million and, together with due diligence expenses and legal fees of $ 0.1 million, reflect deferred offering costs of $ 0.7 million, were included on the condensed balance sheet in 'Other long-term assets'. The deferred offering costs were charged against 'Additional paid-in capital' based upon proceeds from the sale of common stock under the Purchase Agreement. During the three and nine months ended September 30, 2024 and 2023 , there were no deferred offering costs charged against 'Additional paid-in capital'. During the three and nine months ended September 30, 2024 , the Company expensed zero and $ 0.7 million, respectively, of deferred offering costs to 'Other (expense) income, net' in the condensed statements of operations as a result of changes in the probability of our ability to fully utilize the LPC Facility prior to the termination date. As of September 30, 2024 , zero deferred offering costs remain. As of September 30, 2024 , the Company had remaining available capacity for share issuances of up to $ 46.9 million under the LPC facility, subject to the restrictions and limitations of the underlying facilities. During the nine months ended September 30, 2024, the Company raised approximately $ 0.6 million ($ 0.6 million after deducting underwriting discounts and commissions and offering expenses payable), in gross proceeds from the sale of 313,928 common shares at a weighted average price per share of $ 1.99 under the ATM facility. On April 5, 2024, the Company filed Supplement No. 1 to the ATM Prospectus Supplement dated December 22, 2021. To comply with volume limitations under applicable SEC rules and regulations, Supplement No. 1 reduced the aggregate offering price to up to $ 100,000 of shares in order to maximize the amount the Company could offer under the April 2024 Offering (defined below ) . Following the successful completion of the Company’s April 2024 Offering, the Company is no longer subject to volume limitations under applicable SEC rules and regulations that limit their availability as sources of funding. On August 7, 2024, the Company filed Supplement No. 2 to the ATM Prospectus Supplement dated December 22, 2021 to increase the aggregate offering price under the ATM facility up to $ 50.0 million of shares. As of September 30, 2024 , the Company had remaining available capacity for share issuances of up to $ 28.2 million under the ATM facility. April 2024 Offering Summary On April 9, 2024, the Company closed an underwritten offering of common stock and a concurrent private placement. Collectively, the Company raised net proceeds of approximately $ 51.3 million. Underwritten Offering On April 9, 2024, the Company closed an underwritten offering (the Offering) of 17,391,832 shares of its common stock (the Common Stock). The Common Stock was issued and sold pursuant to an underwriting agreement (the Underwriting Agreement), dated April 5, 2024, by and between the Company and TD Securities (USA) LLC, William Blair & Company, L.L.C., and Canaccord Genuity LLC as representatives of the underwriters (the Underwriters), at a price to the public of $ 1.15 per share. The Company received net proceeds of approximately $ 18.3 million from the Offering after deducting underwriting discounts and commissions and estimated offering expenses payable by the Company. The Underwriting Agreement contains customary representations, warranties and agreements by the Company, customary conditions to closing, indemnification obligations of the Company and the Underwriters, including for liabilities under the Securities Act, other obligations of the parties and termination provisions. The Underwriting Agreement also includes lock up restrictions that will be in effect during the period ending 90 days subsequent to April 5, 2024. The representations, warranties, and agreements contained in the Underwriting Agreement were made only for purposes of such agreement and as of specific dates, were solely for the benefit of the parties to such agreement, and may be subject to limitations agreed upon by the contracting parties. The Offering was made pursuant to the Company’s effective Registration Statement on Form S-3 (File No. 333-261095) previously filed with the SEC on November 29, 2021 and a prospectus supplement, dated April 5, 2024 relating to the Offering. Concurrent Private Placement On April 5, 2024, the Company entered into securities purchase agreements (the Securities Purchase Agreements) with various investors, including certain members of management, certain of its directors and funds affiliated with those directors (the Investors) for the issuance and sale by the Company of an aggregate of 760,857 shares of Series A Non-Voting Convertible Preferred Stock, par value $ 0.001 per share (the Series A Preferred Stock) in an offering (the Concurrent Private Placement). The Preferred Stock was issued to the Investors pursuant to an exemption from the registration requirements of the Securities Act of 1933, as amended (the Securities Act) afforded by Section 4(a)(2) of the Securities Act. Pursuant to the terms of the Securities Purchase Agreements, the Company agreed to submit to its stockholders the approval of the (i) conversion of the Preferred Stock into shares of Common Stock in accordance with Nasdaq Stock Market Rules (the Conversion Proposal) and (ii) the issuance of Series A Preferred Stock to certain members of management, certain of its directors and funds affiliated with those directors (the Issuance Proposal) at its 2024 annual meeting of stockholders. The Securities Purchase Agreements include customary representations, warranties and covenants by the parties to the agreement. Pursuant to the Securities Purchase Agreements, the Investors purchased the Preferred Stock at a purchase price of $ 46.00 per share for an aggregate purchase price of approximately $ 35.0 million. Registration Rights Agreement In connection with the Concurrent Private Placement, the Company also entered into a Registration Rights Agreement, dated April 5, 2024 (the Registration Rights Agreement), with the Investors, which provides that the Company will register the resale of the shares of Common Stock issuable upon conversion of the Preferred Stock. Pursuant to the Registration Rights Agreement, the Company was required to prepare and file an initial registration statement with the SEC as soon as reasonably practicable, but in no event later than April 23, 2024 (the Filing Deadline), and to use reasonable best efforts to have the registration statement declared effective within 50 days after the closing of the Concurrent Private Placement, subject to the approval of the conversion of the Private Placement Shares being received at the Company’s 2024 annual meeting of stockholders. On April 8, 2024, the Company filed a Certificate of Designations of Preferences, Rights and Limitations of the Series A Non-Voting Convertible Preferred Stock with the Secretary of State of the State of Delaware (the Certificate of Designations) in connection with the Concurrent Private Placement. The Certificate of Designations provided for the issuance of up to 760,857 shares of the Series A Preferred Stock. Following stockholder approval of the Conversion Proposal, each share of Series A Preferred Stock automatically converted into 40 shares of Common Stock, subject to certain limitations, including that a holder of Series A Preferred Stock was prohibited from converting shares of Series A Preferred Stock into shares of Common Stock if, as a result of such conversion, such holder, together with its affiliates, would beneficially own more than a specified percentage (established by the holder between 0 % and 19.9 %) of the total number of shares of Common Stock issued and outstanding immediately after giving effect to such conversion. On May 21, 2024, the Company held its 2024 annual meeting of stockholders in which the Conversion Proposal and Issuance Proposal were approved by the Company's stockholders. Upon approval, each share of Series A Preferred Stock automatically converted into 40 shares of Common Stock and, on May 23, 2024, the Company issued 30,434,280 shares of Common Stock in exchange for all Series A Preferred Stock. Warrants During 2018, the Company issued warrants to purchase shares of convertible preferred stock in conjunction with the sale of certain convertible preferred shares and issuance of debt. The Company issued to the lender a warrant to purchase 613,333 shares of Series G convertible preferred stock, at an exercise price of $ 0.75 per share, subject to adjustment upon specified dilutive issuances. The warrant was immediately exercisable upon issuance and expires on February 23, 2028 . Through the effective date of the Company’s initial public offering (IPO) in October 2020, the Series G warrants were remeasured to an estimate of fair value using a Black-Scholes pricing model. As a result of the Company’s IPO, the preferred stock warrants were automatically converted to warrants to purchase 103,326 shares of common stock with a weighted average exercise price of $ 4.46 and were also transferred to additional paid-in capita l. All common stock warrants remain outstanding as of September 30, 2024. On November 21, 2022, as consideration for the Perceptive Term Loan Facility (see Note 6 – Debt ), the Company issued the Perceptive Warrant to purchase up to 5,000,000 shares of the Company's common stock, including the Initial Warrants. The per share exercise price for the Initial Warrants is equal to $ 1.0648 , which is equal to the lower of (A) the 10-day VWAP of the Company’s common stock on the business day immediately prior to the Closing Date of the Tranche A Loan or (B) the public offering price per share of common stock of $ 1.15 . The Initial Warrants are equity classified and were immediately exercisable upon issuance and expire on November 21, 2032 . The Initial Warrants were valued at $ 2.9 million using the Black-Scholes option-pricing model assuming an expected term of 10 years, a volatility of 81.3 %, a dividend yield of 0 % and a risk-free interest rate of 3.67 %. All Initial Warrants remain outstanding as of September 30, 2024. On May 10, 2023, as consideration for the First Amendment (see Note 6 – Debt ), the Company agreed to issue to Perceptive a warrant to purchase up to 500,000 shares of the Company’s common stock (the First Amendment Warrants) at a per share exercise price equal to $ 1.6254 , which is equal to the 10-day VWAP of the Company’s common stock ending on the business day immediately prior to the First Amendment Effective Date. The First Amendment Warrants are equity classified and immediately exercisable upon issuance and expire on May 10, 2033 . The First Amendment Warrants were valued at $ 0.7 million using the Black-Scholes option-pricing model assuming an expected term of 10 years, a volatility of 78.7 %, a dividend yield of 0 % and a risk-free interest rate of 3.49 %. All First Amendment Warrants remain outstanding as of September 30, 2024. On December 15, 2023 (the Tranche B Borrowing Date), the Company exercised its ability to draw the Tranche B loan (see Note 8 – Debt ). In connection with the Tranche B draw, the Company remeasured the Tranche B Warrants through the Tranche B Borrowing Date and recorded the change in fair value through the statements of operations and, subsequently, reclassified the fair value to additional paid-in capital. The Tranche B Warrants are now equity classified and immediately exercisable upon issuance and expire on December 15, 2033 . The Tranche B Warrants were valued at $ 1.3 million using the Black-Scholes option-pricing model assuming an expected term of 10 years, a volatility of 76.2 %, a dividend yield of 0 % and a risk-free interest rate of 3.91 %. All Tranche B Warrants remain outstanding as of September 30, 2024 .

