Q2 2026 Karyopharm Therapeutics Inc Earnings Call
Speaker #1: Good morning. My name is Anis, and I'll be your conference operator today. At this time, we'd like to welcome everyone to Karyopharm Therapeutics, second quarter, 2026, financial results conference call.
Speaker #1: There will be a question-and-answer session to follow. Please be advised that this call is being recorded at the company's request. I would now like to join the conference over to Brendan Strong, Senior Vice President, Investor Relations.
Speaker #2: Good morning, and thank you all for joining us on today's conference call to discuss Karyopharm's second quarter 2026 financial results and recent company progress.
Speaker #2: We issued a press release this morning detailing our financial results for the second quarter of 2026. This release, along with the slide presentation that we will reference during our call today, is available on our website.
Speaker #2: For today's call, as shown on slide 2, I'm joined by Richard, Reshma, Sohanya, and Lori, who will review our second quarter financial results, provide an update on the significant progress we've made advancing our myelofibrosis program, discuss the clinical and regulatory momentum supporting our planned SNDA submission, and review our financial position and capital allocation priorities.
Speaker #2: Before we begin our formal comments, I'll remind you that various remarks we will make today constitute forward-looking statements for purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995, as outlined on slide 3.
Speaker #2: Actual results may differ materially from those indicated by these forward-looking statements, as a result of various important factors, including those discussed in the risk factors section of our most recent Form 10-Q or 10-K on file with the SEC, and in other filings we may make with the SEC in the future.
Speaker #2: Any forward-looking statements represent our views as of today only. While we may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so, even if our views change.
Speaker #2: Therefore, you should not rely on these forward-looking statements as representing our views as of any later date. I'll now turn the call over to Richard.
Speaker #2: Please turn to slide 5.
Speaker #3: Thank you, Brendan, and good morning, everyone. Thank you for joining us today. The second quarter marked the beginning of an important new chapter for Karyopharm.
Speaker #3: As we advanced selinexor from a compelling and differentiated Phase III dataset toward our planned supplemental New Drug Application, under the FDA's Accelerated Approval pathway for patients with myelofibrosis.
Speaker #3: Over the past several months, we've remained focused, moved with urgency, and executed against an ambitious plan. From generating and presenting this entry data, to publishing the results in the Journal of Clinical Oncology, to working collaboratively with the FDA to establish a regulatory pathway as we prepare our planned submission, this entry study demonstrated statistically significant rapid deep and sustained spleen responses together with preliminary overall survival findings and evidence of potential disease modification.
Speaker #3: These findings have now been presented at leading international scientific meetings, published in a peer-reviewed journal, and continue to generate strong interest globally among the hematology community.
Speaker #3: Taken together, we believe these data reinforce the potential for Salinexor to fundamentally change the treatment of patients with myelofibrosis. That same focus urgency and commitment to execution continues to guide every step as we advance into the next phase of our myelofibrosis program.
Speaker #3: Turning to slide 6, as we announced in July, we remain on track to submit our sNDA in August as we complete the final elements of our submission in collaboration with the FDA.
Speaker #3: Our interactions with the agency continue to be constructive, and we remain focused on delivering a high-quality submission. Our confidence in this opportunity continues to be grounded in both the consistency of this entry data and our constructive regulatory engagement.
Speaker #3: If approved, selinexor in combination with ruxolitinib would be the first approved combination therapy for patients with myelofibrosis, introducing a novel therapeutic mechanism for the treatment of this disease.
Speaker #3: Turning to slide 7, while our focus today is on the important progress we've made in myelofibrosis, I'd also like to briefly address the top-line results from our Phase III export ECO42 study, and the actions we've taken following those results.
Speaker #3: While we were disappointed that the study did not achieve statistical significance for its primary endpoint in the MITT population, I want to thank the patients, investigators, and study teams whose commitment made this important trial possible.
Speaker #3: Although we observed a numerical improvement in median progression-free survival favoring selinexor, the study did not meet the statistical threshold required to support our development plans in endometrial cancer.
