CYTOKINETICS INC, 10-Q filed on 11/5/2025
Quarterly Report
v3.25.3
Document and Entity Information - shares
 9 Months Ended
Sep. 30, 2025
Nov. 03, 2025
Cover [Abstract]    
Document Type 10-Q  
Amendment Flag false  
Document Period End Date Sep. 30, 2025  
Document Fiscal Year Focus 2025  
Document Fiscal Period Focus Q3  
Trading Symbol CYTK  
Entity Registrant Name CYTOKINETICS, INCORPORATED  
Entity Central Index Key 0001061983  
Current Fiscal Year End Date --12-31  
Entity Current Reporting Status Yes  
Entity Interactive Data Current Yes  
Entity Filer Category Large Accelerated Filer  
Entity Shell Company false  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity File Number 000-50633  
Entity Incorporation, State or Country Code DE  
Entity Tax Identification Number 94-3291317  
Entity Address, Address Line One 350 Oyster Point Blvd  
Entity Address, City or Town South San Francisco  
Entity Address, State or Province CA  
Entity Address, Postal Zip Code 94080  
City Area Code 650  
Local Phone Number 624-3000  
Entity Common Stock, Shares Outstanding   122,264,929
Title of 12(b) Security Common Stock, $0.001 par value  
Security Exchange Name NASDAQ  
Document Quarterly Report true  
Document Transition Report false  
v3.25.3
Condensed Consolidated Balance Sheets (Unaudited) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Current assets:    
Cash and cash equivalents $ 225,467 $ 94,857
Short-term investments 737,068 981,157
Accounts receivable 1,808 16,650
Prepaid expenses and other current assets 13,006 15,276
Total current assets 977,349 1,107,940
Long-term investments 288,817 145,055
Property and equipment, net 76,001 65,815
Operating lease right-of-use assets 77,580 75,158
Other assets 16,810 7,705
Total assets 1,436,557 1,401,673
Current liabilities:    
Accounts payable 22,084 20,369
Accrued liabilities 61,633 55,323
Short-term operating lease liabilities 20,647 18,978
Current portion of long-term debt 17,280 11,520
Derivative liabilities measured at fair value 16,900 11,300
Deferred revenue 1,612 52,370
Other current liabilities 1,988 9,814
Total current liabilities 142,144 179,674
Term loans, net 158,747 93,227
Convertible notes, net 889,524 552,370
Liabilities related to revenue participation right purchase agreements, net 504,498 462,192
Long-term operating lease liabilities 110,655 112,582
Liabilities related to RPI Transactions measured at fair value 150,500 137,000
Other non-current liabilities 1,612 0
Total liabilities 1,957,680 1,537,045
Commitments and contingencies
Stockholders' deficit    
Preferred stock 0 0
Common stock 122 118
Additional paid-in capital 2,782,409 2,563,876
Accumulated other comprehensive income 34 2,398
Accumulated deficit (3,303,688) (2,701,764)
Total stockholders' deficit (521,123) (135,372)
Total liabilities and stockholders' deficit $ 1,436,557 $ 1,401,673
v3.25.3
Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Revenues:        
Revenues $ 1,936 $ 463 $ 70,284 $ 1,547
Operating expenses:        
Research and development 99,233 84,612 311,628 245,779
General and administrative 69,458 56,652 192,548 152,976
Total operating expenses 168,691 141,264 504,176 398,755
Operating loss (166,755) (140,801) (433,892) (397,208)
Interest expense (11,353) (8,928) (31,305) (28,763)
Non-cash interest expense on liabilities related to revenue participation right purchase agreements (14,969) (13,370) (42,228) (35,155)
Interest and other income, net 10,248 17,054 36,950 36,520
Change in fair value of derivative liabilities 700 700 3,300 100
Change in fair value of liabilities related to RPI Transactions (2,800) (15,200) (13,500) (15,000)
Debt conversion expense (121,249) 0 (121,249) 0
Net loss $ (306,178) $ (160,545) $ (601,924) $ (439,506)
Net loss per share - basic $ (2.55) $ (1.36) $ (5.04) $ (4)
Net loss per share - diluted $ (2.55) $ (1.36) $ (5.04) $ (4)
Weighted-average number of shares used in computing net loss per share - basic 119,982 117,685 119,317 109,932
Weighted-average number of shares used in computing net loss per share - diluted 119,982 117,685 119,317 109,932
Other comprehensive (loss) gain:        
Unrealized gain (loss) on available-for-sale securities, net $ 167 $ 6,535 $ (1,225) $ 5,480
Foreign currency translation adjustments 25 (126) (1,139) (83)
Comprehensive loss (305,986) (154,136) (604,288) (434,109)
Collaboration Revenues [Member]        
Revenues:        
Revenues 1,936 463 5,931 1,547
License and Milestone Revenues [Member]        
Revenues:        
Revenues $ 0 $ 0 $ 64,353 $ 0
v3.25.3
Condensed Consolidated Statements of Stockholders' (Deficit) Equity (Unaudited) - USD ($)
$ in Thousands
Total
At The Market Offering [Member]
Public Offering [Member]
Common Stock [Member]
Common Stock [Member]
At The Market Offering [Member]
Common Stock [Member]
Public Offering [Member]
Additional Paid-in Capital [Member]
Additional Paid-in Capital [Member]
At The Market Offering [Member]
Additional Paid-in Capital [Member]
Public Offering [Member]
Accumulated Other Comprehensive Income (Loss) [Member]
Accumulated Deficit [Member]
Beginning Balance at Dec. 31, 2023 $ (386,323)     $ 102     $ 1,725,823     $ (10) $ (2,112,238)
Beginning Balance, shares at Dec. 31, 2023       101,637,922              
Exercise of stock options, value 29,532     $ 2     29,530        
Exercise of stock options, shares       1,466,359              
Vesting of restricted stock units, shares       695,140              
Shares withheld related to net share settlement of equity awards, value (18,449)           (18,449)        
Shares withheld related to net share settlement of equity awards, shares       (274,256)              
Issuance of common stock, net of issuance costs, value   $ 93,640     $ 1            
Issuance of common stock, net of issuance costs, shares         1,237,460     93,639      
Exercise of warrants, net, share       11,335              
Stock-based compensation 21,612           21,612        
Unrealized loss on available-for-sale securities, net (556)                 (556)  
Foreign currency translation adjustments 27                 27  
Net loss (135,643)                   (135,643)
Ending Balance at Mar. 31, 2024 (396,160)     $ 105     1,852,155     (539) (2,247,881)
Ending Balance, shares at Mar. 31, 2024       104,773,960              
Beginning Balance at Dec. 31, 2023 (386,323)     $ 102     1,725,823     (10) (2,112,238)
Beginning Balance, shares at Dec. 31, 2023       101,637,922              
Unrealized loss on available-for-sale securities, net 5,480                    
Foreign currency translation adjustments (83)                    
Net loss (439,506)                    
Ending Balance at Sep. 30, 2024 (13,911)     $ 118     2,532,328     5,387 (2,551,744)
Ending Balance, shares at Sep. 30, 2024       117,888,619              
Beginning Balance at Mar. 31, 2024 (396,160)     $ 105     1,852,155     (539) (2,247,881)
Beginning Balance, shares at Mar. 31, 2024       104,773,960              
Exercise of stock options, value 8,007           8,007        
Exercise of stock options, shares       356,281              
Vesting of restricted stock units, shares       46,034              
Issuance of common stock, net of issuance costs, value     $ 563,204     $ 11     $ 563,193    
Issuance of common stock, net of issuance costs, shares           11,274,510          
Issuance of common stock upon private placement, shares       980,392              
Issuance of common stock upon private placement, value 50,000     $ 1     49,999        
Issuance of common stock under Employee Stock Purchase Plan, shares       93,857              
Issuance of common stock under Employee Stock Purchase Plan, value 2,678           2,678        
Stock-based compensation 24,622           24,622        
Unrealized loss on available-for-sale securities, net (499)                 (499)  
Foreign currency translation adjustments 16                 16  
Net loss (143,318)                   (143,318)
Ending Balance at Jun. 30, 2024 108,550     $ 117     2,500,654     (1,022) (2,391,199)
Ending Balance, shares at Jun. 30, 2024       117,525,034              
Exercise of stock options, value 6,319     $ 1     6,318        
Exercise of stock options, shares       362,431              
Vesting of restricted stock units, shares       1,154              
Stock-based compensation 25,356           25,356        
Unrealized loss on available-for-sale securities, net 6,535                 6,535  
Foreign currency translation adjustments (126)                 (126)  
Net loss (160,545)                   (160,545)
Ending Balance at Sep. 30, 2024 (13,911)     $ 118     2,532,328     5,387 (2,551,744)
Ending Balance, shares at Sep. 30, 2024       117,888,619              
Beginning Balance at Dec. 31, 2024 (135,372)     $ 118     2,563,876     2,398 (2,701,764)
Beginning Balance, shares at Dec. 31, 2024       118,209,139              
Exercise of stock options, value 7,651           7,651        
Exercise of stock options, shares       351,985              
Vesting of restricted stock units, net of taxes withheld, value (12)     $ 1     (13)        
Vesting of restricted stock units, net of taxes withheld, shares       659,179              
Stock-based compensation 23,549           23,549        
Unrealized loss on available-for-sale securities, net (541)                 (541)  
Foreign currency translation adjustments (312)                 (312)  
Net loss (161,376)                   (161,376)
Ending Balance at Mar. 31, 2025 (266,413)     $ 119     2,595,063     1,545 (2,863,140)
Ending Balance, shares at Mar. 31, 2025       119,220,303              
Beginning Balance at Dec. 31, 2024 (135,372)     $ 118     2,563,876     2,398 (2,701,764)
Beginning Balance, shares at Dec. 31, 2024       118,209,139              
Unrealized loss on available-for-sale securities, net (1,225)                    
Foreign currency translation adjustments (1,139)                    
Net loss (601,924)                    
Ending Balance at Sep. 30, 2025 (521,123)     $ 122     2,782,409     34 (3,303,688)
Ending Balance, shares at Sep. 30, 2025       122,119,460              
Beginning Balance at Mar. 31, 2025 (266,413)     $ 119     2,595,063     1,545 (2,863,140)
Beginning Balance, shares at Mar. 31, 2025       119,220,303              
Exercise of stock options, value 3,868           3,868        
Exercise of stock options, shares       219,077              
Vesting of restricted stock units, shares       70,686              
Shares withheld related to net share settlement of equity awards, value (514)           (514)        
Shares withheld related to net share settlement of equity awards, shares       (15,630)              
Issuance of common stock under Employee Stock Purchase Plan, shares       109,116              
Issuance of common stock under Employee Stock Purchase Plan, value 2,877           2,877        
Stock-based compensation 27,535           27,535        
Unrealized loss on available-for-sale securities, net (851)                 (851)  
Foreign currency translation adjustments (852)                 (852)  
Net loss (134,370)                   (134,370)
Ending Balance at Jun. 30, 2025 (368,720)     $ 119     2,628,829     (158) (2,997,510)
Ending Balance, shares at Jun. 30, 2025       119,603,552              
Exercise of stock options, value 6,935     $ 1     6,934        
Exercise of stock options, shares       321,536              
Vesting of restricted stock units, net of taxes withheld, shares       38,684              
Shares withheld related to net share settlement of equity awards, value (720)           (720)        
Shares withheld related to net share settlement of equity awards, shares       (13,118)              
Induced conversion of convertible notes, shares       2,168,806              
Induced conversion of convertible notes 116,672     $ 2     116,670        
Stock-based compensation 30,696           30,696        
Unrealized loss on available-for-sale securities, net 167                 167  
Foreign currency translation adjustments 25                 25  
Net loss (306,178)                   (306,178)
Ending Balance at Sep. 30, 2025 $ (521,123)     $ 122     $ 2,782,409     $ 34 $ (3,303,688)
Ending Balance, shares at Sep. 30, 2025       122,119,460              
v3.25.3
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash flows from operating activities:    
Net loss $ (601,924) $ (439,506)
Adjustments to reconcile net loss to net cash used in operating activities:    
Non-cash interest expense on liabilities related to revenue participation right purchase agreements 42,306 35,233
Stock-based compensation expense 81,780 71,590
Non-cash lease expense 4,038 3,152
Depreciation of property and equipment 7,264 7,148
Change in fair value of derivative liabilities (3,300) (100)
Change in fair value of liabilities related to RPI Transactions 13,500 15,000
Realized gain on investment, net (17) 0
Interest receivable and amortization on investments (12,902) (24,814)
Non-cash interest expense related to debt 14,431 8,027
Debt conversion expense 121,249 0
Changes in operating assets and liabilities:    
Accounts receivable 14,842 1,039
Prepaid and other assets 1,264 6,006
Accounts payable 2,972 (10,388)
Deferred revenue (50,758) 0
Accrued and other liabilities 7,235 4,105
Operating lease liabilities (6,616) (5,219)
Other non-current liabilities (2,722) (1,593)
Net cash used in operating activities (367,358) (330,320)
Cash flows from investing activities:    
Purchases of investments (717,523) (1,172,291)
Investment in non-marketable equity security (5,000) 0
Maturities of investments 823,551 510,947
Sales of investments 5,993 0
Purchases of property and equipment (19,163) (2,616)
Net cash provided by (used in) investing activities 87,858 (663,960)
Cash flows from financing activities:    
Repayment of finance lease liabilities (204) (696)
Repayment of term loans (8,087) (6,008)
Repayment of convertible debt (402,500)  
Proceeds from issuance of convertible debt, net 729,460  
Proceeds from RPI Transactions 75,000 200,000
Proceeds from issuance of common stock related to private placement, net of issuance costs 0 50,000
Proceeds from issuance of common stock under equity incentive and stock purchase plans 21,331 46,536
Taxes paid related to net share settlement of equity awards (1,247) (18,449)
Net cash provided by financing activities 413,753 928,227
Effect of exchange rate changes on cash (906) (83)
Net (decrease) increase in cash, cash equivalents, and restricted cash 133,347 (66,136)
Cash, cash equivalents, and restricted cash, beginning of period 95,232 113,399
Cash, cash equivalents, and restricted cash, end of period 228,579 47,263
Supplemental cash flow disclosures:    
Cash paid for interest 19,874 25,334
Non-cash investing and financing activities:    
Right-of-use assets recognized in exchange for operating lease obligations 6,427 509
Amounts unpaid for purchases of property and equipment 2,088 462
Issuance of common stock in connection with repurchase of convertible note 107,920 0
At The Market Offering [Member]    
Cash flows from financing activities:    
Proceeds from issuance of common stock related to at-the-market offering, net of issuance costs 0 93,640
Public Offering [Member]    
Cash flows from financing activities:    
Proceeds from issuance of common stock related to at-the-market offering, net of issuance costs $ 0 $ 563,204
v3.25.3
Pay vs Performance Disclosure - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Jun. 30, 2025
Mar. 31, 2025
Sep. 30, 2024
Jun. 30, 2024
Mar. 31, 2024
Sep. 30, 2025
Sep. 30, 2024
Pay vs Performance Disclosure                
Net Income (Loss) $ (306,178) $ (134,370) $ (161,376) $ (160,545) $ (143,318) $ (135,643) $ (601,924) $ (439,506)
v3.25.3
Insider Trading Arrangements
 3 Months Ended
Sep. 30, 2025
shares
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement

The following directors and officers adopted into or terminated a Rule 10b5-1 trading arrangement during the second quarter of 2025:

•
Andrew Callos – Mr. Callos terminated an existing 10b5-1 trading arrangement, which had been adopted on December 12, 2024, on September 2, 2025. Mr. Callos adopted a new Rule 10b5-1 trading arrangement on September 5, 2025 that was intended to satisfy the affirmative defense provided for under Rule 10b5-1(c) (the “Callos Plan”). The Callos Plan provides for the sale of up to 219,833 shares of our common stock at pre-specified dates during the term of the plan. The Callos Plan will terminate on the earlier of (x) December 1, 2026 and (y) the sale of all securities that are subject to the plan.
•
John T. Henderson – Dr. Henderson adopted a Rule 10b5-1 trading arrangement on September 2, 2025 that was intended to satisfy the affirmative defense provided for under Rule 10b5-1(c) (the “Henderson Plan”). The Henderson Plan provides for the sale of up to 28,750 shares of our common stock. The Henderson Plan will terminate on the earlier of (x) May 18, 2026 and (y) the sale of all securities that are subject to the plan.
•
B. Lynne Parshall – Ms. Parshall adopted a Rule 10b5-1 trading arrangement on August 20, 2025 that was intended to satisfy the affirmative defense provided for under Rule 10b5-1(c) (the “Parshall Plan”). The Parshall Plan provides for the sale of up to 20,000 shares of our common stock. The Parshall Plan will terminate on the earlier of (x) September 3, 2026 and (y) the sale of all securities that are subject to the plan.

