10-Q
1
f10q0620_actiniumpharma.htm
QUARTERLY REPORT
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
☒ QUARTERLY
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2020
or
☐ TRANSITION
REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from __________ to
__________
Commission File Number: 001-36374
ACTINIUM PHARMACEUTICALS, INC.
(Exact name of registrant as specified in its
charter)
Delaware
74-2963609
(State or Other Jurisdiction of
Incorporation or Organization)
(I.R.S. Employer
Identification No.)
275 Madison Ave, 7 th Floor
New York, NY
10016
(Address of Principal Executive Offices)
(Zip Code)
(646) 677-3870
(Registrant’s Telephone Number, Including
Area Code)
Securities registered
pursuant to Section 12(b) of the Act:
Title of each class
Trading Symbol
Name of exchange on which registered
Common stock, par value $0.001
ATNM
NYSE American
Indicate by check mark
whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of
1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2)
has been subject to such filing requirements for the past 90 days. ☒ Yes No ☐
Indicate by check mark
whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of
Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was
required to submit such files). ☒ Yes No ☐
Indicate by check mark
whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company,
or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,”
“smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer
☐
Accelerated filer
☐
Non-accelerated filer
☒
Smaller reporting company
☒
Emerging growth company
☐
If an emerging growth company,
indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised
financial accounting standards, provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark
whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). ☐ Yes ☒ No
Indicate the number of shares outstanding of each of the issuer’s
classes of common stock, as of August 13, 2020: 13,585,222
Actinium Pharmaceuticals, Inc.
FORM 10-Q
For the six months ended June 30, 2020
INDEX
PART I – FINANCIAL INFORMATION
Item 1.
Financial Statements
1
Item 2.
Management’s Discussion and Analysis of Financial Condition and Results of Operations
15
Item 3.
Quantitative and Qualitative Disclosures About Market Risk
26
Item 4.
Controls and Procedures
26
PART II – OTHER INFORMATION
Item 1.
Legal Proceedings
27
Item 1A.
Risk Factors
27
Item 2.
Unregistered Sales of Equity Securities and Use of Proceeds
54
Item 3.
Defaults Upon Senior Securities
54
Item 4.
Mine Safety Disclosures
54
Item 5.
Other Information
54
Item 6.
Exhibits
57
SIGNATURES
59
i
PART I - FINANCIAL INFORMATION
ITEM 1. FINANCIAL STATEMENTS
The accompanying consolidated financial statements
have been prepared by the Company and are unaudited. In the opinion of management, all adjustments (which include only normal recurring
adjustments) necessary to present fairly the financial position at June 30, 2020 and December 31, 2019, and the results of operations
and cash flows for the three and six months ended June 30, 2020 and 2019, respectively, have been made. Certain information and
footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted
in the United States of America have been condensed or omitted. It is suggested that these financial statements be read in conjunction
with the financial statements and notes thereto included in the Company’s audited financial statements for the year ended
December 31, 2019 in the Company’s Annual Report on Form 10-K. The results of operations for the three and six months ended
June 30, 2020 are not necessarily indicative of the operating results for the full year.
1
Actinium Pharmaceuticals, Inc.
Consolidated Balance Sheets
(amounts in thousands, except share and per
share data)
June 30,
2020
December 31,
2019
(Unaudited)
Assets
Current Assets:
Cash and cash equivalents
$ 53,466
$ 9,254
Restricted cash – current
48
48
Prepaid expenses and other current assets
994
786
Total Current Assets
54,508
10,088
Property and equipment, net of accumulated depreciation of $260 and $237, respectively
90
113
Operating leases right-of-use assets
738
807
Finance leases right-of-use assets
181
221
Security deposit
50
50
Restricted cash
391
391
Total Assets
$ 55,958
$ 11,670
Liabilities and Stockholders’ Equity
Current Liabilities:
Accounts payable and accrued expenses
$ 4,092
$ 4,598
Note payable
154
381
Operating leases current liability
328
286
Finance leases current liability
82
79
Total Current Liabilities
4,656
5,344
Long-term operating leases obligations
419
531
Long-term finance leases obligations
109
151
Total Liabilities
5,184
6,026
Commitments and contingencies
Stockholders’ Equity:
Preferred stock, $0.001 par value; 50,000,000 shares authorized, 0 shares issued and outstanding
-
-
Common stock, $0.001 par value; 1,000,000,000 shares authorized;
13,171,824 and 5,490,038 shares issued and outstanding, respectively
13
5
Additional paid-in capital
269,815
214,397
Accumulated deficit
(219,054 )
(208,758 )
Total Stockholders’ Equity
50,774
5,644
Total Liabilities and Stockholders’ Equity
$ 55,958
$ 11,670
See accompanying notes to the consolidated financial
statements.
2
Actinium Pharmaceuticals, Inc.
Consolidated Statements of Operations
(Unaudited)
(amounts in thousands, except share and per
share data)
For the Three Months Ended
June 30,
For the Six Months Ended
June 30,
2020
2019
2020
2019
Revenue
$ -
$ -
$ -
$ -
Operating expenses:
Research and development, net of reimbursements
3,508
4,010
7,659
8,345
General and administrative
1,154
1,076
2,686
2,440
Total operating expenses
4,662
5,086
10,345
10,785
Loss from operations
(4,662 )
(5,086 )
(10,345 )
(10,785 )
Other income:
Interest income - net
37
59
50
88
Total other income
37
59
50
88
Net loss
$ (4,625 )
$ (5,027 )
$ (10,295 )
$ (10,697 )
Deemed dividend for warrant down-round protection provision
(1 )
(1 )
(1 )
(1 )
Net loss applicable to common stockholders
$ (4,626 )
$ (5,028 )
$ (10,296 )
$ (10,698 )
Net loss per share of common stock – basic and diluted
$ (0.41 )
$ (1.00 )
$ (1.20 )
$ (2.39 )
Weighted average shares of common stock outstanding, including outstanding pre-funded warrants– basic and diluted
11,379,345
5,051,471
8,559,385
4,476,215
See accompanying notes to the consolidated financial
statements.
3
Actinium Pharmaceuticals, Inc.
Consolidated Statement of Changes in Stockholders’
Equity
For the Three and Six Months Ended June 30,
2020
(Unaudited)
(amounts in thousands, except share amounts)
Common Stock
Additional Paid-In
Accumulated
Stockholders’
Shares
Amount
Capital
Deficit
Equity
Balance, January 1, 2020
5,490,038
$ 5
$ 214,397
$ (208,758 )
$ 5,644
Stock-based compensation
-
-
372
-
372
Sale of common stock, net of offering costs
337,944
1
2,673
-
2,674
Net loss
-
-
-
(5,670 )
(5,670 )
Balance, March 31, 2020
5,827,982
6
217,442
(214,428 )
3,020
Stock-based compensation
5,240
-
210
-
210
Issuance of common stock from exercise of pre-funded warrants
1,200,000
1
3
-
4
Sale of common stock and pre-funded warrants, net of offering costs
6,138,602
6
52,159
-
52,165
Deemed dividend for warrant down-round protection provision
-
-
1
(1 )
-
Net loss
-
-
-
(4,625 )
(4,625 )
Balance, June 30, 2020
13,171,824
$ 13
$ 269,815
$ (219,054 )
$ 50,774
See accompanying notes to the consolidated financial
statements.
4
Actinium Pharmaceuticals, Inc.
Consolidated Statement of Changes in Stockholders’
Equity
For the Three and Six Months Ended June 30,
2019
(Unaudited)
(amounts in thousands, except share amounts)
Common Stock
Additional Paid-In
Accumulated
Stockholders’
Shares
Amount
Capital
Deficit
Equity
Balance, January 1, 2019
3,856,768
$ 4
$ 195,666
$ (186,857 )
$ 8,813
Stock-based compensation
74
-
316
-
316
Issuance of common stock from exercise of warrants
83,542
-
1,504
-
1,504
Sale of common stock, net of offering costs
30,817
-
380
-
380
Net loss
-
-
-
(5,670 )
(5,670 )
Balance, March 31, 2019
3,971,201
4
197,866
(192,527 )
5,343
Stock-based compensation
-
-
277
-
277
Issuance of common stock from exercise of warrants
1,249
-
-
-
-
Sale of common stock and warrants, net of offering costs
1,428,667
1
15,107
-
15,108
Deemed dividend for warrant down-round protection provision
-
-
1
(1 )
-
Net loss
-
-
-
(5,027 )
(5,027 )
Balance, June 30, 2019
5,401,117
$ 5
$ 213,251
$ (197,555 )
$ 15,701
See accompanying notes to the consolidated financial
statements.
5
Actinium Pharmaceuticals, Inc.
Consolidated Statements of Cash Flows
(Unaudited)
(amounts in thousands)
For the Six Months Ended
June 30,
2020
2019
Cash Flows From Operating Activities:
Net loss
$ (10,295 )
$ (10,697 )
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation expense
582
593
Depreciation & amortization expenses
216
209
Changes in operating assets and liabilities:
Prepaid expenses and other current assets
(208 )
280
Accounts payable and accrued expenses
(506 )
(1,111 )
Operating lease liabilities
(154 )
(127 )
Net Cash Used In Operating Activities
(10,365 )
(10,853 )
Cash Flows Used In Investing Activities:
Purchase of property and equipment
-
(59 )
Net Cash Used In Investing Activities
-
(59 )
Cash Flows From Financing Activities:
Payments on note payable
(227 )
(148 )
Payments on finance leases
(39 )
(36 )
Sales of shares of common stock and pre-funded warrants, net of costs
54,839
-
Sales of shares of common stock and warrants, net of costs
-
15,488
Proceeds from exercise of pre-funded warrants
4
-
Proceeds from exercise of warrants
-
1,504
Net Cash Provided By Financing Activities
54,577
16,808
Net change in cash, cash equivalents, and restricted cash
44,212
5,896
Cash, cash equivalents, and restricted cash at beginning of period
9,693
14,104
Cash, cash equivalents, and restricted cash at end of period
$ 53,905
$ 20,000
Supplemental disclosure of cash flow information:
Cash paid for interest on note payable
$ 6
$ 4
Cash paid for taxes
$ -
$ -
Supplemental disclosure of non-cash flow information:
Deemed dividend for warrant down-round protection provision
$ 1
$ 1
See accompanying notes to the consolidated financial
statements.
6
Actinium Pharmaceuticals, Inc.
Notes to Consolidated Financial Statements
(Unaudited)
Note 1 - Description of Business and Summary
of Significant Accounting Policies
Nature of Business -
Actinium Pharmaceuticals, Inc. (the “Company”, “Actinium”, or “We”) is a clinical-stage, biopharmaceutical
company applying its proprietary platform technology and deep understanding of radioimmunobiology to the development of novel targeted
therapies known as ARCs or Antibody Radiation-Conjugates.
Basis of Presentation
- Unaudited Interim Financial Information - The accompanying unaudited interim consolidated financial statements and related
notes have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S.
GAAP”) for interim financial information, and in accordance with the rules and regulations of the United States Securities
and Exchange Commission (the “SEC”) with respect to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do
not include all of the information and footnotes required by U.S. GAAP for complete financial statements. The unaudited interim
consolidated financial statements furnished reflect all adjustments (consisting of normal recurring adjustments) which are, in
the opinion of management, necessary for a fair statement of the results for the interim periods presented. Interim results are
not necessarily indicative of the results for the full year. These unaudited interim consolidated financial statements should be
read in conjunction with the audited consolidated financial statements and notes thereto contained in the Company’s annual
report on Form 10-K for the year ended December 31, 2019.
Reverse Stock Split
- On April 29, 2020, the Company received a deficiency letter from the NYSE American LLC, or NYSE American, indicating that
the Company was not in compliance with the NYSE American continued listing standard set forth in Section 1003(f)(v) of the NYSE
American Company Guide because its shares of common stock had been selling for a substantial period of time at a low price per
share. Pursuant to Section 1003(f)(v) of the NYSE American Company Guide, the NYSE American staff determined that the Company’s
continued listing is predicated on the Company effecting a reverse stock split of its common stock or otherwise demonstrating sustained
price improvement within a reasonable period of time, which the staff determined to be no later than October 29, 2020.
On October 18, 2019, the
Company’s board of directors, or the Board, unanimously approved, subject to stockholder approval, an amendment to the Company’s
certificate of incorporation to effect a reverse stock split of its outstanding common stock by combining outstanding shares of
common stock into a lesser number of outstanding shares of common stock by a ratio of not more than 1-for-75 prior to December
18, 2020, with the exact ratio to be set within this range by the Board at its sole discretion. At its Annual Meeting of Stockholders
held on December 18, 2019, the Company’s stockholders approved such amendment to its certificate of incorporation.
7
On August 7, 2020, the Board unanimously approved a reverse
stock split of its outstanding common stock by combining outstanding shares of common stock into a lesser number of outstanding
shares of common stock by a ratio of 1-for-30, and on August 10, 2020, the Company filed with the Secretary of State of Delaware
a certificate of amendment to its certificate of incorporation to effect the reverse stock split. The reverse stock split became
effective as of 5:00 p.m. Eastern Time on August 10, 2020, and the Company’s common stock began trading on a split-adjusted
basis when the market opened on August 11, 2020. Accordingly, all common share and per common share data in these consolidated
financial statements and related notes hereto have been retroactively adjusted to account for the effect of this reverse stock
split for all periods presented. In addition, at the effective time of the reverse stock split, the number of shares of our common
stock reserved for issuance upon exercise of all options and warrants to acquire common stock have been proportionally decreased,
and the exercise price of all options and warrants to acquire common stock have been proportionally increased.
Principles of Consolidation
- The consolidated financial statements include the Company’s accounts and those of the Company’s wholly owned
subsidiary.
Use of Estimates in
Financial Statement Presentation - The preparation of these consolidated financial statements in conformity with U.S. GAAP
requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities at the date of
the consolidated financial statements and the reported amounts of expenses during the reporting period. Actual results could differ
from those estimates.
Impact of COVID–19
Pandemic on Financial Statements
In December 2019, a novel
strain of COVID-19 was reported in China. Since then, COVID-19 has spread globally. The spread of COVID-19 from China to other
countries has resulted in the World Health Organization (“WHO”) declaring the outbreak of COVID-19 as a “pandemic,”
or a worldwide spread of a new disease, on March 11, 2020. Many countries around the world have imposed quarantines and restrictions
on travel and mass gatherings to slow the spread of the virus and have closed non-essential businesses, and many local jurisdictions
continue to have such restrictions in place.
As local jurisdictions
continue to put restrictions in place, the Company’s ability to continue to operate its business may also be limited. Such
events may result in a period of business, supply and drug product manufacturing disruption, and in reduced operations, any of
which could materially affect the Company’s business, financial condition and results of operations. In response to COVID-19,
the Company implemented remote working and thus far, has not experienced a significant disruption or delay in its operations as
it relates to the clinical development or drug production of our drug candidates.
The spread of COVID-19,
which has caused a broad impact globally, may materially affect the Company economically. While the ultimate economic impact brought
by, and the duration of, the COVID-19 pandemic may be difficult to assess or predict, including new information which may emerge
concerning the severity of COVID-19 and the actions to contain COVID-19 or treat its impact, among others, the pandemic has resulted
significant disruptions in the general commercial activity and the global economy and caused financial market volatility and uncertainty
in significant and unforeseen ways in the recent months. A continuation or worsening of the levels of market disruption and volatility
seen in the recent past could have an adverse effect on the Company’s ability to access capital, which could in the future
negatively affect the Company’s liquidity. In addition, a recession or market correction resulting from the spread of COVID-19
could materially affect the Company’s business and the value of the Company’s common stock.
Additionally, COVID-19
may result in delays in receiving approvals from local and foreign regulatory authorities, delays in necessary interactions
with IRB’s or Institutional Review Boards, local and foreign regulators, ethics committees and other important agencies and
contractors due to limitations in employee resources or forced furlough of government employees.
To date, COVID-19 has not
had a financial impact on the Company. However, COVID-19 has caused severe disruptions in transportation and limited access to
the Company’s facility, resulting in limited support from its staff and professional advisors.
Cash, Cash Equivalents
and Restricted Cash - The Company considers all highly liquid accounts with original maturities of three months or less to
be cash equivalents. Balances held by the Company are typically in excess of Federal Deposit Insurance Corporation insured limits.
8
The following is a summary
of cash, cash equivalents and restricted cash at June 30, 2020 and December 31, 2019:
(in thousands)
June 30,
2020
December 31,
2019
Cash and cash equivalents
$ 53,466
$ 9,254
Restricted cash – current
48
48
Restricted cash – long-term
391
391
Cash, cash equivalents and restricted cash
$ 53,905
$ 9,693
Current restricted cash
relates to credit card accounts, while long-term restricted cash relates to a certificate of deposit held as collateral for a letter
of credit issued in connection with the Company’s lease for corporate office space.
Leases – The
Company has operating and finance leases for corporate office space, office equipment and furniture located at the corporate office
space. Leases with an initial term of 12 months or less are not recorded on the balance sheet; lease expense for these leases is
recognized on a straight-line basis over the lease term.
Fair Value of Financial
Instruments - Fair value is defined as the price that would be received to sell an asset, or paid to transfer a liability,
in an orderly transaction between market participants. A fair value hierarchy has been established for valuation inputs that gives
the highest priority to quoted prices in active markets for identical assets or liabilities and the lowest priority to unobservable
inputs.
Research and Development
Costs - Research and development costs are expensed as incurred. These costs include the costs of manufacturing drug product,
the costs of clinical trials, costs of employees and associated overhead, and depreciation and amortization costs related to facilities
and equipment. Research and development reimbursements are recorded by the Company as a reduction of research and development costs.
Share-Based Payments
- The Company estimates the fair value of each stock option award at the grant date by using the Black-Scholes option pricing
model. The fair value determined represents the cost for the award and is recognized over the vesting period during which an employee
is required to provide service in exchange for the award. The Company accounts for forfeitures of stock options as they occur.
Net Loss Per Common
Share - Basic loss per common share is computed by dividing the net loss available to common stockholders by the weighted
average number of common shares outstanding during the reporting period. For periods of net income, and when the effects are not
anti-dilutive, diluted earnings per share is computed by dividing net income available to common stockholders by the weighted-average
number of shares outstanding plus the impact of all potential dilutive common shares, consisting primarily of common shares underlying
common stock options and warrants using the treasury stock method. The Company issued pre-funded warrants in April 2020 and June
2020 that are considered outstanding shares for the purposes of calculating net loss per common share, see Note 4 for additional
information. Since the shares underlying the outstanding 2.3 million pre-funded warrants are issuable for negligible consideration
and are fully vested and exercisable, they are considered outstanding for the calculations of both basic and diluted loss per
share.
9
For periods of net loss,
diluted loss per share is calculated similarly to basic loss per share because the impact of all potential dilutive common shares
is anti-dilutive. For the six months ended June 30, 2020 and 2019, the Company’s potentially dilutive shares, which include
outstanding common stock options and warrants have not been included in the computation of diluted net loss per share as the result
would have been anti-dilutive.
(in thousands)
June 30,
2020
June 30,
2019
Options
365
264
Warrants
2,871
2,878
Total
3,236
3,142
Accounting Standards
Recently Adopted
In August 2018, FASB issued
ASU 2018-13, Fair Value Measurement - Disclosure Framework (Topic 820). The updated guidance improves the disclosure requirements
on fair value measurements, primarily associated with Level 3 fair value measurements and is effective for fiscal years, and interim
periods within those fiscal years, beginning after December 15, 2019. Early adoption is permitted upon issuance of the standard
for disclosures modified or removed with a delay of adoption of the additional disclosures until their effective date. The Company
adopted this standard effective January 1, 2020 and the standard did not have a significant impact to the Company’s financial
statements.
In November 2018, FASB
issued ASU 2018-18, C ollaborative Arrangements (Topic 808): Clarifying the Interaction Between Topic 808 and Topic 606, which,
among other things, provides guidance on how to assess whether certain collaborative arrangement transactions should be accounted
for under Topic 606. The amendments in this ASU are effective for fiscal years, and interim periods within those fiscal years,
beginning after December 15, 2019, with early adoption permitted. The Company adopted this standard effective January 1, 2020
and the standard did not have a significant impact to the Company’s financial statements.
Note 2 - Commitments and Contingencies
Agreements
The Company has entered
into agreements with third parties for the rights to certain intellectual property, manufacturing and clinical trial services under
which the Company may incur obligations to make payments including upfront payments as well as milestone and royalty payments.
Notable inclusions in this category are:
a.
Oak Ridge National Laboratory (“ORNL”) – The Company is contracted to purchase radioactive material to be used for research and development, with a renewal option at the contract end. During the six months ended June 30, 2020 and 2019, the Company purchased material from ORNL of $0.1 million in each period. In November 2019, the Company signed a contract with ORNL to purchase $0.3 million of radioactive material during calendar year 2020.
b.
On June 15, 2012, the Company entered into a license and sponsored research agreement with Fred Hutchinson Cancer Research Center (“FHCRC”) to build upon previous and ongoing clinical trials with BC8 (licensed antibody). FHCRC has completed both a Phase 1 and Phase 2 clinical trial with BC8. The Company has been granted exclusive rights to the BC8 antibody and related master cell bank developed by FHCRC. A milestone payment of $1 million will be due to FHCRC upon FDA approval of the first drug utilizing the licensed BC 8 antibody. Upon commercial sale of the drug, royalty payments of 2% of net sales will be due to FHCRC.