Speaker #3: Following these results, we made the deliberate decision to sharpen our focus on hematology, with our opportunities in myelofibrosis and multiple myeloma, where we believe selinexor has the greatest potential to improve patients' lives and create long-term shareholder value.
Speaker #3: While we continue to follow patients in the near term, we are meaningfully reducing planned investment in endometrial cancer. Moving forward, our priorities are clear.
Speaker #3: Advancing our myelofibrosis program through the regulatory process, continuing to grow our multiple myeloma business, and leveraging the commercial, medical, and market access capabilities we have built over many years to support a rapid and efficient launch in myelofibrosis if approved.
Speaker #3: As we execute against these priorities, we are equally focused on disciplined capital allocation. As we'll discuss, we are actively evaluating a range of financing opportunities and strategic alternatives, with the objective of maximizing long-term shareholder value while preserving strategic flexibility as we advance our myelofibrosis program through these important milestones.
Speaker #3: We are approaching this with the same focus, urgency, and discipline that have characterized our execution over the past several months. Looking ahead, we believe the company is entering one of the most important periods in its history.
Speaker #3: Turning to slide 8, over the coming quarters, we expect several important milestones. Beginning with the potential inclusion in the treatment guidelines and compendia, our planned SNDA submission of myelofibrosis this month, followed by potential FDA filing acceptance of the SNDA, and its potential to be accepted for priority review.
Speaker #3: And ultimately, a potential approval and launch as early as the first quarter of 2027. Additionally, we remain on track to report top-line data from the 60-milligram cohort of the Phase II entry 2 study in the second half of this year, which we expect will further establish the role of Salinexor in myelofibrosis.
Speaker #3: We are entering this next phase with a clear strategy of focused organization and an established hematology platform that positions us well for what lies ahead.
Speaker #3: With that, I'll turn the call over to Reshma, who will discuss the clinical and regulatory foundation supporting our planned submission for the first-ever combination, and why we believe selinexor, as a novel therapeutic mechanism, has the potential to fundamentally change the treatment of patients with myelofibrosis.
Speaker #3: Reshma?
Speaker #2: Thank you, Richard. As Richard discussed, we believe Salinexor has the potential to fundamentally change the treatment of patients with myelofibrosis. I'd like to spend the next few minutes discussing why we believe the scientific evidence supporting that opportunity has continued to strengthen why it supports our planned SNDA submission, and how we continue to build the clinical foundation for Salinexor in myelofibrosis.
Speaker #2: Turning to slide 10, the biological rationale for combining XPO1 and JAK inhibition is compelling. JAK-STAT activation is a key driver of malignant clone proliferation, splenomegaly, and disease-related symptoms, while XPO1 activity is important for malignant cell survival.
Speaker #2: By targeting these complementary pathways simultaneously, we believe Salinexor has the potential to complement JAK inhibition and improve outcomes beyond symptom control alone. Turning to slide 11, myelofibrosis remains a disease with a high unmet need given clinical activity with the currently approved therapies as modest.
Speaker #2: As a result, spleen volume reduction of at least 35% is observed in less than a third of patients, overall survival improvements are limited, and meaningful modification of the underlying disease is not observed.
Speaker #2: Turning to slide 12, a distinctive profile has been observed from the Sentry trial, given the compelling SVR35 results that are rapid, deep, and sustained; a promising OS signal with a first-of-a-kind prediction between SVR35 and OS; and a safe and manageable adverse event profile.
Speaker #2: These data appear to support SVR35 as a reasonably likely surrogate endpoint, enabling an SNDA under the accelerated approval pathway. Turning to slide 13, at week 24, a nearly double spleen response rate was observed with the combination of Salinexor plus ruxolitinib versus ruxolitinib alone.
Speaker #2: What is particularly important is the quality and kinetics of that response. As shown on slide 14, the responses were rapid, emerging as early as week 12, and deep, with greater average spleen volume reductions relative to baseline observed with the combination.
Speaker #2: Both response rates and depth of response were sustained through week 36. Importantly, as seen on slide 15, the benefit was consistent across pre-specified patient subgroups, reinforcing the robustness of the treatment effect in the vast majority of front-line myelofibrosis patients.
