Prepared by Mikayla Blomquist ‘27, Quinn Dunkle ‘27, Hayley Kelleher ‘28, Kaitlyn Toner ‘29
Company Overview
Centessa Pharmaceuticals (NASDAQ: CNTA) is a clinical-stage biotechnology company headquartered in Boston and London, founded in 2021. The company follows an “asset-centric” R&D model, meaning each therapeutic program operates semi-independently under its own leadership team. This approach increases agility, reduces spending, and allows Centessa to focus resources on its most promising asset: ORX750, a first-in-class Orexin-2 receptor (OX2R) agonist designed to address narcolepsy and idiopathic hypersomnia. Since the pitch, the company has secured a 250 million dollar investment into its pipeline program.
Investment Thesis
The pitch team initiated a BUY recommendation prior to the release of Phase 2a data for ORX750 expecting a positive result. Indeed, the results were positive and led to a 10% increase in CNTA stock price. We believe that even after this increase the company is a buy as it remains a strong candidate for an acquisition by a larger pharmaceutical company.
Centessa’s leadership team and streamlined capital strategy provide further confidence. Their focus on a single, high-value neurological indication significantly enhances capital efficiency and probability of success compared to broader, multi-asset biotech peers.
Market Opportunity
The unmet need in sleep neurology remains vast. In the United States, roughly 170,000 individuals suffer from narcolepsy, and only about 25% currently receive treatment. An additional 65,000 patients are affected by idiopathic hypersomnia (IH), which causes debilitating daytime sleepiness and cognitive impairment despite long sleep durations.
Existing treatments, including sodium oxybate products like Xyrem and Xywav, and stimulants such as modafinil or amphetamines, focus only on symptom management. These drugs carry significant drawbacks, from abuse potential and cardiovascular side effects to the need for strict monitoring programs. Centessa’s ORX750, by contrast, directly targets the root cause of narcolepsy, orexin deficiency, making it the first therapy designed to correct the underlying biological imbalance.
Clinical Progress and Competitive Advantage
ORX750 is an orally administered, selective full OX2R agonist that mimics the body’s natural orexin signaling. The compound has shown robust wake-promoting effects and improvements in cognition, fatigue, and attention, without the toxicity concerns seen in competitor programs.
With successful Phase 2a data released just after the pitch date, Centessa aims to begin registrational studies in 2026. A positive readout validated Centessa’s science but also made the company one of the most valuable independent players in the sleep disorder space.
Financial Strength and Valuation
Centessa remains well-capitalized, with a cash runway extending into mid-2027 and beyond. Management has demonstrated disciplined spending by prioritizing the OX2R program and maintaining a streamlined organizational structure. This allows Centessa to progress through registrational trials without the need for near-term dilution: a key differentiator among small-cap biotech firms.
As of November 4, 2025 (pitch date), CNTA traded at $24.90 per share, up more than 150% from its 52-week low of $9.60, reflecting renewed market confidence ahead of clinical catalysts. The company’s market capitalization of $3.3 billion is somewhat higher than two comparable acquisitions, but we believe that CNTA’s multi-billion dollar narcolepsy market justifies the valuation.
M&A Potential
The most likely long-term outcome for Centessa is an acquisition by a larger pharmaceutical company with an established neurology or sleep-medicine effort. Comparable deals support this thesis. In October 2025, Alkermes plc acquired Avadel Pharmaceuticals, developer of the narcolepsy drug Lumryz, for $2.1 billion, while Axsome Therapeutics bought U.S. rights to Sunosi from Jazz Pharmaceuticals for $53 million plus royalties. Given the $2 billion-plus revenue potential for oxybate-based therapies, Big Pharma is clearly willing to pay a premium for innovative treatments in this space.
Leadership and Track Record
CEO Dr. Saurabh Saha, formerly a global R&D leader at Bristol Myers Squibb, has successfully advanced multiple drugs through late-stage clinical development and has a proven track record of delivering at key inflection points. CFO John Crowley brings over 20 years of experience in biotech finance and operations, having previously led Fusion Pharmaceuticals through its $2.4 billion acquisition by AstraZeneca in 2024. His career began at a Big Four accounting firm and includes executive roles at Ironwood Pharmaceuticals and Vertex, where he contributed to commercialization and strategic deal execution. Centessa’s board of directors includes industry veterans from Pfizer, Vertex, Takeda, and Novartis, collectively representing decades of experience in advancing companies through clinical milestones and multi-billion-dollar exits.
Risks and Outlook
Key risks include clinical uncertainty inherent to central nervous system drug development, patient recruitment challenges for rare sleep disorders, and concentration risk as a single-asset company. However, Centessa’s pipeline includes multiple follow-on OX2R agonists that could extend the company’s long-term relevance. The recent 250-million-dollar investment has de-risked the single-asset hesitation on Centessa, as that money will be allocated towards their pipeline program.