Collaborative Agreement
In March 2018, the
Company entered into a research and option agreement with Astellas Pharma Inc. (“Astellas”) to develop ARCs using the
Company’s AWE Technology Platform. Under this collaboration, the Company will utilize its AWE Platform to conjugate and label
selected Astellas targeting agents with an Actinium-225 payload. The Company is also responsible for conducting preclinical validation
studies on any ARCs generated. Payments from Astellas under this agreement are accounted for as a reduction to research and development
expense.
10
Note 3 - Leases
The Company adopted ASC
842 as of January 1, 2019, using a modified retrospective approach and applying the standard’s transition provisions at January
1, 2019, the effective date. The Company made an accounting policy election to exclude from balance sheet reporting those leases
with initial terms of 12 months or less.
The Company determines
if an arrangement is a lease at inception. This determination generally depends on whether the arrangement conveys to the Company
the right to control the use of a fixed asset for a period of time in exchange for consideration. Control of an underlying asset
is conveyed to the Company if the Company obtains the rights to direct the use of and to obtain substantially all of the economic
benefits from using the underlying asset. The Company has lease agreements which include lease and non-lease components, which
the Company has elected to account for as a single lease component for all classes of underlying assets. Lease expense for variable
lease components are recognized when the obligation is probable.
Right-of-use assets and
liabilities are recognized at commencement date based on the present value of lease payments over the lease term. ASC 842 requires
a lessee to discount its unpaid lease payments using the interest rate implicit in the lease or, if that rate cannot be readily
determined, its incremental borrowing rate. As an implicit interest rate is not readily determinable in the Company’s leases,
the incremental borrowing rate is used based on the information available at commencement date in determining the present value
of lease payments.
The lease term for all
of the Company’s leases includes the non-cancellable period of the lease plus any additional periods covered by either a
Company option to extend (or not to terminate) the lease that the Company is reasonably certain to exercise, or an option to extend
(or not to terminate) the lease controlled by the lessor. Options for lease renewals have been excluded from the lease term (and
lease liability) for the majority of the Company’s leases as the reasonably certain threshold is not met.
At June 30, 2020, the Company
has an operating lease for corporate office space and two finance leases for office equipment and furniture located in the corporate
office space. In addition, the Company has auxiliary corporate office space that it rents on a month-to-month basis; this rental
is accounted for as an operating lease with the same term as the Company’s main office in the same building.
The components of lease expense are as follows:
Three months ended
Six months ended
(in thousands)
June 30,
2020
June 30,
2019
June 30,
2020
June 30,
2019
Operating lease expense
$ 93
$ 93
$ 186
$ 186
Finance lease cost
Amortization of right-to-use assets
$ 21
$ 20
$ 41
$ 41
Interest on lease liabilities
$ 4
$ 6
$ 9
$ 11
Total finance lease cost
$ 25
$ 26
$ 50
$ 52
Supplemental cash flow information related to
leases are as follows:
Cash flow information:
Six months ended
(in thousands)
June 30,
2020
June 30,
2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flow use from operating leases
$
188
$
172
Operating cash flow use from finance leases
$
9
$
12
Financing cash flow use from finance leases
$
39
$
36
Non-cash activity:
Right-of-use assets obtained in exchange for lease obligations:
Operating leases
$
83
$
1,177
Finance Leases
$
-
$
302
11
Weighted average remaining lease terms are as
follows at June 30, 2020:
Weighted average remaining lease term:
Operating leases
2.2 years
Finance Leases
2.2 years
As the Company’s
leases do not provide an implicit rate, the Company used its incremental borrowing rate based on the information available at adoption
date in determining the present value of lease payments. Below is information on the weighted average discount rates used:
Weighted average discount rates:
Operating leases
8
%
Finance Leases
8
%
Maturities of lease liabilities
are as follows:
(in
thousands)
Year ending December 31,
Operating
Leases
Finance
Leases
2020 (excluding six months
ended June 30, 2020)
187
47
2021
377
94
2022
252
64
2023
-
4
Total lease payments
$
816
$
209
Less imputed interest
(69
)
(18
)
Present value of lease liabilities
$
747
$
191
Note 4 - Equity
On August 7, 2020,
the Board unanimously approved a reverse stock split of its outstanding common stock by combining outstanding shares of common
stock into a lesser number of outstanding shares of common stock by a ratio of 1-for-30, and on August 10, 2020, the Company filed
with the Secretary of State of Delaware a certificate of amendment to its certificate of incorporation to effect the reverse stock
split. Accordingly, all common share and per common share data in these consolidated financial statements and related notes hereto
have been retroactively adjusted to account for the effect of this reverse stock split for all periods presented.
On April 24, 2020,
the Company issued and sold 4.3 million shares of common stock and 2.8 million pre-funded warrants to purchase shares of common
stock. The price to the public in this offering for each share of common stock was $4.50 and for each pre-funded warrant was $4.497.
Each pre-funded warrant has an exercise price of $0.003 per share and is exercisable immediately upon issuance. The pre-funded
warrants are subject to certain limitations on beneficial ownership. Gross proceeds from this offering to Actinium were $31.6 million,
before deducting underwriting discounts and commissions and other offering expenses payable by the Company. Net proceeds from this
offering were $29.1 million.
In June 2020, holders
of 1.2 million pre-funded April 2020 warrants exercised their warrants at $0.003 per share and received 1.2 million shares of common
stock.
12
On June 19, 2020, the
Company issued and sold 1.9 million shares of common stock and 0.7 million pre-funded warrants to purchase shares of common stock.
The price to the public in this offering for each share of common stock was $9.75 and for each pre-funded warrant was $9.747. Each
pre-funded warrant has an exercise price of $0.003 per share and is exercisable immediately upon issuance. The pre-funded warrants
are subject to certain limitations on beneficial ownership. Gross proceeds from this offering to Actinium were $25.0 million, before
deducting underwriting discounts and commissions and other offering expenses payable by the Company. Net proceeds from this offering
were $23.0 million.
In December 2018, the
Company entered into the Amended and Restated At Market Issuance Sales Agreement with B. Riley FBR, Inc. and JonesTrading Institutional
Services LLC, pursuant to which the Company conducted its at-the market program. During the six months ended June 30, 2020, the
Company sold 0.3 million common shares through its at-the-market program, resulting in net proceeds of $2.5 million.
In October 2018, the
Company and Lincoln Park Capital Fund, LLC (“Lincoln Park”) entered into a purchase agreement and a registration rights
agreement, pursuant to which the Company has the right to sell to Lincoln Park shares of the Company’s common stock having
an aggregate value of up to $32.5 million, subject to certain limitations and conditions set forth in the agreement. During the
six months ended June 30, 2020, the Company elected to sell to Lincoln Park 27 thousand shares and received $0.2 million.
In June 2020, the Company
issued 5 thousand shares of restricted common stock, valued at $30 thousand, for consulting services.
For the six months
ended June 30, 2019, holders of March 2018 series A warrants exercised 83 thousand shares, resulting in the Company receiving $1.5
million. The remaining March 2018 series A warrants expired in March 2019.
The Company has outstanding
warrants to purchase 1,907 shares of common stock that include down-round protection. For warrants with down-round protection,
a deemed dividend is recorded for the change in fair value of the warrants when the down-round provision is triggered. As result
of the April 2019 offering, the exercise price of the warrant was reset from $37.50 per share to $26.40 per share. As a result
of the April 2020 offering and June 2020 offering, the exercise price of the warrant was reset from $26.40 per share to $15.60
per share. The down-round protection provision in the above warrants created a deemed dividend to common stockholders of $1 thousand
in the six months ended June 30, 2020 and 2019, which are reflected in the accompanying consolidated statement of operations and
consolidated statement of changes in stockholders’ equity.
Stock Options
The following is a summary
of stock option activity for the six months ended June 30, 2020:
(in thousands, except for per-share amounts)
Number of Shares
Weighted
Average
Exercise
Price
Weighted
Average
Remaining
Contractual
Term
(in years)
Aggregate
Intrinsic
Value
Outstanding, December 31, 2019
380
$ 35.10
7.88
$ -
Granted
-
Cancelled
(15 )
15.86
Outstanding, June 30, 2020
365
36.00
7.49
519
Exercisable, June 30, 2020
194
56.43
6.47
112
13
During the six months
ended June 30, 2020, options to purchase 15 thousand shares were cancelled upon the termination of employment for several employees.
The fair values of all
options issued and outstanding are being amortized over their respective vesting periods. The unrecognized compensation expense
at June 30, 2020 was $1.5 million related to unvested options, which is expected to be expensed over a weighted average of 2.8
years. During the six months ended June 30, 2020 and 2019, the Company recorded compensation expense related to stock options of
$0.5 million and $0.3 million, respectively.
Pre-funded Warrants
As part of the April
2020 offering and the June 2020 offering, the Company issued pre-funded warrants. Each pre-funded warrant has an exercise price
of $0.003 per share and is exercisable immediately upon issuance. The pre-funded warrants are subject to certain limitations on
beneficial ownership. The pre-funded warrants do not have an expiration date. Management determined that the pre-funded warrants
are freestanding instruments and that the pre-funded warrants should be classified as permanent equity in accordance with authoritative
guidance.
Following is a summary
of pre-funded warrant activity for the six months ended June 30, 2020.
(in thousands, except for per-share amounts)
Number of Shares
Weighted
Average
Exercise
Price
Aggregate
Intrinsic
Value
Outstanding, December 31, 2019
-
$ -
$ -
Granted
3,459
0.003
Exercised
(1,200 )
0.003
Outstanding, June 30, 2020
2,259
$ 0.003
$ 23,814
Exercisable, June 30, 2020
2,259
$ 0.003
$ 23,814
Warrants
Following is a summary
of warrant activity for the six months ended June 30, 2020:
(in thousands, except for per-share amounts)
Number of Shares
Weighted
Average
Exercise
Price
Weighted
Average
Remaining
Contractual
Term
(in years)
Aggregate
Intrinsic
Value
Outstanding, December 31, 2019
2,871
$ 20.71
2.95
$ 301
Granted
-
-
Exercised
-
-
Cancelled/Expired
-
-
Outstanding, June 30, 2020
2,871
$ 20.71
2.45
$ 497
Exercisable, June 30, 2020
2,865
$ 20.37
2.45
$ 496
Subsequent Events
In July 2020, holders
of 0.4 million pre-funded April 2020 and June 2020 warrants exercised their warrants at $0.003 per share and received 0.4 million
shares of common stock. Holders of 2 thousand April 2019 warrants exercised their warrants at $15.00 per share and received 2 thousand
shares.
In August 2020, the
Company filed a registration statement including a base prospectus which covers the offering, issuance and sale of up to $500 million
of common stock, preferred stock, warrants, units and/or subscription rights; and a sales agreement prospectus covering the offering,
issuance and sale of up to a maximum aggregate offering price of $200 million of common stock that may be issued and sold under
the Capital on Demand™ Sales Agreement with JonesTrading Institutional Services LLC.
Since June 30, 2020, the
Company has issued stock options for 357,189 shares to employees and 33,332 shares to non-employee directors.
14
ITEM 2. MANAGEMENT’S DISCUSSION
AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATION
FORWARD-LOOKING STATEMENT NOTICE
This Form 10-Q contains
certain forward-looking statements. For this purpose, any statements contained in this Form 10-Q that are
not statements of historical fact may be deemed to be forward-looking statements. Without limiting the foregoing, words such
as “may,” “will,” “expect,” “believe,” “anticipate,” “estimate”
or “continue” or comparable terminology are intended to identify forward-looking statements. These statements
by their nature involve substantial risks and uncertainties, and actual results may differ materially depending on a variety of
factors, many of which are not within our control. These factors include but are not limited to economic conditions generally
and in the industries in which we may participate; competition within our chosen industry, including competition from much larger
competitors; technological advances and failure to successfully develop business relationships.
Description of Business
Actinium Pharmaceuticals,
Inc. is a clinical-stage, biopharmaceutical company applying its proprietary platform technology and deep understanding of radioimmunobiology
to the development of novel targeted therapies known as ARCs or Antibody Radiation-Conjugates. Radiation is an effective therapeutic
modality that is used in the treatment of over fifty percent of all cancer patients and often combined with chemotherapy and immunotherapy
for greater therapeutic effect. Radiation is typically administered from outside the body, which constrains the amount that can
be administered to patients due to dose-limiting toxicities. In addition, due to the diffuse nature of the external radiation beam,
its usage is limited to solid tumors and cannot be used in blood cancers, which are diffuse. ARCs combine the cell-killing ability
of a radioisotope payload with a targeting agent, such as a monoclonal antibody, or mAb, to deliver radiation inside the body to
specific cells, to potentially generate greater efficacy and less toxicity. ARCs usage is broader than external delivered radiation
as they can be used for both solid tumors and blood cancers. Blood or hematologic cancers are highly sensitive to radiation and
our clinical pipeline is focused on ARCs targeting the antigens CD45 and CD33, both of which are expressed in multiple hematologic
cancers. Our clinical programs are focused on two primary areas: targeted conditioning prior to a cell or gene therapy procedure
and therapeutics, either in combination with other agents or as a monotherapy. Our product development strategy is actively informed
by clinical data with our ARCs in over 500 patients, including the ongoing SIERRA trial. Our clinical pipeline has emanated from
our AWE, or Antibody Warhead Enabling technology platform, which is protected by over 120 issued and pending patents, trade secrets
and know-how and is being utilized in a collaborative research partnership with Astellas Pharma, Inc.
We are advancing the only
multi-target, multi-indication clinical-stage pipeline for targeted conditioning and the only ARC-based targeted conditioning regimens
in development. Our ARCs for targeted conditioning are intended to potentially enable improved access to cell-based therapies with
curative potential, including BMT, or bone marrow transplant, ACT, or adoptive cell therapy such as CAR-T, and Gene Therapy, as
well as improved outcomes. Conditioning in the context of BMT, ACT or Gene Therapy is the act of depleting certain blood and immune-forming
cells, including bone marrow stem cells and, in some cases, diseased cells prior to transplanting new cells into a patient. Currently,
conditioning is accomplished using a combination of chemotherapeutic agents and external radiation. These non-targeted conditioning
regimens may prevent a patient from receiving a potentially curative therapy and hinder outcomes due to their toxicities. ARCs
have the potential to increase patient access and outcomes by way of their ability to selectively deplete targeted cells while
sparing normal healthy cells. We use our ARCs at high isotope dose levels to achieve myeloablation, which fully depletes bone marrow
stem cells and at lower isotope dose levels to achieve lymphodepletion, which spares bone marrow stem cells from depletion. In
addition, dosing may be titrated downward from myeloablative doses to achieve partial myeloablation, which may be appropriate for
certain gene therapy programs.
15
CD45 Targeted Conditioning Program
Our CD45 ARC is comprised
of the anti-CD45 monoclonal antibody known as apamistamab (formerly BC8) and the radioisotope I-131 or Iodine-131. CD45 is an antigen
expressed on leukemia, lymphoma and myeloma cancer cells, as well as nucleated immune cells, but is not expressed outside of the
hematopoietic, or blood, system. This unique expression on blood cancer and immune cells enables simultaneous depletion of both
cell types, making CD45 an optimal antigen for targeted conditioning applications. CD45 is a cell surface antigen with an average
expression of 200,000 copies per cell, however, it only internalizes at a rate of 10-15%. We believe our ARC approach is the most
effective method to target CD45 positive cells, as the radioisotope payload linear energy transfer can readily ablate a targeted
cell without requiring payload internalization like an antibody drug conjugate or rely on biological effector function processes
like a naked antibody. Furthermore, since CD45 expression level varies from low to high antigen density as the immune cells become
more terminally differentiated, we can selectively condition depending on the therapeutic application, from full myeloablation
to transient lymphodepletion, by adjusting the dose or intensity of the I-131 isotope payload. Full myeloablation can be achieved
with high doses of I-131, as its energy pathlength and crossfire effect can penetrate into bone marrow niches to target and deplete
blood and immune system forming bone marrow stem cells. Myeloablation is applicable to autologous or allogeneic BMT and to autologous
gene-edited or modified therapies that can reconstitute a patient’s blood and immune systems. Alternatively, low doses of
I-131 can be transiently lymphodepleting and spare a patient’s bone marrow stem cells, which we believe is ideal for ACT
applications such as CAR-T. We intend to develop our CD45 targeted conditioning program for BMT, ACT and Gene Therapy applications
for malignant and non-malignant diseases.
Our lead CD45 targeted
conditioning product candidate is Iomab-B, which uses high doses of I-131 to achieve myeloablative conditioning prior to a BMT.
Iomab-B is currently being studied in the pivotal Phase 3 Study of Iomab-B in Elderly Relapsed or Refractory AML, or SIERRA, clinical
trial for targeted conditioning prior to an allogeneic BMT for patients with active, relapsed or refractory (r/r) Acute Myeloid
Leukemia, or AML, who are age 55 or older. Patients with active, r/r AML are not normally considered eligible for BMT and the SIERRA
trial is the only randomized Phase 3 trial to offer BMT as a treatment option for this patient population. The SIERRA trial compares
outcomes of patients randomized to receive Iomab-B and a BMT (the study arm) to those patients randomized to receive physician’s
choice of salvage chemotherapy (the control arm). Salvage chemotherapy is also defined as conventional care, as no standard of
care exists for this patient population. Patients who fail to achieve a CR or Complete Response on the control arm are ineligible
to proceed to a BMT, but the trial design permits these patients to “cross over” to receive the study arm treatment
if they meet the eligibility criteria. The primary endpoint of the SIERRA trial is durable Complete Remission, or dCR, of six months
and the secondary endpoint is one-year Overall Survival, or OS. When the crossover patients receive Iomab-B and BMT, they have
not achieved remission with their salvage therapy and are considered to be failures for the primary endpoint of the study. The
SIERRA trial is currently active at 20 sites in the United States and Canada, which includes many of the leading BMT sites based
on volume. We expect to complete enrollment of the SIERRA trial and have topline data that we believe will support the submission
of a Biologics License Application, or BLA, with the U.S. Food and Drug Administration, or FDA, in 2021. If approved, we expect
our initial commercial launch would target the leading 50-100 BMT and medical centers that perform the vast majority of BMT’s
in the United States. In the European Union or EU, we received favorable feedback from the European Medicines Agency or EMA via
their scientific advice program that the trial design, primary endpoint and planned statistical analysis from the SIERRA trial
are acceptable as the basis for a Marketing Authorization Application or MAA. Additionally, the EMA commented that it does not
anticipate the need for further standalone preclinical toxicology or safety studies. Overall, transplant procedures in the EU are
approximately fifty percent higher than in the United States with a similar market dynamic with a majority of BMT volume being
conducted in a concentrated number of leading medical centers. We intend to secure a partner for Iomab-B in the EU.
Safety and feasibility
data from the first 75 patients enrolled on the SIERRA trial, which represents 50% of the total of 150 patients to be enrolled
in the trial, was presented in an oral presentation at the Transplantation & Cellular Therapy Meetings of the American Society
for Transplantation and Cellular Therapy (ASTCT) and Center for International Bone & Marrow Transplant Research (CIBMTER) in
February 2020. It was reported that 100% of patients (31/31) on the study arm that received a therapeutic dose of Iomab-B received
a BMT, with a median time to BMT of 30 days, and all patients achieved neutrophil and platelet engraftment in a median time of
20 days despite a high median blast count of 30%. On the control arm, only 18% of patients (7/38) achieved remission after salvage
therapy, and then received a BMT with a median time to BMT of 67 days and median blast count of 26%. Of the 82% of patients failing
to achieve a CR with conventional care (31/38), 20 patients were eligible to cross over to the study arm. These patients are considered
as having failed the primary endpoint of the study. All crossover patients who received the therapeutic dose of Iomab-B (20/20)
received a BMT, with a median time to BMT of 64 days and all patients achieved engraftment in a median time of 19 days despite
high median blast count of 35% at time of crossover. It was also reported that 100-day non-relapse transplant-related mortality
(100-day TRM) of the study or Iomab-B arm was 6% (2/31) of patients that received a BMT compared to 29% of patients (2/7) who received
a BMT after salvage therapy on the control arm. The universal engraftment rate and low 100-day TRM rate of the Iomab-B arm resulted
in 29 patients potentially evaluable for the primary endpoint compared to 5 patients in the control arm, a nearly six times difference.
16
The SIERRA trial is
powered for up to two interim analyses of the primary endpoint of dCR of 180 days exercisable at our discretion and triggered by
an enrollment range of 70 to 110 patients. We exercised a single ad-hoc analysis in the second quarter of 2020, based on the data
reported from SIERRA thus far and the status of enrollment at the time of triggering our ad hoc analysis. The ad hoc analysis is
expected to be completed by the end of 2020, which could generate topline data for the primary endpoint and early termination of
the trial if positive. Based on the statistical plan of the study, a single ad-hoc analysis would result in a minimal alpha spend
of no more than 0.00925, depending on the number of patients included in the ad-hoc analysis.
Our Iomab-ACT program is
intended for targeted conditioning prior to ACT or Gene Therapy and uses the same 131 I-apamistamab ARC construct as
Iomab-B at varying doses. At lower doses of one-eighth to one-sixth of the myeloablative dose, it is applicable for lymphodepletion
prior to CAR-T or certain Gene Therapy applications where stem cell myeloablation is not necessary. At higher doses it is applicable
for Gene Therapy applications where stem cell myeloablation is necessary.
