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Starling Oncology Institute
(NASDAQ:STLN)
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Rating:50Neutral
Price Target:
$5.00
▼(-3.66% Downside)
Action:Reiterated
Date:08/07/26
The score is held down primarily by weak financial performance (ongoing losses, cash burn per statements, and negative equity). Offsetting this, the latest earnings call was constructive with raised guidance, improved profitability trajectory, better cash flow, and a balance-sheet refinancing. Technicals are mixed and valuation support is limited by negative earnings and no provided dividend yield.
Positive Factors
Specialty Pharmacy Scale
Rapid specialty pharmacy expansion has materially increased gross profit and procurement scale. Durable demand for oncology drugs and improved supply economics support recurring revenue and cash generation, enabling operating leverage that can sustainably bolster margins and free cash flow over coming quarters.
Negative Factors
Negative Stockholders' Equity
Persistently negative equity reflects accumulated losses and constrains financial flexibility. This structural weakness increases sensitivity to operational setbacks, complicates access to unsecured capital, and raises solvency risk if profitability or cash flow improvements stall during capitation scale‑up over the next 2–6 months.
Read all positive and negative factors
Positive Factors
Negative Factors
Specialty Pharmacy Scale
Rapid specialty pharmacy expansion has materially increased gross profit and procurement scale. Durable demand for oncology drugs and improved supply economics support recurring revenue and cash generation, enabling operating leverage that can sustainably bolster margins and free cash flow over coming quarters.
Read all positive factors
Starling Oncology Institute (STLN) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$485.92M
Dividend YieldN/A
Average Volume (3M)1.95M
Price to Earnings (P/E)―
Beta (1Y)1.76
Revenue Growth35.37%
EPS Growth46.10%
CountryUS
Employees641
SectorHealthcare
Sector Strength45
IndustryMedical - Care Facilities
Share Statistics
EPS (TTM)-0.35
Shares Outstanding99,982,930
10 Day Avg. Volume1,978,047
30 Day Avg. Volume1,952,546
Financial Highlights & Ratios
PEG Ratio0.28
Price to Book (P/B)-209.23
Price to Sales (P/S)6.54
P/FCF Ratio-118.37
Enterprise Value/Market Cap<0.01
Enterprise Value/Revenue<0.01
Enterprise Value/Gross Profit<0.01
Enterprise Value/Ebitda>-0.01
Forecast
1Y Price Target
$9.25Price Target Upside78.23% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
EPS Forecast (FY)-0.14
Revenue Forecast (FY)$650.95M
Starling Oncology Institute Business Overview & Revenue Model
Company Description
Starling Oncology, Inc., formerly The Oncology Institute, is a value-based oncology company advancing cancer care in the community setting. Founded in 2007, the company offers cutting-edge, evidence-based cancer treatments, including clinical tria...
How the Company Makes Money
TOI primarily makes money by providing oncology medical services to patients and billing third-party payers. Key revenue streams include (1) professional fees for physician and advanced practice provider services (e.g., evaluation and management v...
Starling Oncology Institute Earnings Call Summary
Earnings Call Date:Aug 06, 2026
(Q2-2026)
| % Change Since: |
Next Earnings Date:Nov 11, 2026
Earnings Call Sentiment Positive
The call highlighted strong revenue growth (34.6% YoY), robust Specialty Pharmacy performance (57.6% revenue growth; 85.1% gross profit growth), improved margins and the company's second profitable quarter as a public company with positive adjusted EBITDA. Cash flow turned positive, free cash flow improved materially, and a refinancing strengthened the balance sheet without dilution. Management also announced meaningful capitated contract wins that add substantial lives and annualized capitation revenue, and they launched a provider portal expected to drive longer-term clinical and commercial benefits. Headwinds include a materially higher MLR (85.5% in Q2 vs 71% prior year), a steep decline in Patient Services gross profit (~57% YoY decline), timing delays that push some launches into Q4 and potential variability in pharmacy margin gains. Overall, the positive top-line, profitability improvement, cash flow progress and balance sheet actions outweigh the near-term operational and margin challenges while scaling capitated lives.Positive Updates
Strong Top-Line Growth
Total revenue of $161.3M for Q2 2026, up 34.6% year-over-year (vs $119.8M in Q2 2025). Management raised full-year revenue guidance to $650M–$670M.