Revenue and Accounts Receivable

Revenue and Accounts Receivable Credit Concentration	9 Months Ended
	Sep. 30, 2024
Revenue from Contract with Customer [Abstract]
Revenue and Accounts Receivable Credit Concentration	Note 9 – Revenue and Accounts Receivable Credit Concentration We derive our revenue from two primary sources: (i) providing diagnostic testing in the clinical setting (Diagnostic Tests); and (ii) providing biopharmaceutical companies with services that include diagnostic research, clinical research, clinical trial testing, development and testing services provided outside the clinical setting and governed by individual contracts with third parties as well as development and commercialization of companion diagnostics. We also recognize revenue from other services, including amounts derived from licensing our technologies (Biopharmaceutical Services and other). Diagnostic test revenues consist of blood-based lung tests which are recognized in the amount expected to be received in exchange for diagnostic tests when the diagnostic tests are delivered. The Company conducts diagnostic tests and delivers the completed test results to the prescribing physician or patient, as applicable. The fees for diagnostic tests are billed either to a third party such as Medicare, medical facilities, commercial insurance payers, or to the patient. The Company determines the transaction price related to its diagnostic test contracts by considering the nature of the payer, test type, and historical price concessions granted to groups of customers. For diagnostic test revenue, the Company estimates the transaction price, which is the amount of consideration it expects to be entitled to receive in exchange for providing services based on its historical collection experience, using a portfolio approach. The Company recognizes revenues for diagnostic tests upon delivery of the tests to the physicians requesting the tests or patient, as applicable. Services revenue consists of on-market tests, pipeline tests, custom diagnostic testing, and other scientific services for a purpose as defined by any individual customer, which is often with biopharmaceutical companies. The performance obligations and related revenue for these sales is defined by a written agreement between the Company and the customer. These services are generally completed upon the delivery of testing results, or other contractually defined milestone(s), to the customer. Revenue for these services is recognized upon delivery of the completed test results, or upon completion of the contractual milestone(s). In addition, other revenue includes amounts derived from licensing our digital sequencing technologies to our international laboratory partners. We are compensated through royalty-based payments for the licensed technology, and depending on the nature of the technology licensing arrangements and considering factors including but not limited to enforceable right to payment and payment terms, and if an asset with alternative use is created, these revenues are recognized in the period when royalty-bearing sales occur. Revenues consisted of the following (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Diagnostic Tests $ 17,168 $ 12,301 $ 47,503 $ 32,395 Biopharmaceutical Services and other 983 1,190 3,391 2,024 Total revenue $ 18,151 $ 13,491 $ 50,894 $ 34,419 Deferred Revenue Deferred revenue consists of cash payments from customers received in advance of delivery. As test results are delivered, the Company recognizes the deferred revenue in ‘Re venues’ in the condensed statements of operations. The Company had $ 0.3 million in ‘Deferred revenue’ recorded in the condensed balance sheet as of December 31, 2023 and $ 0.9 million was added throughout 2024 to ‘Deferred revenue’ for up-front cash payments while $ 0.5 million was recognized in revenues during the nine months ended September 30, 2024 . The ‘Deferred revenue’ of $ 0.7 million recorded in the condensed balance sheet as of September 30, 2024 is expected to be recognized in revenues over the next twelve months as test results are delivered and services are performed. As of September 30, 2024 and December 31, 2023 , the Company had $ 0.3 million i n non-current deferred revenue, respectively, recorded within ‘Other long-term liabilities’ in the condensed balance sheets which represent amounts to be recognized in excess of twelve months from the respective balance sheet date. The Company’s customers in excess of 10% of total revenue and their related revenue as a percentage of total revenue were as follows: Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 United Healthcare 7 % 10 % 8 % 10 % In addition to the above table, we collect reimbursement on behalf of customers covered by Medicare, which accounted for 40 % of the Company’s total revenue for both the three and nine months ended September 30, 2024 compared to 41 % and 45 % for the three and nine months ended September 30, 2023, respectively. The Company is subject to credit risk from its accounts receivable related to services provided to its customers. The Company’s third-party payors and other customers in excess of 10% of accounts receivable, and their related accounts receivable as a percentage of total accounts receivable were as follows: As of September 30, 2024 December 31, 2023 Medicare 26 % 21 %

Share-Based Compensation

Share-Based Compensation	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
Share-Based Compensation	Note 10 – Share-Based Compensation The Company’s share-based compensation awards are issued under the 2020 Equity Incentive Plan (2020 Plan), the predecessor 2016 Equity Incentive Plan (2016 Plan) and 2006 Equity Incentive Plan (2006 Plan). Any awards that expire or are forfeited under the 2016 Plan or 2006 Plan become available for issuance under the 2020 Plan. As of September 30, 2024 , 809,163 shares of com mon stock remained available for future issuance under the 2020 Plan. Share-Based Compensation Expense Share-based compensation expense reported in the Company’s condensed statements of operations was (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Direct costs and expenses $ 20 $ 17 $ 54 $ 41 Research and development 110 68 240 249 Sales, marketing, general and administrative 1,385 869 5,079 4,002 Total $ 1,515 $ 954 $ 5,373 $ 4,292 The unrecognized remaining share-based compensation expen se for options and RSUs was approximately $ 6.5 million as of September 30, 2024 and is expected to be amortized to expense over the next 2.2 years. Stock Options Stock option activity during the nine months ended September 30, 2024, excluding the Bonus Option Program described below, was (in thousands, except weighted average exercise price and weighted average contractual life): Number of Weighted Average Weighted Average Aggregate Outstanding - January 1, 2024 2,041 $ 3.36 6.9 $ 964 Granted 2,226 1.67 — — Forfeited/canceled ( 221 ) 1.96 — — Exercised ( 27 ) 0.72 — — Outstanding ‑ September 30, 2024 4,019 $ 2.52 7.9 $ 1,250 Exercisable ‑ September 30, 2024 1,719 $ 3.48 6.2 $ 822 Restricted Stock Unit Activity Restricted stock unit activity during the nine months ended September 30, 2024 was (in thousands, except weighted average grant date fair value per share): Number of Shares Weighted Average Outstanding ‑ January 1, 2024 2,729 $ 1.91 Granted 1,670 1.81 Forfeited/canceled ( 15 ) 1.92 Released ( 591 ) 2.01 Outstanding ‑ September 30, 2024 3,793 $ 1.85 Bonus-to-Options Program The Company also has a Bonus-to-Options Program (the Bonus Option Program) which allows participants who so elect to convert a portion of their annual cash bonus into fully vested, non-qualified stock options to purchase shares of common stock. Participation is limited to the Chief Executive Officer, direct reports to the Chief Executive Officer and Vice Presidents of the Company. As part of the Bonus Option Program, the Company recorded the following activity during the nine months ended September 30, 2024 (in thousands, excepted weighted average exercise price and weighted average contractual life): Number of Weighted Average Weighted Average Aggregate Outstanding ‑ January 1, 2024 1,050 $ 2.81 8.4 $ 22 Granted 341 1.46 — — Forfeited/canceled ( 27 ) 24.34 — — Exercised — — — — Outstanding ‑ September 30, 2024 1,364 $ 2.04 8.2 $ 129 Exercisable ‑ September 30, 2024 1,364 $ 2.04 8.2 $ 129 The Company record ed $ 0.3 million and $ 0.7 million for the three and nine months ended September 30, 2024 , respectively, compared to an insignificant amount and $ 0.2 million for the three and nine months ended September 30, 2023, respectively, related to the estimate of the Bonus Option Program. Options granted, if any, pertaining to the performance of the Bonus Option Program are typically approved and granted in first quarter of the year following completion of the fiscal year. Employee Stock Purchase Plan The ESPP provides for successive six-month offering perio ds beginning on September 1st and March 1st of each year. During the nine months ended September 30, 2024 , 471,843 shares were issued under the ESPP leaving 175,275 shares reserved for f uture issuance.

Net Loss per Common Share

Net Loss per Common Share	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Net Loss per Common Share	Note 11 – Net Loss per Common Share Basic net loss per share excludes dilution and is computed by dividing net loss attributable to the common stockholders by the weighted-average shares outstanding during the period. Diluted net loss per common share reflects the potential dilution that could occur if securities or other contracts to issue common stock were exercised, resulting in the issuance of shares of common stock that would then share in the earnings or losses of the Company. Basic and diluted loss per share for the three and nine months ended September 30, 2024 and 2023 were (in thousands, except per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Numerator Net loss attributable to common stockholders $ ( 10,258 ) $ ( 10,949 ) $ ( 34,680 ) $ ( 43,007 ) Denominator Weighted-average shares outstanding used 146,296 79,709 123,634 78,672 Net loss per share, basic and diluted $ ( 0.07 ) $ ( 0.14 ) $ ( 0.28 ) $ ( 0.55 ) The following outstanding common stock equivalents were excluded from diluted net loss attributable to common stockholders for the periods presented because inclusion would be anti-dilutive (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Options to purchase common stock 5,383 3,262 5,383 3,262 Shares committed under ESPP 22 17 22 17 Warrants 4,603 5,603 4,603 5,603 Restricted stock units 3,793 2,769 3,793 2,769 Total 13,801 11,651 13,801 11,651

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Note 12 – Income Taxes Since inception, the Company has incurred net taxable losses, and accordingly, no provision for income taxes has been recorded. There w as no cash paid for income taxes during the three and nine months ended September 30, 2024 and 2023 .

