Syndax outlines 2026 operating expense target of approximately $400M as Revuforj expands in NPM1

Earnings Call Insights: Syndax Pharmaceuticals (SNDX) Q1 2026

MANAGEMENT VIEW

* “In the first quarter, we delivered over $100 million in combined sales of Revuforj and Niktimvo, underscoring robust demand for both medicines and advancing the company towards profitability,” said CEO Michael Metzger.
* “Revuforj net revenue totaled $49 million in the first quarter,” Metzger said, adding that “recent analysis indicates that Revuforj is enabling nearly half of KMT2A patients to receive a potentially curative stem cell transplant, a significant increase from our prior estimates of 33%.”
* “Niktimvo delivered $55 million in net revenue in the first quarter,” Metzger said, noting it reflected “consistent new patient starts, partially offset by natural attrition among the large cohort of predominantly later-line patients.”
* “We are well positioned to be the first to get a menin inhibitor approved in frontline AML with strong global site activation and patient enrollment underway in our pivotal trials,” Metzger said.
* “Total revenue for the first quarter was $64.9 million,” CFO Keith Goldan said, and “we are well funded to continue investing in our commercial and development priorities with $352.1 million in cash, cash equivalents and marketable securities as of March 31st, 2026.”

OUTLOOK

* “We will continue to expand the body of evidence supporting our medicines with multiple important data readouts anticipated in the second quarter and throughout the year,” CEO Michael Metzger said, highlighting “new maintenance data, which will be highlighted in an oral session at ASCO.”
* “We are also nearing 2 potentially transformative Niktimvo readouts in the fourth quarter, including Phase II data in idiopathic pulmonary fibrosis, or IPF, and in newly diagnosed chronic GVHD patients treated with Niktimvo plus Jakafi,” Metzger said.
* “We are now expecting top line data from the Phase II trial of axatilimab plus ruxolitinib in the fourth quarter, a time line which pulled in due to faster-than-anticipated accrual,” said Head of R&D and CMO Nicholas Botwood.
* “Guidance remains at total R&D plus SG&A expenses in 2026 of approximately $400 million, excluding the impact of $50 million in estimated non-cash stock compensation expense,” CFO Keith Goldan said.
* “Sorry, we don't provide revenue guidance,” Goldan said.

FINANCIAL RESULTS

* Total revenue was $64.9 million vs. $69,825,520.0 (analysts’ estimate) for fiscal Q1 2026; EPS was not disclosed in the transcript.
* “Demand for Revuforj remains strong with $48.9 million in net revenue,” CFO Keith Goldan said, adding that results came “even with typical first quarter dynamics, including severe winter storms” and “a growing number of KMT2A patients temporarily pausing Revuforj to proceed to transplant.”
* “Our 50% share of the net commercial profit totaling $15.9 million in collaboration revenue in the first quarter,” Goldan said, describing the Niktimvo contribution as “within the range of 25% to 30% that we've been guiding to.”
* “Inventory levels remain within the 2- to 3-week range we have previously guided,” Goldan said.

Q&A

* Anupam Rama, JPMorgan: asked what to watch for in upcoming multicenter real-world Revuforj data and whether it includes KMT2A and NPM1; Head of R&D and CMO Botwood said, “I'm not going to talk about the data specifically,” but flagged “broad coverage across the genetic subtypes, including NUP98,” plus focus areas including “the number of patients that are progressing to transplant” and “the ability to get patients on to maintenance.”
* Corinne Jenkins, Goldman Sachs: asked to quantify the transplant headwind and update KMT2A penetration; CEO Michael Metzger said, “we do think we'll get nicely north of 50% this year,” while CCO Steven Closter said restart timing “is probably 3 to 4 months” on average, with some patients “6 months or more off treatment.”
* Philip Nadeau, TD Cowen: asked what gates NPM1 penetration and whether FLT3 combo data matters; CCO Closter said, “it's a different market,” and “the time to peak will just be a little bit longer in the NPM1 population relative to KMT2A.”
* Bradley Canino, Guggenheim: asked when transplant/maintenance flips from headwind to tailwind and about gross-to-net; CCO Closter said, “I don't expect it to be much higher than 50%,” and CFO Keith Goldan said, “we expect gross to nets to settle in the 20% to 25% range... and I'm not changing our guidance at this time.”
* Josh (for Steve Willey), Stifel: asked whether axatilimab+rux Phase II could support compendia use; Botwood said, “if you see a meaningful improvement... I think that could not only inform clinical practice, but potentially also compendia listing.”
* Barclays: asked for 2026 revenue guidance and competitive dynamics; Goldan said, “we don't provide revenue guidance,” and Closter said, “we think it's a good thing that there's another menin player in the market, raising awareness.”

