Karyopharm Reports Fourth Quarter and Full Year 2024 Financial Results, Announces Update to Phase 3 XPORT-EC-042 Trial and Highlights Recent Company Progress
Rhea-AI Summary
Karyopharm Therapeutics reported financial results for Q4 and full year 2024, achieving total revenue of $145.2 million and U.S. XPOVIO net product revenue of $112.8 million for the full year. The company provided 2025 guidance with total revenue expected between $140-155 million.
Key updates include modifications to the Phase 3 XPORT-EC-042 trial in endometrial cancer, with enrollment now focusing on patients with pMMR tumors or dMMR tumors ineligible for checkpoint inhibitors. The sample size has been increased to 276 patients, with top-line data expected in mid-2026.
The Phase 3 SENTRY trial in myelofibrosis is on track for enrollment completion in 1H 2025, with top-line data expected in 2H 2025. The company's cash position was $109.1 million as of December 31, 2024, expected to fund operations into Q1 2026.
Positive
- Total revenue reached $145.2 million for full year 2024
- U.S. XPOVIO net product revenue increased to $112.8 million from $112.0 million in 2023
- Positive 2025 revenue guidance of $140-155 million
- Global expansion with approvals in over 45 countries
Negative
- Net loss of $76.4 million for full year 2024
- Cash position decreased to $109.1 million from $192.4 million year-over-year
- Higher R&D expenses at $143.2 million compared to $138.8 million in 2023
- Increased interest expense to $37.4 million from $23.8 million in 2023
Insights
The financial results and strategic updates present a challenging outlook for Karyopharm. The company's flat revenue growth in 2024 (
The modification of the Phase 3 XPORT-EC-042 trial design and extension of the timeline to mid-2026 reflects the rapidly evolving treatment landscape in endometrial cancer. The increased sample size to 276 patients and refined patient population focus demonstrates a more targeted approach but will require additional resources and extend the development timeline.
The company's cash position of
The Phase 3 SENTRY trial in myelofibrosis represents a significant opportunity, with data expected in 2H 2025. However, the endpoint modification and increased sample size to 350 patients, while potentially strengthening the statistical significance, will increase development costs. The preliminary Phase 1 data showing
Operating expenses remain high with combined R&D and SG&A of
– Total Revenue of
– Top-Line Data Readout from Phase 3 SENTRY Trial Evaluating Selinexor in Combination with Ruxolitinib in Patients with JAKi-Naïve Myelofibrosis Anticipated in 2H 2025; Company on Track to Complete Enrollment in 1H 2025 –
– Company Announces Update to Phase 3 XPORT-EC-042 Trial of Selinexor as Maintenance Therapy in Advanced or Recurrent TP53 Wild-Type Endometrial Cancer. Following Dialogue with the FDA Regarding the Evolving Treatment Landscape, Trial to Focus Enrollment on Patients with Either pMMR Tumors or Patients with dMMR Tumors that are Medically Ineligible for Checkpoint Inhibitors. Increasing Sample Size to 276; Top-Line Data Now Expected in Mid-2026 –
– Company Provides Full-Year 2025 Total Revenue Guidance of
– Conference Call Scheduled for Today at 8:00 a.m. ET –
"In 2025, our teams remain focused on the transformative opportunity to redefine the standard of care in myelofibrosis, with top-line data from our Phase 3 SENTRY trial evaluating selinexor in combination with ruxolitinib on-track for the second half of 2025. We look forward to completing enrollment of our SENTRY trial in the first half of this year and leveraging our demonstrated commercialization capabilities in multiple myeloma to support a rapid launch, subject to approval," said Richard Paulson, President and Chief Executive Officer of Karyopharm. "In endometrial cancer, today we announced our updated plans for our Phase 3 trial and intend to primarily focus on the TP53 wild-type pMMR population, which represents approximately
Fourth Quarter 2024 and Recent Highlights
XPOVIO Commercial Performance
- Achieved
U.S. net product revenue for the year ended December 31, 2024 of , compared to$113 million for the year ended December 31, 2023.$112 million U.S. net product revenue for the fourth quarter of 2024 was , compared to$29 million for the fourth quarter of 2023.$25 million - Demand for XPOVIO was consistent in 2024 versus 2023, with demand growth in the second half of 2024 in both the community setting, which represents approximately
60% of XPOVIO net product revenue, and the academic setting, offsetting a decline in demand in the first half of the year due to an intensified competitive landscape. - XPOVIO net product revenue was impacted year-over-year by higher gross-to-net adjustments in 2024, driven primarily by increased 340B discounts and Medicare rebates.
