Exelixis: A Modest Proposal for Curing Cancer (and Profiting)

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Exelixis. The name itself sounds like a particularly potent magical incantation, doesn’t it?1 It’s a company with ambitions, and let’s be frank, ambition in the pharmaceutical industry is usually a good sign…for shareholders, at least. They’ve declared their intention to become a ‘top five solid tumor oncology company,’ which is a bit like a gnome announcing his intention to become King of the Dwarves. Bold, certainly. Achievable? Well, that depends on a lot of things, mostly involving molecules, money, and the sheer obstinacy of cancer cells.

They currently possess a rather lucrative potion – cabozantinib – that’s funding a pipeline of, shall we say, experimental concoctions. Shares have been doing rather well, up over 20% in the last year and a frankly alarming 97% over five. This isn’t just luck; it’s a sign that someone, somewhere, is doing something right. Or at least, something that convinces other someones to part with their money.

Here are three reasons why this particular alchemical enterprise might continue to yield returns. Though, let’s be clear, investment is never a guarantee. Unless you’re a dragon. Dragons are quite good at guarantees.

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1. Cabozantinib: The Potion That Keeps on Giving

Cabozantinib, sold under the rather grand names of Cabometyx and Cometriq, is the current star of the Exelixis show. It’s proving effective against kidney cancer, thyroid cancer, liver cancer, and even those particularly nasty pancreatic neuroendocrine tumors. It’s a bit like a universal solvent, dissolving cancerous growths with alarming efficiency.2 The capsule form, Cometriq, is reserved for a particularly aggressive strain of thyroid cancer, which is always unpleasant.

Currently, they’re testing it on advanced neuroendocrine tumors of the lung, thymus, and gastrointestinal tract. One suspects the tumors aren’t thrilled about this. Exelixis has managed to ward off generic competition until around 2031, a victory secured in a lawsuit against MSN Pharmaceuticals. It’s good to see someone defending intellectual property, even if it’s for a potion that costs a king’s ransom.

In 2025, revenue rose 7% to $2.3 billion, mostly from cabozantinib. Earnings per share jumped 57.9% to $2.78. They’re also engaging in a $750 million stock repurchase program, which is a polite way of saying they’re buying back shares to artificially inflate the price. It’s a time-honored tradition, really.

2. Zanzalintinib: The Next Generation Potion

On February 2nd, the FDA approved a New Drug Application for zanzalintinib, to be used in combination with atezolizumab for metastatic colorectal cancer. It’s a hopeful sign, though one always wonders what the FDA actually approves. They’re expected to make a decision on its wider application by December 3rd.3

Zanzalintinib is currently undergoing four phase 3 trials for various cancers and is being examined in three early-stage trials. It’s a versatile potion, it seems. Exelixis is also experimenting with antibody-drug conjugates, which combine antibodies that seek out cancer cells with a drug that destroys them. It’s a bit like sending in a guided missile, only with less collateral damage…hopefully.

3. Exelixis: The Art of Collaboration (and Profit Sharing)

Exelixis isn’t trying to do everything itself, which is sensible. They’ve formed partnerships with Takeda Pharmaceutical and Ipsen to sell cabozantinib in Japan. It’s a mutually beneficial arrangement, of course. Exelixis gets access to a new market, and Takeda and Ipsen get a share of the profits.

Recently, they announced an agreement with Natera. Natera’s Signatera assay will be used to identify colorectal cancer patients with minimal residual disease, who will then be enrolled in a phase 3 trial for zanzalintinib. It’s a clever way to target the trial, and it also benefits Natera, who get to showcase their technology. It’s a win-win, as they say, though someone is always winning a little more.

Exelixis is also collaborating with Merck on a trial of zanzalintinib in combination with Keytruda for head and neck cancer, and with Welireg for kidney cancer. It’s a network of partnerships, all designed to maximize profits and, hopefully, cure cancer. Though, let’s be honest, the profits are usually the primary motivation.

1 Derived, naturally, from the ancient Elixir of Life, but with a slightly more modern, pharmaceutical ring to it.

2 Side effects may include spontaneous combustion, an uncontrollable urge to collect porcelain gnomes, and a temporary inability to distinguish between reality and a particularly vivid dream.

3 The FDA’s decision-making process is shrouded in mystery, rumored to involve a panel of highly trained hamsters and a complex algorithm based on the alignment of the planets.

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2026-02-28 12:42