Certain of our officers have made elections to participate in, and are participating in, our employee stock purchase plan, which may be designed to satisfy the affirmative defense conditions of Rule 10b5-1 under the Exchange Act or may constitute non-Rule 10b5–1 trading arrangements. In addition, certain of our directors have made elections to participate in, and are participating in, our director equity in lieu of cash retainer option program (as described in the “Director Compensation” section of our Proxy Statement for our 2024 Annual Meeting), which may be designed to satisfy the affirmative defense conditions of Rule 10b5-1 under the Exchange Act or may constitute non-Rule 10b5–1 trading arrangements.
Andrew Callos [Member]  
Trading Arrangements, by Individual  
Name Andrew Callos
Rule 10b5-1 Arrangement Adopted true
Adoption Date September 5, 2025
Rule 10b5-1 Arrangement Terminated false
Expiration Date December 1, 2026
Arrangement Duration 456 days
Aggregate Available 219,833
John T. Henderson [Member]  
Trading Arrangements, by Individual  
Name John T. Henderson
Rule 10b5-1 Arrangement Adopted true
Adoption Date September 2, 2025
Rule 10b5-1 Arrangement Terminated false
Expiration Date May 18, 2026
Arrangement Duration 207 days
Aggregate Available 28,750
B. Lynne Parshall [Member]  
Trading Arrangements, by Individual  
Name B. Lynne Parshall
Rule 10b5-1 Arrangement Adopted true
Adoption Date August 20, 2025
Rule 10b5-1 Arrangement Terminated false
Expiration Date September 3, 2026
Arrangement Duration 380 days
Aggregate Available 20,000
v3.25.3
Organization and Significant Accounting Policies
 9 Months Ended
Sep. 30, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization and Significant Accounting Policies

Note 1 — Organization and Significant Accounting Policies

Cytokinetics, Incorporated was incorporated under the laws of the state of Delaware on August 5, 1997. We are a late-stage biopharmaceutical company focused on the discovery and development of novel small molecule therapeutics that modulate muscle function for the potential treatment of serious diseases and medical conditions.

Our financial statements contemplate the conduct of our operations in the normal course of business. We have incurred an accumulated deficit of approximately $3.3 billion since inception and there can be no assurance that we will attain profitability. We had a net loss of $601.9 million and net cash used in operations of $367.4 million for the nine months ended September 30, 2025. Cash, cash equivalents, and investments was $1.3 billion as of September 30, 2025. We anticipate that we will have operating losses and net cash outflows in future periods.

We are subject to risks common to late-stage biopharmaceutical companies including, but not limited to, development of new drug candidates, dependence on key personnel, and the ability to obtain additional capital as needed to fund our future plans. Our liquidity will be impaired if sufficient additional capital is not available on terms acceptable to us. To date, we have funded operations primarily through sales of our common stock, contract payments under our collaboration agreements, sales of future revenues and royalties, debt financing arrangements, and interest income. Until we achieve profitable operations, we intend to continue to fund operations through payments from strategic collaborations, additional sales of equity securities, grants and debt financings. We have never generated revenues from commercial sales of our drugs. The earliest we might reasonably expect to commence commercial sales and record revenues is following the PDUFA target action date of December 26, 2025 for the NDA for aficamten in oHCM.

Our success is dependent on our ability to obtain additional capital by entering into financings or new strategic collaborations, and ultimately on our and our collaborators’ ability to successfully develop and market one or more of our drug candidates. We cannot be certain that sufficient funds will be available from financings or such collaborators when needed or on satisfactory terms. Additionally, there can be no assurance that any of our drug candidates will be accepted in the marketplace or that any future products can be developed or manufactured at an acceptable cost. These factors could have a material adverse effect on our future financial results, financial position and cash flows.

Based on the current status of our research and development and pre-launch activities, we believe that our existing cash, cash equivalents and investments will be sufficient to fund cash requirements for at least the next 12 months after the issuance of this Quarterly Report on Form 10-Q. If, at any time, our prospects for financing our research and development programs decline, we may decide to reduce research and development expenses by delaying, discontinuing or reducing our funding of one or more of our research or development programs. Alternatively, we might raise funds through strategic collaborations, public or private financings or other arrangements. Such funding, if needed, may not be available on favorable terms, or at all. The financial statements do not include any adjustments that might result from the outcome of this uncertainty.

Basis of Presentation

Our condensed consolidated financial statements include the accounts of Cytokinetics and our wholly-owned subsidiaries. The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with GAAP for interim financial information and the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. The financial statements include all adjustments (consisting only of normal recurring adjustments) that management believes are necessary for the fair statement of our financial information. These interim results are not necessarily indicative of results to be expected for the full fiscal year or any future interim period. The balance sheet as of December 31, 2024 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by GAAP for complete financial statements. The interim condensed financial statements should be read in conjunction with the audited financial statements and notes thereto contained in the Company’s Form 10-K for the year ended December 31, 2024, as filed with the Securities and Exchange Commission.

Use of Estimates

The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting periods. We evaluate our estimates on an ongoing basis. We base our estimates on our historical experience and also on assumptions that we believe are reasonable; however, actual results could significantly differ from those estimates.

Investment in non-marketable equity security

During the first quarter of 2025, we made an equity investment of $5.0 million that does not have a readily determinable fair value. We have elected the measurement alternative under which we measure the investment at cost, less any impairment. If we observe price changes in orderly transactions for identical or similar securities of the same issuer, we will remeasure the investment at fair value as of the date of the observable transaction. As of September 30, 2025, the investment has a carrying value of $5.0 million and is classified as “Other assets” on the condensed consolidated balance sheet.

Segment Information

We have one primary business activity and operate in one reportable segment.

Our chief operating decision maker (“CODM”) is our Chief Executive Officer ("CEO") who evaluates performance and makes operating decisions about allocating resources based on financial data presented on a consolidated basis. The measures of profitability and the significant segment expenses reviewed by the CODM are consistent with these financial statements and footnotes.
v3.25.3
Net Loss Per Share
 9 Months Ended
Sep. 30, 2025
Earnings Per Share [Abstract]  
Net Loss Per Share

Note 2 — Net Loss Per Share

The following instruments were excluded from the computation of diluted net loss per share for the periods presented because their effect would have been antidilutive (in thousands):

 

 

September 30, 2025

 

 

September 30, 2024

 

Options to purchase common stock

 

 

11,442

 

 

 

10,566

 

Restricted stock and performance units

 

 

2,544

 

 

 

1,998

 

Shares issuable related to the ESPP

 

 

87

 

 

 

45

 

Shares issuable upon conversion of 2026 Notes

 

 

2,003

 

 

 

2,003

 

Shares issuable upon conversion of 2027 Notes

 

 

2,751

 

 

 

10,572

 

Shares issuable upon conversion of 2031 Notes

 

 

10,962

 

 

 

—

 

Total shares

 

 

29,789

 

 

 

25,184

 
v3.25.3
Agreements with Royalty Pharma
 9 Months Ended
Sep. 30, 2025
Agreements with Royalty Pharma [Abstract]  
Agreements with Royalty Pharma

Note 3 — Agreements with Royalty Pharma

On January 7, 2022, we announced that we had entered into the 2022 RPI Transactions with affiliates of Royalty Pharma International plc.

Pursuant to the 2022 RPI Transactions, the RP Multi Tranche Loan Agreement and the RP Aficamten RPA described below, are determined to be debt instruments subsequently measured at amortized cost and were entered into with parties that were at the time of our entry into the 2022 RPI Transactions affiliated and in contemplation of one another. We used the relative fair value method and made separate estimates of the fair value of each freestanding financial instrument and then allocated the proceeds in proportion to those fair value amounts. Arrangement consideration for the RP Multi Tranche Loan Agreement and the RP Aficamten RPA totaled $150 million, consisting of the two $50 million up front payments for the signing of the RP Multi Tranche Loan Agreement and the RP Aficamten RPA and milestone of $50 million for initiation of the first pivotal trial in oHCM for aficamten that was deemed probable at the signing of the agreements.

On May 22, 2024, we announced that we had entered into the 2024 RPI Transactions with affiliates of Royalty Pharma International plc, which included an amendment to the RP Aficamten RPA, a component of the 2022 RPI Transactions. The 2024 RPI Transactions include the 2024 RP OM Loan Agreement, the RP Ulacamten RPA, the RP Stock Purchase Agreement, the RP Multi Tranche Loan Agreement Amendment and the RP Aficamten RPA Amendment, as described below, are accounted for as a debt modification of the 2022 RPI Transactions.

The 2024 RPI Transactions consideration of $200.0 million received was allocated as follows (in thousands):

 

 

Allocation

 

Units of Accounting:

 

 

 

RP Aficamten RPA

 

$

33,300

 

Tranche 6 of RP Multi Tranche Loan Agreement

 

 

41,200

 

Tranche 6 of RP Multi Tranche Loan Agreement - Embedded Derivatives

 

 

4,400

 

Tranche 4 of RP Multi Tranche Loan Agreement - Embedded Derivatives

 

 

3,700

 

Ulacamten RPA

 

 

12,700

 

RP OM Loan Agreement

 

 

104,700

 

Total consideration

 

$

200,000

 

Liabilities Related to RPI Transactions Measured at Fair Value

As permitted under ASC 825, we elected the fair value option for recognizing the liabilities related to the 2024 RP OM Loan Agreement and the RP Ulacamten RPA. The fair value option was elected because these liabilities included embedded derivatives which would have otherwise required separate recognition and measurement. The Company elected the fair value option as it is believed to be more practical for each liability as a single unit of account at fair value. Under the fair value option, debt issuance costs are expensed as incurred and the Company is required to record the fair value option elected arrangements at their fair value on the date of issuance and at each balance sheet thereafter. Changes in the estimated fair value of the arrangements are recognized as changes in fair value of liabilities related to RPI Transactions in the condensed consolidated statement of operations and comprehensive loss.

RP OM Loan

The RP OM Loan Agreement provides for a loan in a principal amount of $100.0 million that was drawn at the closing.

The loan under the RP OM Loan Agreement matures on the 10 year anniversary of the funding date and is repayable in quarterly installments as follows:

•
Scenario 1: If the Phase 3 clinical trial of Cytokinetics’ proprietary small molecule cardiac myosin activator known as omecamtiv mecarbil is successful (defined as meeting the composite primary endpoint of the first event, whichever occurs first, comprising of cardiovascular death, heart failure event, LVAD implementation/cardiac transplantation, or stroke, with a hazard ratio (HR) of less than 0.85 and cardiovascular death endpoint HR of less than 1.0) by June 30, 2028 and we receive the marketing approval from the FDA for omecamtiv mecarbil on or prior to December 31, 2029 (“OM Approval Date”), commencing on the calendar quarter during which the FDA approval is obtained, we are required to pay RPDF (x) (i) $75.0 million ten business days after the OM Approval Date and (ii) $25.0 million on the first anniversary of the OM Approval Date and (y) on a quarterly basis an amount equal to 2.0% of the annual worldwide net sales of omecamtiv mecarbil, subject to a minimum floor amount ranging from $5.0 million to $8.0 million during the first 18 calendar quarters (the payment of the 2.0% of the annual worldwide net sales starting from the 19th calendar quarter shall be referred to as the “Royalty Payment”). Our obligation to pay the Royalty Payment will continue after maturity of the Loan;
•
Scenario 2: If the Phase 3 clinical trial of omecamtiv mecarbil is successful by June 30, 2028 but we have not received the marketing approval from the FDA for omecamtiv mecarbil on or prior to December 31, 2029, we are required to pay RPDF 18 equal quarterly cash payments totaling 237.5% of the principal amount of the loan commencing on March 31, 2030; and
•
Scenario 3: If the Phase 3 clinical trial of omecamtiv mecarbil is not successful by June 30, 2028, we are required to pay RPDF 22 equal quarterly cash payments totaling 227.5% of the principal amount of the loan commencing on September 30, 2028;

(the aggregate amount to be paid by us with respect to each scenario is referred to as the “Scheduled Payment Amount”).

The interest of the loan is included in the Scheduled Payment Amount for each scenario. In each scenario, we may prepay the loan in full (but not in part) at any time at its option by paying an amount equal to the unpaid portion of Scheduled Payment Amount for the outstanding loan; provided that, in scenario 1, we would be required to continue to pay the Royalty Payment after such prepayment.

In addition, upon the occurrence of a change of control of the Company, the loan is repayable in full at the option of either the Company or the lender in an amount equal to (x) depending on when such change of control occurs, 150.0% to 237.5% of the principal amount of the loan minus (y) the then paid Scheduled Payment Amount. The RP OM Loan Agreement contains customary representations and warranties and customary affirmative and negative covenants applicable to the Company and its subsidiaries, including, among other things, restrictions on dispositions, mergers, indebtedness, encumbrances, distributions, stock repurchases, investments and transactions with affiliates.

The RP OM Loan Agreement also includes customary events of default, including but not limited to the nonpayment of principal or interest, violations of covenants, material adverse changes, attachment, levy, restraint on business, cross-defaults on material indebtedness, bankruptcy, delisting, material judgments, misrepresentations, governmental approvals, payment defaults under other royalty purchase agreements and development funding agreements with RPDF or RPI ICAV. Upon an event of default or simultaneously with payment in full of the term loans in the RP OM Loan Agreement, the lenders may, among other things, accelerate the loan (with the amount payable between 227.5% and 237.5% of the principal amount (less amounts previously paid) in the case of other events of default).

Upon execution of the RP OM Loan Agreement in the second quarter of 2024, we recorded liabilities of $104.7 million using the probability-weighted expected return method and the fair value inputs are classified as Level 3 in the fair value hierarchy.

The following table demonstrates the future minimum payments for our RP OM Loan under Scenario 3, based on 227.5% of the principal amount with repayment expected to start in 2028 as defined above, as of September 30, 2025 (in thousands):

Years ending December 31:

 

 

 

2025 remainder

 

$

—

 

2026

 

 

—

 

2027

 

 

—

 

2028

 

 

20,682

 

2029

 

 

41,363

 

Thereafter

 

 

165,455

 

Future minimum payments

 

$

227,500

 

The minimum repayment schedule under Scenario 2 would be 237.5% of the principal amount with quarterly payments starting in 2030. The minimum repayment schedule under Scenario 1 would be a total of 124.0% of the principal amount and the royalty payment with quarterly payments starting in 2028. In addition, under Scenario 1 we would be obligated to make the royalty payment each quarter, and such amounts are not determinable at this time.

Ulacamten RPA

Pursuant to the RP Ulacamten RPA, RPI ICAV purchased the right to receive 1% of annual net sales of ulacamten by us, our affiliates or licensees, in exchange for $50 million which was paid up-front.

Following the initiation of the first Phase 3 clinical trial (or the Phase 3 portion of the first Phase 2b/3 clinical trial) in heart failure with preserved ejection fraction in humans for ulacamten, at RPI ICAV’s sole option and discretion, it may invest up to in aggregate $150 million in quarterly payments to fund 50.0% of the research and development cost for a potential Phase 3 clinical trial of ulacamten in exchange for an incremental 3.5% for annual net sales of ulacamten (depending on the aggregate amounts funded by RPI ICAV), subject to reduction in certain circumstances. RPI ICAV will also be entitled to a milestone payment equal to 75% of its aggregate investment in ulacamten upon market approval by the FDA, or if market approval of ulacamten by the European Medicines Agency is obtained prior to market approval by the FDA, a 37.5% milestone payment of its aggregate investment in ulacamten for such obtained approval and an additional 37.5% milestone payment for its aggregate investment in ulacamten upon subsequent market approval by the FDA.

Upon execution of the RP Ulacamten RPA in the second quarter of 2024, we recorded a liability of $12.7 million using a combination of the discounted cash flow method and the probability-weighted expected return method. The fair value inputs are classified as Level 3 in the fair value hierarchy. We account for the RP Ulacamten RPA as a liability because, among other reasons, we have significant continuing involvement in generating the related revenue stream from which the liability will be repaid.

Accounting for RPI Transactions Measured at Fair Value

The fair values of the liabilities for the RP OM Loan Agreement and Ulacamten RPA are based on significant unobservable inputs, including the probability of clinical success and regulatory approval based on historical industry success rates for product development specific to cardiovascular products, the estimated date of a product launch, estimates of pricing, sales ramp, variables for the timing of the related events, probability of change of control, and discount rates (which range from 11% to 17% as of September 30, 2025 and 2024), which are deemed to be Level 3 inputs in the fair value hierarchy. As products containing omecamtiv mecarbil and ulacamten have not yet been commercialized, the estimates are highly subjective. For example, assumed increases in the probability of the clinical success for the omecamtiv mecarbil or ulacamten programs could increase the value of the liabilities. Similarly, assumed decreases in the discount rates used in the fair value measurements could also increase the value of the liabilities at period end.

The Company recorded a loss of $2.8 million and $13.5 million for the three and nine months ended September 30, 2025, respectively, and a loss of $15.2 million and $15.0 million for the three and nine months ended September 30, 2024, respectively, associated with the change in fair value of the liabilities related to 2024 RP OM Loan Agreement and the Ulacamten RPA. The change in the fair value has been recognized in the condensed consolidated statement of operations and comprehensive loss.

The following tables summarize the changes of the fair value of the Ulacamten RPA and RP OM Loan (in thousands):

 

 

2025

 

 

2024

 

 

 

Ulacamten RPA

 

 

RP OM Loan

 

 

Ulacamten RPA

 

 

RP OM Loan

 

Beginning balance, January 1

 

$

14,000

 

 

$

123,000

 

 

$

—

 

 

$

—

 

Change in fair value

 

 

(300

)

 

 

(3,600

)

 

 

—

 

 

 

—

 

Ending balance, March 31

 

 

13,700

 

 

 

119,400

 

 

 

—

 

 

 

—

 

Initial measurement

 

 

—

 

 

 

—

 

 

 

12,700

 

 

 

104,700

 

Change in fair value

 

 

300

 

 

 

14,300

 

 

 

—

 

 

 

(200

)

Ending balance, June 30

 

 

14,000

 

 

 

133,700

 

 

 

12,700

 

 

 

104,500

 

Change in fair value

 

 

—

 

 

 

2,800

 

 

 

1,100

 

 

 

14,100

 

Ending balance, September 30

 

$

14,000

 

 

$

136,500

 

 

$

13,800

 

 

$

118,600

 

Liabilities Related to Revenue Participation Right Purchase Agreements

RP Aficamten Royalty Purchase Agreement

On January 7, 2022, we entered into the RP Aficamten RPA with RPI ICAV, pursuant to which RPI ICAV purchased rights to certain revenue streams from net sales of pharmaceutical products containing aficamten by us, our affiliates and our licensees in exchange for up to $150.0 million in consideration, $50.0 million of which was paid on the closing date, $50.0 million of which was paid to us in March 2022 following the initiation of the first pivotal trial in oHCM for aficamten, and $50.0 million of which was paid to us in September 2023 following the initiation of the first pivotal clinical trial in nHCM for aficamten. The RP Aficamten RPA also provides that the parties will negotiate terms for additional funding if we achieve proof of concept results in certain other indications for aficamten, with a reduction in the applicable royalty if we and RPI ICAV fail to agree on such terms in certain circumstances.