Speaker #2: Especially important is the subgroup analysis by ruxolitinib dosing, as seen on slide 16, even with average suboptimal doses of ruxolitinib less than 15 milligrams per day, SVR35 rates with the combination were as high as 50% compared to 0 observed with ruxolitinib alone, indicating that with the combination, SVR35 is driven by Salinexor and supported by modest doses of ruxolitinib.
Speaker #2: From a clinical practice standpoint, these data suggest that ruxolitinib dose reductions may not compromise efficacy when combined with selinexor. As shown on slide 17, at the time of the top-line analysis, the overall survival hazard ratio was 0.43, and patients continued to be followed as these data mature.
Speaker #2: On slide 18, a post-hoc landmark analysis demonstrated that irrespective of treatment, SVR35 at week 24 predicted overall survival. This observation is further reinforced by the longer-term follow-up from the Phase I trial on slide 19, in which the same relationship between SVR35 and overall survival is observed.
Speaker #2: On slide 20, the importance of the SVR35 OS relationship becomes even clearer when viewed in the context of the broader myelofibrosis literature. Over the past several years, a substantial body of retrospective evidence from Phase III JAK inhibitor trials has demonstrated that greater SVR35 rate differences observed across the two arms correlate with improved overall survival.
Speaker #2: SENTRY now provides an important opportunity to build on that body of evidence as the first Phase III trial that prospectively demonstrates the same relationship, and establishes SVR35 as a potential surrogate endpoint for overall survival.
Speaker #2: This underscores the importance of treating patients with the combination early in the disease course, increasing the likelihood of SVR35 reduction as observed, thus potentially maximizing overall survival.
Speaker #2: On slide 21, we also observed higher rates of variant allele frequency reduction with selinexor plus ruxolitinib as early as week 24. These molecular findings are important because vast reduction was associated with a greater likelihood of achieving SVR35, providing additional biological evidence that is consistent with the clinical findings.
Speaker #2: Taken together, on slide 22, the rapid, deep, and sustained spleen responses, the promising overall survival findings, the relationship between SVR35 and survival, and the molecular data all point in the same direction.
Speaker #2: We believe this unique and compelling profile strengthens the scientific rationale for SVR35 as a meaningful predictor of long-term survival. It is the combination of this growing body of evidence, the strength of the Sentry data, and the significant unmet need in myelofibrosis that formed the basis of our scientific discussions with the FDA regarding the role of SVR35 in supporting our planned SNDA submission.
Speaker #2: We believe the FDA's written feedback indicating that SVR35 appears to qualify as a reasonably likely surrogate endpoint to predict overall survival represents an important scientific and regulatory milestone.
Speaker #2: Importantly, this builds upon years of scientific evidence supporting the relationship between SVR35 and long-term outcomes, together with the prospective randomized evidence generated through Sentry.
Speaker #2: Our planned submission will be based on the week 24 SVR35 results. We intend to use additional long-term overall survival data from the ongoing Sentry trial to verify clinical benefit, a requirement under the accelerated approval pathway, to later convert to traditional approval.
Speaker #2: While our immediate priority is our planned submission, we continue to explore the broader role of Salinexor in myelofibrosis. On slide 23, the ongoing Sentry II study provides an opportunity to further characterize the activity of Salinexor as a monotherapy and explore the potential flexibility of XPO1 inhibition in combination with additional JAK inhibitors.
Speaker #2: The study will help us better understand the intrinsic contribution of Salinexor and continue to define the broader role of XPO1 inhibition across the treatment of patients with myelofibrosis.
Speaker #2: As Richard noted, we expect top-line data from the 60-milligram cohort of SENTRY II during the second half of this year. Taken together, we believe the strength and consistency of the evidence generated through SENTRY, together with our continued clinical development efforts, provide a strong scientific foundation for our planned sNDA submission and reinforce our belief that selinexor has the potential to fundamentally change the treatment of patients with myelofibrosis.
Speaker #2: With that, I'll turn the call over to Sohanya.