- Expanded global patient access for selinexor in 2024 with favorable reimbursement decisions in the
United Kingdom ,France ,Italy ,China andSouth Korea and additional regulatory approvals inUAE ,Kuwait ,China ,Malaysia ,Turkey ,Thailand , andSouth Korea in various indications, increasing the number of countries where selinexor is now approved in more than 45 countries.
Research and Development (R&D) Highlights
Myelofibrosis
- Updated the co-primary endpoint in the Phase 3 SENTRY trial (XPORT-MF-034; NCT04562389) to absolute mean change in total symptom score (Abs-TSS) following alignment with the
U.S. Food and Drug Administration (FDA) and proactively increased the total sample size to approximately 350 patients to further increase the statistical powering. Abs-TSS measures the average improvement in symptom scores over 24 weeks relative to the baseline symptom score. Abs-TSS is viewed by many key opinion leaders (KOLs) and patient advocacy organizations as a more accurate assessment of symptom improvement in head-to-head clinical trials, such as SENTRY which is evaluating selinexor in combination with ruxolitinib in patients with JAK inhibitor (JAKi) naïve myelofibrosis versus ruxolitinib alone. Spleen volume reduction ≥35% (SVR35) at week 24 remains the other co-primary endpoint. These two co-primary endpoints will be tested sequentially starting with SVR35 followed by Abs-TSS. - Hosted an investor event with leading KOLs in October 2024 to discuss the change in the co-primary endpoint in the Phase 3 SENTRY trial to Abs-TSS and highlight the strength of the data from the Company's Phase 1 trial in myelofibrosis. Data from the Company's Phase 1 trial, evaluating the combination of selinexor 60 mg plus ruxolitinib in JAKi naïve myelofibrosis patients, demonstrated that
79% of patients in the intent to treat population (n=14) achieved SVR35 and an average Abs-TSS improvement of 18.5 points in the efficacy evaluable population (n=9), at week 24 relative to baseline. Acknowledging the small sample size, these data suggest that the combination is favorable compared to historical ruxolitinib monotherapy data which indicates that less than half of patients achieve SVR35 and an Abs-TSS improvement of 11 to 14 points1. As of the most recent data cut off, the safety profile remained consistent and no new safety signals were identified. - The Company continues to enroll patients into the 60 mg cohort of the Phase 2 SENTRY-2 trial of selinexor monotherapy in JAKi naïve patients with moderate thrombocytopenia (XPORT-MF-044; NCT05980806).
1Phase 3 MANIFEST trial. Rampal R, et al. ASH 2023. Oral 628; Phase 3 TRANSFORM-1 trial Pemmaraju N, et al. ASH 2023 abstract 620.
Endometrial Cancer
- The Company is modifying the design of its Phase 3 XPORT-EC-042 trial evaluating selinexor as a maintenance-only therapy following systemic therapy versus placebo in patients with TP53 wild-type advanced or recurrent endometrial cancer. In late 2024 and early 2025, the Company engaged in communications with the FDA regarding the design adequacy of XPORT-EC-042 given the changing standard of care in endometrial cancer, particularly the approval of checkpoint inhibitors for patients with advanced or recurrent endometrial cancer regardless of mismatch repair status. In light of the FDA's acknowledgement that the magnitude of benefit achieved from checkpoint inhibitors is less for patients with pMMR tumors than patients with dMMR tumors, consistent with the biology and mechanism of action of checkpoint inhibitors, the Company's modifications include defining two patient populations for which the primary endpoint of progression free survival (PFS), tested sequentially, and key secondary endpoint of overall survival (OS) will be evaluated:
- a modified intent to treat population (mITT) that will include patients with:
- TP53 wild-type tumors with proficient mismatch repair status (pMMR); or,
- TP53 wild-type tumors with deficient mismatch repair status (dMMR), who are medically ineligible to receive checkpoint inhibitors.