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 13 – Commitments and Contingencies Co-Development Agreement In April 2014 and amended in October 2016, the Company entered into a worldwide agreement with AVEO to develop and commercialize AVEO's hepatocyte growth factor inhibitory antibody ficlatuzumab with the Company's proprietary companion diagnostic test, BDX004, a version of the Company’s serum protein test that is commercially available to help physicians guide treatment decisions for patients with advanced non-small cell lung cancer (NSCLC). Under the terms of the agreement, AVEO conducted a proof of concept (POC) clinical study of ficlatuzumab for NSCLC in which BDX004 was used to select clinical trial subjects (the NSCLC POC Trial). Under the agreement, the Company and AVEO shared equally in the costs of the NSCLC POC Trial, and each were responsible for 50 % of development and regulatory costs associated with all future clinical trials agreed upon by the Company and AVEO. In September 2020, the Company exercised its opt-out right with AVEO for the payment of 50 % of development and regulatory costs for ficlatuzumab effective December 2, 2020 (the AVEO Effective Date). Following the AVEO Effective Date, the Company is entitled to a 10 % royalty of net sales of ficlatuzumab and 25 % of license income generated from the licensing of ficlatuzumab from AVEO. In September 2021, AVEO announced that the FDA has granted Fast Track Designation (FTD) to ficlatuzumab for the treatment of patients with relapsed or recurrent head and neck squamous cell carcinoma. In November 2021 A VEO also announced plans to initiate a registrational Phase 3 clinical trial for ficlatuzumab which began in January 2024. There were no royalties received or expenses related to this agreement for the three and nine months ended September 30, 2024 and 2023 and t he Company has no obligations related to the AVEO agreement as of September 30, 2024. License Agreements In August 2019, we entered into a non-exclusive license agreement with Bio-Rad Laboratories, Inc. (Bio-Rad) (the Bio-Rad License). Under the terms of the Bio-Rad License, the Company received a non-exclusive license, without the right to grant sublicenses, to utilize certain of Bio-Rad’s intellectual property, machinery, materials, reagents, supplies and know-how necessary for the performance of Droplet Digital PCR™ (ddPCR) in cancer detection testing for third parties in the United States. The Company also agreed to purchase all of the necessary supplies and reagents for such testing exclusively from Bio-Rad, pursuant to a separately executed supply agreement (the Supply Agreement) with Bio-Rad. The Bio-Rad License was set to expire in August 2024 . In May 2024, the Company amended the agreement to extend the Supply Agreement to August 2026. Either party may terminate for the other’s uncured material breach or bankruptcy events. Bio-Rad may terminate the Bio-Rad License if the Company does not purchase licensed products under the Supply Agreement for a consecutive twelve-month period or for any material breach by us of the Supply Agreement. On May 13, 2021 (the CellCarta Effective Date), we reached agreement with CellCarta Biosciences Inc. (formerly “Caprion Biosciences, Inc.”) (the CellCarta License) on a new royalty bearing license agreement for the Nodify XL2 test. The parties agreed to terminate all prior agreements and replace with this new arrangement, which has a 1 % fee on net sales made from the first commercial sale of the Nodify XL2 test to the CellCarta Effective Date as an upfront make-good payment covering past royalties due and a royalty rate of 0.675 % on future Nodify XL2 test net sales worldwide for 15 years from the first commercial sale, ending in 2034 . Royalty expense under the CellCarta License was $ 0.1 million and $ 0.2 million for the three and nine months ended September 30, 2024 , respectively, and $ 0.1 million for both the three and nine months ended September 30, 2023, respectively. On October 31, 2019, we completed an acquisition of Freenome's United States operations (formerly "Oncimmune USA" or "Oncimmune") including its COLA/CLIA lab in De Soto, Kansas and its pulmonary nodule malignancy test, then marketed in the United States as the EarlyCDT Lung® test. We renamed and relaunched the test on February 28, 2020 as the Nodify CDT test. As part of the acquisition of the assets of Oncimmune, the Company entered into several agreements to govern the relationship between the parties. The Company agreed to a license agreement and royalty payment related to the Nodify CDT test of 8 % of recognized revenue for non-screening tests up to an annual minimum volume and 5 % thereafter. Royalty expense s were $ 0.5 million and $ 1.1 million for the three and nine months ended September 30, 2024, respectively, compared to $ 0.2 million and $ 0.6 million f or the three and nine months ended September 30, 2023, respectively. Litigation, Claims and Assessments From time to time, we may become involved in legal proceedings or investigations which could have an adverse impact on our reputation, business and financial condition and divert the attention of our management from the operation of our business. We are not presently a party to any legal proceedings that, if determined adversely to us, would individually or taken together have a material adverse effect on our business, results of operations, financial condition, or cash flows.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2024
Subsequent Events [Abstract]
Subsequent Events	Note 14 – Subsequent Events On October 30, 2024 (the Fourth Amendment Effective Date), the Company entered into the Fourth Amendment to the Credit Agreement and Guaranty (the Fourth Amendment) with Perceptive, as lender and administrative agent, and the Company, as borrower, whereby subject to the terms and conditions of the Fourth Amendment, the Minimum Net Revenue Covenant (as defined in the Credit Agreement) was amended to reduce the relevant threshold as of the last day of each fiscal quarter commencing on the fiscal quarter ending June 30, 2025 through and including the fiscal quarter ending December 31, 2027. On November 1, 2024, the Company expects to file a shelf registration statement on Form S-3 and enter into a new sales agreement with a financial institution, pursuant to which the Company may issue and sell, from time to time, shares of its common stock having an aggregate offering price of up to $50.0 million, subject to terms and conditions (the 2024 ATM Program). The shares of common stock offered pursuant to the 2024 ATM Program will be offered and sold by the Company pursuant to its registration statement on Form S-3 once declared effective by the SEC. Sales of common stock under the 2024 ATM Program, if any, will be made at market prices by methods deemed to be an “at-the-market offering” as defined in Rule 415 promulgated under the Securities Act of 1933, as amended, including sales made directly on the NASDAQ Global Market, or any other existing trading market for our common stock. In connection with establishing the 2024 ATM Program, the Company terminated its prior $50.0 million ATM program established in November 2021, and no additional stock can be issued thereunder.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed financial statements have been prepared in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X for interim financial information and reflect all adjustments necessary to state fairly the Company’s financial position, results of operations and cash flows for the interim periods presented. All such adjustments are of a normal recurring nature. Results for interim periods are not indicative of the results for the entire fiscal year. The accompanying unaudited condensed financial statements should be read in conjunction with the audited financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023. Certain information and footnote disclosures, including significant accounting policies, normally included in fiscal year financial statements prepared in accordance with accounting principles generally accepted in the U.S. (GAAP) have been condensed or omitted. The condensed balance sheet as of December 31, 2023 was derived from the audited financial statements. Liquidity and Capital Resources As of September 30, 2024, we maintained cash and cash equivalents of $ 31.4 million and we have $ 40.0 million in outstanding aggregate principal amount on our Perceptive Term Loan Facility (see Note 6 – Debt ). We have incurred significant losses since inception and, as a result, we have funded our operations to date primarily through the sale of common stock, the sale of convertible preferred stock, the issuance of notes payable, and from our two primary revenue sources: (i) diagnostic testing, which includes lung diagnostic testing and (ii) providing biopharmaceutical companies with development and testing services and licensing our technologies. In accordance with Accounting Standards Update 2014-15 (ASC Topic 205-40), Presentation of Financial Statements - Going Concern: Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern , the Company is required to evaluate whether there is substantial doubt about its ability to continue as a going concern each reporting period, including interim periods. In evaluating the Company’s ability to continue as a going concern, management projected its cash flow sources and evaluated the conditions and events that could raise substantial doubt about the Company’s ability to continue as a going concern within one year after the date that these financial statements were issued. Management considered the Company’s current projections of future cash flows, our ability to execute our current operating plan, current financial condition, sources of liquidity and debt obligations for at least one year from the date of issuance of this Form 10-Q in considering whether it has the ability to meet its obligations. Our ability to meet our obligations as they come due may be impacted by our ability to remain compliant with financial covenants in our Perceptive Term Loan Facility (see Note 6 – Debt ) or to obtain waivers or amendments that impact the related covenants. As of September 30, 2024, the Company was in compliance with all restrictive and financial covenants associated with its borrowings. Our ability to maintain our financial covenants under our Perceptive Term Loan Facility during the next twelve months is, in part, dependent upon executing our current operating plan. If we do not execute our current operating plan and maintain our financial covenants, this could result in an Event of Default (as defined in the Perceptive Term Loan Facility), causing an acceleration and repayment of the outstanding balances. The Perceptive Term Loan Facility requires the Company to meet certain minimum net revenue threshold amounts agreed to between the Company and Perceptive as of the last day of each fiscal quarter, which commenced with the fiscal quarter ending March 31, 2023. During 2023, the Company entered into various amendments to the Perceptive Term Loan Facility to reduce the relevant Minimum Net Revenue thresholds. On February 29, 2024, the Company entered into a third amendment to the Perceptive Term Loan Facility, whereby, subject to the terms and conditions of the third amendment, the Minimum Net Revenue Covenant was amended to reduce the relevant threshold through the fiscal quarter ended December 31, 2025 (see Note 6 – Debt ). During the three months ended June 30, 2024 , the Company completed an underwritten offering of common stock and a concurrent private placement (the April 2024 Offering). Collectively, the Company raised net proceeds of approximately $ 51.3 million (see Note 8 – Equity ). We have taken steps to improve our liquidity through raising debt and equity capital and have also undertaken several proactive measures including, among other things, the reduction of planned capital expenditures and certain operating expenses as previously disclosed. If we do not execute our current operating plan, we may need to consider further measures to reduce our operating expenses. These measures would limit or reduce our operations and could include a hiring freeze, reductions in our workforce, reduction in cash compensation, deferring capital expenditures, and reducing other operating costs. If we do not execute our current operating plan we may need to continue to raise additional funds from external sources, such as through the issuance of debt or equity securities. We may also raise additional capital to restructure our existing debt or for general working capital purposes, or both. If we raise additional capital through debt financing, we may be subject to covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends. If we do raise additional capital through equity offerings, the ownership interest of our existing stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect our existing stockholders’ rights. There can be no assurance that additional capital will be available to us or, if available, will be available in sufficient amounts or on terms acceptable to us or on a timely basis. We expect to continue to incur operating losses in the near term while we make investments to support our anticipated growth. Our ability to maintain our financial covenants is, in part, dependent upon executing our current operating plan and, along with the items noted above, raises substantial doubt about the Company’s ability to continue as a going concern within one year after the date the financial statements are issued. Our unaudited financial statements have been prepared assuming we will continue as a going concern and do not include any adjustments that might be necessary should we be unable to continue as a going concern.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the balance sheet date and the reported amounts of revenue and expenses during the reporting periods. Actual results could differ from those estimates.
Concentrations of Credit Risk and Other Uncertainties	Concentrations of Credit Risk and Other Uncertainties Substantially all of the Company’s cash and cash equivalents are deposited with one major financial institution in the United States. The Company continually monitors its positions with, and the credit quality of, the financial institution with which it holds cash. Periodically throughout the year, the Company has maintained balances in various operating and money market accounts in excess of federally insured limits. The Company has not experienced any losses on its deposits of cash and cash equivalents. Several of the components for certain of the Company's sample collection kits, test reagents, and test systems are obtained from single-source suppliers. If these single-source suppliers fail to satisfy the Company's requirements on a timely basis, the Company could suffer delays in being able to deliver its diagnostic solutions, a possible loss of revenue, or incur higher costs, any of which could adversely affect its operating results. For a discussion of credit risk concentration of accounts receivable as of September 30, 2024 and December 31, 2023, see Note 9 – Revenue and Accounts Receivable Credit Concentration .
Restricted Cash	Restricted Cash Restricted cash consists of deposits related to the Company’s corporate credit card. For both of the periods ended September 30, 2024 and December 31, 2023 , the Company had $ 0.1 million restricted cash, respectively, which was included in ‘ Other current assets ’ in the accompanying condensed balance sheets.
Inventory	Inventory Inventory consists primarily of material supplies, which are consumed in the performance of testing services and charged to ‘Direct costs and expenses’. Inventory is stated at cost and reported within ‘Other current assets’ in the condensed balance s heets and was $ 1.2 million and $ 1.4 million as of September 30, 2024 and December 31, 2023 , respectively. The Company recorded a reserve for excess inventory of zero and $ 0.1 million as of September 30, 2024 and December 31, 2023, respectively. During the nine months ended September 30, 2024 and 2023, the Company record ed an insignificant amount and $ 0.1 million, respectively , to the condensed statements of operations for excess and obsolete inventory.
Other Assets	Other Assets The Company has a $ 5.0 million cash refundable deposit to secure the performance of the Company’s obligations associated with the operating lease agreement with Centennial Valley Properties I, LLC and subsequently assigned to CVP I Owner LLC (see Note 7 – Leases ). As of September 30, 2024 and December 31, 2023 , the $ 5.0 million refundable deposit is reported within 'Other long-term assets' in the condensed balance sheets.
Fair Value of Financial Instruments	Fair Value of Financial Instruments U.S. GAAP for fair value establishes a hierarchy that prioritizes fair value measurements based on the types of inputs used for the various valuation techniques (market approach, income approach and cost approach). We utilize a combination of market and income approaches to value our financial instruments. Our financial assets and liabilities are measured using inputs from the three levels of the fair value hierarchy. Fair value measurements are categorized within the fair value hierarchy based upon the lowest level of the most significant inputs used to determine fair value. The three levels of the hierarchy and the related inputs are as follows: Level Inputs 1 Unadjusted quoted prices in active markets for identical assets and liabilities. 2 Unadjusted quoted prices in active markets for similar assets and liabilities; Unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active; or Inputs other than quoted prices that are observable for the asset or liability. 3 Unobservable inputs for the asset or liability. The carrying amounts of certain financial instruments including cash and cash equivalents, accounts receivable, prepaid expenses and other current assets, other long-term assets, accounts payable and accrued liabilities approximate fair value due to their relatively short maturities. See Note 4 — Fair Value for further discussion related to estimated fair value measurements.
Recently Issued Accounting Standards	Standards Being Evaluated In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting: Improvements to Reportable Segment Disclosures (ASC Topic 280). This ASU requires all public entities to provide additional disclosures about the entity's reportable segments and more detailed information about a reportable segment's expenses. This guidance will become effective for the Company for the annual period beginning on January 1, 2024, and interim periods beginning on January 1, 2025. The Company is currently evaluating this guidance and assessing the overall impact on its financial statements. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures . This ASU improves the transparency of income tax disclosures by requiring consistent categories and greater disaggregation of information in the rate reconciliation and income taxes paid by jurisdiction. This guidance will become effective for the Company beginning January 1, 2025, with early adoption permitted. The Company is currently evaluating this guidance and assessing the overall impact on its financial statements.