Pursuant to the RP Aficamten RPA, RPI ICAV purchased the right to receive a percentage of net sales equal to 4.5% for annual worldwide net sales of pharmaceutical products containing aficamten up to $1 billion and 3.5% for annual worldwide net sales of pharmaceutical products containing aficamten in excess of $1 billion, subject to reduction in certain circumstances. On May 22, 2024, we entered into the RP Aficamten RPA Amendment to restructure the royalty so that RPI will now be entitled to receive 4.5% of the first $5.0 billion of worldwide annual net sales of aficamten and 1% of any incremental annual worldwide net sales of aficamten by us and our licensees. Our liability to RPI ICAV is referred to as the “RP Aficamten Liability”.

We account for the RP Aficamten Liability as a liability primarily because we have significant continuing involvement in generating the related revenue stream from which the liability will be repaid. If and when aficamten is commercialized and royalties become due, we will recognize the portion of royalties paid to RPI ICAV as a decrease to the RP Aficamten Liability and a corresponding reduction in cash.

The carrying amount of the RP Aficamten Liability is based on our estimate of the future royalties to be paid to RPI ICAV over the life of the arrangement as discounted using an imputed rate of interest. In the second quarter of 2024, we recorded an additional $33.3 million to the carrying value related to the 2024 RPI Transactions entered into May 22, 2024. The imputed rate of interest on the carrying value of the RP Aficamten Liability was approximately 22.1% as of September 30, 2025 and 24.4% as of September 30, 2024.

During the third quarter of 2025, we updated our analyses of the RP Aficamten RPA to reflect our revised assumptions resulting from ongoing global market research and to reflect other adjustments in connection with our anticipated commercialization. Our estimates regarding the amount of future royalty payments under the RP Aficamten RPA changed from the fourth quarter of 2024 due to changes in management’s estimates of unobservable inputs related to market and patient dynamics and timing to include projections of future royalty payments. The adjustment is accounted for on a prospective basis in our liability calculation and resulted in changes in our imputed interest rate. For the three months ended September 30, 2025, the change in estimate increased our non-cash interest expense by $1.0 million and net loss per share by $0.01. For the nine months ended September 30, 2025, the change in estimate increased our non-cash interest expense by $1.0 million and had no material impact on net loss per share.

2017 RP Omecamtiv Mecarbil Royalty Purchase Agreement

In February 2017, we entered into the RP OM RPA pursuant to which we sold a portion of our right to receive royalties from Amgen on future net sales of omecamtiv mecarbil to RPFT for a one-time payment of $90 million, which is non-refundable even if omecamtiv mecarbil is never commercialized. Concurrently, we entered into a common stock purchase agreement with RPFT through which RPFT purchased 875,656 shares of the Company’s common stock for $10.0 million. We allocated the consideration and issuance costs on a relative fair value basis to our liability to RPFT related to sale of future royalties under the RP OM RPA (the “RP OM Liability”) and the common stock sold to RPFT, which resulted in the RP OM Liability being initially recognized at $92.3 million. The RP OM RPA, as amended, provides for the sale of a royalty to RPFT of 5.5% on worldwide net sales of omecamtiv mecarbil.

We account for the RP OM Liability as a liability primarily because we have significant continuing involvement in generating the related revenue stream from which the liability will be repaid. If and when omecamtiv mecarbil is commercialized and royalties become due, we will recognize the portion of royalties paid to RPFT as a decrease to the RP OM Liability and a corresponding reduction in cash.

The carrying amount of the RP OM Liability is based on our estimate of the future royalties to be paid to RPFT over the life of the arrangement as discounted using an imputed rate of interest. The excess of future estimated royalty payments over the $92.3 million of allocated proceeds, less issuance costs, is recognized as non-cash interest expense using the effective interest method. The imputed rate of interest on the carrying value of the RP OM Liability was approximately 0.1% as of September 30, 2025 and September 30, 2024.

Accounting for Revenue Participation Right Purchase Agreements

We periodically assess the amount and timing of expected royalty payments using a combination of internal projections and forecasts from external sources. To the extent such payments are greater or less than our initial estimates or the timing of such payments is materially different than its original estimates, we will prospectively adjust the amortization of the RP OM Liability and the RP Aficamten Liability and the effective interest rate.

There are a number of factors that could materially affect the amount and timing of royalty payments, a number of which are not within our control. The RP OM Liability and the RP Aficamten Liability are recognized using significant unobservable inputs. The estimates of future royalties require the use of several assumptions such as: the probability of clinical success, the probability of regulatory approval, the estimated date of a product launch, estimates of eligible patient populations, estimates of prescribing behavior and patient compliance behavior, estimates of pricing, payor reimbursement and coverage, and sales ramp. A significant change in unobservable inputs could result in a material increase or decrease to the effective interest rate of the RP OM Liability and the RP Aficamten Liability.

We recorded $50.0 million of additional carrying value associated with the 2022 RP Aficamten Royalty Purchase Agreement upon receipt of the cash in the third quarter of 2023. In the second quarter of 2024, we recorded an additional $33.3 million to the carrying value related to the 2024 RPI Transactions entered on May 22, 2024.

We review our assumptions on a regular basis and our estimates may change in the future as we refine and reassess our assumptions. Changes to the RP Aficamten Liability and the RP OM Liability are as follows (in thousands):

 

 

RP Aficamten Liability

 

 

RP OM Liability

 

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Beginning balance, January 1

 

$

262,599

 

 

$

180,591

 

 

$

199,593

 

 

$

199,384

 

Interest accretion

 

 

14,037

 

 

 

10,239

 

 

 

41

 

 

 

(21

)

Amortization of issuance costs

 

 

—

 

 

 

—

 

 

 

26

 

 

 

26

 

Ending balance, March 31

 

 

276,636

 

 

 

190,830

 

 

 

199,660

 

 

 

199,389

 

Modification in the 2024 RPI Transactions

 

 

—

 

 

 

33,300

 

 

 

—

 

 

 

—

 

Interest accretion

 

 

13,140

 

 

 

11,525

 

 

 

41

 

 

 

42

 

Amortization of issuance costs

 

 

—

 

 

 

—

 

 

 

26

 

 

 

26

 

Ending balance, June 30

 

 

289,776

 

 

 

235,655

 

 

 

199,727

 

 

 

199,457

 

Interest accretion

 

 

14,927

 

 

 

13,328

 

 

 

42

 

 

 

42

 

Amortization of issuance costs

 

 

—

 

 

 

—

 

 

 

26

 

 

 

27

 

Ending balance, September 30

 

$

304,703

 

 

$

248,983

 

 

$

199,795

 

 

$

199,526

 

 

RP Multi Tranche Term Loan

On May 22, 2024, we entered into the RP Multi Tranche Loan Agreement Amendment which provides for two additional tranches (6 & 7) as follows:

•
$50.0 million tranche 6 term loan, which was drawn on May 22, 2024; and
•
$175.0 million tranche 7 term loan drawable at Cytokinetics’ discretion within one year of a future FDA approval of aficamten in obstructive hypertrophic cardiomyopathy if such approval is obtained on or prior to December 31, 2025.

In December 2023, we announced positive topline results from SEQUOIA-HCM, the Phase 3 trial for aficamten. This entitled us to draw $75.0 million under tranche 4 at any time prior to April 3, 2025. In April 2025, $75.0 million was disbursed to us under tranche 4 of the RP Multi Tranche Loan Agreement.

In November 2024, we announced that FDA has accepted our NDA for aficamten. This entitled us to draw $100.0 million under tranche 5 at any time prior to November 25, 2025. As a subsequent event, in October 2025, $100.0 million was disbursed to us under tranche 5 of the RP Multi Tranche Loan agreement.

Each term loan under the RP Multi Tranche Loan Agreement matures on the 10 year anniversary of the funding date for such term loan and is repayable in quarterly installments of principal, interest and fees commencing on the last business day of the seventh full calendar quarter following the calendar quarter of the applicable funding date for such term loan, with the aggregate amount payable in respect of each term loan (including interest and other applicable fees) equal to 190% of the principal amount of the term loan for the tranche 1, tranche 4, tranche 5, tranche 6, and tranche 7 term loans (such amount with respect to each term loan, “Final Payment Amount”). We account for amounts drawn under the RP Multi Tranche Loan Agreement using the effective interest method.

The RP Multi Tranche Loan Agreement and amendment contains embedded derivative features. The fair values of the embedded derivatives are based on significant unobservable inputs, including the probability of change of control, the probability of default, discount rates and other factors. We have bifurcated and recognized the embedded derivatives as Derivative Liabilities Measured at Fair Value as discussed below.

We may prepay the term loans in full (but not in part) at any time at our option by paying an amount equal to the unpaid portion of Final Payment Amount for the outstanding term loans under the RP Multi Tranche Loan Agreement. In addition, the term loans under the RP Multi Tranche Loan Agreement are repayable in full at the option of either us or the lender in an amount equal to the unpaid portion of Final Payment Amount for the outstanding term loans upon a change of control of Cytokinetics.

Future minimum payments under the existing borrowing under Tranche 1, Tranche 4, and Tranche 6 of the RP Multi Tranche Loan are (in thousands):

Years ending December 31:

 

 

 

2025 remainder

 

$

2,880

 

2026

 

 

20,160

 

2027

 

 

36,000

 

2028

 

 

40,320

 

2029

 

 

40,320

 

Thereafter

 

 

172,760

 

Future minimum payments

 

 

312,440

 

Less: Unamortized interest and loan costs

 

 

(136,413

)

Term Loan, net

 

$

176,027

 

The weighted-average effective rate of interest on the RP Multi Tranche Loan was approximately 12.5% as of September 30, 2025 and 11.7% as of September 30, 2024.

As of September 30, 2025, the estimated fair value of the Tranche 1, Tranche 4, and Tranche 6 term loans was $183.5 million. The fair value was estimated based on Level 3 inputs.

Derivative Liabilities Measured at Fair Value

We have bifurcated and recognized the embedded derivatives in the RP Multi Tranche Loan Agreement. These embedded derivatives include repayment features based upon a change in control.

We recognize the derivative liabilities at fair value in the condensed consolidated balance sheets. Each period, the fair value of the derivative liabilities will be recalculated and resulting gains and losses from the changes in fair value of the derivatives with non-credit components are recognized in income, while the change in fair value associated with credit components is recognized in accumulated other comprehensive loss. Estimating fair values of derivative instruments requires the development of significant and subjective estimates that may, and are likely to, change over the duration of the instrument with related changes in internal and external market factors.

In April 2025, a previously bifurcated embedded derivative related to the mandatory draw was settled in connection with the drawing on Tranche 4 and was reclassified into the carrying value of the associated term loan.

The fair values of the derivative liabilities is determined using the probability-weighted expected return method and the “with and without” method. The fair values are based on significant unobservable inputs, including the probability of change of control, the probability of default (less than 10%), discount rates (ranging from 11% to 12% for the three months ended September 30, 2025 and 11% to 13% for the three months ended September 30, 2024) and other factors.

The Company recorded a gain of $0.7 million and $3.3 million for the three and nine months ended September 30, 2025, respectively, and a gain of $0.7 million and $0.1 million for the three and nine months ended September 30, 2024, respectively, associated with the change in fair value of the derivative liabilities. The amounts have been recorded in the condensed consolidated statement of operations and comprehensive loss.

The following table summarizes the changes of the fair value of the derivative liabilities for the RP Multi Tranche Loan Agreement (in thousands):

 

 

RP Multi Tranche Loan Agreement Derivatives

 

 

 

2025

 

 

2024

 

Beginning balance, January 1

 

$

11,300

 

 

$

—

 

Change in fair value

 

 

400

 

 

 

—

 

Ending balance, March 31

 

 

11,700

 

 

 

—

 

Settlement

 

 

(3,900

)

 

 

—

 

Initial measurement

 

 

12,800

 

 

 

12,600

 

Change in fair value

 

 

(3,000

)

 

 

600

 

Ending balance, June 30

 

 

17,600

 

 

 

13,200

 

Change in fair value

 

 

(700

)

 

 

(700

)

Ending balance, September 30

 

$

16,900

 

 

 

12,500

 

RP Stock Purchase Agreement

Concurrently with the closing of our underwritten public offering on May 28, 2024, RPI ICAV purchased 980,392 shares of Common Stock in a private placement transaction at a price of $51.00 per share. The proceeds from this private placement were $50 million.
v3.25.3
Research and Development Arrangements
 9 Months Ended
Sep. 30, 2025
Research and Development [Abstract]  
Research and Development Arrangements

Note 4 — Research and Development Arrangements

Collaboration for Commercialization of Omecamtiv Mecarbil in Greater China

On December 20, 2021, we entered into a license and collaboration agreement with Corxel, or the Corxel OM License Agreement, pursuant to which we granted to Corxel an exclusive license to develop and commercialize omecamtiv mecarbil in China and Taiwan. Under the terms of the Corxel OM License Agreement, we received a $50.0 million nonrefundable payment from Corxel comprised of a $40.0 million payment as consideration for the rights granted by us to Corxel and $10.0 million attributable to our having submitted to FDA an NDA for omecamtiv mecarbil. In December 2024, we entered into a mutual termination agreement with Corxel to terminate the Corxel OM License Agreement. Accordingly, all rights to develop and commercialize omecamtiv mecarbil have reverted to us.

Collaboration for Commercialization of Aficamten in Greater China

On July 14, 2020, we entered into the Corxel Aficamten License Agreement, pursuant to which we granted to Corxel an exclusive license to develop and commercialize aficamten in China and Taiwan. On December 17, 2024, Corxel assigned all of its rights under our license and collaboration agreement to Sanofi. As a result of the Corxel assignment transaction with Sanofi, we received a $15.0 million non-refundable payment in connection with a modification of the original license prior to the assignment of Corxel’s rights under our license and collaboration agreement for the development and commercialization of aficamten in China to Sanofi. We are also eligible to receive an additional $10.0 million payment from Corxel contingent on aficamten being approved in China and included on China's National Reimbursement Drug List.

Effective December 17, 2024, Sanofi has an exclusive license to develop and commercialize aficamten in China and Taiwan (the "Sanofi License Agreement"). The total maximum development and commercial milestone payments achievable for development and commercial milestone events in the field of oHCM and nHCM are $160.0 million, of which we have already earned and received $10.0 million. We are also entitled to receive tiered royalties in the low-to-high teens range on the net sales of pharmaceutical products containing aficamten in China and Taiwan, subject to certain reductions for generic competition, patent expiration and payments for licenses to third party patents.

The Sanofi License Agreement will, unless terminated earlier, continue on a market-by-market basis until expiration of the relevant royalty term.

Accounting for the License and Collaboration Agreements in Greater China

We assessed the original arrangements of the Corxel License Agreements in accordance with ASC 606 and concluded that there was one performance obligation, for which the counterparty is a customer for the unit of account, relating to the license of functional intellectual property for each agreement. The performance obligation was satisfied, and we recognized the residual allocation of arrangement consideration as revenue of $54.9 million in 2021 for the Corxel OM License Agreement and $36.5 million in 2020 for the Corxel Aficamten License Agreement. Due to the nature of development, including the inherent risk of development and approval by regulatory authorities, we are unable to estimate if and when the development milestone payments could be achieved or become due and, accordingly, we consider the milestone payments to be fully constrained and exclude the milestone payments from the transaction price. For the other transactions in collaborative arrangements, consisting of research and development cost reimbursements, we recognize the research and development cost reimbursements as collaboration revenues in our condensed consolidated statement of operations.

In the fourth quarter of 2024, we entered into an agreement to modify the Corxel Aficamten License Agreement. The $15.0 million up-front payment was recognized upon execution of the modification as all performance obligations were satisfied. The $10.0 million contingent payment to be earned upon aficamten being approved in China and included on China's National Reimbursement Drug List is constrained due to the significant uncertainty as of September 30, 2025.

Collaboration revenues for China were $0.4 million and $0.5 million for the three months ended September 30, 2025 and 2024, respectively, and $0.5 million and $1.5 million for the nine months ended September 30, 2025 and 2024, respectively, related to certain development cost reimbursements. Accounts receivable was $0.4 million at September 30, 2025 for Sanofi and was $16.5 million from Corxel as of December 31, 2024, respectively.

Collaboration for Commercialization of Aficamten in Japan

On November 19, 2024, we announced that we had entered into a collaboration and license agreement with Bayer Consumer Care AG, an affiliate of Bayer AG, for the exclusive development and commercialization of aficamten in Japan, subject to certain reserved development rights of Cytokinetics to continue to conduct certain clinical trials (the "Bayer License Agreement").

The Company received an upfront payment of €50.0 million (equivalent to $52.4 million) and was, at the time, eligible to receive up to an additional €90.0 million upon the achievement of development and commercial milestones (we have since earned €10.0 million and remain eligible to receipt up to an additional €80.0 million). The Company is also eligible to receive up to an additional €490.0 million in commercial milestone payments upon the achievement of certain sales milestones, and tiered royalties on net sales of aficamten in Japan.