In January 2020, we announced
a collaboration with University of California Davis to utilize Iomab-ACT conditioning in an ongoing Phase 1/2 trial with a novel
anti-HIV autologous stem cell gene therapy for patients with HIV-related lymphoma. We believe this to be the first Gene Therapy
trial to use an ARC-based conditioning regimen. 131 I-Apamistamab has clinical proof of concept as a targeted conditioning
regimen for patients with high-risk, relapsed or refractory lymphoma prior to an autologous stem cell transplant from a previous
study, where a favorable safety profile with no dose-limiting toxicities and minimal non-hematologic toxicities were observed and
promising efficacy with median overall survival not reached (range: 29 months to not reached) and 31% of patients in prolonged
remission at a median of 36 months follow up (range: 25 – 41 months). In this study, Iomab-ACT is intended to replace the
chemotherapy-based condition regimen known as BEAM (BCNU/carmustine, etoposide, cytarabine, and melphalan) to simultaneously kill
the patient’s lymphoma cells and deplete the patient’s stem cells to make room for the transplant. Upon engraftment,
the transplanted gene-modified autologous stem cells containing three anti-HIV genes are intended to equip the patient with a new
immune system that is resistant to the HIV virus. Iomab-ACT will be substituted for BEAM in the ongoing Phase 1/2 trial and we
expect to have clinical proof of concept data in 2021.
We believe our Iomab-ACT
program is highly differentiated when compared to Fludarabine and Cyclophosphamide or Flu/Cy or other chemotherapy-based regimens
that are used as the standard of practice today for lymphodepletion prior to CAR-T. CD45 is an antigen expressed on certain immune
cell types that are relevant to the mechanism of CAR-T therapies including lymphocytes, regulatory T cells and macrophages that
have been associated with clinical responses that may limit the safety, efficacy and durability of response of these CAR-T therapies
including Cytokine Release Syndrome, or CRS, and neurotoxicity. Some of these limitations may be attributable to the chemotherapy-based
conditioning agents that are being used prior to CAR-T therapies. Preclinical data supporting the rational for our Iomab-ACT program
was presented at multiple medical conferences in 2019. Unlike chemotherapy, preclinical data suggests Iomab-ACT is targeted in
nature and, due to this targeted effect, we expect we can improve CAR-T cell expansion more efficiently, potentially resulting
in responses that are more durable, but also resulting in reduced CAR-T related toxicities. Importantly, we expect the Iomab-ACT
program construct to enable lymphodepletion through a single-dose, outpatient administration versus Flu/Cy or other chemotherapy-based
lymphodepletion regimens that can require multiple infusion cycles over several days. Because of this potentially superior profile,
the Iomab-ACT construct could result in improved access to CAR-T therapy and better outcomes. We intend to begin a clinical trial
with 131 I-apamistamab as a targeted conditioning agent prior to CAR-T, subject to identifying a suitable partner and
we expect to have Phase 1 clinical proof of concept data in 2021.
17
CD33 Program: Targeted Conditioning, Combinations
and Therapeutics
Our CD33 program is evaluating
the clinical utility of an ARC comprised of the anti-CD33 mAb lintuzumab linked to the potent alpha-emitting radioisotope Actinium-225
or Ac-225. CD33 is expressed in the majority of patients with AML and myelodysplastic syndrome, or MDS, as well as approximately
one third of patients with multiple myeloma. Our CD33 development program is driven by data obtained from over one hundred treated
patients, including results from a Phase 1/2 trial that was conducted in 58 patients with newly diagnosed AML, which was completed
in 2018. This clinical data, as well as our experience with Iomab-B, is shaping a two-pronged approach with our CD33 program, where
at high doses we are exploring its use for targeted conditioning and at low doses we are exploring its use for therapeutic purposes
in combination with other modalities, such as chemotherapy, targeted agents or immunotherapy.
Actimab-MDS is our second
clinical trial focused on targeted conditioning, in this case for patients with high-risk MDS and is our second pivotal program.
Actimab-MDS is informed by prior experience with our CD33 ARC in multiple trials for patients with AML, MDS and for patients that
have progressed from MDS to AML, which is also known as secondary AML. Data from these trials showed that our CD33 ARC had single-agent
activity capable of producing complete remissions (CRs) in certain patients at varying dose levels with minimal non-hematologic
extramedullary toxicities. However, dose-dependent myelosuppression, a class effect of CD33 directed therapies, was seen in many
of these patients. Given that myelosuppression is necessary prior to a BMT and that a BMT can rescue patients with myelosuppression,
we decided to pursue a trial in targeted conditioning in high-risk MDS patients with this ARC in combination with Reduced Intensity
Conditioning, or RIC, regimens. RIC regimens are comprised of low doses of chemotherapies such as fludarabine, cytarabine, busulfan
or melphalan. A BMT is the only curative treatment option for these patients with high-risk MDS who have poor, or very poor cytogenetics.
However, these patients have poor outcomes due to high relapse rates following a BMT. Based on our interactions with FDA to date,
we will conduct a Phase 1 dose-finding clinical trial that will be followed by a randomized trial that, depending on the results
observed, may potentially serve as a pivotal trial to support the submission of a BLA. We are currently finalizing discussions
with the FDA.
We are also studying our
CD33 ARC construct at various dose levels and dosing regimens in combination with other therapeutic modalities such as chemotherapy,
targeted agents or immunotherapy in CD33 expressing hematologic disease indications. We believe that radiation can be synergistic
when used in combination with these modalities based on mechanistic rationale supported by our own clinical data, preclinical research
and scientific and clinical evidence in the literature. We have prioritized our efforts and resources in favor of combination trials
for our CD33 program development strategy rather than single agent trials, which we are no longer advancing at this time. Our CD33
ARC development program encompasses the following ongoing and planned trials:
Combination Trials :
●
Phase 1 investigator initiated Actimab-A + CLAG-M combination trial with the salvage chemotherapy regimen CLAG-M (cladribine, cytarabine, filgrastim and mitoxantrone) for patients with relapsed or refractory AML at the Medical College of Wisconsin. At the 2019 American Society of Hematology Annual Meeting, it was reported that 86% of patients (6/7) receiving 0.50 µCi/kg of Actimab-A, and CLAG-M achieved a complete remission after receiving Actimab-A + CLAG-M, which is nearly 60% greater than the 55% remission rate observed in a study of CLAG-M alone conducted at MCW in the same r/r AML patient population. In addition, 71% of these patients (5/7) achieved negative minimal residual disease status, indicating that these are deep remissions. The 0.50 µCi/kg dose of Actimab-A was shown to be subtherapeutic as a single agent. Since the combination to date has been well tolerated, the study progressed to the third and final cohort for the study of Actimab-A at a dose of 0.75 µCi/kg in March 2020 and we expect to complete this trial by the end of 2020. Upon completion, we intend to explore a regulatory pathway for a pivotal trial that could potentially support a registration. The combination of Actimab-A + CLAG-M is supported by mechanistic rationale for combining inhibitors of DNA replication and/or repair processes such as mitoxantrone, a topoisomerase-II inhibitor, and radiation, as imparted by tumor targeting of Ac-225 with Actimab-A. The Actimab-A + CLAG-M combination study has provided proof of principle that the addition of subtherapeutic doses of Actimab-A to other AML therapies can lead to well tolerated regimens with improved responses.
18
Phase 1 Actimab-A + Ven combination trial with the BCL-2 inhibitor Venetoclax (Ven) for patients with relapsed or refractory AML. This trial will be led by UCLA Medical Center and will be conducted at three additional trial sites. This combination is supported by mechanistic evidence in preclinical studies using Ven-resistant AML tumor cell lines. In these models, we have demonstrated that Actimab-A can deplete Mcl-1 and Bcl-XL, two proteins implicated in mediating resistance to venetoclax, in addition to causing potentially lethal double-stranded DNA breaks in these CD33 targeted cells. Furthermore, in vivo studies in animal models of Ven-resistant AML demonstrated robust tumor regression and improved survival in cohorts receiving the Actimab-A Ven combination compared to Ven alone. The rationale for this clinical study is that the addition of Actimab-A will; 1) have a direct anti-tumor effect via double-stranded DNA breaks and 2) deplete Mcl-1 and BCL-XL making the AML cells more susceptible to Ven. We expect to initiate the trial and have preliminary proof of concept clinical data from this combination study by the end of 2020.
●
Phase 1 Actimab-A + 7+3 combination trial in patients with newly diagnosed AML with intermediate or high-risk cytogenetics or molecular markers. In February 2020, we announced plans to initiate this combination trial to add Actimab-A to 7+3, which is the standard of care chemotherapy regimen comprised of cytarabine and daunorubicin for patients with newly diagnosed AML who are fit for intensive therapy. As we have seen with the combination of Actimab-A + CLAG-M chemotherapy, we believe that Actimab-A will have synergistic and potentiating properties when added to 7+3, which causes DNA damage and has radiation sensitizing properties since daunorubicin is an anthracycline antibiotic that cytotoxically inhibits DNA replication and repair and RNA synthesis through inhibition of topoisomerase II. The rationale for studying Actimab-A in combination with 7+3 is the potential for both additive and synergistic effects due to the interplay of various mechanisms including DNA damage from alpha radiation and the chemotherapy combination, radiation sensitization, and prevention of DNA damage repair. We expect to initiate this Phase 1 trial by the end of 2020 and have proof of concept data in 2021.
Antibody Warhead Enabling Technology Platform
Our proprietary Antibody
Warhead Enabling, or AWE, Technology Platform is supported by intellectual property, know-how and trade secrets that cover the
generation, development, methods of use and manufacture of ARCs and certain of their components. Our AWE technology patent portfolio
includes 29 patent families comprised of over 120 issued and pending patent applications, of which 9 are issued and 25 pending
in the United States, and 92 are issued or pending internationally. The effective life of the patents in our portfolio range from
expirations between 2021 and 2040. Our technology enables the direct labeling, or conjugation and labeling, of a biomolecular targeting
agent to a radionuclide warhead and its development and use as a therapeutic regimen for the treatment of diseases such as cancer.
Our AWE intellectual property covers various methods of use for ARCs in multiple diseases, including indication, dose and scheduling,
radionuclide warhead, and therapeutic combinations.
Recent Developments
Impact of COVID–19 Pandemic
In December 2019, a novel
strain of COVID-19 was reported in China. Since then, COVID-19 has spread globally. The spread of COVID-19 from China to other
countries has resulted in the World Health Organization (WHO) declaring the outbreak of COVID-19 as a “pandemic,” or
a worldwide spread of a new disease, on March 11, 2020. Many countries around the world have imposed quarantines and restrictions
on travel and mass gatherings to slow the spread of the virus and have closed non-essential businesses, and as of the date of this
prospectus, many local jurisdictions continue to have such restrictions in place.
As many local jurisdictions
continue to have such restrictions in place, our ability to continue to operate our business may also be limited. Such events may
result in a period of business, supply and drug product manufacturing disruption, and in reduced operations, any of which could
materially affect our business, financial condition and results of operations. In response to COVID-19, we implemented remote working
and thus far have not experienced a significant disruption or delay in our operations as it relates to the clinical development
of our drug candidates. Such government-imposed precautionary measures may have been relaxed in certain countries or states, but
there is no assurance that more strict measures will be put in place again due to a resurgence in COVID-19 cases. Therefore, the
COVID-19 pandemic may continue to affect our operation, may further divert the attention and efforts of the medical community to
coping with COVID-19 and disrupt the marketplace in which we operate and may have a material adverse effect on our operations.
19
The spread of COVID-19,
which has caused a broad impact globally, may materially affect us economically. While the ultimate economic impact brought by,
and the duration of, the COVID-19 pandemic may be difficult to assess or predict, including new information which may emerge concerning
the severity of COVID-19 and the actions to contain COVID-19 or treat its impact, among others, the pandemic has resulted significant
disruptions in the general commercial activity and the global economy and caused financial market volatility and uncertainty in
significant and unforeseen ways in the recent months. A continuation or worsening of the levels of market disruption and volatility
seen in the recent past could have an adverse effect on our ability to access capital, which could in the future negatively affect
our liquidity. In addition, a recession or market correction resulting from the spread of COVID-19 could materially affect our
business and the value of our common stock.
Currently, the Phase
3 SIERRA trial for our lead program, Iomab-B, continues to remain active at a majority of our clinical trial sites, with investigators
providing feedback that recruitment and enrollment will remain active because of the acute nature of the disease, the high unmet
needs of patients with relapsed or refractory AML, the potentially curative nature of BMT and the differentiated profile of Iomab-B.
Certain sites that had not been actively enrolling due to COVID-19 have resumed recruitment and enrollment, and we currently anticipate
that other sites that have not been actively enrolling due to COVID-19 will likely resume recruitment and enrollment in the summer
timeframe. We also believe our earlier stage clinical trials for our CD33 program will also continue to recruit and enroll patients
given the acute nature of relapsed or refractory AML. The continuation of the pandemic could adversely affect our planned clinical
trial operations, including our ability to conduct the trials on the expected timelines and recruit and retain patients and principal
investigators and site staff who, as healthcare providers, may have heightened exposure to COVID-19 if their geography is impacted
by the pandemic. Further, the continuation and/or resurgence of the COVID-19 pandemic could result in delays in our clinical trials
due to prioritization of hospital resources toward the pandemic, restrictions in travel, potential unwillingness of patients to
enroll in trials at this time, or the inability of patients to comply with clinical trial protocols if quarantines or travel restrictions
impede patient movement or interrupt healthcare services. In addition, we rely on independent clinical investigators, contract
research organizations and other third-party service providers to assist us in managing, monitoring and otherwise carrying out
our preclinical studies and clinical trials, and the pandemic may affect their ability to devote sufficient time and resources
to our programs or to travel to sites to perform work for us.
Additionally, COVID-19
may result in delays in receiving approvals from local and foreign regulatory authorities, delays in necessary interactions
with IRB’s or Institutional Review Boards, local and foreign regulators, ethics committees and other important agencies and
contractors due to limitations in employee resources or forced furlough of government employees.
To date, COVID-19 has not
had a financial impact on our company. However, COVID-19 has caused severe disruptions in transportation and limited access to
our facility, resulting in limited support from our staff and professional advisors.
The ultimate impact from
COVID-19 on our business operations and financial results during 2020 will depend on, among other things, the ultimate severity
and scope of the pandemic, the pace at which governmental and private travel restrictions and public concerns about public gatherings
will ease, the rate at which historically large increases in unemployment rates will decrease, if at all, and whether, and the
speed with which the economy recovers. We are not able to fully quantify the impact that these factors will have on our financial
results during 2020 and beyond, but developments related to COVID-19 may materially affect us in 2020.
Reverse Stock Split
On April 29, 2020, we received
a deficiency letter from the NYSE American LLC, or the NYSE American, indicating that we are not in compliance with certain NYSE
American continued listing standards. The deficiency letter stated that our shares of common stock have been selling for a low
price per share for a substantial period of time. Pursuant to Section 1003(f)(v) of the Company Guide, the NYSE American staff
determined that our continued listing is predicated on us effecting a reverse stock split of our common stock or otherwise demonstrating
sustained price improvement within a reasonable period of time, which the staff determined to be until October 29, 2020.
20
The letter further stated
that as a result of the foregoing, we have become subject to the procedures and requirements of Section 1009 of the NYSE American
Company Guide, which could, among other things, result in the initiation of delisting proceedings, unless we cure the deficiency
in a timely manner. Our common stock will continue to be listed on the NYSE American while we attempt to regain compliance with
the listing standards, subject to our compliance with other continued listing requirements.
In addition, the NYSE American
has advised us that its policy is to immediately suspend trading in shares of, and commence delisting procedures with respect to,
a listed company if the market price of its shares falls below $0.06 per share at any time during the trading day.
On October 18, 2019, our
board of directors unanimously approved, subject to stockholder approval, an amendment to our certificate of incorporation to effect
a reverse stock split of our outstanding common stock by combining outstanding shares of common stock into a lesser number of outstanding
shares of common stock by a ratio of not more than 1-for-75 prior to December 18, 2020, with the exact ratio to be set within this
range by our board of directors at its sole discretion. On December 18, 2019, at our 2019 Annual Meeting of Stockholders, our stockholders
approved such proposed amendment to our certificate of incorporation. The primary intent of effecting the reverse stock split,
would be to ensure that we are able to maintain compliance with the listing standards of the NYSE American.
On August 7, 2020,
the Board unanimously approved a reverse stock split of its outstanding common stock by combining outstanding shares of common
stock into a lesser number of outstanding shares of common stock by a ratio of 1-for-30, and on August 10, 2020, we filed with
the Secretary of State of Delaware a certificate of amendment to its certificate of incorporation to effect the reverse stock split.
The reverse stock split became effective as of 5:00 p.m. Eastern Time on August 10, 2020, and our common stock began trading on
a split-adjusted basis when the market opened on August 11, 2020. Accordingly. all common share and per common share data in these
consolidated financial statements and related notes hereto have been retroactively adjusted to account for the effect of this reverse
stock split for all periods presented. In addition, at the effective time of the reverse stock split, the number of shares of our
common stock reserved for issuance upon exercise of all options and warrants to acquire common stock have been proportionally decreased,
and the exercise price of all options and warrants to acquire common stock have been proportionally increased. In addition, we
adjusted and proportionately decreased the total number of shares of our common stock that may be the subject of the future grants
under our stock plans.
Results of Operations
– Three Months Ended June 30, 2020 Compared to Three Months Ended June 30, 2019
The following table sets
forth, for the periods indicated, data derived from our statements of operations:
For the Three Months Ended
June 30,
(in thousands)
2020
2019
Revenue
$ -
$ -
Operating expenses:
Research and development, net of reimbursements
3,508
4,010
General and administrative
1,154
1,076
Total operating expenses
4,662
5,086
Other income:
Interest income – net
37
59
Total other income
37
59
Net loss
$ (4,625 )
$ (5,027 )
21
Revenue
We recorded no commercial
revenue for the three months ended June 30, 2020 and 2019.
Research and Development Expense
Research and development
expenses decreased $0.5 million to $3.5 million for the three months ended June 30, 2020 compared to $4.0 million for the three
months ended June 30, 2019. The decrease in expenses was primarily due to manufacturing related to the antibody component of Iomab-B,
as in prior periods we have manufactured sufficient antibody supply for the SIERRA trial and other planned trials.
General and Administrative Expenses
General and administrative
expenses of $1.2 million for the three months ended June 30, 2020 increased $0.1 million from the $1.1 million recorded for the
three months ended June 30, 2019, primarily attributable to higher professional fees.
Other Income
Other income is comprised
of net interest income in both reporting periods. The amount for the three months ended June 30, 2020 of $37 thousand fell from
$59 thousand for the three months ended June 30, 2019, primarily due to lower interest rates.
Net Loss
Net loss of $4.6 million
for the three months ended June 30, 2020 decreased by $0.4 million from the prior-year comparison period due to lower research
and development expenses.
Results of Operations
– Six Months Ended June 30, 2020 Compared to Six Months Ended June 30, 2019
The following table sets
forth, for the periods indicated, data derived from our statements of operations:
For the Six Months Ended
June 30,
(in thousands)
2020
2019
Revenue
$
-
$
-
Operating expenses:
Research and development, net of reimbursements
7,659
8,345
General and administrative
2,686
2,440
Total operating expenses
10,345
10,785
Other income:
Interest income – net
50
88
Total other income
50
88
Net loss
$
(10,295
)
$
(10,697
)
Revenue
We recorded no commercial
revenue for the six months ended June 30, 2020 and 2019.
Research and Development Expense
Research and development
expenses decreased $0.6 million to $7.7 million for the six months ended June 30, 2020 compared to $8.3 million for the six months
ended June 30, 2019. The decrease in expenses was primarily due to manufacturing related to the antibody component of Iomab-B,
as in prior periods we have manufactured sufficient antibody supply for the SIERRA trial and other planned trials.
22
General and Administrative
Expenses
General and administrative
expenses of $2.7 million for the six months ended June 30, 2020 increased $0.3 million compared to $2.4 million for the six months
ended June 30, 2019, primarily attributable to higher professional fees.
Other Income
Other income is comprised
of net interest income in both reporting periods. The amount for the six months ended June 30, 2020 of $50 thousand fell from $88
thousand for the six months ended June 30, 2019 primarily due to lower interest rates.
Net Loss
Net loss of $10.3 million
for the six months ended June 30, 2020 decreased $0.4 million from $10.7 million reported in the prior-year comparison period,
primarily due to lower research and development expenses, slightly offset by higher general and administrative expenses.
Liquidity and Capital Resources
We have financed our
operations primarily through sales of our common stock and warrants. The following tables sets forth selected cash flow information
for the periods indicated:
For the Six Months Ended
June 30,
(in thousands)
2020
2019
Cash used in operating activities
$ (10,365 )
$ (10,853 )
Cash used in investing activities
-
(59 )
Cash provided by financing activities
54,577
16,808
Net change in cash, cash equivalents and restricted cash
$ 44,212
$ 5,896
Net cash used in operating
activities for the six months ended June 30, 2020 of $10.4 million decreased by $0.5 million from $10.9 million in the prior-year
period, reflecting the lower net loss due to lower research and development expenses, as well as the timing of payments to vendors.
Net cash provided by financing
activities was $54.6 million for the six months ended June 30, 2020, reflecting sales of common stock and pre-funded warrants.
During the six months ended June 30, 2019, net cash provided by financing activities was $16.8 million, reflecting $15.5 million
in proceeds from the sale of common stock, plus $1.5 million in proceeds from the exercise of warrants.
On April 24,
2020, we issued and sold 4.3 million shares of common stock and pre-funded warrants to purchase 2.8 million shares of common
stock. The price to the public for each share of common stock sold in the offering was $4.50, and the price to the public for
each pre-funded warrant sold in the offering was $4.497. The pre-funded warrants are exercisable at an exercise price of
$0.003 per share and are subject to certain limitations on beneficial ownership. Gross proceeds from this offering were $31.6
million, before deducting underwriting discounts and commissions and other offering expenses payable by us. Net proceeds from
the offering were approximately $29.1 million. In June 2020, holders of 1.2 million pre-funded April 2020 warrants exercised
their warrants and received 1.2 million shares of common stock.
