speaker
Operator
Conference Operator

Thank you for standing by and welcome to the Corset Therapeutics Second Quarter 2026 Earnings Conference Call. At this time, all participants are in listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you'll need to press star 11 on your telephone. If your question has been answered and you'd like to remove yourself from the queue, simply press star 11 again. As a reminder, today's program is being recorded. And now I'd like to introduce your host for today's program, Atabak Mokari, CFO. Please go ahead, sir.

speaker
Atabak Mokari
Chief Financial Officer

Hello, everyone. Good afternoon, and thank you for joining us. Today, we issued a press release announcing our financial results for the second quarter and providing a corporate update. The copy is available at courseup.com. Our complete financial results will be available when we file our form and queue with the SEC. Today's call is being recorded. A replay will be available at the Investors Past Events tab of our website. Statements during this call, other than statements of historical fact, are forward-looking statements based on our plans and expectations that are subject to risks and uncertainties, which might cause actual results to be materially different from those such statements express or imply. The risks and uncertainties that may affect our forward-looking statements are described in our annual report on Form 10-K and our quarterly reports on Form 10-Q, which are available at the SEC's website. Please refer to those documents for more information. Claim any intention or duty to update forward-looking statements. A revenue in the second quarter of 2026 was $256.1 million, a 32% increase over the prior year period. Corelum and authorized generic product revenue was $208.6 million. Purely product revenue was $47.6 million in its first quarter of availability. We expect growth to continue and have increased our 2026 revenue guidance to a range of $1.1 to $1.2 billion. Net income was $43 million in the second quarter of 2026 compared to net income of $35 million in the prior year period. Please note that our operating expenses in the second quarter were flat to the first quarter of 2026. Our cash and investments at June 30 were $545 million. I will now turn the call over to Sean Maduck, President of our Endocrinology Division. Sean?

speaker
Sean Maduck
President, Endocrinology Division

Thanks, Atabak. Our Cushing Center business continues to experience strong demand. The second quarter saw a record number of new prescriptions and first-time prescribers. We have never had more patients receiving our medications or more active prescribers. Our growth is due to physicians increasing awareness that hypercortisolism is a serious disease that is more prevalent than previously understood. Hypercortisolism is underdiagnosed because its signs and symptoms, such as difficult to treat diabetes or resistant hypertension, are the same as those of other more common conditions. Tens of millions of people have diabetes or hypertension or both. but those patients whose conditions are being driven by hypercortisolism have often been missed. That is especially important because hypercortisolism-induced hyperglycemia or hypertension responds poorly, if at all, to conventional pharmacotherapy. A drug that reduces excess cortisol activity is required to treat these patients. As clinical practice adapts to this critical insight, screening for and treatment of Cushing syndrome will continue to increase, as will the number of patients receiving our medications. Our landmark catalyst and momentum trials are driving increased physician awareness of hypercortisolism. Catalysts showed that 24% of patients with difficult-to-treat diabetes had hypercortisolism and that treatment with coralline led to substantial reductions in hemoglobin A1c, excess body weight, and waist circumference. Momentum screened more than 1,000 patients with high blood pressure that was not controlled despite concurrent use of three or more antihypertension medications, a condition known as resistant hypertension, and found that 27% of these patients had hypercortisolism. patients with both resistant diabetes and resistant hypertension, the prevalence of hypercortisolism was even higher, 39.7% in Catalyst and 32.6% in Momentum. These paradigm-shifting findings will take time to be fully incorporated into medical practice, a process that is only just beginning. Catalyst results were published in the field's leading journal, Diabetes Care, in 2025 and were referenced in the American Association of Clinical Endocrinology, or ACE, guidance documents for the management of diabetes in March of this year. Momentum's results are also recent. We first presented them at the annual conference of the American College of Cardiology, or ACC, in March, and again at the American Diabetes Association, or ADA, annual scientific sessions in June. The results will be published in a major medical journal later this year. That being said, the catalyst and momentum results are becoming more widely known, and doctors are acting upon them. Screening for and treatment of Cushing syndrome is increasing, and with it the number of patients being treated with our medications. We expect this trend to continue, propelling our current Cushing syndrome business to at least $2 billion in annual revenue by the end of this decade. Relacorlin's availability, which should occur shortly after the December 17th PDUFA date assigned to its resubmission, will accelerate this growth. With the addition of Relacorlin, we expect that our Cushing syndrome annual revenue will grow to between $3 and $5 billion in 2020. I will now turn it all over to Roberto Vieira, President of our Oncology Division. Roberto? Thanks, Sean.