Accounting for the License and Collaboration Agreement in Japan

In the fourth quarter of 2024, we assessed the Bayer License Agreement under ASC 606 and concluded that there was one performance obligation, for which the counterparty is a customer for the unit of account, relating to the license of functional intellectual property. The €50.0 million (equivalent to $52.4 million) up-front payment received under this agreement was recorded as deferred revenue in the fourth quarter of 2024, as the technology transfer related to the license of functional intellectual property had not yet been satisfied. The agreement also includes additional milestone payments, including future milestone payments totaling up to an additional €90.0 million (€10.0 million of which has been earned) upon achievement of development and commercial milestones. These payments are constrained due to uncertainties related to regulatory and development progress and will be recognized as revenue only when it becomes probable that a significant revenue reversal will not occur. In addition, we are eligible to receive up to €490.0 million in commercial milestone payments based on the achievement of specific sales thresholds in addition to tiered royalties on net sales of aficamten in Japan. The sales-based milestone payments, including royalties, will be recognized when the related sales occur under the sales and usage-based royalty exception of ASC 606 as these amounts have been determined to relate predominantly to the license.

License and milestone revenues from Bayer was not material for the three months ended September 30, 2025. License and milestone revenues from Bayer was $64.3 million for the nine months ended September 30, 2025, respectively, including $52.4 million related to the successful completion of the technology transfer that was recorded as deferred revenue as of December 31, 2024, and certain clinical milestone achievements. The license and milestone revenues included two €5.0 million milestones (equivalent to $5.9 million each) recognized in connection with the achievement of the first dose of aficamten to the first patient in Japan in a Phase 3 clinical trial in nHCM and in a Phase 3 clinical trial in oHCM during the second quarter of 2025. The first dose of aficamten in Japan in a Phase 3 clinical trial in nHCM occurred in June 2025 and the first dose of aficamten in Japan in a Phase 3 clinical trial in oHCM occurred in August 2025. There are no outstanding receivable related to license and milestone revenues from Bayer as of September 30, 2025.

Collaboration revenues from Bayer were $1.5 million and $5.4 million for the three and nine months ended September 30, 2025, respectively, related to certain research and development cost reimbursements. We had accounts receivable from Bayer of $1.4 million as of September 30, 2025 and accounts receivable was immaterial at December 31, 2024.

We re-evaluate the probability of achievement of development milestones and any related constraints each reporting period. We will include consideration, without constraint, in the transaction price to the extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur.

Research Collaboration

In May 2025, we entered into a research collaboration where we will reimburse our collaborative research partner for their research expenses. The reimbursement of research expenses will be recorded as research and development. Subject to the terms of the agreement, our collaborative research partner may receive potential research, development and commercial milestone and royalty payments from us and we may develop and commercialize development candidates.

v3.25.3
Fair Value Measurements
 9 Months Ended
Sep. 30, 2025
Fair Value Disclosures [Abstract]  
Fair Value Measurements

Note 5 — Fair Value Measurements

We value our financial assets and liabilities at fair value, defined as the price that would be received for assets when sold or paid to transfer a liability in an orderly transaction between market participants at the measurement date (exit price). We utilize market data or assumptions that we believe market participants would use in pricing the asset or liability, including assumptions about risk and the risks inherent in the inputs to the valuation technique. These inputs can be readily observable, market corroborated or generally unobservable.

We primarily apply the market approach for recurring fair value measurements and endeavor to utilize the best information reasonably available. Accordingly, we use valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs to the extent possible and consider the security issuers’ and the third-party issuers’ credit risk in our assessment of fair value.

We classify fair value based on the observability of those inputs using a hierarchy that prioritizes the inputs used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurement) and the lowest priority to unobservable inputs (Level 3 measurement):

Level 1 — Observable inputs, such as quoted prices in active markets for identical assets or liabilities;

Level 2 — Inputs, other than the quoted prices in active markets, that are observable either directly or through corroboration with observable market data; and

Level 3 — Unobservable inputs, for which there is little or no market data for the assets or liabilities, such as internally-developed valuation models.

Fair Value of Financial Assets:

The following tables set forth the fair value of our financial assets, which consists of cash equivalents and investments classified as available-for-sale securities, that were measured on a recurring basis (in thousands):

 

 

 

 

September 30, 2025

 

 

 

Fair Value
Hierarchy
Level

 

Amortized
Cost

 

 

Unrealized
Gains

 

 

Unrealized
Losses

 

 

Fair
Value

 

Money market funds

 

Level 1

 

$

204,504

 

 

$

—

 

 

$

—

 

 

$

204,504

 

U.S. Treasury securities

 

Level 1

 

 

334,782

 

 

 

549

 

 

 

(19

)

 

 

335,312

 

U.S. Government agency securities

 

Level 2

 

 

176,351

 

 

 

124

 

 

 

(45

)

 

 

176,430

 

Commercial paper

 

Level 2

 

 

228,090

 

 

 

49

 

 

 

(76

)

 

 

228,063

 

Corporate obligations

 

Level 2

 

 

300,611

 

 

 

453

 

 

 

(95

)

 

 

300,969

 

 

 

 

$

1,244,338

 

 

$

1,175

 

 

$

(235

)

 

$

1,245,278

 

 

 

 

 

 

December 31, 2024

 

 

 

Fair Value
Hierarchy
Level

 

Amortized
Cost

 

 

Unrealized
Gains

 

 

Unrealized
Losses

 

 

Fair
Value

 

Money market funds

 

Level 1

 

$

71,515

 

 

$

—

 

 

$

—

 

 

$

71,515

 

U.S. Treasury securities

 

Level 1

 

 

404,377

 

 

 

1,192

 

 

 

(74

)

 

 

405,495

 

U.S. Government agency securities

 

Level 2

 

 

134,547

 

 

 

339

 

 

 

(23

)

 

 

134,863

 

Commercial paper

 

Level 2

 

 

302,043

 

 

 

399

 

 

 

(128

)

 

 

302,314

 

Asset-backed securities

 

Level 2

 

 

13,924

 

 

 

42

 

 

 

—

 

 

 

13,966

 

Corporate obligations

 

Level 2

 

 

290,616

 

 

 

598

 

 

 

(182

)

 

 

291,032

 

 

 

 

 

$

1,217,022

 

 

$

2,570

 

 

$

(407

)

 

$

1,219,185

 

Investments in corporate debt securities, commercial paper, asset-backed securities and U.S. Government agency securities are classified as Level 2 as they are valued based upon quoted market prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active and model-based valuation techniques for which all significant inputs are observable in the market or can be corroborated by observable market data for substantially the full term of the assets. Where applicable, these models project future cash flows and discount the future amounts to a present value using market-based observable inputs obtained from various third-party data providers, including but not limited to benchmark yields, interest rate curves, reported trades, broker/dealer quotes and reference data.

No credit losses on debt securities were recognized in the periods presented. In its evaluation to determine expected credit losses, management considered all available historical and current information, expectations of future economic conditions, the type of security, the credit rating of the security, and the size of the loss position, as well as other relevant information. The unrealized losses as of September 30, 2025 are attributed to market interest rate changes and are not attributed to credit. The Company does not intend to sell any of these available-for-sale investments before their effective maturity or market price recovery.
v3.25.3
Balance Sheet Components
 9 Months Ended
Sep. 30, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Balance Sheet Components

Note 6 — Balance Sheet Components

A reconciliation of cash, cash equivalents, and restricted cash reported in the accompanying condensed consolidated balance sheets to the amount reported within the accompanying condensed consolidated statements of cash flows was as follows (in thousands):

 

 

September 30, 2025

 

 

December 31, 2024

 

Cash and cash equivalents

 

$

225,467

 

 

$

94,857

 

Restricted cash

 

 

3,112

 

 

 

375

 

Total cash, cash equivalents, and restricted cash as reported within our condensed consolidated statement of cash flows

 

$

228,579

 

 

$

95,232

 

As of September 30, 2025, our restricted cash balance of $3.1 million is used to collateralize certain credit instruments.

Accrued liabilities were as follows (in thousands):

 

 

September 30, 2025

 

 

December 31, 2024

 

Accrued liabilities:

 

 

 

 

 

 

Clinical and preclinical costs

 

$

16,400

 

 

$

13,567

 

Compensation related

 

 

33,199

 

 

 

35,132

 

Other accrued expenses

 

 

12,034

 

 

 

6,624

 

Total accrued liabilities

 

$

61,633

 

 

$

55,323

 
v3.25.3
Debt
 9 Months Ended
Sep. 30, 2025
Debt Disclosure [Abstract]  
Debt

Note 7 — Debt

Convertible Notes

On November 13, 2019, we issued $138.0 million aggregate principal amount of 2026 Notes. On July 6, 2022, we issued $540.0 million aggregate principal amount of 2027 Notes and used approximately $140.3 million of the net proceeds from the offering of 2027 Notes and issued 8,071,343 shares of common stock to repurchase approximately $116.9 million aggregate principal amount of the 2026 Notes pursuant to privately negotiated exchange agreements entered into with certain holders of the 2026 Notes concurrently with the pricing of the offering of the 2027 Notes.

On September 19, 2025, we issued $750.0 million aggregate principal amount of 2031 Notes and used approximately $402.5 million of the net proceeds from the offering of 2031 Notes and issued 2,168,806 shares of common stock to repurchase approximately $399.5 million aggregate principal amount of the 2027 Notes pursuant to privately negotiated exchange agreements entered into with certain holders of the 2027 Notes concurrently with the pricing of the offering of the 2031 Notes. This resulted in recording a debt conversion expense in the third quarter of 2025 of $121.2 million, consisting of the difference between the consideration provided to the holders pursuant to the exchange agreements and the if-converted value of the 2027 Notes under the original terms.

As of September 30, 2025, there remains $21.1 million aggregate principal amount of 2026 Notes outstanding, $140.5 million of aggregate principal amount of 2027 Notes outstanding, and $750.0 million of aggregate principal amount of 2031 Notes outstanding. The conversion feature of the 2031 Notes was not bifurcated as a derivative as it is indexed to our own stock and meets the conditions for equity classification under ASC 815.

2031 Notes

The 2031 Notes are our senior unsecured obligations and shares equal in right of payment with our other indebtedness, including the 2026 Notes and 2027 Notes. The 2031 Notes bear interest at a rate of 1.75% per year, payable semiannually in arrears on April 1 and October 1 of each year, beginning April 1, 2026. The 2031 Notes will mature on October 1, 2031, unless earlier converted, redeemed, or repurchased. Holders of the 2031 Notes may convert their 2031 Notes, under certain circumstances, into cash, shares of our common stock or a combination of cash and shares of our common stock, at our election, based on an initial conversion rate of 14.6156 shares per $1,000 principal amount, which is equivalent to an initial conversion price of approximately $68.42 per share.

As of September 30, 2025, the holders of the 2031 Notes have the option to convert their 2031 Notes only in the following circumstances: (i) if the last reported sale price per share of our common stock exceeds 130% of the conversion price for at least 20 trading days within a 30-day period starting from the last trading day of the preceding quarter after December 31, 2025; (ii) within 5 consecutive business days following any 10 consecutive trading day period if the trading price per $1,000 principal amount of 2031 Notes during such period falls below 98% of the product of the last reported sale price per share of our common stock and the conversion rate; (iii) upon certain corporate events or distributions on our common stock outlined in the 2031 Indenture; (iv) upon our call for redemption of the 2031 Notes; and (v) from July 1, 2031, until the second scheduled trading day immediately preceding the maturity date. We may not redeem the 2031 Notes at our option at any time before October 6, 2028. During the three-month period ended September 30, 2025, the conditions allowing holders of the 2031 Notes to convert were not met. As a result, the 2031 Notes are not convertible as of September 30, 2025 at the option of the holders thereof.

The 2031 Notes are not redeemable prior to October 6, 2028 by the Company. On or after October 6, 2028, the 2031 Notes will be redeemable, in whole or in part (subject to the Partial Redemption Limitation), at our option at any time and from time to time, and, in the case of any partial redemption, on or before the 40th scheduled trading day before the maturity date, at a cash redemption price equal to the principal amount of the 2031 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if the 2031 Notes are freely tradable and all accrued and unpaid additional interest, if any, has been paid in full, as of the first interest payment date occurring on or before such redemption notice date, and the last reported sale price per share of our common stock exceeds 130% of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (ii) the trading day immediately before the date we may send such notice.

The conversion rate for the 2031 Notes, 2027 Notes, and 2026 Notes will be subject to adjustment upon the occurrence of certain specified events. In addition, upon the occurrence of a make-whole fundamental change (as defined in the each respective indenture for the 2026 Notes, 2027 Notes and 2031 Notes), we will, in certain circumstances, increase the conversion rate by a number of additional shares for a holder that elects to convert its notes in connection with such make-whole fundamental change.

The following table presents the total amount of interest cost recognized relating to the 2031 Notes (in thousands):

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30, 2025

 

 

September 30, 2024

 

 

September 30, 2025

 

 

September 30, 2024

 

Contractual interest expense

 

$

401

 

 

$

—

 

 

$

401

 

 

$

—

 

Amortization of debt issuance costs

 

 

136

 

 

 

—

 

 

 

136

 

 

 

—

 

Total interest expense recognized

 

$

537

 

 

$

—

 

 

$

537

 

 

$

—

 

The effective interest rate of the 2031 Notes was 2.2% as of September 30, 2025. As of September 30, 2025, the unamortized debt issuance cost for the 2031 Notes was $20.4 million and will be amortized over approximately 6.1 years.

2027 Notes

As of September 30, 2025, the 2027 Notes aggregate principal balance was $140.5 million. The 2027 Notes are our senior unsecured obligations and shares equal in right of payment with our other indebtedness, including the 2026 Notes and the 2031 Notes. The 2027 Notes bear interest at a rate of 3.50% per year, payable semiannually in arrears on January 1 and July 1 of each year, beginning on January 1, 2023. The 2027 Notes will mature on July 1, 2027, unless earlier converted, redeemed or repurchased. The 2027 Notes are convertible into cash, shares of our common stock or a combination of cash and shares of our common stock, at our election, based on the applicable conversion rate(s). The initial conversion rate for the 2027 Notes is 19.5783 shares of our common stock per $1,000 principal amount of such Notes, which is equivalent to an initial conversion price of approximately $51.08 per share.

As of September 30, 2025, the holders of the 2027 Notes have the option to convert their convertible 2027 Notes only in the following circumstances: (i) if the last reported sale price per share of our common stock exceeds 130% of the conversion price for at least 20 trading days within a 30-day period starting from the last trading day of the preceding quarter after September 30, 2022; (ii) within 5 consecutive business days following any 10 consecutive trading day period if the trading price per $1,000 principal amount of 2027 Notes during such period falls below 98% of the product of the last reported sale price per share of our common stock and the conversion rate; (iii) upon certain corporate events or distributions on our common stock outlined in the 2027 Indenture; (iv) upon our call for redemption of the 2027 Notes; and (v) from March 1, 2027, until the scheduled trading day immediately preceding the maturity date. During the three months ended September 30, 2025, the conditions allowing holders of the 2027 Notes to convert were not met. As a result, the 2027 Notes are not convertible as of September 30, 2025 at the option of the holders thereof.

The 2027 Notes are redeemable, in whole or in part (subject to the Partial Redemption Limitation), at our option at any time, and from time to time, and, in the case of any partial redemption, on or before the 60th scheduled trading day before the maturity date, at a cash redemption price equal to the principal amount of the 2027 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if the last reported sale price per share of our common stock exceeds 130% of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (ii) the trading day immediately before the date we may send such notice.

The following table presents the total amount of interest cost recognized relating to the 2027 Notes (in thousands):

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30, 2025

 

 

September 30, 2024

 

 

September 30, 2025

 

 

September 30, 2024

 

Contractual interest expense

 

$

4,259

 

 

$

4,725

 

 

$

13,710

 

 

$

14,175

 

Amortization of debt issuance costs

 

 

804

 

 

 

851

 

 

 

2,367

 

 

 

2,406

 

Total interest expense recognized

 

$

5,063

 

 

$

5,576

 

 

$

16,077

 

 

$

16,581

 

The effective interest rate of the 2027 Notes was 4.2% as of September 30, 2025 and 2024. As of September 30, 2025, the unamortized debt issuance cost for the 2027 Notes was $1.6 million and will be amortized over approximately 1.8 years. During the nine months ended September 30, 2025, the conditions allowing holders of the 2027 Notes to convert were not met. As a result, the 2027 Notes are not convertible as of September 30, 2025.

2026 Notes

As of September 30, 2025, the 2026 Notes aggregate principal balance was $21.1 million. The 2026 Notes are senior unsecured obligations and bear interest at an annual rate of 4.0% per year, payable semi-annually on May 15 and December 15 of each year, beginning May 15, 2020. The 2026 Notes will mature on November 15, 2026, unless earlier repurchased or redeemed by us or converted at the option of the holders. We may redeem the 2026 Notes prior to the maturity date but we are not required to and no sinking fund is provided for the 2026 Notes. The 2026 Notes may be converted, under certain circumstances, based on an initial conversion rate of 94.7811 shares of common stock per $1,000 principal amount (which represents an initial conversion price of $10.55 per share).

As of September 30, 2025, the holders of the 2026 Notes have the option to convert their 2026 Notes only in the following circumstances: (i) if the last reported sale price per share of our common stock exceeds 130% of the conversion price for at least 20 trading days within a 30-day period; (ii) within 5 consecutive business days following any 10 consecutive trading day period if the trading price per $1,000 principal amount of 2026 Notes during such period falls below 98% of the product of the last reported sale price per share of our common stock and the conversion rate; (iii) upon certain corporate events or distributions on our common stock outlined in the 2026 Indenture; (iv) upon our call for redemption of the 2026 Notes; and (v) from July 15, 2026, until the scheduled trading day immediately preceding the maturity date. During the three-month period ended September 30, 2025, the sale price condition was met. As a result, the 2026 Notes are convertible as of September 30, 2025 at the option of the holders thereof.

