Medpace posted Q4 results with revenue up 32% to $708.5M. EPS came in at $4.67, up from $3.67 a year ago. Net new business awards jumped 39% to $736.6M, giving them a book-to-bill ratio of 1.04x. They issued 2026 guidance forecasting revenue between $2.755B and $2.855B, which is about 9% to 13% growth. Management also noted they repurchased over $912M in stock during the full year 2025, though they didn't buy back any shares in Q4 specifically.