Speaker #1: Thank you, Reshma. Turning to slide 25—my focus today is on why we believe Karyopharm is well-positioned to commercialize this opportunity. Importantly, we are not preparing to build a commercial organization from the ground up.
Speaker #1: We are leveraging an established hematology platform that we have built over many years through the commercialization of Xpovio. On the scientific side, we have clinical development experience, active medical and scientific affairs teams, investigative relationships, and growing visibility across the myelofibrosis community.
Speaker #1: On the commercial side, we have established coverage in both community and academic hematology, key account capabilities, and market access expertise. And through Karyoford, we have an existing patient support platform designed to help patients and caregivers navigate access, reimbursement, and treatment initiation.
Speaker #1: Importantly, these capabilities already work together today in multiple myeloma, and can now be leveraged to support the potential expansion of selinexor into myelofibrosis, which is a significant strategic advantage to enable a rapid and efficient launch.
Speaker #1: Turning to slide 26, Q2 was a breakout quarter with top-tier recognition across leading global oncology platforms. As Richard discussed, the Sentry data have now been presented at ASCO and EHA, published in the Journal of Clinical Oncology, and continue to be highlighted at scientific meetings throughout the hematology community.
Speaker #1: Importantly, while commercial promotion begins only following regulatory approval, scientific engagement is already well underway. Our medical and scientific affairs organization is already deeply engaged within the myelofibrosis community.
Speaker #1: Following ASCO and EHA, on medical and scientific affairs teams have continued scientific exchange with investigators and treating physicians, participated in regional educational programs and scientific symposia, and continued building upon the relationships established throughout the Sentry clinical development program.
Speaker #1: We see significant engagement and thoughtful discussion surrounding the Sentry results, particularly the rapid, deep, and sustained spleen responses, the promising overall survival findings, and the potential for disease modification.
Speaker #1: Furthermore, the structure of the myelofibrosis market is also well aligned with our existing footprint, as shown on slide 27. Approximately 70% of patients are treated in the community setting, and 30% in academic centers.
Speaker #1: Across both settings, the majority of patients are concentrated within a manageable group of treatment centers. This concentration allows us to focus our resources on the physicians caring for the majority of patients, and to deploy our existing organization efficiently.
Speaker #1: Our physician segmentation work has also given us a detailed understanding of the high-volume, innovation-oriented physicians most likely to adopt a new combination approach early.
Speaker #1: These physicians place significant importance on achieving rapid, deep, and sustained spleen responses, and are actively considering how treatment may influence longer-term outcomes. There is also opportunity for prevalent patients treated with a JAK inhibitor to benefit from the combination therapy.
Speaker #1: We hear physician interest in the ability of selinexor to maintain spleen responses even when ruxolitinib doses are reduced, which is clinically relevant given how frequently dose adjustments occur in practice.
Speaker #1: Finally, as we turn to slide 28 and looking at the commercial opportunity in myelofibrosis, we believe Salinexor plus ruxolitinib has the potential to generate up to approximately a billion in peak annual revenue in the US alone.
Speaker #1: Approximately 20,000 patients are currently living with myelofibrosis in the U.S., with roughly 4,000 newly treated front-line patients each year and no approved combination therapy in front-line myelofibrosis.
Speaker #1: Let's now review our multiple myeloma performance, which continues to provide the commercial and operational foundation for the broader hematology platform I have described. As shown on slide 30, we delivered another quarter of strong commercial execution.
Speaker #1: With Xpovio USNET product revenue of $30.8 million, underlying demand remained relatively consistent with the second quarter of last year, despite an increasingly competitive treatment landscape.
Speaker #1: This performance reflects the resilience of our multiple myeloma franchise and, importantly, the strength of the relationships our commercial organization has built with hematologists and oncologists across both community and academic practices.
Speaker #1: Turning to slide 31, we continue to believe Xpovio is well-positioned for sustained performance. Our focus remains on the community setting, which represents approximately 60% of our U.S. business, where physicians continue to value Xpovio as a differentiated and convenient oral therapy.
Speaker #1: In addition, Xpovio continues to occupy a unique position in the evolving treatment landscape surrounding T-cell-engaging therapies, providing physicians with flexibility both before CAR-T therapy and following progression on a T-cell-engaging therapy.
