Geoffrey Gewurz

A year ago, when I started covering Caris Life Sciences, diagnostics was not center stage. Today it's probably one of the most overvalued sectors in the market. Natera leads at roughly 20x revenue, with growth unlikely to justify it. Tools and diagnostics alike trade at rich multiples: Repligen, Guardant Health, even Illumina after a massive run. 10x Genomics is up tenfold while revenue has barely moved. That makes valuing Caris harder, not easier. The stock is up about 100% from its lows, but how much is company-specific and how much is the sector? The Caris story is about market acceptance of its superior tests. The Kevin Costner advertising campaign was an excellent move and could lift the multiple from about 8–9x 2026 sales toward the higher industry level. For a sense of the excitement: Grail jumped 55% in a week on a positive FDA panel vote and now trades at about 36x trailing revenue. Much of this is market excitement about things few people truly understand. But as long as the bull market in growth and healthcare continues, Caris has catch-up ahead, with Detect, other new products and possibly MRD. An exciting time for Caris, with a clear cautionary tale for the sector. Where does Natera go from here: a $100 billion market cap on $3 billion in revenue? $CAI $NTRA $GH $RGEN $ILMN $TXG $GRAL

What a great endorsement and partnership. Caris is a class act.

I like this quite a bit and think the choices of creative are excellent.

It’s been a while since I wrote about Caris Life Sciences (NASDAQ: CAI). In fact, it has been relatively quiet for a while. Beyond the earnings reports and scientific publications, we haven’t seen much new news flow around additional AI biomarker signatures, and we certainly haven’t seen the kind of new pharma partnerships that I had hoped might emerge from Caris’s extraordinary database. That is worth pointing out. On the other hand, the core business continues to execute extremely well. Q2 revenue grew 45%, CGP penetration continues to increase, margins are expanding, and management raised 2026 revenue guidance to $1.03–1.04 billion. The stock has responded accordingly. (Caris Life Sciences, Inc.) There are several smaller catalysts ahead. Caris is building the commercial infrastructure around MI Clarity and ChromoSeq, with ChromoSeq having the advantage of reimbursement already in place. Assure is awaiting New York State approval and is expected to be Caris’s next FDA submission. MRD should become increasingly relevant toward year-end and into 2027, particularly as reimbursement develops. An improvement in PAMA reimbursement rates could provide another earnings catalyst. I’m also still waiting for a meaningful update on ACHIEVE-2, which we did not get on the last call. Meanwhile, GRAIL is moving through the FDA process, with its Galleri advisory committee scheduled for September 23. The competitive and regulatory landscape in MCED is moving quickly. But to me, all of these remain secondary. Detect is the big one. What has impressed me recently is how much more polished and serious the Detect effort has become. The website, messaging and overall presentation increasingly look like those of a company preparing to market a major consumer healthcare product—not simply launch another laboratory test. Caris officially launched Detect on July 1. (Caris Life Sciences) The question now is whether the commercial rollout can match the ambition. David Halbert said Caris is expanding capacity from roughly $1 billion to $3 billion of annual Detect revenue capability and still worries that demand could exceed capacity. That is a very big statement. Now we need to see the action behind it. The recent Moderna/Merck personalized-cancer-vaccine news also reminded the market that Caris has had a multi-year strategic relationship with Moderna since 2023. I wouldn’t attach major financial value to that relationship yet, but the direction of personalized oncology clearly plays directly into Caris’s strengths. (Caris Life Sciences) So after a relatively quiet period, my view remains fairly simple: CGP is executing. Clarity, ChromoSeq, Assure, MRD and reimbursement are incremental catalysts. New signatures and pharma partnerships would be very welcome. But the next major leg for Caris is Detect. The infrastructure is being built. The presentation is becoming increasingly professional. The science has created the opportunity. Now we wait to see whether Caris can create the demand.