23
On June 19, 2020, we
issued and sold 1.9 million shares of common stock and pre-funded warrants to purchase 0.7 million shares of common stock. The
price to the public in this offering for each share of common stock was $9.75 and for each pre-funded warrant was $9.747. Each
pre-funded warrant has an exercise price of $0.003 per share and is exercisable immediately upon issuance. Gross proceeds from
this offering to us were $25.0 million, before deducting underwriting discounts and commissions and other offering expenses payable
us. Net proceeds from this offering were approximately $23.0 million.
In December 2018, we
entered into the Amended and Restated At Market Issuance Sales Agreement with B. Riley FBR, Inc. and JonesTrading Institutional
Services LLC, pursuant to which we conducted our at-the market program. During the six months ended June 30, 2020, we sold 0.3
million common shares through its at-the-market program, resulting in net proceeds of $2.5 million.
In October 2018,
we and Lincoln Park Capital Fund, LLC (“Lincoln Park”) entered into a purchase agreement and a registration rights
agreement, pursuant to which we have the right to sell to Lincoln Park shares of our common stock having an aggregate value of
up to $32.5 million, subject to certain limitations and conditions set forth in the agreement. During the six months ended June
30, 2020, we elected to sell to Lincoln Park 27 thousand shares and received $0.2 million.
Off-Balance Sheet Arrangements
We do not have any off-balance
sheet arrangements that have, or are reasonably likely to have a current or future effect on our financial condition, changes in
financial condition, revenue or expenses, results of operations, liquidity, capital expenditures or capital resources that is material
to investors.
Critical Accounting Policies and Use of Estimates
Our management’s
discussion and analysis of financial condition and results of operations is based on our consolidated financial statements, which
have been prepared in accordance with accounting principles generally accepted in the United States, or GAAP. The preparation of
these financial statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities
and expenses and the disclosure of contingent assets and liabilities in our consolidated financial statements during the reporting
periods. These items are monitored and analyzed by us for changes in facts and circumstances, and material changes in these estimates
could occur in the future. We base our estimates on historical experience, known trends and events, and on various other factors
that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying
value of assets and liabilities that are not readily apparent from other sources. Changes in estimates are reflected in reported
results for the period in which they become known. Actual results may differ materially from these estimates under different assumptions
or conditions.
Our significant accounting
policies are described in detail in the notes to our consolidated financial statements appearing in our Annual Report filed on
Form 10-K for the year ended December 31, 2019.
Fair Value of Financial Instruments
Fair value is defined as
the price that would be received to sell an asset, or paid to transfer a liability, in an orderly transaction between market participants.
A fair value hierarchy has been established for valuation inputs that gives the highest priority to quoted prices in active markets
for identical assets or liabilities and the lowest priority to unobservable inputs.
24
Research and Development Costs
Research and development
costs are expensed as incurred. These costs include the costs of manufacturing drug components and final drug product, the costs
of clinical trials, costs of employees and associated overhead, and depreciation and amortization costs related to facilities and
equipment. Research and development reimbursements are recorded by us as a reduction of research and development costs.
Share-Based Payments
We estimate the fair value
of each stock option award at the grant date by using the Black-Scholes option pricing model. The fair value determined represents
the cost for the award and is recognized over the vesting period during which an employee is required to provide service in exchange
for the award. We account for forfeitures of stock options as they occur.
Accounting Standards
Recently Adopted -
In August 2018, FASB issued
ASU 2018-13, Fair Value Measurement - Disclosure Framework (Topic 820). The updated guidance improves the disclosure requirements
on fair value measurements, primarily associated with Level 3 fair value measurements and is effective for fiscal years, and interim
periods within those fiscal years, beginning after December 15, 2019. Early adoption is permitted upon issuance of the standard
for disclosures modified or removed with a delay of adoption of the additional disclosures until their effective date. We adopted
this standard effective January 1, 2020 and the standard did not have a significant impact to our financial statements.
In November 2018, FASB
issued ASU 2018-18, C ollaborative Arrangements (Topic 808): Clarifying the Interaction Between Topic 808 and Topic 606,
which, among other things, provides guidance on how to assess whether certain collaborative arrangement transactions should be
accounted for under Topic 606. The amendments in this ASU are effective for fiscal years, and interim periods within those fiscal
years, beginning after December 15, 2019, with early adoption permitted. We adopted this standard effective January 1, 2020 and
the standard did not have a significant impact to our financial statements.
25
ITEM 3. QUANTITATIVE AND QUALITATIVE
DISCLOSURES ABOUT MARKET RISK.
Not applicable.
ITEM 4. CONTROLS AND PROCEDURES.
Evaluation of Disclosure
Controls and Procedures . Under the supervision and with the participation of our management, including our chief executive
officer and principal financial and accounting officer, we conducted an evaluation of the effectiveness, as of June 30, 2020, of
our disclosure controls and procedures, as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934,
as amended, or the Exchange Act. Based upon such evaluation, our chief executive officer and principal financial and accounting
officer have concluded that, as of June 30, 2020, our disclosure controls and procedures were effective to provide reasonable assurance
that the information we are required to disclose in our filings with the Securities and Exchange Commission, or SEC, under the
Exchange Act (i) is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and
forms and (ii) accumulated and communicated to our management, including our chief executive officer and principal financial and
accounting officer, as appropriate to allow timely decisions regarding required disclosure.
Changes in Internal
Control over Financial Reporting . There were no changes in our system of internal controls over financial reporting during
the period covered by this report that has materially affected, or are reasonably likely to materially affect, our internal control
over financial reporting.
26
PART II – OTHER INFORMATION
ITEM 1. LEGAL PROCEEDINGS
None.
ITEM 1A. RISK FACTORS
In analyzing our company,
you should consider carefully the following risk factors, together with all of the other information included in this Quarterly
Report on Form 10-Q. Factors that could cause or contribute to differences in our actual results include those discussed in
the following subsection, as well as those discussed above in “Management’s Discussion and Analysis of Financial Condition
and Results of Operations” and in our Annual Report filed on Form 10-K for the year ended December 31, 2019. Each of the
following risk factors, either alone or taken together, could adversely affect our business, operating results and financial condition,
as well as adversely affect the value of an investment in our company. The risks and uncertainties described below are not the
only ones we face. Additional risks not currently known to us or other factors not perceived by us to present significant risks
to our business at this time also may impair our business operations.
Risks Related to Our Business
We are a clinical-stage company and have generated no revenue
from commercial sales to date.
We are a clinical-stage
biopharmaceutical company with a limited operating history. We have no products approved for commercial sale and have not generated
any revenue from product sales to date. We will encounter risks and difficulties frequently experienced by early-stage companies
in rapidly evolving fields. If we do not address these risks successfully, our business will suffer.
We have incurred net losses in every year since our inception
and anticipate that we will continue to incur net losses in the future.
We are not profitable and
have incurred losses in each period since our inception. As of June 30, 2020 and December 31, 2019, we had an accumulated deficit
of $219.1 million and $208.8 million, respectively. We reported a net loss of $10.3 million and $10.7 million for the six months
ended June 30, 2020 and June 30, 2019, respectively. We expect to continue to operate at a net loss as we continue our research
and development efforts, continue to conduct clinical trials and develop manufacturing, sales, marketing and distribution capabilities.
There can be no assurance that the products under development by us will be approved for sale in the United States or elsewhere.
Furthermore, there can be no assurance that if such products are approved, they will be successfully commercialized, which would
have an adverse effect on our business prospects, financial condition and results of operation.
If we fail to obtain additional financing,
we will be unable to continue or complete our product development and you will likely lose your entire investment.
On April 24, 2020,
we issued and sold 4.3 million shares of common stock and pre-funded warrants to purchase 2.8 million shares of common stock. Gross
proceeds from this offering to us were $31.6 million, before deducting underwriting discounts and commissions and other offering
expenses payable by us. On June 19, 2020, we issued and sold 1.9 million shares of common stock and 0.7 million pre-funded warrants
to purchase shares of common stock. Gross proceeds from this offering to us were $25.0 million, before deducting underwriting discounts
and commissions and other offering expenses payable us. As of the date of filing this report, we expect that our existing resources
will be more than sufficient to fund our planned operations for more than 12 months following the date of this report.
Our business or operations
may change in a manner that would consume available funds more rapidly than anticipated and substantial additional funding may
be required to maintain operations, fund expansion, develop new or enhanced products, acquire complementary products, business
or technologies or otherwise respond to competitive pressures and opportunities, such as a change in the regulatory environment
or a change in preferred cancer treatment modalities. However, we may not be able to secure funding when we need it or on favorable
terms or indeed on any terms. In addition, from time to time, we may not be able to secure enough capital in a timely enough manner
which may cause the generation of a going-concern opinion from our auditors which can and may impair our stock market valuation
and also our ability to finance on favorable terms or indeed on any terms.
27
To raise additional capital,
we may in the future offer additional shares of our common stock or other securities convertible into or exchangeable for our common
stock. We cannot assure you that we will be able to sell shares or other securities in any other offering at a price per share
that is equal to or greater than the price per share paid by investors, and investors purchasing shares or other securities in
the future could have rights superior to existing stockholders.
If we cannot raise adequate
funds to satisfy our capital requirements, we will have to delay, scale back or eliminate our research and development activities,
clinical studies or future operations. We may also be required to obtain funds through arrangements with collaborators, which arrangements
may require us to relinquish rights to certain technologies or products that we otherwise would not consider relinquishing, including
rights to future product candidates or certain major geographic markets. We may further have to license our technology to others.
This could result in sharing revenues which we might otherwise have retained for ourselves. Any of these actions may harm our business,
financial condition and results of operations.
The amount of funding we
will need depends on many factors, including the progress, timing and scope of our product development programs; the progress,
timing and scope of our preclinical studies and clinical trials; the time and cost necessary to obtain regulatory approvals; the
time and cost necessary to further develop manufacturing processes and arrange for contract manufacturing; our ability to enter
into and maintain collaborative, licensing and other commercial relationships; and our partners’ commitment of time and resources
to the development and commercialization of our products.
We have limited access to the capital
markets and even if we can raise additional funding, we may be required to do so on terms that are dilutive to you.
We have limited access
to the capital markets to raise funds. The capital markets have been unpredictable in the recent past for radioisotope and other
oncology companies and unprofitable companies such as ours. Furthermore, the COVID-19 pandemic has created significant economic
uncertainty and volatility in the credit and capital markets. A continuation or worsening of the levels of market disruption and
volatility seen in the recent past could have an adverse effect on our ability to access capital. In addition, it is generally
difficult for development-stage companies to raise capital under current market conditions. The amount of capital that a company
such as ours is able to raise often depends on variables that are beyond our control. As a result, we may not be able to secure
financing on terms attractive to us, or at all. If we are able to consummate a financing arrangement, the amount raised may not
be sufficient to meet our future needs. If adequate funds are not available on acceptable terms, or at all, our business, including
our technology licenses, results of operations, financial condition and our continued viability will be materially adversely affected.
We are highly dependent on the success
of Iomab-B and the SIERRA trial and we many not able to complete the necessary clinical development or our development efforts
may not result in the data necessary to receive regulatory approval.
Iomab-B, which we licensed
from the Fred Hutchinson Cancer Research Center in June 2012 is our lead program to which we allocate a significant portion of
our resources. We are currently enrolling patients in the pivotal Phase 3 SIERRA trial (Study of Iomab-B in Elderly Relapsed or
Refractory AML), a 150-patient multi-center randomized trial that will compare outcomes of patients who receive Iomab-B and a BMT
to those patients receiving physician’s choice of salvage chemotherapy, defined as conventional care, as no standard of care
exists for this patient population. The SIERRA trial may be unsuccessful and fail to demonstrate a safety and efficacy profile
that is necessary to receive favorable regulatory approval. The trials DMC or Data Monitoring Committee may recommend that the
trial be stopped early for safety or efficacy concerns, which could prevent us from completing the SIERRA trial. Even if Iomab-B
receives favorable regulatory approval, we may not be successful in securing adequate reimbursement or establishing successful
commercial operations. Any or all of these factors could have a material adverse impact on our business and ability to continue
operations.
28
We may be unable to establish sales,
marketing and commercial supply capabilities.
We do not currently have,
nor have we ever had, commercial sales and marketing capabilities. If any of our product candidates become approved, we would have
to build and establish these capabilities in order to commercialize our approved product candidates. The process of establishing
commercial capabilities will be expensive and time consuming. Even if we are successful in building sales and marketing capabilities,
we may not be successful in commercializing any of our product candidates. Any delays in commercialization or failure to successfully
commercialize any product candidate may have material adverse impacts on our business and ability to continue operations.
Our business could be adversely affected
by the effects of health epidemics, including the global COVID-19 pandemic.
In December 2019, a novel
strain of COVID-19 was reported in China. Since then, COVID-19 has spread globally. The spread of COVID-19 from China to other
countries has resulted in the World Health Organization (WHO) declaring the outbreak of COVID-19 as a “pandemic,” or
a worldwide spread of a new disease, on March 11, 2020. Many countries around the world have imposed quarantines and restrictions
on travel and mass gatherings to slow the spread of the virus and have closed non-essential businesses, and many local jurisdictions
continue to have such restrictions in place.
As many local jurisdictions
continue to have such restrictions in place, our ability to continue to operate our business may also be limited. Such events may
result in a period of business, supply and drug product manufacturing disruption, and in reduced operations, any of which could
materially affect our business, financial condition and results of operations. In response to COVID-19, we implemented remote working
and thus far have not experienced a significant disruption or delay in our operations as it relates to the clinical development
of our drug candidates. Such government-imposed precautionary measures may have been relaxed in certain countries or states, but
there is no assurance that more strict measures will be put in place again due to a resurgence in COVID-19 cases. Therefore, the
COVID-19 pandemic may continue to affect our operation, may further divert the attention and efforts of the medical community to
coping with COVID-19 and disrupt the marketplace in which we operate and may have a material adverse effect on our operations.
The spread of COVID-19,
which has caused a broad impact globally, may materially affect us economically. While the ultimate economic impact brought by,
and the duration of, the COVID-19 pandemic may be difficult to assess or predict, including new information which may emerge concerning
the severity of COVID-19 and the actions to contain COVID-19 or treat its impact, among others, the pandemic has resulted in significant
disruptions in the general commercial activity and the global economy and caused financial market volatility and uncertainty in
significant and unforeseen ways in the recent months. A continuation or worsening of the levels of market disruption and volatility
seen in the recent past could have an adverse effect on our ability to access capital, which could in the future negatively affect
our liquidity. In addition, a recession or market correction resulting from the spread of COVID-19 could materially affect our
business and the value of our common stock.
Currently, the Phase
3 SIERRA trial for our lead program, Iomab-B, continues to remain active at a majority of our clinical trial sites, with investigators
providing feedback that recruitment and enrollment will remain active because of the acute nature of the disease, the high unmet
needs of patients with relapsed or refractory AML, the potentially curative nature of BMT and the differentiated profile of Iomab-B.
Certain sites that had not been actively enrolling due to COVID-19 have resumed recruitment and enrollment, and wecurrently anticipate
that other sites that have not been actively enrolling due to COVID-19 will likely resume recruitment and enrollment in the summer
timeframe. We also believe our earlier stage clinical trials for our CD33 program will also continue to recruit and enroll patients
given the acute nature of relapsed or refractory AML. The continuation of the pandemic globally could adversely affect our planned
clinical trial operations, including our ability to conduct the trials on the expected timelines and recruit and retain patients
and principal investigators and site staff who, as healthcare providers, may have heightened exposure to COVID-19 if their geography
is impacted by the pandemic. Further, the continuation and/or resurgence of the COVID-19 pandemic could result in delays in our
clinical trials due to prioritization of hospital resources toward the pandemic, restrictions in travel, potential unwillingness
of patients to enroll in trials at this time, or the inability of patients to comply with clinical trial protocols if quarantines
or travel restrictions impede patient movement or interrupt healthcare services. In addition, we rely on independent clinical investigators,
contract research organizations and other third-party service providers to assist us in managing, monitoring and otherwise carrying
out our preclinical studies and clinical trials, and the pandemic may affect their ability to devote sufficient time and resources
to our programs or to travel to sites to perform work for us.
29
Additionally, COVID-19
may result in delays in receiving approvals from local and foreign regulatory authorities, delays in necessary interactions with
IRB’s or Institutional Review Boards, local and foreign regulators, ethics committees and other important agencies and contractors
due to limitations in employee resources or forced furlough of government employees.
COVID-19 has caused severe
disruptions in transportation and limited access to our facility, resulting in limited support from our staff and professional
advisors. The small size of our accounting staff and the additional responsibilities emanating from COVID-19 presented difficulties
to our ability to complete our Annual Report on Form 10-K and our Quarterly Report on Form 10-Q for the quarter ended March 31,
2020, resulting in the delay of filing of each of those reports.
The ultimate impact from
COVID-19 on our business operations and financial results during 2020 will depend on, among other things, the ultimate severity
and scope of the pandemic, the pace at which governmental and private travel restrictions and public concerns about public gatherings
will ease, the rate at which historically large increases in unemployment rates will decrease, if at all, and whether, and the
speed with which the economy recovers. We are not able to fully quantify the impact that these factors will have on our financial
results during 2020 and beyond, but developments related to COVID-19 may materially affect us in 2020.
Our business is subject to cybersecurity risks.
Our operations are increasingly
dependent on information technologies and services. Threats to information technology systems associated with cybersecurity risks
and cyber incidents or attacks continue to grow, and include, among other things, storms and natural disasters, terrorist attacks,
utility outages, theft, viruses, phishing, malware, design defects, human error, and complications encountered as existing systems
are maintained, repaired, replaced, or upgraded. Risks associated with these threats include, among other things:
●
theft or misappropriation of funds;
●
loss, corruption, or misappropriation of intellectual property, or other proprietary, confidential or personally identifiable information (including supplier, clinical data or employee data);
●
disruption or impairment of our and our business operations and safety procedures;
●
damage to our reputation with our potential partners, patients and the market;
●
exposure to litigation;
●
increased costs to prevent, respond to or mitigate cybersecurity events.
Although we utilize various
procedures and controls to mitigate our exposure to such risk, cybersecurity attacks and other cyber events are evolving and unpredictable.
Moreover, we have no control over the information technology systems of third parties conducting our clinical trials, our suppliers,
and others with which our systems may connect and communicate. As a result, the occurrence of a cyber incident could go unnoticed
for a period time.
We do not presently maintain
insurance coverage to protect against cybersecurity risks. If we procure such coverage in the future, we cannot ensure that it
will be sufficient to cover any particular losses we may experience as a result of such cyberattacks. Any cyber incident could
have a material adverse effect on our business, financial condition and results of operations.
30
Risks Related to Regulation
The FDA or comparable foreign regulatory
authorities may disagree with our regulatory plans and we may fail to obtain regulatory approval of our product candidates.
Our products are subject
to rigorous regulation by the FDA and numerous other federal, state and foreign governmental authorities. The process of seeking
regulatory approval to market an antibody radiation-conjugate product is expensive and time-consuming, and, notwithstanding the
effort and expense incurred, approval is never guaranteed. If we are not successful in obtaining timely approval of our products
from the FDA, we may never be able to generate significant revenue and may be forced to cease operations. In particular, the FDA
permits commercial distribution of a new antibody radiation-conjugate product only after a BLA for the product has received FDA
approval. The BLA process is costly, lengthy and inherently uncertain. Any BLA filed by us will have to be supported by extensive
data, including, but not limited to, technical, preclinical, clinical trial, manufacturing and labeling data, to demonstrate to
the FDA’s satisfaction the safety and efficacy of the product for its intended use. The lengthy approval process as well
as the unpredictability of future clinical trial results may result in our failing to obtain regulatory approval to market our
product candidates, which would significantly harm our business, results of operations and prospects. In addition, even if we were
to obtain approval, regulatory authorities may approve any of our product candidates for fewer or more limited indications than
we request, may not approve the price we intend to charge for our products, may grant approval contingent on the performance of
costly post-marketing clinical trials, or may approve a product candidate with a label that does not include the labeling claims
necessary or desirable for the successful commercialization of that product candidate. Any of the foregoing scenarios could materially
harm the commercial prospects for our product candidates.
The approval process in
the United States and in other countries could result in unexpected and significant costs for us and consume management’s
time and other resources. The FDA and other foreign regulatory agencies could ask us to supplement our submissions, collect non-clinical
data, conduct additional clinical trials or engage in other time-consuming actions, or it could simply deny our applications. In
addition, even if we obtain approval to market our products in the United States or in other countries, the approval could be revoked,
or other restrictions imposed if post-market data demonstrates safety issues or lack of effectiveness. We cannot predict with certainty
how, or when, the FDA or other regulatory authorities will act. If we are unable to obtain the necessary regulatory approvals,
our financial condition and cash flow may be materially adversely affected, and our ability to grow domestically and internationally
may be limited. Additionally, even if we obtain approval, regulatory authorities may approve any of our product candidates for
fewer or more limited indications that we request. The Company’s products may not be approved for the specific indications
that are most necessary or desirable for successful commercialization or profitability.
We have not demonstrated that any of
our products are safe and effective for any indication and will continue to expend substantial time and resources on clinical development
before any of our current or future product candidates will be eligible for FDA approval, if ever.