The 2026 Notes are redeemable by the Company, in whole or in part, at our option at any time, and from time to time, and, in the case of any partial redemption, on or before the 60th scheduled trading day before the maturity date, at a cash redemption price equal to the principal amount of the 2026 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date but only if the last reported sale price per share of our common stock exceeds 130% of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (ii) the trading day immediately before the date we may send such notice.

The following table presents the total amount of interest cost recognized relating to the 2026 Notes (in thousands):

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30, 2025

 

 

September 30, 2024

 

 

September 30, 2025

 

 

September 30, 2024

 

Contractual interest expense

 

$

211

 

 

$

211

 

 

$

633

 

 

$

633

 

Amortization of debt issuance costs

 

 

32

 

 

 

29

 

 

 

87

 

 

 

84

 

Total interest expense recognized

 

$

243

 

 

$

240

 

 

$

720

 

 

$

717

 

The effective interest rate of the 2026 Notes was 4.6% as of September 30, 2025 and 2024. As of September 30, 2025, the unamortized debt issuance cost for the 2026 Notes was $0.1 million and will be amortized over approximately 1.1 years. The 2026 Notes are convertible at September 30, 2025 at the option of the holder.

Future minimum payments under the 2031 Notes, 2027 Notes and 2026 Notes are (in thousands):

Years ending December 31:

 

2031 Notes

 

 

2027 Notes

 

 

2026 Notes

 

 

Total

 

2025 remainder

 

$

-

 

 

$

—

 

 

$

423

 

 

$

423

 

2026

 

 

13,526

 

 

 

4,919

 

 

 

21,978

 

 

 

40,423

 

2027

 

 

13,125

 

 

 

145,448

 

 

 

—

 

 

 

158,573

 

2028

 

 

13,125

 

 

 

—

 

 

 

—

 

 

 

13,125

 

2029

 

 

13,125

 

 

 

—

 

 

 

—

 

 

 

13,125

 

Thereafter

 

 

776,250

 

 

 

—

 

 

 

—

 

 

 

776,250

 

Future minimum payments

 

 

829,151

 

 

 

150,367

 

 

 

22,401

 

 

 

1,001,919

 

Less: Interest

 

 

(79,151

)

 

 

(9,838

)

 

 

(1,268

)

 

 

(90,257

)

Convertible notes, principal amount

 

 

750,000

 

 

 

140,529

 

 

 

21,133

 

 

 

911,662

 

Less: Unamortized debt issuance costs on the convertible notes

 

 

(20,405

)

 

 

(1,589

)

 

 

(144

)

 

 

(22,138

)

Net carrying amount of the convertible notes

 

$

729,595

 

 

$

138,940

 

 

$

20,989

 

 

$

889,524

 

As of September 30, 2025, the estimated fair value of the 2031 Notes, 2027 Notes, and 2026 Notes was $854.4 million, $182.9 million and $110.2 million, respectively, and was based upon observable, Level 2 inputs, including pricing information from recent trades of the Convertible Notes.
v3.25.3
Stockholders' Equity
 9 Months Ended
Sep. 30, 2025
Equity [Abstract]  
Stockholders' Equity

Note 8 — Stockholders’ Equity

Common Stock

In May 2025, our stockholders further approved an amendment to the Company’s Amended and Restated Certificate of Incorporation to increase the number of authorized shares of common stock available for issuance by the Company from 163.0 million to 326.0 million shares.

Equity Incentive Plan

Our 2004 Plan provides for us to grant incentive stock options, non-statutory stock options, restricted stock, stock appreciation rights, restricted stock units, performance shares and performance units to employees, directors, and consultants. We may grant options for terms of up to ten years at prices not lower than 100% of the fair market value of our common stock on the date of grant. Options granted to new employees generally vest 25% after one year and monthly thereafter over a period of four years. Options granted to existing employees generally vest monthly over a period of four years.

Our annual grant of stock-based compensation takes place during the first quarter of each year. Our stock options and restricted stock units granted during the first quarter of 2025 were as follows:

 

 

Grants

 

 

Weighted
Average Grant Date Fair Value per Share

 

 Stock options

 

 

1,861,099

 

 

$

44.53

 

 Restricted stock units

 

 

1,390,967

 

 

$

44.40

 

In May 2025, our stockholders approved an amendment to the 2004 Plan to increase the number of authorized shares reserved for issuance under the 2004 Plan by an additional 5.0 million shares.

As of September 30, 2025, the total authorized shares under the 2004 Plan available for grant was 6,394,601.

Total stock-based compensation expense was recorded in the condensed consolidated statements of operations and allocated as follows (in thousands):

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30, 2025

 

 

September 30, 2024

 

 

September 30, 2025

 

 

September 30, 2024

 

 Research and development

 

$

15,138

 

 

$

11,417

 

 

$

40,358

 

 

$

31,520

 

 General and administrative

 

 

15,558

 

 

 

13,939

 

 

 

41,422

 

 

 

40,070

 

 

 

$

30,696

 

 

$

25,356

 

 

$

81,780

 

 

$

71,590

 

Performance Stock Units

During 2024 through the first quarter of 2025, the Compensation Committee granted a total of 467,804 performance stock units ("PSUs") to certain employees with a grant date fair value ranging from $44.36 to $63.75 per unit. The fair value of the PSUs was determined on the grant date based on the fair value of the Company’s common stock at such time. The PSU awards are subject to performance goals and will be earned as to a pre-determined fixed number of shares subject to the certification by the Compensation and Talent Committee of the Company’s Board of Directors (the “Compensation Committee”) that the Company has achieved one or more of the relevant performance goals, in each case vesting as to 50% of the earned shares on applicable Compensation Committee certification date and as to the remaining 50% of the earned shares following the one-year anniversary of the applicable Compensation Committee certification date.

The Company recognized expense for the PSUs of $0.8 million and $2.5 million for the three months ended September 30, 2025 and 2024, respectively, and $0.9 million and $5.1 million for the nine months ended September 30, 2025 and 2024, respectively. The decrease year over year was due to our PDUFA target action date for NDA for aficamten in oHCM was extended to December 26, 2025. This resulted in a revision of the PSU assumptions. As of September 30, 2025, there was $1.3 million of unamortized stock-based compensation related to the portion of PSUs vesting that is deemed probable. The Company will assess the probability of achieving the performance conditions quarterly and the expense recognized will be adjusted accordingly.

Public Offering of Common Stock and Concurrent Private Placement

On May 28, 2024, the Company closed an underwritten public offering of 9,803,922 shares of Common Stock at a public offering price of $51.00 per share, which included the exercise in full by the underwriters of their option to purchase up to 1,470,588 shares of Common Stock at the public offering price. The gross proceeds to the Company from the offering were approximately $575.0 million and net proceeds were approximately $563.2 million, after deducting the applicable underwriting discounts and commissions. Concurrently with the closing of the underwritten public offering, RPI ICAV purchased 980,392 shares of Common Stock pursuant to the RP Common Stock Purchase Agreement at a price of $51.00 per share in a concurrent private placement. The proceeds from the concurrent private placement were $50.0 million.

Controlled Equity Offering Sales Agreement

On February 27, 2025, we entered into an Open Market Sale AgreementSM with Jefferies LLC under which we may offer and sell, from time to time, at our sole discretion, shares of common stock in “at the market offerings” pursuant to Rule 415(a)(4) under the Securities Act of 1933 through Jefferies LLC, as sales agent. As of September 30, 2025, we have not sold any shares of common stock under the Open Market Sale AgreementSM with Jefferies LLC.
v3.25.3
Commitments and Contingencies
 9 Months Ended
Sep. 30, 2025
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies

Note 9 — Commitments and Contingencies

Operating Leases

In July 2019, we entered into the Oyster Point Lease for office and laboratory space at a facility located in South San Francisco, California, and we entered into amendments to the Oyster Point Lease in 2020 through 2024. The Oyster Point Lease commenced on March 31, 2021 and has an expiration date of October 31, 2033.

In January 2022, we entered into a series of lease agreements with the sub-landlord and landlord and leased an office space at a facility located in Radnor, Pennsylvania (the "Radnor Lease"). The Radnor Lease commenced in September 2022, when the leasehold improvements were substantially completed, and we gained control over the use of the underlying assets. The Radnor Lease had an original expiration date of July 31, 2027 with one five-year option to extend the lease. In February 2025, the Company amended the Radnor Lease to include additional office space and to extend the lease term for both the existing and the newly leased spaces through July 2029, with one five-year renewal option. As a result of the lease modification for the existing office space, the Company remeasured and increased its operating lease right-of-use asset and lease liability by $1.1 million. Upon commencement of the lease for the additional office space, the Company recognized a right-of-use asset and lease liability of $2.4 million, using a discount rate of 8.9%.

In August 2025, we entered into a new operating lease for office space located in Zug, Switzerland (the "Zug Lease"). The lease has an initial term of approximately five years, with an option to extend for an additional five years that is not reasonably certain to be exercised as of the commencement date. Upon lease commencement in August 2025, the Company recognized a right-of-use asset and lease liability of approximately $2.6 million, using a discount rate of 9.0%.
v3.25.3
Subsequent Event
 9 Months Ended
Sep. 30, 2025
Subsequent Events [Abstract]  
Subsequent Event

Note 10 — Subsequent Event

In November 2024, we announced that FDA has accepted our NDA for aficamten. This entitled us to draw $100.0 million under tranche 5 at any time prior to November 25, 2025. In October 2025, RPI disbursed $100.0 million under tranche 5 of the RP Multi Tranche Loan agreement.

v3.25.3
Organization and Significant Accounting Policies (Policies)
 9 Months Ended
Sep. 30, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization

Cytokinetics, Incorporated was incorporated under the laws of the state of Delaware on August 5, 1997. We are a late-stage biopharmaceutical company focused on the discovery and development of novel small molecule therapeutics that modulate muscle function for the potential treatment of serious diseases and medical conditions.

Our financial statements contemplate the conduct of our operations in the normal course of business. We have incurred an accumulated deficit of approximately $3.3 billion since inception and there can be no assurance that we will attain profitability. We had a net loss of $601.9 million and net cash used in operations of $367.4 million for the nine months ended September 30, 2025. Cash, cash equivalents, and investments was $1.3 billion as of September 30, 2025. We anticipate that we will have operating losses and net cash outflows in future periods.

We are subject to risks common to late-stage biopharmaceutical companies including, but not limited to, development of new drug candidates, dependence on key personnel, and the ability to obtain additional capital as needed to fund our future plans. Our liquidity will be impaired if sufficient additional capital is not available on terms acceptable to us. To date, we have funded operations primarily through sales of our common stock, contract payments under our collaboration agreements, sales of future revenues and royalties, debt financing arrangements, and interest income. Until we achieve profitable operations, we intend to continue to fund operations through payments from strategic collaborations, additional sales of equity securities, grants and debt financings. We have never generated revenues from commercial sales of our drugs. The earliest we might reasonably expect to commence commercial sales and record revenues is following the PDUFA target action date of December 26, 2025 for the NDA for aficamten in oHCM.

Our success is dependent on our ability to obtain additional capital by entering into financings or new strategic collaborations, and ultimately on our and our collaborators’ ability to successfully develop and market one or more of our drug candidates. We cannot be certain that sufficient funds will be available from financings or such collaborators when needed or on satisfactory terms. Additionally, there can be no assurance that any of our drug candidates will be accepted in the marketplace or that any future products can be developed or manufactured at an acceptable cost. These factors could have a material adverse effect on our future financial results, financial position and cash flows.

Based on the current status of our research and development and pre-launch activities, we believe that our existing cash, cash equivalents and investments will be sufficient to fund cash requirements for at least the next 12 months after the issuance of this Quarterly Report on Form 10-Q. If, at any time, our prospects for financing our research and development programs decline, we may decide to reduce research and development expenses by delaying, discontinuing or reducing our funding of one or more of our research or development programs. Alternatively, we might raise funds through strategic collaborations, public or private financings or other arrangements. Such funding, if needed, may not be available on favorable terms, or at all. The financial statements do not include any adjustments that might result from the outcome of this uncertainty.

Basis of Presentation

Basis of Presentation

Our condensed consolidated financial statements include the accounts of Cytokinetics and our wholly-owned subsidiaries. The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with GAAP for interim financial information and the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. The financial statements include all adjustments (consisting only of normal recurring adjustments) that management believes are necessary for the fair statement of our financial information. These interim results are not necessarily indicative of results to be expected for the full fiscal year or any future interim period. The balance sheet as of December 31, 2024 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by GAAP for complete financial statements. The interim condensed financial statements should be read in conjunction with the audited financial statements and notes thereto contained in the Company’s Form 10-K for the year ended December 31, 2024, as filed with the Securities and Exchange Commission.
Use of Estimates

Use of Estimates

The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting periods. We evaluate our estimates on an ongoing basis. We base our estimates on our historical experience and also on assumptions that we believe are reasonable; however, actual results could significantly differ from those estimates
Investment in non-marketable equity security

Investment in non-marketable equity security

During the first quarter of 2025, we made an equity investment of $5.0 million that does not have a readily determinable fair value. We have elected the measurement alternative under which we measure the investment at cost, less any impairment. If we observe price changes in orderly transactions for identical or similar securities of the same issuer, we will remeasure the investment at fair value as of the date of the observable transaction. As of September 30, 2025, the investment has a carrying value of $5.0 million and is classified as “Other assets” on the condensed consolidated balance sheet.
Segment Information

Segment Information

We have one primary business activity and operate in one reportable segment.

Our chief operating decision maker (“CODM”) is our Chief Executive Officer ("CEO") who evaluates performance and makes operating decisions about allocating resources based on financial data presented on a consolidated basis. The measures of profitability and the significant segment expenses reviewed by the CODM are consistent with these financial statements and footnotes.
v3.25.3
Net Loss Per Share (Tables)
 9 Months Ended
Sep. 30, 2025
Earnings Per Share [Abstract]  
Instruments Excluded from the Computation of Diluted Net Loss Per Share

The following instruments were excluded from the computation of diluted net loss per share for the periods presented because their effect would have been antidilutive (in thousands):

 

 

September 30, 2025

 

 

September 30, 2024

 

Options to purchase common stock

 

 

11,442

 

 

 

10,566

 

Restricted stock and performance units

 

 

2,544

 

 

 

1,998

 

Shares issuable related to the ESPP

 

 

87

 

 

 

45

 

Shares issuable upon conversion of 2026 Notes

 

 

2,003

 

 

 

2,003

 

Shares issuable upon conversion of 2027 Notes

 

 

2,751

 

 

 

10,572

 

Shares issuable upon conversion of 2031 Notes

 

 

10,962

 

 

 

—

 

Total shares

 

 

29,789

 

 

 

25,184

 
v3.25.3
Agreements with Royalty Pharma (Tables)
 9 Months Ended
Sep. 30, 2025
Debt Instrument [Line Items]  
Schedule of Transactions Consideration

The 2024 RPI Transactions consideration of $200.0 million received was allocated as follows (in thousands):

 

 

Allocation

 

Units of Accounting:

 

 

 

RP Aficamten RPA

 

$

33,300

 

Tranche 6 of RP Multi Tranche Loan Agreement

 

 

41,200

 

Tranche 6 of RP Multi Tranche Loan Agreement - Embedded Derivatives

 

 

4,400

 

Tranche 4 of RP Multi Tranche Loan Agreement - Embedded Derivatives

 

 

3,700

 

Ulacamten RPA

 

 

12,700

 

RP OM Loan Agreement

 

 

104,700

 

Total consideration

 

$

200,000

 
Summary of Changes of the Fair Value of Liabilities

The following tables summarize the changes of the fair value of the Ulacamten RPA and RP OM Loan (in thousands):

 

 

2025

 

 

2024

 

 

 

Ulacamten RPA

 

 

RP OM Loan

 

 

Ulacamten RPA

 

 

RP OM Loan

 

Beginning balance, January 1

 

$

14,000

 

 

$

123,000

 

 

$

—

 

 

$

—

 

Change in fair value

 

 

(300

)

 

 

(3,600

)

 

 

—

 

 

 

—

 

Ending balance, March 31

 

 

13,700

 

 

 

119,400

 

 

 

—

 

 

 

—

 

Initial measurement

 

 

—

 

 

 

—

 

 

 

12,700

 

 

 

104,700

 

Change in fair value

 

 

300

 

 

 

14,300

 

 

 

—

 

 

 

(200

)

Ending balance, June 30

 

 

14,000

 

 

 

133,700

 

 

 

12,700

 

 

 

104,500

 

Change in fair value

 

 

—

 

 

 

2,800

 

 

 

1,100

 

 

 

14,100

 

Ending balance, September 30

 

$

14,000

 

 

$

136,500

 

 

$

13,800

 

 

$

118,600

 
Schedule of Activity within Liabilities Related to Sale of Future Royalties Changes to the RP Aficamten Liability and the RP OM Liability are as follows (in thousands):

 

 

RP Aficamten Liability

 

 

RP OM Liability

 

 

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Beginning balance, January 1

 

$

262,599

 

 

$

180,591

 

 

$

199,593

 

 

$

199,384

 

Interest accretion

 

 

14,037

 

 

 

10,239

 

 

 

41

 

 

 

(21

)

Amortization of issuance costs

 

 

—

 

 

 

—

 

 

 

26

 

 

 

26

 

Ending balance, March 31

 

 

276,636

 

 

 

190,830

 

 

 

199,660

 

 

 

199,389

 

Modification in the 2024 RPI Transactions

 

 

—

 

 

 

33,300

 

 

 

—

 

 

 

—

 

Interest accretion

 

 

13,140

 

 

 

11,525

 

 

 

41

 

 

 

42

 

Amortization of issuance costs

 

 

—

 

 

 

—

 

 

 

26

 

 

 

26

 

Ending balance, June 30

 

 

289,776

 

 

 

235,655

 

 

 

199,727

 

 

 

199,457

 

Interest accretion

 

 

14,927

 

 

 

13,328

 

 

 

42

 

 