Speaker #1: Our commercialization capabilities position us to continue to build on the foundation of multiple myeloma and, importantly, drive a transformative launch in the multibillion-dollar myelofibrosis marketplace.
Speaker #1: With that, I'll turn the call over to Lori to review our financial results and discuss how our discipline capital allocation strategy supports the opportunities ahead.
Speaker #2: Thank you, Sohanya. Good morning, everyone. Turning to slide 33, I will focus on our second quarter financial performance, our financial outlook, and the actions we're taking to support the important milestones Richard outlined.
Speaker #2: Starting with revenue, total revenue for the second quarter was $33.4 million, compared to $37.9 million in the prior year period. The decrease reflects the conclusion of Medireading's reimbursement of development-related expenses at the end of 2025.
Speaker #2: which reduced revenue by approximately $6.5 million compared with the prior year quarter. US Xpovio net product revenue was $30.8 million, compared to $29.7 million in the prior year period.
Speaker #2: Underlying demand remained consistent, and our growth-to-net rate of 26.6% was comparable to the second quarter of 2025. Turning to expenses, we remain focused on disciplined execution.
Speaker #2: R&D expenses were $29 million, and SG&A expenses were $25.9 million. Down 12% and 9%, respectively, year over year. This reflects our continued prioritization of disciplined investment and focus on advancing our highest value late-stage programs, with our Phase III trials having completed enrollment.
Speaker #2: We also continue to maintain disciplined alignment of pre-launch investments with clinical and regulatory milestones. Net loss was $67 million for the quarter, compared to $37.3 million in the prior year period.
Speaker #2: As a reminder, net loss includes non-cash mark-to-market adjustments related to our financing structure. From an underlying operating perspective, performance improved with approximately an 8% reduction in loss from operations.
Speaker #2: Reflecting stable net product revenue and continued expense discipline. Turning to the balance sheet, we ended the quarter with $65.4 million in cash, cash equivalents, restricted cash, and investments.
Speaker #2: Based on our current operating plan, we expect our existing liquidity, including cash, cash equivalents, and investments, together with anticipated cash flow from net product revenue and license and other revenue, to fund our current operating plans into September 2026.
Speaker #2: As Richard discussed, we are actively evaluating a range of financing opportunities and strategic alternatives with the objective of extending our cash runway, preserving strategic flexibility, and maximizing long-term shareholder value as we advance our myofibrosis program.
Speaker #2: On September 10, 2026, a $16.8 million principal payment is due, under our senior secure term loan facility. If that payment is made without additional financing or a waiver from our lenders, we expect our cash, cash equivalents, and investments will fall below our $10 million minimum liquidity covenant.
Speaker #2: Which would constitute an event of default under the term loan. Importantly, our immediate priority is to address this. And strengthen our financial position and provide the flexibility needed to continue executing our myofibrosis strategy.
Speaker #2: Every capital allocation decision we make is intended to support the important clinical, regulatory, and commercial milestones ahead, while maintaining disciplined execution across our multiple myeloma business.
Speaker #2: And maximizing long-term value for patients and shareholders. Turning to guidance, we are reaffirming our full-year 2026 outlook. We continue to expect total revenue in the range of $130 million to $150 million.
Speaker #2: If the license and other revenue consisting entirely of royalties over the next two quarters, and US Xpovio net product revenue of $115 million to $130 million.
Speaker #2: We continue to expect combined R&D and SG&A expenses of $230 million to $245 million in 2026, excluding certain one-time costs that we may incur associated with our endometrial cancer program and evaluating financing opportunities and/or strategic transactions.
Speaker #2: As a result of our decision to prioritize myofibrosis and multiple myeloma, we are actively reducing investment across the endometrial cancer program. And we expect our cost structure to decline over time.
Speaker #2: The greater financial benefit will be realized in 2027, as we continue patient follow-up for the near term and evaluate the evolving data set, together with responsibly completing the remaining clinical and operational activities associated with the ECO42 trial.