speaker
Roberto Vieira
President, Oncology Division

Lithioly's launch is one of the strongest ever for an oncology medication. The FDA approved Lithioly on March 25th, nearly four months ahead of its PDUFA date. A few days after that, on April 1st, we sold our first Lithioly capsules. Revenue for the first quarter was $47.6 million. Our success has been driven in large part by NIFIOL's compelling clinical characteristics. Patients with ovarian cancer have few good treatment options. This is especially true for those with platinum-resistant ovarian cancer. They and their physicians are excited to have a new treatment, backed by strong efficacy data, a very manageable safety profile, convenient oral administration, and no biomarker requirements. Accordingly, Lifioly is on its way to becoming a new standard of care. Payer coverage for Lifioly has been excellent. The National Comprehensive Cancer Network, or NCCN guidelines, listed Lifioly as a preferred regimen just 15 days after approval, an unusually quick action that has supported broad insurance coverage and accelerated physician adoption. As of today, More than 70% of the combined Medicare, Medicaid, and commercial lives have formal coverage policies for leafy oil in place. More than 1,300 patients have now started treatment with leafy oil, a number that continues to grow every day. Demand has come from gynecology, medical, and hematology oncologists in academic and non-teaching hospitals, as well as community oncology clinics across the country. As of today, more than 1,000 doctors have prescribed Lithioly to at least one patient and an increasing number of physicians have written prescriptions for multiple patients. While we are extremely pleased with Lithioly's rapid uptake, we are just getting started. In IATA, we expect to reach more physicians at more oncology practices, large and small. We also expect physicians to prescribe Lithioly more frequently as they gain experience with the drug. Those efforts alone should grow Lithuania's annual revenue in the United States to more than $1 billion. I will now turn the call over to Joe Belanoff, our Chief Executive Officer. Joe?

speaker
Joe Belanoff
Chief Executive Officer

Thank you, Roberto, and thank you everyone for joining us. Since our founding, Corset has worked to discover and develop

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Operator
Conference Operator

Ladies and gentlemen, please stand by.

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Operator
Conference Operator

Your program will resume momentarily.

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Operator
Conference Operator

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Operator
Conference Operator

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Operator
Conference Operator

Okay, we're back.

