Starling Oncology, Inc. (STLN) SEC Filings & Earnings Calls

New debt increases financial leverage and interest obligations.

“Credit agreement entered into; terms not disclosed in excerpt.”

Dependence on capitated contract ramp and network expansion

“The increase in capitated revenue was driven by momentum in new markets in addition to the impact of our investments in referral relationship management and our ramp up in new capitated contracts.” · word for word

Fee-for-service revenue decline

“Partially offset by a 17% and 13% decrease, respectively in fee-for-service revenue for the prior year three and six month periods.” · word for word

Dependence on capitated contract wins and ramp; execution risk in onboarding Florida delegated lives

“as the Company onboards and ramps our Florida delegated lives” · word for word

Tariff and exchange rate risks could negatively impact global market assumptions

“would likely be negatively impacted if recent tariff rate increases and exchange rate changes persist” · word for word

Refinancing reduces near-term debt maturity risk but adds new secured debt obligation.

“New $75M term loan with OrbiMed replaces $86M convertible note, extending maturity to 2031.”

Activist investor exit

“The Reporting Persons ceased to beneficially own five percent or more of the Common Stock upon completion of the sale on May 14, 2026 described above.” · word for word

Activist investor exit

“The Reporting Persons ceased to beneficially own five percent or more of the Common Stock upon completion of the sale on May 14, 2026 described above.” · word for word

Dependence on value-based care contracts

“Capitation revenue is subject to membership fluctuations and contract renewals; a 54% increase in capitated revenue indicates concentration risk.”

Specialty pharmacy margin pressure

“Average revenue per fill decreased 12.4% while cost per fill decreased 12.5%, indicating potential pricing pressure from PBMs.”

Clinical trials segment restructuring

“Clinical trials revenue declined 60.2% due to profit sharing agreement with Helios CR, Inc., reducing direct revenue contribution.”

Operating losses persist

“Company continues to report operating losses (-4.4% margin) and negative adjusted EBITDA (-$2.4M).”

Continued net loss despite improvement; adjusted EBITDA still negative

“Net loss of $2.5 million; Adjusted EBITDA of $(2.4) million”

Free Cash Flow guidance raised but still wide range; uncertainty in achieving profitability

“Free Cash Flow guidance raised to $5 to $15 million from $(15) to $5 million; Adjusted EBITDA guidance unchanged $0 to $9 million”

Tariff and macroeconomic risks cited in outlook

“Outlook assumes a largely stable global market, which would likely be negatively impacted if recent tariff rate increases and exchange rate changes persist” · word for word

Debt covenant and refinancing risk

“The Facility Agreement contains various covenants, including a requirement to maintain a minimum revenue of $100,000,000 for each fiscal quarter ending during the fiscal year 2026.” · word for word

Geopolitical risk from Iran conflict

“Following the February and March 2026 missile strikes in Iran, there has been increased instability, including airspace closures in the Middle East, damage to airports and the de facto closure of Strait of Hormuz.” · word for word

Dilution risk from warrants

“As of December 31, 2025, there were 2,187,283 private placement warrants from the Business Combination outstanding and there were 8,216,918 Common Warrants outstanding from the Company’s 2025 Private Placement.” · word for word

Seasonality and reimbursement lag in Q1; Adj. EBITDA expected negative -$1 to -$3M.

“the Company anticipates first quarter Adjusted EBITDA to be between $(1) million and $(3) million due to seasonality with patients' deductibles reset and annual drug pricing increases that are not immediately reflected in reimbursement rates.” · word for word

Tariff and exchange rate risks could impact global market stability and company outlook.

“TOI's outlook assumes a largely stable global market, which would likely be negatively impacted if recent tariff rate increases and exchange rate changes persist and adversely affect world trade.” · word for word

Profitability from newly onboarded delegated contracts may take time to materialize.

“Profitability from newly onboarded delegated contracts to build progressively over the course of the year, with more fully realized economics in 2027.” · word for word

Cybersecurity incident risk from software provider.

“Impact of a cybersecurity incident affecting a software provider on TOI's business.” · word for word

Competitive and regulatory risks in healthcare.

“Changes in patient or payors' preferences, prospects and competitive conditions.”

Dispensary pricing pressure

“Average revenue per fill decreased 20.4% in Q3 2025 vs Q3 2024.”

Clinical trials revenue decline

“Clinical trials revenue decreased 75.6% in Q3 2025 vs Q3 2024 due to profit sharing arrangement.”

Derivative liability volatility

“Change in fair value of conversion option derivative liabilities increased $5,977 in Q3 2025 due to stock price increase.” · word for word

Net loss remains high at $16.5M, though stable YoY.

“Net loss of $16.5 million compared to net loss of $16.1 million.” · word for word