Speaker #2: In the near term, third-quarter expenses may be modestly higher than the second quarter. This reflects a unique transition period for the company, as we simultaneously advance our myelofibrosis program.
Speaker #2: Implement the organizational changes associated with our decision to prioritize myofibrosis and multiple myeloma, following the ECO42 top-line results. And the cost we may incur to evaluate financing opportunities and strategic alternatives.
Speaker #2: With that, I will turn the call back over to Richard.
Speaker #1: Thank you. Before we open the call for questions, I'd like to leave you with one final thought. Karyopharm is entering one of the most important periods in our history.
Speaker #1: We have a compelling opportunity in myofibrosis, a regulatory path forward, an experienced hematology organization prepared to support a potential launch if approved, and a team that has consistently demonstrated the ability to execute with focused, urgency, and discipline.
Speaker #1: We also recognize the importance and urgency of this moment, and that is why we are acting with discipline—not only in advancing our myelofibrosis program, but also in how we allocate capital and evaluate the financing opportunities and strategic alternatives discussed today.
Speaker #1: Every decision we make is guided by a single objective, maximizing long-term value for patients and shareholders. I'd like to thank our employees for their extraordinary dedication, our investigators and collaborators for their partnership, and most importantly, the patients and families who have placed their trust in Karyopharm by participating in our clinical trials.
Speaker #1: We appreciate your continued support and look forward to updating you on our progress over the coming quarters and with that operator, we'd now be pleased to take your questions.
Speaker #3: Thank you. question and answer session. If you'd like to ask a question, please press star follow button number one on your Karyopharm keypad. We ask analysts to limit themselves to one question in the follow-up.
Speaker #3: If your question has been answered and you would like to withdraw from the queue, Ladies and gentlemen, we now begin the please press star follow button number two.
Speaker #3: And if you're using a speakerphone, please lift your hands before pressing any keys. One moment, please, while we compile the roster. Your first question comes from 1010Talk with Piper Sandler.
Speaker #3: Please go ahead.
Speaker #4: Great. Thank you very much. I just have some questions with respect to what still had to be done for the SBO or SMDA considering obviously acetaminophen was already approved in multiple myeloma.
Speaker #4: How much of the filings already done and is there anything else that you need to compile on the clinical side? Any sites that need to be revisited or does all that already seem to be taken care of with the current approval?
Speaker #4: Thanks a ton.
Speaker #1: Yeah, thank you, Jed. I'll turn to Reshma to go into that in more detail.
Speaker #2: Yeah, thank you, Ted. And Richard, so Ted, the team is actively been working on the SMDA. By and large, the vast majority has already been put together.
Speaker #2: It's ready to go. One of the key pieces that we are just aligning and finalizing with the FDA is just around the confirmatory data piece, right?
Speaker #2: So, I think as we all appreciate, under accelerated approval, we are provided an approval, a label, but we do need to provide clinical benefit at some point in the future.
Speaker #2: And so right now, our discussions really have been focused on using the mature overall survival observed from Century for finalizing the statistical analysis plans.
Speaker #2: Again, aligning on those last details which is something that is required before we submit the SMDA. So great productive conversations with the FDA and we still are very much on track to submit the SMDA in August.
Speaker #4: That's really helpful. Just to make sure I understand, you'll use the OS data from the ongoing Century as the confirmatory data set?
Speaker #2: That is correct, right? We designed Century intentionally from the very beginning to follow all the way for overall survival so that study continues with patients, sites, blinded.
Speaker #2: We continue they continue on treatment. They continue to provide scans as well as OS data. So yes, we are going to leverage that maturing OS to confirm the benefit, which is going to occur.
Speaker #2: Likely years from now, but that is going to serve as the confirmatory data set. We believe upon alignment with the FDA.
Speaker #4: That's really helpful. Thanks, Reshma. Good luck.
Speaker #2: Thank you.
Speaker #1: Thanks, Edit.
Speaker #3: Thank you. Your next question comes from Yanis Orzidis with Kantor. Please go ahead.
Speaker #5: Hey folks, appreciate the updates here. I guess just a quick question on kind of what is the right way to think about the feasibility here of future operations. Is accelerated approval absolutely needed, or do you believe that inclusion in the NCCN committee could provide sufficient revenues to address the debt and operating needs?
