Geron Eyes High End of 2026 RYTELO Revenue Guidance as Community Adoption Expands

Key Points

• Geron expects 2026 RYTELO revenue of approximately $230 million to $240 million, toward the midpoint to high end of its previously issued $220 million-$240 million guidance. The company reported record quarterly revenue of $57.5 million and three consecutive quarters of growth.
• Commercial efforts are shifting toward community oncology practices, which account for about 80% of the lower-risk MDS market. Geron is adding 100 to 200 new RYTELO accounts per quarter, while 34% of business already comes from first- and second-line patients.
• Geron plans to outline its European commercialization strategy before year-end and continues the 327-patient IMpactMF Phase 3 trial in relapsed or refractory myelofibrosis. The company ended the period with more than $300 million in cash and reiterated 2026 operating-expense guidance of $230 million-$240 million.

Geron NASDAQ: GERN executives said the company remains on track to generate 2026 RYTELO net revenue of $220 million to $240 million, with Chief Executive Officer Harout Semerjian saying the company now expects results toward the midpoint to high end of that range, or approximately $230 million to $240 million.

Speaking at the H.C. Wainwright 28th Annual Global Investment Conference, Semerjian said RYTELO, or imetelstat, was launched in July 2024 as the first telomerase inhibitor for patients with lower-risk myelodysplastic syndromes, or MDS. He described the therapy's mechanism as one designed to target the disease itself rather than mask symptoms.

The company reported $57.5 million in net revenue in its latest quarter, which Semerjian called its highest quarterly sales figure since the launch. Geron has delivered three consecutive quarters of growth, he said, while acknowledging that the company still has work to do to expand use of the drug.

Commercial focus shifts toward community practices

Semerjian said Geron’s commercial efforts are increasingly focused on the second-line lower-risk MDS population, particularly within community treatment settings. He said approximately 80% of the business in the disease area is in the community, making simplified physician messaging and engagement with high-volume community accounts important to the launch.

Geron initially concentrated on building experience with RYTELO at academic medical centers, according to Semerjian, partly because many clinical trials for the drug were conducted outside the United States. The company is now seeking to translate that experience into broader community adoption.

Chief Medical Officer Joseph Eid said the company has emphasized physician education on RYTELO’s mechanism, patient management and cytopenias associated with the new drug class. Geron has also expanded its educational efforts through continuing medical education programs and regional hematology meetings.

Eid noted that National Comprehensive Cancer Network guidelines have been updated twice since RYTELO’s launch and position the therapy as a second-line option. He also said luspatercept’s move from second-line to first-line treatment has supported RYTELO uptake, because some patients who receive luspatercept may have elevated serum erythropoietin levels that make erythropoiesis-stimulating agents less suitable.

Early-line mix and account additions

Semerjian said 34% of Geron’s business, measured using a 12-month lookback, came from first- and second-line patients. The company views that as an important indicator because the IMerge trial and RYTELO’s approved indication were primarily focused on second-line patients.

He said physicians often initially use new oncology therapies in later-line, higher-need patients before utilization migrates toward the studied population. Geron expects its early-line mix to continue growing over time.

The company has added between 100 and 200 new accounts per quarter that had not previously ordered RYTELO, Semerjian said. While account breadth is especially important during the initial years of a product launch, Geron expects patient depth within existing accounts—particularly high-volume accounts—to become increasingly important over time.

Geron has not provided peak-sales guidance for RYTELO. However, Semerjian pointed to the size of the lower-risk MDS market and said luspatercept represents a business of roughly $2.5 billion and is growing in that setting. He also said Geron holds worldwide rights to RYTELO and has not entered into an ex-U.S. commercialization deal.

European strategy and myelofibrosis program

Semerjian said Geron plans to provide an ex-U.S. strategy, particularly for Europe, before year-end. The company is evaluating multiple options but does not intend to pursue a traditional large-scale country-by-country commercial buildout, he said. Geron is considering payer dynamics and changes affecting global launch sequencing while holding discussions with stakeholders outside the U.S.

Geron also discussed its IMpactMF Phase 3 trial in relapsed or refractory myelofibrosis following treatment with a JAK inhibitor. Eid said the 327-patient study completed enrollment last September and compares imetelstat with best available therapy, with overall survival as the primary endpoint.

The company has been discussing the planned interim analysis with U.S. and European regulators to seek alignment on parameters that could support a positive outcome if the analysis is triggered. Eid said Geron’s base case has been that the trial proceeds to final analysis, noting that interim analyses for overall-survival studies generally present a high bar.

Semerjian said Geron had more than $300 million in cash and recently hired its first chief business officer. He added that the company reiterated operating-expense guidance of $230 million to $240 million, alongside its projected $230 million to $240 million in 2026 RYTELO revenue.

About Geron (NASDAQ:GERN)

Geron Corporation is a biopharmaceutical company focused on developing and commercializing treatments for myeloid hematologic malignancies, including certain bone marrow cancers. The company's approach centers on imetelstat, a telomerase inhibitor designed to target malignant stem and progenitor cells.

Geron's lead product, Rytelo (imetelstat), is approved in the United States for adults with lower-risk myelodysplastic syndromes who have transfusion-dependent anemia requiring or having failed treatment with erythropoiesis-stimulating agents.

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