Starling Oncology (STLN) Q2 2026 earnings summary

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.