Quite a day in precision oncology. Seeing Caris Life Sciences rally more than 15% while BillionToOne fell roughly 30–40% and Grail declined around 10% was a striking divergence. The market clearly distinguished between companies with a compelling commercial execution story today and those still needing to prove it. Caris delivered what looked like an outstanding quarter. The core comprehensive genomic profiling (CGP) franchise continues to outperform, with record clinical volumes, higher average selling prices, expanding margins, positive free cash flow, and another increase in full-year revenue guidance. Importantly, management emphasized that demand remains extremely strong, even as the company prepares to expand capacity substantially over the coming years. (PR Newswire) What stood out even more on the conference call was that the excitement wasn’t driven solely by the existing business. Detect increasingly feels like a meaningful second growth engine rather than a speculative future product. Management described strong early interest following the launch, discussed plans for a national direct-to-consumer marketing campaign, and reiterated that current guidance does not include any meaningful Detect revenue. That leaves investors with a mature, rapidly growing CGP business while retaining substantial optionality from early cancer detection. (Investing.com) Another positive was seeing founder and CEO David Halbert at the forefront of the call. His confidence, long-term vision, and detailed discussion of both the existing franchise and Detect reinforced the impression that Caris remains founder-led in the best sense of the term. For many investors, that matters when evaluating companies attempting to build durable platforms rather than single-product businesses. Perhaps the most encouraging signal was the market’s reaction. The stock was exceptionally well supported on very heavy volume despite a significant post-earnings move. Strong volume following strong fundamentals often suggests that longer-term institutional investors are establishing or adding positions rather than simply creating a short-lived trading spike. The investment thesis also appears increasingly balanced. The original CGP business continues to demonstrate that it can grow faster than many expected while becoming meaningfully more profitable. At the same time, Detect offers the possibility of opening a much larger addressable market over time. That combination—a proven cash-generating core business with a potentially transformational second act—is uncommon in healthcare. One quarter never proves a long-term investment case, but this was an important step forward. Based on both the reported results and management’s commentary, Caris appears to be executing well on the business investors already understand while simultaneously laying the groundwork for what could become a much larger opportunity through Detect.

I’ve been relatively quiet about Caris recently because, frankly, I’ve been somewhat underwhelmed by the commercial launch of Caris Detect. The scientific results remain extremely interesting, and it is still very early. Caris has plenty of time to build out the product, improve the customer experience and develop meaningful distribution. But the launch, so far, has not met my expectations. CarisDetect.com simply redirects users to a Detect page located within the physician-testing section of Caris’s main corporate website. The page itself is professionally presented and explains the testing process, but what is publicly visible today feels more like a soft launch than the introduction of a major new consumer-health platform. Earlier this year, Caris announced that Detect would be launched through Everlywell, highlighting Everlywell’s consumer reach, digital infrastructure and relationships with major health plans. Yet I currently cannot find Detect prominently offered through Everlywell’s public consumer marketplace. Galleri, on the other hand, is clearly visible and directly purchasable there. I also see little public evidence so far of meaningful outbound marketing, employer distribution, health-plan adoption or a broad physician-acquisition campaign for Detect. That does not prove nothing is happening internally. It does mean that investors should distinguish between announcing commercial availability and demonstrating an effective commercial launch. This matters more after looking at what Matthew Rabinowitz is building through MyOme. Rabinowitz appears to be approaching preventive health from the opposite direction: acquire healthy people earlier and at a lower initial cost, sequence their genomes, build a longitudinal relationship around their health data, and continually add new products and interpretations over time. A whole-genome preventive-health product is not itself an MCED test. But it potentially gives Rabinowitz time to develop or incorporate an MCED offering while already owning the relationship with a growing population of healthy customers. The customer-acquisition problem may be partly solved before the cancer-detection product even arrives. Caris may ultimately have the superior cancer-detection technology. But superior technology is not enough if a competitor owns the patient relationship, the preventive-health platform and the lower end of the customer-acquisition funnel. I remain constructive on Caris’s broader scientific platform and recognize that Detect has only just launched. But at $3,500, this product will require a much more ambitious and visible commercial strategy than what we have seen so far. For now, my view is simple: Caris has launched the test, but it has not yet demonstrated that it has truly launched the market.

Both stocks are crushed so if one doesn’t fear Google a small portfolio makes sense

Zillow’s new Zillow Pro is not just another product launch. It is Zillow’s response to the incentive problem. CoStar/Homes.com has been attacking Zillow on agent alignment: “Your listing. Your lead. Zillow is the tollbooth.” Zillow is now answering differently: “Your clients are already on Zillow. Bring them into your workflow, connect your CRM, and we’ll show you intent signals you cannot see elsewhere.” That is a much better defense than simply selling more leads. Zillow is trying to move from lead marketplace to agent operating layer — CRM + consumer search + behavioral intent + seller signals. The key line is not “Zillow Pro.” The key line is “Likely to List.” If Zillow can help agents identify which past clients may be preparing to sell, the platform becomes less hated tollbooth and more useful infrastructure. This does not kill CoStar. But it does make the anti-Zillow revolt thesis less clean. CoStar is trying to win the industry. Zillow is trying to remind the industry where the consumer already lives. This is becoming one of the more interesting competitive battles in public markets.

