Puma Biotechnology Q3 2026 Earnings Call Transcript

Puma Biotechnology (NASDAQ:PBYI) reported third-quarter financial results on Thursday. The transcript from the company’s third-quarter earnings call has been provided below.

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Summary

Puma Biotechnology reported total revenue of $55.1 million for Q3 2026, with net product revenue from Nerlynx sales at $54.1 million, showing a slight increase compared to previous quarters.

The company is progressing with its Phase 2 trials of alisertib in breast and lung cancer, with plans for a Phase 3 trial based on encouraging interim results. Marketing efforts continue to focus on increasing awareness of Nerlynx’s benefits.

Guidance for 2026 anticipates net Nerlynx product revenue between $205 to $208 million, with a full-year net income estimate of $20 to $22 million. This reflects a slight revision downward due to inventory and lower demand.

Operational highlights include a strategic shift towards the Specialty Distributor channel, which accounted for 61% of business in Q3 2026, and the company being debt-free after paying off its loan obligations.

Management expressed commitment to maintaining positive net income and highlighted ongoing efforts to potentially in-license or acquire additional drugs to diversify their portfolio.

Full Transcript

Latonya (Operator)

Good afternoon. My name is Latonya and I will be your conference call operator today. At this time, all participants are in a listen-only mode. After the speaker’s formal remarks, there will be a question-and-answer session. If you would like to ask a question during that time, simply press the star key, then the number one on your telephone keypad. If you would like to withdraw your question, please press star two. If you should require operator assistance during the conference, please press star zero on your telephone keypad.

As a reminder, this conference is being recorded. I would now like to turn the conference call over to Marianne, Senior Director of Investor Relations for Puma Biotechnology. You may begin the conference.

Marianne (Senior Director of Investor Relations)

Thank you, Latonya. Good afternoon and welcome to Puma’s conference call to discuss our earnings results for the third quarter of 2026. Joining me on the call today are Alan Auerbach, Chief Executive Officer, President and Chairman of the Board of Puma Biotechnology; Maximo Nougues, Chief Financial Officer; Heather Blaber, Senior Vice President of Marketing; and Roger Storms, Senior Vice President of Sales. After the close today, Puma issued a news release detailing earnings results for the third quarter of 2026. That news release, the slides that Roger will refer to, and a webcast of this call are accessible via the home page and investor sections of our website at pumabiotechnology.com. The webcast and presentation slides will be archived on our website and available for replay for the next 90 days.

Today’s conference call will include statements about Puma’s future expectations, plans and prospects that constitute forward-looking statements. For purposes of federal securities laws, such statements are subject to risks and uncertainties and actual events and results may differ from those expressed in these forward-looking statements. For a full discussion of these risks and uncertainties, please review our periodic and current reports filed with the SEC from time to time, including our Annual Report on Form 10-K for the year ended December 31, 2025.

You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this live conference call, November 5, 2026. Puma undertakes no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this conference call, except as required by law. During today’s call, we may refer to certain non-GAAP financial measures that involve adjustments to our GAAP figures. We believe these non-GAAP metrics may be useful to investors as a supplement to, but not a substitute for, our GAAP financial measures. Please refer to our third quarter 2026 earnings release for a reconciliation of our GAAP to non-GAAP results.

I will now turn the call over to Alan.

Alan Auerbach (President and CEO)

Thank you, Marianne, and thank you all for joining our call today. Today, Puma reported total revenue for the third quarter of 2026 of $55.1 million. Total revenue includes product revenue, net, which consists entirely of Nerlynx sales as well as royalties from our sublicensees. Product revenue, net, was $54.1 million in the third quarter of 2026, an increase from $53.6 million reported in Q2 2026 and $51.9 million reported in Q3 2025. As a reminder to investors, Puma’s reported Nerlynx sales include both U.S. net sales of Nerlynx and product supply revenues of Nerlynx to Puma’s ex-U.S. partners. Product revenue for the third quarter of 2026 included approximately $1.5 million of inventory drawdown at our specialty pharmacies and specialty distributors. Royalty revenue was slightly below $1 million in the third quarter of 2026 compared to $2.9 million in Q2 2026 and $2.6 million in Q2 2025. We reported 2,818 bottles of Nerlynx sold in the third quarter of 2026 compared to 2,929 bottles sold in Q2 2026. In Q3 2026, we estimate that inventory decreased by 82 bottles.

