NovoCure Q1 Earnings Call Highlights

Key Points

• Optune PAX received FDA approval and a U.S. launch, with 868 healthcare providers certified in seven weeks, 169 prescriptions received and 83 patients on therapy at quarter end, and early payer coverage from Elevance Health—management called initial uptake encouraging.
• Financially, Q1 net revenue was $174 million (up 12% YoY) and NovoCure raised full‑year revenue guidance to $690–$710 million; the company reported a net loss of $71 million (or $28M excluding a one‑time share‑based comp), updated Adjusted EBITDA guidance to −$15M to breakeven, and held $432 million in cash.
• PANOVA‑4 met its primary endpoint with a 74% disease control rate in metastatic pancreatic cancer, NovoCure is exploring combinations with KRAS inhibitors showing preclinical synergy, and the next major catalyst is top‑line TRIDENT GBM data expected in Q2.

NovoCure NASDAQ: NVCR reported first-quarter 2026 results highlighted by double-digit year-over-year growth in both active patients and net revenue, driven in part by strength outside the U.S. and an early commercial ramp for its newly approved pancreatic cancer therapy. Executive Chairman Bill Doyle said the company had “a strong start to the year,” pointing to progress on profitability and multiple expected catalysts later in 2026.

Optune PAX launch in pancreatic cancer

The biggest development in the quarter was the FDA approval and U.S. launch of Optune PAX for patients with locally advanced pancreatic cancer. Doyle said physician feedback has been positive since PANOVA-3 data were presented and published at ASCO last year, noting “broad recognition” of outcomes including extensions in overall survival and time to pain progression.

NovoCure received FDA approval on Feb. 11. In the seven weeks between approval and quarter end, the company said it certified 868 healthcare providers, including 27 prescribers in academic centers—an area where the company historically saw slower TTFields adoption. Through March 31, NovoCure reported:

• 169 prescriptions received
• 90 patient starts completed
• 83 patients on therapy at quarter end, with a “backlog of starts in the funnel”

On reimbursement, the company highlighted its first major payer coverage policy for Optune PAX with Elevance Health, which it said covers more than 30 million lives. Management cautioned that it will take a few quarters to understand adoption and reimbursement dynamics, but described early signals as encouraging.

In the Q&A, executives said demand metrics for Optune PAX were “multiples” of what NovoCure saw during its lung cancer launch, though they did not provide a specific prescriber count for Q1. CEO Frank Leonard said the initial uptake has been broad-based across community and academic sites, adding that some prescribers wrote multiple prescriptions within the first five weeks. Leonard also pointed to investments such as the company’s HCP Portal, which he said has reduced administrative burden and helped accelerate prescribing.

PANOVA-4 metastatic pancreatic data and RAS inhibitor work

During the quarter, NovoCure also reported top-line results from the Phase II PANOVA-4 trial evaluating TTFields therapy with atezolizumab and gemcitabine in metastatic pancreatic cancer. Doyle said the study met its primary endpoint, delivering a disease control rate of 74% versus 48% in a historical control. He added that median duration of therapy was 25.6 weeks, which he characterized as evidence TTFields is feasible in the metastatic setting.

Chief Innovation and Medical Officer Uri Weinberg discussed the company’s interest in combining TTFields with KRAS inhibition. He said TTFields have been found to inhibit c-Myc and could complement “upstream KRAS inhibition,” including in scenarios where c-Myc is activated through bypass pathways. NovoCure referenced posters presented at AACR describing in vitro and in vivo evaluations of TTFields with divarasib in pancreatic cancer models, which management said showed greater antitumor activity in combination compared with either therapy alone. Weinberg also cited independent Mayo Clinic researchers who “reported even a synergy when the two therapies were used concomitantly.”

GBM and lung cancer updates

Leonard said Optune Gio remains the company’s core commercial driver, with 9% year-over-year global growth in active patients. He highlighted strength in Japan, Germany, and France, where active patient growth was 20%, 12%, and 9%, respectively. NovoCure’s “global market segment” grew active patients 17% year-over-year, which Leonard attributed to a “promising launch in Spain.” The company said it expects low- to mid-single-digit growth in mature markets and higher growth in newer markets such as Spain and Czechia.

