−Removed: MANAGEMENT’S DISCUSSION
−Removed: AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATION
−Removed: FORWARD-LOOKING STATEMENT NOTICE
−Removed: This Form 10-Q contains certain
−Removed: forward-looking statements.
−Removed: For this purpose, any statements contained in this Form 10-Q that are not statements of historical fact may
−Removed: be deemed to be forward-looking statements.
−Removed: Without limiting the foregoing, words such as “may,” “will,”
−Removed: “expect,” “believe,” “anticipate,” “estimate” or “continue” or comparable
−Removed: terminology are intended to identify forward-looking statements.
−Removed: These statements by their nature involve substantial risks and
−Removed: uncertainties, and actual results may differ materially depending on a variety of factors, many of which are not within our control.
−Removed: factors include but are not limited to economic conditions generally and in the industries in which we may participate;
−Removed: competition within
−Removed: our chosen industry, including competition from much larger competitors;
−Removed: technological advances and failure to successfully develop business
−Removed: relationships.
−Removed: Description of Business
+Added: MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATION
+Added: FORWARD-LOOKING
+Added: STATEMENT NOTICE
+Added: Form 10-Q contains certain forward-looking statements.
+Added: For this purpose, any statements contained in this Form 10-Q that are not statements
+Added: of historical fact may be deemed to be forward-looking statements.
+Added: Without limiting the foregoing, words such as “may,”
+Added: “will,” “expect,” “believe,” “anticipate,” “estimate” or “continue”
+Added: or comparable terminology are intended to identify forward-looking statements.
+Added: These statements by their nature involve substantial
+Added: risks and uncertainties, and actual results may differ materially depending on a variety of factors, many of which are not within our
+Added: These factors include but are not limited to economic conditions generally and in the industries in which we may participate;
+Added: competition within our chosen industry, including competition from much larger competitors;
+Added: technological advances and failure to successfully
+Added: develop business relationships.
Actinium Pharmaceuticals, Inc.
28 unchanged sentences
with our expanded research and development organization and research laboratories leveraging our drug development experience.
−Removed: Targeted Conditioning
−Removed: To the best of our knowledge,
−Removed: we are advancing the only multi-target, multi-indication, clinical-stage pipeline for targeted conditioning.
−Removed: Our targeted conditioning
−Removed: agents are intended to potentially enable improved access and outcomes to cell-based therapies with curative potential, including BMT,
−Removed: ACT, and gene therapy.
−Removed: Conditioning in the context of BMT, ACT or gene therapy is the act of depleting certain blood and immune-forming
−Removed: cells, including bone marrow stem cells and, in some cases, cancer cells prior to transplanting new cells into a patient.
−Removed: Currently, conditioning
−Removed: is accomplished using a combination of cytotoxic chemotherapeutic agents and external radiation.
−Removed: These non-targeted conditioning regimens
−Removed: are highly toxic and may prevent a patient from receiving a potentially curative therapy and hinder outcomes.
−Removed: We believe our targeted
−Removed: conditioning agents have the potential to increase patient access and outcomes by way of their ability to selectively deplete targeted
−Removed: cells while sparing normal healthy cells, resulting in potentially lower systemic and off-target toxicities.
−Removed: We use our ARCs both at high
−Removed: isotope dose levels to achieve myeloablation, which fully depletes bone marrow stem cells and at lower isotope dose levels to achieve
−Removed: lymphodepletion, which spares bone marrow stem cells from depletion.
−Removed: In addition, dosing may be titrated downward from myeloablative doses
−Removed: to achieve partial myeloablation, which may be appropriate for certain gene therapy programs.
−Removed: CD45 Targeted Conditioning Program
−Removed: Iomab-B (I-131 apamistamab),
−Removed: our lead candidate and targeted conditioning agent is comprised of the anti-CD45 monoclonal antibody known as apamistamab (formerly BC8)
−Removed: and the radioisotope Iodine-131 (“I-131”).
−Removed: CD45 is an antigen expressed on leukemia, lymphoma and myeloma cancer cells, as
−Removed: well as nucleated immune cells including bone marrow stem cells, but is not expressed outside of the hematopoietic, or blood forming,
−Removed: This unique expression on blood cancer and immune cells enables simultaneous depletion of both cell types, making CD45 an optimal
−Removed: antigen for targeted conditioning applications.
−Removed: CD45 is a cell surface antigen with an average expression of 200,000 copies per cell,
−Removed: however, it only internalizes at a rate of 10-15%.
−Removed: We believe our ARC approach is the most effective method to target CD45 positive cells,
−Removed: as the radioisotope payload linear energy transfer can readily ablate a targeted cell without requiring payload internalization like an
−Removed: antibody drug conjugate or without relying on biological effector function processes like a naked antibody.
−Removed: Furthermore, since CD45 expression
−Removed: level varies from low to high antigen density as the immune cells become more terminally differentiated, we can selectively condition
−Removed: depending on the therapeutic application, from full myeloablation to transient lymphodepletion, by adjusting the dose or intensity of
−Removed: the I-131 isotope payload.
−Removed: Full myeloablation can be achieved with high doses of I-131, as its energy pathlength and crossfire effect
−Removed: can penetrate into bone marrow niches to target and deplete blood and immune system forming bone marrow stem cells.
−Removed: Myeloablation is applicable
−Removed: to autologous or allogeneic BMT and to autologous gene-edited or modified therapies that can reconstitute a patient’s blood and
−Removed: immune systems.
−Removed: Alternatively, low doses of I-131 can be transiently lymphodepleting and spare a patient’s bone marrow stem cells,
−Removed: which we believe is ideal for ACT applications such as CAR-T.
−Removed: We intend to develop our CD45 targeted conditioning program for BMT, ACT
−Removed: and gene therapy applications for malignant and non-malignant diseases and believe that multiple radioisotopes beyond I-131 may be utilized
−Removed: including alpha and beta emitters.
−Removed: Iomab-B uses high doses of
−Removed: I-131 to achieve myeloablative conditioning prior to a BMT.
−Removed: Iomab-B is currently being studied in the pivotal Phase 3 Study of Iomab-B
−Removed: in Elderly Relapsed or Refractory AML (“SIERRA”), clinical trial for targeted conditioning prior to an allogeneic BMT for
−Removed: patients with active, relapsed or refractory (“r/r”) Acute Myeloid Leukemia, (“AML”), who are age 55 or older.
−Removed: Enrollment of the planned 150 patients in the SIERRA trial was completed in the third quarter of 2021 with the last patient receiving
−Removed: their BMT in the fourth quarter of 2021.
−Removed: Patients with active, r/r AML are not normally considered eligible for BMT and the SIERRA trial
−Removed: is the only randomized Phase 3 trial to offer BMT as a treatment option for this patient population.
−Removed: The SIERRA trial compares outcomes
−Removed: of patients randomized to receive Iomab-B and a BMT (the “study arm”) to those patients randomized to receive physician’s
−Removed: choice of salvage therapy (the “control arm”).
−Removed: The control arm is also defined as conventional care, as no standard of care
−Removed: exists for this patient population and includes over 20 agents that may be used as single agents or in combination including venetoclax,
−Removed: a targeted Bcl-2 inhibitor, Midostaurin and Sorafenib, targeted FLT3 inhibitors, hypomethylating agents and cytotoxic chemotherapies.
−Removed: Patients who fail to achieve a Complete Remission (“CR”) on the control arm are ineligible to proceed to a BMT, but the trial
−Removed: design permits these patients to “cross over” to receive the study arm treatment if they meet the eligibility criteria.
−Removed: primary endpoint of the SIERRA trial is durable Complete Remission (“dCR”) of 180 days and the secondary endpoint is Overall
−Removed: Survival (“OS”).
−Removed: When the crossover patients receive Iomab-B and BMT, they have not achieved remission with their salvage
−Removed: therapy and are considered to be failures for the primary endpoint of the study.
−Removed: The SIERRA trial recruited patients at 24 sites in the
−Removed: United States and Canada, which includes many of the leading BMT sites based on volume.
−Removed: If approved, we expect our
−Removed: initial commercial launch would target the leading 50-100 BMT and medical centers that perform the vast majority of BMT’s in the
−Removed: United States.
−Removed: In the European Union (“EU”), we received favorable feedback from the European Medicines Agency (“EMA”)
−Removed: via their scientific advice program that the trial design, primary endpoint and planned statistical analysis from the SIERRA trial are
−Removed: acceptable as the basis for a Marketing Authorization Application, or MAA.
−Removed: Additionally, the EMA commented that it does not anticipate
−Removed: the need for further standalone preclinical toxicology or safety studies.
−Removed: Overall, transplant procedures in the EU are approximately fifty
−Removed: percent higher than in the United States with a similar market dynamic, with a majority of BMT volume being conducted in a concentrated
−Removed: number of leading medical centers.
−Removed: In April 2022, we entered into a license and supply agreement with Immedica Pharma AB, or Immedica,
−Removed: pursuant to which Immedica licensed the exclusive product rights for commercialization of Iomab-B in the European Economic Area, Middle
−Removed: East and North Africa.
−Removed: including Algeria, Andorra, Bahrain, Cyprus, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libya.
−Removed: Morocco, Oman, Palestine, Qatar, San Marino, Saudi Arabia, Switzerland, Syria, Tunisia, Turkey, the United Arab Emirates, the United Kingdom,
−Removed: the Vatican City and Yemen.
−Removed: Upon signing, we are entitled to an upfront payment of $35 million from Immedica, which we received in May 2022.
−Removed: Under the terms of the agreement,
−Removed: we are eligible to receive aggregate regulatory and commercial milestone payments of up to approximately $417 million, subject to future
−Removed: currency exchange rates.
−Removed: Additionally, we are entitled to receive royalties in the mid-20 percent range on net sales of the product in
−Removed: certain countries that may result from the License Agreement.
−Removed: We will continue to be responsible for certain clinical development activities
−Removed: and the manufacturing of Iomab-B and will retain commercialization rights in the U.S.
+Added: the best of our knowledge, we are advancing the most advanced multi-target, multi-indication, clinical-stage pipeline for targeted conditioning.
+Added: Our targeted conditioning agents are intended to potentially enable improved access and outcomes to cell-based therapies with curative
+Added: potential, including BMT, ACT and gene therapy.
+Added: Conditioning in the context of BMT, ACT or gene therapy is the act of depleting certain
+Added: blood and immune-forming cells, including bone marrow stem cells and, in some cases, cancer cells prior to transplanting new cells into
+Added: Currently, conditioning is accomplished using a combination of cytotoxic chemotherapeutic agents and external radiation.
+Added: non-targeted conditioning regimens are highly toxic and may prevent a patient from receiving a potentially curative therapy and hinder
+Added: We believe our targeted conditioning agents have the potential to increase patient access and outcomes by way of their ability
+Added: to selectively deplete targeted cells while sparing normal healthy cells, resulting in potentially lower systemic and off-target toxicities.