We expect that a substantial
portion of our efforts and expenditures over the next few years will be devoted to development of our existing and contemplated
biological product candidates. Accordingly, our business currently depends heavily on the successful development, FDA approval,
and commercialization of such candidates, which may never receive FDA approval or be successfully commercialized even if FDA approval
is received. The research, testing, manufacturing, labeling, approval, sale, marketing, and distribution of our biological product
candidates are, and will remain, subject to extensive regulation by the FDA and other regulatory authorities in the United States
and other countries, as applicable. We are currently not permitted to market any of our current or future product candidates in
the United States until we receive FDA approval (of each) via the BLA process. To date, we have two product candidates in
clinical development and have not-yet submitted a BLA for any of our candidates and, for many such candidates, do not expect to
be in a position to do so for the foreseeable future, as there are numerous developmental steps that must be completed before we
can prepare and submit a BLA.
31
In the United States, the
FDA regulates pharmaceutical and biological product candidates under the Federal Food, Drug and Cosmetic Act (“FDCA”)
and the Public Health Service Act (“PHSA”), as well as their respective implementing regulations. Such products and
product candidates are also subject to other federal, state, and local statutes and regulations. The process of obtaining regulatory
approvals and the subsequent compliance with appropriate federal, state, local, and foreign statutes and regulations requires the
expenditure of substantial time and financial resources. The process required by the FDA before a drug or biological product may
be marketed in the United States generally involves the following:
●
completion of preclinical laboratory tests and animal studies in accordance with FDA’s good laboratory practices (“GLPs”) and applicable requirements for the humane use of laboratory animals or other applicable regulations;
●
submission to the FDA of an IND, which must become effective before human clinical trials in the United States may begin;
●
performance of adequate and well-controlled human clinical trials in accordance with FDA’s IND regulations, good clinical practices (“GCPs”), and any additional requirements for the protection of human research subjects and their health information, to establish the safety and efficacy of the proposed biological product for its intended use;
●
submission to the FDA of a BLA for marketing approval that meets applicable requirements to ensure the continued safety, purity, and potency of the product that is the subject of the BLA based on results of preclinical testing and clinical trials;
●
satisfactory completion of an FDA inspection of the manufacturing facility or facilities where the biological product is produced, to assess compliance with current good manufacturing processes (“cGMPs”) and assure that the facilities, methods and controls are adequate to preserve the biological product’s identity, strength, quality and purity;
●
potential FDA audit of the nonclinical study and clinical trial sites that generated the data in support of the BLA; and
●
FDA review and approval, or denial, of the BLA.
Before testing any biological
product candidate in humans, the product candidate enters the preclinical testing stage. Preclinical tests include laboratory evaluations
of product chemistry, toxicity and formulation, as well as animal studies to assess the potential safety and activity of the product
candidate. The conduct of the preclinical tests must comply with federal regulations and requirements including GLPs. The clinical
trial sponsor must submit the results of the preclinical tests, together with manufacturing information, analytical data, any available
clinical data or literature and a proposed clinical protocol, to the FDA as part of the IND. Some preclinical testing may continue
even after the IND is submitted. The IND automatically becomes effective 30 days after receipt by the FDA, unless the FDA raises
concerns or questions regarding the proposed clinical trials and places the trial on a clinical hold within that 30-day time period.
In such a case, the IND sponsor and the FDA must resolve any outstanding concerns before the clinical trial can begin. The FDA
may also impose clinical holds on a biological product candidate at any time before or during clinical trials due to safety concerns
or non-compliance. If the FDA imposes a clinical hold, trials may not recommence without FDA authorization and then only under
terms authorized by the FDA. Accordingly, we cannot be sure that submission of an IND will result in the FDA allowing clinical
trials to begin or that, for those that have already commenced under an active IND, that issues will not arise that suspend or
terminate such trials.
32
Clinical trials involve
the administration of the biological product candidate to healthy volunteers or patients under the supervision of qualified investigators,
generally physicians not employed by or under the trial sponsor’s control. Clinical trials are conducted under protocols
detailing, among other things, the objectives of the clinical trial, dosing procedures, subject selection and exclusion criteria,
and the parameters to be used to monitor subject safety, including stopping rules that assure a clinical trial will be stopped
if certain adverse events should occur. Each protocol and any amendments to the protocol must be submitted to the FDA as part of
the IND. Clinical trials must be conducted and monitored in accordance with the FDA’s regulations composing the GCP requirements,
including the requirement that all research subjects provide informed consent. Further, each clinical trial must be reviewed and
approved by an independent institutional review board, or IRB, at or servicing each institution at which the clinical trial will
be conducted. An IRB is charged with protecting the welfare and rights of trial participants and considers such items as whether
the risks to individuals participating in the clinical trials are minimized and are reasonable in relation to anticipated benefits.
The IRB also approves the form and content of the informed consent that must be signed by each clinical trial subject or his or
her legal representative and must monitor the clinical trial until completed. Human clinical trials are typically conducted in
three sequential phases that may overlap or be combined:
●
Phase 1. The biological product is initially introduced into healthy human subjects and tested for safety. In the case of some products for severe or life-threatening diseases, especially when the product may be too inherently toxic to ethically administer to healthy volunteers, the initial human testing is often conducted in subjects.
●
Phase 2. The biological product is evaluated in a limited patient population to identify possible adverse effects and safety risks, to preliminarily evaluate the efficacy of the product for specific targeted diseases and to determine dosage tolerance, optimal dosage and dosing schedule.
●
Phase 3. Clinical trials are undertaken to further evaluate dosage, clinical efficacy, potency, and safety in an expanded patient population at geographically dispersed clinical trial sites. These clinical trials are intended to establish the overall risk to benefit ratio of the product and provide an adequate basis for product labeling.
Post-approval clinical
trials, sometimes referred to as Phase 4 clinical trials, may be conducted after initial marketing approval. These clinical trials
are used to gain additional experience from the treatment of patients in the intended therapeutic indication, particularly for
long-term safety follow-up.
After the completion of
clinical trials of a biological product, FDA approval of a BLA must be obtained before commercial marketing of the biological product.
The BLA must include results of product development, laboratory and animal studies, human trials, information on the manufacture
and composition of the product, proposed labeling and other relevant information. The FDA may grant deferrals for submission of
data, or full or partial waivers. The testing and approval processes require substantial time and effort and there can be no assurance
that the FDA will accept the BLA for filing and, even if filed, that any approval will be granted on a timely basis, if at all.
Before approving a BLA, the FDA will inspect the facilities at which the product is manufactured. The FDA will not approve the
product unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirements and adequate
to assure consistent production of the product within required specifications. Additionally, before approving a BLA, the FDA will
typically inspect one or more clinical sites to assure that the clinical trials were conducted in compliance with IND trial requirements
and GCP requirements. To assure cGMP and GCP compliance, an applicant must incur significant expenditure of time, money and effort
in the areas of training, record keeping, production, and quality control.
33
Notwithstanding the submission
of relevant data and information, the FDA may ultimately decide that the BLA does not satisfy its regulatory criteria for approval
and deny approval. Data obtained from clinical trials are not always conclusive and the FDA may interpret data differently than
we interpret the same data. Our product candidates are in the earliest stages of clinical development and, therefore, a long way
from BLA submission. We cannot predict with any certainty if or when we might submit a BLA for regulatory approval for our product
candidates or whether any such BLA will be approved by the FDA. Human clinical trials are very expensive and difficult to design
and implement, in part because they are subject to rigorous regulatory requirements. For example, the FDA may not agree with our
proposed endpoints for any clinical trial we propose, which may delay the commencement of our clinical trials. The clinical trial
process is also lengthy and requires substantial time and effort.
In December 2015, the FDA
cleared our IND filing for Iomab-B (for acute myeloid leukemia or AML), and we are currently enrolling patients in a randomized,
controlled, pivotal Phase 3 clinical trial under such IND to study Iomab-B in patients 55 years of age or older with relapsed or
refractory AML. Assuming the Phase 3 trial meets its endpoints and there are no unexpected issues or delays, it will form the basis
for a BLA in the reasonably near future for Iomab-B for use in preparing and conditioning AML patients for bone marrow transplants
(BMTs). Additionally, there are physician IND trials at the Fred Hutchinson Cancer Research Center (FHCRC) that have been conducted
or are currently ongoing at FHCRC with Iomab-B (for other target indications) and the BC8 antibody we licensed. And, we have multiple
Phase 1 and Phase 2 clinical trials ongoing and others that we have planned but not-yet commenced, for our other drug candidates
under our own sponsorship and multiple investigator-initiated trials ongoing. Except for Iomab-B (for patients with AML), we expect
that the clinical trials we need to conduct to be in a position to submit BLAs for our product candidates currently in-development
will take, at least, several years to complete. Moreover, failure can occur at any stage of the trials, and we could encounter
problems that cause us to abandon or repeat clinical trials. Also, the results of early preclinical and clinical testing may not
be predictive of the results of subsequent clinical trials. A number of companies in the biopharmaceutical industry have suffered
significant setbacks in advanced clinical trials due to lack of efficacy or adverse safety profiles, notwithstanding promising
results in earlier studies. And, preclinical and clinical data are often susceptible to multiple interpretations and analyses.
Many companies that have believed their product candidates performed satisfactorily in preclinical studies and clinical trials
have, nonetheless, failed to obtain marketing approval of their products. Success in preclinical testing and early clinical trials
does not ensure that later clinical trials, which involve many more subjects, and the results of later clinical trials may not
replicate the results of prior clinical trials and preclinical testing. Any failure or substantial delay in our product development
plans may have a material adverse effect on our business.
We may encounter substantial delays in
our clinical trials or may not be able to conduct our trials on the timelines we expect.
We cannot predict whether
we will encounter problems with any of our ongoing or planned clinical trials that will cause us or regulatory authorities to delay,
suspend, or discontinue clinical trials or to delay the analysis of data from ongoing clinical trials. Any of the following could
delay or disrupt the clinical development of our product candidates and potentially cause our product candidates to fail to receive
regulatory approval:
●
conditions imposed on us by the FDA or comparable foreign authorities regarding the scope or design of our clinical trials;
●
delays in receiving, or the inability to obtain, required approvals from institutional review boards (IRBs) or other reviewing entities at clinical sites selected for participation in our clinical trials;
●
delays in enrolling patients into clinical trials;
●
a lower than anticipated retention rate of patients in clinical trials;
●
the need to repeat or discontinue clinical trials as a result of inconclusive or negative results or unforeseen complications in testing or because the results of later trials may not confirm positive results from earlier preclinical studies or clinical trials;
34
●
inadequate supply, delays in distribution, deficient quality of, or inability to purchase or manufacture drug product, comparator drugs or other materials necessary to conduct our clinical trials;
●
unfavorable FDA or other foreign regulatory inspection and review of a clinical trial site or records of any clinical or preclinical investigation;
●
serious and unexpected drug-related side effects experienced by participants in our clinical trials, which may occur even if they were not observed in earlier trials or only observed in a limited number of participants;
●
a finding that the trial participants are being exposed to unacceptable health risks;
●
the placement by the FDA or a foreign regulatory authority of a clinical hold on a trial; or
●
delays in obtaining regulatory agency authorization for the conduct of our clinical trials.
We may suspend, or the
FDA or other applicable regulatory authorities may require us to suspend, clinical trials of a product candidate at any time if
we or they believe the patients participating in such clinical trials, or in independent third-party clinical trials for drugs
based on similar technologies, are being exposed to unacceptable health risks or for other reasons.
Further, individuals involved
with our clinical trials may serve as consultants to us from time to time and receive stock options or cash compensation in connection
with such services. If these relationships and any related compensation to the clinical investigator carrying out the study result
in perceived or actual conflicts of interest, or the FDA concludes that the financial relationship may have affected interpretation
of the study, the integrity of the data generated at the applicable clinical trial site may be questioned and the utility of the
clinical trial itself may be jeopardized. The delay, suspension or discontinuation of any of our clinical trials, or a delay in
the analysis of clinical data for our product candidates, for any of the foregoing reasons, could adversely affect our efforts
to obtain regulatory approval for and to commercialize our product candidates, increase our operating expenses and have a material
adverse effect on our financial results.
Clinical trials may also
be delayed or terminated as a result of ambiguous or negative interim results. In addition, a clinical trial may be suspended or
terminated by us, the FDA, the IRBs at the sites where the IRBs are overseeing a trial, or a data safety monitoring board, or DSMB
(Data Safety Monitoring Board)/DMC (Data Monitoring Committee), overseeing the clinical trial at issue, or other regulatory authorities
due to a number of factors, including:
●
failure to conduct the clinical trial in accordance with regulatory requirements or our clinical protocols;
●
inspection of the clinical trial operations or trial sites by the FDA or other regulatory authorities resulting in the imposition of a clinical hold;
●
varying interpretation of data by the FDA or similar foreign regulatory authorities;
●
failure to achieve primary or secondary endpoints or other failure to demonstrate efficacy;
●
unforeseen safety issues; or
●
lack of adequate funding to continue the clinical trial.
35
Modifications to our product candidates may require federal
approvals.
The BLA application is
the vehicle through which the company may formally propose that the FDA approve a new pharmaceutical for sale and marketing in
the United States. Once a particular product candidate receives FDA approval, expanded uses or uses in new indications of our products
may require additional human clinical trials and new regulatory approvals, including additional IND and BLA submissions and premarket
approvals before we can begin clinical development, and/or prior to marketing and sales. If the FDA requires new approvals for
a particular use or indication, we may be required to conduct additional clinical studies, which would require additional expenditures
and harm our operating results. If the products are already being used for these new indications, we may also be subject to significant
enforcement actions.
Conducting clinical trials
and obtaining approvals is a time-consuming process, and delays in obtaining required future approvals could adversely affect our
ability to introduce new or enhanced products in a timely manner, which in turn would have an adverse effect on our business prospects,
financial condition and results of operation.
The FDA or comparable foreign regulatory
authorities may disagree with our regulatory plans, and we may fail to obtain regulatory approval of our product candidates.
In June 2012, we acquired
rights to BC8 (Iomab), a clinical stage monoclonal antibody with safety and efficacy data in more than 300 patients in need of
a BMT. Iomab-B is our product candidate that links I-131 to the BC8 antibody that is being studied in an ongoing Phase 3 pivotal
trial. Product candidates utilizing this antibody would require BLA approval before they can be marketed in the United States.
We are also evaluating a lower dose of the BC8 antibody and I-131 for lymphodepletion prior to CAR-T or adoptive cell therapy.
We are currently evaluating clinical trials that would use our construct for lymphodepletion. Our lintuzumab-Ac-225 product candidate
is also being studied in several Phase 1 trials under our sponsorship and investigator-initiated trials in patients with AML, myelodysplastic
syndrome and multiple myeloma. Product candidates utilizing the lintuzumab antibody would require BLA approval before they can
be marketed in the United States. We are in the early stages of evaluating other product candidates consisting of conjugates of
Ac-225 with human or humanized antibodies for pre-clinical and clinical development in other types of cancer. The FDA may not approve
these products for the indications that are necessary or desirable for successful commercialization. The FDA may fail to approve
any BLA we submit for new product candidates or for new intended uses or indications for approved products or future product candidates.
Failure to obtain FDA approval for our products in the proposed indications would have a material adverse effect on our business
prospects, financial condition and results of operations.
Clinical trials necessary to support
approval of our product candidates are time-consuming and expensive.
Initiating and completing
clinical trials necessary to support FDA approval of a BLA for Iomab-B, CD33 program candidates, and other product candidates,
is a time-consuming and expensive process, and the outcome is inherently uncertain. Moreover, the results of early clinical trials
are not necessarily predictive of future results, and any product candidate we advance into clinical trials may not have favorable
results in later clinical trials. We have worked with the FDA to develop a clinical trial designed to test the safety and efficacy
of Iomab-B in patients with relapsed or refractory AML who are age 55 and above prior to a BMT. This trial is designed to support
a BLA filing for marketing approval by the FDA, pending results from the trial. We have also worked with the FDA to develop a regulatory
pathway for our Actimab-MDS trial that consists of a dose-confirming Phase 1 trial that can be followed by a randomized, controlled
pivotal trial that could support a BLA filing. There can be no assurance that the data generated during the trial will meet our
chosen safety and effectiveness endpoints or otherwise produce results that will eventually support the filing or approval of a
BLA. Even if the data from this trial are favorable, the data may not be predictive of the results of any future clinical trials.
36
Our clinical trials may fail to demonstrate
adequately the efficacy and safety of our product candidates, which would prevent or delay regulatory approval and commercialization.
Even if our clinical trials
are completed as planned, we cannot be certain that their results will support our product candidate claims or that the FDA or
foreign authorities will agree with our conclusions regarding them. Success in pre-clinical studies and early clinical trials does
not ensure that later clinical trials will be successful, and we cannot be sure that the later trials will replicate the results
of prior trials and pre-clinical studies. The clinical trial process may fail to demonstrate that our product candidates are safe
and effective for the proposed indicated uses. If FDA concludes that the clinical trials for Iomab-B, lintzumab-Ac-225, or any
other product candidate for which we might seek approval, have failed to demonstrate safety and effectiveness, we would not receive
FDA approval to market that product candidate in the United States for the indications sought. In addition, such an outcome could
cause us to abandon the product candidate and might delay development of others. Any delay or termination of our clinical trials
will delay or preclude the filing of any submissions with the FDA and, ultimately, our ability to commercialize our product candidates
and generate revenues. It is also possible that patients enrolled in clinical trials will experience adverse side effects that
are not currently part of a product candidate’s profile.
The intellectual property related to
antibodies we have licensed has expired or likely expired
The key patents related
to the humanized antibody, lintuzumab, which we use in our CD33 program product candidates have expired. It is generally possible
that others may be eventually able to use an antibody with the same sequence, and we will then need to rely on additional patent
protection covering alpha particle drug products comprising Ac-225. Our final drug construct consists of the lintuzumab antibody
labeled with the isotope Ac-225. We have licensed issued patents that relate to the linker technology we use to conjugate the isotope
to the antibody. Further, we own issued and pending patents related to methods for drug conjugation and isotope labeling and for
methods of isotope production. In addition, we possess trade secrets and know how related to the manufacturing and use of isotopes.
Any competing product based on the lintuzumab antibody is likely to require several years of development before achieving our product
candidate’s current status and may be subject to significant regulatory hurdles but is nevertheless a possibility that could
negatively impact our business in the future. We own an issued patent in the US relating to composition of the Iomab-B product
candidate. Five related patents are also pending in the US and internationally. We have and may continue to file patents related
to Iomab-B that can provide barriers to entry but there is no certainty that these patents will be granted or such granting thereof
will adequately prevent others from seeking to replicate and use the BC8 antibody or the construct. We have pending patents related
to radioimmunoconjugate composition, formulation administration, and methods of use in solid or liquid cancers. This matter includes
composition, administration, and methods of treatment for our products Actimab-A and Iomab-B. Any competing product based on the
antibody used in Iomab-B is likely to require several years of development before achieving our product candidate’s current
status and may be subject to significant regulatory hurdles but is nevertheless a possibility that could negatively impact our
business in the future.
Our CD33 program clinical trials are
testing the same drug construct
Our CD33 program is comprised
of several clinical trials including several investigator-initiated trials including AML, MDS and Multiple Myeloma that are studying
the same drug construct consisting of lintuzumab-Ac-225. Negative results from any of these trials could negatively impact our
ability to enroll or complete our other trials studying lintzumab-Ac-225. Additionally, negative outcomes including safety concerns,
may result in the FDA discontinuing other trials utilizing lintuzumab-Ac-225.
We may be unable to obtain a sufficient
supply of isotopes to support clinical development or at commercial scale.
Iodine-131 is a key component
of our Iomab-B drug candidate. We currently source medical grade I-131 from three suppliers including two leading global manufacturers.
Currently, there is sufficient supply of I-131 to advance our ongoing SIERRA clinical trial, support additional trials we may undertake
utilizing I-131 and for commercialization of Iomab-B. We continually evaluate I-131 manufacturers and suppliers and intend to have
multiple qualified suppliers prior to the commercial launch of Iomab-B. While we consider I-131 to be commoditized and obtainable
through several suppliers, there can be no guarantee that we will be able to secure I-131 or obtain I-131 on terms that are acceptable
to us.
37
Actinium-225 is a key component
of our CD33 ARC program, AWE platform and other drug candidates that we might consider for development with the Ac-225 payload.
There are adequate quantities of Ac-225 available today to meet our current needs via our present supplier, the Department of Energy,
or DOE. The current Ac-225 currently supplied to Actinium’s clinical trials from the DOE is derived from the natural decay
of thorium-229 from so-called ‘thorium-cows’ and is able to produce sufficient quantities that are several multiples
of the amount of Ac-225 we require to supply our clinical programs through to early commercialization phase. The DOE is also producing
Ac-225 from a recently developed alternative route for Ac-225 production via a linear accelerator that is currently being evaluated
by Actinium. Initial preclinical and modelling results have indicated that the linear accelerator sourced Ac-225 does not impact
labelling efficiency and expected distribution. Per representations made by the Department of Energy, the capacity of Ac-225 from
this route is expected to be sufficient to supply all of Actinium’s pipeline and commercial Ac-225 needs and support new
program expansion by not just Actinium but also other companies that are developing Ac-225 based products. Additional routes of
Ac-225 production are being pursued by the DOE including the generation of new thorium cows and production via a cyclotron. The
cyclotron production method for Ac-225 production leverages Actinium’s proprietary technology and know-how and presents an
additional path towards production of high-quality Ac-225 that would be able to satisfy commercial needs. In addition, we are aware
of at least six other government and non-government entities globally including the U.S., Canada, Russia, Belgium, France and Japan
that have, or expect to have ability to supply Ac-225 or equipment for its production within the timeframes relevant to first commercial
approval of our Ac-225 ARC.
