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Stock-Based Compensation (Tables)
 12 Months Ended
Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]  
Schedule of Stock Option Activity
A summary of the Company’s stock option activity under the 2012 Plan, the 2018 Plan and the 2023 Plan, and related information is as follows:
Options Outstanding
Shares
Available for Grant 		Shares Subject to Options OutstandingWeighted-Average Exercise Price Weighted-Average Remaining Contractual Life (Years)Aggregate Intrinsic Value
(in thousands)
Balance as of January 1, 2021
1,819,223 3,101,181 $15.80 6.9$350,670 
2018 Plan annual increase(1)
3,689,000 — 
Granted(345,774)345,774 119.82 
Exercised— (693,074)11.19 
Canceled65,523 (128,907)47.51 
Restricted stock units granted(873,916)— 
Restricted stock units canceled
315,988 — 
Market-based restricted stock units canceled558,254 — 
Performance-based restricted stock units granted(52,917)— 
Performance-based restricted stock units canceled56,243 — 
Balance as of December 31, 2021
5,231,624 2,624,974 29.17 6.5193,014 
2018 Plan annual increase(1)
3,689,000 — 
Granted(1,051,466)1,051,466 44.86 
Granted in connection with the Joint Venture Acquisition(15,128)15,128 4.90 
Exercised— (228,311)6.29 
Canceled56,391 (60,683)90.84 
Restricted stock units granted(2,995,533)— 
Restricted stock units canceled
490,525 — 
Performance-based restricted stock units granted(26,935)— 
Performance-based restricted stock units canceled59,818 — 
Balance as of December 31, 2022
5,438,296 3,402,574 34.34 6.839,749 
2018 Plan annual increase(1)
3,689,000 — 
Shares authorized under the 2023 Plan5,000,000 — 
Granted(1,000,760)1,000,760 30.80 
Exercised— (51,124)7.93 
Canceled338,570 (339,307)58.45 
Restricted stock units granted(2,436,947)— 
Restricted stock units canceled
1,049,447 — 
Performance-based restricted stock units granted(126,041)— 
Performance-based restricted stock units canceled51,829 — 
Balance as of December 31, 2023
12,003,394 4,012,903 $31.76 6.6$39,115 
Vested and Exercisable as of December 31, 2023
2,401,061 $25.39 4.9$37,730 
(1)Effective as of January 1, 2021, 2022 and 2023, an additional 3,689,000 shares of common stock became available for issuance under the 2018 Plan, as a result of the operation of the automatic annual increase provision therein.
A summary of the Joint Venture's stock option activity under the AMEA 2020 Plan and related information is as follows:
Options Outstanding
Shares
Available for Grant 		Shares Subject to Options OutstandingWeighted-Average Exercise Price Weighted-Average Remaining Contractual Life (Years)Aggregate Intrinsic Value
(in thousands)
Balance as of January 1, 2021
542,2204,053,335$0.58 9.6$— 
Granted(826,667)826,6670.58 
Exercised—(602,408)0.58 
Canceled625,375(625,375)0.58 
Balance as of December 31, 2021
340,9283,652,2190.58 8.8— 
Exercised—(2,051,645)0.58 
Canceled82,407(82,407)0.58 
Canceled in connection with the Joint Venture Acquisition(423,335)(1,518,167)0.58 
Balance as of December 31, 2022
——$— 0.0$— 
Schedule of Restricted Stock Unit Activity
A summary of the Company’s restricted stock unit activity excluding the performance-based and market-based restricted stock units under the 2012 Plan, the 2018 Plan and the 2023 Plan, and related information is as follows:
Restricted Stock Units OutstandingWeighted-Average Grant Date Fair Value
Balance as of January 1, 2021
1,118,655 $92.89 
Granted873,916 123.36 
Vested and released(178,030)92.14 
Canceled(315,988)97.79 
Balance as of December 31, 2021
1,498,553 109.72 
Granted2,902,21745.04 
Granted in connection with the Joint Venture Acquisition93,31638.24 
Vested and released(315,673)96.36 
Canceled(490,525)90.52 
Balance as of December 31, 2022
3,687,88860.70 
Granted2,436,94726.62 
Vested and released(728,603)60.07 
Canceled(1,049,447)56.85 
Balance as of December 31, 2023
4,346,785$42.63 
A summary of the Company’s performance-based restricted stock unit activity under the 2018 Plan and related information is as follows:
Performance-based Restricted Stock Units OutstandingWeighted-Average Grant Date Fair Value
Balance as of January 1, 2021
377,922 $113.40 
Granted52,917 135.94 
Canceled(56,243)113.40 
Balance as of December 31, 2021
374,596 116.58 
Granted26,935 37.50 
Canceled(59,818)114.94 
Balance as of December 31, 2022
341,713 110.64 
Granted126,041 32.84 
Vested and released(3,435)32.86 
Canceled(51,829)80.91 
Balance as of December 31, 2023
412,490$91.25 
A summary of the Company’s market-based restricted stock unit activity under the 2018 Plan and related information is as follows:
Market-based Restricted Stock Units OutstandingWeighted-Average Grant Date Fair Value
Balance as of January 1, 2021
3,391,148 $67.00 
Vested and released(572,130)70.58 
Canceled (1)
(558,254)70.58 
Balance as of December 31, 2021
2,260,764 65.20 
Balance as of December 31, 2022
2,260,764 65.20 
Balance as of December 31, 2023
2,260,764 $65.20 
(1)Represented shares withheld by the Company for the holders' tax obligation upon release of vested MSUs.
Schedule of Performance-based Restricted Stock Unites Vesting Conditions The following table presents additional information relating to each MSU award:
TranchePrice GoalNumber of RSUs
Tranche 1
$120 per share
565,192
Tranche 2
$150 per share
565,191
Tranche 3
$200 per share
565,191
Schedule of Stock Based Compensation Expense
The following table presents the effect of employee and non‑employee related stock‑based compensation expense including the Joint Venture:
Year Ended December 31,
202320222021
(in thousands)
Cost of precision oncology testing
$4,614 $5,498 $3,468 
Cost of development services and other1,851 — — 
Research and development expense
34,682 26,630 18,907 
Sales and marketing expense
24,764 25,442 15,479 
General and administrative expense
24,848 37,115 113,595 
Total stock-based compensation expense
$90,759 $94,685 $151,449 
Schedule of Stock Options Valuation Assumptions
The grant date fair value of stock options was estimated using a Black-Scholes option-pricing model with the following weighted-average assumptions including the Joint Venture:
Year Ended December 31,
202320222021
Expected term (in years)
5.50 – 6.10
5.50 – 6.10
5.49 – 6.06
Expected volatility
69.3% – 70.5%
63.3% – 67.6%
63.6% – 66.7%
Risk-free interest rate
3.4% – 4.5%
1.9% – 4.4%
0.3% – 1.3%
Expected dividend yield
0%
0%
0%
Schedule of Employee Stock Purchase Plan Valuation Assumptions
The grant date fair value of the stock purchase right granted under the ESPP was estimated on the first day of each offering period using the Black-Scholes option pricing model. The following assumptions used in the valuation were substantially consistent with the assumptions used to value stock options with the exception of the expected term which was based on the term of each purchase period:
Year Ended December 31,
202320222021
Expected term (in years)
0.50
0.50
0.50
Expected volatility
51.5% – 76.6%
81.8% – 92.0%
46.5% – 50.8%
Risk-free interest rate
5.2% – 5.4%
1.5% – 4.5%
0% – 0.1%
Expected dividend yield
0%
0%
0%