Company Overview - Crinetics Pharmaceuticals is a clinical stage pharmaceutical company focused on discovering, developing, and commercializing novel therapeutics for endocrine diseases and endocrine-related tumors [3] - The company's lead development candidate, paltusotine, is an investigational once-daily, oral, selective somatostatin receptor type 2 (SST2) nonpeptide agonist in clinical development for acromegaly and carcinoid syndrome associated with neuroendocrine tumors [3] - Crinetics is also developing atumelnant, a first-in-class oral ACTH antagonist for treating congenital adrenal hyperplasia and Cushing's disease [3] - All drug candidates are orally delivered, small molecules resulting from in-house drug discovery efforts, targeting various endocrine conditions [3] Recent Developments - On May 10, 2025, the Compensation Committee granted non-qualified stock option awards to purchase an aggregate of 152,475 shares and 101,800 restricted stock unit (RSU) awards to 35 new non-executive employees [1] - The stock options have an exercise price of $30.68 per share, equal to the closing price on May 9, 2025 [2] - The stock options and RSUs are granted under the 2021 Employment Inducement Incentive Award Plan, aimed at attracting new employees [1][2]

Company Performance - Crinetics Pharmaceuticals reported a quarterly loss of $1.04 per share, which was worse than the Zacks Consensus Estimate of a loss of $0.99, and compared to a loss of $0.93 per share a year ago, indicating a decline in performance [1] - The company posted revenues of $0.36 million for the quarter ended March 2025, surpassing the Zacks Consensus Estimate by 261%, but this was a decrease from year-ago revenues of $0.64 million [2] - Over the last four quarters, Crinetics has only surpassed consensus EPS estimates once, indicating inconsistent performance [2] Stock Movement and Outlook - Crinetics Pharmaceuticals shares have declined approximately 38.6% since the beginning of the year, significantly underperforming the S&P 500, which declined by only 4.3% [3] - The company's earnings outlook is uncertain, with current consensus EPS estimates for the upcoming quarter at -$1.10 on revenues of $2.6 million, and for the current fiscal year at -$4.33 on revenues of $5.63 million [7] Industry Context - The Medical - Drugs industry, to which Crinetics belongs, is currently ranked in the top 26% of over 250 Zacks industries, suggesting a relatively strong industry performance [8] - The performance of Crinetics may be influenced by the overall outlook for the industry, as empirical research indicates that the top 50% of Zacks-ranked industries outperform the bottom 50% by more than 2 to 1 [8]

