Geron (NASDAQ:GERN) executives said the company is focused on expanding commercial uptake of RYTELO, its first-in-class telomerase inhibitor imetelstat, while preparing for a key myelofibrosis trial analysis expected before year-end.
Speaking at a Stifel investor event, Chief Executive Officer Harout Semerjian said Geron has been working to transition from a development-stage organization into a commercial company following RYTELO’s launch in lower-risk myelodysplastic syndromes, or MDS.
Semerjian said Geron reported $184 million in full-year net revenue for 2025 and has guided to $220 million to $240 million in net revenue this year. He said the company has organized itself around achieving that growth target.
Geron Tracks Demand, Accounts and Line of Therapy
Semerjian said sales remain the ultimate measure of commercialization progress, but he described them as a lagging indicator. Internally, Geron also watches demand, the number of new accounts ordering RYTELO and the mix of patients by treatment line.
He said the company recently added another 150 accounts, a pace he described as consistent quarter over quarter. He also said 33% of patients are now coming from first- or second-line use, up from 30% in the prior quarter.
Semerjian said the company wants to increase the share of patients treated in the second-line setting. He pointed to updated NCCN guidelines, which he said now identify RYTELO as a preferred second-line agent ahead of hypomethylating agents, or HMAs.
“We’ve refined our strategy to solely focus on the second-line patient setting, which we believe are around 8,000 patients in the U.S.,” Semerjian said.
Chief Medical Officer Joseph Eid said luspatercept-aamt’s movement into the first-line setting should create additional space in second-line treatment, where he said imetelstat is now positioned by the NCCN guideline.
Community Uptake Remains a Commercial Focus
Semerjian said MDS is primarily treated in the community, with about 80% of patients managed outside academic medical centers. However, he said Geron’s sales have been closer to a 50/50 split between academic centers and the community, which he said is typical early in a launch.
He said academic centers are important early adopters because physicians there present data and help shape clinical practice. Over time, he said Geron wants sales to better reflect where patients are treated, noting that recent new ordering accounts were predominantly community sites.
Eid said community physicians are still moving through a learning curve with imetelstat and generally follow the lead of academic medical centers. He said Geron is using commercial, medical and peer-to-peer outreach to reach community physicians.
Executives Highlight Cytopenia Data and Real-World Evidence
Eid discussed data presented at ASH showing a correlation between cytopenias and clinical benefit in patients treated with RYTELO. He said some physicians initially stopped treatment after one or two cycles when cytopenias occurred, but the ASH data suggested cytopenia may reflect an on-target effect and correlate with durable response.
He said cytopenias in the IMerge study occurred predictably around the second or third cycle and recovered within two to four weeks for the majority of patients, with more than 80% recovering. He also said the company observed no bleeding or infections in that context.
Eid also referenced longer-term ASH data, saying RYTELO showed favorable outcomes at 45 months across overall survival, progression-free survival and conversion to leukemia.
Looking ahead to the European Hematology Association meeting, Eid said real-world data from Moffitt Cancer Center includes a retrospective component from the early launch period, when many patients were treated in third-line-plus settings, as well as a prospective component that is still accruing patients. He said the retrospective data appeared to replicate, and potentially improve upon, results seen in the phase 3 setting.
Myelofibrosis Trial Readout Expected Before Year-End
Geron is also awaiting an interim overall survival analysis from the phase 3 IMpactMF trial in myelofibrosis before the end of the year. Eid said the independent data monitoring committee has options to recommend stopping the trial for efficacy, stopping for futility or continuing to the final analysis. He said continuing to final analysis is the company’s expected likely scenario.
Eid said patients in the trial appear to be living longer than historical populations, which he attributed to improved supportive care, additional JAK inhibitors and more clinical trial options. He said Moffitt is also conducting an analysis to contextualize survival in the current real-world treatment environment.
On patient crossover in IMpactMF, Eid said the trial design includes measures intended to limit crossover because it can dilute an overall survival benefit. He said crossover exists but is limited by design.
Capital Allocation Focused on Growth and Optionality
Semerjian said Geron sees a path to profitability, with revenue and operating expense guidance in a similar range. He said the company’s strategy includes expanding RYTELO use in the U.S., evaluating options outside the U.S. and advancing the myelofibrosis program.
He also said Geron has about $340 million in cash on its balance sheet, giving it flexibility for business development. Semerjian said the company is interested in “opportunistic innovation,” particularly assets with strong overlap with Geron’s existing hematology commercial infrastructure.
“We have the fuel in the tank to actually go through that, and we have a very good drug and also a company now that’s much more focused on the commercialization,” Semerjian said.
About Geron (NASDAQ:GERN)
Geron Corporation (NASDAQ: GERN) is a clinical-stage biotechnology company dedicated to developing and commercializing novel treatments that target telomerase, an enzyme critical to cancer cell immortality. The company’s research is focused on hematologic malignancies and solid tumors, with a pipeline designed to address diseases that have historically had limited therapeutic options.
The lead product candidate, imetelstat, is a first-in-class telomerase inhibitor currently in Phase II and Phase III clinical trials for myelofibrosis and myelodysplastic syndromes.