Speaker #5: And then I have a quick follow-up.
Speaker #1: Yeah, thanks, Yanni. I think as we've talked through, there's really a few of those milestones happening very much in the near term. And obviously, given that we're already an approved is very important.
Speaker #1: And I think it's something which, as we know, physicians utilize a lot. I think we've talked to that previously—where with NCCN, in similar situations, if NCCN is all that you achieve, usually products will achieve about 50% of what their peak may be.
Speaker #1: But obviously, our goal is to enable as broad access as possible. One component is NCCN. The other component, as we've talked about, is really continuing to advance down the regulatory pathway.
Speaker #1: So I think both of those are occurring very, very positively over the near term. And I think both will be very positive for us in terms of being able to fund operations and obviously being able to enable patients to get access to sell an external myofibrosis.
Speaker #5: Got it, appreciate it. And then, just relatedly, I appreciate the transparency regarding the upcoming payment required and the debt covenants there.
Speaker #5: I guess, is there a sense of what would be kind of the stopgap, in your mind, to position the company well financially from a liquidity perspective to make it through these near-term milestones, and ideally—I would imagine—make it through at least the first half or end of 2027?
Speaker #1: Yeah, I think as we've seen before, our lenders have consistently been very, very supportive with us. And I don't have any reason to believe that they won't continue to do so.
Speaker #1: And so I think as we announced, we are working on a range of financing opportunities in strategic alternatives. We're in direct dialogue with our lenders with respect to these options.
Speaker #1: And I think obviously our goal is to work with lenders and potentially equity investors and find a way to enhance our liquidity, extend the runway as we have these really important milestones in front of us in the second half of 2026.
Speaker #1: So I think we'll be able to continue to execute on that and find the right balance as we move forward.
Speaker #5: Got it. Understood. All right, thanks so much.
Speaker #1: Thanks, Yanni.
Speaker #3: Thank you. Your next question comes from Brian Abrahams with RBC Capital Markets. Please go ahead.
Speaker #6: Oh, hey, good morning. Thanks so much for taking my question and congrats on the continued progress. You mentioned in milestones the potential for inclusion of sell an X or in the compendia in the back half of this year.
Speaker #6: That seems pretty rapid if the NCCN meeting is happening just this week. So I'm just curious if you're hearing anything emerging from the meeting that gives you confidence and maybe you could remind us of the process there.
Speaker #6: And then maybe just secondly, just curious if in your dialogue, you're hearing any insights from the FDA on whether and how open they might be to priority review?
Speaker #6: Thanks.
Speaker #1: Sure. Thanks, Brian. I'll address the first part and I'll turn to Reshma for the second part. Obviously, NCCN is an independent committee and an independent body.
Speaker #1: So they'll go through their process and evaluate. Importantly, we've put the right components in place in terms of our ASCO presentation, our EHOP presentation, our journal clinical oncology.
Speaker #1: Manuscripts, I think all the right components are there. And we hear a high level of interest from opinion leaders to be able to get access to selinexor plus ruxolitinib.
Speaker #1: So I think we're on track, as we said, to see that in the second half of this year. And for the second part, I'll turn to Reshma to talk to the FDA.
Speaker #2: Yeah, thanks, Brian. So, as I mentioned, really great, productive conversations with the FDA. In terms of priority review—not necessarily. So, this is a request that we need to make with the FDA at the time that the application is submitted.
Speaker #2: They have approximately 60 days to review that request and then they'll provide that update shortly thereafter. So no specific insight, but we do believe that we have a strong package potentially a differentiating profile and need for a combination therapy.
Speaker #2: So, hopefully, they will review it and expedite the PDUFA date, which will enable an approval sometime early in next year.
Speaker #1: Super helpful. Thanks so much.
Speaker #4: Thanks, Brian.
Speaker #3: Thank you. Your next question comes from Murray Raycroft with Jefferies. Please go ahead.
