Starling Oncology
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Starling Oncology (STLN) investor relations material

Starling Oncology Q2 2026 earnings summary

Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.
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Q2 2026 earnings summary6 Aug, 2026

Executive summary

  • Achieved record revenue of $161.3 million in Q2 2026, up 34.6% year-over-year, with positive adjusted EBITDA and narrowed net loss to $9.8 million, marking the second consecutive profitable quarter as a public company.

  • Completed a strategic refinancing, repaying $86 million convertible note with a $75 million term loan and $11 million cash, extending debt maturity to 2031 and improving liquidity without shareholder dilution.

  • Rebranded to Starling Oncology to reflect national value-based oncology leadership and launched the Starling Nexus provider portal, with phased onboarding and future e-prescribing integration.

  • Operates 65 clinics across five states, managing 2.1 million lives under value-based contracts.

  • Signed first delegated contracts outside Florida (Nevada, Oregon) and secured exclusivity with a major California partner, adding 230,000 capitated lives.

Financial highlights

  • Q2 2026 revenue reached $161.3 million, up 34.6% year-over-year; specialty pharmacy revenue grew 57.6%.

  • Gross profit was $27.2 million, up from $17.5 million in Q2 2025; overall gross margin improved to 16.8%.

  • Adjusted EBITDA turned positive at $229,000, a $4.3 million improvement year-over-year.

  • Free cash flow for Q2 was $12.5 million, with year-to-date free cash flow at $9.7 million, a $24 million improvement over the prior year.

  • Ended Q2 with $41.1 million in cash and cash equivalents.

Outlook and guidance

  • Raised full-year 2026 guidance: revenue of $650–$670 million, gross profit of $105–$110 million, adjusted EBITDA of $2–$7 million, and free cash flow of $5–$15 million.

  • Q3 2026 Adjusted EBITDA expected between $500,000 and $1.5 million as Florida delegated lives ramp up.

  • Capitated revenue expected to double in 2027, driven by new contracts and expansions.

  • Management expects sufficient liquidity for at least one year and continued revenue growth from new markets and contracts.

  • Minimum net revenue covenant of $700 million annually under new term loan agreement, effective from December 2027.

Starling Nexus role in clinical pathway adherence
Drivers of 58% Specialty Pharmacy revenue growth
Expansion into Nevada and Oregon delegated markets
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