Financial Data and Key Metrics Changes - The company recognized $400,000 in revenue during Q1 2025, down from $600,000 in Q1 2024, with revenue being non-cash based on amortization of payments from a licensing arrangement [40] - Research and development (R&D) expenses increased by 43% to $76.2 million in Q1 2025 compared to the same period in 2024, primarily due to additional personnel and higher manufacturing costs [40] - Selling, general, and administrative (SG&A) expenses rose by 71% to $35.5 million in Q1 2025, driven by growth to support ongoing programs and the planned commercial launch of paltusotine [41] - Cash used in operations for Q1 2025 was $88.5 million, compared to $52.9 million in Q1 2024, with expectations of cash used in operations for 2025 between $340 million and $380 million [42] - The company ended Q1 2025 with approximately $1.3 billion in cash, cash equivalents, and investments, expected to fund operations into 2029 [42] Business Line Data and Key Metrics Changes - The company is focused on the anticipated commercial launch of paltusotine, which is expected to significantly improve treatment for patients with acromegaly [8][10] - The pipeline includes two late-stage candidates and three additional candidates in preclinical studies, indicating a robust development strategy [8] Market Data and Key Metrics Changes - The company is preparing for the launch of paltusotine in the U.S. and has engaged with payers, receiving positive feedback regarding the product's value proposition [18][23] - The anticipated launch strategy includes educating healthcare professionals and patients, with a focus on addressing the unmet needs in acromegaly treatment [12][16] Company Strategy and Development Direction - The company aims to become a fully integrated global commercial organization, with a strong commitment to patient care and scientific innovation [8] - The strategic focus includes advancing a robust pipeline while preparing for the commercial launch of paltusotine, which is seen as a pivotal milestone [10][24] - The company is also exploring opportunities in the CAH (congenital adrenal hyperplasia) market with the development of adomelna [34] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the regulatory engagement with the FDA and the progress of clinical development activities [10][24] - The company remains optimistic about the potential uptake of paltusotine during the early launch phase, anticipating major interest from healthcare providers and patients [23] Other Important Information - The company has welcomed a new CFO, Toby Schulke, who brings extensive experience in transitioning R&D-focused companies into commercial organizations [9] - The company has launched the Kineticare patient support service platform to assist patients throughout their treatment journey [16][17] Q&A Session Summary Question: Can you discuss the powering of your primary endpoint and any data from cohort four? - Management indicated that the study is highly powered to detect significant differences between treatment and placebo groups, and cohort four is currently enrolling with no data available yet [46][48] Question: Is the CALM CAH study design approved by the FDA for registration? - The protocol was developed with input from the FDA, and the company expects to discuss the indication statement based on the data collected [51][54] Question: What is the rationale for testing the primary endpoint at a single time point? - Management explained that responder analyses are typically conducted at single points in time due to variability in biochemical markers, and they are confident in achieving the endpoint [57][58] Question: What is the rationale for morning versus evening dosing in cohort four? - The company aims to explore the convenience of morning dosing while considering the diurnal rhythm of CAH patients [61][62] Question: How is the launch strategy different in Europe compared to the U.S.? - The European markets are more concentrated in terms of patient populations, and the company is preparing for a launch in Germany while considering Brazil for expansion [64][68]

Financial Data and Key Metrics Changes - The company recognized $400,000 in revenue for Q1 2025, down from $600,000 in Q1 2024, with revenue being non-cash based on amortization of licensing payments [39] - Research and development (R&D) expenses increased by 43% to $76.2 million in Q1 2025 compared to the same period in 2024 [39] - Selling, general and administrative (SG&A) expenses rose by 71% to $35.5 million in Q1 2025 compared to Q1 2024 [40] - Cash used in operations was $88.5 million for Q1 2025, compared to $52.9 million in Q1 2024, with an anticipated cash usage of $340 million to $380 million for the full year [41][42] Business Line Data and Key Metrics Changes - The company is focused on the anticipated commercial launch of paltusotine, which is expected to significantly improve treatment for acromegaly [7][10] - The company is advancing a robust pipeline, including two late-stage candidates and three additional candidates in preclinical studies [7][8] Market Data and Key Metrics Changes - The company is preparing for the U.S. launch of paltusotine in September, with significant engagement with healthcare professionals and payers [12][19] - The company anticipates major uptake during the early launch phase as it educates healthcare providers and patient communities about paltusotine [23] Company Strategy and Development Direction - The company aims to become a fully integrated global commercial organization, with a strong focus on patient-centric therapies [6][10] - The company is actively engaging with regulatory authorities and preparing for the launch of paltusotine, which is seen as a defining milestone [10][24] - The company is also pursuing a Phase III trial for adomelna in congenital adrenal hyperplasia (CAH), aiming to redefine treatment standards [11][29] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the regulatory engagement with the FDA and the progress of clinical development activities [10][24] - The company remains optimistic about the potential of paltusotine to become the new standard of care in acromegaly, addressing significant unmet needs [23][24] Other Important Information - The company ended Q1 2025 with approximately $1.3 billion in cash, which is expected to fund operations into 2029 [42] - The company has received orphan drug designation for paltusotine in the EU, highlighting the unmet need in acromegaly [25] Q&A Session Summary Question: Could you talk about the powering of your very innovative primary endpoint? - The study is highly powered to detect statistically significant differences between treatment and placebo arms, and the endpoint is better described as a composite rather than a co-primary endpoint [47][49] Question: Is the CALM CAH study design fully signed off on by FDA? - The protocol was developed based on input from the FDA and other health authorities, and they are aware of the final study design [53][54] Question: What is the rationale for looking at morning dosing versus evening dosing in the fourth cohort? - Morning dosing may be more convenient for patients, and the study aims to explore this option [60][61] Question: How are you thinking about launch strategy in different geographies? - The company is preparing for the launch in Germany, where there is a significant unmet need, and is also considering expansion into Brazil [68][69] Question: Can you give an update on enrollment and follow-up for the long-term extension study? - Enrollment is proceeding, and updates will be provided once a critical mass is reached [87] Question: Is there a risk that A4 variability may lead to some non-responders? - Responder analyses are generally conducted at single points in time, and there is confidence that the compound can achieve both components of the composite primary endpoint [57][58]

