Jefferies Global Healthcare Conference 3 June 5, 2025 Forward-looking Statements and Other Important Information This presentation 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 beliefs about the market opportunity and annual peak revenue opportunities for selinexor; expectations with respect to commercialization efforts; the ability of selinexor to treat patients with multip ...

Karyopharm Therapeutics (KPTI) Conference Summary Company Overview - Karyopharm Therapeutics is an innovation-driven commercial stage oncology company focusing on myelofibrosis and endometrial cancer treatments [3][4] Key Points on Myelofibrosis - The company is conducting two transformative Phase 3 studies: one for myelofibrosis and another for endometrial cancer, with top-line data expected by the end of 2025 or early 2026 [2][4] - The potential peak opportunity for myelofibrosis treatment is projected to exceed $1 billion [5] - The ongoing Phase 3 program targets JAK naive patients, with a focus on the efficacy of selinexor in combination with ruxolitinib [5][6] - Selinexor has shown promising results in heavily pretreated patients, demonstrating significant spleen volume reduction and symptom improvement [6][16] - The combination therapy has achieved a 79% SVR 35 rate compared to the 30-35% rate seen with ruxolitinib alone [16][28] - The durability of response is notable, with a 100% probability of maintaining spleen volume reduction among patients achieving SVR 35 [18] - The company emphasizes the importance of modifying the underlying disease and improving patient outcomes through innovative treatment approaches [34] Key Points on Endometrial Cancer - Karyopharm is leveraging the p53 wild type biomarker in endometrial cancer, which is present in approximately 50% of patients [38][39] - Selinexor has demonstrated a median progression-free survival (PFS) of 28.4 months in p53 wild type patients, significantly outperforming placebo [40] - The ongoing Phase 3 trial for endometrial cancer will evaluate selinexor as a monotherapy in a maintenance setting, with a planned enrollment of 276 patients [41] Additional Insights - The company has established commercialization capabilities to rapidly launch treatments upon receiving positive data [9][10] - The focus on innovative therapies aims to transform treatment standards in both myelofibrosis and endometrial cancer, enhancing patient outcomes [44] - The management team expresses confidence in the potential of selinexor to address unmet needs in oncology, particularly in challenging patient populations [11][12] Conclusion - Karyopharm Therapeutics is positioned for significant advancements in oncology with its innovative treatments for myelofibrosis and endometrial cancer, backed by promising clinical data and a strong commercialization strategy [44]

Financial Data and Key Metrics Changes - The company reported a quorum with 8,569,618 shares of common stock entitled to vote at the meeting, indicating strong shareholder engagement [5] - The preliminary voting results showed that all proposals, including the election of directors and amendments to the equity incentive plan, were approved, reflecting shareholder support for the company's strategic direction [12] Business Line Data and Key Metrics Changes - The company emphasized its focus on advancing its late-stage pipeline, particularly in multiple myeloma, which is a core area of revenue generation [17] Market Data and Key Metrics Changes - The management acknowledged the competitive nature of the myeloma market and the importance of progressing Phase III trials to create new standards of care and enhance shareholder value [18] Company Strategy and Development Direction - The company is committed to maximizing shareholder value by focusing on its late-stage pipeline and exploring alternatives to extend its cash runway [17][18] - The management is actively working to create long-term shareholder value through the success of its commercial organization and product revenue [18] Management's Comments on Operating Environment and Future Outlook - Management expressed understanding of shareholder frustrations regarding stock performance and reiterated their commitment to advancing clinical trials and generating revenue [18] - The company is focused on addressing high unmet needs in the market, which is critical for both patient outcomes and shareholder value [17] Other Important Information - The meeting was conducted virtually, allowing shareholders to participate and submit questions online, demonstrating the company's commitment to transparency and engagement [3] Q&A Session Summary Question: Why are patients and investors best served by the current path given potential noncompliance with lender requirements? - Management highlighted their focus on maximizing shareholder value and advancing their late-stage pipeline to serve patients better and grow revenues [17] Question: What is the plan to maximize shareholder value given insufficient cash runway? - Management acknowledged shareholder frustrations and emphasized their commitment to building shareholder value through progressing Phase III trials and focusing on product revenue [18] Conclusion - The meeting concluded with no further questions, indicating a clear communication of the company's strategies and future outlook [20]