speaker
Joe Belanoff
Chief Executive Officer

I apologize. Yeah, I apologize to everyone. We had a drop in the telephone line, but I will start my section again. Thank you, Roberto, for your oncology update, and thank you, everyone, for joining us. Since our founding, Corsept has worked to discover and develop molecules that harness glucocorticoid receptor, GR antagonist, to treat serious diseases. We have made important progress. It is now established that hypercortisolism is much more prevalent than previously believed, and that modulating cortisol's activity can help many patients. But Vioreli's unprecedented uptake as a treatment for platinum-resistant ovarian cancer is eye-catching, and it's an important step to proving that GR antagonism can help treat many types of solid tumors. And our plans go well beyond Cushing syndrome and oncology. Reliquarylant's new drug application, MDA, in Cushing syndrome is based on the positive outcome of our pivotal Phase 3 GRACE trial with confirmatory evidence from our double-blind, placebo-controlled Phase 3 gradient trial, our long-term extension study, and our earlier stage development data. Collectively, these results show that patients treated with Reliquarylant experience meaningful, durable improvements in the signs and symptoms of Cushing syndrome. and without the serious adverse events associated with the currently approved medications, hypokalemia, endometrial hypertrophy, vaginal bleeding, adrenal insufficiency or QT prolongation. To say that we were disappointed when we received a complete response letter at the end of last year is an understatement. At our meeting with the FDA in April, the agency requested additional analyses of the data in our original NDA submission. We completed those analyses and based on their results, we resubmitted our NDA on June 17th. The FDA accepted our resubmission and has assigned it a PDUPA date of December 17th, 2026. It is important to make reliquarylent available as soon as possible. As Sean said, the catalyst and momentum studies are changing medicine. A screening for hypercortisolism becomes the norm rather than the exception in patients with resistant diabetes and hypertension. Many patients whose health has been damaged by previously undiagnosed hypercortisolism will be able to receive more effective, targeted care. Better treatments are greatly needed. The approval of Lipiorly was enormously gratifying. It is wonderful to be able to offer patients with platinum-resistant ovarian cancer One of the most challenging forms of cancer, a safe and effective treatment option. We presented complete results from Lifiorli's pivotal trial, Rosella, in April at the Society of Gynecologic Oncology, SGO's, annual meeting with their simultaneous publication in The Lancet. In Rosella, Lipiorla met both primary endpoints, significantly delaying disease progression, and even more important, significantly extending overall survival. Patients treated with Lipiorla and napaclitaxel chemotherapy experienced a 35% reduction in their risk of death, a hazard ratio of 0.65, compared to patients treated with napaclitaxel alone. The p-value was 0.0004. Notably, the survival benefits were achieved in all patients with platinum-resistant ovarian cancer, not just those selected based on a specific biomarker. LaFiori's approval is just the first step toward advancing GR antagonism to full potential to treat solid tumors. Many tumors exploit GR signaling to drive treatment resistance. Beyond platinum-resistant ovarian cancer, GR Antacanum has the potential to treat any solid tumor expressing the GR in combination with any anti-cancer agent. Our oncology development program aims to provide the evidence needed to realize the potential. We are evaluating Relichloraline combined with chemotherapy in a variety of solid tumors. One of the arms of our BELLA trial is studying the effect Avrelacoralin plus Snap Paclitaxel and Bevacizumab in women with platinum-resistant ovarian cancer. This arm will produce results this year. Our Bella trial has two other arms, one which is studying the treatment of patients with platinum-sensitive ovarian cancer and earlier stage of the disease, and one which is studying endometrial cancer. Our STELLA trial in cervical cancer and our TRIDEN trial as a first-line treatment for pancreatic cancer are also underway. These trials will all produce results by the end of next year. We expect data from these studies to be NCCN guideline enabling and to inform our future development decisions. Successful results would immediately increase the number of patients that relacoralin may help by five-fold. Also, very important, GR antagonism may augment the effects of immunotherapy. Cortisol suppresses the immune system, blunting the effectiveness of therapies that stimulated an immune response. A treatment regimen combining an immunotherapy agent with a GR antagonist may stimulate a stronger, more effective immune response. We have initiated Synergy, a Phase 1b study of our proprietary selective GR antagonist, Nenacorrelant, in combination with nivolumab, a PD-1 directed immunotherapy across a broad range of solid tumors. We expect results from Synergy by the end of next year. Finally, cortisol activity at the GR stimulates the growth of prostate cancer tumors, helping them escape the effects of androgen deprivation therapy. Our collaborators at the University of Chicago are enrolling a randomized placebo-controlled phase two trial of relacoralant plus the androgen receptor blocker enzalutamide in patients with early-stage prostate cancer to see if adding a GR antagonist can block cortisol-mediated tumor escape routes. Cortisol activity is involved in the development and progression of metabolic dysfunction associated with steatohepatitis, or MASH. This serious liver disorder afflicts millions of patients worldwide and is a significant and rapidly growing cause of liver and cardiometabolic morbidity and mortality. Our proprietary selective cortisol modulator, Miraclorelent, is very potent in the liver. In our Phase 1B study, it rapidly reduced liver fat and improved other elements of important markers of liver health, including fibrosis. Miraclorelent was well tolerated without the gastrointestinal side effects commonly seen in patients being treated for MASH. Our 175-patient, double-blind, placebo-controlled Phase IIb Monarch study has completed enrollment and will produce data later this year. Positive results would support advancement to Phase III. Patients with ALS frequently have elevated cortisol levels, which is why we believe cortisol modulation may help them. Results from DAZZLS, the Phase II trial of our proprietary selective cortisol modulator, Dazacoralant, have been very encouraging. Patients who received 300 milligrams of dazocoralin exhibited an 84% reduction in risk of death at the one-year mark compared to patients who received placebo. The p-value for this finding was .0009. This survival benefit persisted into the study's second year with an 87% reduction in risk of death with a p-value of less than .0001. There is a common misperception that death from ALS is always coterminous with severe functional decline. It isn't. Many patients die from complications such as pneumonia or cardiovascular events arising well before they have lost significant function and quality of life. Cortisol modulation could prevent such complications or help patients to survive them. It would provide a significant benefit. We are currently conducting a study to see if dose titration can improve dazocoralin's gastrointestinal tolerability. Non-serious GI distress caused most of the discontinuations in dazzles. The findings from this study will inform the design of the pivotal trial that we plan to start early next year. To sum up, our Cushing Syndrome business is growing and is poised for accelerated growth Driven by increasing awareness of hypercortisolism's true prevalence and the increasing evidence of the importance of treating it. Our landmark catalyst and momentum studies are leading to much wider screening for and treatment of Cushing syndrome. Approval of relacoralin would lead to even faster growth. The launch of Lathiorli in platinum-resistant ovarian cancer is off to a very strong start. We believe that GR antagonism has a broad utility in oncology. We look forward to helping many more patients with cancer in the near future. Our Bella, Stella, and Trident studies will produce results by the end of next year and have the potential to increase the number of patients LaFiori could benefit by a factor of five. We are also evaluating the treatment of other solid tumors and other treatment combinations to fully realize our potential in oncology. Following up on our positive Phase 2 Dazzles findings, we are conducting a dose titration study to inform the design of our planned Phase 3 trial in patients with ALS. By year end, we will have results from our Phase 2 Monarch trial in patients with MASH. If those results are sufficiently positive, we will proceed to Phase 3. The potential of cortisol modulation is immense. Developing that potential into safe and effective medications is important work. We thank the patients who participate in our trials, our employees, our clinical investigators, and our academic collaborators who make it possible.

