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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2017
Sep. 30, 2016
Operating activities:    
Net loss $ (134,994) $ (125,180)
Adjustments to reconcile net loss to net cash used for operating activities:    
Stock-based compensation expense 23,647 18,697
Depreciation and amortization 1,146 793
Amortization of debt discount 570 510
Gain on disposal of property and equipment (7)
(Accretion of discount) amortization of premium on short-term investments (259) 219
Change in operating assets and liabilities:    
Accounts receivable (26,891)
Prepaid expenses and other current assets (849) 428
Inventory 171 (1,983)
Accounts payable (1,477) 2,790
Accrued clinical liabilities 2,310 4,608
Accrued payroll and employee liabilities (564) 3,813
Deferred revenue 4,461
Other accrued liabilities 9,585 (271)
Net cash used for operating activities (123,151) (95,576)
Investing activities:    
Purchases of short-term investments (93,776) (43,318)
Maturities and sales of short-term investments 123,284 55,829
Purchases of property and equipment (1,419) (2,446)
Proceeds from the sale of property and equipment 13
Net cash provided by investing activities 28,102 10,065
Financing activities:    
Net proceeds from sale of common stock 163,747
Proceeds from issuance of promissory note payable 50,000
Repayment of promissory note payable (25,000)
Proceeds from purchases under the Employee Stock Purchase Plan 576 251
Proceeds from stock option exercises 7,836 5,720
Net cash provided by financing activities 147,159 55,971
Net increase (decrease) in cash and cash equivalents 52,110 (29,540)
Cash and cash equivalents at beginning of year 13,414 75,180
Cash and cash equivalents at end of period 65,524 45,640
Supplemental disclosure of cash flow information:    
Interest paid $ 2,289 $ 622