+Added: We use our ARCs both at high isotope dose levels to achieve myeloablation, which fully depletes bone marrow stem cells and at lower isotope
+Added: dose levels to achieve lymphodepletion, which spares bone marrow stem cells from depletion.
+Added: In addition, dosing may be titrated downward
+Added: from myeloablative doses to achieve partial myeloablation, which may be appropriate for certain gene therapy programs.
+Added: Targeted Conditioning Program
+Added: (I-131 apamistamab), our lead candidate and targeted conditioning agent is comprised of the anti-CD45 monoclonal antibody known as apamistamab
+Added: (formerly BC8) and the radioisotope Iodine-131 (“I-131”).
+Added: CD45 is an antigen expressed on leukemia, lymphoma and myeloma
+Added: cancer cells, as well as nucleated immune cells including bone marrow stem cells, but is not expressed outside of the hematopoietic,
+Added: or blood forming, system.
+Added: This unique expression on blood cancer and immune cells enables simultaneous depletion of both cell types,
+Added: making CD45 an optimal antigen for targeted conditioning applications.
+Added: CD45 is a cell surface antigen with an average expression of 200,000
+Added: copies per cell, however, it only internalizes at a rate of 10-15%.
+Added: We believe our ARC approach is the most effective method to target
+Added: CD45 positive cells, as the radioisotope payload linear energy transfer can readily ablate a targeted cell without requiring payload
+Added: internalization like an antibody drug conjugate or without relying on biological effector function processes like a naked antibody.
+Added: since CD45 expression level varies from low to high antigen density as the immune cells become more terminally differentiated, we can
+Added: selectively condition depending on the therapeutic application, from full myeloablation to transient lymphodepletion, by adjusting the
+Added: dose or intensity of the I-131 isotope payload.
+Added: Full myeloablation can be achieved with high doses of I-131, as its energy pathlength
+Added: and crossfire effect can penetrate into bone marrow niches to target and deplete blood and immune system forming bone marrow stem cells.
+Added: Myeloablation is applicable to autologous or allogeneic BMT and to autologous gene-edited or modified therapies that can reconstitute
+Added: a patient’s blood and immune systems.
+Added: Alternatively, low doses of I-131 can be transiently lymphodepleting and spare a patient’s
+Added: bone marrow stem cells, which we believe is ideal for ACT applications such as CAR-T.
+Added: We intend to develop our CD45 targeted conditioning
+Added: program for BMT, ACT and gene therapy applications for malignant and non-malignant diseases and believe that multiple radioisotopes beyond
+Added: I-131 may be utilized including alpha and beta emitters.
+Added: uses high doses of I-131 to achieve myeloablative conditioning prior to a BMT.
+Added: Iomab-B is currently being studied in the pivotal Phase
+Added: 3 Study of Iomab-B in Elderly Relapsed or Refractory AML (“SIERRA”), clinical trial for targeted conditioning prior to an
+Added: allogeneic BMT for patients with active, relapsed or refractory (“r/r”) Acute Myeloid Leukemia, (“AML”), who
+Added: are age 55 or older.
+Added: Enrollment of the planned 150 patients in the SIERRA trial was completed in the third quarter of 2021 with the last
+Added: patient receiving their BMT in the fourth quarter of 2021.
+Added: Patients with active, r/r AML are not normally considered eligible for BMT
+Added: and the SIERRA trial is the only randomized Phase 3 trial to offer BMT as a treatment option for this patient population.
+Added: trial compares outcomes of patients randomized to receive Iomab-B and a BMT (the “study arm”) to those patients randomized
+Added: to receive physician’s choice of salvage therapy (the “control arm”).
+Added: The control arm is also defined as conventional
+Added: care, as no standard of care exists for this patient population and includes over 20 agents that may be used as single agents or in combination
+Added: including venetoclax, a targeted Bcl-2 inhibitor, Midostaurin and Sorafenib, targeted FLT3 inhibitors, hypomethylating agents and cytotoxic
+Added: chemotherapies.
+Added: Patients who fail to achieve a Complete Remission (“CR”) on the control arm are ineligible to proceed to
+Added: a BMT, but the trial design permits these patients to “cross over” to receive the study arm treatment if they meet the eligibility
+Added: The primary endpoint of the SIERRA trial is durable Complete Remission (“dCR”) of 180 days and the secondary endpoint
+Added: is Overall Survival (“OS”).
+Added: When the crossover patients receive Iomab-B and BMT, they have not achieved remission with their
+Added: salvage therapy and are considered to be failures for the primary endpoint of the study.
+Added: The SIERRA trial recruited patients at 24 sites
+Added: in the United States and Canada, which includes many of the leading BMT sites based on volume.
+Added: approved, we expect our initial commercial launch would target the leading 50-100 BMT and medical centers that perform the vast majority
+Added: of BMTs in the United States.
+Added: In the European Union (“EU”), we received favorable feedback from the European Medicines Agency
+Added: (“EMA”) via their scientific advice program that the trial design, primary endpoint and planned statistical analysis from
+Added: the SIERRA trial are acceptable as the basis for a Marketing Authorization Application, or MAA.
+Added: Additionally, the EMA commented that
+Added: it does not anticipate the need for further standalone preclinical toxicology or safety studies.
+Added: Overall, transplant procedures in the
+Added: EU are approximately fifty percent higher than in the United States with a similar market dynamic, with a majority of BMT volume being
+Added: conducted in a concentrated number of leading medical centers.
+Added: In April 2022, we entered into a license and supply agreement with Immedica
+Added: Pharma AB, or Immedica, pursuant to which Immedica licensed the exclusive product rights for commercialization of Iomab-B in the European
+Added: Economic Area, Middle East and North Africa.
+Added: including Algeria, Andorra, Bahrain, Cyprus, Egypt, Iran, Iraq, Israel, Jordan, Kuwait,
+Added: Lebanon, Libya.
+Added: Monaco, Morocco, Oman, Palestine, Qatar, San Marino, Saudi Arabia, Switzerland, Syria, Tunisia, Turkey, the United Arab
+Added: Emirates, the United Kingdom, the Vatican City and Yemen.
+Added: Upon signing, we were entitled to an upfront payment of $35 million from Immedica,
+Added: which we received in May 2022.
+Added: Under the terms of the agreement, we are eligible to receive regulatory and commercial milestone payments
+Added: and we are entitled to receive royalties in the mid-20 percent range on net sales of the product in certain countries that may result
+Added: from the License Agreement.
+Added: We will continue to be responsible for certain clinical development activities and the manufacturing of Iomab-B
+Added: and will retain commercialization rights in the U.S.
and rest of the world.
−Removed: Data from full patient enrollment
−Removed: in the SIERRA trial (153 patients), was presented at the Transplantation & Cellular Therapy (TCT) Tandem Meetings of ASTCT and CIBMTR,
−Removed: the combined annual meetings of the American Society for Transplantation and Cellular Therapy (ASTCT) and the Center for International
−Removed: Blood & Marrow Transplant Research (CIBMTR) in April 2022.
−Removed: The data presented includes rates of BMT access and engraftment, 100-day
−Removed: non-relapse transplant-related mortality (100-day TRM) and adverse events, which has been reported from interim analyses conducted at
−Removed: 25%, 50%, 75% and 100% of patient enrollment pursuant to the study protocol.
−Removed: The data presented at ASH highlighted that 100% of patients
−Removed: (66/66) 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
−Removed: achieved neutrophil and platelet engraftment in a median time of 18 days despite a high median blast count of 30%.
−Removed: On the control arm,
−Removed: only 18% of patients (14/77) achieved remission after salvage therapy, and then received a BMT with a median time to BMT of 67 days and
−Removed: median blast count of 20%.
−Removed: Of the 82% of patients failing to achieve a complete remission (“CR”) with conventional care (63/77),
−Removed: 40 patients were eligible and elected to cross over to receive Iomab-B followed by transplant.
−Removed: These patients are considered as having
−Removed: failed the primary endpoint of the study.
−Removed: All crossover patients who received the therapeutic dose of Iomab-B (40/40) received a BMT,
−Removed: with a median time to BMT of 24 days and they achieved engraftment in a median time of 19 days despite high median blast count of 35%
−Removed: at time of crossover.
−Removed: It was also reported that 100-day TRM of the study or Iomab-B arm was 09% (6/65) of patients that received a BMT
−Removed: compared to 14% of patients (2/14) who received a BMT after salvage therapy on the control arm.
−Removed: The universal engraftment rate and low
−Removed: 100-day TRM rate of the Iomab-B arm resulted in 59 patients potentially evaluable for the primary endpoint compared to 12 patients in
−Removed: the control arm, an approximate five times difference.
−Removed: At each of the interim analyses throughout the SIERRA trial, this approximate five
−Removed: times difference has been consistent in favor of the Iomab-B arm as a result of higher rates of BMT engraftment and lower rates of 100-day
−Removed: Top-line data for the primary endpoint of durable Complete Remission is expected to be presented in the fourth quarter of 2022 based
−Removed: on the current status of the data collection and data query process with certain SIERRA trial sites.
−Removed: We believe topline data from SIERRA
−Removed: will support the submission of a Biologics License Application (“BLA”) with the FDA, which we expect to file in the first
−Removed: half of 2023.
−Removed: Our Iomab-ACT program is
−Removed: intended for targeted conditioning prior to ACT or gene therapy and uses the same I-131-apamistamab construct as Iomab-B at varying doses.
−Removed: 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
−Removed: therapy applications where stem cell myeloablation is not necessary.
−Removed: At higher doses it is applicable for gene therapy applications where
−Removed: stem cell myeloablation is necessary.
−Removed: We believe our Iomab-ACT
−Removed: program is highly differentiated when compared to Fludarabine and Cyclophosphamide (“Flu/Cy”) or other chemotherapy-based
−Removed: regimens that are used as the standard of practice today for lymphodepletion prior to CAR-T.
−Removed: CD45 is an antigen expressed on certain
−Removed: immune cell types that are relevant to the mechanism of CAR-T therapies including lymphocytes, regulatory T-cells and macrophages that
−Removed: have been associated with clinical responses that may limit the safety, efficacy and durability of response of these CAR-T therapies
+Added: from full patient enrollment in the SIERRA trial (153 patients), was presented at the Transplantation & Cellular Therapy (TCT) Tandem
+Added: Meetings of ASTCT and CIBMTR, the combined annual meetings of the American Society for Transplantation and Cellular Therapy (ASTCT) and
+Added: the Center for International Blood & Marrow Transplant Research (CIBMTR) in April 2022.
+Added: The data presented includes rates of BMT
+Added: access and engraftment, 100-day non-relapse transplant-related mortality (100-day TRM) and adverse events, which has been reported from
+Added: interim analyses conducted at 25%, 50%, 75% and 100% of patient enrollment pursuant to the study protocol.
