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Karyopharm Therapeutics Inc. (KPTI)·Q4 2024 Earnings Summary
Executive Summary
- Q4 2024 revenue was $30.5M with U.S. XPOVIO net product revenue of $29.3M; product revenue grew 16% YoY (vs. $25.1M in Q4 2023), while total revenue declined on lower license/other revenue .
- 2025 initial guidance: total revenue $140–$155M; U.S. XPOVIO $115–$130M; R&D+SG&A $240–$255M; cash runway into Q1 2026 (Q4 2025 including debt repayment/min liquidity covenant) .
- Clinical pivots: SENTRY Phase 3 in myelofibrosis remains on track (enrollment completion 1H25; topline 2H25). Endometrial Phase 3 EC-042 is refocused on TP53 wt pMMR (plus dMMR ineligible for CPI), sample size increased to ~276, pushing topline to mid-2026—an important narrative shift for the franchise .
- Street comparisons: S&P Global consensus could not be retrieved at time of writing; as a result, beat/miss vs. estimates cannot be assessed (S&P Global data unavailable).
What Went Well and What Went Wrong
What Went Well
- U.S. XPOVIO execution: Q4 net product revenue rose to $29.3M (+16% YoY) with steady demand in H2 across community (~60% of mix) and academic settings; management emphasized resilient demand despite an intensified competitive landscape .
- Cost discipline: SG&A fell to $27.2M in Q4 from $30.7M YoY; full-year R&D+SG&A landed toward the low end of the narrowed FY24 guidance, reflecting ongoing cost optimization .
- Clear 2025 catalysts and confidence: “In 2025, our teams remain focused on the transformative opportunity to redefine the standard of care in myelofibrosis,” positioning a potentially rapid launch if approved .
What Went Wrong
- Mix headwind: License/other revenue declined to $1.3M in Q4 (vs. $8.7M YoY), pulling total revenue down despite stronger product sales .
- Gross-to-net pressure: Q4/XFY gross-to-net rose to 33.3%/30.9% (vs. 23.5%/22.3% in 2023), driven primarily by increased 340B discounts and Medicare rebates—constraining net revenue conversion .
- EC-042 timing push: Trial design modifications (focus on pMMR and dMMR CPI-ineligible) increased sample size to ~276 and moved topline to mid-2026, extending timelines for second major catalyst beyond SENTRY .
Financial Results
Segment/mix (revenue components):
Key KPIs and operating items:
Notes: Q4 YoY XPOVIO net product revenue +16% ($29.3M vs. $25.1M) . Total revenue YoY decline reflects lower license/other revenue .
Guidance Changes
Earnings Call Themes & Trends
Management Commentary
- “In 2025, our teams remain focused on the transformative opportunity to redefine the standard of care in myelofibrosis… and leveraging our demonstrated commercialization capabilities in multiple myeloma to support a rapid launch, subject to approval.” — CEO Richard Paulson .
- “The gross to net discount for XPOVIO in the fourth quarter and full year 2024 was 33.3% and 30.9%… primarily driven by 340B utilization and Medicare rebates. We expect the gross to net discount to be similar in 2025 to 2024.” — CFO Lori Macomber .
- “We… aligned with the FDA last year on a change in our co-primary endpoint to absolute TSS. This was a very favorable change that we believe increases the probability of success of our Phase III SENTRY trial.” — CEO Richard Paulson .
- “We are modifying the design of our Phase 3 XPORT-EC-042 trial… focus on TP53 wild-type pMMR or dMMR medically ineligible… increasing the trial sample size to ~276… topline mid-2026.” — Company update .
Q&A Highlights
- SENTRY Abs‑TSS buffer/statistical context: Mgmt believes a 3–4+ point delta is achievable; prior Phase 3 showed significance with ~2‑point difference, supporting power assumptions, though specific SENTRY stats not disclosed .
- EC-042 FDA dialogue: Shift driven by evolving SoC (CPI for all MMR statuses) and modest CPI benefit in pMMR; FDA recommended focus on pMMR; SIENDO subgroup data (TP53 wt) viewed as supportive .
- SENTRY enrollment/baseline comparability: Patient characteristics tracking Phase 1 and contemporary Phase 3 MF trials; discontinuation/dose modifications tracking expectations (blinded) .
- Symptom endpoint excluding fatigue: Primary Abs‑TSS analysis excludes fatigue (consistent with precedent); FDA aligned; fatigue can be analyzed later .
- Cash runway/financing: Company evaluating BD, alliances, debt extension, or equity to extend runway through key readouts while maintaining discipline .
Estimates Context
- Wall Street consensus from S&P Global for Q4 2024 revenue and EPS was unavailable at the time of analysis due to access limits; therefore, we cannot assess beat/miss vs. estimates. Estimates may need to adjust for: (1) persistent gross‑to‑net pressure; (2) lower license/other revenue in Q4; (3) 2025 guide midpoint implying ~flat total revenue vs 2024 but +~11% midpoint growth in U.S. XPOVIO .
Key Takeaways for Investors
- XPOVIO demand remains resilient; Q4 net product revenue rose 16% YoY to $29.3M, though total revenue fell on softer license/other, underscoring sensitivity to non‑product contributions .
- Elevated gross‑to‑net (Q4 33.3%, FY24 30.9%) is now a structural headwind; 2025 gross‑to‑net expected similar to 2024, with typical seasonal 1Q step-up .
- 2025 guide frames a year of execution: total revenue $140–$155M and U.S. XPOVIO $115–$130M; cost base trending down with R&D+SG&A $240–$255M .
- Primary stock catalyst: SENTRY topline in 2H25; enrollment completion in 1H25 could be an interim sentiment driver. A clear, positive Abs‑TSS/SVR35 outcome could be transformational for valuation and launch setup .
- EC-042’s narrowed design enhances regulatory clarity but moves topline to mid‑2026; defers the second major catalyst and concentrates near-term focus on MF readout .
- Balance sheet adequate into Q1’26 (Q4’25 including notes/covenant), but management is actively evaluating financing/BD options—this remains a potential overhang until addressed .
- For near-term trading, watch: updates on SENTRY enrollment completion, any SENTRY‑2 (MF monotherapy) data subset in 1H25, and cadence on gross‑to‑net/340B dynamics that affect quarterly revenue prints .
Appendix: Additional Detail
- Q4 detail: Total revenue $30.5M; product $29.3M; license/other $1.3M; cost of sales $1.3M; R&D $33.3M; SG&A $27.2M; interest expense $11.2M; net loss $30.8M .
- FY24: Total revenue $145.2M; U.S. XPOVIO $112.8M; cash/cash equivalents/restricted/investments $109.1M at year-end .
Sources:
- Q4 2024 press release and financials .
- 8‑K (Item 2.02) incorporating press release .
- Q4 2024 earnings call transcript (prepared remarks and Q&A) .
- Prior quarters: Q3 and Q2 2024 press releases ; .
S&P Global consensus data was unavailable at time of writing; beat/miss vs. consensus could not be assessed.