Speaker #6: Hi, thanks for taking my questions. Maybe I'll just ask one on the term loan negotiations. Lori, you mentioned potential for a waiver. What are those discussions look like?
Speaker #6: And what could updated obligations look like if there’s a waiver? And what is the likelihood of that? And then I’ve got a follow-up question.
Speaker #1: Sure. Maybe Murray, I'll address that one. I mean, just at a high level, we're not going to obviously go into the details of the conversations and negotiations, but I think as we mentioned, the lenders have been consistently supportive with us.
Speaker #1: And again, I think we don't have any reason to believe that they won't continue to do so. So good productive conversations and working on the right solution.
Speaker #1: As we move forward. And obviously, that's something that we're very focused on and working to achieve rapidly.
Speaker #6: Understood. That's helpful. And then for NCCN compendia listing, I guess, what's your plan to get patients from your clinical studies onto paid drug? And do you have a sense of the proportion of patients from your studies that would make that switch early on with only the NCCN compendia listing?
Speaker #1: Well, I think on our study, as we mentioned, we hope to see our study continue, right? So our study continues, patients are blinded. Clinicians are blinded.
Speaker #1: We have a blinded study team inside Karyopharm. So we would look to see our study continue. And I think as Reshma mentioned, we're looking to see that to be the confirmatory data from an accelerated approval perspective.
Speaker #1: So our focus would be to make sure we're really working with the sites, investigators, patients, etc., to continue patients on our Phase 3 program.
Speaker #6: Understood. Okay, thanks for taking my questions.
Speaker #1: Thanks, Murray.
Speaker #3: Thank you. Your next question comes from Michael King with Rodman & Renshaw. Please go ahead.
Speaker #7: Thanks. Good morning, guys. Thanks for taking the question. Just a little further granularity—excuse me—on the filing and the interaction with the FDA.
Speaker #7: I was just wondering, given that recent interaction with the BNC, meetings, and the updated analysis that you presented at ESMO, if any part of the data set that you're going to submit could be considered to be a major amendment.
Speaker #7: Obviously, this would be very impactful for the approval timeline. So I'm just wondering how you're thinking about submitting the data to the agency.
Speaker #1: Yeah, let me turn to Reshma for that part.
Speaker #2: Yeah, thanks, Michael. Great question. So the SMDA, under the accelerated approval, is really going to be based upon the week 24 data. So the week 24 that we really believe is compelling and differentiating, of course, is going to be that SVR 35 data.
Speaker #2: Not only at week 24, that's the time point at which the primary analysis was conducted. But the kinetic really suggests something very differentiating. So, of course, that SVR 35 at week 12, 24, 36 shows that sustained SVR, of course, the overall survival data, the post-talk analysis with the relationship between SVR OS, the disease modification data, and the safety.
Speaker #2: So that's the profile, again, very compelling at week 24. And again, we'll form the basis for that and for the SMDA.
Speaker #7: Okay. And no 48-week data to be submitted then. Is that correct?
Speaker #2: That's correct. We're going to really focus on the week 24 data now. There are some patients that have been followed through week 48. We'll provide that data.
Speaker #2: As well, but the primary focus is really going to be on week 24.
Speaker #7: Okay. And can you say whether you'll include the prespecified OS confirmatory analysis in that submission?
Speaker #2: Yeah, absolutely. That's part of the differentiating package. And that OS data, that we observed and, of course, presented at ASCO, EHON, was included in the JCO, really was the basis for that post-talk analysis that allowed us to show that relationship between SVR OS.
Speaker #2: So it is a very important data point. Of course, we'll continue to follow patients on overall survival. And as mentioned earlier, we'll use those data to ultimately confirm the benefit in the future.
Speaker #7: Great. Thanks for taking the questions.
Speaker #1: Thanks, Michael.
Speaker #3: Thank you, Michael. There are no additional questions in the queue. I will turn it back to Richard for some closing remarks.
Speaker #1: Thank you, operator. And thank you, everyone, for joining us today in your continued interest in Karyopharm. I guess we've highlighted we very much look forward to providing you additional updates on our regulatory and financing developments very much in the near future.
Speaker #1: So, once again, thanks for joining us.