Fair Value (Tables)

Fair Value (Tables)	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Summary of Fair Value of Outstanding Borrowings	The table below presents the carryi ng and fair values of outstanding borrowings, which are classified as Level 2, as of the dates indicated (in thousands): As of September 30, 2024 December 31, 2023 Carrying Value Fair Value Carrying Value Fair Value Borrowings $ 36,141 $ 36,550 $ 35,276 $ 35,506
Schedule of Reported Fair values of Contingent Consideration and Warrant Liabilities	The table below presents the reported fair values of contingent consideration and warrant liabilities, which are classified as Level 3 in the fair value hierarchy, as of the dates indicated (in thousands): As of Description September 30, 2024 December 31, 2023 Contingent consideration $ — $ 21,857 Warrant liabilities $ — $ — Contingent value rights $ — $ —
Schedule of Changes in Contingent Consideration and Warrant Liabilities	The following table presents the changes in contingent consideration for the dates indicated (in thousands): For the nine months ended Level 3 Rollforward Contingent Consideration Balance - January 1, 2024 $ 21,857 Interest expense 1,137 Loss on extinguishment of liabilities 248 Payments ( 23,242 ) Balance - September 30, 2024 $ — The following table presents the changes in contingent consideration and warrant liabilities for the dates indicated (in thousands): For the nine months ended Level 3 Rollforward Contingent Consideration Warrant Liabilities Beginning balances - January 1, 2023 $ 28,986 $ 61 Changes in fair value, net — 1,332 Interest expense 3,094 — Payments ( 7,591 ) — Ending balances - September 30, 2023 $ 24,489 $ 1,393

Supplementary Balance Sheet I_2

Supplementary Balance Sheet Information (Tables)	9 Months Ended
	Sep. 30, 2024
Balance Sheet Related Disclosures [Abstract]
Schedule of Property and Equipment	Property and equipment consist of the following (in thousands): As of September 30, 2024 December 31, 2023 Lab equipment $ 5,877 $ 6,089 Leasehold improvements 28,165 24,713 Computer equipment 1,307 1,221 Furniture and fixtures 1,073 1,034 Software 325 325 Vehicles 97 97 Construction in process 88 — 36,932 33,479 Less accumulated depreciation ( 8,249 ) ( 5,612 ) Total property and equipment, net $ 28,683 $ 27,867
Schedule of Intangible Assets, Excluding Goodwill	Intangible assets, excluding goodwill, consist of the following (in thousands): September 30, 2024 December 31, 2023 Cost Accumulated Net Carrying Value Cost Accumulated Net Carrying Value Intangible assets subject to amortization Patents $ 2,000 $ ( 843 ) $ 1,157 $ 1,975 $ ( 752 ) $ 1,223 Purchased technology 16,900 ( 11,736 ) 5,164 16,900 ( 10,328 ) 6,572 Intangible assets not subject to Trademarks 117 — 117 116 — 116 Total $ 19,017 $ ( 12,579 ) $ 6,438 $ 18,991 $ ( 11,080 ) $ 7,911
Schedule of Future Estimated Amortization Expense of Intangible Assets	Future estimated amortization expense of intangible assets is (in thousands): As of Remainder of 2024 $ 501 2025 2,000 2026 1,979 2027 1,021 2028 73 2029 and thereafter 747 Total $ 6,321
Schedule of Accrued Liabilities	Accrued liabilities consist of the following (in thousands): As of September 30, 2024 December 31, 2023 Compensation related accruals $ 4,958 $ 3,855 Accrued clinical trial expense 940 983 Other expenses 2,655 2,872 Total accrued liabilities $ 8,553 $ 7,710