- TP53 wild-type tumors with proficient mismatch repair status (pMMR); or,
- the trial's original intent to treat (ITT) population, which will include all patients enrolled in the trial whose tumors are TP53 wild-type, regardless of MMR status.
- a modified intent to treat population (mITT) that will include patients with:
- The Company is increasing the trial sample size from 220 patients to approximately 276 patients, to ensure that the mITT population includes approximately 220 patients who are either: a) TP53 wild-type pMMR or b) TP53 wild-type dMMR and medically ineligible to receive a checkpoint inhibitor. The increase in sample size maintains sufficient power for the primary endpoint of PFS in the mITT population. To date, approximately
80% of patients enrolled meet the new eligibility definition for the mITT population. - The proposed modifications are intended to address certain of the FDA's feedback regarding the evolving treatment landscape, including the approval of multiple checkpoint inhibitors for advanced/recurrent endometrial cancer patients with pMMR and/or dMMR tumors in 2023 and 2024.
- Enrollment continues in the XPORT-EC-042 trial and, depending on the strength of the data, the Company intends to pursue regulatory approval. As a result of the proposed modifications, the Company now expects topline data in mid-2026.
Multiple Myeloma
- Completed enrollment of the Phase 3 XPORT-MM-031 trial (EMN29; NCT05028348) of approximately 120 patients, leveraging the data published on selinexor 40 mg, pomalidomide and dexamethasone (SPd40) in 2024. The Phase 3 XPORT-MM-031 trial is being conducted in collaboration with the European Myeloma Network and is evaluating the all-oral combination SPd40 in patients with previously treated multiple myeloma who received an anti-CD38 in their immediate prior line of therapy. Pending ongoing engagement with regulatory agencies on the updated protocol and statistical plan, the Company intends to provide an update on this trial.
Anticipated Catalysts and Operational Objectives in 2025
Myelofibrosis
- Announce completion of enrollment of the Phase 3 SENTRY trial evaluating selinexor in combination with ruxolitinib in JAKi naive myelofibrosis patients in 1H 2025.
- Report preliminary data on a subset of participants in the 60 mg cohort from the Phase 2 SENTRY-2 trial evaluating selinexor as a monotherapy in patients with JAKi naïve myelofibrosis with moderate thrombocytopenia in 1H 2025.
- Report top-line results from the Phase 3 SENTRY trial in 2H 2025.
Multiple Myeloma
- Maintain the Company's commercial foundation in the competitive multiple myeloma marketplace and drive increased XPOVIO revenues.
- Continue global launches and reimbursement approvals for selinexor by partners in ex-
U.S. territories. - Continue to follow patients that are enrolled in the Phase 3 XPORT-MM-031 (EMN29) trial. Pending ongoing engagement with regulatory agencies on the updated protocol and statistical plan, the Company intends to provide an update on this trial.
Endometrial Cancer
- Continue to enroll patients into the Phase 3 XPORT-EC-042 trial of selinexor as a maintenance monotherapy for patients with TP53 wild-type advanced or recurrent endometrial cancer.