speaker
Operator
Conference Operator

Operator, let's proceed to questions. Certainly, and as a reminder, ladies and gentlemen, if you do have a question at this time, please press star 11 on your telephone. Our first question comes from the line of David Anselm from Piper Sandler. Your question, please.

speaker
David Anselm
Analyst, Piper Sandler

Thanks. So just a few for me, first on the patient level metrics on Liffey-Orly. Can you talk to the number of patients on treatment currently or at the end of 2Q? And when you talk about accelerating demand, I just want to get a sense of what exactly that means. Does that mean you're adding the pace of patient ads continue to increase through June and into July. That kind of color would be helpful. And then secondly, on the upward revisions of the guidance, is it fair to say that most of that is related to the launch of Lifiorli? And if so, can you talk to The dynamics you're seeing surrounding Coraline, are there any additional bottlenecks or lingering bottlenecks, I should say, regarding the specialty pharmacy and what kinds of assumptions are now embedded in Coraline with this upward vision to your guide? Thank you.

speaker
Joe Belanoff
Chief Executive Officer

Okay, thank you, David. And several questions, I'll try to sort them out. First question, I think we'll go to Roberto, our president of oncology.

speaker
Roberto Vieira
President, Oncology Division

Thank you, Joe. Thank you, David. So, David, we spoke about the 1,300 patients that we have initiated on therapy since we have launched. As you can see from what we discussed in the previous quarter as well, we have really accelerated the adoption of patients there. And we are very happy. We see a very broad range of patients. We see patients very early lines of therapy, but also patients across the entire spectrum, late lines as well. and we have maintained actually a very strong pace of adding patients every week. We are on our way to become market leaders as well as to realize the potential of $1 billion just for platinum resistant ovarian cancer in itself. So I think that you can derive from there where we are headed. We are very happy with market access as we discussed. So overall the story holds together as significant growth is ahead of us. Now, talking about this rate of acceleration of demand, we have, of course, as I said, very strong uptake so far. And we are actually working very hard to educate a much broader group of physicians that expands across new clinics. We think we have meaningful opportunity ahead. So our goal is to really go early and go broad. And when I say go early, we think that Lithioly is a drug that belongs early in the intervention. We think that the overall survival benefit, especially the fact that the drug has the opportunity to impact the disease, has a disease modification effect. You look at the overall survival curve, you see that those curves separate over time, so there's an increasingly positive benefit to patients. And all those things together point to this drug really belonging into early lines of platinum-resistant ovarian cancer. So when you put all this together, the profile of the drug, the outcome opportunity, you should be looking to continue to grow for the brand for the quarter to come.

speaker
Joe Belanoff
Chief Executive Officer

Very good. Thank you, Roberto. And Sean, why don't you take the next question about where things stand with the pharmacy?