+Added: The data presented at ASH
+Added: highlighted that 100% of patients (66/66) on the study arm that received a therapeutic dose of Iomab-B received a BMT, with a median
+Added: time to BMT of 30 days, and all patients achieved neutrophil and platelet engraftment in a median time of 18 days despite a high median
+Added: blast count of 30%.
+Added: On the control arm, only 18% of patients (14/77) achieved remission after salvage therapy, and then received a BMT
+Added: with a median time to BMT of 67 days and median blast count of 20%.
+Added: Of the 82% of patients failing to achieve a complete remission (“CR”)
+Added: with conventional care (63/77), 40 patients were eligible and elected to cross over to receive Iomab-B followed by transplant.
+Added: patients are considered as having failed the primary endpoint of the study.
+Added: All crossover patients who received the therapeutic dose
+Added: of Iomab-B (40/40) received a BMT, with a median time to BMT of 24 days and they achieved engraftment in a median time of 19 days despite
+Added: high median blast count of 35% at time of crossover.
+Added: It was also reported that 100-day TRM of the study or Iomab-B arm was 09% (6/65)
+Added: of patients that received a BMT compared to 14% of patients (2/14) who received a BMT after salvage therapy on the control arm.
+Added: The universal
+Added: engraftment rate and low 100-day TRM rate of the Iomab-B arm resulted in 59 patients potentially evaluable for the primary endpoint compared
+Added: to 12 patients in the control arm, an approximate five times difference.
+Added: At each of the interim analyses throughout the SIERRA trial,
+Added: this approximate five times difference has been consistent in favor of the Iomab-B arm as a result of higher rates of BMT engraftment
+Added: and lower rates of 100-day TRM.
+Added: Top-line data for the primary endpoint of durable Complete Remission is expected to be presented in the
+Added: fourth quarter of 2022 based on the current status of the data collection and data query process with certain SIERRA trial sites.
+Added: believe topline data from SIERRA will support the submission of a Biologics License Application (“BLA”) with the FDA, which
+Added: we expect to file in the first half of 2023.
+Added: Iomab-ACT program is intended for targeted conditioning prior to ACT or gene therapy and uses the same I-131-apamistamab construct as
+Added: Iomab-B at varying doses.
+Added: At lower doses of one-eighth to one-sixth of the myeloablative dose, it is applicable for lymphodepletion prior
+Added: to CAR-T or certain gene therapy applications where stem cell myeloablation is not necessary.
+Added: At higher doses it is applicable for gene
+Added: therapy applications where stem cell myeloablation is necessary.
+Added: believe our Iomab-ACT program is highly differentiated when compared to Fludarabine and Cyclophosphamide (“Flu/Cy”) or other
+Added: chemotherapy-based regimens that are used as the standard of practice today for lymphodepletion prior to CAR-T.
+Added: CD45 is an antigen expressed
+Added: on certain immune cell types that are relevant to the mechanism of CAR-T therapies including lymphocytes, regulatory T-cells and macrophages
+Added: 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 (“CRS”) and neurotoxicity.
11 unchanged sentences
and better outcomes.
−Removed: We are studying Iomab-ACT
−Removed: in a clinical collaboration with Memorial Sloan Kettering Cancer Center (“MSKCC”) for targeted conditioning prior to administration
−Removed: of MSKCC’s 19-28z CD19 targeting CAR-T in patients with relapsed or refractory B-cell acute lymphoblastic leukemia (“ALL”)
−Removed: or diffuse large B-cell lymphoma (“DLBCL”).
−Removed: We received grant funding from the National Institute of Health (“NIH”)
−Removed: to fund this trial with MSKCC being a co-recipient on this grant.
−Removed: This is a first of its kind study to use an ARC-based conditioning
−Removed: regimen with CAR-T therapy.
−Removed: The hypothesized rationale for this study is that Iomab-ACT will exert an anti-tumor effect on the chemotherapy-refractory
−Removed: B-ALL cells that are sensitive to radiation resulting in reduced disease burden and simultaneously deplete CD45 expressing immune cells
−Removed: implicated in CAR-T related toxicities, resulting in an optimal homeostatic environment for the CAR-T cells.
−Removed: Results with MSKCC’s
−Removed: 19-28z CD-19 CAR-T in 53 patients with r/r B-ALL published in the New England Journal of Medicine reported complete remissions in 83%
−Removed: (44/53) of patients, which compares favorably to standard chemotherapy regimens that have complete remission rates of 18% - 45% in this
−Removed: patient population.
−Removed: Median event-free survival (“EFS”) was 6.1 months and median overall survival (“OS”) was
−Removed: 12.9 months at a median follow up period of 29 months (range 1 – 65 months).
−Removed: There was a 26% (14/53) rate of Grade 3 or greater
−Removed: CRS and a 42% rate of Grade 3 or 4 neurotoxicity reported.
−Removed: The study will evaluate the feasibility of using an ARC-based conditioning
−Removed: regimen with CAR-T therapy and will evaluate safety measures including incidence of CRS and neurotoxicity and efficacy measures including
−Removed: responses and survival outcomes.
+Added: are studying Iomab-ACT in a clinical collaboration with Memorial Sloan Kettering Cancer Center (“MSKCC”) for targeted conditioning
+Added: prior to administration of MSKCC’s 19-28z CD19 targeting CAR-T in patients with relapsed or refractory B-cell acute lymphoblastic
+Added: leukemia (“ALL”) or diffuse large B-cell lymphoma (“DLBCL”).
+Added: We received grant funding from the National Institute
+Added: of Health (“NIH”) to fund this trial with MSKCC being a co-recipient on this grant.
+Added: This is a first of its kind study to
+Added: use an ARC-based conditioning regimen with CAR-T therapy.
+Added: The hypothesized rationale for this study is that Iomab-ACT will exert an anti-tumor
+Added: effect on the chemotherapy-refractory B-ALL cells that are sensitive to radiation resulting in reduced disease burden and simultaneously
+Added: deplete CD45 expressing immune cells implicated in CAR-T related toxicities, resulting in an optimal homeostatic environment for the
+Added: Results with MSKCC’s 19-28z CD-19 CAR-T in 53 patients with r/r B-ALL published in the New England Journal of Medicine
+Added: reported complete remissions in 83% (44/53) of patients, which compares favorably to standard chemotherapy regimens that have complete
+Added: remission rates of 18% - 45% in this patient population.
+Added: Median event-free survival (“EFS”) was 6.1 months and median overall
+Added: survival (“OS”) was 12.9 months at a median follow up period of 29 months (range 1 – 65 months).
+Added: There was a 26% (14/53)
+Added: rate of Grade 3 or greater CRS and a 42% rate of Grade 3 or 4 neurotoxicity reported.
+Added: The study will evaluate the feasibility of using
+Added: an ARC-based conditioning regimen with CAR-T therapy and will evaluate safety measures including incidence of CRS and neurotoxicity and
+Added: efficacy measures including responses and survival outcomes.
We expect proof of concept data from this study in the second half of 2022.
−Removed: In addition, we are working
−Removed: in collaboration with the University of California Davis to utilize Iomab-ACT conditioning with a novel anti-HIV autologous gene therapy.
−Removed: We continue to identify additional gene therapies for which Iomab-ACT can be used for targeted conditioning with the goal of collaborating
−Removed: with multiple academic or industry developers to establish Iomab-ACT as a non-chemotherapy universal targeted conditioning solution.
−Removed: CD33 Program:
+Added: addition, we are working in collaboration with the University of California Davis to utilize Iomab-ACT conditioning with a novel anti-HIV
+Added: autologous gene therapy.
+Added: We continue to identify additional gene therapies for which Iomab-ACT can be used for targeted conditioning
+Added: with the goal of collaborating with multiple academic or industry developers to establish Iomab-ACT as a non-chemotherapy universal targeted
+Added: conditioning solution.
Combinations and Therapeutics
−Removed: Our CD33 program is evaluating
−Removed: the clinical utility of Actimab-A, comprised of the anti-CD33 mAb lintuzumab linked to the potent alpha-emitting radioisotope Actinium-225
−Removed: CD33 is expressed in the majority of patients with AML and myelodysplastic syndrome (“MDS”) as well
−Removed: as approximately one-third of patients with multiple myeloma.
−Removed: Ac-225 emits four alpha particles and can kill a cell with one alpha-particle
−Removed: hit, making it one of the most powerful cell-killing agents with no know resistance mechanism to the double strand DNA breaks it can
+Added: CD33 program is evaluating the clinical utility of Actimab-A, comprised of the anti-CD33 mAb lintuzumab linked to the potent alpha-emitting
+Added: radioisotope Actinium-225 (“Ac-225”).
+Added: CD33 is expressed in the majority of patients with AML and myelodysplastic syndrome
+Added: (“MDS”) as well as approximately one-third of patients with multiple myeloma.
+Added: Ac-225 emits four alpha particles and can kill
+Added: a cell with one alpha-particle hit, making it one of the most powerful cell-killing agents with no know resistance mechanism to the double
+Added: strand DNA breaks it can cause.
We source Ac-225 from the Department of Energy’s Oak Ridge National Laboratory.
−Removed: Our CD33 development program
−Removed: is driven by data obtained from nearly one hundred fifty treated patients, including results from a Phase 1/2 trial that studied Actimab-A
−Removed: as a single agent at multiple dose levels in 58 patients with newly diagnosed AML, which was completed in 2018, as well as trials studying
−Removed: Actimab-A in combination with other agents.
−Removed: We believe that radiation
−Removed: delivered internally via a targeting moiety can be synergistic when used in combination with chemotherapy, targeted agents and immunotherapy
−Removed: based on mechanistic rationales supported by our own clinical data, preclinical research and scientific and clinical evidence in the
−Removed: We have prioritized our efforts and resources in favor of combination trials for our CD33 program development strategy rather
−Removed: than single agent trials at this time as we believe Actimab-A can be a backbone therapy in AML when combined with other therapeutic modalities.
+Added: CD33 development program is driven by data obtained from over one hundred fifty treated patients, including results from a Phase 1/2
+Added: trial that studied Actimab-A as a single agent at multiple dose levels in 58 patients with newly diagnosed AML, which was completed in
+Added: 2018, as well as trials studying Actimab-A in combination with other agents.
+Added: believe that radiation delivered internally via a targeting moiety can be synergistic when used in combination with chemotherapy, targeted
+Added: agents and immunotherapy based on mechanistic rationales supported by our own clinical data, preclinical research and scientific and
+Added: clinical evidence in the literature.
+Added: We have prioritized our efforts and resources in favor of combination trials for our CD33 program
+Added: development strategy rather than single agent trials at this time as we believe Actimab-A can be a backbone therapy in AML when combined
+Added: with other therapeutic modalities.
