Cabo funds the next Exelixis bet
- CABOMETYX is the main business, generating the vast majority of current product revenue.
- The drug is the number one prescribed TKI in renal cell carcinoma, a form of kidney cancer.
- Management lowered 2026 revenue guidance by $50 million at the midpoint due to a slower ramp in neuroendocrine tumors.
- Zanzalintinib is under FDA review for colorectal cancer, with a December 3, 2026 decision date.
- The main risk is concentration because most current revenue still depends on cabozantinib.
One big drug, one big follow-up
Exelixis is in a stronger spot than many biotech companies because it already makes real money. CABOMETYX, its brand name for cabozantinib, funds the company while it runs trials and buys back stock. The core business captures more than 45% new patient market share in second-line plus neuroendocrine tumors, known as NET.
The bull case is simple. Cabo is still growing in kidney cancer. The company also has a clear path to a second major franchise if the FDA approves zanzalintinib for colorectal cancer on December 3, 2026.
The bear case centers on the pace of growth and trial setbacks. Management lowered 2026 revenue guidance by $50 million at the midpoint because the NET indication is ramping slower than expected. Also, a specific patient subgroup in the key colorectal cancer trial failed to meet statistical significance for overall survival. Until zanzalintinib is approved and starts selling, Exelixis remains mostly a one-product story.
Finn considers the setup balanced. Exelixis has strong current performance and financial health, but the stock needs proof that the next drug can become a broad commercial success.
Cabo pays the bills
Exelixis makes most of its money by selling CABOMETYX in the United States. It also receives collaboration revenue, mainly royalties from Ipsen and Takeda, which sell cabozantinib outside the United States.
The business is heavily tied to U.S. cabo demand. In Q1 2026, Exelixis reported $610.8 million of total revenue, with net product revenue making up $555.0 million of that total.
The company uses this cash to fund cancer trials, especially zanzalintinib, and to support business development. This model works well when cabo keeps growing and trials hit. It breaks if payers cut net prices, doctors switch to rivals, or zanzalintinib fails to win broad approval.
What Exelixis sells and tests
CABOMETYX in renal cell carcinoma
This is the core market for Exelixis. RCC is kidney cancer, and CABOMETYX is the number one prescribed TKI there.
CABOMETYX in neuroendocrine tumors
The FDA approved CABOMETYX for pNET and epNET in 2025. Uptake is steady, though the indolent nature of the disease has slowed the initial revenue ramp.
Zanzalintinib in colorectal cancer
This is the key next-drug bet. The FDA accepted the NDA for zanzalintinib plus atezolizumab, with a December 3, 2026 PDUFA decision date.
Zanzalintinib in non-clear cell RCC
STELLAR-304 tests zanzalintinib plus nivolumab against sunitinib in untreated non-clear cell kidney cancer. Top-line results are expected in the second half of 2026.
Early oncology pipeline
Exelixis is testing earlier drugs such as XL309, XB010, XB628, and XB371. These could matter later, but they are not the main value driver today.
Partnered legacy products
COTELLIC and MINNEBRO came from Exelixis research and are marketed through partners. They add breadth, but cabo remains the main business.
Revenue is still concentrated
The mix uses Q1 2026 revenue from the latest 10-Q. Net product revenue was about 91% of total revenue, so Exelixis still depends mostly on U.S. cabozantinib sales.
What could go wrong
Zanzalintinib label disappoints
High impact · Medium oddsThe FDA has accepted the colorectal cancer application, so the key risk has moved to the final regulatory decision. The non-liver metastasis subgroup failed to hit statistical significance for overall survival, introducing the risk of a narrower label than investors hope.
Cabo growth slows
High impact · Medium oddsMost revenue still comes from cabozantinib. Management lowered 2026 guidance by $50 million because the neuroendocrine tumor launch is ramping gradually. If kidney cancer share also weakens, growth will stall.
STELLAR-304 data miss
High impact · Medium oddsSTELLAR-304 is the next major zanzalintinib kidney cancer trial. A weak result would hurt the case that zanzalintinib can become a broad franchise.
Payer discounts pressure margins
Medium impact · Medium oddsManagement guided 2026 gross-to-net to 30% to 31%. Gross-to-net is the gap between list price and what the company keeps after rebates and fees. A higher percentage means Exelixis keeps less of each sale.
Competition changes doctor habits
Medium impact · Medium oddsCABOMETYX competes with other TKIs and immune therapy combinations. It leads in renal cell carcinoma today, but doctors can change prescribing if rivals show better data or cleaner safety.
In one breath
How does Exelixis make money?
Exelixis mainly sells CABOMETYX in the United States. It also earns collaboration revenue, including royalties from Ipsen and Takeda for cabozantinib sales outside the United States.
What is the biggest upcoming Exelixis catalyst?
The biggest dated catalyst is the FDA decision for zanzalintinib in colorectal cancer on December 3, 2026. Investors will also watch STELLAR-304 data in non-clear cell kidney cancer in the second half of 2026.
Why does concentration risk matter for EXEL?
Most current revenue depends on cabozantinib. If CABOMETYX loses share, faces access pressure, or has a safety issue, Exelixis would feel it quickly because zanzalintinib is not yet a major seller.