In Q3 2026, new prescriptions were down approximately 13% compared to Q2 2026 and total prescriptions were down approximately 5% compared to Q2 2026. Roger will provide further details in his comments and slides. I will now provide updates from Puma’s ongoing Phase 2 trials of alisertib in small cell lung cancer and HER2-negative ER-positive breast cancer, also referred to as ALISCA Lung 1, ALISCA Lung 2 and ALISCA Breast 1. Heather Blaber and Roger Storms will add additional color on Nerlynx’s commercial activities. Maximo Nougues will follow with highlights of the key components of our financial statements for the third quarter of 2026.

As investors are aware, Puma currently has three ongoing Phase 2 studies of our investigational drug alisertib: ALISCA Breast 1, a Phase 2 trial of alisertib in combination with endocrine treatment in patients with HER2-negative, hormone receptor–positive recurrent or metastatic breast cancer; ALISCA Lung 1, a Phase 2 study looking at the efficacy of alisertib monotherapy in patients with small cell lung cancer; and ALISCA Lung 2, a Phase 2 trial of alisertib in combination with paclitaxel for the treatment of patients with advanced small cell lung cancer.

As a reminder, the ALISCA Breast 1 trial investigates alisertib in combination with endocrine treatment consisting of either anastrozole, exemestane, letrozole, fulvestrant or tamoxifen in patients with HER2-negative, hormone receptor–positive recurrent or metastatic breast cancer. Patients must be chemotherapy-naive in the recurrent or metastatic setting, have had previous treatment with a CDK4/6 inhibitor and have received at least two prior lines of endocrine therapy to be eligible for the trial.

Patients were initially dosed with alisertib given at either 30 mg, 40 mg or 50 mg twice daily on days 1 to 3, 8 to 10 and 15 to 17 of a 28-day cycle in combination with endocrine therapy of the investigator’s choice. Patients must not have previously been treated with the endocrine treatment in the metastatic setting that will be given in combination with alisertib in the trial. Interim data from this trial was presented on the company’s first quarter conference call. As discussed during that presentation, the company believes that the data obtained to date from ALISCA Breast 1 is providing a preliminary indication of potentially better activity in patients with biomarkers where the Aurora kinase pathway plays a role. Based on feedback that we have received from breast cancer key opinion leaders on this interim data, the trial has been amended such that we are only continuing enrollment in the 40 mg and 50 mg dose groups.

We began enrollment under that amended protocol during Q3. We are anticipating that updated interim data from the ALISCA Breast 1 study, including longer patient follow-up, will be presented at the San Antonio Breast Cancer Symposium in December. Based on our initial analysis of this data, we believe that the data from ALISCA Breast 1 is supportive of a Phase 3 trial of alisertib in patients with HER2-negative, hormone receptor–positive recurrent or metastatic breast cancer.

The company is looking to engage with global regulatory authorities regarding the design of this Phase 3 trial in the first half of 2027. With respect to the ALISCA Lung 1 study, as investors are aware, Puma has an ongoing Phase 2 trial of our investigational drug alisertib to investigate the efficacy of alisertib monotherapy in patients with extensive-stage small cell lung cancer. Interim data from this trial was presented on the company’s first quarter earnings call. As discussed during that presentation, the company believes that the data obtained to date from ALISCA Lung is providing a preliminary indication of potentially better activity in patients with biomarkers where the Aurora kinase pathway plays a role.

As was also discussed on the call, the company previously amended the trial to increase the dose from 50 mg BID to 60 mg BID. Dosing in this trial was further increased to 70 mg BID and the company is currently enrolling patients at the 70 mg BID dose level. Puma also initiated a second trial of alisertib in advanced small cell lung cancer, ALISCA Lung 2, where alisertib is given in combination with paclitaxel, similar to the Phase 2 randomized trial that was previously published in the Journal of Thoracic Oncology in September 2026.

The company anticipates that it will have additional interim data from the ALISCA Lung 1 trial and initial data from ALISCA Lung 2 in 2027. As mentioned on prior earnings calls and in response to investor questions, Puma continues to evaluate several commercial-stage and development-stage drugs to potentially in-license or acquire that would allow the company to diversify itself and leverage Puma’s existing R&D, regulatory and commercial infrastructure. The company will keep investors updated on this as it progresses.

