Exelixis (EXEL) FY Conference Summary Company Overview - **Company**: Exelixis (EXEL) - **Event**: Sixth Annual Oncology Innovation Summit - **Date**: May 27, 2025 Key Points Commercial Performance - **Cabo Performance**: Cabo had a strong Q1, with increasing prescriptions and market share in renal cell carcinoma (RCC) [4][8] - **Clinical Trials Orders**: Clinical trials orders fluctuated between 4 million and 22 million per quarter historically, with a recent order of 12 million [4] - **Net Approval**: The approval for neuroendocrine tumors (NET) occurred late in the quarter, impacting tracking metrics [5][8] Market Dynamics - **IQVIA Tracking Issues**: IQVIA's tracking was inaccurate this quarter, attributed to the complexity of real-world data and seasonality [6][12][13] - **Gross to Net Dynamics**: The gross to net ratio was higher in Q1, influenced by the phase-in of the rebate period under the IRA [14][15] Future Projections - **Revenue Growth**: Exelixis anticipates Cabo's revenue to grow from approximately $2 billion to $3 billion by 2030, driven by the NET launch and continued momentum in the base business [15] - **Rebate Impact**: A 1% rebate phase-in under the IRA is expected to have a minimal impact on overall business [16][26] NET Launch Insights - **Patient Dynamics**: The launch of Cabo for NET is expected to be steady rather than a bolus due to the advanced state of patients [30][31] - **Broad Label Impact**: The broad label for Cabo is anticipated to positively affect a wide range of patients, with no specific pockets of accelerated uptake identified [32][33] Competitive Landscape - **Lutathera Comparison**: Lutathera presents unique challenges for patients, and Cabo is positioned to capture market share from oral cytotoxics rather than directly competing with Lutathera [36][37] - **Somatostatin Analogs**: Cabo is expected to be used alongside background somatostatin analogs, enhancing its therapeutic impact [39] Pipeline Developments - **ZENZA Study**: The Stellar 303 study has elevated liver metastases patients to a co-primary endpoint due to differentiated event rates observed [40][41] - **Head and Neck Cancer Trials**: The Stellar 305 study aims to evaluate Zanza in combination with Keytruda, learning from previous trial outcomes [45][46] - **Early Pipeline**: The bispecific program (628) has generated significant interest, focusing on combining PD-L1 and NKG2A mechanisms [61][62] Regulatory and Market Considerations - **Non-Clear Cell RCC Study**: The ongoing study aims to establish a new standard of care in the non-clear cell RCC segment, with results expected later this year [55][56] - **Collaboration with Merck**: Exelixis is collaborating with Merck on various studies, with details to be shared as trials progress [58][60] Additional Insights - **Market Research**: Continuous market research and KOL engagement are crucial for understanding patient dynamics and optimizing marketing strategies [37][38] - **Regulatory Landscape**: The evolving regulatory environment, particularly regarding rebates and pricing, will impact future revenue and market strategies [19][20] This summary encapsulates the key insights and developments discussed during the Exelixis FY Conference, highlighting the company's commercial performance, market dynamics, future projections, and ongoing pipeline developments.

Financial Data and Key Metrics Changes - The company reported total revenues of approximately $555 million for Q1 2025, which included cabozantinib franchise net product revenues of $513.3 million, a 36% year-over-year increase from $378 million in Q1 2024 [7][13] - Non-GAAP net income for Q1 2025 was approximately $179.6 million, or $0.64 per share basic, compared to $159.6 million GAAP net income [16] - The company increased its full-year 2025 net product revenue guidance to $2.05 billion to $2.15 billion, reflecting a $100 million increase from previous guidance [18] Business Line Data and Key Metrics Changes - The U.S. cabozantinib franchise net product revenues grew 36% year-over-year to $513 million [7] - Global cabozantinib franchise net product revenues were approximately $680 million in Q1 2025, compared to $559 million in Q1 2024 [7] - The gross-to-net for the cabozantinib franchise in Q1 2025 was 28.9%, higher than the previous quarter, primarily due to increased PHS and 340B volumes [13] Market Data and Key Metrics Changes - CABOMETYX grew its market share from 40% to 44% in the TKI market basket, with TRx volume growing 18% year-over-year [20][21] - New prescription share for CABOMETYX increased from 38% to 43%, with NRx volume growing 27% year-over-year [22] - The oral market opportunity for neuroendocrine tumors in 2025 is forecasted to be approximately $1 billion in the U.S. [24] Company Strategy and Development Direction - The company aims to build a multi-compound, multi-franchise oncology enterprise, focusing on improving the standard of care for cancer patients [4][5] - The launch of CABOMETYX in neuroendocrine tumors is seen as a significant commercial opportunity, with expectations of rapid establishment as a market leader [20][25] - The company is advancing ZANZA as its next oncology franchise opportunity, with several pivotal trials expected to report data in the second half of 2025 [10][29] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the strong performance of CABOMETYX and the potential for new indications to drive further growth [6][9] - The company is focused on advancing new molecules from its pipeline and expects to file up to three new INDs in 2025 [11][34] - Management highlighted the importance of capital allocation, balancing investments in R&D, business development, and share repurchases [12][86] Other Important Information - The company repurchased approximately $289 million of its shares during Q1 2025, with a remaining authorization of $5.5 million under the previous buyback plan [17] - The company is focused on late-stage assets in GU and GI oncology for business development opportunities [72] Q&A Session Summary Question: What has been driving CABOMETYX growth? - The company noted significant growth in market share and volume, particularly in frontline RCC, driven by positive physician feedback and updated data from CheckMate 9ER [42][46] Question: What are the expectations for the NET launch? - Management indicated that it is early days for the NET launch, with positive prescriber excitement and new prescriptions being tracked closely [49][54] Question: What is the impact of Medicare Part D redesign? - The company reported minimal impact from the redesign, with a roughly equal split between commercial and Medicare business [74][78] Question: What is the company's approach to business development? - The company remains open to business development opportunities, focusing on high-conviction assets that align with its oncology franchise [68][70]