 

42

 

Amortization of issuance costs

 

 

—

 

 

 

—

 

 

 

26

 

 

 

27

 

Ending balance, September 30

 

$

304,703

 

 

$

248,983

 

 

$

199,795

 

 

$

199,526

 

 
Summary of Changes of Fair Value of Derivative Liabilities

The following table summarizes the changes of the fair value of the derivative liabilities for the RP Multi Tranche Loan Agreement (in thousands):

 

 

RP Multi Tranche Loan Agreement Derivatives

 

 

 

2025

 

 

2024

 

Beginning balance, January 1

 

$

11,300

 

 

$

—

 

Change in fair value

 

 

400

 

 

 

—

 

Ending balance, March 31

 

 

11,700

 

 

 

—

 

Settlement

 

 

(3,900

)

 

 

—

 

Initial measurement

 

 

12,800

 

 

 

12,600

 

Change in fair value

 

 

(3,000

)

 

 

600

 

Ending balance, June 30

 

 

17,600

 

 

 

13,200

 

Change in fair value

 

 

(700

)

 

 

(700

)

Ending balance, September 30

 

$

16,900

 

 

 

12,500

 
RP OM Loan Agreement [Member]  
Debt Instrument [Line Items]  
Schedule of Future Minimum Payments under Loan Agreement

The following table demonstrates the future minimum payments for our RP OM Loan under Scenario 3, based on 227.5% of the principal amount with repayment expected to start in 2028 as defined above, as of September 30, 2025 (in thousands):

Years ending December 31:

 

 

 

2025 remainder

 

$

—

 

2026

 

 

—

 

2027

 

 

—

 

2028

 

 

20,682

 

2029

 

 

41,363

 

Thereafter

 

 

165,455

 

Future minimum payments

 

$

227,500

 
The minimum repayment schedule under Scenario 2 would be 237.5% of the principal amount with quarterly payments starting in 2030. T
RP Multi Tranche Loan [Member]  
Debt Instrument [Line Items]  
Schedule of Future Minimum Payments under Loan Agreement

Future minimum payments under the existing borrowing under Tranche 1, Tranche 4, and Tranche 6 of the RP Multi Tranche Loan are (in thousands):

Years ending December 31:

 

 

 

2025 remainder

 

$

2,880

 

2026

 

 

20,160

 

2027

 

 

36,000

 

2028

 

 

40,320

 

2029

 

 

40,320

 

Thereafter

 

 

172,760

 

Future minimum payments

 

 

312,440

 

Less: Unamortized interest and loan costs

 

 

(136,413

)

Term Loan, net

 

$

176,027

 
v3.25.3
Fair Value Measurements (Tables)
 9 Months Ended
Sep. 30, 2025
Fair Value Disclosures [Abstract]  
Summary of Fair Value of Financial Assets Consists of Cash Equivalents and Investments Classified as Available-for-sale Securities Measured on Recurring Basis

The following tables set forth the fair value of our financial assets, which consists of cash equivalents and investments classified as available-for-sale securities, that were measured on a recurring basis (in thousands):

 

 

 

 

September 30, 2025

 

 

 

Fair Value
Hierarchy
Level

 

Amortized
Cost

 

 

Unrealized
Gains

 

 

Unrealized
Losses

 

 

Fair
Value

 

Money market funds

 

Level 1

 

$

204,504

 

 

$

—

 

 

$

—

 

 

$

204,504

 

U.S. Treasury securities

 

Level 1

 

 

334,782

 

 

 

549

 

 

 

(19

)

 

 

335,312

 

U.S. Government agency securities

 

Level 2

 

 

176,351

 

 

 

124

 

 

 

(45

)

 

 

176,430

 

Commercial paper

 

Level 2

 

 

228,090

 

 

 

49

 

 

 

(76

)

 

 

228,063

 

Corporate obligations

 

Level 2

 

 

300,611

 

 

 

453

 

 

 

(95

)

 

 

300,969

 

 

 

 

$

1,244,338

 

 

$

1,175

 

 

$

(235

)

 

$

1,245,278

 

 

 

 

 

 

December 31, 2024

 

 

 

Fair Value
Hierarchy
Level

 

Amortized
Cost

 

 

Unrealized
Gains

 

 

Unrealized
Losses

 

 

Fair
Value

 

Money market funds

 

Level 1

 

$

71,515

 

 

$

—

 

 

$

—

 

 

$

71,515

 

U.S. Treasury securities

 

Level 1

 

 

404,377

 

 

 

1,192

 

 

 

(74

)

 

 

405,495

 

U.S. Government agency securities

 

Level 2

 

 

134,547

 

 

 

339

 

 

 

(23

)

 

 

134,863

 

Commercial paper

 

Level 2

 

 

302,043

 

 

 

399

 

 

 

(128

)

 

 

302,314

 

Asset-backed securities

 

Level 2

 

 

13,924

 

 

 

42

 

 

 

—

 

 

 

13,966

 

Corporate obligations

 

Level 2

 

 

290,616

 

 

 

598

 

 

 

(182

)

 

 

291,032

 

 

 

 

 

$

1,217,022

 

 

$

2,570

 

 

$

(407

)

 

$

1,219,185

 
v3.25.3
Balance Sheet Components (Tables)
 9 Months Ended
Sep. 30, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Reconciliation of Cash, Cash Equivalents, and Restricted Cash

A reconciliation of cash, cash equivalents, and restricted cash reported in the accompanying condensed consolidated balance sheets to the amount reported within the accompanying condensed consolidated statements of cash flows was as follows (in thousands):

 

 

September 30, 2025

 

 

December 31, 2024

 

Cash and cash equivalents

 

$

225,467

 

 

$

94,857

 

Restricted cash

 

 

3,112

 

 

 

375

 

Total cash, cash equivalents, and restricted cash as reported within our condensed consolidated statement of cash flows

 

$

228,579

 

 

$

95,232

 
Summary of Accrued Liabilities

Accrued liabilities were as follows (in thousands):

 

 

September 30, 2025

 

 

December 31, 2024

 

Accrued liabilities:

 

 

 

 

 

 

Clinical and preclinical costs

 

$

16,400

 

 

$

13,567

 

Compensation related

 

 

33,199

 

 

 

35,132

 

Other accrued expenses

 

 

12,034

 

 

 

6,624

 

Total accrued liabilities

 

$

61,633

 

 

$

55,323

 
v3.25.3
Debt (Tables)
 9 Months Ended
Sep. 30, 2025
Debt Disclosure [Abstract]  
Schedule of Interest Cost Relating to Notes

The following table presents the total amount of interest cost recognized relating to the 2031 Notes (in thousands):

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30, 2025

 

 

September 30, 2024

 

 

September 30, 2025

 

 

September 30, 2024

 

Contractual interest expense

 

$

401

 

 

$

—

 

 

$

401

 

 

$

—

 

Amortization of debt issuance costs

 

 

136

 

 

 

—

 

 

 

136

 

 

 

—

 

Total interest expense recognized

 

$

537

 

 

$

—

 

 

$

537

 

 

$

—

 

The following table presents the total amount of interest cost recognized relating to the 2027 Notes (in thousands):

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30, 2025

 

 

September 30, 2024

 

 

September 30, 2025

 

 

September 30, 2024

 

Contractual interest expense

 

$

4,259

 

 

$

4,725

 

 

$

13,710

 

 

$

14,175

 

Amortization of debt issuance costs

 

 

804

 

 

 

851

 

 

 

2,367

 

 

 

2,406

 

Total interest expense recognized

 

$

5,063

 

 

$

5,576

 

 

$

16,077

 

 

$

16,581

 

The following table presents the total amount of interest cost recognized relating to the 2026 Notes (in thousands):

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30, 2025

 

 

September 30, 2024

 

 

September 30, 2025

 

 

September 30, 2024

 

Contractual interest expense

 

$

211

 

 

$

211

 

 

$

633

 

 

$

633

 

Amortization of debt issuance costs

 

 

32

 

 

 

29

 

 

 

87

 

 

 

84

 

Total interest expense recognized

 

$

243

 

 

$

240

 

 

$

720

 

 

$

717

 
Schedule of Maturities of Notes

Future minimum payments under the 2031 Notes, 2027 Notes and 2026 Notes are (in thousands):

Years ending December 31:

 

2031 Notes

 

 

2027 Notes

 

 

2026 Notes

 

 

Total

 

2025 remainder

 

$

-

 

 

$

—

 

 

$

423

 

 

$

423

 

2026

 

 

13,526

 

 

 

4,919

 

 

 

21,978

 

 

 

40,423

 

2027

 

 

13,125

 

 

 

145,448

 

 

 

—

 

 

 

158,573

 

2028

 

 

13,125

 

 

 

—

 

 

 

—

 

 

 

13,125

 

2029

 

 

13,125

 

 

 

—

 

 

 

—

 

 

 

13,125

 

Thereafter

 

 

776,250

 

 

 

—

 

 

 

—

 

 

 

776,250

 

Future minimum payments

 

 

829,151

 

 

 

150,367

 

 

 

22,401

 

 

 

1,001,919

 

Less: Interest

 

 

(79,151

)

 

 

(9,838

)

 

 

(1,268

)

 

 

(90,257

)

Convertible notes, principal amount

 

 

750,000

 

 

 

140,529

 

 

 

21,133

 

 

 

911,662

 

Less: Unamortized debt issuance costs on the convertible notes

 

 

(20,405

)

 

 

(1,589

)

 

 

(144

)

 

 

(22,138

)

Net carrying amount of the convertible notes

 

$

729,595

 

 

$

138,940

 

 

$

20,989

 

 

$

889,524

 
v3.25.3
Stockholders' Equity (Tables)
 9 Months Ended
Sep. 30, 2025
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]  
Summary of Stock Options and Restricted Stock Units Granted

Our annual grant of stock-based compensation takes place during the first quarter of each year. Our stock options and restricted stock units granted during the first quarter of 2025 were as follows:

 

 

Grants

 

 

Weighted
Average Grant Date Fair Value per Share

 

 Stock options

 

 

1,861,099

 

 

$

44.53

 

 Restricted stock units

 

 

1,390,967

 

 

$

44.40

 
Summary of Stock-Based Compensation Expense

Total stock-based compensation expense was recorded in the condensed consolidated statements of operations and allocated as follows (in thousands):

 

 

Three Months Ended

 

 

Nine Months Ended

 

 

 

September 30, 2025

 

 

September 30, 2024

 

 

September 30, 2025

 

 

September 30, 2024

 

 Research and development

 

$

15,138

 

 

$

11,417

 

 

$

40,358

 

 

$

31,520

 

 General and administrative

 

 

15,558

 

 

 

13,939

 

 

 

41,422

 

 

 

40,070

 

 

 

$

30,696

 

 

$

25,356

 

 

$

81,780

 

 