I will now turn the call over to Heather Blaber for an update on our marketing initiatives, with Roger Storms to follow with a review of our commercial performance during the quarter.

Heather Blaber (Senior Vice President of Marketing)

Thank you, Alan. I appreciate the opportunity to share some additional insights into our marketing strategy. The marketing team is focused on continued awareness of both clinical data for Nerlynx as well as reinforcing the continued unmet need in HER2-positive early-stage breast cancer after adjuvant therapy. We continue to invest in market research to help us understand and validate the most effective ways to communicate our data with healthcare professionals through both personal and non-personal promotions.

Our strategy is focused on increasing awareness of our dual indication in HER2-positive breast cancer. We believe Nerlynx plays an important role in the early stage by reducing the risk of recurrence and in the metastatic setting by helping protect against progression. Not only do physicians who have experience with Nerlynx continue to identify appropriate patients that could benefit from additional therapy post adjuvant treatment, but we continue to adopt new prescribers year over year who recognize the unmet need in HER2-positive early-stage breast cancer and how Nerlynx may help their patients reduce their risk of recurrence.

In summary, we are excited and committed to engage with more oncologists and support their patients diagnosed with HER2-positive breast cancer in both the early and metastatic setting. I will now turn the call over to Roger Storms to provide an overview on the commercial performance for the third quarter.

Roger Storms (Senior Vice President of Sales)

Thank you, Heather, and thanks to everyone for joining our third quarter earnings call. Before I move into the commercial review, just a reminder that I’ll be making forward-looking statements. The sales team remains committed to expanding the appropriate use of Nerlynx with a primary emphasis on patients at elevated risk of recurrence. The team continues to strengthen clinical education and healthcare provider engagement through non-personal promotional initiatives while leveraging patient support resources to encourage treatment adherence, persistence and successful completion of Nerlynx therapy.

Let me now transition to some of the commercial slides. We’ll provide some additional specifics around performance. Slide 3 is an illustration of our distribution model, which is broken out into the Specialty Pharmacy (SP) channel and the Specialty Distributor (SD) or in-office dispensing channel. Regarding the overall distribution of our business in Q3 2026, about 61% of our business was purchased through the SD channel and the remaining 39% was purchased through the SP channel.

We continue to see stronger growth in the SD channel driven by two main factors: one, increased sales in the group purchasing organizations, or GPO, segment; and two, increasing 340B purchasing. Nerlynx net product revenue in Q3 2026 was $54.1 million, an increase from the $53.6 million we reported in Q2 of 2026 and the $51.9 million we reported in Q3 of 2025. As a reminder to investors, Puma’s reported Nerlynx sales include both U.S. net sales of Nerlynx and product supply revenues of Nerlynx to Puma’s ex-U.S. partners. Please note that in Q3 2026 we reported $3.6 million of product supply revenue versus about $17,000 in Q2 of 2026. I’ll provide some more details around inventory changes, and Maximo will provide some additional specifics around gross-to-net expenses during his update.

In Q3 2026, we estimate that inventory decreased by about $1.5 million. As a comparator, we estimate that inventory decreased by about $1 million in Q2 of 2026. Slide 5 shows Q3 2026 ex-factory bottle sales and also provides both a year-over-year and quarter-over-quarter comparison. As a reminder, ex-factory bottle sales include sales to our SP and SD channels. In Q3 2026, Nerlynx ex-factory bottle sales were 2,818, which represents an approximate 4% decrease quarter over quarter and year over year. Let me specifically call out the inventory changes from a bottle perspective. In Q3 2026, we estimate that inventory decreased by 82 bottles.

As a comparator, we estimate that inventory decreased by 57 bottles in Q2 of 2026 and increased by about 182 bottles in Q3 of 2025. Slide 6 highlights our commercial demand for the quarter. In Q3 2026, U.S. demand was 2,899 bottles, which represents an approximate 3% decrease quarter over quarter and 5% increase year over year. As noted earlier, strong account management and pull-through drove 19% year-over-year growth in the SD channel, extending the growth and shift towards this channel seen in recent quarters. In the SP channel, total prescriptions, or TRx, decreased by 5% quarter over quarter while remaining flat year over year.