Our CD33 development program encompasses the following ongoing trials:
−Removed: Actimab -A Combination Trials :
−Removed: Actimab-A + CLAG-M
−Removed: The combination of Actimab-A
−Removed: with CLAG-M has been studied in a Phase 1 combination trial that was conducted in collaboration with the Medical College of Wisconsin
−Removed: (“MCW”) in patients age 18 and above with r/r AML who are fit for intensive therapy.
−Removed: Patient enrollment was completed in
−Removed: November 2021.
−Removed: CLAG-M (cladribine, cytarabine, filgrastim and mitoxantrone) is a salvage chemotherapy regimen that produced a 55% remission
−Removed: rate in patients with r/r AML in a previous study conducted by MCW that compared outcomes of patients receiving either CLAG-M, MEC or
−Removed: CLAG salvage therapy regimens.
−Removed: Data from the Phase 1 combination trial of Actimab-A + CLAG-M were presented at ASH in December 2021.
−Removed: After completion of dose-escalation in the Phase 1 trial, the recommended Phase 2 dose was determined to be 0.75 µCi/kg of Actimab-A.
−Removed: 3 patients were enrolled in the 0.75 µCi/kg dose cohort, which had a 100% remission rate comprised of 1 complete remission (“CR”)
−Removed: and 2 complete remissions with incomplete platelet recovery (“CRp”), there were no dose limiting toxicities (“DLTs”)
−Removed: or 30-day mortality reported.
−Removed: Overall, a 67% (12/18) overall response rate (“ORR”) was reported across all dose cohorts (0.25
−Removed: – 1.0 µCi/kg) and remissions were achieved in every dose cohort including the 0.25 and 0.50 µCi/kg doses of Actimab-A,
−Removed: which have been shown to be subtherapeutic as a single agent.
−Removed: In addition, there was a 72% minimal residual disease (“MRD”)
−Removed: negativity rate, which compares favorably to the 39% MRD negativity rate reported by MCW with CLAG-M alone.
−Removed: This study enrolled patients
−Removed: who previously failed Venetoclax, a targeted Bcl-2 inhibitor, and efficacy was similar in patients Venetoclax naïve and those that
−Removed: previously failed Venetoclax, with a 60% response rate in previous Venetoclax failures.
−Removed: We are working to develop a regulatory and development
−Removed: pathway for the Actimab-A CLAG-M combination and will be evaluating potential registration enabling strategies.
−Removed: In addition, we believe
−Removed: this Actimab-A + CLAG-M combination study has provided proof of principle that the addition of Actimab-A to other AML therapies can lead
−Removed: to well-tolerated regimens with improved responses, which supports our Actimab-A backbone therapy in AML strategy.
−Removed: Actimab-A + Venetoclax
−Removed: We are also conducting a Phase
−Removed: 1/2 Actimab-A combination trial with the Bcl-2 inhibitor Venetoclax in fit and unfit patients age 18 and above with relapsed or refractory
+Added: -A Combination Trials :
+Added: combination of Actimab-A with CLAG-M has been studied in a Phase 1 combination trial that was conducted in collaboration with the Medical
+Added: College of Wisconsin (“MCW”) in patients age 18 and above with r/r AML who are fit for intensive therapy.
+Added: Patient enrollment
+Added: was completed in November 2021.
+Added: CLAG-M (cladribine, cytarabine, filgrastim and mitoxantrone) is a salvage chemotherapy regimen that produced
+Added: a 55% remission rate in patients with r/r AML in a previous study conducted by MCW that compared outcomes of patients receiving either
+Added: CLAG-M, MEC or CLAG salvage therapy regimens.
+Added: Data from the Phase 1 combination trial of Actimab-A + CLAG-M were presented at ASH in
+Added: December 2021.
+Added: After completion of dose-escalation in the Phase 1 trial, the recommended Phase 2 dose was determined to be 0.75 µCi/kg
+Added: of Actimab-A.
+Added: 3 patients were enrolled in the 0.75 µCi/kg dose cohort, which had a 100% remission rate comprised of 1 complete
+Added: remission (“CR”) and 2 complete remissions with incomplete platelet recovery (“CRp”), there were no dose limiting
+Added: toxicities (“DLTs”) or 30-day mortality reported.
+Added: Overall, a 67% (12/18) overall response rate (“ORR”) was reported
+Added: across all dose cohorts (0.25 – 1.0 µCi/kg) and remissions were achieved in every dose cohort including the 0.25 and 0.50
+Added: µCi/kg doses of Actimab-A, which have been shown to be subtherapeutic as a single agent.
+Added: In addition, there was a 72% minimal residual
+Added: disease (“MRD”) negativity rate, which compares favorably to the 39% MRD negativity rate reported by MCW with CLAG-M alone.
+Added: This study enrolled patients who previously failed Venetoclax, a targeted Bcl-2 inhibitor, and efficacy was similar in patients Venetoclax
+Added: naïve and those that previously failed Venetoclax, with a 60% response rate in previous Venetoclax failures.
+Added: We are working to develop
+Added: a regulatory and development pathway for the Actimab-A CLAG-M combination and will be evaluating potential registration enabling strategies.
+Added: In addition, we believe this Actimab-A + CLAG-M combination study has provided proof of principle that the addition of Actimab-A to other
+Added: AML therapies can lead to well-tolerated regimens with improved responses, which supports our Actimab-A backbone therapy in AML strategy.
+Added: are also conducting a Phase 1/2 Actimab-A combination trial with the Bcl-2 inhibitor Venetoclax in fit and unfit patients age 18 and
+Added: above with relapsed or refractory AML.
This multi-center trial is being led by UCLA Medical Center.
−Removed: This combination is supported by mechanistic evidence in preclinical
−Removed: studies using Venetoclax -resistant AML tumor cell lines.
−Removed: In these models, we have demonstrated that Actimab-A can deplete Mcl-1 and Bcl-XL,
−Removed: two proteins implicated in mediating resistance to Venetoclax, in addition to causing potentially lethal double-stranded DNA breaks in
−Removed: these CD33 expressing cells.
−Removed: Furthermore, in vivo studies in animal models of Venetoclax-resistant AML demonstrated robust tumor regression
−Removed: and improved survival in cohorts receiving the Actimab-A Venetoclax combination compared to Venetoclax alone.
−Removed: The rationale for this clinical
−Removed: study is that the addition of Actimab-A will;
−Removed: 1) have a direct anti-tumor effect via double-stranded DNA breaks and 2) deplete Mcl-1 and
−Removed: Bcl-XL making the AML cells more susceptible to Venetoclax.
−Removed: Updated data from the Phase 1 dose escalation portion of this study was presented
−Removed: at ASH in December 2021 from three dose cohorts of 0.50, 0.75 and 1.0 µCi/kg of Actimab-A in a total of 12 patients.
−Removed: 50% of patients
−Removed: received Venetoclax therapy prior to enrollment on the Actimab-A combination trial.
−Removed: And 67% of patients had poor risk cytogenetics, of
−Removed: which, 3 had a TP53 mutation, which is associate with poorer response rates and survival outcomes.
−Removed: Of the patients with a TP53 mutation,
−Removed: 67% achieved a remission including a patient that achieved a CR who remained in follow-up 230 days (~7.5 months) at the time of data cutoff
−Removed: The combination of Actimab-A with Venetoclax was reported to be well-tolerated with no 30-day mortality.
−Removed: The data to date support
−Removed: advancing to the Phase 2 portion of the trial and we expect to provide an update on the development strategy, including consideration
−Removed: of patients with a TP53 mutation, after the Phase 1 dose finding portion of the trial is complete and the recommended Phase 2 dose is
−Removed: In addition to these ongoing trials,
−Removed: we actively seek and evaluate additional modalities and agents that can be the basis for Actimab-A therapeutic combinations such as the
−Removed: CD47 immunotherapy magrolimab combinations we announced at the Society for Immunotherapy of Cancer (“SITC”) in November 2021
−Removed: to leverage our clinical experience, supply chain and AWE technology platform.
−Removed: CD47 Based ARC Combinations in Solid Tumors
−Removed: and Blood Cancers
−Removed: CD47 is a macrophage checkpoint
−Removed: that is upregulated in multiple cancers including blood cancers such as AML and MDS as well as solid tumors.
−Removed: CD47 acts as a “don’t
−Removed: eat me” signal on cancer cells to suppress phagocytosis and evade detection and destruction by the immune system.
−Removed: It has become
−Removed: an immunotherapy target of significant interest with multiple biopharmaceutical companies actively developing CD47 targeting agents across
−Removed: a wide range of oncology and hematology indications.
−Removed: CD47 targeting agents have shown limited efficacy as single agent monotherapies in
−Removed: AML/MDS or solid tumors, which has led to combinations such as with hypomethylating agents in AML/MDS.
−Removed: We hypothesized that targeted radiotherapy
−Removed: via ARCs could synergize with CD47 targeting agents via the direct cytotoxic and immunogenic effect of ARCs without overlapping toxicities.
−Removed: To explore this synergy and the potential to improve patient outcomes and we have initiated a program in AML with our Actimab-A ARC, consistent
−Removed: with our strategy to establish Actimab-A as a backbone AML therapy, and in solid tumors with a HER2 and HER3 targeting ARCs, which emanated
−Removed: from our AWE technology platform.
−Removed: To our knowledge, these are the first and only ARC-based targeted radiotherapy combinations with CD47
−Removed: immunotherapy.
−Removed: Data from the novel HER2 magrolimab combination was presented at the 36 th Annual SITC Meeting in April 2022
−Removed: and at the HER3 magrolimab combination was presented American Association for Cancer Research (“AACR”) Annual Meeting in April
−Removed: 2022 that showed a significant increase in tumor control compared to magrolimab alone in preclinical non-small cell lung cancer (“NSCLC”)
−Removed: The most advanced CD47 development
−Removed: programs are being studied in patients with AML and MDS.
−Removed: Leveraging our clinical experience with Actimab-A in these indications we have
−Removed: begun studying Actimab-A with the anti-CD47 antibody immunotherapy magrolimab, which is owned by Gilead Sciences, Inc., in preclinical
−Removed: models of AML.
−Removed: In preclinical models, it was shown that in multiple AML cell lines, the combination of Actimab-A with magrolimab led
−Removed: to increased phagocytosis of AML cells compared to magrolimab alone.
−Removed: Our studies also demonstrated that AML cell lines exposed to Actimab-A
−Removed: had an upregulation of calreticulin, which is a pro-phagocytic or “eat me” signal, which we hypothesize makes Actimab-A potentially
−Removed: synergistic with magrolimab and other anti-CD47 antibodies.
−Removed: The Actimab-A and magrolimab combination showed a significant increase in
−Removed: survival compared to Actimab-A alone in a disseminated AML animal tumor model.
−Removed: We intend to continue to study preclinically this combination
−Removed: with the goal of advancing to human clinical trials.
−Removed: In January 2022, we announced a research collaboration
−Removed: with EpicentRx that will evaluate Actimab-A in combination with EpicentRx’s RRx-001in AML.