Core Viewpoint - Karyopharm Therapeutics (KPTI) has experienced a bearish trend, losing 13.7% in the past week, but the formation of a hammer chart pattern suggests a potential trend reversal as buying interest may be increasing [1][2]. Technical Analysis - The hammer chart pattern indicates a possible bottoming out, with reduced selling pressure, suggesting that bulls may be gaining control [2][5]. - A hammer pattern forms when there is a small candle body with a long lower wick, indicating that after a new low, buying interest emerges to push the stock price up towards the opening price [4][5]. - This pattern is significant when it appears at the bottom of a downtrend, signaling that bears may have lost control [5]. Fundamental Analysis - There has been a positive trend in earnings estimate revisions for KPTI, with a 4.9% increase in the consensus EPS estimate over the last 30 days, indicating that analysts expect better earnings than previously predicted [7][8]. - KPTI holds a Zacks Rank of 2 (Buy), placing it in the top 20% of over 4,000 ranked stocks, which typically outperform the market [9]. - The Zacks Rank serves as a timing indicator, suggesting that the company's prospects are beginning to improve, further supporting the case for a trend reversal [9].

Summary of Karyopharm Therapeutics (KPTI) Conference Call Company Overview - **Company**: Karyopharm Therapeutics (KPTI) - **Key Products**: Selinexor (XPOVIO) - **Focus Areas**: Oncology, specifically multiple myeloma and myelofibrosis Key Points Commercial Performance and Product Dynamics - **Q1 Demand Growth**: KPTI reported a 5% year-over-year demand growth for XPOVIO in Q1, despite a one-time impact of $5 million from atypical returns related to high-dose selinexor [3][4] - **Real-World Utilization**: The company is focusing on increasing the utilization of selinexor in both community and academic settings, with a particular emphasis on lower doses [4][5] - **Community Treatment**: Selinexor is primarily used in the community setting for multiple myeloma patients, positioned in the second to fourth line of treatment [5][6] Growth Drivers and Future Outlook - **T Cell Engaging Therapies**: KPTI is generating data to support the use of selinexor in conjunction with T cell engaging therapies, which are becoming more prevalent in earlier treatment lines [9][10] - **Myelofibrosis Opportunity**: The ongoing SENTRI trial is evaluating selinexor in combination with ruxolitinib, with promising early data showing a 79% SVR 35 rate at week 24 compared to 30-35% for ruxolitinib alone [12][13][15] - **Durability of Response**: The company reported a 100% durability of response for patients achieving SVR 35 or TSS 50, indicating sustained benefits from treatment [17] Clinical Trials and Data - **Phase III Trials**: KPTI is focused on executing its Phase III trials for both myelofibrosis and endometrial cancer, with the latter leveraging a biomarker (p53 wild type) for patient selection [45][46] - **Endpoint Changes**: The transition from TSS 50 to absolute TSS is seen as a more sensitive measure for symptom improvement, gaining positive feedback from investigators and regulators [28][29] Safety and Tolerability - **Antiemetic Use**: KPTI has incorporated dual antiemetics in its Phase III trials to mitigate nausea and vomiting, achieving over 85% compliance and lower rates of these side effects [36][38] - **Safety Profile**: The safety profile of selinexor is evolving positively, with improvements noted in gastrointestinal side effects [17][38] Commercial Strategy - **Market Positioning**: KPTI aims to target all frontline myelofibrosis patients, leveraging existing commercial infrastructure to facilitate rapid uptake among physicians [41][42] - **Unmet Need**: Research indicates a significant unmet need in the myelofibrosis market, with 75% of physicians willing to adopt therapies that address key disease hallmarks [42] Financial Discipline - **Operational Focus**: KPTI is maintaining a disciplined approach to operational expenditures, concentrating resources on Phase III readouts and shutting down non-essential programs [48][49] Additional Insights - **Endometrial Cancer Landscape**: The company anticipates that selinexor will address a sizable unmet need in patients with p53 wild type tumors, with enrollment for the Phase III trial progressing well [46][47] - **Future Readouts**: KPTI is positioned for significant upcoming data readouts that could transform treatment paradigms in both myelofibrosis and endometrial cancer [49]