speaker
Sean Maduck
President, Endocrinology Division

Yeah, no, happy to take that. So in terms of just how the quarter ended up, I want to just set the stage. I mean, we had record enrollments. We had a record number of new prescribers, a record number of patients on medicine, which, of course, led to the highest tablets we've seen. The market is growing. and of course that was evidence in our business in the second quarter but we expect that to continue to grow and of course to continue to benefit our business. Now in terms of the pharmacy specifically, we saw continuous improvement every single day and we expect that continued improvement to move forward. As I just mentioned, the market is growing, our business is growing and we expect them to continue to improve and continue to keep up.

speaker
Joe Belanoff
Chief Executive Officer

And Atabak, perhaps you can respond to the guidance question.

speaker
Atabak Mokari
Chief Financial Officer

Sure. Yeah, so our new guidance range reflects strength across both of our businesses, across both endocrinology and oncology. And so both of those are reflected in the updated guidance. Okay.

speaker
Operator
Conference Operator

Please. Thank you, David. And next question? Certainly. And our next question comes from the line of Swayam Pakula Rambakant from HC Wainwright. Your question, please.

speaker
Swayam Pakula Rambakant
Analyst, HC Wainwright

Thank you. Good afternoon. I have just a couple of questions, one on Liferle and one on Coraline. Liferle did approximately $48 million in the first quarter with more than 1,300 patients started, as you stated. How much of that reflects distance demand versus initial channel build? And how many unique prescribers do you have at this point? and beyond the 200 that you cited in April. And any commentary on duration of therapy would be helpful as well. And then on colon, we are back to seeing 27% sequential growth. How much of this is clearing up of the backlog from the pharmacy transition versus capacity growth? that you currently have gained with the new pharmacy on board.

speaker
Joe Belanoff
Chief Executive Officer

Okay. Thank you, RK. I think we've got both of those questions. Roberto, would you like to answer the first question on oncology growth?

speaker
Roberto Vieira
President, Oncology Division

Yeah. So, RK, as you said, 1,300 patients initiated therapy and 1,000 unique prescribers since we have launched. So, that is, I think, the answer to your question. You asked about Thank you, Roberto.

speaker
Atabak Mokari
Chief Financial Officer

We had a question on inventory.

speaker
Joe Belanoff
Chief Executive Officer

The question was related to inventory. That's for you, Atabak.

speaker
Atabak Mokari
Chief Financial Officer

I'll take that one. So your question on that, the simple answer is no, there's not much inventory contribution in the quarter results. And so what do I mean by that? So the background is that we sell through both specialty pharmacies and specialty distributors. Revenues through the specialty pharmacy are direct to patient, so there is no inventory at the channel level. It's all direct to patient and realized when the patient received the medicine. So through the specialty distributor... and just to be clear, in our Cushing Syndrome business, almost 100% of our business goes through the specialty pharmacy. On the oncology side, about 30% goes through the specialty pharmacy and the rest goes through specialty distributors which do hold inventory to then ultimately provide to hospital pharmacies and so forth. Within that, I mean, ultimately this is, given the cost of the medication, The distributors want to hold minimal inventory, so you're talking about roughly about a week of demand that they keep on hand. So like I started at the beginning, very little of inventory dynamics in the quarter results. Thank you.

speaker
Joe Belanoff
Chief Executive Officer

Okay, and Sean, you have a couple questions here.

speaker
Sean Maduck
President, Endocrinology Division

Yeah, so thanks, RK. So your question, I think, was the $44 million growth we saw from Q2 over Q1 driven by sort of catch-up associated with the pharmacy transition, and the answer to that is no. The transition is behind us. The number was driven by continued servicing of our existing patient base, and as I shared earlier, a record number of new enrollments coming in, so the servicing of new patients coming in. We've had a record number of patients every single month, and we expect that to continue to grow. Thank you, Sean. Thank you. Okay.

speaker
Joe Belanoff
Chief Executive Officer

Thank you. Well, thank you everyone. It was a very exciting quarter for us. It's really wonderful to be able to help this new group of patients. We really hope to enlarge that as we go forward and really have great expectations that we will. So we'll talk to you next quarter. Thank you very much and enjoy the rest of your summer. Bye-bye.

speaker
Operator
Conference Operator

Thank you, ladies and gentlemen, for your participation in today's conference. This does conclude the program. You may now disconnect. Good day.

Disclaimer

This conference call transcript was computer generated and almost certianly contains errors. This transcript is provided for information purposes only.EarningsCall, LLC makes no representation about the accuracy of the aforementioned transcript, and you are cautioned not to place undue reliance on the information provided by the transcript.

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