$

71,590

 
v3.25.3
Organization and Significant Accounting Policies - Additional Information (Detail)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
USD ($)
Jun. 30, 2025
USD ($)
Mar. 31, 2025
USD ($)
Sep. 30, 2024
USD ($)
Jun. 30, 2024
USD ($)
Mar. 31, 2024
USD ($)
Sep. 30, 2025
USD ($)
Segment
Business
Sep. 30, 2024
USD ($)
Dec. 31, 2024
USD ($)
Summary Of Significant Accounting Policies [Line Items]                  
Accumulated deficit incurred $ (3,303,688)           $ (3,303,688)   $ (2,701,764)
Cash requirements term             12 months    
Net Income (Loss) (306,178) $ (134,370) $ (161,376) $ (160,545) $ (143,318) $ (135,643) $ (601,924) $ (439,506)  
Cash, cash equivalents and investments 1,300,000           1,300,000    
Net cash provided by (used in) operating activities             $ 367,358 $ 330,320  
Number of business activity | Business             1    
Number of reportable segments | Segment             1    
Equity investment without readily determinable fair value     $ 5,000            
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description             Our chief operating decision maker (“CODM”) is our Chief Executive Officer ("CEO") who evaluates performance and makes operating decisions about allocating resources based on financial data presented on a consolidated basis. The measures of profitability and the significant segment expenses reviewed by the CODM are consistent with these financial statements and footnotes.    
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]             srt:ChiefExecutiveOfficerMember    
Other Assets [Member]                  
Summary Of Significant Accounting Policies [Line Items]                  
Equity investment without readily determinable fair value $ 5,000           $ 5,000    
v3.25.3
Net Loss Per Share - Instruments Excluded from the Computation of Diluted Net Loss Per Share (Detail) - shares
shares in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Total shares 29,789 25,184
Options to Purchase Common Stock [Member]    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Total shares 11,442 10,566
Restricted Stock and Performance Units [Member]    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Total shares 2,544 1,998
Shares Issuable Related to the ESSP [Member]    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Total shares 87 45
2026 Notes [Member]    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Total shares 2,003 2,003
2027 Notes [Member]    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Total shares 2,751 10,572
2031 Notes [Member]    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Total shares 10,962 0
v3.25.3
Agreements with Royalty Pharma - Additional Information (Detail) - USD ($)
$ / shares in Units, $ in Thousands
 1 Months Ended 3 Months Ended 6 Months Ended 9 Months Ended
May 22, 2024
Jan. 07, 2022
Mar. 31, 2022
Feb. 28, 2017
Sep. 30, 2025
Jun. 30, 2025
Mar. 31, 2025
Sep. 30, 2024
Jun. 30, 2024
Sep. 30, 2023
Jun. 30, 2025
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2023
Apr. 30, 2025
Dec. 31, 2024
Nov. 30, 2024
Dec. 31, 2023
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Long term debt         $ 1,001,919             $ 1,001,919            
Debt Instrument, Face Amount         911,662             911,662            
Arrangement consideration of debt transaction   $ 150,000                                
Liabilities         1,957,680             $ 1,957,680       $ 1,537,045    
RP OM Loan Agreement [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Term loan, maturity year 10 years                                  
Debt Instrument, Face Amount $ 100,000                                  
RP OM Loan Agreement [Member] | Level 3 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Liabilities at fair value                 $ 104,700                  
RP OM Loan Agreement [Member] | Maximum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percentage of change of control occur of principal amount of loan 237.50%                                  
Percentage of amount payable of principal amount 237.50%                                  
RP OM Loan Agreement [Member] | Minimum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percentage of change of control occur of principal amount of loan 150.00%                                  
Percentage of amount payable of principal amount 227.50%                                  
RP OM Loan Agreement [Member] | Scenario 1 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Repayable loan percentage to principal amount                       124.00%            
Percentage of net sales payable 2.00%                                  
Percentage of net sales payable for excess of annual worldwide net sales 2.00%                                  
Payment of RPDF for ten business days after OM approval date $ 75,000                                  
Payment of RPDF for first anniversary after of OM approval date 25,000                                  
RP OM Loan Agreement [Member] | Scenario 1 [Member] | Maximum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Subject to minimum floor amount 8,000                                  
RP OM Loan Agreement [Member] | Scenario 1 [Member] | Minimum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Subject to minimum floor amount $ 5,000                                  
RP OM Loan Agreement [Member] | Scenario 2 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Number of RPDF equal quarterly 18 equal quarterly                                  
Percentage of cash payments of principal amount 237.50%                                  
Loan commencing, date Mar. 31, 2030                                  
Repayable loan percentage to principal amount                       237.50%            
RP OM Loan Agreement [Member] | Scenario 3 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Number of RPDF equal quarterly 22 equal quarterly                                  
Percentage of cash payments of principal amount 227.50%                                  
Loan commencing, date Sep. 30, 2028                                  
Repayable loan percentage to principal amount                     227.50%              
RP Ulacamten RPA, RPI ICAV [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percentage of payment to fund of research and development cost 50.00%                                  
Percentage of incremental for annual net sales 3.50%                                  
Percentage of milestone payment aggregate investment 75.00%                                  
Percentage of prior to market aggregate investment 37.50%                                  
Percentage of aggregate investment subsequent market approval 37.50%                                  
Percentage of annual net sales 0.01                                  
Debt Instrument, Face Amount $ 150,000                                  
Purchased rights to certain revenue streams from net sales in consideration payment $ 50,000                                  
RP Ulacamten RPA, RPI ICAV [Member] | Level 3 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Liabilities at fair value                 12,700                  
RP OM Loan Agreement and Ulacamten RPA [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Change in fair value of liabilities         $ 2,800     $ 15,200       $ 13,500 $ 15,000          
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]                       Liabilities, Fair Value Adjustment            
RP OM Loan Agreement and Ulacamten RPA [Member] | Maximum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percentage of discount rates for fair values of derivative liabilities         17.00%     17.00%                    
RP OM Loan Agreement and Ulacamten RPA [Member] | Minimum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percentage of discount rates for fair values of derivative liabilities         11.00%     11.00%                    
RP Loan Agreement [Member] | Term Loan Tranche 4 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Term loan, drawn amount                             $ 75,000      
RP Multi Tranche Loan [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percentage of probability of default of derivative liabilities                       10.00%            
Change in fair value derivative liabilities         $ 700     $ 700       $ 3,300 $ 100          
RP Multi Tranche Loan [Member] | Maximum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percentage of discount rates for fair values of derivative liabilities         12.00%     13.00%                    
RP Multi Tranche Loan [Member] | Minimum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percentage of discount rates for fair values of derivative liabilities         11.00%     11.00%                    
2022 Royalty Pharma Transactions [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Milestone payment   50,000                                
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Upfront payment   50,000                                
Purchased rights to certain revenue streams from net sales in consideration payment   $ 50,000                                
Percentage of net sales payable 4.50% 4.50%                                
4.5% of net revenue to be receivable from annual worldwide net sales $ 5,000,000 $ 1,000,000                                
Percentage of net sales payable for incremental annual worldwide net sales 1.00%                                  
Percentage of net sales payable for excess of annual worldwide net sales   3.50%                                
3.5% of net sales payable for excess of annual worldwide net sales   $ 1,000,000                                
Imputed rate of interest on unamortized portion of liability         22.10%     24.40%       22.10% 24.40%          
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member] | Change in Accounting Estimate [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Change in non-cash interest expense and net loss         $ 1,000             $ 1,000            
Change in net loss per share         $ 0.01             $ 0            
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member] | oHCM [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Additional consideration amount paid of first pivotal clinical trail     $ 50,000                              
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member] | nHCM [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Additional consideration amount paid of first pivotal clinical trail                           $ 50,000        
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member] | Maximum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Purchased rights to certain revenue streams from net sales in consideration payment   150,000                                
2022 Royalty Pharma Transactions [Member] | RP Multi Tranche Loan [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Term loan, maturity year 10 years                                  
Weighted-average effective rate of interest         12.50%     11.70%       12.50% 11.70%          
2022 Royalty Pharma Transactions [Member] | RP Multi Tranche Loan [Member] | Term Loan Tranche 1 Tranche 4 Tranche 5 Tranche 6 and Tranche 7 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Repayable loan percentage to principal amount Including interest and other fees 190.00%                                  
2022 Royalty Pharma Transactions [Member] | RP Multi Tranche Loan [Member] | Term Loan Tranche 1, Tranche 4 and Tranche 6 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Estimated fair value of long term debt         $ 183,500             $ 183,500            
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Additional carrying value                   $ 50,000                
2024 RPI Transactions [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Consideration fair value allocation $ 200,000                                  
Additional carrying value                 33,300                  
2024 RPI Transactions [Member] | RP OM Loan Agreement [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Change in fair value of liabilities         $ 2,800 $ 14,300 $ (3,600) $ 14,100 (200)                  
Royalty Purchase Finance Trust Agreement [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Modification in 2024 RPI transactions           $ 0     $ 0                  
Royalty Purchase Finance Trust Agreement [Member] | RP OM RPA [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Imputed rate of interest on unamortized portion of liability         0.10%     0.10%       0.10% 0.10%          
Non-cash interest expense recognized                       $ 92,300            
CRL Option [Member] | RP Loan Agreement [Member] | Term Loan Tranche 4 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Term loan, drawn amount                                   $ 75,000
CRL Option [Member] | RP Multi Tranche Loan [Member] | Term Loan Tranche 6 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Term loan, drawn amount   50,000                                
CRL Option [Member] | RP Multi Tranche Loan [Member] | Term Loan Tranche 7 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Term loan, maximum borrowing capacity   $ 175,000                                
CRL Option [Member] | 2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member] | Term Loan Tranche 5 [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Term loan, drawn amount                                 $ 100,000  
CRL Option [Member] | Royalty Purchase Finance Trust Agreement [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Cash payment under royalty agreement       $ 90,000                            
Purchase of common stock shares       875,656                            
Stock issued during period, value, issued for services       $ 10,000                            
Liabilities       $ 92,300                            
CRL Option [Member] | Royalty Purchase Finance Trust Agreement [Member] | Minimum [Member]                                    
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                                    
Percent of royalty on net sale       5.50%                            
v3.25.3
Agreements with Royalty Pharma - Schedule of Transactions Consideration (Detail) - 2024 RPI Transactions [Member]
$ in Thousands
May 22, 2024
USD ($)
Debt Instrument [Line Items]  
Consideration allocation $ 200,000
RP Aficamten RPA [Member]  
Debt Instrument [Line Items]  
Consideration allocation 33,300
Tranche 6 of RP Multi Tranche Loan Agreement [Member]  
Debt Instrument [Line Items]  
Consideration allocation 41,200
Tranche 6 of RP Multi Tranche Loan Agreement - Embedded Derivatives [Member]  
Debt Instrument [Line Items]  
Consideration allocation 4,400
Tranche 4 of RP Multi Tranche Loan Agreement - Embedded Derivatives  
Debt Instrument [Line Items]  
Consideration allocation 3,700
Rp CK-586 RPA [Member]  
Debt Instrument [Line Items]  
Consideration allocation 12,700
RP OM Loan Agreement [Member]  
Debt Instrument [Line Items]  
Consideration allocation $ 104,700
v3.25.3
Agreements with Royalty Pharma - Schedule of Future Minimum Payments of Principal Amount with Repayment (Detail)
$ in Thousands
Sep. 30, 2025
USD ($)
Debt Instrument [Line Items]  
2025 remainder $ 423
2026 40,423
2027 158,573
2028 13,125
2029 13,125
RP OM Loan Agreement [Member] | Scenario 3 [Member]  
Debt Instrument [Line Items]  
2025 remainder 0
2026 0
2027 0
2028 20,682
2029 41,363
Thereafter 165,455
Future minimum payments $ 227,500
v3.25.3
Agreements with Royalty Pharma - Summary of Changes of Fair Value of Liabilities (Detail) - 2024 RPI Transactions [Member] - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Jun. 30, 2025
Mar. 31, 2025
Sep. 30, 2024
Jun. 30, 2024
Sep. 30, 2025
Ulacamten RPA            
Debt Instrument [Line Items]            
Beginning balance $ 14,000 $ 13,700 $ 14,000 $ 12,700 $ 12,700 $ 14,000
Change in fair value   300 (300) 1,100    
Ending balance 14,000 14,000 13,700 13,800 12,700 14,000
RP OM Loan Agreement [Member]            
Debt Instrument [Line Items]            
Beginning balance 133,700 119,400 123,000 104,500 104,700 123,000
Change in fair value 2,800 14,300 (3,600) 14,100 (200)  
Ending balance $ 136,500 $ 133,700 $ 119,400 $ 118,600 $ 104,500 $ 136,500
v3.25.3
Agreements with Royalty Pharma - Schedule Represents Allocation of Transaction Consideration on a Relative Fair Value Basis to the Liability and the Common Stock (Detail) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Jun. 30, 2025
Mar. 31, 2025
Sep. 30, 2024
Jun. 30, 2024
Mar. 31, 2024
Sep. 30, 2025
Sep. 30, 2024
RP Aficamten Liability [Member]                
Royalty Liability [Line Items]                
Liabilities related to revenue participation right purchase agreements, net beginning balance $ 289,776 $ 276,636 $ 262,599 $ 235,655 $ 190,830 $ 180,591 $ 262,599 $ 180,591
Modification in 2024 RPI transactions   0     33,300      
Interest accretion 14,927 13,140 14,037 13,328 11,525 10,239    
Amortization of issuance costs 0 0 0 0 0 0    
Liabilities related to revenue participation right purchase agreements, net ending balance 304,703 289,776 276,636 248,983 235,655 190,830 304,703 248,983
RPOM Liability [Member]                
Royalty Liability [Line Items]                
Liabilities related to revenue participation right purchase agreements, net beginning balance 199,727 199,660 199,593 199,457 199,389 199,384 199,593 199,384
Modification in 2024 RPI transactions   0     0      
Interest accretion 42 41 41 42 42 (21)    
Amortization of issuance costs 26 26 26 27 26 26    
Liabilities related to revenue participation right purchase agreements, net ending balance $ 199,795 $ 199,727 $ 199,660 $ 199,526 $ 199,457 $ 199,389 $ 199,795 $ 199,526
v3.25.3
Agreements with Royalty Pharma - Schedule of Future Minimum Payments under Loan Agreement (Detail)
$ in Thousands
Sep. 30, 2025
USD ($)
Debt Instrument [Line Items]  
2025 remainder $ 423
2026 40,423
2027 158,573
2028 13,125
2029 13,125
Less: Unamortized interest and loan costs (22,138)
Term Loan, net 1,001,919
RP Multi Tranche Loan [Member] | Tranche 1, Tranche 4 and Tranche 6 [Member]  
Debt Instrument [Line Items]  
2025 remainder 2,880
2026 20,160
2027 36,000
2028 40,320
2029 40,320
Thereafter 172,760
Future minimum payments 312,440
Less: Unamortized interest and loan costs (136,413)
Term Loan, net $ 176,027
v3.25.3
Agreements with Royalty Pharma - Summary of Changes of Fair Value of Derivative Liabilities (Detail) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Jun. 30, 2025
Mar. 31, 2025
Sep. 30, 2024
Jun. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Derivatives, Fair Value [Line Items]              
Change in fair value $ 700     $ 700   $ 3,300 $ 100
RP Multi Tranche Loan Agreement Derivatives              
Derivatives, Fair Value [Line Items]              
Beginning balance 17,600 $ 11,700 $ 11,300 13,200   11,300  
Settlement   (3,900)          
Change in fair value (700) (3,000) 400 (700) $ 600    
Ending balance 16,900 17,600 $ 11,700 12,500 13,200 $ 16,900 $ 12,500
RP Multi Tranche Loan Agreement Derivatives | Initial measurement              
Derivatives, Fair Value [Line Items]              
Beginning balance $ 12,800     $ 12,600      
Ending balance   $ 12,800     $ 12,600    
v3.25.3
Agreements with Royalty Pharma - Additional Information (Detail 1) - RP Stock Purchase Agreement [Member] - Private Placement [Member]
$ / shares in Units, $ in Millions
May 28, 2024
USD ($)
$ / shares
shares
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]  
Issuance of shares of common stock | shares 980,392
Public offering price per share | $ / shares $ 51.00
Gross proceeds from issuance of private placement | $ $ 50
v3.25.3
Research and Development Arrangements - Additional Information (Detail)
$ in Thousands, € in Millions
 3 Months Ended 9 Months Ended 12 Months Ended
Nov. 19, 2024
EUR (€)
Sep. 30, 2025
USD ($)
Jun. 30, 2025
USD ($)
Jun. 30, 2025
EUR (€)
Dec. 31, 2024
USD ($)
Dec. 31, 2024
EUR (€)
Sep. 30, 2024
USD ($)
Sep. 30, 2025
USD ($)
Sep. 30, 2025
EUR (€)
Sep. 30, 2024
USD ($)
Dec. 31, 2021
USD ($)
Dec. 31, 2020
USD ($)
Sep. 30, 2025
EUR (€)
Dec. 31, 2024
EUR (€)
Dec. 17, 2024
USD ($)
Nov. 19, 2024
USD ($)
Nov. 19, 2024
EUR (€)
Dec. 20, 2021
USD ($)
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Total revenues   $ 1,936         $ 463 $ 70,284   $ 1,547                
Accounts receivable   1,808     $ 16,650     1,808                    
Deferred revenue   1,612     52,370     1,612                    
Corxel Omecamtiv Mecarbil License and Collaboration Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Nonrefundable payment obligation                                   $ 50,000
Corxel Aficamten License and Collaboration Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Nonrefundable payment obligation   15,000           15,000                    
Potential additional payments receivable                             $ 10,000      
Maximum future development and commercial milestone payments achievable   160,000           160,000                    
Development and commercial milestone received               10,000                    
Bayer License Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Potential additional milestone earned | €                 € 10.0                  
Potential milestone payments and royalties unearned and receivable upon achievement of milestone | €                         € 80.0          
Accounts receivable   1,400           1,400                    
Upfront payment received         52,400                 € 50.0   $ 52,400 € 50.0  
Corxel License Agreements [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Accounts receivable         16,500                          
Sanofi License Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Accounts receivable   400           400                    
Accounting for the License and Collaboration Agreements in China [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Potential additional payments receivable         10,000                          
Maximum [Member] | Bayer License Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Potential additional payments receivable | €                           € 90.0     € 90.0  
Commercial based milestone payments | € € 490.0         € 490.0                        
License and Milestone Revenues [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Total revenues   0         0 64,353   0 $ 54,900              
License and Milestone Revenues [Member] | Corxel Aficamten License and Collaboration Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Total revenues                       $ 36,500            
License and Milestone Revenues [Member] | Bayer License Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Total revenues               64,300                    
Deferred revenue         52,400                          
License and Milestone Revenues [Member] | Bayer License Agreement [Member] | nHCM [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Milestone revenues recognized     $ 5,900 € 5.0                            
License and Milestone Revenues [Member] | Bayer License Agreement [Member] | oHCM [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Milestone revenues recognized     $ 5,900 € 5.0                            
License and Milestone Revenues [Member] | Accounting for the License and Collaboration Agreements in China [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Total revenues         $ 15,000                          
Collaboration Revenues [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Total revenues   1,936         463 5,931   1,547                
Collaboration Revenues [Member] | China [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Total revenues   400         $ 500 500   $ 1,500                
Collaboration Revenues [Member] | Bayer License Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Total revenues   $ 1,500           $ 5,400                    
Rights Granted [Member] | Corxel Omecamtiv Mecarbil License and Collaboration Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Nonrefundable payment obligation                                   40,000
New Drug Application [Member] | Corxel Omecamtiv Mecarbil License and Collaboration Agreement [Member]                                    
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                                    
Nonrefundable payment obligation                                   $ 10,000
v3.25.3
Fair Value Measurements - Summary of Fair Value of Financial Assets Consists of Cash Equivalents and Investments Classified as Available-for-sale Securities Measured on Recurring Basis (Detail) - Fair Value, Measurements, Recurring [Member] - Cash and Cash Equivalents and Investments [Member] - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost $ 1,244,338 $ 1,217,022
Unrealized Gains 1,175 2,570
Unrealized Losses (235) (407)
Fair Value 1,245,278 1,219,185
Money Market Funds [Member] | Fair Value Measurements Using Level 1 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 204,504 71,515
Unrealized Gains 0 0
Unrealized Losses 0 0
Fair Value 204,504 71,515
U.S. Treasury Securities [Member] | Fair Value Measurements Using Level 1 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 334,782 404,377
Unrealized Gains 549 1,192
Unrealized Losses (19) (74)
Fair Value 335,312 405,495
U.S. Government agency securities | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 176,351 134,547
Unrealized Gains 124 339
Unrealized Losses (45) (23)
Fair Value 176,430 134,863
Commercial Paper [Member] | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 228,090 302,043
Unrealized Gains 49 399
Unrealized Losses (76) (128)