Our contract for supply
of this isotope from the DOE must be renewed yearly, and the current contract extends through the end of 2020. While we expect
this contract will be renewed at the end of its term as it has since 2009, there can be no assurance that the DOE will renew the
contract or that change its policies that allow for the sale of isotope to us. Failure to acquire sufficient quantities of medical
grade Ac-225 would make it impossible to effectively complete clinical trials and to commercialize any Ac-225 based drug candidates
that we may develop and would materially harm our business.
Our ability to conduct
clinical trials to advance our ARC drug candidates is dependent on our ability to obtain the radioisotopes I-131, Ac-225 and other
isotopes we may choose to utilize in the future. Currently, we are dependent on third party manufacturers and suppliers for our
isotopes. These suppliers may not perform their contracted services or may breach or terminate their agreements with us. Our suppliers
are subject to regulations and standards that are overseen by regulatory and government agencies and we have no control over our
suppliers’ compliance to these standards. Failure to comply with regulations and standards may result in their inability
to supply isotope could result in delays in our clinical trials, which could have a negative impact on our business. We have developed
intellectual property, know-how and trade secrets related to the manufacturing process of Ac-225. While we have manufactured medical
grade Ac-225 of a purity compared to the cyclotron sourced material in the past, this activity was terminated due to operating
cost reasons and we currently do not have experience in manufacturing medical grade Ac-225 and may not obtain the resources necessary
to establish our own manufacturing capabilities in future. Our inability to build out and establish our own manufacturing facilities
would require us to continue to rely on third party suppliers as we currently do. However, based on our current third-party suppliers
and potential future suppliers of Ac-225 we expect to have adequate isotope supply to support our current ongoing clinical trials,
current AWE program activities and commercialization should our drug candidates receive approval.
If we encounter difficulties enrolling
patients in our clinical trials, our clinical development activities could be delayed or otherwise adversely affected.
The timely completion of
clinical trials in accordance with their protocols depends on our ability to enroll a sufficient number of patients who remain
in the trial until its conclusion. We may experience difficulties in patient enrollment in our clinical trials for a variety of
reasons, including:
●
the size and nature of the patient population;
●
the patient eligibility criteria defined in the protocol;
38
●
the size of the study population required for analysis of the trial’s primary endpoints;
●
the proximity of patients to trial sites;
●
the design of the trial;
●
our ability to recruit clinical trial investigators with the appropriate competencies and expertise;
●
competing clinical trials for similar or alternate therapeutic treatments;
●
clinician’s and patients’ perceptions as to the potential advantages and side effects of the product candidate being studied in relation to other available therapies;
●
our ability to obtain and maintain patient consents; and
●
the risk that patients enrolled in clinical trials will not complete a clinical trial.
In addition, refractory
patients, which several of our trials are enrolling, participating in clinical trials are seriously and often terminally ill and
therefore may not complete the clinical trial due to reasons including comorbid conditions or occurrence of adverse medical events
related or unrelated to the investigational products, or death. Even if we are able to enroll a sufficient number of patients in
our clinical trials, delays in patient enrollment will result in increased costs or affect the timing of our planned trials, which
could adversely affect our ability to advance the development of our product candidates.
FDA may take actions that would prolong,
delay, suspend, or terminate clinical trials of our product candidates, which may delay or prevent us from commercializing our
product candidates on a timely basis.
There can be no assurance
that the data generated in our clinical trials will be acceptable to FDA or that if future modifications during the trial are necessary,
that any such modifications will be acceptable to FDA. Certain modifications to a clinical trial protocol made during the course
of the clinical trial have to be submitted to the FDA. This could result in the delay or halt of a clinical trial while the modification
is evaluated. In addition, depending on the quantity and nature of the changes made, FDA could take the position that some or all
of the data generated by the clinical trial is not usable because the same protocol was not used throughout the trial. This might
require the enrollment of additional subjects, which could result in the extension of the clinical trial and the FDA delaying approval
of a product candidate. If the FDA believes that its prior approval is required for a particular modification, it can delay or
halt a clinical trial while it evaluates additional information regarding the change.
Any delay or termination
of our current or future clinical trials as a result of the risks summarized above, including delays in obtaining or maintaining
required approvals from IRBs, delays in patient enrollment, the failure of patients to continue to participate in a clinical trial,
and delays or termination of clinical trials as a result of protocol modifications or adverse events during the trials, may cause
an increase in costs and delays in the filing of any submissions with the FDA, delay the approval and commercialization of our
product candidates or result in the failure of the clinical trial, which could adversely affect our business, operating results
and prospects. Lengthy delays in the completion of our Iomab-B clinical trials would adversely affect our business and prospects
and could cause us to cease operations.
We have obtained orphan drug designation
from FDA for two of our current product candidates and intend to pursue such designation for other candidates and indications in
the future, but we may be unable to obtain such designations or to maintain the benefits associated with any orphan drug designations
we have received or may receive in the future.
We have received orphan
drug designation for Iomab-B and lintuzumab-CD33 ARC for treatment of AML in both the United States and the EU. Under the Orphan
Drug Act, the FDA may grant orphan designation to a drug or biologic intended to treat a rare disease or condition, which is a
disease or condition that affects fewer than 200,000 individuals in the United States, or if it affects more than 200,000 individuals
in the United States, there is no reasonable expectation that the cost of developing and making available a drug or biologic for
this type of disease or condition will be recovered from sales in the United States for that drug or biologic. Similarly, the EMA
grants orphan drug designation to promote the development of products that are intended for the diagnosis, prevention, or treatment
of a life-threatening or chronically debilitating condition affecting not more than five in 10,000 persons in the EU.
39
Orphan drug designation
neither shortens the development time or regulatory review time of a drug or biologic nor gives the drug or biologic any advantage
in the regulatory review or approval process. In the United States, orphan drug designation entitles a party to financial incentives,
such as opportunities for grant funding towards clinical trial costs, tax advantages, and application fee waivers. In addition,
if a product candidate receives the first FDA approval for the indication for which it has orphan designation, such product is
entitled, upon approval, to seven years of orphan-drug exclusivity, during which the FDA may not approve any other application
to market the same drug for the same indication, unless a subsequently approved product is clinically superior to orphan drug or
where the manufacturer is unable to assure sufficient product quantity in the applicable patient population. In the EU, orphan
drug designation entitles a party to financial incentives such as reduction of fees or fee waivers and ten years of market exclusivity
following drug or biological product approval. This period may be reduced to six years if the orphan drug designation criteria
are no longer met, including where it is shown that the product is sufficiently profitable not to justify maintenance of market
exclusivity.
Even if we obtain (or have
obtained) orphan drug designation for certain product candidates, we may not be the first to obtain marketing approval for such
candidates for the applicable indications due to the uncertainties inherent in the development of novel biologic products. And,
an orphan drug candidate may not receive orphan-drug exclusivity upon approval if such candidate is approved for a use that is
broader than the indication for which it received orphan designation. In addition, exclusive marketing rights in the United States
may be lost if the FDA later determines that the request for designation was materially defective or if the manufacturer is unable
to assure sufficient quantities of the product to meet the needs of patients with the rare disease or condition.
Finally, even if we successfully
obtain orphan-drug exclusivity for an orphan drug candidate upon approval, such exclusivity may not effectively protect the product
from competition because (i) different drugs with different active moieties can be approved for the same condition; and (ii) the
FDA or EMA can also subsequently approve a subsequent product with the same active moiety and for the same indication as the orphan
drug if the later-approved drug if deemed clinically superior to the orphan drug.
Even if we receive regulatory approval
of our product candidates, we will be subject to ongoing regulatory obligations and continued regulatory review.
Any regulatory approvals
that we receive for our product candidates will require surveillance to monitor the safety and efficacy of the product candidate.
The FDA may also require a risk evaluation and mitigation strategy in order to approve our product candidates, which could entail
requirements for a medication guide, physician communication plans or additional elements to ensure safe use, such as restricted
distribution methods, patient registries and other risk minimization tools. In addition, if the FDA or a comparable foreign regulatory
authority approves our product candidates, the manufacturing processes, labeling, packaging, distribution, adverse event reporting,
storage, advertising, promotion, import, export and recordkeeping for our product candidates will be subject to extensive and ongoing
regulatory requirements. These requirements include submissions of safety and other post-marketing information and reports, registration,
as well as continued compliance with cGMPs and GCPs for any clinical trials that we conduct post-approval. In addition, the FDA
could require us to conduct another study to obtain additional safety or biomarker information. Later discovery of previously unknown
problems with our product candidates, including adverse events of unanticipated severity or frequency, or with our third-party
suppliers or manufacturing processes, or failure to comply with regulatory requirements, may result in, among other things:
●
restrictions on the marketing or manufacturing of our product candidates, withdrawal of the product from the market, or voluntary or mandatory product recalls;
●
fines, warning letters or holds on clinical trials;
40
●
refusal by the FDA to approve pending applications or supplements to approved applications filed by us or suspension or revocation of license approvals;
●
product seizure or detention, or refusal to permit the import or export of our product candidates; and
●
injunctions or the imposition of civil or criminal penalties.
The FDA’s and other
regulatory authorities’ policies may change, and additional government regulations may be enacted that could prevent, limit
or delay regulatory approval of our product candidates. We cannot predict the likelihood, nature or extent of government regulation
that may arise from future legislation or administrative action, either in the United States or abroad. If we are slow or unable
to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we are not able to maintain
regulatory compliance, we may lose any marketing approval that we may have obtained, and we may not achieve or sustain profitability.
Coverage and reimbursement may be limited or unavailable in
certain market segments for our product candidates which could limit our sales of our product candidates, if approved.
The commercial success
of our product candidates in both domestic and international markets will be substantially dependent on whether third-party coverage
and reimbursement is available for patients that use our products. However, the availability of insurance coverage and reimbursement
for newly approved cancer therapies is uncertain, and therefore, third-party coverage may be particularly difficult to obtain even
if our products are approved by the FDA as safe and efficacious. Patients using existing approved therapies are generally reimbursed
all or part of the product cost by Medicare or other third-party payors. Medicare, Medicaid, health maintenance organizations and
other third-party payors are increasingly attempting to contain healthcare costs by limiting both coverage and the level of reimbursement
of new drugs, and, as a result, they may not cover or provide adequate payment for these products. Submission of applications for
reimbursement approval generally does not occur prior to the filing of a BLA for that product and may not be granted until many
months after BLA approval. In order to obtain coverage and reimbursement for these products, we or our commercialization partners
may have to agree to a net sales price lower than the net sales price we might charge in other sales channels. The continuing efforts
of government and third-party payors to contain or reduce the costs of healthcare may limit our revenue. Initial dependence on
the commercial success of our products may make our revenues particularly susceptible to any cost containment or reduction efforts.
Healthcare legislative reform measures
intended to increase pressure to reduce prices of pharmaceutical products paid for by Medicare or, otherwise, affect the federal
regulation of the U.S. healthcare system could have a material adverse effect our business, future revenue, if any, and results
of operations.
In the United States, the
Medicare Prescription Drug, Improvement, and Modernization Act of 2003, also called the MMA, changed the way Medicare covers and
pays for pharmaceutical products. The legislation expanded Medicare coverage for drug purchases by the elderly and introduced a
new reimbursement methodology based on average sales prices for physician-administered drugs. In addition, this legislation provided
authority for limiting the number of drugs that will be covered in any therapeutic class. As a result of this legislation and the
expansion of federal coverage of drug products, we expect that there will be additional pressure to reduce costs. These cost reduction
initiatives and other provisions of this legislation could decrease the scope of coverage and the price that we receive for any
approved products and could harm our business. While the MMA applies only to drug benefits for Medicare beneficiaries, private
payors often follow Medicare coverage policies and payment limitations in setting their own reimbursement rates, and any reduction
in reimbursement that results from the MMA may cause a similar reduction in payments from private payors. This legislation may
pose an even greater risk to our drug candidates as a significant portion of the target patient population for our drug candidates
would likely be over 65 years of age and, therefore, many such patients will be covered by Medicare.
41
On March 23, 2010, President
Obama signed the “Patient Protection and Affordable Care Act” (P.L. 111-148) and on March 30, 2010, the signed the
“Health Care and Education Reconciliation Act” (P.L. 111-152) (collectively, the “Healthcare Reform Law”).
The Healthcare Reform Law included a number of new rules regarding health insurance, the provision of healthcare, conditions to
reimbursement for healthcare services provided to Medicare and Medicaid patients, and other healthcare policy reforms. Through
the law-making process, substantial changes have been and continue to be made to the current system for paying for healthcare in
the U.S., including changes made to extend medical benefits to certain Americans who lacked insurance coverage and to contain or
reduce healthcare costs (such as by reducing or conditioning reimbursement amounts for healthcare services and drugs, and imposing
additional taxes, fees, and rebate obligations on pharmaceutical and medical device companies). This legislation was one of the
most comprehensive and significant reforms ever experienced by the U.S. in the healthcare industry and has significantly changed
the way healthcare is financed by both governmental and private insurers. This legislation has impacted the scope of healthcare
insurance and incentives for consumers and insurance companies, among others. Additionally, the Healthcare Reform Law’s
provisions were designed to encourage providers to find cost savings in their clinical operations. Pharmaceuticals represent a
significant portion of the cost of providing care. This environment has caused changes in the purchasing habits of consumers and
providers and resulted in specific attention to the pricing negotiation, product selection and utilization review surrounding pharmaceuticals.
This attention may result in our current commercial products, products we may commercialize or promote in the future, and our therapeutic
candidates, being chosen less frequently or the pricing being substantially lowered. At this stage, it is difficult to estimate
the full extent of the direct or indirect impact of the Healthcare Reform Law on us.
These structural changes
could entail further modifications to the existing system of private payors and government programs (such as Medicare, Medicaid,
and the State Children’s Health Insurance Program), creation of government-sponsored healthcare insurance sources, or some
combination of both, as well as other changes. Restructuring the coverage of medical care in the U.S. could impact the reimbursement
for prescribed drugs and pharmaceuticals, including our current commercial products, those we and our development or commercialization
partners are currently developing or those that we may commercialize or promote in the future. If reimbursement for the products
we currently commercialize or promote, any product we may commercialize or promote, or approved therapeutic candidates is substantially
reduced or otherwise adversely affected in the future, or rebate obligations associated with them are substantially increased,
it could have a material adverse effect on our reputation, business, financial condition or results of operations.
Extending medical benefits
to those who currently lack coverage will likely result in substantial costs to the U.S. federal government, which may force significant
additional changes to the healthcare system in the U.S. Much of the funding for expanded healthcare coverage may be sought through
cost savings. While some of these savings may come from realizing greater efficiencies in delivering care, improving the effectiveness
of preventive care and enhancing the overall quality of care, much of the cost savings may come from reducing the cost of care
and increased enforcement activities. Cost of care could be reduced further by decreasing the level of reimbursement for medical
services or products (including our current commercial products, our development or commercialization partners or any product we
may commercialize or promote, or those therapeutic candidates currently being developed by us), or by restricting coverage (and,
thereby, utilization) of medical services or products. In either case, a reduction in the utilization of, or reimbursement for
our current commercial products, any product we may commercialize or promote, or any therapeutic candidate, or for which we receive
marketing approval in the future, could have a material adverse effect on our reputation, business, financial condition or results
of operations.
Several states and private
entities initially mounted legal challenges to the Healthcare Reform Law, and they continue to litigate various aspects of the
legislation. On July 26, 2012, the U.S. Supreme Court generally upheld the provisions of the Healthcare Reform Law at issue as
constitutional. However, the U.S. Supreme Court held that the legislation improperly required the states to expand their Medicaid
programs to cover more individuals. As a result, the states have a choice as to whether they will expand the number of individuals
covered by their respective state Medicaid programs. Some states have not expanded their Medicaid programs and have chosen to develop
other cost-saving and coverage measures to provide care to currently uninsured individuals. Many of these efforts to date have
included the institution of Medicaid-managed care programs. The manner in which these cost-saving and coverage measures are implemented
could have a material adverse effect on our reputation, business, financial condition or results of operations.
Further, the healthcare
regulatory environment has seen significant changes in recent years and is still in flux. Legislative initiatives to modify,
limit, replace, or repeal the Healthcare Reform Law and judicial challenges continue, and may increase in light of the current
administration and legislative environment. We cannot predict the impact on our business of future legislative and legal challenges
to the Healthcare Reform Law or other changes to the current laws and regulations. The financial impact of U.S. healthcare reform
legislation over the next few years will depend on a number of factors, including the policies reflected in implementing regulations
and guidance and changes in sales volumes for therapeutics affected by the legislation. From time to time, legislation is drafted,
introduced and passed in the U.S. Congress that could significantly change the statutory provisions governing coverage, reimbursement,
and marketing of pharmaceutical products. In addition, third-party payor coverage and reimbursement policies are often revised
or interpreted in ways that may significantly affect our business and our products.
42
Since taking office, President
Trump has continued to support the repeal of all or portions of the Healthcare Reform Law. President Trump has also issued an executive
order in which he stated that it is his administration’s policy to seek the prompt repeal of the Healthcare Reform Law and
in which he directed executive departments and federal agencies to waive, defer, grant exemptions from, or delay the implementation
of the provisions of the Healthcare Reform Law to the maximum extent permitted by law. Congress has enacted legislation that repeals
certain portions of the Healthcare Reform Law, including but not limited to the Tax Cuts and Jobs Act, passed in December 2017,
which included a provision that eliminates the penalty under the Healthcare Reform Law’s individual mandate, effective January
1, 2019, as well as the Bipartisan Budget Act of 2018, passed in February 2018, which, among other things, repealed the Independent
Payment Advisory Board (which was established by the Healthcare Reform Law and was intended to reduce the rate of growth in Medicare
spending).
Additionally, in December
2018, a district court in Texas held that the individual mandate is unconstitutional and that the rest of the Affordable Care Act
is, therefore, invalid. On appeal, the Fifth Circuit Court of Appeals affirmed the holding on the individual mandate but remanded
the case back to the lower court to reassess whether and how such holding affects the validity of the rest of the Affordable Care
Act. Substantial uncertainty remains as to the future of the Affordable Care Act after the U.S. Supreme Court declined to expedite
its review of the Fifth Circuit’s holding on January 21, 2020. It is, thus, unlikely that these issues will be resolved before
the next presidential election in November 2020. The current administration may seek to pass additional reform measures before
the upcoming election. We cannot predict the outcome of the election, nor can we predict the healthcare-reform-related initiatives
that the newly elected (or re-elected, as applicable) administration will put forth thereafter. There is no way to know whether,
and to what extent, if any, the Affordable Care Act will remain in-effect in the future, and it is unclear how judicial decisions,
subsequent appeals, election-related measures, or other efforts to repeal and replace or, possibly, to restore the Affordable Care
Act will impact the U.S. healthcare industry or our business.
Risks Related to Third Parties
We rely on third parties to conduct our
clinical trials. If these third parties do not successfully carry out their contractual duties or meet expected deadlines or comply
with regulatory requirements, we may not be able to obtain regulatory approval for or commercialize our product candidates.
We do not have the ability
to independently conduct our pre-clinical and clinical trials for our product candidates and we must rely on third parties, such
as contract research organizations, medical institutions, clinical investigators and contract laboratories to conduct such trials.
Our reliance on these third parties for clinical development activities results in reduced control over these activities. Moreover,
the FDA requires us to comply with regulations and standards, commonly referred to as GCPs (good clinical practices), for conducting,
recording and reporting the results of clinical trials to assure that data and reported results are credible and accurate and that
the trial participants are adequately protected. Our reliance on third parties does not relieve us of these responsibilities and
requirements. If we or any of our third-party contractors fail to comply with applicable GCPs, the clinical data generated in our
clinical trials may be deemed unreliable and the FDA or comparable foreign regulatory authorities may require us to perform additional
clinical trials before approving our marketing applications. We cannot assure you that upon inspection by a given regulatory authority,
such regulatory authority will determine that any of our clinical trials complies with GCP regulations. In addition, our clinical
trials must be conducted with product produced under current good manufacturing practice, or cGMP, regulations. Our failure to
comply with these regulations may require us to repeat clinical trials, which would delay the regulatory approval process.
If our consultants, contract
research organizations and other similar entities with which we are working do not successfully carry out their contractual duties,
meet expected deadlines, or comply with applicable regulations, we may be required to replace them. Although we believe that there
are a number of other third-party contractors, we could engage to continue these activities, we may not be able to enter into arrangements
with alternative third-party contractors or to do so on commercially reasonable terms, which may result in a delay of our planned
clinical trials and delayed development of our product candidates.
43
In addition, our third-party
contractors are not our employees, and except for remedies available to us under our agreements with such third-party contractors,
we cannot control whether or not they devote sufficient time and resources to our programs. If these third parties do not successfully
carry out their contractual duties or regulatory obligations or meet expected deadlines, or if the quality or accuracy of the data
they obtain is compromised due to the failure to adhere to our clinical protocols or regulatory requirements or for other reasons,
our pre-clinical development activities or clinical trials may be extended, delayed, suspended or terminated, and we may not be
able to obtain regulatory approval for, or successfully commercialize, our product candidates on a timely basis, if at all, and
our business, operating results and prospects would be adversely affected.
The antibodies we use in our antibody
radiation-conjugate product candidates may be subject to generic competition.
