Cabo funds the next Exelixis bet
- CABOMETYX is the main business, with Q1 2026 net product revenue of $555 million.
- The drug is the number one prescribed TKI in renal cell carcinoma, a form of kidney cancer.
- The 2025 launch in neuroendocrine tumors passed $100 million of U.S. cabo revenue in its first year.
- Zanzalintinib is under FDA review for colorectal cancer, with a December 3, 2026 decision date.
- The main risk is concentration: 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. In Q1 2026, U.S. CABO franchise net product revenue grew 8% year over year to $555 million, and management said the quarter had the highest number of new CABOMETYX patient starts ever.
The bull case is simple. Cabo is still growing in kidney cancer and is off to a strong start in neuroendocrine tumors. 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 is also simple. Until zanzalintinib is approved and starts selling, Exelixis is still mostly a one-product story. The next major zanzalintinib kidney cancer readout, STELLAR-304, moved to the second half of 2026, which leaves more weight on the colorectal cancer review and the cabo sales trend.
Finn's view is balanced. Exelixis has strong current performance and financial health, but the stock still needs proof that the next drug can become more than a pipeline promise.
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.
In Q1 2026, Exelixis reported $610.8 million of total revenue. Net product revenue was $555.0 million, while collaboration revenue was $55.8 million. That means the business is heavily tied to U.S. cabo demand.
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 approval.
What Exelixis sells and tests
CABOMETYX in renal cell carcinoma
This is Exelixis's core market. 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. U.S. cabo revenue from this use passed $100 million in 2025, its first year on the market.
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, depending on event rates.
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 from trial data to the final regulatory decision. Approval is not guaranteed, and the label could be narrower than investors hope, especially around the non-liver metastasis population.
STELLAR-304 data miss or slip again
High impact · Medium oddsSTELLAR-304 is the next major zanzalintinib kidney cancer trial. Management moved the expected readout to the second half of 2026 because event rates affect timing. A weak result would hurt the case that zanzalintinib can become a broad franchise.
Cabo growth slows
High impact · Medium oddsMost revenue still comes from cabozantinib. If kidney cancer share weakens or the neuroendocrine tumor launch fades after the early surge, Exelixis would have less growth while it waits for zanzalintinib.
Payer discounts pressure margins
Medium impact · Medium oddsManagement guided 2026 gross-to-net to 31% to 32%. Gross-to-net is the gap between list price and what the company keeps after rebates, discounts, and fees. A higher number 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, cleaner safety, or easier use.
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.