Genmab’s royalty engine generated $742 million in the first quarter of 2026 — up 26% year-over-year — and that number matters because it reveals a structural tension the company cannot ignore indefinitely: DARZALEX and Kesimpta are financing the next generation of Genmab’s ambitions, but those ambitions cost more every quarter and are not yet generating revenue of their own.
The math is blunt. Total revenue hit $896 million, a 25% jump, driven almost entirely by royalties on assets Genmab does not control commercially. DARZALEX alone cleared nearly $4 billion in net sales at J&J, generating the royalty flow that kept Genmab’s lights on while operating expenses rose $121 million — a 25% increase — largely from advancing Rina-S and petosemtamab toward launch readiness and absorbing the Merus integration. Operating profit actually declined modestly on a reported basis, from $188 million to $180 million, because the $45 million in Merus-related severance and retention charges hit the P&L in full. Strip those out and the adjusted operating number improves, but the direction of travel is clear: spend is accelerating faster than the proprietary revenue base can currently support.
The EPKINLY hospitalization label update — the FDA removal of the 24-hour observation requirement for third-line-plus relapsed/refractory DLBCL — is a genuine commercial lever, not a housekeeping footnote. Bispecific T-cell engagers have faced real adoption friction in community oncology settings precisely because infusion center logistics around monitoring requirements create barriers that hospital-based academic centers absorb more easily. Eliminating that requirement expands the addressable prescriber base without a new trial, new indication, or new investment. That is a high-return regulatory move.
The strategic question for Genmab is whether petosemtamab — the EGFR x LGR5 bispecific targeting colorectal cancer inherited from Merus — can become a proprietary commercial asset that breaks the royalty-dependency pattern before DARZALEX biosimilar pressure compounds. Rina-S (rinatabart sesutecan) in gynecologic cancers adds a second potential launch vector. But the single marker worth tracking now is petosemtamab’s pivotal readout timeline: that data will determine whether Merus was a $1.8 billion bet that reshapes Genmab’s revenue mix or one that extends the royalty-funded waiting game another cycle.
Jon Napitupulu is Director of Media Relations at The Clinical Trial Vanguard. Jon, a computer data scientist, focuses on the latest clinical trial industry news and trends.