The next major clinical catalyst in GBM is top-line data from the Phase III TRIDENT trial, which Leonard said is expected in the second quarter. He explained that TRIDENT evaluates earlier use of TTFields, beginning with chemoradiation rather than after chemoradiation, and includes a broader population than the EF14 trial by allowing inclusion of patients who might progress between chemoradiation and screening.

For Optune Lua in non-small cell lung cancer, Leonard said the company received national reimbursement in Japan in March and began treating commercial patients. He cited a March 15 symposium attended by about 250 Japanese lung cancer physicians and said NovoCure has been encouraged by early interest and engagement. Leonard also said NovoCure is exploring modifications to the LUNAR-2 trial aimed at compressing the timeline and “significantly reducing the cost,” with plans to engage regulators and provide a full update later this year.

Product enhancements and new torso arrays

Doyle described product development initiatives intended to improve usability, including the HCP Portal, lighter “high-intensity arrays” for Optune Gio, and a mobile app to support patients and caregivers. He said these efforts are showing up in a rising 90-day persistence rate, which “hovered below 70% as recently as 2024” and has increased to 73% in 2025.

He also said the company is finalizing the design of a new torso array compatible with Optune PAX and Optune Lua. NovoCure expects improvements in comfort and usability and said the new arrays are expected to be more cost-effective to manufacture. The company has completed usability testing in healthy volunteers and is evaluating performance in non-small cell lung cancer patients, with an aim to have the arrays available for use in future pancreatic and lung cancer trials by year-end.

Financial results, guidance updates, and profitability focus

CFO Christoph Brackmann reported first-quarter net revenue of $174 million, up 12% year-over-year. He said the increase was driven primarily by continued growth outside the U.S., including revenue increases of $6 million from Germany and $5 million from France. Brackmann noted one-time benefits of $2.5 million in Germany from increased approval rates and $1 million in France from contract performance improvement. He also cited a $5.6 million tailwind from foreign exchange rates compared with Q1 2025.

Net revenue from Optune Lua was $3 million in Q1 2026, compared with $1.5 million in Q1 2025. Based on the quarter and what Brackmann called a strong start in GBM, NovoCure raised its full-year revenue guidance to $690 million to $710 million, representing 5% to 8% growth. The company maintained its full-year combined revenue guidance for Optune Lua and Optune PAX at $15 million to $25 million.

Gross margin was 78% in Q1, up from 75% a year earlier, which Brackmann attributed primarily to lower array costs from improved utilization and lower supplier prices. NovoCure reiterated expectations for annual gross margin in the mid-70s for 2026, citing anticipated impacts as more Optune PAX patients start therapy ahead of broad reimbursement.

Operating expenses rose, including R&D expense of $58 million (up 8%), which Brackmann said was primarily driven by higher costs associated with the 700-plus patient KEYNOTE-D58 trial, which NovoCure expects to fully enroll by year-end. Sales and marketing expense was $58 million (up 5%), driven by launch costs for Optune PAX in the U.S. and Optune Lua in Japan. G&A expense was $86 million (up 92%), reflecting a $43 million share-based compensation charge triggered by Optune PAX approval; Brackmann emphasized that the grant “did not vest and shares were not distributed.”

NovoCure reported a net loss of $71 million versus $34 million in Q1 2025. Excluding the one-time share-based compensation expense, net loss was $28 million. Loss per share was -$0.62. Adjusted EBITDA was -$0.3 million compared with -$5 million in the prior-year period.

The company also updated full-year Adjusted EBITDA guidance to a range of -$15 million to breakeven, which Brackmann said reflects the strong start to the year and “accelerated expenses” from the Optune PAX launch. Cash and investments totaled $432 million as of March 31, 2026.

In closing remarks, Doyle said NovoCure is focused on both “double-digit growth” over time and “bringing the company to profitability,” while highlighting upcoming catalysts including TRIDENT top-line data.

About NovoCure NASDAQ: NVCR

NovoCure is a global oncology company pioneering Tumor Treating Fields (TTFields), a novel anti-mitotic therapy for solid tumors. The company's non-invasive treatment platforms deliver low-intensity, alternating electric fields designed to disrupt cancer cell division. NovoCure's approach offers an alternative modality to complement existing therapies in oncology, with a focus on hard-to-treat malignancies.

Founded in 2000 and headquartered in Haifa, Israel, NovoCure maintains a second operational center in Portsmouth, New Hampshire.

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