2025 Financial Outlook
Based on its current operating plans, Karyopharm expects the following for full year 2025:
- Total revenue to be in the range of
to$140 million . Total revenue consists of$155 million U.S. XPOVIO net product revenue and license, royalty and milestone revenue earned from partners. U.S. XPOVIO net product revenue to be in the range of to$115 million .$130 million - R&D and selling, general and administrative (SG&A) expenses to be in the range of
to$240 million , which includes approximately$255 million of estimated non-cash stock-based compensation expense.$20 million - The Company expects that its existing cash, cash equivalents and investments, and the revenue it expects to generate from XPOVIO net product sales, as well as revenue generated from its license agreements, will be sufficient to fund its planned operations into the first quarter of 2026.2
2Excluding re-payment of
Full Year and Fourth Quarter 2024 Financial Results
Total revenue: Total revenue for the fourth quarter of 2024 was
Net product revenue: Net product revenue for the fourth quarter of 2024 was
License and other revenue: License and other revenue for the fourth quarter of 2024 was
Cost of sales: Cost of sales for the fourth quarter of 2024 was
R&D expenses: R&D expenses for the fourth quarter of 2024 were
SG&A expenses: SG&A expenses for the fourth quarter of 2024 were
Interest income: Interest income for the fourth quarter of 2024 was
Interest expense: Interest expense for the fourth quarter of 2024 was
Gain on extinguishment of debt and other income: Other income for the fourth quarter of 2024 was
Net loss: Karyopharm reported a net loss of
Cash position: Cash, cash equivalents, restricted cash and investments as of December 31, 2024 totaled
Conference Call Information
Karyopharm will host a conference call today, February 19, 2025, at 8:00 a.m. Eastern Time, to discuss the fourth quarter and full year 2024 financial results, the financial outlook for 2025 and to provide other business updates. To access the conference call, please dial (800) 836-8184 (local) or (646) 357-8785 (international) at least 10 minutes prior to the start time and ask to be joined into the Karyopharm Therapeutics call. A live audio webcast of the call, along with accompanying slides, will be available under "Events & Presentations" in the Investor section of the Company's website. An archived webcast will be available on the Company's website approximately two hours after the event.
About XPOVIO® (selinexor)
XPOVIO is a first-in-class, oral exportin 1 (XPO1) inhibitor and the first of Karyopharm's Selective Inhibitor of Nuclear Export (SINE) compounds for the treatment of cancer. XPOVIO functions by selectively binding to and inhibiting the nuclear export protein XPO1. XPOVIO is approved in the
For more information about Karyopharm's products or clinical trials, please contact the Medical Information department at: Tel: +1 (888) 209-9326; Email: medicalinformation@karyopharm.com
XPOVIO® (selinexor) is a prescription medicine approved:
- In combination with bortezomib and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy (XVd).
- In combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti‐CD38 monoclonal antibody (Xd).
- For the treatment of adult patients with relapsed or refractory diffuse large B‐cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma, after at least two lines of systemic therapy. This indication is approved under accelerated approval based on response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trial(s).
SELECT IMPORTANT SAFETY INFORMATION
Warnings and Precautions
- Thrombocytopenia: Monitor platelet counts throughout treatment. Manage with dose interruption and/or reduction and supportive care.
- Neutropenia: Monitor neutrophil counts throughout treatment. Manage with dose interruption and/or reduction and granulocyte colony‐stimulating factors.
- Gastrointestinal Toxicity: Nausea, vomiting, diarrhea, anorexia, and weight loss may occur. Provide antiemetic prophylaxis. Manage with dose interruption and/or reduction, antiemetics, and supportive care.
- Hyponatremia: Monitor serum sodium levels throughout treatment. Correct for concurrent hyperglycemia and high serum paraprotein levels. Manage with dose interruption, reduction, or discontinuation, and supportive care.
- Serious Infection: Monitor for infection and treat promptly.
- Neurological Toxicity: Advise patients to refrain from driving and engaging in hazardous occupations or activities until neurological toxicity resolves. Optimize hydration status and concomitant medications to avoid dizziness or mental status changes.
- Embryo‐Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential and males with a female partner of reproductive potential, of the potential risk to a fetus and use of effective contraception.
- Cataract: Cataracts may develop or progress. Treatment of cataracts usually requires surgical removal of the cataract.