SENTIMENT ANALYSIS

* Analyst sentiment was slightly negative to pressing on near-term revenue mechanics, with repeated challenges on the transplant “headwind,” restart timing, and access frictions (e.g., step edits), alongside requests for revenue guidance.
* Management sentiment was slightly positive in prepared remarks and more explanatory in Q&A, emphasizing timing and evidence-building; CEO Michael Metzger said, “we do expect in future quarters to start to see some of the compounding effect,” while also acknowledging restart timing variability: “it's more like 5, 6 months, maybe even longer.”
* Versus the prior quarter, the tone shifted toward defending/clarifying commercial mechanics (transplant pause, restarts, gross-to-net seasonality) rather than celebrating launch momentum, while maintaining confidence in leadership positioning.

QUARTER-OVER-QUARTER COMPARISON

* Revuforj net revenue increased to $49 million from $44.2 million, while Niktimvo net revenue was $55 million vs. $56 million in Q4.
* The transplant narrative sharpened: management moved from “approximately 1/3 of KMT2A patients” proceeding to transplant in Q4 to “nearly half” in Q1, with greater focus on the short-term pause vs. longer-term maintenance opportunity.
* Maintenance restarts were discussed as still building, with Q4 citing “approximately 40% to 45%” restarted and Q1 reiterating “around 45%” alongside comments that some patients can take “5, 6 months, maybe even longer” to return.
* Cash and funding language stayed consistent (profitability path with stable expenses), with cash declining to $352.1 million from $394 million at the prior quarter-end.

RISKS AND CONCERNS

* “Severe winter storms... had a transient impact on both products,” CFO Keith Goldan said.
* Management repeatedly flagged the KMT2A transplant pause as a near-term commercial headwind, with CEO Michael Metzger stating, “the robust transplant rate seen with Revuforj has a short-term impact on the business.”
* Competitive and access risk remained a topic in Q&A; CCO Steven Closter said step edits existed for “literally 3 plans,” and “it's less than 1% of the overall.”
* Seasonality and pricing dynamics were noted around gross-to-net, with Goldan citing “typical 1Q seasonality impacts... due to the high deductible commercial resets and the Part D donut hole.”

FINAL TAKEAWAY

Management framed Q1 as a step toward profitability driven by over $100 million in combined quarterly product sales, with Revuforj’s NPM1 expansion and a higher KMT2A transplant rate reshaping near-term revenue cadence while potentially extending longer-term duration via post-transplant maintenance. Leadership emphasized multiple 2026 catalysts—ASCO/EHA/ASH data flow, frontline menin inhibitor trials, and fourth-quarter readouts in IPF and frontline chronic GVHD—while holding 2026 operating expense guidance at approximately $400 million and reiterating that the company does not provide revenue guidance.

Read the full Earnings Call Transcript [https://seekingalpha.com/symbol/sndx/earnings/transcripts]

MORE ON SYNDAX PHARMACEUTICALS

* Syndax Pharmaceuticals, Inc. (SNDX) Q1 2026 Earnings Call Transcript [https://seekingalpha.com/article/4897195-syndax-pharmaceuticals-inc-sndx-q1-2026-earnings-call-transcript]
* Syndax Pharma: Two Drug Launches Fuel Transformational Growth [https://seekingalpha.com/article/4883740-syndax-pharma-two-drug-launches-fuel-transformational-growth]
* Syndax Pharmaceuticals, Inc. (SNDX) Presents at Barclays 28th Annual Global Healthcare Conference Transcript [https://seekingalpha.com/article/4881749-syndax-pharmaceuticals-inc-sndx-presents-at-barclays-28th-annual-global-healthcare-conference]
* Syndax Pharmaceuticals GAAP EPS of -$0.48 beats by $0.13, revenue of $64.9M misses by $4.93M [https://seekingalpha.com/news/4583249-syndax-pharmaceuticals-gaap-eps-of--048-beats-by-013-revenue-of-649m-misses-by-493m]
* Syndax Pharmaceuticals Q1 2026 Earnings Preview [https://seekingalpha.com/news/4581717-syndax-pharmaceuticals-q1-2026-earnings-preview]