Name: Upstream Bio, Inc. Q3 2024 Earnings Call
Start: 2024-11-07T00:00:00.000Z

Executive Summary

Upstream Bio reported Q3 2024 collaboration revenue of $0.607M, net loss of $16.0M, and EPS of $-6.96 as it scaled Phase 2 programs; losses increased year over year on higher clinical and manufacturing spend .
Cash, cash equivalents, and short-term investments were $220.7M at 9/30/24; together with ~$268.7M net IPO proceeds in October, management guides runway through 2027 .
Management highlighted verekitug potency and a differentiated dosing profile; CRSwNP Phase 2 topline is targeted for H2 2025 and severe asthma topline for H2 2026, with COPD Phase 2 first patient in H2 2025 .
No earnings call transcript was available; Street consensus estimates via S&P Global were unavailable, limiting beat/miss comparisons (see Estimates Context).
Near-term stock reaction catalysts: IPO proceeds extending runway, Phase 2 execution updates, and comparative potency vs tezepelumab positioning verekitug for potential differentiation .

What Went Well and What Went Wrong

“Our recently completed initial public offering has provided us with sufficient capital to fund our planned operations through 2027” .
PK/PD modeling demonstrated verekitug is “highly potent, with an approximately 50% greater effect on fractional exhaled nitric oxide (FeNO) than has been previously reported with tezepelumab” .
Phase 2 programs advancing: CRSwNP topline H2 2025; severe asthma topline H2 2026; COPD Phase 2 startup commenced with first patient targeted H2 2025 .

Net loss widened to $16.0M from $3.1M year over year primarily due to increased R&D and G&A expenses as programs scaled .
Total operating expenses nearly doubled year over year (+$9.5M) reflecting higher clinical and manufacturing costs and personnel-related G&A .
Lack of traditional product revenue; related-party collaboration revenue was flat year over year ($0.607M vs $0.621M), underscoring reliance on financing and milestone progress .

Metric	Q3 2023	Q3 2024
Collaboration Revenue ($USD Millions)	$0.621	$0.607
Research & Development Expense ($USD Millions)	$7.788	$15.433
General & Administrative Expense ($USD Millions)	$2.219	$4.067
Total Operating Expenses ($USD Millions)	$10.007	$19.500
Loss from Operations ($USD Millions)	$(9.386)	$(18.893)
Interest Income ($USD Millions)	$1.527	$2.904
Net Loss ($USD Millions)	$(3.102)	$(15.992)
EPS ($ per share, basic & diluted)	$-2.11	$-6.96

Balance sheet snapshot:

Metric	Dec 31, 2023	Sep 30, 2024
Cash & Cash Equivalents ($USD Millions)	$25.833	$32.948
Short-term Investments ($USD Millions)	$83.977	$187.711
Total Current Assets ($USD Millions)	$116.996	$227.273
Total Liabilities ($USD Millions)	$9.389	$12.137
Redeemable Convertible Preferred Stock ($USD Millions)	$230.935	$380.874
Stockholders’ Deficit ($USD Millions)	$(123.126)	$(160.311)

KPIs and program data:

KPI	Prior	Current
Verekitug FeNO Max Reduction	N/A	Up to 54% at 12 weeks
Blood Eosinophil Reduction	N/A	Up to 65% at 12 weeks
TSLP Receptor Occupancy	N/A	100% after one dose
Potency vs Tezepelumab (FeNO effect)	N/A	~1.5x higher maximal predicted reduction
Dosing Intervals Tested	N/A	12 weeks (asthma/CRSwNP), 24 weeks (asthma)

Notes:

Prior quarter (Q2 2024) data was not publicly available (pre-IPO); comparisons focus on year-over-year.

Metric	Period	Previous Guidance	Current Guidance	Change
CRSwNP Phase 2 Topline	H2 2025	Not previously specified	Topline in H2 2025	New/Established timeline
Severe Asthma Phase 2 Topline	H2 2026	Not previously specified	Topline in H2 2026	New/Established timeline
COPD Phase 2 First Patient	H2 2025	Planning initiated	First patient H2 2025	Maintained/Refined timing
Cash Runway	Through 2027	N/A	Funded through 2027	New disclosure
Conferences	Dec 2024–Mar 2025	N/A	Piper Sandler (Dec), J.P. Morgan (Jan), TD Cowen (Mar)	New disclosure

No Q3 2024 earnings call transcript was available.

Topic	Previous Mentions (Q-2, Q-1)	Current Period (Q3 2024)	Trend
R&D Execution	Not publicly available pre-IPO	Advancing Phase 2 in asthma and CRSwNP; COPD Phase 2 startup	Positive execution progress
Product Performance	Not publicly available pre-IPO	Potency and PK/PD modeling suggest differentiated efficacy and dosing	Constructive vs peers
Regulatory/Legal	Not publicly available pre-IPO	Standard forward-looking risk disclosure	Stable
Funding/Runway	Not publicly available pre-IPO	IPO completed; runway through 2027	Strengthened
Macro/Supply Chain	Not publicly available pre-IPO	Not highlighted	Neutral

“We expect to report top-line data from our ongoing Phase 2 clinical trials in severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) in the second half of 2026 and the second half of 2025, respectively.” — Rand Sutherland, CEO .
“Our recently completed initial public offering has provided us with sufficient capital to fund our planned operations through 2027.” — Rand Sutherland, CEO .
PK/PD modeling “demonstrated that verekitug is highly potent, with an approximately 50% greater effect on fractional exhaled nitric oxide (FeNO) than has been previously reported with tezepelumab” and supports extended dosing intervals (Q12W and Q24W) .
Phase 1b data showed “100% TSLP receptor occupancy after one dose, up to 54% reduction in FeNO and up to 65% reduction in blood eosinophils at 12 weeks,” sustained up to 24 weeks after last dose .

Wall Street consensus estimates (EPS, revenue) via S&P Global were unavailable in our tools environment for Q3 2024; as a newly public, clinical-stage company without product revenue, coverage may be limited. Without consensus, beat/miss cannot be assessed at this time.
Implication: Analysts may focus on opex run-rate, cash runway, and clinical timelines rather than near-term P&L beats; expect models to incorporate IPO net proceeds and increased Phase 2 spend .

The IPO materially de-risks funding; management guides runway through 2027, enabling completion of Phase 2 readouts in CRSwNP (H2 2025) and severe asthma (H2 2026) and initiation in COPD (H2 2025) .
Clinical signals and PK/PD modeling indicate verekitug’s potency and support for extended dosing, potentially differentiating versus tezepelumab on efficacy and dosing frequency in severe asthma .
Operating expenses are scaling with clinical execution; Q3 opex up ~95% year over year, with R&D driving the increase—expect continued elevated spend as programs progress .
Earnings comparisons to Street estimates are not available; trading will likely hinge on data/package updates, conference visibility, and regulatory milestones rather than quarterly P&L variance.
Near-term events (Piper Sandler, J.P. Morgan, TD Cowen) may provide additional clinical and strategic color; watch for updates on enrollment, dosing intervals, and CRSwNP study progress .
Balance sheet strength post-IPO (cash + ST investments $220.7M at 9/30/24 plus ~$268.7M net IPO proceeds) supports multi-program execution without immediate financing risk .
Risk factors remain typical for clinical-stage biotech (trial execution, manufacturing, regulatory outcomes, competition); management reiterates forward-looking uncertainties .