We are not aware of any
existing or pending regulations or legislation that pertains to generic radiopharmaceutical products such as our antibody radiation-conjugate
product candidates. Our product candidates are regulated by the FDA as biologic products and we intend to seek approval for these
products pursuant to the BLA pathway. The Biologics Price Competition and Innovation Act of 2009, or BPCIA, created an abbreviated
pathway for the approval of biosimilar and interchangeable biologic products. The abbreviated regulatory pathway establishes legal
authority for the FDA to review and approve biosimilar biologics, including the possible designation of a biosimilar as “interchangeable”
based on its similarity to an existing brand product. Under the BPCIA, an application for a biosimilar product cannot be approved
by the FDA until 12 years after the original branded product was approved under a BLA. The law is complex and is still being interpreted
and implemented by the FDA. As a result, its ultimate impact, implementation, and meaning are subject to uncertainty. Even if a
biosimilar gets approved for one of the antibodies that we use, the final constructs of our drug candidates consist of an antibody,
radioisotope and in some cases a linker. Therefore, we do not believe that the final drug product of our candidates can be subject
to competition from a biosimilar as outlined in BPCIA.
Our product candidates may never achieve
market acceptance.
Iomab-B, CD33 ARC program
candidates and future product candidates that we may develop may never gain market acceptance among physicians, patients and the
medical community. The degree of market acceptance of any of our products will depend on a number of factors, including the actual
and perceived effectiveness and reliability of the product; the results of any long-term clinical trials relating to use of the
product; the availability, relative cost and perceived advantages and disadvantages of alternative technologies; the degree to
which treatments using the product are approved for reimbursement by public and private insurers; the strength of our marketing
and distribution infrastructure; and the level of education and awareness among physicians and hospitals concerning the product.
We believe that oncologists
and other physicians will not widely adopt a product candidate unless they determine, based on experience, clinical data, and published
peer-reviewed journal articles, that the use of that product candidate provides an effective alternative to other means of treating
specific cancers. Patient studies or clinical experience may indicate that treatment with our product candidates does not provide
patients with sufficient benefits in extension of life or quality of life. We believe that recommendations and support for the
use of each product candidate from influential physicians will be essential for widespread market acceptance. Our product candidates
are still in the development stage and it is premature to attempt to gain support from physicians at this time. We can provide
no assurance that such support will ever be obtained. If our product candidates do not receive such support from these physicians
and from long-term data, physicians may not use or continue to use, and hospitals may not purchase or continue to purchase, them.
Failure of Iomab-B, CD33
ARC program candidates or any of our other product candidates to significantly penetrate current or new markets would negatively
impact our business financial condition and results of operations.
44
We may be subject to claims that our
third-party service providers, consultants or current or former employees have wrongfully used or disclosed confidential information
of third parties.
We have received confidential
and proprietary information from third parties. In addition, we employ individuals who were previously employed at other biotechnology
or pharmaceutical companies. We may be subject to claims that we or our employees, consultants or independent contractors have
inadvertently or otherwise used or disclosed confidential information of these third parties or our employees’ former employers.
Litigation may be necessary to defend against these claims. Even if we are successful in defending against these claims, litigation
could result in substantial cost and be a distraction to our management and employees.
We currently depend on a single third-party manufacturer to
produce our pre-clinical and clinical trial drug supplies. Any disruption in the operations of our current third-party manufacturer,
or other third-party manufacturers we may engage in the future, could adversely affect our business and results of operations.
We do not currently operate
manufacturing facilities for pre-clinical or clinical production of any of our product candidates. We rely on third-party manufacturers
to supply, store, and distribute pre-clinical and clinical supply of the components of our drug product candidates including monoclonal
antibodies, linkers and radioisotopes, as well as the final construct which comprises our drug product candidates. We expect to
continue to depend on third-party manufacturers for the foreseeable future. Any performance failure on the part of our existing
or future manufacturers could delay clinical development, cause us to suspend or terminate development or delay or prohibit regulatory
approval of our product candidates or commercialization of any approved products. Further avenues of disruption to our clinical
or eventual commercial supply may also occur due to the sale, acquisition, business reprioritization, bankruptcy or other unforeseen
circumstances that might occur at any of our suppliers or contract manufacturing partners including an inability to come to terms
on renewal of existing contracts or new contracts.
We currently rely on single
manufacturers to manufacture our pre-clinical and clinical trial drug supplies. With a view to maintaining business continuity
we are evaluating alternatives and second and even third sources of supply or manufacturing for our core suppliers and manufacturing
partners, however there can be no assurances that we will be able to identify such suppliers or partners and assuming we did, that
we would be able to enter into contracts that are on favorable terms or on terms that will enable sufficient supply to ensure business
continuity and support our growth plans.
Our product candidates
require precise, high-quality manufacturing. Failure by our current contract manufacturer or other third-party manufacturers we
may engage in the future to achieve and maintain high manufacturing standards could result in patient injury or death, product
recalls or withdrawals, delays or failures in testing or delivery, cost overruns, or other problems that could seriously hurt our
business. Contract manufacturers may encounter difficulties involving production yields, quality control, and quality assurance.
These manufacturers are subject to ongoing periodic and unannounced inspections by the FDA and corresponding state and foreign
agencies to ensure strict compliance with cGMPs and other applicable government regulations and corresponding foreign standards;
we do not have control over third-party manufacturers’ compliance with these regulations and standards.
We depend on vendors with
specialized operations, equipment and know-how to manufacture the respective components of our drug candidates. We have entered
into manufacturing and supply agreements with these third-parties, and in some instances, we have agreed that such vendor be the
exclusive manufacturer and supplier. If any of the third-parties we depend on encounter difficulties in their operations, fail
to comply with required regulations or breach their contractual obligations it may be difficult, or we may be unable to identify
suitable alternative third-party manufacturers. While we identify and evaluate third-party manufacturers from time to time, even
if we do identify suitable alternative third-parties, we may fail to reach agreement on contractual terms, it may be prohibitively
expensive and there can be no assurance that we can successfully complete technology transfer and development work necessary or
complete the necessary work in a timely manner. Any of which could prevent us from commencing manufacturing with third-parties.
which could cause delays or suspension of our clinical trials and pre-clinical work that may have a negative impact on our business.
45
Furthermore, these third-party
contractors, whether foreign or domestic, may experience regulatory compliance difficulty, mechanical shut downs, employee strikes,
or any other unforeseeable acts that may delay or limit production. Our inability to adequately establish, supervise and conduct
(either ourselves or through third parties) all aspects of the formulation and manufacturing processes, and the inability of third-party
manufacturers to consistently supply quality product when required would have a material adverse effect on our ability to develop
or commercialize our products. We have faced delays and risks associated with reliance on key third party manufacturers in the
past and may be faced with such delays and risks in the future. Any future manufacturing interruptions or related supply issues
could have an adverse effect on our company, including delays in clinical trials.
If we are successful in obtaining marketing
approval from the FDA and/or other regulatory agencies for any of our product candidates, we anticipate continued reliance on third-party
manufacturers.
To date, our product candidates
have been manufactured in small quantities for preclinical and clinical testing by third-party manufacturers. If the FDA or other
regulatory agencies approve any of our product candidates for commercial sale, we expect that we would continue to rely, at least
initially, on third-party specialized manufacturers to produce commercial quantities of approved products. These manufacturers
may not be able to successfully increase the manufacturing capacity for any approved product in a timely or economic manner, or
at all. Significant scale-up of manufacturing may require additional validation studies, which the FDA must review and approve.
If third party manufacturers are unable to successfully increase the manufacturing capacity for a product candidate, or we are
unable to establish our own manufacturing capabilities, the commercial launch of any approved products may be delayed or there
may be a shortage in supply, which in turn could have a material adverse effect on our business.
In addition, the facilities
used by our contract manufacturers to manufacture our product candidates must be approved by the FDA pursuant to inspections that
will be conducted after we submit a BLA to the FDA. We do not control the manufacturing process of, and are completely dependent
on, our contract manufacturing partners for compliance with cGMPs. If our contract manufacturers cannot successfully manufacture
material that conforms to our specifications and the strict regulatory requirements of the FDA or other regulatory authorities,
they will not be able to secure and/or maintain regulatory approval for their manufacturing facilities. If the FDA or a comparable
foreign regulatory authority does not approve these facilities for the manufacture of our product candidates or if it withdraws
any such approval in the future, we may need to find alternative manufacturing facilities, which would significantly impact our
ability to develop, obtain regulatory approval for or market our product candidates, if approved.
We may have conflicts with our partners
that could delay or prevent the development or commercialization of our product candidates.
We may have conflicts with
our partners, such as conflicts concerning the interpretation of preclinical or clinical data, the achievement of milestones, the
interpretation of contractual obligations, payments for services, development obligations or the ownership of intellectual property
developed during our collaboration. If any conflicts arise with any of our partners, such partner may act in a manner that is averse
to our best interests. Any such disagreement could result in one or more of the following, each of which could delay or prevent
the development or commercialization of our product candidates, and in turn prevent us from generating revenues: unwillingness
on the part of a partner to pay us milestone payments or royalties we believe are due under a collaboration; uncertainty regarding
ownership of intellectual property rights arising from our collaborative activities, which could prevent us from entering into
additional collaborations; unwillingness by the partner to cooperate in the development or manufacture of the product, including
providing us with product data or materials; unwillingness on the part of a partner to keep us informed regarding the progress
of its development and commercialization activities or to permit public disclosure of the results of those activities; initiating
litigation or alternative dispute resolution options by either party to resolve the dispute; or attempts by either party to terminate
the agreement.
46
We face significant competition from
other biotechnology and pharmaceutical companies.
Our product candidates
face, and will continue to face, intense competition from large pharmaceutical and biotechnology companies, as well as academic
and research institutions. We compete in an industry that is characterized by (i) rapid technological change, (ii) evolving industry
standards, (iii) emerging competition and (iv) new product introductions. Our competitors have existing products and technologies
that will compete with our product candidates and technologies and may develop and commercialize additional products and technologies
that will compete with our product candidates and technologies. Because several competing companies and institutions have greater
financial resources than us, they may be able to (i) provide broader services and product lines, (ii) make greater investments
in research and development, or R&D, and (iii) carry on broader R&D initiatives. Our competitors also have greater development
capabilities than we do and have substantially greater experience in undertaking preclinical and clinical testing of product candidates,
obtaining regulatory approvals, and manufacturing and marketing pharmaceutical products. They also have greater name recognition
and better access to customers than us.
Our product candidates may cause undesirable
side effects or have other properties that could halt their clinical development, prevent their regulatory approval, limit their
commercial potential, or result in significant negative consequences
Undesirable side effects
caused by our product candidates could cause us or regulatory authorities to interrupt, delay or halt clinical trials and could
result in a more restrictive label or the delay or denial of regulatory approval by the FDA or other comparable foreign authorities.
The drug-related side effects could affect patient recruitment or the ability of enrolled patients to complete the trial or result
in potential product liability claims. Any of these occurrences may harm our business, financial condition and prospects significantly.
Even if any of our product candidates receives marketing approval, as greater numbers of patients use a product following its approval,
an increase in the incidence of side effects or the incidence of other post-approval problems that were not seen or anticipated
during pre-approval clinical trials could result in a number of potentially significant negative consequences, including:
●
regulatory authorities may withdraw their approval of the product;
●
regulatory authorities may require the addition of labeling statements, such as warnings or contraindications;
●
we may be required to change the way the product is administered, conduct additional clinical trials or change the labeling of the product;
●
we may elect, or we may be required, to recall or withdraw product from the market;
●
we could be sued and held liable for harm caused to patients; and
●
our reputation may suffer.
Any of these events could
substantially increase the costs and expenses of developing, commercializing and marketing any such product candidates or could
harm or prevent sales of any approved products.
Risks Related to Our Intellectual Property
We depend upon securing and protecting critical intellectual
property.
We are dependent on obtaining
and maintaining patents, trade secrets, copyright and trademark protection of our technologies in the United States and other jurisdictions,
as well as successfully enforcing this intellectual property and defending this intellectual property against third-party challenges.
The degree of future protection of our proprietary rights is uncertain for product candidates that are currently in the early stages
of development because we cannot predict which of these product candidates will ultimately reach the commercial market or whether
the commercial versions of these product candidates will incorporate proprietary technologies.
47
Our patent position is highly uncertain
and involves complex legal and factual questions.
Accordingly, we cannot
predict the breadth of claims that may be allowed or enforced under our patents or in third-party patents. For example, we or our
licensors might not have been the first to make the inventions covered by each of our pending patent applications and issued patents;
we or our licensors might not have been the first to file patent applications for these inventions; others may independently develop
similar or alternative technologies or duplicate any of our technologies; it is possible that none of our pending patent applications
or the pending patent applications of our licensors will result in issued patents; our issued patents and issued patents of our
licensors may not provide a basis for commercially viable technologies, or may not provide us with any competitive advantages,
or may be challenged and invalidated by third parties; and, we may not develop additional proprietary technologies that are patentable.
As a result, our owned
and licensed patents may not be valid, and we may not be able to obtain and enforce patents and to maintain trade secret protection
for the full commercial extent of our technology. The extent to which we are unable to do so could materially harm our business.
We or our licensors have
applied for and will continue to apply for patents for certain products. Such applications may not result in the issuance of any
patents, and any patents now held or that may be issued may not provide us with adequate protection from competition. Furthermore,
it is possible that patents issued or licensed to us may be challenged successfully. In that event, if we have a preferred competitive
position because of such patents, such preferred position would be lost. If we are unable to secure or to continue to maintain
a preferred position, we could become subject to competition from the sale of generic products. Failure to receive, inability to
protect, or expiration of our patents for medical use, manufacture, conjugation and labeling of Ac-225, the antibodies that we
license from third parties, or subsequent related filings, would adversely affect our business and operations.
Patents issued or licensed
to us may be infringed by the products or processes of others. The cost of enforcing our patent rights against infringers, if such
enforcement is required, could be significant, and we do not currently have the financial resources to fund such litigation. Further,
such litigation can go on for years and the time demands could interfere with our normal operations. There has been substantial
litigation and other proceedings regarding patent and other intellectual property rights in the pharmaceutical industry. We may
become a party to patent litigation and other proceedings. The cost to us of any patent litigation, even if resolved in our favor,
could be substantial. Some of our competitors may be able to sustain the costs of such litigation more effectively than we can
because of their substantially greater financial resources. Litigation may also absorb significant management time.
Unpatented trade secrets,
improvements, confidential know-how and continuing technological innovation are important to our scientific and commercial success.
Although we attempt to and will continue to attempt to protect our proprietary information through reliance on trade secret laws
and the use of confidentiality agreements with our partners, collaborators, employees and consultants and other appropriate means,
these measures may not effectively prevent disclosure of our proprietary information, and, in any event, others may develop independently,
or obtain access to, the same or similar information.
Certain of our patent rights
are licensed to us by third parties. If we fail to comply with the terms of these license agreements, our rights to those patents
may be terminated, and we will be unable to conduct our business.
If we are found to be infringing on patents
or trade secrets owned by others, we may be forced to cease or alter our product development efforts, obtain a license to continue
the development or sale of our products, and/or pay damages.
Our manufacturing processes
and potential products may violate proprietary rights of patents that have been or may be granted to competitors, universities
or others, or the trade secrets of those persons and entities. As the pharmaceutical industry expands and more patents are issued,
the risk increases that our processes and potential products may give rise to claims that they infringe the patents or trade secrets
of others. These other persons could bring legal actions against us claiming damages and seeking to enjoin clinical testing, manufacturing
and marketing of the affected product or process. If any of these actions are successful, in addition to any potential liability
for damages, we could be required to obtain a license in order to continue to conduct clinical tests, manufacture or market the
affected product or use the affected process. Required licenses may not be available on acceptable terms, if at all, and the results
of litigation are uncertain. If we become involved in litigation or other proceedings, it could consume a substantial portion of
our financial resources and the efforts of our personnel.
48
Our ability to protect and enforce our
patents does not guarantee that we will secure the right to commercialize our patents.
A patent is a limited monopoly
right conferred upon an inventor, and his successors in title, in return for the making and disclosing of a new and non-obvious
invention. This monopoly is of limited duration but, while in force, allows the patent holder to prevent others from making and/or
using its invention. While a patent gives the holder this right to exclude others, it is not a license to commercialize the invention
where other permissions may be required for commercialization to occur. For example, a drug cannot be marketed without the appropriate
authorization from the FDA, regardless of the existence of a patent covering the product. Further, the invention, even if patented
itself, cannot be commercialized if it infringes the valid patent rights of another party.
We rely on confidentiality agreements
to protect our trade secrets. If these agreements are breached by our employees or other parties, our trade secrets may become
known to our competitors.
We rely on trade secrets
that we seek to protect through confidentiality agreements with our employees and other parties. If these agreements are breached,
our competitors may obtain and use our trade secrets to gain a competitive advantage over us. We may not have any remedies against
our competitors and any remedies that may be available to us may not be adequate to protect our business or compensate us for the
damaging disclosure. In addition, we may have to expend resources to protect our interests from possible infringement by others.
The use of hazardous materials, including
radioactive and biological materials, in our research and development efforts imposes certain compliance costs on us and may subject
us to liability for claims arising from the use or misuse of these materials.
Our research, development
and manufacturing activities involve the controlled use of hazardous materials, including chemicals, radioactive and biological
materials, such as radioactive isotopes. We are subject to federal, state, local and foreign environmental laws and regulations
governing, among other matters, the handling, storage, use and disposal of these materials and some waste products. We cannot completely
eliminate the risk of contamination or injury from these materials and we could be held liable for any damages that result, which
could exceed our financial resources. We currently maintain insurance coverage for injuries resulting from the hazardous materials
we use; however, future claims may exceed the amount of our coverage. Also, we do not have insurance coverage for pollution cleanup
and removal. Currently the costs of complying with such federal, state, local and foreign environmental regulations are not significant,
and consist primarily of waste disposal expenses. However, they could become expensive, and current or future environmental laws
or regulations may impair our research, development, production and commercialization efforts.
We may undertake international operations,
which will subject us to risks inherent with operations outside of the United States.
Although we do not have
any international operations at this time, we intend to seek market clearances in foreign markets that we believe will generate
significant opportunities. However, even with the cooperating of a commercialization partner, conducting drug development in foreign
countries involves inherent risks, including, but not limited to difficulties in staffing, funding and managing foreign operations;
unexpected changes in regulatory requirements; export restrictions; tariffs and other trade barriers; difficulties in protecting,
acquiring, enforcing and litigating intellectual property rights; fluctuations in currency exchange rates; and potentially adverse
tax consequences.
If we were to experience
any of the difficulties listed above, or any other difficulties, any international development activities and our overall financial
condition may suffer and cause us to reduce or discontinue our international development and registration efforts.
49
We are highly dependent on our key personnel,
and if we are not successful in attracting and retaining highly qualified personnel, we may not be able to successfully implement
our business strategy.
Our future operations and
successes depend in large part upon the continued service of key members of our senior management team whom we are highly dependent
upon to manage our business. If any member of our current senior management terminates his employment with us and we are unable
to find a suitable replacement quickly, the departure could have a material adverse effect on our business.
Our future success also
depends on our ability to identify, attract, hire or engage, retain and motivate other well-qualified managerial, technical, clinical
and regulatory personnel. There can be no assurance that such professionals will be available in the market, or that we will be
able to retain existing professionals or meet or continue to meet their compensation requirements. Furthermore, the cost base in
relation to such compensation, which may include equity compensation, may increase significantly, which could have a material adverse
effect on us. Failure to establish and maintain an effective management team and workforce could adversely affect our ability to
operate, grow and manage our business.
Managing our growth as we expand operations
may strain our resources.
We expect to need to grow
rapidly in order to support additional, larger, and potentially international, pivotal clinical trials of our product candidates,
which will place a significant strain on our financial, managerial and operational resources. In order to achieve and manage growth
effectively, we must continue to improve and expand our operational and financial management capabilities. Moreover, we will need
to increase staffing and to train, motivate and manage our employees. All of these activities will increase our expenses and may
require us to raise additional capital sooner than expected. Failure to manage growth effectively could materially harm our business,
financial condition or results of operations.
We may expand our business through the
acquisition of rights to new product candidates that could disrupt our business, harm our financial condition and may also dilute
current stockholders’ ownership interests in our company.
Our business strategy includes
expanding our products and capabilities, and we may seek acquisitions of product candidates, antibodies or technologies to do so.
Acquisitions involve numerous risks, including substantial cash expenditures; potentially dilutive issuance of equity securities;
incurrence of debt and contingent liabilities, some of which may be difficult or impossible to identify at the time of acquisition;
difficulties in assimilating acquired technologies or the operations of the acquired companies; diverting our management’s
attention away from other business concerns; risks of entering markets in which we have limited or no direct experience; and the
potential loss of our key employees or key employees of the acquired companies.
We can make no assurances
that any acquisition will result in short-term or long-term benefits to us. We may incorrectly judge the value or worth of an acquired
product, company or business. In addition, our future success would depend in part on our ability to manage the rapid growth associated
with some of these acquisitions. We cannot assure that we will be able to make the combination of our business with that of acquired
products, businesses or companies work or be successful. Furthermore, the development or expansion of our business or any acquired
products, business or companies may require a substantial capital investment by us. We may not have these necessary funds, or they
might not be available to us on acceptable terms or at all. We may also seek to raise funds by selling shares of our preferred
or common stock, which could dilute each current stockholder’s ownership interest in the Company.
50
Risks Related to Ownership of Our Common
Stock
The sale of securities by us in any equity
or debt financing could result in dilution to our existing stockholders and have a material adverse effect on our earnings.
We have financed our operations
primarily through sales of stock and warrants. It is likely that during the next twelve months we will seek to raise additional
capital through the sales of stock and warrants in order to expand our level of operations to continue our research and development
efforts.