Clinical Trials and Drug Development - The company reported positive topline data from the PATHFNDR-1 study for paltusotine, achieving the primary endpoint and all secondary endpoints, with no serious adverse events reported[97]. - The PATHFNDR-2 study also met statistical significance (p<0.0001) on the primary endpoint, with paltusotine being well-tolerated and no serious adverse events reported[98]. - The company plans to initiate the CAREFNDR Phase 3 clinical trial for carcinoid syndrome in the second half of 2025, focusing on the frequency of flushing episodes as the primary endpoint[102]. - Atumelnant is being developed for conditions caused by excess ACTH, with an estimated 17,000 potential candidates for treatment in the U.S.[104]. - The Phase 1 study of atumelnant showed positive topline data, demonstrating dose-dependent reductions in cortisol levels and no serious adverse events[105]. - The CALM-CAH Phase 3 trial for congenital adrenal hyperplasia (CAH) is set to begin in the second half of 2025, with the primary endpoint being the proportion of participants with androstenedione levels ≤ULN at week 32[107]. - The company is collaborating with the NIH for a clinical trial of atumelnant in ACTH-dependent Cushing's Syndrome, with plans to initiate a Phase 2/3 study in the second half of 2025[108]. - The company has developed a first-in-class nonpeptide drug conjugate, CRN09682, for treating SST2+ neuroendocrine tumors, with a Phase 1/2 study approved to begin[109]. - The company is developing PTH receptor antagonists for primary hyperparathyroidism, with an estimated incidence of 200,000 cases in the U.S.[110]. - The company is also developing TSHR antagonists for Graves' disease, affecting around 3 million people in the U.S.[111]. - The company has identified investigational SST3 agonists for treating Autosomal Dominant Polycystic Kidney Disease, which affects over 300,000 individuals[112]. Financial Performance - As of March 31, 2025, the company had unrestricted cash and equivalents of $1.3 billion, supporting ongoing operations[121]. - The company has incurred cumulative net losses of $1.0 billion since inception, with expected increases in expenses as clinical trials progress[122]. - The company has not generated any product sales and relies on grant and license revenues for funding[120]. - Research and development expenses increased to $76.2 million for the three months ended March 31, 2025, compared to $53.3 million for the same period in 2024, reflecting a change of $22.9 million[137]. - The company reported a net loss of $96.8 million for the three months ended March 31, 2025, compared to a net loss of $66.9 million for the same period in 2024, representing an increase in loss of $29.9 million[136]. - Total operating expenses rose to $111.8 million for the three months ended March 31, 2025, up from $74.2 million in 2024, marking an increase of $37.6 million[136]. - Other income, net increased to $14.6 million for the three months ended March 31, 2025, compared to $7.1 million in 2024, an increase of $7.5 million[147]. - Cash used in operating activities was $88.5 million for the three months ended March 31, 2025, compared to $52.9 million in 2024, an increase of $35.6 million[148]. - The company had unrestricted cash, cash equivalents, and investment securities of $1.3 billion as of March 31, 2025, with an accumulated deficit of $1.0 billion[148]. - Research and development expenses for the paltusotine program were $16.5 million for the three months ended March 31, 2025, compared to $13.0 million in 2024, an increase of $3.5 million[139]. - Selling, general and administrative expenses increased to $35.5 million for the three months ended March 31, 2025, from $20.8 million in 2024, reflecting an increase of $14.7 million[145]. - The total external research and development expenses amounted to $32.2 million for the three months ended March 31, 2025, compared to $23.7 million in 2024, an increase of $8.5 million[139]. - Net cash provided by financing activities was $4.4 million for the three months ended March 31, 2025, compared to $393.6 million for the same period in 2024[150]. Future Financial Outlook - The company plans to increase research and development expenses in the foreseeable future to support ongoing clinical programs and discovery efforts[131]. - Future capital requirements will depend on various factors, including the costs and timing of clinical trials and regulatory reviews[152]. - The company expects to finance cash needs through equity offerings, debt financings, or collaborations, which may dilute stockholder ownership[153]. - In the 2019 ATM Offering, the company issued 1,223,775 shares for net proceeds of approximately $43.4 million[154]. - The 2024 ATM Offering allows the company to sell up to $350.0 million of common stock, with no shares sold as of March 31, 2025[155]. - A stock purchase agreement in February 2024 resulted in the issuance of 8,333,334 shares at $42.00 per share, generating approximately $350.0 million in gross proceeds[156]. - An underwritten public offering on October 10, 2024, raised approximately $542.8 million from the sale of 11,500,000 shares at $50.00 per share[157]. Market and Economic Factors - The company has exposure to fluctuations in foreign currency rates due to contracts with vendors and CROs in various countries, but believes this exposure to be immaterial[162]. - Inflationary factors may adversely affect operating results, although no material impact has been observed to date[163].