Core Viewpoint - Karyopharm Therapeutics (KPTI) shows significant upside potential with a mean price target of $33.07, indicating a 521.6% increase from its current price of $5.32 [1] Price Targets and Analyst Consensus - The average price target consists of seven estimates ranging from $8 to $67.47, with a standard deviation of $23.37, suggesting a high variability in analyst predictions [2] - The lowest estimate indicates a potential increase of 50.4%, while the highest suggests an upside of 1168.2% [2] - A low standard deviation among price targets indicates strong agreement among analysts regarding the stock's price movement direction [9] Earnings Estimates and Analyst Optimism - Analysts exhibit strong agreement in revising KPTI's earnings estimates higher, which correlates with potential stock price increases [4][11] - Over the past 30 days, one estimate has increased, leading to a 4.9% rise in the Zacks Consensus Estimate for the current year [12] - KPTI holds a Zacks Rank 2 (Buy), placing it in the top 20% of over 4,000 ranked stocks based on earnings estimate factors [13] Caution on Price Targets - While price targets are commonly referenced, they can mislead investors, as empirical research shows they rarely indicate actual stock price movements [7][10] - Analysts may set overly optimistic price targets due to business incentives, which can inflate expectations [8]

Core Insights - Karyopharm Therapeutics Inc. announced that its abstract on selinexor monotherapy for myelofibrosis has been selected for presentation at the 2025 European Hematology Association Annual Meeting [1][2] - The data from the Phase 2 XPORT-MF-035 trial indicates that selinexor shows clinical activity in heavily pretreated myelofibrosis patients, demonstrating spleen volume reduction, hemoglobin stabilization, and symptom improvement [2][4] Summary by Sections Company Overview - Karyopharm Therapeutics is a commercial-stage pharmaceutical company focused on developing novel cancer therapies, particularly through its lead compound, XPOVIO (selinexor), which is a first-in-class oral exportin 1 (XPO1) inhibitor [4][11] - The company has received regulatory approvals for XPOVIO in multiple oncology indications in the U.S. and various international markets, including Europe and China [5][11] Clinical Trial Insights - The XPORT-MF-035 trial involved 24 patients, randomized 1:1 to receive either selinexor monotherapy or physician's choice treatment, with selinexor administered at 80 mg weekly for the first two cycles, then reduced to 60 mg [4] - Key findings from the trial include: - 67% of selinexor-treated patients achieved a spleen volume reduction of 25% or more compared to 38% in the physician's choice group [4] - 33% of selinexor patients achieved a spleen volume reduction of 35% or more versus 13% in the physician's choice group [4] - Patients on selinexor had higher mean hemoglobin levels and lower rates of red blood cell transfusions compared to those on physician's choice [4] Safety and Adverse Events - The most common treatment-emergent adverse events (TEAEs) in the selinexor arm included decreased weight (50%), asthenia (42%), and nausea (33%) [4] - Serious adverse reactions were reported in 52% of patients in the BOSTON trial, with a treatment discontinuation rate of 19% due to adverse reactions [9]

Financial Performance - Karyopharm Therapeutics reported quarterly losses of $2.77 per share, which was better than the analyst consensus estimate of losses of $4.16 per share [1] - The company reported quarterly sales of $30.02 million, missing the analyst consensus estimate of $35.24 million [1] Clinical Trial Update - The Phase 3 SENTRY trial in patients with JAKi-naïve myelofibrosis has passed its pre-specified futility analysis and continues as planned without modifications [2] - New data in hard-to-treat myelofibrosis patients showed spleen volume reduction, symptom improvement, hemoglobin stabilization, and evidence of disease modification with selinexor monotherapy [2] Sales Guidance and Market Reaction - Karyopharm affirmed FY2025 sales guidance of $140.00 million to $155.00 million, compared to market estimates of $149.32 million [3] - Following the earnings announcement, Karyopharm shares fell 15.6% to trade at $5.17 [3] Analyst Ratings and Price Targets - Baird analyst Michael Ulz maintained an Outperform rating and lowered the price target from $54 to $42 [8] - Barclays analyst Peter Lawson maintained an Overweight rating and raised the price target from $5 to $10 [8] - RBC Capital analyst Brian Abrahams maintained an Outperform rating and lowered the price target from $34 to $33 [8]