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Summary of Long-term Notes Payable	Long-term notes payable were as follows (in thousands): As of September 30, 2024 December 31, 2023 Perceptive Term Loan Facility $ 40,000 $ 40,000 Other 40 78 Unamortized debt discount and debt issuance costs ( 3,899 ) ( 4,802 ) 36,141 35,276 Less: current maturities 29 51 Long-term notes payable $ 36,112 $ 35,225
Scheduled Principal Repayments (Maturities) of Long-term Obligations	Scheduled principal repayments (maturities) of long-term obligations were as follows (in thousands): As of Remainder of 2024 $ 13 2025 21 2026 6 2027 and thereafter 40,000 Total $ 40,040

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2024
Leases [Abstract]
Summary of Future Minimum Lease Payments for Operating Leases	Future minimum lease payments associated with our operating leases were as follows (in thousands): As of Remainder of 2024 $ 696 2025 3,909 2026 4,171 2027 4,063 2028 4,151 2029 and thereafter 28,113 Total future minimum lease payments 45,103 Less amount representing interest ( 19,288 ) Total lease liabilities $ 25,815

Revenue and Accounts Receivab_2

Revenue and Accounts Receivable Credit Concentration (Tables)	9 Months Ended
	Sep. 30, 2024
Revenue from Contract with Customer [Abstract]
Summary of Revenue	Revenues consisted of the following (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Diagnostic Tests $ 17,168 $ 12,301 $ 47,503 $ 32,395 Biopharmaceutical Services and other 983 1,190 3,391 2,024 Total revenue $ 18,151 $ 13,491 $ 50,894 $ 34,419
Summary of Revenue and Accounts Receivable by Third-party Payors and Other Customers	The Company’s customers in excess of 10% of total revenue and their related revenue as a percentage of total revenue were as follows: Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 United Healthcare 7 % 10 % 8 % 10 % The Company’s third-party payors and other customers in excess of 10% of accounts receivable, and their related accounts receivable as a percentage of total accounts receivable were as follows: As of September 30, 2024 December 31, 2023 Medicare 26 % 21 %

Share-Based Compensation (Table

Share-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2024
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Summary of Share-based Compensation Expense	Share-based compensation expense reported in the Company’s condensed statements of operations was (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Direct costs and expenses $ 20 $ 17 $ 54 $ 41 Research and development 110 68 240 249 Sales, marketing, general and administrative 1,385 869 5,079 4,002 Total $ 1,515 $ 954 $ 5,373 $ 4,292
Summary of Stock Option Activity	Stock option activity during the nine months ended September 30, 2024, excluding the Bonus Option Program described below, was (in thousands, except weighted average exercise price and weighted average contractual life): Number of Weighted Average Weighted Average Aggregate Outstanding - January 1, 2024 2,041 $ 3.36 6.9 $ 964 Granted 2,226 1.67 — — Forfeited/canceled ( 221 ) 1.96 — — Exercised ( 27 ) 0.72 — — Outstanding ‑ September 30, 2024 4,019 $ 2.52 7.9 $ 1,250 Exercisable ‑ September 30, 2024 1,719 $ 3.48 6.2 $ 822
Summary of Restricted Stock Units Activity	Restricted stock unit activity during the nine months ended September 30, 2024 was (in thousands, except weighted average grant date fair value per share): Number of Shares Weighted Average Outstanding ‑ January 1, 2024 2,729 $ 1.91 Granted 1,670 1.81 Forfeited/canceled ( 15 ) 1.92 Released ( 591 ) 2.01 Outstanding ‑ September 30, 2024 3,793 $ 1.85
Bonus-To-Options Program
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Summary of Stock Option Activity	As part of the Bonus Option Program, the Company recorded the following activity during the nine months ended September 30, 2024 (in thousands, excepted weighted average exercise price and weighted average contractual life): Number of Weighted Average Weighted Average Aggregate Outstanding ‑ January 1, 2024 1,050 $ 2.81 8.4 $ 22 Granted 341 1.46 — — Forfeited/canceled ( 27 ) 24.34 — — Exercised — — — — Outstanding ‑ September 30, 2024 1,364 $ 2.04 8.2 $ 129 Exercisable ‑ September 30, 2024 1,364 $ 2.04 8.2 $ 129

Net Loss per Common Share (Tabl

Net Loss per Common Share (Tables)	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Schedule of Computation of Basic and Diluted Loss per Share Attributable to Stockholders	Basic and diluted loss per share for the three and nine months ended September 30, 2024 and 2023 were (in thousands, except per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Numerator Net loss attributable to common stockholders $ ( 10,258 ) $ ( 10,949 ) $ ( 34,680 ) $ ( 43,007 ) Denominator Weighted-average shares outstanding used 146,296 79,709 123,634 78,672 Net loss per share, basic and diluted $ ( 0.07 ) $ ( 0.14 ) $ ( 0.28 ) $ ( 0.55 )
Schedule of Common Stock Equivalents Excluded from Diluted Net Loss Attributable to Common Stockholders	The following outstanding common stock equivalents were excluded from diluted net loss attributable to common stockholders for the periods presented because inclusion would be anti-dilutive (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Options to purchase common stock 5,383 3,262 5,383 3,262 Shares committed under ESPP 22 17 22 17 Warrants 4,603 5,603 4,603 5,603 Restricted stock units 3,793 2,769 3,793 2,769 Total 13,801 11,651 13,801 11,651

Organization and Description _2

Organization and Description of Business - Additional Information (Details)	9 Months Ended
	Sep. 30, 2024 Test
Organization And Description Of Business [Abstract]
Number of blood based lung cancer test	5
Number of commercial blood-based test	2

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Thousands		9 Months Ended
	Apr. 09, 2024	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Summary Of Significant Accounting Policies [Line Items]
Cash and cash equivalents		$ 31,406		$ 26,284
Reserve for inventory		0		100
Restricted cash		$ 100		$ 100
Restricted Cash, Current, Statement of Financial Position [Extensible Enumeration]		Other Assets, Current		Other Assets, Current
Excess and obsolete inventory		$ 20	$ 115
April 2024 Offering
Summary Of Significant Accounting Policies [Line Items]
Private placement in net equity proceeds	$ 51,300
Other Current Assets
Summary Of Significant Accounting Policies [Line Items]
Inventory		1,200		$ 1,400
Other Long-term Assets
Summary Of Significant Accounting Policies [Line Items]
Refundable deposit		5,000		$ 5,000
Perceptive Term Loan Facility | April 2024 Offering
Summary Of Significant Accounting Policies [Line Items]
Private placement in net equity proceeds	$ 51,300
Perceptive Term Loan
Summary Of Significant Accounting Policies [Line Items]
Cash and cash equivalents		31,400
Principal balance outstanding		$ 40,000

Fair Value - Summary of Fair Va

Fair Value - Summary of Fair Value of Outstanding Borrowings (Details) - Fair Value, Recurring - Level 2 - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Carrying Value
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Borrowings	$ 36,141	$ 35,276
Fair Value
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Borrowings	$ 36,550	$ 35,506

Fair Value - Schedule of Report

Fair Value - Schedule of Reported Fair values of Contingent Consideration and Warrant Liabilities (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Fair Value, Recurring | Contingent Consideration | Level 3
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Current portion of contingent consideration	$ 21,857

Fair Value - Schedule of Change

Fair Value - Schedule of Changes in Contingent Consideration and Warrant Liabilities (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Loss on extinguishment of liabilities	$ 248
Fair Value, Recurring | Level 3 | Contingent Consideration
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Balance	21,857	$ 28,986
Interest expense	1,137	3,094
Loss on extinguishment of liabilities	248
Payments	(23,242)	(7,591)
Balance	$ 0	24,489
Fair Value, Recurring | Level 3 | Warrant Liabilities
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Balance		61
Changes in fair value, net		1,332
Balance		$ 1,393

Fair Value - Additional Informa

Fair Value - Additional Information (Details) $ in Thousands

1 Months Ended

3 Months Ended

9 Months Ended

12 Months Ended

Sep. 30, 2024 USD ($) shares

Jul. 31, 2023 USD ($) Installment

Apr. 07, 2022

Oct. 31, 2024 USD ($)

Jul. 31, 2024 USD ($)

Apr. 30, 2024 USD ($) Installment

Apr. 30, 2022 USD ($) Installment

Jan. 31, 2016 USD ($) shares

Sep. 30, 2024 USD ($) shares

Sep. 30, 2023 USD ($)

Sep. 30, 2024 USD ($) shares

Sep. 30, 2023 USD ($)

Dec. 31, 2018 USD ($) Installment shares

Nov. 21, 2022 shares

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Change in fair value of warrant liability

$ 1,393

$ 1,332

Loss on debt extinguishment

$ (248)

2018 Notes | Series G Preferred Stock

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Warrant issued to purchase shares | shares

613,333

613,333

613,333

Contingent Consideration

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Interest expense due to passage of time and fixed payment schedule

$ 200

1,000

$ 1,100

3,100

Contingent Consideration | Third Amendment to APA Agreement

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Milestone payment

$ 8,400

Warrant Liabilities

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Warrant issued to purchase shares | shares

5,000,000

Change in fair value of warrant liability

0

1,400

0

1,300

Contingent Value Rights | Series F Preferred Stock

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Change in fair value of warrant liability

$ 0

$ 0

$ 0

$ 0

Percentage of net proceeds

15%

Contingent Value Rights | Series F Preferred Stock | Ficlatuzumab

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Contingent value rights interest rate

0.00375%

Shares issued | shares

3,999

Drug interest rate percentage

15%

Contingent value rights

$ 500

Integrated Diagnostics, Inc

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Exit fee payment

$ 6,100

Integrated Diagnostics, Inc | Contingent Consideration

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition description

requires additional consideration to be paid by the Company to such shareholders upon attainment of a three-consecutive month

Business acquisition contingent consideration gross margin target

$ 2,000

Business acquisition contingent consideration gross margin target period

7 years

Integrated Diagnostics, Inc | Contingent Consideration | Third Amendment to APA Agreement

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Contingent consideration number of installments | Installment

3

1

5

Milestone payment

$ 3,000

$ 5,000

$ 2,000

Percentage of interest on installment payments

10%

Integrated Diagnostics, Inc | Contingent Consideration | Subsequent Event | Third Amendment to APA Agreement

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Exit fee payment

$ 6,100

Integrated Diagnostics, Inc | Common Stock | Contingent Consideration

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition description

If Indi elected to not exercise its option, the Company had 12 months to repurchase the common stock in two equal and consecutive quarterly cash installments totaling $37.0 million.