Zillow vs CoStar may become one of the best public-market case studies in game theory. Zillow controls consumer attention. CoStar is trying to control industry alignment. Zillow’s model: monetize buyer/renter demand. CoStar’s model: align with agents, listings, landlords, builders, and property data. Now Google is pushing further into discovery. Courts are involved. MLS rules are shifting. Private listings are becoming a battlefield. Apartments.com is being attacked by Zillow. Homes.com is attacking Zillow’s residential moat. This is not just “portal competition.” It is a fight over who captures the economics of real estate search, data, workflow, and distribution. My instinct: CoStar may have a stronger incentive structure with the people who actually create and control inventory. Zillow may have the consumer habit. CoStar may have the industry coalition. This will be fought in the courts, outside the courts, and on the field. One of the more interesting battles in the market. $Z $CSGP

What if the liquid biopsy trade is pricing a bigger diagnostic shift than the workflow can support? What if late-stage CGP is already closer to mature than company decks imply? What if tissue remains the anchor, while liquid biopsy becomes a powerful complement rather than the default layer? What if MRD decentralizes into existing oncology platforms instead of becoming winner-take-most? What if early detection is not really a price debate, but a signal-quality debate? And what if a cheap false positive is not actually cheap? open.substack.com/pub/gg86/p…

Caris has not worked as a stock so far. No way around it. Compared with Guardant, Natera, Personalis, GeneDx, Veracyte — Caris has not been the momentum name in diagnostics/genomics. In this market, many investors follow price action first. That is understandable. That is the game. But yesterday I looked again at the Caris Detect page — not as an investor defending an old thesis, but as a 57-year-old person looking at the product today — and I had a very different reaction. It felt like an iPhone-system moment for people my age. Not just “another MCED test.” Grail already introduced the world to the idea of a multi-cancer blood test. What makes Caris Detect feel different to me is the combination of: Achieve 1 numbers — especially the early-stage sensitivity and specificity; the report structure — cancer signal not detected, atypical signal, or cancer signal detected; and most importantly, the downstream system around the result. That is where Caris may be meaningfully different. This does not feel like just a blood draw followed by a vague answer. It feels like a system: physician review, suspected tumor-of-origin, follow-up testing, imaging, specialist referral, and the Precision Oncology Alliance behind the next step. For a 55-, 60-, or 70-year-old with means, the appeal is obvious: Tell me if I may be missing something. Help me catch it early. Give me a clear path if something is found. And if nothing is found, give me peace of mind. That is not just curiosity. That can become a recurring preventive-health habit. Caris still has to prove the commercial adoption curve. But looking at Detect today, I would make the same product claim fresh: This does not feel like only a test. It feels like a system. And I am invested in this.

And who does?

Check out the web page.

If CAI will keep its promise MCED should be launched next week.

The market is treating Zillow like a broken housing-cycle stock. I think that misses the bigger point. The cycle is not the main risk. The agent relationship is. Every aggregator has the same structural tension: it controls demand, but the suppliers resent the toll. Booking had it with hotels. Amazon had it with merchants. Google had it with publishers. Zillow has it with agents. In Zillow’s case, the tension is more acute because the transaction tickets are enormous. Real estate commissions are a very large profit pool, and agents naturally fear that Zillow is moving from traffic provider to transaction controller. That is the core bear case. But if Zillow can manage that friction — by making agents more productive rather than simply making them feel taxed or displaced — the upside is significant. Bad housing markets may actually help Zillow. When the market is easy, agents and landlords can survive with weak distribution. When the market is hard, dependence on traffic, leads, pricing data, mortgage tools and conversion infrastructure goes up. That is where Zillow becomes more important. At roughly 2–3x revenue and low-teens forward earnings, Zillow is not priced like a dominant consumer platform embedded in one of the largest markets in the economy. Unlike many software companies, I do not see Zillow as structurally impaired by AI. I see it as a platform that can use AI, data, traffic and workflow integration to deepen its role in the transaction. The stock is hated because housing is bad. But the real question is whether Zillow can solve the supplier-friction problem. If it can, bad housing may be exactly when Zillow’s grip gets stronger. I believe that and own the shares.

Caris is solid here. MCED supposed to be launched any day. The company is also hiring 20-30 salespeople for MI Clarity. Is reimbursement near? Possibly.

The market cap of Natera is approaching Autodesk. Early narrative across the sector but very expensive.