Our Q3 2026 call activity decreased 8% year over year and 9% quarter over quarter, largely due to a temporary increase in vacancies and time off territory that we expect to normalize shortly. Enrollments in the quarter decreased by 12% quarter over quarter and 6% year over year, while commercial new patient starts decreased by 13% quarter over quarter and 9% year over year. Continued messaging and adoption of dose escalation remains an important commercial priority, and 80% of patients started Nerlynx at a reduced dose. We believe dose escalation, coupled with patient education resources, will give patients better support throughout their Nerlynx therapy and ultimately help them reduce the risk of recurrence.

Slide 7 highlights the strategic collaborations we formed across the globe. The most recent launch remains the Q1 2026 Nerlynx launch in Thailand in the extended adjuvant setting. We really appreciate the excellent work being done by our partners around the world and look forward to supporting their continued success moving forward. I’ll close by expressing my heartfelt gratitude to the entire Puma team for their unwavering dedication to patients and families impacted by breast cancer. While significant progress has been made in the fight against this devastating disease, important challenges remain. Together we have the opportunity to continue making a meaningful difference in advancing outcomes for those who need it most. I will now turn the call over to Maximo for a review of our financial results.

Maximo Nougues (Chief Financial Officer)

Thanks, Roger. I will begin with a brief summary of our financial results for the third quarter of 2026. Please note that I will make comparisons to Q2 2026, which we believe is a better indication of our progress as a commercial company than year-over-year comparisons. For more information, I recommend that you refer to our third quarter 2026 Form 10-Q, which will be filed by Monday and includes our consolidated financial statements. For the third quarter of 2026, we reported net income based on GAAP of $6 million, or $0.11 per diluted share. This compares to net income in Q2 2026 of $8.2 million, or $0.16 per share. On a non-GAAP basis, which is adjusted to remove the impact of stock-based compensation expense, we reported net income of $8 million, or $0.15 per basic and diluted share for the third quarter of 2026.

Gross revenue from Nerlynx sales was $75.1 million in Q3 2026 and $74.3 million in Q2 2026. As Alan mentioned, net product revenue from Nerlynx sales was $54.1 million, an increase from $53.6 million reported in Q2 2026 and $51.9 million reported in Q3 2025. As a reminder to investors, Puma’s reported Nerlynx sales include both U.S. net sales of Nerlynx and product supply revenue of Nerlynx to Puma ex-U.S. partners. Please note that in Q3 2026 we reported product supply revenue to our international partners of about $3.6 million.

Therefore, U.S. net sales of Nerlynx in Q3 2026 were $50.6 million versus $53.6 million in Q2 2026. The reduction in net product revenue in Q3 2026 versus Q2 2026 was driven by lower demand, an inventory decrease in Q3 of about $1.5 million versus an inventory decrease of $1 million in Q2 2026, and higher gross to net in Q3. Royalty revenue totaled $0.9 million in the third quarter of 2026 compared to $2.9 million in Q2 2026. Under our sublicense agreement covering China, the royalty rate payable to us is subject to reduction when the market share of generic versions of Nerlynx in China reaches a specific threshold. In October of 2026, the company received new third-party market data indicating that the market share of generic versions of Nerlynx in China reached a specific threshold during 2025.

To reflect this, the company recorded a $2.1 million cumulative reduction to royalty revenue in Q3 2026. A reduced royalty rate will be applied to China sales going forward. Our gross-to-net adjustment in Q3 2026 was about 28% and 27.9% in Q2 2026. The higher gross-to-net adjustment was mostly driven by higher Medicaid share. Cost of sales for Q3 2026 was $15.2 million and includes $2.4 million for the amortization of intangible assets related to our neratinib license. Cost of sales for Q2 2026 was $12.5 million. Going forward, we will continue to recognize amortization of milestones to the licensor of about $2.4 million per quarter as cost of sales.

For fiscal year 2026, Puma anticipates that net Nerlynx product revenue will be in the range of $205 to $208 million, slightly lower than our prior guidance of $205 to $209 million. We also anticipate that our gross-to-net adjustment for the full year 2026 will be between 27.5% and 28%, higher than our prior guidance, mostly due to Medicaid share. In addition, for fiscal year 2026 we anticipate receiving royalties from our partners around the world in the range of $18 to $19 million, slightly lower than our prior guidance of $20 to $23 million.