Adverse Reactions
- The most common adverse reactions (≥
20% ) in patients with multiple myeloma who receive XVd are fatigue, nausea, decreased appetite, diarrhea, peripheral neuropathy, upper respiratory tract infection, decreased weight, cataract and vomiting. Grade 3‐4 laboratory abnormalities (≥10% ) are thrombocytopenia, lymphopenia, hypophosphatemia, anemia, hyponatremia and neutropenia. In theBOSTON trial, fatal adverse reactions occurred in6% of patients within 30 days of last treatment. Serious adverse reactions occurred in52% of patients. Treatment discontinuation rate due to adverse reactions was19% . - The most common adverse reactions (≥
20% ) in patients with multiple myeloma who receive Xd are thrombocytopenia, fatigue, nausea, anemia, decreased appetite, decreased weight, diarrhea, vomiting, hyponatremia, neutropenia, leukopenia, constipation, dyspnea and upper respiratory tract infection. In the STORM trial, fatal adverse reactions occurred in9% of patients. Serious adverse reactions occurred in58% of patients. Treatment discontinuation rate due to adverse reactions was27% . - The most common adverse reactions (incidence ≥
20% ) in patients with DLBCL, excluding laboratory abnormalities, are fatigue, nausea, diarrhea, appetite decrease, weight decrease, constipation, vomiting, and pyrexia. Grade 3‐4 laboratory abnormalities (≥15% ) are thrombocytopenia, lymphopenia, neutropenia, anemia, and hyponatremia. In the SADAL trial, fatal adverse reactions occurred in3.7% of patients within 30 days, and5% of patients within 60 days of last treatment; the most frequent fatal adverse reactions was infection (4.5% of patients). Serious adverse reactions occurred in46% of patients; the most frequent serious adverse reaction was infection (21% of patients). Discontinuation due to adverse reactions occurred in17% of patients.
Use In Specific Populations
Lactation: Advise not to breastfeed.
For additional product information, including full prescribing information, please visit www.XPOVIO.com.
To report SUSPECTED ADVERSE REACTIONS, contact Karyopharm Therapeutics Inc. at 1‐888‐209‐9326 or FDA at 1‐800‐FDA‐1088 or www.fda.gov/medwatch.
About Karyopharm Therapeutics
Karyopharm Therapeutics Inc. (Nasdaq: KPTI) is a commercial-stage pharmaceutical company whose dedication to pioneering novel cancer therapies is fueled by a belief in the extraordinary strength and courage of patients with cancer. Since its founding, Karyopharm has been an industry leader in oral compounds that address nuclear export dysregulation, a fundamental mechanism of oncogenesis. Karyopharm's lead compound and first-in-class, oral exportin 1 (XPO1) inhibitor, XPOVIO® (selinexor), is approved in the
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of The Private Securities Litigation Reform Act of 1995. Such forward-looking statements include those regarding Karyopharm's guidance on its 2025 total revenue, 2025 U.S. net product revenue and 2025 R&D and SG&A expenses; expected cash runway; expectations with respect to commercialization efforts; the ability of selinexor to treat patients with multiple myeloma, endometrial cancer, myelofibrosis, diffuse large B-cell lymphoma and other diseases; and expectations with respect to the clinical development plans and potential regulatory submissions of selinexor. Such statements are subject to numerous important factors, risks and uncertainties, many of which are beyond Karyopharm's control, that may cause actual events or results to differ materially from Karyopharm's current expectations. For example, there can be no guarantee that Karyopharm will successfully commercialize XPOVIO or that any of Karyopharm's drug candidates, including selinexor, will successfully complete necessary clinical development phases or that development of any of Karyopharm's drug candidates will continue. Further, there can be no guarantee that any positive developments in the development or commercialization of Karyopharm's drug candidate portfolio will result in stock price appreciation. Management's expectations and, therefore, any forward-looking statements in this press release could also be affected by risks and uncertainties relating to a number of other factors, including the following: the adoption of XPOVIO in the commercial marketplace, the timing and costs involved in commercializing XPOVIO or any of Karyopharm's drug candidates that receive regulatory approval; the ability to obtain and retain regulatory approval of XPOVIO or any of Karyopharm's drug candidates that receive regulatory approval; Karyopharm's results of clinical trials and preclinical trials, including subsequent analysis of existing data and new data received from ongoing and future trials; the content and timing of decisions made by the
XPOVIO® and NEXPOVIO® are registered trademarks of Karyopharm Therapeutics Inc.
