Oct 29, 2026 earnings call — Optune Lua Japan launch and OptunePax update
Raised 2026 net revenue guidance to between $736 million and $743 million.
Revenue $0.2B (est $0.2B) · EPS $-0.09 (est $-0.23) · Next-quarter revenue outlook $0.7B–$0.7B
Key quotes
"For our 4.73 thousand GBM patients on therapy, an 11% increase year over year and our highest GBM active patient count to date."
"The PANOVA-5 trial will explore the concomitant use of OptunePax, gemcitabine, nab-paclitaxel, and Verastem's KRAS G12D inhibitor, VS-5, in our approved locally advanced setting."
"We are updating our full year adjusted EBITDA guidance today to a range of $24 million to $34 million"
Analyst Q&A 5
Pax launch patient and script volumes
Q (Vijay Kumar · Evercore): Analyst asked why patient and script volumes fell sequentially for Optune Pax and for more detail on the Pax launch. He also asked about the sustainability and path forward for adjusted EBITDA.
A: Management said the U.S. Pax launch faced challenges because many patients are entering practices now, which has increased insurance appeals and skin irritation and left practices overwhelmed. They said clinician interest remains and they are committed to the indication. On adjusted EBITDA, they said Q3 was a very strong quarter and they remain committed to adjusted EBITDA breakeven on a full year basis but expect quarter-to-quarter fluctuations.
"To give a little bit of color, I think we all need to think about the just the sheer volume of patients now coming into practices and asking for diraxonrasib." — Frank Leonard (CEO)
2027 growth and Japan launches
Q (Larry Biegelsen · Wells Fargo): Analyst asked whether the company still strives for double-digit top-line growth in 2027 and what headwinds and tailwinds lie behind that. He also asked for expectations and timing for Optune Lua and Pax in Japan and why Japan is an exciting opportunity.
A: Management said they remain committed to delivering double-digit top-line growth going forward. They said Japan is a material tailwind: Optune Lua launched successfully and interest is strong, and Optune Pax received regulatory approval with reimbursement expected early in 2027 (first quarter), which would allow the Pax launch there. They also noted price resets with MHLW raised Lua pricing and they hope for a similar outcome for Pax.
"And we expect to have reimbursement early in 2027 first quarter of 27, which would then allow us to begin the launch in Optune Pax." — Frank Leonard (CEO)
Why Pax prescriptions slowed; payers and R&D
Q (Japan Bednar · Piper Sandler): Analyst asked whether initial Pax prescribers kept using the product or if prescribing dried up, whether practices are overwhelmed or using Pax more broadly, and asked for an update on payer engagement and how R&D spending should trend after KEYNOTE-D58 completes.
A: Management said they are not seeing patients leave Optune Pax in substantial numbers to start diraxonrasib and they do not see widespread first-line use of diraxonrasib except when chemo cannot be tolerated. They believe practices are simply overwhelmed, and they see strong clinician interest from meetings like ESMO. On payers, they said the next milestone is NCCN guideline inclusion which will drive further payer engagement and noted an existing coverage policy with Elevance. On R&D, they said 2026 had high spend due to phase 3 activity, 2027 will still include D58 and LUNAR-2 with R&D flat to slightly declining, and beyond those trials R&D expense should go down if not replaced.
"First and foremost, what I want to highlight is that we are not seeing patients leaving Optune Pax in substantial numbers to start diraxonrasib." — Frank Leonard (CEO)
Why Q4 revenue guidance is lower
Q (Tanmay Patwardhan · JPMorgan): Analyst noted the revised annual revenue guidance implies Q4 revenue below Q3 and asked which assumptions drive this sequential step down.
A: Management said Q3 was a very successful quarter and included about $4.4 million of one-time revenue. They explained that if Q4 equals Q3 less that one-time item, it gets to around the midpoint of guidance, and they also allowed for some collections risk and other opportunities when setting guidance.
"First, Q3 was really a very successful quarter in terms of net revenue." — Christoph Brackmann (CFO)
Verastem trial goals and learnings
Q (Kevin DeGeeter · Ladenburg Thalmann): Analyst asked what Novocure hopes to learn from the Verastem collaboration trial: the antitumor benefit of combining with a KRAS inhibitor or how skin toxicities interact, and what the study aims to show.
A: Management said they are pleased to work with Verastem and view the trial in locally advanced pancreatic cancer as validation of Optune Pax in that indication. They described two small single-arm studies (PANOVA-5 and PANOVA-6), each about 25 patients, designed to show feasibility, tolerability, and toxicity of using Optune Pax with KRAS inhibitors and standard chemo. They said they will learn about toxicity but are not particularly concerned given the local nature of the therapy and prior skin toxicity experience; preclinical data suggests potential synergy with KRAS inhibition.
"These 2 smaller single arm studies intend to give the first experience showing feasibility and tolerability and toxicity of the concomitant use of Optune Pax with KRAS inhibition." — Uri Weinberg