Negative Updates
Higher Medical Loss Ratio (MLR)
Company reported an MLR of 85.5% in Q2 2026 vs 71% a year ago. Management expects MLR to fluctuate and be in the 80%–90% range over the next 12 months due to onboarding delegated members (delegated product target 75%–85% when fully ramped; narrow network 70%–75%).
Read all updates
Q2-2026 Updates
Positive
Negative
Strong Top-Line Growth
Total revenue of $161.3M for Q2 2026, up 34.6% year-over-year (vs $119.8M in Q2 2025). Management raised full-year revenue guidance to $650M–$670M.
Read all positive updates
Company Guidance
Management raised and narrowed full‑year guidance, now targeting revenue of $650–$670 million (including roughly $150 million of capitation in 2026), gross profit of $105–$110 million, adjusted EBITDA of $2 million to $7 million, and free cash flow of $5 million to $15 million; they expect Q3 adjusted EBITDA to be positive but muted at $0.5–$1.5 million while onboarding ~230,000 new members, anticipate medical loss ratios to run roughly 80%–90% over the next 12 months (delegated ~75%–85% fully ramped; narrow‑network 70%–75%), and reiterated plans to add three delegated capitated contracts (~80,000 lives / ~$50 million annualized capitation) plus a California exclusivity (~230,000 lives / ~$6 million annualized), with management forecasting about a 100% increase in capitated revenue in 2027.Starling Oncology Institute Financial Statement Overview
Summary
Income Statement
32
Negative
Balance Sheet
22
Negative
Cash Flow
24
Negative
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 545.76M | 502.73M | 393.41M | 324.24M | 252.48M | 203.00M |
| Gross Profit | 80.89M | 76.44M | 54.00M | 59.57M | 52.09M | 40.85M |
| EBITDA | -29.23M | -42.52M | -50.88M | -54.28M | -67.60M | -42.04M |
| Net Income | -43.51M | -60.61M | -64.66M | -83.07M | 152.00K | -10.93M |
Balance Sheet | ||||||
| Total Assets | 168.23M | 164.66M | 172.72M | 209.24M | 261.67M | 203.44M |
| Cash, Cash Equivalents and Short-Term Investments | 30.28M | 33.56M | 49.67M | 82.86M | 73.81M | 114.30M |
| Total Debt | 104.86M | 103.69M | 123.15M | 119.67M | 108.18M | 183.00K |
| Total Liabilities | 184.51M | 180.38M | 169.13M | 152.22M | 138.49M | 99.28M |
| Stockholders Equity | -16.29M | -15.72M | 3.59M | 57.02M | 123.17M | 104.16M |
Cash Flow | ||||||
| Free Cash Flow | -25.73M | -27.79M | -30.33M | -40.88M | -67.28M | -35.73M |
| Operating Cash Flow | -21.81M | -24.59M | -26.54M | -36.31M | -61.76M | -32.68M |
| Investing Cash Flow | -3.91M | -3.07M | 46.21M | 62.64M | -131.61M | -12.15M |
| Financing Cash Flow | 16.27M | 11.56M | -3.49M | -6.85M | 92.21M | 154.01M |
Starling Oncology Institute Technical Analysis
Positive
5.19
Price Trends
5.23
Positive
4.42
Positive
3.89
Positive
Market Momentum
0.03
Negative
66.48
Neutral
57.59
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For STLN, the sentiment is Positive. The current price of 5.19 is below the 20-day moving average (MA) of 5.33, below the 50-day MA of 5.23, and above the 200-day MA of 3.89, indicating a bullish trend. The MACD of 0.03 indicates Negative momentum. The RSI at 66.48 is Neutral, neither overbought nor oversold. The STOCH value of 57.59 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for STLN.
Starling Oncology Institute Risk Analysis
Starling Oncology Institute disclosed 56 risk factors in its most recent earnings report. Starling Oncology Institute reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Starling Oncology Institute Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
65 Neutral | $874.42M | 1,110.64 | 1.03% | ― | 22.64% | -58.05% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
51 Neutral | $1.53B | -4.04 | -119.35% | ― | -2.82% | -45.70% | |
50 Neutral | $485.92M | -13.89 | 326.77% | ― | 35.37% | 46.10% | |
42 Neutral | $393.42M | -1.23 | 20.91% | ― | -5.25% | ― |
* Healthcare Sector Average
STLN
Starling Oncology Institute
6.41
2.17
51.18%
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Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.