Core Viewpoint - Karyopharm Therapeutics reported a quarterly loss of $2.77 per share, significantly better than the Zacks Consensus Estimate of a loss of $4.21, marking an earnings surprise of 34.20% [1] Financial Performance - The company posted revenues of $30.02 million for the quarter ended March 2025, missing the Zacks Consensus Estimate by 16.18%, compared to $33.13 million in the same quarter last year [2] - Over the last four quarters, Karyopharm has surpassed consensus EPS estimates four times and topped consensus revenue estimates three times [2] Stock Performance - Karyopharm shares have declined approximately 40.7% since the beginning of the year, while the S&P 500 has decreased by 3.8% [3] - The current consensus EPS estimate for the upcoming quarter is -$3.90 on revenues of $39.29 million, and for the current fiscal year, it is -$14.05 on revenues of $150.29 million [7] Industry Outlook - The Medical - Drugs industry, to which Karyopharm belongs, is currently ranked in the top 27% of over 250 Zacks industries, indicating a favorable outlook compared to lower-ranked industries [8]

Financial Data and Key Metrics Changes - Total revenue for Q1 2025 was $30 million, down from $33.1 million in Q1 2024 [46] - U.S. XPOVIO net product revenue decreased to $21.1 million from $26 million year-over-year, attributed to a $5 million increase in product return reserves [47] - Gross to net provisions for XPOVIO were 45% in Q1 2025 compared to 29.3% in the same period in 2024 [47] - Cash, cash equivalents, and investments at the end of Q1 2025 were $70.3 million, down from $109.1 million at the end of 2024 [48] Business Line Data and Key Metrics Changes - Demand growth for Q1 was 5% year-over-year, with net product revenue impacted by atypical returns of expired products [40] - Royalty revenue increased by 57% to $1.7 million in Q1 2025 compared to Q1 2024, reflecting growing global demand for XPOVIO [42] Market Data and Key Metrics Changes - The multiple myeloma market remains highly competitive, with expectations of additional new entrants this year [41] - The company anticipates a peak revenue potential of approximately $1 billion in the U.S. for selinexor in myelofibrosis if approved [10] Company Strategy and Development Direction - The company is focused on completing enrollment in the Phase III SENTRY trial for myelofibrosis and advancing the Phase III trial in endometrial cancer [7][38] - The strategy includes leveraging a profitable commercial organization in multiple myeloma to drive rapid commercialization in new disease areas [7] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the potential of selinexor to redefine the standard of care in myelofibrosis, with encouraging clinical data supporting its efficacy [8][10] - The company is exploring various opportunities to extend its cash runway while focusing on advancing clinical trials and commercial performance [51][53] Other Important Information - The Phase III SENTRY trial successfully passed its pre-specified futility analysis, allowing the study to continue as planned [35] - The company expects to complete enrollment in the SENTRY trial by June-July 2025 [35][67] Q&A Session Summary Question: Can you talk about the futility analysis and its basis? - The futility analysis was based on efficacy and safety data from the first 61 patients, with thresholds for no worsening compared to ruxolitinib alone [55][56] Question: What are the assumptions for achieving full enrollment in June and July? - The company is currently 80% enrolled and expects to complete enrollment in the June-July timeframe, with a press release to follow [67] Question: What is driving utilization in multiple myeloma? - The company reported 5% growth in demand, with utilization driven by its flexible combination therapy positioning in both community and academic settings [82] Question: What is the normal run rate of return product? - The atypical returns of $5 million were related to high-dose products, and the company does not expect this to continue into future quarters [89] Question: How confident is the company in reaching its revenue guidance? - The company believes it can deliver at the lower end of its revenue guidance due to strong demand growth and global partner revenue [97]