--- title: "Karyopharm (KPTI) Leans on SENTRY in Pivotal Call" type: "News" locale: "en" url: "https://longbridge.com/en/news/287005767.md" description: "Karyopharm Therapeutics (KPTI) reported Q1 earnings, highlighting strong Phase III data from the SENTRY trial, which showed significant spleen volume reduction and overall survival benefits. Despite a 17% revenue increase to $35.1 million, the company faces competitive pressures and a limited cash runway, with $91.2 million on hand. Management remains optimistic about potential market opportunities in myelofibrosis and endometrial cancer, while acknowledging challenges from new competitors affecting XPOVIO sales." datetime: "2026-05-20T04:38:14.000Z" locales: - [zh-CN](https://longbridge.com/zh-CN/news/287005767.md) - [en](https://longbridge.com/en/news/287005767.md) - [zh-HK](https://longbridge.com/zh-HK/news/287005767.md) --- # Karyopharm (KPTI) Leans on SENTRY in Pivotal Call Karyopharm Therapeutics INC ((KPTI)) has held its Q1 earnings call. Read on for the main highlights of the call. ### Claim 55% Off TipRanks - Unlock hedge fund-level data and powerful investing tools for smarter, sharper decisions - Discover top-performing stock ideas and upgrade to a portfolio of market leaders with Smart Investor Picks Karyopharm Therapeutics struck an optimistic tone on its latest earnings call, highlighting robust Phase III data and a string of near‑term catalysts that could reshape its growth profile. Management balanced this enthusiasm with candid acknowledgment of competitive headwinds for XPOVIO, continued losses and a relatively short cash runway, leaving investors weighing strong science against execution and financing risks. ## SENTRY Delivers Strong Spleen Response in Myelofibrosis SENTRY’s co‑primary endpoint showed a 50% spleen volume reduction rate at week 24 for selinexor plus ruxolitinib, versus 28% for ruxolitinib alone, with p below 0.0001. The company stressed that meaningful spleen volume reductions appeared as early as week 12 and were maintained through week 36, pointing to a durable treatment effect. ## Overall Survival Signal and Signs of Disease Modification Beyond spleen responses, SENTRY produced an overall survival hazard ratio of 0.43 in favor of the combination, with a nominal p value of 0.0222. Post‑hoc analyses suggested that achieving SVR35 correlated with better survival and that 32% of patients on the combo had at least a 20% drop in variant allele frequency, hinting at potential disease‑modifying activity. ## Scientific Spotlight: ASCO Stage and Publication Plans The strength of the SENTRY package has earned it a late‑breaking oral slot at the ASCO meeting, a key forum for oncologists and investors alike. Management also plans to submit a full manuscript to a peer‑reviewed journal around mid‑2026, aiming to cement selinexor’s profile and expand scientific visibility. ## Endometrial Cancer: EC042 Completes Enrollment In endometrial cancer, Karyopharm completed enrollment in EC042 with 257 intent‑to‑treat patients and roughly 220 in the primary analysis set, targeting a top‑line readout in mid‑2026. The team repeatedly pointed to prior SIENDO data, where p53 wild‑type patients saw median progression‑free survival of 13.7 versus 3.7 months at top‑line and up to 28.4 months on long‑term follow‑up. ## SIENDO Benchmarks Raise Expectations in p53 wt/MMRp The company underscored that the p53 wild‑type and MMR‑proficient subgroup in SIENDO reached an estimated median progression‑free survival of about 40 months, with a hazard ratio of 0.36. Management argued that these outcomes compare favorably with the RUBY benchmark, reinforcing confidence that EC042 could unlock a sizable maintenance opportunity. ## Revenue Growth Aided by Gross‑to‑Net Tailwinds Karyopharm reported first‑quarter total revenue of $35.1 million, up about 17% from $30.0 million in the prior year period. U.S. XPOVIO net product revenue climbed to $29.2 million from $21.1 million, as the gross‑to‑net rate dropped to 21.8% from 45.0%, a swing management described as a roughly 23‑point improvement. ## Underlying Profitability Trends Show Incremental Progress The quarterly net loss narrowed slightly to $22.4 million from $23.5 million a year earlier, and management cited a 20% reduction in loss from operations on an underlying basis. The company reaffirmed that expense discipline is starting to take hold even as it funds multiple late‑stage programs, though overall operating costs remain high. ## Balance Sheet Bolstered but Runway Remains Limited The firm finished the quarter with $91.2 million in cash, cash equivalents and restricted cash, including around $50 million raised in March. Executives said this should fund operations into late third quarter 2026 and noted that existing sales and medical infrastructure should