Contingent consideration shares | shares

2,520,108

Contingent consideration number of installments | Installment

8

Contingent consideration arrangements, common shares, redemption amount

$ 4,600

$ 37,000

Repayments of debt

9,300

Business combination contingent consideration final payment

$ 37,000

Contingent consideration cash payment

$ 37,000

Investment, Type [Extensible Enumeration]

Repurchase [Member]

Minimum | Contingent Consideration

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Percentage of probabilities of contingent consideration successful achievement of specified product gross margin targets discount rates range

11%

Maximum | Contingent Consideration

Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Percentage of probabilities of contingent consideration successful achievement of specified product gross margin targets discount rates range

16%

Supplementary Balance Sheet I_3

Supplementary Balance Sheet Information - Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 36,932	$ 33,479
Less accumulated depreciation	(8,249)	(5,612)
Total property and equipment, net	28,683	27,867
Lab Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	5,877	6,089
Leasehold Improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	28,165	24,713
Computer Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,307	1,221
Furniture and Fixtures
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,073	1,034
Software
Property, Plant and Equipment [Line Items]
Property and equipment, gross	325	325
Vehicles
Property, Plant and Equipment [Line Items]
Property and equipment, gross	97	$ 97
Construction in Process
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 88

Supplementary Balance Sheet I_4

Supplementary Balance Sheet Information - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Property Plant And Equipment [Line Items]
Depreciation expense	$ 1	$ 0.3	$ 2.8	$ 0.9
Amortization expense of definite-lived intangible assets	$ 0.5	$ 1.5	$ 0.5	$ 1.5

Supplementary Balance Sheet I_5

Supplementary Balance Sheet Information - Intangible Assets, Excluding Goodwill (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Finite Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, Net Carrying Value	$ 6,321
Intangible assets, Cost	19,017	$ 18,991
Intangible assets, Accumulated Amortization	(12,579)	(11,080)
Intangible assets, Net Carrying Value	6,438	7,911
Trademarks
Finite Lived Intangible Assets [Line Items]
Intangible assets not subject to amortization, Cost	117	116
Intangible assets not subject to amortization, Net Carrying Value	117	116
Patents
Finite Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, Cost	2,000	1,975
Intangible assets subject to amortization, Accumulated Amortization	(843)	(752)
Intangible assets subject to amortization, Net Carrying Value	1,157	1,223
Purchased Technology
Finite Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, Cost	16,900	16,900
Intangible assets subject to amortization, Accumulated Amortization	(11,736)	(10,328)
Intangible assets subject to amortization, Net Carrying Value	$ 5,164	$ 6,572

Supplementary Balance Sheet I_6

Supplementary Balance Sheet Information - Schedule of Amortization Related to Remaining Net Intangible Assets Schedule to Amortize (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2024	$ 501
2025	2,000
2026	1,979
2027	1,021
2028	73
2029 and thereafter	747
Intangible assets subject to amortization, Net Carrying Value	$ 6,321

Supplementary Balance Sheet I_7

Supplementary Balance Sheet Information - Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Compensation related accruals	$ 4,958	$ 3,855
Accrued clinical trial expense	940	983
Other expenses	2,655	2,872
Total accrued liabilities	$ 8,553	$ 7,710

Debt - Summary of Long-term Not

Debt - Summary of Long-term Notes Payable (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Unamortized debt discount and debt issuance costs	$ (3,899)	$ (4,802)
Notes payable, total	36,141	35,276
Less: current maturities	29	51
Long-term notes payable	36,112	35,225
Perceptive Term Loan Facility
Debt Instrument [Line Items]
Notes/Loan payable	40,000	40,000
Other
Debt Instrument [Line Items]
Notes/Loan payable	$ 40	$ 78

Debt - Additional Information (

Debt - Additional Information (Details) - USD ($)				9 Months Ended
	Aug. 04, 2023	Nov. 21, 2022	Nov. 16, 2022	Sep. 30, 2024	Sep. 30, 2023	Dec. 15, 2023	May 10, 2023
Debt Instrument [Line Items]
Proceeds from the issuance of common stock				$ 55,625,000	$ 15,316,000
Amount withdrawn				$ 40,040,000
First Amendment
Debt Instrument [Line Items]
Warrant issued to purchase shares							500,000
Warrant, exercise price							$ 1.6254
Initial warrants amount							$ 700,000
2018 Notes | Series G Preferred Stock
Debt Instrument [Line Items]
Warrant issued to purchase shares				613,333
Warrant, exercise price				$ 0.75
Perceptive Term Loan Facility
Debt Instrument [Line Items]
Debt instrument maturity date			Nov. 21, 2027
Interest rate			3%
Applicable margin rate			9%
Effective interest rate				13.90%
Warrant, exercise price			$ 1.0648
Public offering price per share of common stock		$ 1.15
Minimum cash balance at maturity date				$ 2,500,000
Initial warrants amount		$ 2,900,000	$ 2,900,000
Additional warrants amount			100,000
Debt instrument, discount			5,200,000
Perceptive Term Loan Facility | Tranche A Loan
Debt Instrument [Line Items]
Net proceeds from debt, after deducting debt issuance costs and expenses			$ 27,900,000
Warrant, exercise price		$ 1.0648
Perceptive Term Loan Facility | Tranche B Loan
Debt Instrument [Line Items]
Warrant, exercise price			$ 1.0648
Additional warratns exercisable			1,000,000
Amount withdrawn						$ 10,000,000
Perceptive Term Loan Facility | Tranche C Loan
Debt Instrument [Line Items]
Additional warratns exercisable			1,000,000
Amount withdrawn				$ 0
Perceptive Term Loan Facility | Minimum
Debt Instrument [Line Items]
Prepayment premium percentage of aggregate outstanding principal amount			2%
Perceptive Term Loan Facility | Maximum
Debt Instrument [Line Items]
Prepayment premium percentage of aggregate outstanding principal amount			10%
Warrant issued to purchase shares		5,000,000	5,000,000
Perceptive Term Loan Facility | Maximum | Tranche A Loan
Debt Instrument [Line Items]
Debt instrument, aggregate principal amount		$ 30,000,000
Perceptive Term Loan Facility | Maximum | Tranche B Loan
Debt Instrument [Line Items]
Debt instrument, aggregate principal amount			$ 10,000,000
Perceptive Term Loan Facility | Maximum | Tranche C Loan
Debt Instrument [Line Items]
Debt instrument, aggregate principal amount			$ 10,000,000
Second Amendment | Tranche B Loan
Debt Instrument [Line Items]
Gross proceeds from sale of common shares	$ 27,500,000
Amount withdrawn						$ 10,000,000

Debt - Scheduled Principal Repa

Debt - Scheduled Principal Repayments (Maturities) of Long-term Obligations (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Maturities of Long-Term Debt [Abstract]
Remainder of 2024	$ 13
2025	21
2026	6
2027 and thereafter	40,000
Total	$ 40,040

Leases - Additional Information

Leases - Additional Information (Details)		1 Months Ended		3 Months Ended		9 Months Ended
	Mar. 11, 2022 USD ($) ft² RenewalOption	Mar. 31, 2025 USD ($)	Sep. 30, 2024 USD ($) ft²	Sep. 30, 2024 USD ($) ft²	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($) ft²	Sep. 30, 2023 USD ($)	Jun. 30, 2024 ft²	Dec. 31, 2023 USD ($)	Sep. 30, 2022 USD ($)
Lessee, Lease, Description [Line Items]
Operating lease expense				$ 600,000	$ 1,100,000	$ 1,700,000	$ 3,300,000
Operating leases, Weighted-average remaining lease term (in years)			10 years 3 months 18 days	10 years 3 months 18 days		10 years 3 months 18 days
Operating leases, Weighted-average discount rate			11.40%	11.40%		11.40%
Restricted Cash, Current, Statement of Financial Position [Extensible Enumeration]			Other current assets	Other current assets		Other current assets			Other current assets
Scenario Forecast
Lessee, Lease, Description [Line Items]
Accretion of lease liability		$ 25,500,000
Centennial Valley Properties I, LLC Lease Agreement
Lessee, Lease, Description [Line Items]
Lease description						The initial term of the Lease is twelve years (the Initial Term) from the commencement date, which was April 1, 2023 (the Commencement Date). The Company has two renewal options to extend the term of the Lease for an additional seven- or ten-year terms for each renewal.
Lease term	12 years
Lease commencement date	Apr. 01, 2023
Lease agreement number of options to extend | RenewalOption	2
Lease option to extend	true
Leased property building capacity | ft²	79,980
Base rent per month from commencement date	$ 227,000
Rent after fixed escalation provisions	$ 326,000
Area of leased premised obligated to pay base rent | ft²	19,980
Landlord contribution towards cost of construction and tenant improvements	$ 18,800,000
Additional Tenant improvement allowance			$ 2,000,000
Restricted Cash, Current, Statement of Financial Position [Extensible Enumeration]			Other long-term assets	Other long-term assets		Other long-term assets
Interest rate on extra allowance amount	6%
Capital expenditure for leasehold improvements related to leases premises which are tenant improvements									$ 20,800,000
Centennial Valley Properties I, LLC Lease Agreement | Letter of Credit | Cash Collateralized
Lessee, Lease, Description [Line Items]
Long-term Line of Credit										$ 5,000,000
Minimum
Lessee, Lease, Description [Line Items]
Operating lease, expiration term			1 year	1 year		1 year
Maximum
Lessee, Lease, Description [Line Items]
Operating lease, expiration term			3 years	3 years		3 years
Other Long-term Assets
Lessee, Lease, Description [Line Items]
Refundable deposit			$ 5,000,000	$ 5,000,000		$ 5,000,000			$ 5,000,000
Other Long-term Assets | Centennial Valley Properties I, LLC Lease Agreement
Lessee, Lease, Description [Line Items]
Refundable deposit			$ 5,000,000	$ 5,000,000		$ 5,000,000
KANSAS
Lessee, Lease, Description [Line Items]
Area of office space leased | ft²			9,066	9,066		9,066
Area of additional office space leased | ft²								1,772