Financial Performance - Revenues for Q1 2025 were $0.4 million, a decrease from $0.6 million in Q1 2024[7] - Net loss for Q1 2025 was $96.8 million, compared to a net loss of $66.9 million in Q1 2024[12] - Cash, cash equivalents, and investments totaled $1.3 billion as of March 31, 2025, down from $1.4 billion at the end of 2024, expected to fund operations into 2029[12] Expenses - Research and development expenses increased to $76.2 million in Q1 2025 from $53.3 million in Q1 2024, driven by higher personnel and manufacturing costs[7] - Selling, general and administrative expenses rose to $35.5 million in Q1 2025, compared to $20.8 million in Q1 2024, primarily due to increased personnel and outside services costs[7] Regulatory and Clinical Updates - The FDA PDUFA target action date for paltusotine NDA is set for September 25, 2025[7] - The Phase 3 CALM-CAH study for atumelnant is designed to normalize androstenedione levels with physiological glucocorticoid replacement[7] - Crinetics plans to initiate the CAREFNDR Phase 3 trial of paltusotine in carcinoid syndrome in the second half of 2025[7] - The marketing authorization application for paltusotine has been validated by the EMA, with a potential decision expected in the first half of 2026[4] Future Events - The company has scheduled an R&D Day for June 26, 2025, to provide updates on its early-stage pipeline[7]

Core Insights - Crinetics Pharmaceuticals is on track for the FDA review of paltusotine, with a PDUFA date set for September 25, 2025, for the treatment of acromegaly [5][6] - The company is initiating a Phase 3 study for atumelnant aimed at normalizing androstenedione levels in adults with congenital adrenal hyperplasia (CAH) [3][6] - Crinetics has a strong financial position with $1.3 billion in cash and equivalents as of March 31, 2025, expected to fund operations into 2029 [10][14] Regulatory and Clinical Developments - The FDA review process for paltusotine's New Drug Application (NDA) is progressing positively, with consistent engagement from the FDA [6] - The European Medicines Agency (EMA) has validated the marketing authorization application (MAA) for paltusotine, with a potential decision expected in the first half of 2026 [6] - The Phase 2 TouCAHn study of atumelnant in CAH has shown positive results, leading to the initiation of a Phase 3 CALM-CAH study [6][10] Financial Performance - Revenues for the first quarter of 2025 were $0.4 million, down from $0.6 million in the same period of 2024, primarily from a licensing agreement for paltusotine [10][14] - Research and development expenses increased to $76.2 million in Q1 2025 from $53.3 million in Q1 2024, driven by clinical program advancements [10][14] - The net loss for Q1 2025 was $96.8 million, compared to a net loss of $66.9 million in Q1 2024 [10][14] Upcoming Milestones - R&D Day is scheduled for June 26, 2025, to discuss early-stage pipeline strategies and data [3][10] - The company plans to initiate the CAREFNDR Phase 3 trial of paltusotine in carcinoid syndrome in the second half of 2025 [10] - Initiation of the CALM-CAH Phase 3 study in adults and a Phase 2/3 study in pediatrics is expected in the second half of 2025 [10]

