Accuray Taps Turnaround Expert to Revive Commercial Fortunes

MADISON, WI – April 06, 2026 – In a strategic move signaling a major push to bolster its market position, radiation therapy systems provider Accuray Incorporated (NASDAQ: ARAY) today announced the appointment of Paul Miele as its new Senior Vice President and Chief Commercial Officer. Miele, a veteran executive with a reputation for engineering commercial turnarounds, will join the company's executive leadership team and take the helm of its global commercial operations.

The appointment comes at a critical juncture for the Madison-based company, which is navigating significant financial pressures and a highly competitive landscape. Miele is tasked with strengthening commercial execution and advancing a company-wide transformation aimed at long-term growth.

"Paul brings deep global commercial leadership experience and a strong track record of driving transformation and sales growth in complex medical technology businesses," said Steve La Neve, President and Chief Executive Officer of Accuray, in a statement. La Neve emphasized that Miele's background would be "instrumental as we continue to strengthen our commercial performance and position Accuray for long‑term value creation."

A Mandate for Transformation

Miele steps into his new role amidst a challenging period for Accuray. The company's recent financial reports paint a picture of a business facing considerable headwinds. In the first half of fiscal year 2026, Accuray reported declining revenues and sharply compressed gross margins. The second quarter ending December 31, 2025, saw overall gross margins fall to 23.5%, a steep drop from 36.1% in the prior-year period, largely impacted by challenges in its China operations and increased tariffs.

This performance led Accuray to revise its full-year guidance downwards, reducing its revenue forecast to a range of $440-$450 million. The financial strain was further evidenced by the company's announcement of a significant cost-restructuring plan, which includes a 15% reduction in its global workforce, a move intended to improve annualized operating profitability by $25 million. Compounding these issues, the company received a non-compliance notice from Nasdaq in late 2025 after its stock price traded below the $1.00 minimum for 30 consecutive business days.

Against this backdrop, Miele's appointment is clearly more than a routine leadership change. It represents a deliberate strategy to inject new vigor into Accuray's commercial engine. His mandate is to reverse negative trends and build a sustainable model for growth in a market that offers little room for error.

The Turnaround Specialist's Track Record

Accuray is betting that Miele is the right leader for this challenge, and his resume provides compelling evidence for their confidence. With nearly two decades of experience in the capital medical device sector, Miele has built a reputation for revitalizing sales and scaling businesses across the Americas, EMEA, and APAC regions.

His most recent role was as Business Unit Leader and General Manager for the MONARCH™ robotic platform at Johnson & Johnson MedTech. According to industry reports, he was recruited specifically to orchestrate a commercial turnaround. During his tenure, Miele successfully rebuilt the commercial operating model, re-engaged the platform's installed base, and accelerated capital equipment sales. His efforts are credited with reversing a revenue decline and generating double-digit percentage annual sales growth for the division.

Prior to his success at Johnson & Johnson, Miele held senior commercial roles at other major MedTech players, including Globus Medical and Intuitive Surgical, where he reportedly achieved similar success in driving commercial performance. This consistent history of navigating complex market dynamics and delivering tangible sales growth makes him a strategic fit for Accuray's current needs.

Navigating a Competitive Radiation Oncology Landscape

Miele's expertise will be put to the test in the fiercely competitive global radiation therapy market. Accuray competes with industry giants like Varian Medical Systems, now a part of Siemens Healthineers, and Elekta AB, both of which command larger market shares. The market itself is dynamic and expanding, with forecasts projecting growth from approximately $8.14 billion in 2026 to over $12 billion by 2032, fueled by a rising global incidence of cancer and rapid technological innovation.

Key trends shaping this landscape include a strong demand for precision oncology, the adoption of AI-based treatment planning, and the rise of service-centric business models. Competitors are also making aggressive moves. Elekta, for instance, is pursuing its own "Access 2025" strategy focused on innovation and expanding its footprint in emerging markets, alongside its own restructuring efforts.

To succeed, Accuray must not only defend its existing market share but also effectively capitalize on these growth trends. This requires a commercial strategy that can adeptly communicate the value of its unique technologies, such as its CyberKnife and TomoTherapy systems, to clinicians and hospital administrators making critical capital investment decisions.

A New Commercial Blueprint for Growth

As Chief Commercial Officer, Miele will be responsible for architecting and executing Accuray's global commercialization strategy. His purview will be broad, covering sales, marketing, pricing, market access, commercial partnerships, and the execution of new product launches. His experience in strengthening service monetization and unlocking recurring revenue will be particularly relevant as the industry increasingly shifts toward long-term service and solutions contracts.

Expressing his enthusiasm for the role, Miele pointed to the company's strengths and his intended focus. "Accuray has a strong foundation of innovation, a large installed base, a group of dedicated distribution partners, and a meaningful opportunity to further strengthen its commercial impact worldwide," Miele stated. "I'm excited to join the team and help drive growth in systems and services sales, with a particular focus on marketing and selling value-added solutions to our customers, on commercial execution, and on carrying out Accuray's mission for the benefit of countless customers and patients."

His immediate focus will likely be on stabilizing sales, improving commercial discipline, and leveraging Accuray's innovative portfolio to win new business. The industry will be watching closely to see if this turnaround specialist can replicate his past successes and steer Accuray toward a future of renewed growth and profitability.