Leases - Summary of Future Mini

Leases - Summary of Future Minimum Lease Payments for Operating Leases (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Lessee, Operating Lease, Liability, to be Paid, Fiscal Year Maturity [Abstract]
Operating leases, Remainder of 2024	$ 696
Operating leases, 2025	3,909
Operating leases, 2026	4,171
Operating leases, 2027	4,063
Operating leases, 2028	4,151
Operating leases, 2029 and thereafter	28,113
Operating leases, Total future minimum lease payments	45,103
Operating leases, Less amount representing interest	(19,288)
Operating lease liability	$ 25,815

Equity - Additional Information

Equity - Additional Information (Details)

1 Months Ended

3 Months Ended

9 Months Ended

12 Months Ended

May 23, 2024 shares

Apr. 09, 2024 USD ($) shares

Apr. 08, 2024 shares

Apr. 05, 2024 USD ($) $ / shares shares

Nov. 21, 2022 USD ($) $ / shares shares

Mar. 07, 2022 USD ($) shares

Nov. 30, 2021 USD ($)

Sep. 30, 2024 USD ($) $ / shares shares

Jun. 30, 2024 USD ($)

Mar. 31, 2024 USD ($)

Sep. 30, 2023 USD ($)

Mar. 31, 2023 USD ($)

Sep. 30, 2024 USD ($) Facility $ / shares shares

Sep. 30, 2023 USD ($)

Dec. 22, 2022 USD ($)

May 21, 2024 shares

Dec. 31, 2023 $ / shares

Dec. 15, 2023 USD ($)

May 10, 2023 USD ($) $ / shares shares

Nov. 16, 2022 USD ($) $ / shares shares

Class of Stock [Line Items]

Proceeds from the sale of common shares

$ 55,625,000

$ 15,316,000

Aggregate offering price

$ (15,000)

$ 18,198,000

$ 607,000

$ 15,316,000

$ (61,000)

Preferred stock, par value | $ / shares

$ 0.001

$ 0.001

$ 0.001

Warrants, expires period

Feb. 23, 2028

Feb. 23, 2028

Perceptive Term Loan Facility

Class of Stock [Line Items]

Public offering price per share of common stock | $ / shares

$ 1.15

Initial warrants amount

$ 2,900,000

$ 2,900,000

Warrants, expires period

Nov. 21, 2032

Warrant, exercise price | $ / shares

$ 1.0648

Series G Preferred Stock | 2018 Notes

Class of Stock [Line Items]

Warrant issued to purchase shares | shares

613,333

613,333

Warrant, exercise price | $ / shares

$ 0.75

$ 0.75

Series A Preferred Stock

Class of Stock [Line Items]

Number of common shares issuable upon conversion of preferred stock | shares

40

40

Minimum

Class of Stock [Line Items]

Percentage of common stock issued and outstanding required for conversion of securities

0%

Maximum

Class of Stock [Line Items]

Aggregate offering price

$ 50,000,000

Percentage of common stock issued and outstanding required for conversion of securities

19.90%

Maximum | Perceptive Term Loan Facility

Class of Stock [Line Items]

Warrant issued to purchase shares | shares

5,000,000

5,000,000

Maximum | Series A Preferred Stock

Class of Stock [Line Items]

Issuance of common stock, net, Shares | shares

760,857

Tranche B Loan | Perceptive Term Loan Facility

Class of Stock [Line Items]

Warrants, expires period

Dec. 15, 2033

Warrant, exercise price | $ / shares

$ 1.0648

Tranche A Loan | Perceptive Term Loan Facility

Class of Stock [Line Items]

Warrant, exercise price | $ / shares

$ 1.0648

Equity Financing Programs

Class of Stock [Line Items]

Number of facility | Facility

2

Proceeds from the sale of common shares

$ 600,000

Equity Financing Programs | Lincoln Park

Class of Stock [Line Items]

Common stock issuable, committed to purchase

$ 600,000

Diligence expenses and legal fees

$ 100,000

Purchase agreement term

36 months

Shares issued as commitment fee | shares

184,275

Commitment shares issuable on conditional basis | shares

61,425

Adjustments to additional paid-in capital deferred offering costs

$ 0

$ 0

0

$ 0

Deferred offering costs

$ 700,000

0

0

Deferred offering costs

$ 0

700,000

Equity Financing Programs | Lincoln Park | Maximum

Class of Stock [Line Items]

Common stock issuable, committed to purchase

50,000,000

Shares issued as commitment fee, value

$ 20,000,000

At-The-Market Offering

Class of Stock [Line Items]

Net proceeds from sale of common shares after deducting underwriting discounts and commissions and offering expenses

$ 600,000

IPO

Class of Stock [Line Items]

Warrant issued to purchase shares | shares

103,326

103,326

Warrant, exercise price | $ / shares

$ 4.46

$ 4.46

April 2024 Offering

Class of Stock [Line Items]

Private placement in net equity proceeds

$ 51,300,000

Underwritten Offering

Class of Stock [Line Items]

Proceeds from the sale of common shares

$ 18,300,000

Issuance of common stock, net, Shares | shares

17,391,832

Price per share | $ / shares

$ 1.15

Expected Term | Perceptive Term Loan Facility

Class of Stock [Line Items]

Warrants expected term

10 years

Volatility | Perceptive Term Loan Facility

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

81.3

Dividend Yield | Perceptive Term Loan Facility

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

0

Risk-Free Interest Rate | Perceptive Term Loan Facility

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

3.67

Securities Purchase Agreements | Series A Preferred Stock

Class of Stock [Line Items]

Issuance of common stock, net, Shares | shares

760,857

Preferred stock, par value | $ / shares

$ 0.001

Price per share | $ / shares

$ 46

Private placement in net equity proceeds

$ 35,000,000

Registration Rights Agreement | Series A Preferred Stock

Class of Stock [Line Items]

Shares of common stock issued upon conversion of Series A preferred stock | shares

30,434,280

ATM Facility | Maximum

Class of Stock [Line Items]

Aggregate offering price

$ 50,000,000

Issuance of common stock, net, Shares | shares

100,000

ATM Facility | Equity Financing Programs

Class of Stock [Line Items]

Issuance of common stock, net, Shares | shares

313,928

Weighted Average Price Per Share | $ / shares

$ 1.99

ATM Facility | Equity Financing Programs | Maximum

Class of Stock [Line Items]

Line of Credit Facility, Remaining Borrowing Capacity

$ 28,200,000

$ 28,200,000

LPC Facility | Equity Financing Programs

Class of Stock [Line Items]

Line of Credit Facility, Remaining Borrowing Capacity

$ 46,900,000

$ 46,900,000

First Amendment

Class of Stock [Line Items]

Warrant issued to purchase shares | shares

500,000

Initial warrants amount

$ 700,000

Warrants, expires period

May 10, 2033

Warrant, exercise price | $ / shares

$ 1.6254

First Amendment | Expected Term

Class of Stock [Line Items]

Warrants expected term

10 years

First Amendment | Volatility

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

78.7

First Amendment | Dividend Yield

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

0

First Amendment | Risk-Free Interest Rate

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

3.49

Tranche B Warrants

Class of Stock [Line Items]

Initial warrants amount

$ 1,300,000

Warrants, expires period

Dec. 15, 2033

Tranche B Warrants | Expected Term

Class of Stock [Line Items]

Warrants expected term

10 years

Tranche B Warrants | Volatility

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

76.2

Tranche B Warrants | Dividend Yield

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

0

Tranche B Warrants | Risk-Free Interest Rate

Class of Stock [Line Items]