allow future launches with modest additional pre‑approval spend. ## Sizeable Commercial Opportunities in MF and Endometrial Cancer Management framed myelofibrosis as an attractive market, with roughly 20,000 patients living with the disease and about 7,000 new first‑line cases annually, of which around 4,000 are seen as addressable. Based on these assumptions, Karyopharm is modeling up to about $1 billion in potential U.S. peak revenue for the selinexor plus ruxolitinib combination, alongside roughly 17,000 annual advanced or recurrent endometrial cases. ## XPOVIO Faces Demand Pressure from New Rivals Despite reporting higher XPOVIO revenue, the company acknowledged that underlying demand was actually lower than a year earlier because of fresh competition. The quarter’s net product growth therefore leaned heavily on improved gross‑to‑net dynamics rather than organic prescription gains, underscoring the need to defend share. ## Gross‑to‑Net Swings Highlight Revenue Volatility Gross‑to‑net discounts and adjustments have been volatile, swinging from 45.0% in last year’s first quarter, when an unusual product return adjustment hit the numbers, to 21.8% this quarter. Management suggested that the underlying gross‑to‑net this time was closer to 26%, but investors were reminded that revenue can be heavily influenced by these moving parts. ## Cash Burn and Ongoing Net Losses Still a Concern Karyopharm’s guidance for 2026 envisions combined R&D and SG&A spending of $230 million to $245 million, signaling that cash burn will remain substantial. With the latest quarter still showing a more than $22 million net loss, the company may need additional funding or partnership milestones to bridge to potential approvals. ## SENTRY Safety and Data Detail Under the Microscope Management disclosed 23 deaths at the SENTRY top‑line cutoff and described them as in line with expectations for this patient population, but offered limited additional breakdown. Analysts on the call indicated that regulators and investigators will likely push for clearer attribution and more granularity in upcoming presentations and publications. ## Regulatory and Market Access Pathways Not Yet Defined The timing and outcome of FDA discussions for SENTRY remain uncertain, and the company did not commit to a specific supplemental filing timeline. Executives floated the possibility of seeking compendia listing as an interim route but cautioned that this pathway could limit adoption to roughly half of the expected peak market relative to a full label. ## Guidance and Milestones Emphasize a Pivotal 2026 Karyopharm reaffirmed 2026 guidance for total revenue of $130 million to $150 million and U.S. XPOVIO revenue of $115 million to $130 million, with R&D and SG&A combined at $230 million to $245 million. Key operational markers include the mid‑2026 EC042 top‑line readout, further SENTRY disclosures and the potential to convert promising data into regulatory progress and, eventually, commercial uptake. The call left investors with a nuanced picture in which strong late‑stage data and clear commercial ambition were offset by competitive erosion in XPOVIO, funding needs and regulatory unknowns. If Karyopharm can execute on SENTRY and EC042 while managing its balance sheet, the upside from myelofibrosis and endometrial cancer markets could be significant, but the path remains finely balanced between opportunity and risk. ### Related Stocks - [KPTI.US](https://longbridge.com/en/quote/KPTI.US.md) - [IHE.US](https://longbridge.com/en/quote/IHE.US.md) - [XBI.US](https://longbridge.com/en/quote/XBI.US.md) - [IBB.US](https://longbridge.com/en/quote/IBB.US.md) - [SBIO.US](https://longbridge.com/en/quote/SBIO.US.md) - [FBT.US](https://longbridge.com/en/quote/FBT.US.md) - [VHT.US](https://longbridge.com/en/quote/VHT.US.md) - [LABU.US](https://longbridge.com/en/quote/LABU.US.md) - [XLV.US](https://longbridge.com/en/quote/XLV.US.md) - [PBE.US](https://longbridge.com/en/quote/PBE.US.md) - [ARKG.US](https://longbridge.com/en/quote/ARKG.US.md) - [BBH.US](https://longbridge.com/en/quote/BBH.US.md) - [BIB.US](https://longbridge.com/en/quote/BIB.US.md) ## Related News & Research - [RBC Capital Remains a Buy on Karyopharm Therapeutics (KPTI)](https://longbridge.com/en/news/286559865.md) - [Relay's treatment shown to shrink vascular malformations in mid-stage trial](https://longbridge.com/en/news/286890329.md) - [Eton Pharmaceuticals Adds Another 2026 Launch As It Secures U.S. Rights To IMPAVIDO](https://longbridge.com/en/news/287025596.md) - [Zydus buys US specialty drugmaker Assertio in Rs 1,600 crore all-cash deal](https://longbridge.com/en/news/286352725.md) - [Wave Life Sciences posts positive RestorAATion-2 data; WVE-006 restores M-AAT, cuts Z-AAT, supports monthly dosing](https://longbridge.com/en/news/286818220.md)