−Removed: EpicentRx’s RRx-001, currently
−Removed: under investigation in a Phase 3 trial for Small Cell Lung Cancer and in other oncology and non-oncology indications, is a versatile
−Removed: next generation small molecule immunotherapeutic that targets the CD47-SIRPα axis and the NLRP3 inflammasome to alter the
−Removed: tumor microenvironment and optimize immune response.
−Removed: This collaboration will explore the mechanistic synergy of RRx-001’s CD47–SIRPα
−Removed: downregulation with Actinium’s targeted radiotherapy calreticulin upregulation to increase the immune detection and destruction
−Removed: of cancer cells.
−Removed: Preclinical experiments have begun exploring this combination in AML models.
−Removed: We intend to leverage our experience with
−Removed: CD47 targeting agents such as magrolimab in this collaboration.
−Removed: Based on Actimab-A and RRx-001 both being clinical-stage assets, we believe
−Removed: there is a potentially faster pathway to clinical trials with this novel combination, particularly if the preclinical safety and efficacy
−Removed: profile are in line with what was observed with Actimab-A and magrolimab.
−Removed: Antibody Warhead Enabling Technology Platform
+Added: This combination is supported by
+Added: mechanistic evidence in preclinical studies using Venetoclax -resistant AML tumor cell lines.
+Added: In these models, we have demonstrated that
+Added: Actimab-A can deplete Mcl-1 and Bcl-XL, two proteins implicated in mediating resistance to Venetoclax, in addition to causing potentially
+Added: lethal double-stranded DNA breaks in these CD33 expressing cells.
+Added: Furthermore, in vivo studies in animal models of Venetoclax-resistant
+Added: AML demonstrated robust tumor regression and improved survival in cohorts receiving the Actimab-A Venetoclax combination compared to
+Added: Venetoclax alone.
+Added: The rationale for this clinical study is that the addition of Actimab-A will;
+Added: 1) have a direct anti-tumor effect via
+Added: double-stranded DNA breaks and 2) deplete Mcl-1 and Bcl-XL making the AML cells more susceptible to Venetoclax.
+Added: Updated data from the
+Added: Phase 1 dose escalation portion of this study was presented at ASH in December 2021 from three dose cohorts of 0.50, 0.75 and 1.0 µCi/kg
+Added: of Actimab-A in a total of 12 patients.
+Added: 50% of patients received Venetoclax therapy prior to enrollment on the Actimab-A combination
+Added: And 67% of patients had poor risk cytogenetics, of which, 3 had a TP53 mutation, which is associate with poorer response rates
+Added: and survival outcomes.
+Added: Of the patients with a TP53 mutation, 67% achieved a remission including a patient that achieved a CR who remained
+Added: in follow-up 230 days (~7.5 months) at the time of data cutoff for ASH.
+Added: The combination of Actimab-A with Venetoclax was reported to
+Added: be well-tolerated with no 30-day mortality.
+Added: The data to date support advancing to the Phase 2 portion of the trial and we expect to provide
+Added: an update on the development strategy after the Phase 1 dose finding portion of the trial is complete and the recommended Phase 2 dose
+Added: is determined.
+Added: addition to these ongoing trials, we actively seek and evaluate additional modalities and agents that can be the basis for Actimab-A
+Added: therapeutic combinations such as the CD47 immunotherapy magrolimab combinations we announced at the Society for Immunotherapy of Cancer
+Added: (“SITC”) in November 2021 to leverage our clinical experience, supply chain and AWE technology platform.
+Added: Based ARC Combinations in Solid Tumors and Blood Cancers
+Added: is a macrophage checkpoint that is upregulated in multiple cancers including blood cancers such as AML and MDS as well as solid tumors.
+Added: CD47 acts as a “don’t eat me” signal on cancer cells to suppress phagocytosis and evade detection and destruction by
+Added: the immune system.
+Added: It has become an immunotherapy target of significant interest with multiple biopharmaceutical companies actively developing
+Added: CD47 targeting agents across a wide range of oncology and hematology indications.
+Added: CD47 targeting agents have shown limited efficacy as
+Added: single agent monotherapies in AML/MDS or solid tumors, which has led to combinations such as with hypomethylating agents in AML/MDS.
+Added: We hypothesized that targeted radiotherapy via ARCs could synergize with CD47 targeting agents via the direct cytotoxic and immunogenic
+Added: effect of ARCs without overlapping toxicities.
+Added: To explore this synergy and the potential to improve patient outcomes and we have initiated
+Added: a program in AML with our Actimab-A ARC, consistent with our strategy to establish Actimab-A as a backbone AML therapy, and in solid
+Added: tumors with a HER2 and HER3 targeting ARCs, which emanated from our AWE technology platform.
+Added: To our knowledge, these are the first and
+Added: only ARC-based targeted radiotherapy combinations with CD47 immunotherapy.
+Added: Data from the novel HER2 magrolimab combination was presented
+Added: at the 36 th Annual SITC Meeting in April 2022 and at the HER3 magrolimab combination was presented American Association for
+Added: Cancer Research (“AACR”) Annual Meeting in April 2022 that showed a significant increase in tumor control compared to magrolimab
+Added: alone in preclinical non-small cell lung cancer (“NSCLC”)
+Added: most advanced CD47 development programs are being studied in patients with AML and MDS.
+Added: Leveraging our clinical experience with Actimab-A
+Added: in these indications we have begun studying Actimab-A with the anti-CD47 antibody immunotherapy magrolimab, which is owned by Gilead
+Added: Sciences, Inc., in preclinical models of AML.
+Added: In preclinical models, it was shown that in multiple AML cell lines, the combination of
+Added: Actimab-A with magrolimab led to increased phagocytosis of AML cells compared to magrolimab alone.
+Added: Our studies also demonstrated that
+Added: AML cell lines exposed to Actimab-A had an upregulation of calreticulin, which is a pro-phagocytic or “eat me” signal, which
+Added: we hypothesize makes Actimab-A potentially synergistic with magrolimab and other anti-CD47 antibodies.
+Added: The Actimab-A and magrolimab combination
+Added: showed a significant increase in survival compared to Actimab-A alone in a disseminated AML animal tumor model.
+Added: We intend to continue
+Added: to study preclinically this combination with the goal of advancing to human clinical trials.
+Added: January 2022, we announced a research collaboration with EpicentRx that will evaluate Actimab-A in combination with EpicentRx’s
+Added: RRx-001in AML.
+Added: EpicentRx’s RRx-001, currently under investigation in a Phase 3 trial for Small Cell Lung Cancer and in other oncology
+Added: and non-oncology indications, is a versatile next generation small molecule immunotherapeutic that targets the CD47-SIRPα axis
+Added: and the NLRP3 inflammasome to alter the tumor microenvironment and optimize immune response.
+Added: This collaboration will explore the
+Added: mechanistic synergy of RRx-001’s CD47–SIRPα downregulation with Actinium’s targeted radiotherapy calreticulin
+Added: upregulation to increase the immune detection and destruction of cancer cells.
+Added: Preclinical experiments have begun exploring this combination
+Added: in AML models.
+Added: We intend to leverage our experience with CD47 targeting agents such as magrolimab in this collaboration.
+Added: Based on Actimab-A
+Added: and RRx-001 both being clinical-stage assets, we believe there is a potentially faster pathway to clinical trials with this novel combination,
+Added: particularly if the preclinical safety and efficacy profile are in line with what was observed with Actimab-A and magrolimab.
+Added: Warhead Enabling Technology Platform
Our proprietary AWE technology
15 unchanged sentences
manufacturing or Ac-225 in a cyclotron, which we believe has the potential to produce higher quantities of Ac-225 than currently utilized
−Removed: Our research is focused on
−Removed: applying our AWE technology platform to the development of radiation conjugates and to execute on research collaborations.
−Removed: efforts employ a multidisciplinary approach leveraging our team’s knowledge and experience in cancer cell biology, radiochemistry,
−Removed: radiation sciences, immunology and oncology drug development.
−Removed: We intend to focus on generating targeted radiotherapies using our existing
−Removed: intellectual property, evaluating assets for in-licensing to complement our existing clinical pipeline and securing collaborations and
−Removed: partnerships with biopharmaceutical companies.
−Removed: By adding research and development capabilities to our clinical development and clinical
−Removed: supply chain capabilities, we seek to enable the rapid translation of radiotherapies.
−Removed: Our AWE technology platform
−Removed: is being utilized in our ongoing research collaboration with Astellas to arm select targeting agents owned by Astellas with the alpha-emitting
−Removed: radioisotope Ac-225 for the development of theranostics for solid tumor indications, which combine the ability of radioisotopes to be
−Removed: used for both diagnostic and therapeutic purposes.
−Removed: We also utilized AWE to create
−Removed: a HER2-targeting radiotherapy using the antibody Trastuzumab with either Ac-225 or Lu-177 radioisotopes to study in combination with
−Removed: magrolimab for solid tumors.
−Removed: Anti-CD47 monotherapies, such as magrolimab, have not shown meaningful responses in clinical studies in
−Removed: solid tumors.
−Removed: We hypothesized that radiation directed at HER2 expressing cells would upregulate cell surface calreticulin, a pro-phagocytic
−Removed: “eat me” signal, that when combined with an anti-CD47 blockade therapy would enhance antitumor activity.
−Removed: Data from this combination
−Removed: was presented at the Annual Meeting of the Society for Immunotherapy for Cancer in November 2021.
−Removed: In vitro studies showed that immunogenicity,
−Removed: determined by binding to HER2 expressing cells, remained intact after radiolabeling Trastuzumab with Ac-225 or Lu-177.
−Removed: In multiple cells
−Removed: lines radiolabeled Trastuzumab increased cell surface calreticulin and the combination with magrolimab increased phagocytosis.
−Removed: The combination
−Removed: of the Ac-225 or Lu-117 Trastuzumab with magrolimab slowed tumor growth in animal models of solid tumors compared to either the radiolabeled
−Removed: Trastuzumab or magrolimab as single agents.
−Removed: We are continuing to evaluate this combination in additional tumor models, and we intend
−Removed: to continue to study this combination with the goal of advancing to human clinical trials.
−Removed: We are also collaborating
−Removed: with AVEO Oncology (“AVEO”) to develop a targeted radiotherapy against ErbB3, also known as HER3, with the Ac-225 isotope
−Removed: for solid tumor indications.
−Removed: HER3 is overexpressed in several solid tumor indications with high unmet needs, including colorectal, gastric,
−Removed: head and neck, breast, ovarian, melanoma, prostate and bladder cancers with HER3 agents under development demonstrating activity in preclinical
−Removed: and clinical studies.
+Added: research is focused on applying our AWE technology platform to the development of radiation conjugates and to execute on research collaborations.
+Added: Our R&D efforts employ a multidisciplinary approach leveraging our team’s knowledge and experience in cancer cell biology,
+Added: radiochemistry, radiation sciences, immunology and oncology drug development.