Fair Value 228,063 302,314
Asset-backed securities [Member] | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost   13,924
Unrealized Gains   42
Unrealized Losses   0
Fair Value   13,966
Corporate Obligations [Member] | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 300,611 290,616
Unrealized Gains 453 598
Unrealized Losses (95) (182)
Fair Value $ 300,969 $ 291,032
v3.25.3
Fair Value Measurements - Additional Information (Detail) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Credit losses on debt securities $ 0 $ 0
v3.25.3
Balance Sheet Components - Reconciliation of Cash, Cash Equivalents, and Restricted Cash (Detail) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Cash, Cash Equivalent, Restricted Cash, and Restricted Cash Equivalent, Continuing Operation [Abstract]    
Cash and cash equivalents $ 225,467 $ 94,857
Restricted cash 3,112 375
Total cash, cash equivalents, and restricted cash as reported within our condensed consolidated statement of cash flows $ 228,579 $ 95,232
v3.25.3
Balance Sheet Components - Additional Information (Detail) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Cash, Cash Equivalent, Restricted Cash, and Restricted Cash Equivalent, Continuing Operation [Abstract]    
Restricted cash $ 3,112 $ 375
v3.25.3
Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Accrued liabilities:    
Clinical and preclinical costs $ 16,400 $ 13,567
Compensation related 33,199 35,132
Other accrued expenses 12,034 6,624
Total accrued liabilities $ 61,633 $ 55,323
v3.25.3
Debt - Additional Information (Detail)
 3 Months Ended 9 Months Ended
Sep. 19, 2025
USD ($)
$ / shares
shares
Jul. 06, 2022
USD ($)
$ / shares
shares
Nov. 13, 2019
USD ($)
$ / shares
shares
Sep. 30, 2025
USD ($)
Sep. 30, 2024
USD ($)
Sep. 30, 2025
USD ($)
Days
Sep. 30, 2024
USD ($)
Debt Instrument [Line Items]              
Principal amount of original loan       $ 911,662,000   $ 911,662,000  
Debt conversion expense       121,249,000 $ 0 121,249,000 $ 0
2031 Notes [Member]              
Debt Instrument [Line Items]              
Principal amount of original loan $ 750,000,000     750,000,000   750,000,000  
Aggregate principal amount remaining       750,000,000   $ 750,000,000  
Payment associated with convertible notes $ 402,500,000            
Number of instalments description           payable semiannually in arrears on April 1 and October 1 of each year, beginning April 1, 2026.  
Convertible notes, interest rate 1.75%            
Convertible debt, fair value       854,400,000   $ 854,400,000  
Convertible notes, maturity date Oct. 01, 2031            
Convertible notes, shares issued | shares 14.6156            
Convertible notes, principal amount $ 1,000            
Convertible notes, initial conversion price | $ / shares $ 68.42            
Convertible notes, type of equity security issued common stock            
Convertible notes, conversion description           Holders of the 2031 Notes may convert their 2031 Notes, under certain circumstances, into cash, shares of our common stock or a combination of cash and shares of our common stock, at our election, based on an initial conversion rate of 14.6156 shares per $1,000 principal amount, which is equivalent to an initial conversion price of approximately $68.42 per share.As of September 30, 2025, the holders of the 2031 Notes have the option to convert their 2031 Notes only in the following circumstances: (i) if the last reported sale price per share of our common stock exceeds 130% of the conversion price for at least 20 trading days within a 30-day period starting from the last trading day of the preceding quarter after December 31, 2025; (ii) within 5 consecutive business days following any 10 consecutive trading day period if the trading price per $1,000 principal amount of 2031 Notes during such period falls below 98% of the product of the last reported sale price per share of our common stock and the conversion rate; (iii) upon certain corporate events or distributions on our common stock outlined in the 2031 Indenture; (iv) upon our call for redemption of the 2031 Notes; and (v) from July 1, 2031, until the second scheduled trading day immediately preceding the maturity date. We may not redeem the 2031 Notes at our option at any time before October 6, 2028. During the three-month period ended September 30, 2025, the conditions allowing holders of the 2031 Notes to convert were not met. As a result, the 2031 Notes are not convertible as of September 30, 2025 at the option of the holders thereof.  
Convertible notes, percentage of conversion price           130.00%  
Convertible notes, trading days | Days           20  
Convertible notes, consecutive trading days | Days           30  
Convertible notes, redemption description           The 2031 Notes are not redeemable prior to October 6, 2028 by the Company. On or after October 6, 2028, the 2031 Notes will be redeemable, in whole or in part (subject to the Partial Redemption Limitation), at our option at any time and from time to time, and, in the case of any partial redemption, on or before the 40th scheduled trading day before the maturity date, at a cash redemption price equal to the principal amount of the 2031 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if the 2031 Notes are freely tradable and all accrued and unpaid additional interest, if any, has been paid in full, as of the first interest payment date occurring on or before such redemption notice date, and the last reported sale price per share of our common stock exceeds 130% of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (ii) the trading day immediately before the date we may send such notice.The conversion rate for the 2031 Notes, 2027 Notes, and 2026 Notes will be subject to adjustment upon the occurrence of certain specified events. In addition, upon the occurrence of a make-whole fundamental change (as defined in the each respective indenture for the 2026 Notes, 2027 Notes and 2031 Notes), we will, in certain circumstances, increase the conversion rate by a number of additional shares for a holder that elects to convert its notes in connection with such make-whole fundamental change.  
Debt instrument, unamortized debt issuance cost       $ 20,400,000   $ 20,400,000  
Unamortized debt discount amortization period       6 years 1 month 6 days   6 years 1 month 6 days  
2031 Notes [Member] | Liability [Member]              
Debt Instrument [Line Items]              
Debt instrument effective interest rate       2.20%   2.20%  
2031 Notes [Member] | Debt Instrument Convertible Covenant One [Member]              
Debt Instrument [Line Items]              
Convertible notes, percentage of conversion price           130.00%  
Convertible notes, trading days | Days           20  
Convertible notes, consecutive trading days | Days           30  
2031 Notes [Member] | Debt Instrument Convertible Covenant Two [Member]              
Debt Instrument [Line Items]              
Convertible notes, percentage of last reported sale price of common stock           98.00%  
Convertible notes, trading days | Days           5  
Convertible notes, consecutive trading days | Days           10  
2027 Notes [Member]              
Debt Instrument [Line Items]              
Principal amount of original loan   $ 540,000,000   $ 140,529,000   $ 140,529,000  
Issuance of shares of common stock | shares 2,168,806            
Repurchase of principal amount of original loan $ 399,500,000            
Debt conversion expense       121,200,000      
Aggregate principal amount remaining       140,500,000   $ 140,500,000  
Payment associated with convertible notes   $ 140,300,000          
Number of instalments description           payable semiannually in arrears on January 1 and July 1 of each year, beginning on January 1, 2023  
Convertible notes, interest rate   3.50%          
Convertible debt, fair value       182,900,000   $ 182,900,000  
Convertible notes, maturity date   Jul. 01, 2027          
Convertible notes, shares issued | shares   19.5783          
Convertible notes, principal amount   $ 1,000          
Convertible notes, initial conversion price | $ / shares   $ 51.08          
Convertible notes, type of equity security issued   common stock          
Convertible notes, conversion description           The 2027 Notes are convertible into cash, shares of our common stock or a combination of cash and shares of our common stock, at our election, based on the applicable conversion rate(s). The initial conversion rate for the 2027 Notes is 19.5783 shares of our common stock per $1,000 principal amount of such Notes, which is equivalent to an initial conversion price of approximately $51.08 per share. As of September 30, 2025, the holders of the 2027 Notes have the option to convert their convertible 2027 Notes only in the following circumstances: (i) if the last reported sale price per share of our common stock exceeds 130% of the conversion price for at least 20 trading days within a 30-day period starting from the last trading day of the preceding quarter after September 30, 2022; (ii) within 5 consecutive business days following any 10 consecutive trading day period if the trading price per $1,000 principal amount of 2027 Notes during such period falls below 98% of the product of the last reported sale price per share of our common stock and the conversion rate; (iii) upon certain corporate events or distributions on our common stock outlined in the 2027 Indenture; (iv) upon our call for redemption of the 2027 Notes; and (v) from March 1, 2027, until the scheduled trading day immediately preceding the maturity date. During the three months ended September 30, 2025, the conditions allowing holders of the 2027 Notes to convert were not met. As a result, the 2027 Notes are not convertible as of September 30, 2025 at the option of the holders thereof.  
Convertible notes, percentage of conversion price           130.00%  
Convertible notes, trading days | Days           20  
Convertible notes, consecutive trading days | Days           30  
Convertible notes, redemption description           The 2027 Notes are redeemable, in whole or in part (subject to the Partial Redemption Limitation), at our option at any time, and from time to time, and, in the case of any partial redemption, on or before the 60th scheduled trading day before the maturity date, at a cash redemption price equal to the principal amount of the 2027 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if the last reported sale price per share of our common stock exceeds 130% of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (ii) the trading day immediately before the date we may send such notice.  
Debt instrument, unamortized debt issuance cost       $ 1,600,000   $ 1,600,000  
Unamortized debt discount amortization period       1 year 9 months 18 days   1 year 9 months 18 days  
2027 Notes [Member] | Liability [Member]              
Debt Instrument [Line Items]              
Debt instrument effective interest rate       4.20%   4.20%  
2027 Notes [Member] | Debt Instrument Convertible Covenant One [Member]              
Debt Instrument [Line Items]              
Convertible notes, percentage of conversion price           130.00%  
Convertible notes, trading days | Days           20  
Convertible notes, consecutive trading days | Days           30  
2027 Notes [Member] | Debt Instrument Convertible Covenant Two [Member]              
Debt Instrument [Line Items]              
Convertible notes, percentage of last reported sale price of common stock           98.00%  
Convertible notes, trading days | Days           5  
Convertible notes, consecutive trading days | Days           10  
2026 Notes [Member]              
Debt Instrument [Line Items]              
Principal amount of original loan     $ 138,000,000 $ 21,133,000   $ 21,133,000  
Issuance of shares of common stock | shares   8,071,343          
Repurchase of principal amount of original loan   $ 116,900,000          
Aggregate principal amount remaining       $ 21,100,000   $ 21,100,000  
Number of instalments description           payable semi-annually on May 15 and December 15 of each year, beginning May 15, 2020.  
Convertible notes, interest rate       4.00%   4.00%  
Convertible debt, fair value       $ 110,200,000   $ 110,200,000  
Convertible notes, maturity date     Nov. 15, 2026        
Convertible notes, sinking fund     $ 0        
Convertible notes, shares issued | shares     94.7811        
Convertible notes, principal amount     $ 1,000        
Convertible notes, initial conversion price | $ / shares     $ 0.55        
Convertible notes, type of equity security issued     common stock        
Convertible notes, conversion description           As of September 30, 2025, the holders of the 2026 Notes have the option to convert their 2026 Notes only in the following circumstances: (i) if the last reported sale price per share of our common stock exceeds 130% of the conversion price for at least 20 trading days within a 30-day period; (ii) within 5 consecutive business days following any 10 consecutive trading day period if the trading price per $1,000 principal amount of 2026 Notes during such period falls below 98% of the product of the last reported sale price per share of our common stock and the conversion rate; (iii) upon certain corporate events or distributions on our common stock outlined in the 2026 Indenture; (iv) upon our call for redemption of the 2026 Notes; and (v) from July 15, 2026, until the scheduled trading day immediately preceding the maturity date. During the three-month period ended September 30, 2025, the sale price condition was met. As a result, the 2026 Notes are convertible as of September 30, 2025 at the option of the holders thereof.  
Convertible notes, percentage of conversion price           130.00%  
Convertible notes, trading days | Days           20  
Convertible notes, consecutive trading days | Days           30  
Convertible notes, redemption description           The 2026 Notes are redeemable by the Company, in whole or in part, at our option at any time, and from time to time, and, in the case of any partial redemption, on or before the 60th scheduled trading day before the maturity date, at a cash redemption price equal to the principal amount of the 2026 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date but only if the last reported sale price per share of our common stock exceeds 130% of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (ii) the trading day immediately before the date we may send such notice.  
Debt instrument, unamortized debt issuance cost       $ 100,000   $ 100,000  
Unamortized debt discount amortization period       1 year 1 month 6 days   1 year 1 month 6 days  
2026 Notes [Member] | Liability [Member]              
Debt Instrument [Line Items]              
Debt instrument effective interest rate       4.60% 4.60% 4.60% 4.60%
2026 Notes [Member] | Debt Instrument Convertible Covenant One [Member]              
Debt Instrument [Line Items]              
Convertible notes, percentage of conversion price           130.00%  
Convertible notes, trading days | Days           20  
Convertible notes, consecutive trading days | Days           30  
2026 Notes [Member] | Debt Instrument Convertible Covenant Two [Member]              
Debt Instrument [Line Items]              
Convertible notes, percentage of last reported sale price of common stock           98.00%  
Convertible notes, trading days | Days           5  
Convertible notes, consecutive trading days | Days           10  
v3.25.3
Debt - Schedule of Interest Cost Relating to 2031 Notes, 2027 Notes and 2026 Notes (Detail) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
2026 Notes [Member]        
Debt Instrument [Line Items]        
Contractual interest expense $ 211 $ 211 $ 633 $ 633
Amortization of debt issuance costs 32 29 87 84
Total interest expense recognized 243 240 720 717
2027 Notes [Member]        
Debt Instrument [Line Items]        
Contractual interest expense 4,259 4,725 13,710 14,175
Amortization of debt issuance costs 804 851 2,367 2,406
Total interest expense recognized 5,063 5,576 16,077 16,581
2031 Notes [Member]        
Debt Instrument [Line Items]        
Contractual interest expense 401 0 401 0
Amortization of debt issuance costs 136 0 136 0
Total interest expense recognized $ 537 $ 0 $ 537 $ 0
v3.25.3
Debt - Schedule of Future Minimum Payments under 2031 Notes, 2027 Notes and 2026 Notes (Detail) - USD ($)
$ in Thousands
Sep. 30, 2025
Sep. 19, 2025
Dec. 31, 2024
Jul. 06, 2022
Nov. 13, 2019
Debt Instrument [Line Items]          
2025 remainder $ 423        
2026 40,423        
2027 158,573        
2028 13,125        
2029 13,125        
Thereafter 776,250        
Future minimum payments 1,001,919        
Less: Interest (90,257)        
Convertible notes, principal amount 911,662        
Less: Unamortized debt issuance costs on the convertible notes (22,138)        
Net carrying amount of the convertible notes 889,524   $ 552,370    
2026 Notes [Member]          
Debt Instrument [Line Items]          
2025 remainder 423        
2026 21,978        
2027 0        
2028 0        
2029 0        
Thereafter 0        
Future minimum payments 22,401        
Less: Interest (1,268)        
Convertible notes, principal amount 21,133       $ 138,000
Less: Unamortized debt issuance costs on the convertible notes (144)        
Net carrying amount of the convertible notes 20,989        
2027 Notes [Member]          
Debt Instrument [Line Items]          
2025 remainder 0        
2026 4,919        
2027 145,448        
2028 0        
2029 0        
Thereafter 0        
Future minimum payments 150,367        
Less: Interest (9,838)        
Convertible notes, principal amount 140,529     $ 540,000  
Less: Unamortized debt issuance costs on the convertible notes (1,589)        
Net carrying amount of the convertible notes 138,940        
2031 Notes [Member]          
Debt Instrument [Line Items]          
2025 remainder 0        
2026 13,526        
2027 13,125        
2028 13,125        
2029 13,125        
Thereafter 776,250        
Future minimum payments 829,151        
Less: Interest (79,151)        
Convertible notes, principal amount 750,000 $ 750,000      
Less: Unamortized debt issuance costs on the convertible notes (20,405)        
Net carrying amount of the convertible notes $ 729,595        
v3.25.3
Stockholders' Equity - Additional Information (Detail) - USD ($)
$ / shares in Units, $ in Thousands
 3 Months Ended 9 Months Ended 15 Months Ended
May 28, 2024
Sep. 30, 2025
Sep. 30, 2024
Jun. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Mar. 31, 2025
May 31, 2025
Apr. 30, 2025
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Allocated share based compensation expense   $ 30,696 $ 25,356   $ 81,780 $ 71,590      
Public Offering [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Gross proceeds from issuance of common stock $ 575,000                
Net proceeds of issuance of common stock 563,200       $ 0 563,204      
2004 Plan [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Term to grant nonstatutory stock options and incentive stock options         10 years        
Option grant prices as percentage of the fair market value of the common stock         100.00%        
Percentage of options grant to new employees         25.00%        
Shares available for grant   6,394,601     6,394,601        
Increase in number of authorized shares reserved for issuance               5,000,000  
2004 Plan [Member] | New Employee [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Award vesting right         Options granted to new employees generally vest 25% after one year and monthly thereafter over a period of four years        
Period from percentage of stock option vested         1 year        
Vesting period         4 years        
2004 Plan [Member] | Existing Employee [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Award vesting right         Options granted to existing employees generally vest monthly over a period of four years        
Vesting period         4 years        
Performance Stock Units [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Shares available for grant             467,804    
Allocated share based compensation expense   $ 800 $ 2,500   $ 900 $ 5,100      
Unamortized/unrecognized stock-based compensation expense related to PSUs   $ 1,300     $ 1,300        
Performance Stock Units [Member] | Tranche One [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Share-based compensation arrangement by share based payment award award vesting rights percentage         50.00%        
Performance Stock Units [Member] | Tranche Two [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Share-based compensation arrangement by share based payment award award vesting rights percentage         50.00%        
Performance Stock Units [Member] | Maximum [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Per unit weighted average grant date fair value             $ 63.75    
Performance Stock Units [Member] | Minimum [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Per unit weighted average grant date fair value             $ 44.36    
Common Stock [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Gross proceeds from issuance of private placement $ 50,000                
Number of authorized shares of common stock available for issuance               326,000,000 163,000,000
Common Stock [Member] | Private Placement [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Issuance of shares of common stock 980,392                
Public offering price per share $ 51.00                
Common Stock [Member] | Public Offering [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Issuance of shares of common stock 9,803,922     11,274,510          
Public offering price per share $ 51.00                
Common Stock [Member] | Maximum [Member] | Underwriters Option [Member]                  
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                  
Issuance of shares of common stock 1,470,588                
v3.25.3
Stockholders' Equity - Summary of Stock Options and Restricted Stock Units Granted (Detail)
 9 Months Ended
Sep. 30, 2025
$ / shares
shares
Employee Stock Option [Member]  
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]  
Stock options, Grants | shares 1,861,099
Stock options, Weighted average grant date fair value per share | $ / shares $ 44.53
Restricted Stock Units [Member]  
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]  
Restricted stock units, Grants | shares 1,390,967
Restricted stock units, Weighted average grant date fair value per share | $ / shares $ 44.4
v3.25.3
Stockholder's Equity - Summary of Stock-Based Compensation Expense (Detail) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]        
Allocated share based compensation expense $ 30,696 $ 25,356 $ 81,780 $ 71,590
Research and Development [Member]        
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]        
Allocated share based compensation expense 15,138 11,417 40,358 31,520
General and Administrative [Member]        
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]        
Allocated share based compensation expense $ 15,558 $ 13,939 $ 41,422 $ 40,070
v3.25.3
Commitments and Contingencies - Additional Information (Detail) - USD ($)
$ in Thousands
 1 Months Ended 9 Months Ended
Mar. 31, 2021
Aug. 31, 2025
Feb. 28, 2025
Sep. 30, 2022
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Lessee Lease Description [Line Items]              
Increase in operating lease right-of-use asset         $ 6,427 $ 509  
Operating lease right-of-use assets         $ 77,580   $ 75,158
Oyster Point Lease [Member] | California [Member]              
Lessee Lease Description [Line Items]              
Operating lease, lease expiration date         Oct. 31, 2033    
Operating lease, commencement date Mar. 31, 2021            
Radnor Lease [Member] | Pennsylvania [Member]              
Lessee Lease Description [Line Items]              
Operating lease, commencement period       2022-09      
Operating lease commenced, term description         one five-year option to extend the lease    
Radnor Lease Old Expiration Date [Member] | Pennsylvania [Member]              
Lessee Lease Description [Line Items]              
Operating lease, lease expiration date         Jul. 31, 2027    
Amended Radnor Lease for Existing and Additional Space [Member] | Pennsylvania [Member]              
Lessee Lease Description [Line Items]              
Operating lease amended period     2025-02        
Operating lease, extend the lease term         2029-07    
Operating lease commenced, term description         one five-year renewal option    
Increase in operating lease right-of-use asset         $ 1,100    
Operating lease right-of-use assets         2,400    
Operating lease liability         $ 2,400    
Discount rate         8.90%    
Zug Lease [Member] | Switzerland [Member]              
Lessee Lease Description [Line Items]              
Initial term of lease   5 years          
Operating lease, commencement period   2025-08          
Lessee, Operating Lease, Existence of Option to Extend [true false]         true    
Operating lease commenced, term description         an option to extend for an additional five years    
Operating lease right-of-use assets         $ 2,600    
Operating lease liability         $ 2,600    
Discount rate         9.00%    
v3.25.3
Subsequent Event - Additional Information (Detail) - RP Loan Agreement [Member] - Term Loan Tranche 5 [Member] - 2022 Royalty Pharma Transactions [Member] - CRL Option [Member] - USD ($)
$ in Millions
Oct. 31, 2025
Nov. 30, 2024
Subsequent Event [Line Items]    
Term loan, drawn amount   $ 100.0
Subsequent Event [Member]    
Subsequent Event [Line Items]    
Term loan, drawn amount $ 100.0