As mentioned, the China royalty generic threshold has been reached and is reflected in our current guidance. We don’t expect any license revenue in 2026. We also expect that net income for the full year will be in the range of $20 to $22 million, higher than our prior guidance of $17 to $20 million. The current guidance does not include any potential release of any additional tax asset valuation allowance in our net income estimate. The company is reviewing its deferred tax assets as part of its ongoing tax valuation analysis and has not yet determined whether any adjustment will be required or, if so, the potential timing or size of such an adjustment.

We will continue to keep investors updated on this as it progresses. At this time, we do not believe that tariffs imposed, or proposed to be imposed, by the United States, particularly with other countries, will have a material impact on our product cost or results of operation. However, shifts in trade policies in the United States and other countries have been rapidly evolving and are difficult to predict. As a point of reference, our manufacturing product cost accounts for mid- to high-single-digit percentage of our total cost of goods sold.

We anticipate that for Q4 2026 Nerlynx product revenue, net, will be in the range of $56 to $58 million. We expect Q4 royalties revenues will be in the range of $11 to $12 million, and no license revenue. We further estimate that the gross-to-net adjustment in Q4 2026 will be approximately 28% to 29%. Puma anticipates a Q4 net income between $10 and $12 million. SG&A expenses were $16.3 million in the third quarter of 2026 compared to $17.5 million in Q2 2026. SG&A expenses included non-cash charges for stock-based compensation of $1.3 million for Q3 2026 and $1.2 million for Q2 2026. Research and development expenses were $18.3 million in the third quarter of 2026 and $18.9 million in Q2 2026. R&D expenses included non-cash charges for stock-based compensation of about $0.7 million in Q3 2026 and $0.8 million in Q2 2026.

On the expense side, Puma anticipates higher total operating expenses in 2026 compared to 2025. More specifically, we anticipate SG&A expenses to remain flat and R&D expenses to increase by 28% to 30% year over year. The higher increase in R&D is driven by the progress of our clinical trials. In the third quarter of 2026, Puma reported cash earned of approximately $14.7 million. This compares to cash burn of approximately $9.7 million in Q2. Please note that during Q2 2026 we made our final quarterly principal loan payment of $11.1 million related to our obligation with Athyrium. As a result, Puma is now debt free. On September 30, 2026, we had approximately $108.5 million in cash, cash equivalents and marketable securities versus $97.5 million at year end 2025.

Our accounts receivable balance was $32.8 million. Our accounts receivable terms ranged between 10 and 68 days, where our days sales outstanding are about 44 days. We estimate that as of September 30, 2026, our distribution network maintained approximately two weeks of inventory. Overall, we continue to deploy our financial resources to focus on the commercialization of Nerlynx, the development of alisertib and controlling our expenses.

Alan Auerbach (President and CEO)

Thanks, Maximo. On past earnings calls, we have stressed that Puma senior management, in cooperation with the Board of Directors, continues to remain focused on Nerlynx sales trends and recognizes its fiscal responsibility to shareholders to continue to maintain positive net income. We believe that this focus has contributed to our commercial execution thus far in 2026. According to our current projections, 2026 will mark the second year-over-year demand increase for Nerlynx in the United States and the first time in the history of the launch of Nerlynx in the United States that we have seen two positive consecutive year-over-year increases in demand.

We are pleased to report this demand-driven growth in the third quarter of 2026 and believe that the positive net income that the company is guiding to for the full year 2026 has resulted from both this increased demand as well as the continued financial discipline across the company over the last few years. The company remains committed to continuing to achieve this positive net income in 2026 and will continue to reduce expenses if needed to achieve this.

We look forward to updating investors on this in the future. There continues to remain a significant unmet need for patients battling breast cancer, lung cancer and other solid tumors. We at Puma are committed and passionate about finding more effective ways of helping these patients during their journey, and we will continue to strive to achieve that goal. This concludes today’s presentation. We will now turn the floor back to Marianne for closing remarks.

Marianne (Senior Director of Investor Relations)

Thank you all for joining us today. As a reminder, this call may be accessed via replay of the webcast at pumabiotechnology.com beginning later today. Have a good evening.

Latonya (Operator)

Thank you, ladies and gentlemen. Thank you for participating in today’s conference call. This concludes our program. Everyone have a great day, and you may now disconnect.

Disclaimer: This transcript is provided for informational purposes only. While we strive for accuracy, there may be errors or omissions in this automated transcription. For official company statements and financial information, please refer to the company’s SEC filings and official press releases. Corporate participants’ and analysts’ statements reflect their views as of the date of this call and are subject to change without notice.