+Added: We intend to focus on generating targeted radiotherapies
+Added: using our existing intellectual property, evaluating assets for in-licensing to complement our existing clinical pipeline and securing
+Added: collaborations and partnerships with biopharmaceutical companies.
+Added: By adding research and development capabilities to our clinical development
+Added: and clinical supply chain capabilities, we seek to enable the rapid translation of radiotherapies.
+Added: AWE technology platform is being utilized in our ongoing research collaboration with Astellas to arm select targeting agents owned by
+Added: Astellas with the alpha-emitting radioisotope Ac-225 for the development of theranostics for solid tumor indications, which combine the
+Added: ability of radioisotopes to be used for both diagnostic and therapeutic purposes.
+Added: also utilized AWE to create a HER2-targeting radiotherapy using the antibody Trastuzumab with either Ac-225 or Lu-177 radioisotopes to
+Added: study in combination with magrolimab for solid tumors.
+Added: Anti-CD47 monotherapies, such as magrolimab, have not shown meaningful responses
+Added: in clinical studies in solid tumors.
+Added: We hypothesized that radiation directed at HER2 expressing cells would upregulate cell surface calreticulin,
+Added: a pro-phagocytic “eat me” signal, that when combined with an anti-CD47 blockade therapy would enhance antitumor activity.
+Added: Data from this combination was presented at the Annual Meeting of the Society for Immunotherapy for Cancer in November 2021.
+Added: studies showed that immunogenicity, determined by binding to HER2 expressing cells, remained intact after radiolabeling Trastuzumab with
+Added: Ac-225 or Lu-177.
+Added: In multiple cells lines radiolabeled Trastuzumab increased cell surface calreticulin and the combination with magrolimab
+Added: increased phagocytosis.
+Added: The combination of the Ac-225 or Lu-117 Trastuzumab with magrolimab slowed tumor growth in animal models of solid
+Added: tumors compared to either the radiolabeled Trastuzumab or magrolimab as single agents.
+Added: We are continuing to evaluate this combination
+Added: in additional tumor models, and we intend to continue to study this combination with the goal of advancing to human clinical trials.
+Added: are also collaborating with AVEO Oncology (“AVEO”) to develop a targeted radiotherapy against ErbB3, also known as HER3,
+Added: with the Ac-225 isotope for solid tumor indications.
+Added: HER3 is overexpressed in several solid tumor indications with high unmet needs,
+Added: including colorectal, gastric, head and neck, breast, ovarian, melanoma, prostate and bladder cancers with HER3 agents under development
+Added: demonstrating activity in preclinical and clinical studies.
To our knowledge, this is the first HER3 targeting radiotherapy in development.
−Removed: AVEO is developing high affinity
−Removed: antibodies including HER3 targeting AV-203, which has demonstrated preclinical activity across a number of solid tumor indications and
−Removed: was studied in a Phase 1 open-label trial in patients with advanced solid tumors where it was found to be safe and generally well tolerated.
−Removed: In April 2022, we presented data at the AACR Annual Meeting showing potent tumor cell cytotoxicity, enhanced antitumor effects and significantly
−Removed: improved survival with an Ac-225 radiolabeled HER3 antibody compared to a naked HER3 antibody in a preclinical NSCLC model.
−Removed: these preliminary results support our collaboration with AVEO and given that AV-203 has clinical safety data, a potentially accelerated
−Removed: regulatory pathway to clinical studies with an Ac-225 HER3 targeted radiotherapy.
−Removed: Recent Developments
−Removed: Impact of COVID–19 Pandemic
−Removed: The global health crisis
−Removed: caused by the novel coronavirus COVID-19 pandemic and its resurgences has and may continue to negatively impact global economic activity,
−Removed: which, despite progress in vaccination efforts, remains uncertain and cannot be predicted with confidence.
−Removed: In addition, the Omicron variants
−Removed: of COVID-19, which appears to be the most transmissible variants to date, has spread globally.
−Removed: The full impact of the Omicron variants,
−Removed: or any subsequent variants, cannot be predicted at this time, and could depend on numerous factors, including vaccination rates among
−Removed: the population, the effectiveness of COVID-19 vaccines against the Omicron variants and the response by governmental bodies and regulators.
−Removed: Given the ongoing and dynamic nature of the circumstances, it is difficult to predict the impact of the COVID-19 pandemic on our business.
−Removed: Many countries around the
−Removed: world have continued to impose quarantines and restrictions on travel and mass gatherings to slow the spread of the virus.
−Removed: our ability to continue to operate our business may also be limited.
−Removed: Such events may result in a period of business, supply and drug
−Removed: product manufacturing disruption, and in reduced operations, any of which could materially affect our business, financial condition and
−Removed: results of operations.
−Removed: In response to COVID-19, we implemented hybrid working for our office-based staff, while our research staff has
−Removed: been actively working in our laboratory throughout the pandemic and thus far have not experienced a significant disruption or delay in
−Removed: our operations as it relates to the clinical development, preclinical research or manufacturing of our drug candidates.
−Removed: Such government-imposed
−Removed: precautionary measures may have been relaxed in certain countries or states, but there is no assurance that more strict measures will
−Removed: be put in place again due to a resurgence in COVID-19 cases, including those involving new variants of the coronavirus, which may be
−Removed: more contagious and deadly than prior strains.
−Removed: Therefore, the COVID-19 pandemic may continue to affect our operation, may further divert
−Removed: the attention and efforts of the medical community to coping with COVID-19 and disrupt the marketplace in which we operate and may have
−Removed: a material adverse effect on our operations.
−Removed: A continuation or worsening
−Removed: of the levels of market disruption and volatility seen in the recent past could have an adverse effect on our ability to access capital,
−Removed: which could in the future negatively affect our liquidity.
−Removed: In addition, a recession or market correction resulting from the spread of
−Removed: COVID-19 could materially affect our business and the value of our common stock.
−Removed: We believe our earlier stage
−Removed: CD33 clinical trials will continue to recruit and enroll patients given the acute nature of relapsed or refractory AML.
−Removed: The continuation
−Removed: of the pandemic could adversely affect our planned clinical trial operations, including our ability to conduct the trials on the expected
−Removed: timelines and recruit and retain patients and principal investigators and site staff who, as healthcare providers, may have heightened
−Removed: exposure to COVID-19 if their geography is impacted by the pandemic.
−Removed: Further, the continuation and/or resurgence of the COVID-19 pandemic
−Removed: could result in delays in our clinical trials due to prioritization of hospital resources toward the pandemic, restrictions in travel,
−Removed: potential unwillingness of patients to enroll in trials at this time, or the inability of patients to comply with clinical trial protocols
−Removed: if quarantines or travel restrictions impede patient movement or interrupt healthcare services.
−Removed: In addition, we rely on independent clinical
−Removed: investigators, contract research organizations and other third-party service providers to assist us in managing, monitoring and otherwise
−Removed: carrying out our preclinical studies and clinical trials, and the pandemic may affect their ability to devote sufficient time and resources
−Removed: to our programs or to travel to sites to perform work for us, which may result in delays or hinder our ability to collect data from our
−Removed: clinical trials.
−Removed: Additionally, COVID-19 may
−Removed: result in delays in receiving approvals from local and foreign regulatory authorities, delays in necessary interactions with IRB’s
−Removed: or Institutional Review Boards, local and foreign regulators, ethics committees and other important agencies and contractors due to limitations
−Removed: in employee resources or forced furlough of government employees.
−Removed: To date, COVID-19 has not
−Removed: had a financial impact on our company.
−Removed: We continue to monitor the impacts of COVID-19 on the global economy and on our business operations.
−Removed: Although we expect that vaccinations for COVID-19 will continue to improve conditions, the ultimate impact from COVID-19 on our business
−Removed: operations and financial results during 2022 will depend on, among other things, the ultimate severity and scope of the pandemic, including
−Removed: the new variants of the virus, the pace at which governmental and private travel restrictions and public concerns about public gatherings
−Removed: will ease, the rate at which historically large increases in unemployment rates will decrease, if at all, and whether, and the speed
−Removed: with which the economy recovers.
−Removed: We are not able to fully quantify the impact that these factors will have on our financial results during
−Removed: 2022 and beyond.
−Removed: Results of Operations
−Removed: – Three Months Ended March 31, 2022 Compared to Three Months Ended March 31, 2021
−Removed: The following table sets
−Removed: forth, for the periods indicated, data derived from our statements of operations:
+Added: AVEO is developing high affinity antibodies including HER3 targeting AV-203, which has demonstrated preclinical activity across a number
+Added: of solid tumor indications and was studied in a Phase 1 open-label trial in patients with advanced solid tumors where it was found to
+Added: be safe and generally well tolerated.
+Added: In April 2022, we presented data at the AACR Annual Meeting showing potent tumor cell cytotoxicity,
+Added: enhanced antitumor effects and significantly improved survival with an Ac-225 radiolabeled HER3 antibody compared to a naked HER3 antibody
+Added: in a preclinical NSCLC model.
+Added: We believe these preliminary results support our collaboration with AVEO and given that AV-203 has clinical
+Added: safety data, a potentially accelerated regulatory pathway to clinical studies with an Ac-225 HER3 targeted radiotherapy.
+Added: of COVID–19 Pandemic
+Added: The global health crisis caused by the novel coronavirus COVID-19 pandemic
+Added: and its resurgences has and may continue to negatively impact global economic activity, which, despite progress in vaccination efforts,
+Added: remains uncertain and cannot be predicted with confidence.
+Added: In addition, the Omicron variants of COVID-19, including subvariants BA.4 and
+Added: BA.5, which appear to be the most transmissible variants to date, have spread globally.
+Added: The full impact of the Omicron variants, or any
+Added: subsequent variants, cannot be predicted at this time, and could depend on numerous factors, including vaccination rates among the population,
+Added: the effectiveness of COVID-19 vaccines against the Omicron variants and the response by governmental bodies and regulators.
+Added: ongoing and dynamic nature of the circumstances, it is difficult to predict the impact of the COVID-19 pandemic on our business.
+Added: countries around the world have continued to impose quarantines and restrictions on travel and mass gatherings to slow the spread of
+Added: Accordingly, our ability to continue to operate our business may also be limited.
+Added: Such events may result in a period of business,
+Added: supply and drug product manufacturing disruption, and in reduced operations, any of which could materially affect our business, financial
+Added: condition and results of operations.
+Added: In response to COVID-19, we implemented hybrid working for our office-based staff, while our research
+Added: staff has been actively working in our laboratory throughout the pandemic and thus far have not experienced a significant disruption
+Added: or delay in our operations as it relates to the clinical development, preclinical research or manufacturing of our drug candidates.
+Added: government-imposed precautionary measures may have been relaxed in certain countries or states, but there is no assurance that more strict
+Added: measures will be put in place again due to a resurgence in COVID-19 cases, including those involving new variants of the coronavirus,
+Added: which may be more contagious and deadly than prior strains.