KARYOPHARM THERAPEUTICS INC. CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (unaudited) (in thousands, except per share amounts)
| ||||||||||||||||
Three Months Ended | Years Ended | |||||||||||||||
2024 | 2023 | 2024 | 2023 | |||||||||||||
Revenues: | ||||||||||||||||
Product revenue, net | $ | 29,252 | $ | 25,056 | $ | 112,806 | $ | 112,011 | ||||||||
License and other revenue | 1,290 | 8,691 | 32,431 | 34,022 | ||||||||||||
Total revenue | 30,542 | 33,747 | 145,237 | 146,033 | ||||||||||||
Operating expenses: | ||||||||||||||||
Cost of sales | 1,331 | 1,486 | 6,007 | 4,942 | ||||||||||||
Research and development | 33,302 | 39,381 | 143,232 | 138,750 | ||||||||||||
Selling, general and administrative | 27,190 | 30,688 | 115,441 | 131,881 | ||||||||||||
Total operating expenses | 61,823 | 71,555 | 264,680 | 275,573 | ||||||||||||
Loss from operations | (31,281) | (37,808) | (119,443) | (129,540) | ||||||||||||
Other income (expense): | ||||||||||||||||
Interest income | 1,482 | 2,520 | 7,400 | 10,943 | ||||||||||||
Interest expense | (11,204) | (6,208) | (37,422) | (23,823) | ||||||||||||
Gain on extinguishment of debt | — | — | 44,702 | — | ||||||||||||
Other income (expense), net | 10,114 | (211) | 28,398 | (356) | ||||||||||||
Total other income (expense), net | 392 | (3,899) | 43,078 | (13,236) | ||||||||||||
Loss before income taxes | (30,889) | (41,707) | (76,365) | (142,776) | ||||||||||||
Income tax provision | 109 | (130) | (57) | (323) | ||||||||||||
Net loss | $ | (30,780) | $ | (41,837) | $ | (76,422) | $ | (143,099) | ||||||||
Basic net loss per share | $ | (0.24) | $ | (0.36) | $ | (0.63) | $ | (1.25) | ||||||||
Diluted net loss per share | $ | (0.24) | $ | (0.36) | $ | (0.93) | $ | (1.25) | ||||||||
Weighted-average number of common shares | 125,881 | 114,778 | 121,863 | 114,221 | ||||||||||||
Weighted-average number of common shares | 125,881 | 114,778 | 126,809 | 114,221 | ||||||||||||
KARYOPHARM THERAPEUTICS INC. CONDENSED CONSOLIDATED BALANCE SHEETS (unaudited) (in thousands)
| |||||||
December 31, | December 31, | ||||||
Assets | |||||||
Cash, cash equivalents and investments | $ | 108,712 | $ | 191,443 | |||
Restricted cash | 338 | 961 | |||||
Accounts receivable | 30,766 | 26,962 | |||||
Other assets | 24,602 | 21,072 | |||||
Total assets | $ | 164,418 | $ | 240,438 | |||
Liabilities and stockholders' deficit | |||||||
Convertible senior notes due 2025 | $ | 24,426 | $ | 170,919 | |||
Convertible senior notes due 2029 | 68,345 | — | |||||
Senior secured term loan | 94,603 | — | |||||
Deferred royalty obligation | 73,499 | 132,479 | |||||
Other liabilities | 89,562 | 73,246 | |||||
Total liabilities | 350,435 | 376,644 | |||||
Total stockholders' deficit | (186,017) | (136,206) | |||||
Total liabilities and stockholders' deficit; 126,201 and 114,915 shares issued and | $ | 164,418 | $ | 240,438 | |||
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