Warrants and rights outstanding, measurement input

3.91

Revenue and Accounts Receivab_3

Revenue and Accounts Receivable Credit Concentration - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Disaggregation Of Revenue [Line Items]
Primary sources of revenue, description			We derive our revenue from two primary sources: (i) providing diagnostic testing in the clinical setting (Diagnostic Tests); and (ii) providing biopharmaceutical companies with services that include diagnostic research, clinical research, clinical trial testing, development and testing services provided outside the clinical setting and governed by individual contracts with third parties as well as development and commercialization of companion diagnostics. We also recognize revenue from other services, including amounts derived from licensing our technologies (Biopharmaceutical Services and other).
Revenue recognized			$ 500
Deferred revenue	$ 676		$ 676		$ 324
Revenue | Minimum | Customer Concentration Risk | Medicare
Disaggregation Of Revenue [Line Items]
Concentration risk, percentage	40%	41%	40%	45%
Up Front Cash Payments
Disaggregation Of Revenue [Line Items]
Deferred revenue	$ 900		$ 900
Other Long-term Liabilities
Disaggregation Of Revenue [Line Items]
Non-current deferred revenue	$ 300		$ 300		$ 300

Revenue and Accounts Receivab_4

Revenue and Accounts Receivable Credit Concentration - Summary of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Disaggregation Of Revenue [Line Items]
Revenues	$ 18,151	$ 13,491	$ 50,894	$ 34,419
Diagnostic Tests
Disaggregation Of Revenue [Line Items]
Revenues	17,168	12,301	47,503	32,395
Biopharma Services and Other
Disaggregation Of Revenue [Line Items]
Revenues	$ 983	$ 1,190	$ 3,391	$ 2,024

Revenue and Accounts Receivab_5

Revenue and Accounts Receivable Credit Concentration - Summary of Revenue and Accounts Receivable by Third-party Payors and Other Customers (Details) - Customer Concentration Risk - Minimum	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Revenue | United Healthcare
Concentration Risk [Line Items]
Concentration risk, percentage	7%	10%	8%	10%
Revenue | Medicare
Concentration Risk [Line Items]
Concentration risk, percentage	40%	41%	40%	45%
Accounts Receivable | Medicare
Concentration Risk [Line Items]
Concentration risk, percentage			26%		21%

Share-Based Compensation - Addi

Share-Based Compensation - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock remained available for future issuance	809,163		809,163
Stock compensation expense	$ 1,515	$ 954	$ 5,373	$ 4,292
Number of shares reserved for issuance	175,275		175,275
Shares issued			471,843
Description of offering period under plan			ESPP provides for successive six-month offering periods beginning on September 1st and March 1st of each year.
Options and Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Remaining unrecognized share based compensation expense for options and restricted stock units	$ 6,500		$ 6,500
Amortized to expense period			2 years 2 months 12 days
Bonus-To-Options Program
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock compensation expense	$ 300	$ 200	$ 700	$ 200

Share-Based Compensation - Summ

Share-Based Compensation - Summary of Share-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total share-based compensation expense	$ 1,515	$ 954	$ 5,373	$ 4,292
Direct Costs and Expenses
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total share-based compensation expense	20	17	54	41
Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total share-based compensation expense	110	68	240	249
Sales, Marketing, General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total share-based compensation expense	$ 1,385	$ 869	$ 5,079	$ 4,002

Share-Based Compensation - Su_2

Share-Based Compensation - Summary of Stock Option Activity (Details) $ / shares in Units, shares in Thousands, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2024 USD ($) $ / shares shares	Dec. 31, 2023 USD ($) $ / shares shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock Options, Outstanding - January 1, 2024 | shares	2,041
Stock Options, Granted | shares	2,226
Stock Options, Forfeited/canceled | shares	(221)
Stock Options, Exercised | shares	(27)
Stock Options, Outstanding - September 30, 2024 | shares	4,019	2,041
Stock Options Exercisable - September 30, 2024 | shares	1,719
Weighted Average Exercise Price, Outstanding - January 1, 2024 | $ / shares	$ 3.36
Weighted Average Exercise Price, Granted | $ / shares	1.67
Weighted Average Exercise Price, Forfeited/canceled | $ / shares	1.96
Weighted Average Exercise Price, Exercised | $ / shares	0.72
Weighted Average Exercise Price, Outstanding - September 30, 2024 | $ / shares	2.52	$ 3.36
Weighted Average Exercise Price, Exercisable - September 30, 2024 | $ / shares	$ 3.48
Weighted Average Contractual Life (Years), Outstanding	7 years 10 months 24 days	6 years 10 months 24 days
Weighted Average Contractual Life (Years), Exercisable - September 30, 2024	6 years 2 months 12 days
Aggregate Intrinsic Value, Outstanding - January 1, 2024 | $	$ 964
Aggregate Intrinsic Value, Outstanding - September 30, 2024 | $	1,250	$ 964
Aggregate Intrinsic Value, Exercisable - September 30, 2024 | $	$ 822
Bonus-To-Options Program
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock Options, Outstanding - January 1, 2024 | shares	1,050
Stock Options, Granted | shares	341
Stock Options, Forfeited/canceled | shares	(27)
Stock Options, Outstanding - September 30, 2024 | shares	1,364	1,050
Stock Options Exercisable - September 30, 2024 | shares	1,364
Weighted Average Exercise Price, Outstanding - January 1, 2024 | $ / shares	$ 2.81
Weighted Average Exercise Price, Granted | $ / shares	1.46
Weighted Average Exercise Price, Forfeited/canceled | $ / shares	24.34
Weighted Average Exercise Price, Outstanding - September 30, 2024 | $ / shares	2.04	$ 2.81
Weighted Average Exercise Price, Exercisable - September 30, 2024 | $ / shares	$ 2.04
Weighted Average Contractual Life (Years), Outstanding	8 years 2 months 12 days	8 years 4 months 24 days
Weighted Average Contractual Life (Years), Exercisable - September 30, 2024	8 years 2 months 12 days
Aggregate Intrinsic Value, Outstanding - January 1, 2024 | $	$ 22
Aggregate Intrinsic Value, Outstanding - September 30, 2024 | $	129	$ 22
Aggregate Intrinsic Value, Exercisable - September 30, 2024 | $	$ 129

Share-Based Compensation - Su_3

Share-Based Compensation - Summary of Restricted Stock Units Activity (Details) - Restricted Stock Units shares in Thousands	9 Months Ended
	Sep. 30, 2024 $ / shares shares
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of Shares, Outstanding - January 1, 2024 | shares	2,729
Number of Shares, Granted | shares	1,670
Number of Shares, Forfeited/canceled | shares	(15)
Number of Shares, Released | shares	(591)
Number of Shares, Outstanding - September 30, 2024 | shares	3,793
Weighted Average Grant Date Fair Value Per Share, January 1, 2024 | $ / shares	$ 1.91
Weighted Average Grant Date Fair Value Per Share, Granted | $ / shares	1.81
Weighted Average Grant Date Fair Value Per Share, Forefeited/canceled | $ / shares	1.92
Weighted Average Grant Date Fair Value Per Share, Released | $ / shares	2.01
Weighted Average Grant Date Fair Value Per Share, September 30, 2024 | $ / shares	$ 1.85

Net Loss per Common Share - Sch

Net Loss per Common Share - Schedule of Computation of Basic and Diluted Loss per Share Attributable to Stockholders (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Numerator
Net loss attributable to common stockholders	$ (10,258)	$ (10,808)	$ (13,614)	$ (10,949)	$ (13,356)	$ (18,702)	$ (34,680)	$ (43,007)
Denominator
Weighted-average shares outstanding, basic	146,296			79,709			123,634	78,672
Weighted-average shares outstanding, diluted	146,296			79,709			123,634	78,672
Net loss per share, basic	$ (0.07)			$ (0.14)			$ (0.28)	$ (0.55)
Net loss per share, diluted	$ (0.07)			$ (0.14)			$ (0.28)	$ (0.55)

Net Loss per Common Share - S_2

Net Loss per Common Share - Schedule of Common Stock Equivalents Excluded from Diluted Net Loss Attributable to Common Stockholders (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	13,801	11,651	13,801	11,651
Options to Purchase Common Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	5,383	3,262	5,383	3,262
Shares Committed Under ESPP
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	22	17	22	17
Warrants
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	4,603	5,603	4,603	5,603
Restricted Stock Units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	3,793	2,769	3,793	2,769

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Provision for income taxes			$ 0
Cash paid for income taxes	$ 0	$ 0	$ 0	$ 0

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($)			1 Months Ended	3 Months Ended		9 Months Ended
	May 13, 2021	Dec. 02, 2020	Sep. 30, 2020	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Oct. 31, 2016
Loss Contingencies [Line Items]
Research and development				$ 2,547,000	$ 1,938,000	$ 7,145,000	$ 8,099,000
Revenue Share Agreement | Oncimmune Limited
Loss Contingencies [Line Items]
Royalty expense				500,000	200,000	$ 1,100,000	600,000
Percentage of license agreement and royalty payment related to Nodify CDT test recognized revenue for non-screening tests						8%
Minimum annual volume percentage thereafter						5%
Bio-Rad License
Loss Contingencies [Line Items]
License expiry date						2024-08
CellCarta License
Loss Contingencies [Line Items]
Percentage of royalty payments on net revenue	0.675%
Percentage of fee payments on net sales	1%
Term of royalty payments from first commercial sale	15 years
Year of ending royalty payments from first commercial sale	2034
Royalty expense				100,000	100,000	$ 200,000	100,000
AVEO Oncology
Loss Contingencies [Line Items]
Research and development				0	$ 0	0	$ 0
Obligations related to agreement.				$ 0		$ 0
AVEO Oncology | Ficlatuzumab
Loss Contingencies [Line Items]
Percentage of development and regulatory costs exercised using opt-out right			50%
Percentage of royalty payments on net sales		10%
Percentage of license income generated from licensing		25%
AVEO Oncology | NSCLC POC Trial
Loss Contingencies [Line Items]
Responsible percentage of development and regulatory costs								50%