+Added: Therefore, the COVID-19 pandemic may continue to affect our operation, may
+Added: further divert the attention and efforts of the medical community to coping with COVID-19 and disrupt the marketplace in which we operate
+Added: and may have a material adverse effect on our operations.
+Added: continuation or worsening of the levels of market disruption and volatility seen in the recent past could have an adverse effect on our
+Added: ability to access capital, which could in the future negatively affect our liquidity.
+Added: In addition, a recession or market correction resulting
+Added: from the spread of COVID-19 could materially affect our business and the value of our common stock.
+Added: believe our earlier stage CD33 clinical trials will continue to recruit and enroll patients given the acute nature of relapsed or refractory
+Added: The continuation of the pandemic could adversely affect our planned clinical trial operations, including our ability to conduct
+Added: the trials on the expected timelines and recruit and retain patients and principal investigators and site staff who, as healthcare providers,
+Added: may have heightened exposure to COVID-19 if their geography is impacted by the pandemic.
+Added: Further, the continuation and/or resurgence
+Added: of the COVID-19 pandemic could result in delays in our clinical trials due to prioritization of hospital resources toward the pandemic,
+Added: restrictions in travel, potential unwillingness of patients to enroll in trials at this time, or the inability of patients to comply
+Added: with clinical trial protocols if quarantines or travel restrictions impede patient movement or interrupt healthcare services.
+Added: we rely on independent clinical investigators, contract research organizations and other third-party service providers to assist us in
+Added: managing, monitoring and otherwise carrying out our preclinical studies and clinical trials, and the pandemic may affect their ability
+Added: to devote sufficient time and resources to our programs or to travel to sites to perform work for us, which may result in delays or hinder
+Added: our ability to collect data from our clinical trials.
+Added: Additionally,
+Added: COVID-19 may result in delays in receiving approvals from local and foreign regulatory authorities, delays in necessary interactions
+Added: with IRB’s or Institutional Review Boards, local and foreign regulators, ethics committees and other important agencies and contractors
+Added: due to limitations in employee resources or forced furlough of government employees.
+Added: date, COVID-19 has not had a financial impact on our company.
+Added: We continue to monitor the impacts of COVID-19 on the global economy and
+Added: on our business operations.
+Added: Although we expect that vaccinations for COVID-19 will continue to improve conditions, the ultimate impact
+Added: from COVID-19 on our business operations and financial results during 2022 will depend on, among other things, the ultimate severity
+Added: and scope of the pandemic, including the new variants of the virus, the pace at which governmental and private travel restrictions and
+Added: public concerns about public gatherings will ease, the rate at which historically large increases in unemployment rates will decrease,
+Added: if at all, and whether, and the speed with which the economy recovers.
+Added: We are not able to fully quantify the impact that these factors
+Added: will have on our financial results during 2022 and beyond.
+Added: of Operations – Three Months Ended June 30, 2022 Compared to Three Months Ended June 30, 2021
+Added: following table sets forth, for the periods indicated, data derived from our statements of operations:
Three Months Ended
9 unchanged sentences
Total other income
−Removed: We recorded no commercial
−Removed: revenue for the three months ended March 31, 2022 and March 31, 2021.
−Removed: Other revenue
−Removed: We determined that certain
−Removed: collaborations with a third-party are within the scope of Topic ASC 606, Revenue Recognition from Contracts with Customers, or
+Added: recorded no commercial revenue for the three months ended June 30, 2022 and June 30, 2021.
+Added: determined that certain collaborations with a third-party are within the scope of Topic ASC 606, Revenue Recognition from Contracts
+Added: with Customers, or ASC 606.
The collaboration agreement is made up of multiple modules related to various research activities.
−Removed: While the third party has
−Removed: the option to terminate the agreement at the conclusion of any module, we identified a single performance obligation to provide research
−Removed: services within each module for which we receive monetary consideration.
−Removed: Other revenue recognized during the three months ended March
−Removed: 31, 2022 and March 31, 2021 was $0.8 million and $0.6 million respectively.
−Removed: The National Institutes of
−Removed: Health awarded us a Small Business Technology Transfer cost reimbursable grant to support a clinical collaboration with Memorial Sloan
−Removed: Kettering Cancer Center, or MSK, to study Iomab-ACT, our CD45-targeting Antibody Radio-Conjugate, for targeted conditioning to achieve
−Removed: lymphodepletion prior to administration of a CD19-targeted CAR T-cell therapy developed at MSK.
−Removed: We recognized other revenue during the
−Removed: three months ended March 31, 2022 of $0.1 million.
−Removed: Research and development expense
+Added: the third party has the option to terminate the agreement at the conclusion of any module, we identified a single performance obligation
+Added: to provide research services within each module for which we receive monetary consideration.
+Added: Other revenue recognized during the three
+Added: months ended June 30, 2022 and June 30, 2021 was $45 thousand and $0.3 million respectively.
+Added: and development, net of reimbursements
Research and development expenses of $4.7 million for the three months
−Removed: ended March 31, 2022 increased $0.1 million from $4.3 million for the three months ended March 31, 2021.
−Removed: Higher expenses related to our
−Removed: research activities at our laboratory space and government grant program were mostly offset by lower expenses on our CD45 program resulting
−Removed: from the completion of enrollment in the SIERRA trial.
−Removed: General and administrative expense
+Added: ended June 30, 2022 increased $1.1 million from $3.6 million for the three months ended June 30, 2021.
+Added: Higher expenses related to increased
+Added: compensation of $0.5 million, resulting from increased compensation expenses and higher expenses due to an increase in the number of employees
+Added: and increased research activities at our laboratory space.
+Added: and administrative
+Added: and administrative expenses of $3.2 million for the three months ended June 30, 2022 increased $1.5 million from $1.7 million for the
+Added: three months ended June 30, 2021.
+Added: The increase was primarily attributable to increased compensation of $0.8 million, higher professional
+Added: fees and consulting fees including recruitment costs, and higher legal fees.
+Added: income is comprised of net interest income in both reporting periods.
+Added: The amount for the three months ended June 30, 2022 of $83 thousand
+Added: increased from $54 thousand for the three months ended June 30, 2021 due to a higher average balance.
+Added: loss of $7.8 million for the three months ended June 30, 2022 increased by $2.8 million from $5.0 million for the three months ended
+Added: June 30, 2021, due to the increases in research and development expenses and general and administrative expenses.
+Added: of Operations – Six Months Ended June 30, 2022 Compared to Six Months Ended June 30, 2021
+Added: following table sets forth, for the periods indicated, data derived from our statements of operations:
+Added: Six Months Ended
+Added: (in thousands)
+Added: Other revenue
+Added: Total revenue
+Added: Operating expenses:
+Added: Research and development, net of reimbursements
General and administrative
−Removed: expenses of $1.7 million for the three months ended March 31, 2022 were unchanged from $1.7 million for the three months ended March
−Removed: Other income is comprised
−Removed: of net interest income in both reporting periods.
−Removed: The amount for the three months ended March 31, 2022 of $35 thousand decreased from
−Removed: $52 thousand for the three months ended March 31, 2021 due to a lower average interest rate.
−Removed: Net loss of $5.1 million for
−Removed: the three months ended March 31, 2022 decreased by $0.2 million from $5.3 million for the three months ended March 31, 2021 primarily
−Removed: due to the increase in other revenue recognized during the respective periods.
−Removed: Liquidity and Capital Resources
−Removed: Historically, we have financed
−Removed: our operations primarily through sales of shares of our stock.
−Removed: The following tables sets forth selected cash flow information for the
−Removed: periods indicated:
−Removed: Three Months Ended
+Added: Total operating expenses
+Added: Other income:
+Added: Interest income – net
+Added: Total other income
+Added: recorded no commercial revenue for the six months ended June 30, 2022 and June 30, 2021.
+Added: determined that certain collaborations with a third-party are within the scope of ASC 606.
+Added: The collaboration agreement is made up of
+Added: multiple modules related to various research activities.
+Added: While the third party has the option to terminate the agreement at the conclusion
+Added: of any module, we identified a single performance obligation to provide research services within each module for which we receive monetary
+Added: consideration.
+Added: Other revenue recognized during the six months ended June 30, 2022 and June 30, 2021 was $0.9 million and $0.9 million
+Added: respectively.
+Added: National Institutes of Health awarded us a Small Business Technology Transfer cost reimbursable grant to support a clinical collaboration
+Added: with Memorial Sloan Kettering Cancer Center, or MSK, to study Iomab-ACT for targeted conditioning to achieve lymphodepletion prior to
+Added: administration of a CD19-targeted CAR T-cell therapy developed at MSK.
+Added: We recognized other revenue during the six months ended June 30,
+Added: 2022 of $0.1 million.
+Added: and development, net of reimbursements
+Added: and development expenses of $9.0 million for the six months ended June 30, 2022 increased $1.1 million from $7.9 million for the six
+Added: months ended June 30, 2021.
+Added: The increase was due to higher expenses related to our research activities at our laboratory space and government
+Added: grant program and increased compensation of $0.5 million.
+Added: and administrative
+Added: and administrative expenses of $5.0 million for the six months ended June 30, 2022 increased $1.6 million from $3.4 million for the six
+Added: months ended June 30, 2021.
+Added: The increase was primarily attributable to increased compensation of $0.8 million, higher professional fees
+Added: and consulting fees including recruitment costs, and higher legal fees.
+Added: Other income is comprised of net
+Added: interest income in both reporting periods.
+Added: The amount for the six months ended June 30, 2022 of $0.1 million was unchanged from the prior-year
+Added: loss of $12.9 million for the six months ended June 30, 2022 increased by $2.6 million from $10.3 million for the six months ended June
+Added: 30, 2021, due to the increases in research and development expenses and general and administrative expenses.
+Added: and Capital Resources
+Added: Historically,
+Added: we have financed our operations primarily through sales of shares of our stock.
+Added: The following tables sets forth selected cash flow information
+Added: for the periods indicated:
+Added: Six Months Ended
(in thousands)
−Removed: Cash used in operating activities
+Added: Cash provided by/used in operating activities
Cash used in investing activities
−Removed: Cash used in /provided by financing activities
+Added: Cash provided by financing activities
Net change in cash, cash equivalents and restricted cash
−Removed: Net cash used in operating
−Removed: activities for the three months ended March 31, 2022 of $5.8 million increased by $0.2 million from $5.6 million in the prior-year period.
−Removed: A lower net loss of $0.2 million was more than offset by $0.9 million in receipts for other revenue that were received in 2021 and recognized
−Removed: in the three months ended March 31, 2022.
−Removed: Net cash used in financing
−Removed: activities for the three months ended March 31, 2022 was $22 thousand of payments of finance leases.
−Removed: During the three months ended March
−Removed: 31, 2021, net cash provided by financing activities was $14.3 million, primarily from the sale of shares of our common stock.