Any sale of common stock
by us in a future offering could result in dilution to our existing stockholders as a direct result of our issuance of additional
shares of our capital stock. In addition, our business strategy may include expansion through internal growth or by establishing
strategic relationships with targeted customers and vendors. In order to do so, or to finance the cost of our other activities,
we may issue additional equity securities that could dilute our stockholders’ stock ownership. We may also assume additional
debt and incur impairment losses related to goodwill and other tangible assets if we acquire another company and this could negatively
impact our earnings and results of operations.
Our common stock is subject to price
volatility which could lead to losses by stockholders and potential costly security litigation.
The trading volume of our
common stock has been and may continue to be extremely limited and sporadic. We expect the market price of our common stock to
fluctuate substantially due to a variety of factors, including market perception of our ability to achieve our planned growth,
quarterly operating results of other companies in the same industry, trading volume in our common stock, changes in general conditions
in the economy and the financial markets or other developments affecting our competitors or us. This volatility has had a significant
effect on the market price of securities issued by many companies for reasons unrelated to their operating performance and could
have the same effect on our common stock.
The trading price of our
Common Stock may be highly volatile and could fluctuate in response to factors such as:
●
actual or anticipated variations in our operating results;
●
announcements of developments by us or our competitors;
●
the timing of IND and/or BLA approval, the completion and/or results of our clinical trials;
●
regulatory actions regarding our products;
●
announcements by us or our competitors of significant acquisitions, strategic partnerships, joint ventures or capital commitments;
●
adoption of new accounting standards affecting our industry;
●
additions or departures of key personnel;
●
introduction of new products by us or our competitors;
●
sales of our Common Stock or other securities in the open market; and
●
other events or factors, many of which are beyond our control.
The stock market is subject
to significant price and volume fluctuations. Moreover, the COVID-19 pandemic has resulted in significant financial market volatility
and uncertainty in recent months. In the past, following periods of volatility in the market price of a company’s securities,
securities class action litigation has often been initiated against such a company. Litigation initiated against us, whether or
not successful, could result in substantial costs and diversion of our management’s attention and our resources, which could
harm our business and financial condition.
51
We do not intend to pay dividends on
our common stock, so any returns will be determined by the value of our common stock.
We have never declared
or paid any cash dividends on our common stock. For the foreseeable future, it is expected that earnings, if any, generated from
our operations will be used to finance the growth of our business, and that no dividends will be paid to holders of our common
stock. As a result, the success of an investment in our common stock will depend upon any future appreciation in its value. There
is no guarantee that our common stock will appreciate in value.
Certain provisions of our Certificate
of Incorporation and Bylaws and Delaware law make it more difficult for a third party to acquire us and make a takeover more difficult
to complete, even if such a transaction were in our stockholders’ interest.
Provisions of our certificate
of incorporation and bylaws may delay or discourage transactions involving an actual or potential change in our control or change
in our management, including transactions in which stockholders might otherwise receive a premium for their shares, or transactions
that our stockholders might otherwise deem to be in their best interests. Therefore, these provisions could adversely affect the
price of our stock. Among other things, the certificate of incorporation and bylaws:
●
provide that the authorized number of directors may be changed by resolution of the board of directors;
●
provide that all vacancies, including newly-created directorships, may, except as otherwise required by law, be filled by the affirmative vote of a majority of directors then in office, even if less than a quorum;
●
divide the board of directors into three classes;
●
provide that stockholders seeking to present proposals before a meeting of stockholders or to nominate candidates for election as directors at a meeting of stockholders must provide notice in writing in a timely manner, and meet specific requirements as to the form and content of a stockholder’s notice;
In addition, we are governed
by Section 203 of the Delaware General Corporation Law. In general, Section 203 prohibits a public Delaware corporation from engaging
in a “business combination” with an “interested stockholder” for a period of three years after the date
of the transaction in which the person became an interested stockholder, unless the business combination is approved in a prescribed
manner. A “business combination” includes mergers, asset sales or other transactions resulting in a financial benefit
to the stockholder. An “interested stockholder” is a person who, together with affiliates and associates, owns, or
within three years, did own, 15% or more of the corporation’s outstanding voting stock. These provisions may have the effect
of delaying, deferring or preventing a change in our control.
Compliance with the reporting requirements
of federal securities laws can be expensive.
We are subject to the information
and reporting requirements of the Exchange Act and other federal securities laws, and the compliance obligations of the Sarbanes-Oxley
Act. The costs of preparing and filing annual and quarterly reports and other information with the Securities and Exchange Commission
and furnishing audited reports to stockholders are substantial. In addition, we will incur substantial expenses in connection with
the preparation of registration statements and related documents with respect any offerings of our common stock.
Our ability to utilize our net operating
loss carryforwards and certain other tax attributes may be limited.
Our ability to utilize
our federal net operating loss and tax credit carryforwards may be limited under Sections 382 and 383 of the Internal Revenue Code
of 1986, as amended, or the Code. The limitations apply if we experience an “ownership change”, generally defined
as a greater than 50 percentage point change in the ownership of our equity by certain stockholders over a rolling three-year period. Similar
provisions of state tax law may also apply. We have not assessed whether such an ownership change has previously occurred. If
we have experienced an ownership change at any time since our formation, we may already be subject to limitations on our ability
to utilize our existing net operating losses and other tax attributes to offset taxable income. In addition, future changes in
our stock ownership, which may be outside of our control, may trigger an ownership change and, consequently, the limitations under
Sections 382 and 383 of the Code. As a result, if or when we earn net taxable income, our ability to use our pre-change net
operating loss carryforwards and other tax attributes to offset such taxable income may be subject to limitations, which could
adversely affect our future cash flows.
52
Failure to establish and maintain adequate
finance infrastructure and accounting systems and controls could impair our ability to comply with the financial reporting and
internal controls requirements for publicly traded companies.
As a public company, we
operate in an increasingly demanding regulatory environment, including with respect to more complex accounting rules. Company responsibilities
required by the Sarbanes-Oxley Act of 2002, as amended, or the Sarbanes-Oxley Act, include establishing and maintaining corporate
oversight and adequate internal control over financial reporting and disclosure controls and procedures. Effective internal controls
are necessary for us to produce reliable financial reports and are important to help prevent financial fraud.
Our compliance with Section
404 of the Sarbanes-Oxley Act requires that we incur substantial accounting expense and expend significant management efforts.
We complied with Section 404 at December 31, 2019 and 2018 and while our testing did not reveal any material weaknesses in our
internal controls, any material weaknesses in our internal controls in the future would be required us to remediate in a timely
manner so as to be able to comply with the requirements of Section 404 each year. If we are not able to comply with the requirements
of Section 404 in a timely manner each year, we could be subject to sanctions or investigations by the SEC, NYSE American or other
regulatory authorities which would require additional financial and management resources and could adversely affect the market
price of our common stock. Furthermore, if we cannot provide reliable financial reports or prevent fraud, our business and results
of operations could be harmed, and investors could lose confidence in our reported financial information.
If securities or industry analysts do
not publish research or publish inaccurate or unfavorable research about our business, the price of our common stock and trading
volume could decline.
The trading market for
our common stock will depend in part on the research and reports that securities or industry analysts publish about us or our business.
Multiple securities and industry analysts currently cover us. If one or more of the analysts downgrade our common stock or publish
inaccurate or unfavorable research about our business, the price of our common stock would likely decline. If one or more of these
analysts cease coverage of us or fail to publish reports on us regularly, demand for our common stock could decrease, which could
cause the price of our common stock and trading volume to decline.
Our amended and restated bylaws,
as amended, designate the U.S. federal district courts as the exclusive forum for the resolution of any
complaint asserting a cause of action arising under the Securities Act of 1933, as amended.
Our amended and restated bylaws,
as amended, provide that, unless we consent in writing to the selection of an alternative forum, the federal district courts
of the United States of America will be the exclusive forum for resolving any complaint asserting a cause of action arising under
the Securities Act of 1933, as amended. In addition, our amended and restated bylaws, as amended, state that any person purchasing
or otherwise acquiring any interest in our security shall be deemed to have notice of and to have consented to such provision.
Such choice of forum provision may limit a stockholder’s ability to bring a claim in a judicial forum that it finds favorable
for disputes with us or our directors, officers or other employees, which may discourage such lawsuits, if successful, might benefit
our stockholders. Stockholders who do bring a claim in the federal district courts of the United States of America could face additional
litigation costs in pursuing any such claim.
53
ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS.
None.
ITEM 3. DEFAULTS UPON SENIOR SECURITIES.
None.
ITEM 4. MINE SAFETY DISCLOSURES.
None.
ITEM 5. OTHER INFORMATION.
Warrant Modification
On August 11, 2020,
the Company entered into an amendment to its warrant (the “ Amendment”) to purchase an aggregate of 1,907 shares of
common stock at an exercise price of $15.61515 per share issued to Sandesh Seth, the Company’s Chairman and Chief Executive
Officer, on March 14, 2017 (the “Warrants”). The Amendment modified Section 10 of the Warrant, removing the anti-dilution
provision thereto. Accordingly, pursuant to the Amendment, the exercise price of the Warrant will no longer be subject to a proportional
adjustment if and when the Company issues any shares of its common stock for a consideration less than the exercise price of the
Warrant. The Amendment is effective as of August 11, 2020. All other terms of the Warrant remained the same.
Employment Agreements
Employment Agreement with Sandesh Seth
On August 12, 2020, the Company and Sandesh
Seth, the Company’s Chairman and Chief Executive Officer, entered into an employment agreement, which replaces that certain
Employment Agreement, dated as of August 8, 2018, between the Company and Mr. Seth. Pursuant to the employment agreement, Mr. Seth
will serve as Chairman and Chief Executive Officer until February 24, 2020, unless terminated earlier as set forth in the employment
agreement.
Under the terms of the employment agreement,
Mr. Seth will be entitled to (i) a base salary, which will be determined by the Board and adjusted to be competitively aligned
to a range between the 25 th and 75 th percentile of the relevant market data of chief executive officer positions
of similarly situated publicly companies, (ii) a performance bonus with a target of 50% of his annual base salary as well as other
multipliers as determined by the Board and (iii) options to purchase shares of common stock of the Company as the Board may grant.
When and if granted, the options will have an exercise price equal to the closing price of the Company’s common stock on
the date of the approval, and 2% of the grant will vest each month from the grant date until fully vested, in accordance with the
Company’s Amended and Restated 2013 Stock Plan and 2019 Stock Plan. The options will expire 10 years from the grant date,
subject to Mr. Seth’s continuing service with the Company. Mr. Seth will also receive the standard benefits available to
other similarly situated employees.
If Mr. Seth’s employment as Chief
Executive Officer or Chairman are terminated due to death or disability, Mr. Seth will be entitled to earned, but unpaid, salary,
benefits and the Pro-Rated Bonus (as defined herein) for the year of termination. Upon termination of his employment for Cause
(as defined in the employment agreement), or his resignation without Good Reason (as defined in the employment agreement), Mr.
Seth will receive any accrued and unpaid base salary, the Pro-Rated Bonus and benefits through the date of termination.
54
If the Company terminates Mr. Seth’s
employment without Cause, or if Mr. Seth resigns for Good Reason, Mr. Seth will be entitled to (i) a single lump sum payment equal
to the 24 months of his compensation, (ii) continued health benefits for 24 months, (iii) immediate vesting of all outstanding
equity awards granted to Mr. Seth, and (iv) a single lump sum payment equal to his annual bonus subject to the achievement of the
applicable goals, pro-rated based on the number of days in the Company’s fiscal year through the date of termination (the
“Pro-Rated Bonus”).
In addition, if the Company terminates Mr.
Seth’s employment without Cause or if Mr. Seth resigns for Good Reason, or if the Company fails to renew his position as
Chief Executive Officer and Chairman on February 21, 2024, in any case, within the 12-month period beginning on the date of a Change
in Control (as defined in the Company’s Amended and Restated 2013 Stock Plan and 2019 Stock Plan), Mr. Seth will be entitled
to (i) a single lump sum payment equal to 30 months of his compensation, (ii) continued health benefits for 30 months, (iii) immediate
vesting of all outstanding equity awards granted to Mr. Seth.
A copy of the employment agreement is filed
herewith as Exhibit 10.3 and is incorporated hereby reference. The above description is only a summary of the terms of the employment
agreement and does not purport to be complete description of such document and are qualified in their entirety by reference to
the employment agreement.
Employment Agreement with Steve O’Loughlin
On August 12, 2020, the Company and Steve
O’Loughlin, the Company’s Chief Financial Officer, entered into an employment agreement, pursuant to which Mr. O’Loughlin
will serve as Chief Financial Officer of the Company. Under the terms of the employment agreement, Mr. O’Loughlin will be
entitled to (i) a base salary, which shall be determined by the Board, (ii) a performance bonus, which may be up to 30% of the
annual base salary based upon the achievement of certain objectives such as the Board shall determine and (iii) options to purchase
shares of common stock of the Company as the Board may grant. When and if granted, the options will have an exercise price equal
to the closing price of the Company’s common stock on the date of the approval, and 2% of the grant will vest each month
from the grant date until fully vested, in accordance with the Company’s Amended and Restated 2013 Stock Plan and 2019 Stock
Plan. The options will expire 10 years from the grant date, subject to Mr. O’Loughlin’s continuing service with the
Company. Mr. Loughlin will also receive the standard benefits available to other similarly situated employees.
In addition, if the Company terminates Mr.
O’Loughlin’s employment without Cause (as defined in the employment agreement) or if Mr. O’Loughlin resigns for
Good Reason (as defined in the employment agreement), in either case, within the 12-month period beginning on the date of a Change
in Control, Mr. O’Loughlin will be entitled to (i) a single lump sum payment equal to his annual base salary, (ii) continued
health benefits for 12 months, (iii) immediate vesting of all outstanding equity awards granted to Mr. O’Loughlin.
A copy of the employment agreement is filed
herewith as Exhibit 10.2 and is incorporated hereby reference. The above description is only a summary of the terms of the employment
agreement and does not purport to be complete description of such document and are qualified in their entirety by reference to
the employment agreement.
Employment Agreement with Dale Ludwig
On August 12, 2020, the Company and Dale
Ludwig, the Company’s Chief Scientific and Technology Officer, entered into an employment agreement, pursuant to which Dr.
Ludwig will serve as Chief Scientific and Technology Officer of the Company. Under the terms of the employment agreement, Dr. Ludwig
will be entitled to (i) a base salary, which shall be determined by the Board, (ii) a performance bonus, which may be up to 30%
of the annual base salary based upon the achievement of certain objectives such as the Board shall determine and (iii) options
to purchase shares of common stock of the Company as the Board may grant. When and if granted, the options will have an exercise
price equal to the closing price of the Company’s common stock on the date of the approval, and 2% of the grant will vest
each month from the grant date until fully vested, in accordance with the Company’s Amended and Restated 2013 Stock Plan
and 2019 Stock Plan. The options will expire 10 years from the grant date, subject to Mr. Ludwig’s continuing service with
the Company. Dr. Ludwig will also receive the standard benefits available to other similarly situated employees.
55
In addition, if the Company terminates Dr.
Ludwig’s employment without Cause (as defined in the employment agreement) within the 12-month period beginning on the date
of a Change in Control, Dr. Ludwig will be entitled to (i) a single lump sum payment equal to his annual base salary, (ii) continued
health benefits for 12 months, (iii) immediate vesting of all outstanding equity awards granted to Mr. Ludwig.
A copy of the employment agreement is filed
herewith as Exhibit 10.3 and is incorporated hereby reference. The above description is only a summary of the terms of the employment
agreement and does not purport to be complete description of such document and are qualified in their entirety by reference to
the employment agreement.
Employment Agreement with Mark Berger
On August 12, 2020, the Company and Mark
Berger, the Company’s Chief Medical Officer, entered into an employment agreement, pursuant to which Dr. Berger will serve
as Chief Medical Officer of the Company. Under the terms of the employment agreement, Dr. Berger will be entitled to (i) a base
salary, which shall be determined by the Board, (ii) a performance bonus, which may be up to 30% of the annual base salary based
upon the achievement of certain objectives such as the Board shall determine and (iii) options to purchase shares of common stock
of the Company as the Board may grant. When and if granted, the options will have an exercise price equal to the closing price
of the Company’s common stock on the date of the approval, and 2% of the grant will vest each month from the grant date until
fully vested, in accordance with the Company’s Amended and Restated 2013 Stock Plan and 2019 Stock Plan. The options will
expire 10 years from the grant date, subject to Dr. Berger’s continuing service with the Company. Mr. Berger will also receive
the standard benefits available to other similarly situated employees.
In addition, if the Company terminates Dr.
Berger’s employment without Cause (as defined in the employment agreement) within the 12-month period beginning on the date
of a Change in Control, Dr. Berger will be entitled to (i) a single lump sum payment equal to his annual base salary, (ii) continued
health benefits for 12 months, (iii) immediate vesting of all outstanding equity awards granted to Dr. Berger.
A copy of the employment agreement is filed
herewith as Exhibit 10.4 and is incorporated hereby reference. The above description is only a summary of the terms of the employment
agreement and does not purport to be complete description of such document and are qualified in their entirety by reference to
the employment agreement.
56
ITEM 6. EXHIBITS
Copies of the following
documents are included as exhibits to this report pursuant to Item 601 of Regulation S-K.
Exhibit No.
Title of Document
Location
3.1
Certificate of Incorporation of Actinium Pharmaceuticals, Inc. (incorporated by reference to Exhibit 3.1 of the Company’s Form 8-K filed with the SEC on April 17, 2013).
3.2
Certificate of Amendment to Certificate of Incorporation filed January 7, 2014 (incorporated by reference to Exhibit 3.5 to Form S-1 filed on January 31, 2014).
3.3
Certificate of Amendment to Certificate of Incorporation filed February 3, 2014. (incorporated by reference to Exhibit 3.1 to Form 8-K filed on February 7, 2014).
3.4
Certificate of Amendment to Certificate of Incorporation (incorporated by reference to Exhibit 3.1 to Form 8-K filed on March 4, 2015).
3.5
Certificate of Amendment to Certificate of Incorporation, as amended, filed on February 26, 2018 (incorporated by reference to Exhibit 3.1 to Form 8-K filed on February 26, 2018).
3.6
Certificate of Amendment to Certificate of Incorporation, as amended, filed on March 6, 2019 (incorporated by reference to Exhibit 3.7 to Form 10-K filed on March 15, 2019).
3.7
Certificate of Amendment to Certificate of Incorporation, as amended, filed on June 16, 2020 (incorporated by reference to Exhibit 4.1 to Form 8-K filed on June 16, 2020).
3.8
Amended and Restated Bylaws, dated August 8, 2018 (incorporated by reference to Exhibit 3.1 to Form 10-Q filed on August 9, 2018).
3.9
Amendment to the Amended and Restated Bylaws, dated May 7, 2020 (incorporated by reference to Exhibit 3.1 to Form 8-K filed on May 5, 2020).
4.1
Form of Pre-Funded Common Stock Purchase Warrant (incorporated by reference to Exhibit 4.1 to Form 8-K filed on April 24, 2020).
4.2
Form of Pre-Funded Common Stock Warrant (incorporated by reference to Exhibit 4.1 to Form 8-K filed on June 18, 2020).
10.1
Form of Securities Purchase Agreement (incorporated by reference to Exhibit 10.1 to Form 8-K filed on June 18, 2020).
10.2
Amendment to Warrant to Purchase Common Stock of Actinium Pharmaceuticals, Inc., dated March 14, 2017, issued to Sandesh Seth .
Attached
10.3**
Employment Agreement, dated August 12, 2020, by and between Actinium Pharmaceuticals, Inc. and Sandesh Seth.
Attached
10.4**
Employment Agreement, dated August 12, 2020, by and between Actinium Pharmaceuticals, Inc. and Steve O’Loughlin.
Attached
10.5**
Employment Agreement, dated August 12, 2020, by and between Actinium Pharmaceuticals, Inc. and Dale Ludwig.
Attached
10.6**
Employment Agreement, dated August 12, 2020, by and between Actinium Pharmaceuticals, Inc. and Mark Berger.
Attached
57
31.1
Certification of the Chief Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
Attached
31.2
Certification of the Principal Financial and Accounting Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
Attached
32.1
Certification of the Chief Executive Officer pursuant to U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002*
Attached
32.2
Certification of the Principal Financial and Accounting Officer pursuant to U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002*
Attached
101.INS
XBRL Instance Document
Attached
101.SCH
XBRL Taxonomy Extension Schema Document
Attached
101.CAL
XBRL Taxonomy Calculation Linkbase Document
Attached
101.DEF
XBRL Taxonomy Extension Definition Linkbase Document
Attached
101.LAB
XBRL Taxonomy Label Linkbase Document
Attached
101.PRE
XBRL Taxonomy Presentation Linkbase Document
Attached
* The
Exhibit attached to this Form 10-Q shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange
Act of 1934 (the “Exchange Act”) or otherwise subject to liability under that section, nor shall it be deemed incorporated
by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as expressly set forth by
specific reference in such filing.
** Indicates a management contract or compensatory plan.
58
SIGNATURES
Pursuant to the requirements
of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned
thereunto duly authorized.
ACTINIUM PHARMACEUTICALS, INC.
Date: August 14, 2020
By:
/s/ Sandesh Seth
Sandesh Seth
Chairman and Chief Executive Officer
(Duly Authorized Officer and
Principal Executive Officer)
By:
/s/ Steve O’Loughlin
Steve O’Loughlin
Chief Financial Officer
(Duly Authorized Officer and
Principal Financial and Accounting Officer)
59
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