Company Overview - Crinetics Pharmaceuticals, Inc. is a clinical stage pharmaceutical company focused on discovering, developing, and commercializing novel therapeutics for endocrine diseases and endocrine-related tumors [4] - The company's lead development candidate, paltusotine, is the first investigational once-daily, oral, selective somatostatin receptor type 2 (SST2) nonpeptide agonist in clinical development for acromegaly and carcinoid syndrome associated with neuroendocrine tumors [4] - Atumelnant is currently in development for congenital adrenal hyperplasia and ACTH-dependent Cushing's syndrome [4] - All drug candidates are orally delivered, small molecule, new chemical entities resulting from in-house drug discovery efforts, addressing various endocrine conditions such as hyperparathyroidism, polycystic kidney disease, Graves' disease, diabetes, obesity, and GPCR-targeted oncology indications [4] Upcoming Financial Results - Crinetics Pharmaceuticals will report first quarter 2025 financial results on May 8, 2025, after the market closes [1] - Company management will host a conference call at 4:30 p.m. ET to discuss financial results and provide a business update [1] Conference Call Details - The conference call can be accessed via domestic dial-in number 1-833-470-1428 or international dial-in number 1-404-975-4839, with Conference ID: CRNXQ1 [2] - Participants are recommended to connect at least 15 minutes prior to the scheduled start of the call to ensure a timely connection [2] - The webcast will be archived on the Investor Relations section of the Crinetics website [3]

Core Points - Crinetics Pharmaceuticals granted stock options and restricted stock units (RSUs) to 26 new non-executive employees as part of its 2021 Employment Inducement Incentive Award Plan [1][2] - The stock options total 124,950 shares with an exercise price of $26.85 per share, equal to the closing price on April 10, 2025 [2] - The RSUs granted amount to 84,725 shares, with both stock options and RSUs vesting over four years [2] Company Overview - Crinetics Pharmaceuticals is a clinical stage pharmaceutical company focused on developing novel therapeutics for endocrine diseases and related tumors [3] - The lead candidate, paltusotine, is an investigational oral selective somatostatin receptor type 2 (SST2) nonpeptide agonist for acromegaly and carcinoid syndrome [3] - The company is also developing atumelnant, an oral ACTH antagonist for congenital adrenal hyperplasia and Cushing's disease, along with other drug candidates targeting various endocrine conditions [3]

Company Overview - Crinetics Pharmaceuticals, Inc. is a clinical stage pharmaceutical company focused on discovering, developing, and commercializing novel therapeutics for endocrine diseases and endocrine-related tumors [3] - The company's lead development candidate, paltusotine, is an investigational once-daily, oral, selective somatostatin receptor type 2 (SST2) nonpeptide agonist in clinical development for acromegaly and carcinoid syndrome associated with neuroendocrine tumors [3] - Crinetics is also developing atumelnant, a first-in-class oral ACTH antagonist for treating congenital adrenal hyperplasia and Cushing's disease [3] - All drug candidates are orally delivered, small molecules resulting from in-house drug discovery efforts, targeting various endocrine conditions [3] Stock Option and RSU Awards - On April 10, 2025, the Compensation Committee granted non-qualified stock option awards to purchase 124,950 shares and 84,725 restricted stock unit (RSU) awards to 26 new non-executive employees under the 2021 Employment Inducement Incentive Award Plan [1][2] - The stock options have an exercise price of $26.85 per share, equal to the closing price of Crinetics' common stock on the same date [2] - The stock options will vest over four years, with 25% vesting on the one-year anniversary and the remainder vesting in 36 equal monthly installments, contingent on continued employment [2] - The RSUs will also vest over four years in equal annual installments starting on the one-year anniversary, subject to continued employment [2]