−Removed: In August 2020 we entered
−Removed: into the Capital on Demand™ Sales Agreement with JonesTrading Institutional Services LLC, or JonesTrading, pursuant to which we
−Removed: may sell, from time to time, through or to JonesTrading, up to an aggregate of $200 million of our common stock.
−Removed: Shares of common stock
−Removed: are offered pursuant to our shelf registration statement on Form S-3 filed with the SEC on August 7, 2020.
−Removed: As of December 31, 2021, we
−Removed: had sold 6.7 million shares of common stock, resulting in gross proceeds of $59.1 million and net proceeds of $57.0 million.
−Removed: three months ended March 31, 2022, there were no sales of shares of common stock.
−Removed: For the three months ended March 31, 2021, we sold
−Removed: 1.7 million shares of common stock, resulting in gross proceeds of $14.8 million and net proceeds of $14.4 million.
−Removed: As of the date of filing
−Removed: this report, we expect that our existing resources will be more than sufficient to fund our planned operations for more than 12 months
−Removed: following the date of this report.
−Removed: Critical Accounting Policies and Use of Estimates
−Removed: Our management’s discussion
−Removed: and analysis of financial condition and results of operations is based on our consolidated financial statements, which have been prepared
−Removed: in accordance with accounting principles generally accepted in the United States, (“GAAP”).
−Removed: The preparation of these financial
−Removed: statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities and expenses and the disclosure
−Removed: of contingent assets and liabilities in our consolidated financial statements during the reporting periods.
−Removed: These items are monitored
−Removed: and analyzed by us for changes in facts and circumstances, and material changes in these estimates could occur in the future.
−Removed: our estimates on historical experience, known trends and events, and on various other factors that we believe are reasonable under the
−Removed: circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not
−Removed: readily apparent from other sources.
−Removed: Changes in estimates are reflected in reported results for the period in which they become known.
+Added: Net cash provided by operating
+Added: activities for the six months ended June 30, 2022 of $22.1 million increased by $32.3 million from a use of funds of $10.2 million in
+Added: the prior-year period.
+Added: This increase was due to the receipt of the $35.0 million up-front payment from Immedica.
+Added: cash used in investing activities of $0.3 million for the six months ended June 30, 2022 and $0.1 million for the prior-year period are
+Added: primarily due to the acquisition of equipment for our laboratory.
+Added: Net cash provided by financing
+Added: activities for the six months ended June 30, 2022 of $16.6 million and for the six months ended June 30, 2021 of $28.6 million was primarily
+Added: from the sale of shares of our common stock.
+Added: We entered into a lease for corporate office space effective June 1, 2022
+Added: and paid a security deposit to the landlord.
+Added: The lease has a term of 5 years 2 months, with an expiration date of July 30, 2027, and a
+Added: current annual rate of $0.6 million.
+Added: We are also responsible for certain other costs, such as insurance, taxes, utilities and maintenance.
+Added: In July, 2022 a certificate of deposit was provided as collateral for a letter of credit and the security deposit was returned.
+Added: August 2020 we entered into a Capital on Demand™ Sales Agreement with JonesTrading Institutional Services LLC, or JonesTrading,
+Added: pursuant to which we may sell, from time to time, through or to JonesTrading, up to an aggregate of $200 million of our common stock.
+Added: Shares of common stock are offered pursuant to our shelf registration statement on Form S-3 filed with the SEC on August 7, 2020.
+Added: of December 31, 2021, we had sold 6.7 million shares of common stock, resulting in gross proceeds of $59.1 million and net proceeds of
+Added: $57.0 million.
+Added: For the six months ended June 30, 2022, we sold 2.7 million shares of common stock, resulting in gross proceeds of $17.2
+Added: million and net proceeds of $16.7 million.
+Added: For the six months ended June 30, 2021, we sold 3.5 million shares of common stock, resulting
+Added: in gross proceeds of $29.6 million and net proceeds of $28.7 million.
+Added: June 28, 2022, we entered into an Amendment and Restated Capital on Demand™ Sales Agreement, or the A&R Sales Agreement, with
+Added: JonesTrading and B.
+Added: Riley Securities, Inc., or B.
+Added: Riley Securities.
+Added: The A&R Sales Agreement modifies the original Capital on Demand™
+Added: Sales Agreement to include B.
+Added: Riley Securities as an additional sales agent thereunder.
+Added: of the date of filing this report, we expect that our existing resources will be more than sufficient to fund our planned operations
+Added: for more than 12 months following the date of this report.
+Added: Accounting Policies and Use of Estimates
+Added: management’s discussion and analysis of financial condition and results of operations is based on our consolidated financial statements,
+Added: which have been prepared in accordance with accounting principles generally accepted in the United States, (“GAAP”).
+Added: preparation of these financial statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities
+Added: and expenses and the disclosure of contingent assets and liabilities in our consolidated financial statements during the reporting periods.
+Added: These items are monitored and analyzed by us for changes in facts and circumstances, and material changes in these estimates could occur
+Added: in the future.
+Added: We base our estimates on historical experience, known trends and events, and on various other factors that we believe
+Added: are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and
+Added: liabilities that are not readily apparent from other sources.
+Added: Changes in estimates are reflected in reported results for the period in
+Added: which they become known.
Actual results may differ materially from these estimates under different assumptions or conditions.
−Removed: Our significant accounting
−Removed: policies are described in detail in the notes to our consolidated financial statements appearing in our Annual Report filed on Form 10-K
−Removed: for the year ended December 31, 2021.
−Removed: Fair Value of Financial Instruments
−Removed: Fair value is defined as
−Removed: the price that would be received to sell an asset, or paid to transfer a liability, in an orderly transaction between market participants.
−Removed: A fair value hierarchy has been established for valuation inputs that gives the highest priority to quoted prices in active markets for
−Removed: identical assets or liabilities and the lowest priority to unobservable inputs.
−Removed: Revenue Recognition
−Removed: We recognize revenue in accordance
−Removed: with ASC 606.
−Removed: Under ASC 606, we recognize revenue when our customer obtains control of promised goods or services, in an amount that
−Removed: reflects the consideration that we expect to receive in exchange for those goods or services.
−Removed: To determine revenue recognition for arrangements
−Removed: within the scope of ASC 606, we perform the following five steps:
−Removed: (i) identify the contract(s) with a customer;
−Removed: (ii) identify the performance
−Removed: obligations in the contract;
−Removed: (iii) determine the transaction price, including variable consideration, if any;
−Removed: (iv) allocate the transaction
−Removed: price to the performance obligations in the contract;
−Removed: and (v) recognize revenue as we satisfy a performance obligation.
−Removed: We only apply
−Removed: the five-step model to contracts when it is probable that we will collect the consideration to which we are entitled in exchange for
−Removed: the goods or services we transfer to the customer.
−Removed: At contract inception, once
−Removed: the contract is determined to be within the scope of ASC 606, we assess whether the promised goods or services promised within each contract
−Removed: are distinct and, therefore, represent a separate performance obligation.
−Removed: Goods and services that are determined not to be distinct
−Removed: are combined with other promised goods and services until a distinct bundle is identified.
−Removed: In determining whether goods or services are
−Removed: distinct, we evaluate certain criteria, including whether (i) the customer can benefit from the good or service either on its own
−Removed: or together with other resources that are readily available to the customer (capable of being distinct) and (ii) the good or service
−Removed: is separately identifiable from other goods or services in the contract (distinct in the context of the contract).
−Removed: ASC 606 requires us to allocate
−Removed: the arrangement consideration on a relative standalone selling price basis for each performance obligation after determining the transaction
−Removed: price of the contract and identifying the performance obligations to which that amount should be allocated.
−Removed: The relative standalone selling
−Removed: price is defined in the new revenue standard as the price at which an entity would sell a promised good or service separately to a customer.
−Removed: We then recognize as revenue the amount of the transaction price that is allocated to the respective performance obligation as each performance
−Removed: obligation is satisfied, either at a point in time or over time, and if over time, recognition is based on the use of an output or input
−Removed: Collaborative Arrangements
−Removed: We follow the accounting
−Removed: guidance for collaboration agreements, which requires that certain transactions between us and collaborators be recorded in our consolidated
−Removed: statements of operations and comprehensive loss on either a gross basis or net basis, depending on the characteristics of the collaborative
−Removed: relationship, and requires enhanced disclosure of collaborative relationships.
−Removed: We evaluate our collaboration agreements for proper classification
−Removed: in our consolidated statements of operations and comprehensive loss based on the nature of the underlying activity.
−Removed: When we conclude
−Removed: that we have a customer relationship with one of our collaborators, we follow the guidance of ASC 606 .
−Removed: Research and Development Costs
−Removed: Research and development
−Removed: costs are expensed as incurred.
−Removed: These costs include the costs of manufacturing drug product, the costs of clinical trials, costs of employees
−Removed: and associated overhead, and depreciation and amortization costs related to facilities and equipment.
−Removed: Research and development reimbursements
−Removed: are recorded by us as a reduction of research and development costs.
−Removed: Share-Based Payments
−Removed: We estimate the fair value
−Removed: of each stock option award at the grant date by using the Black-Scholes option pricing model.
−Removed: The fair value determined represents the
−Removed: cost for the award and is recognized over the vesting period during which an employee is required to provide service in exchange for
+Added: significant accounting policies are described in detail in the notes to our consolidated financial statements appearing in our Annual
+Added: Report filed on Form 10-K for the year ended December 31, 2021.
+Added: recognize revenue in accordance with ASC 606.
+Added: Under ASC 606, we recognize revenue when our customer obtains control of promised goods
+Added: or services, in an amount that reflects the consideration that we expect to receive in exchange for those goods or services.
+Added: revenue recognition for arrangements within the scope of ASC 606, we perform the following five steps:
+Added: (i) identify the contract(s) with
+Added: (ii) identify the performance obligations in the contract;
+Added: (iii) determine the transaction price, including variable consideration,
+Added: (iv) allocate the transaction price to the performance obligations in the contract;
+Added: and (v) recognize revenue as we satisfy a
+Added: performance obligation.
+Added: We only apply the five-step model to contracts when it is probable that we will collect the consideration to
+Added: which we are entitled in exchange for the goods or services we transfer to the customer.
+Added: contract inception, once the contract is determined to be within the scope of ASC 606, we assess whether the promised goods or services
+Added: promised within each contract are distinct and, therefore, represent a separate performance obligation.
+Added: Goods and services that
+Added: are determined not to be distinct are combined with other promised goods and services until a distinct bundle is identified.
+Added: In determining
+Added: whether goods or services are distinct, we evaluate certain criteria, including whether (i) the customer can benefit from the good
+Added: or service either on its own or together with other resources that are readily available to the customer (capable of being distinct)
+Added: and (ii) the good or service is separately identifiable from other goods or services in the contract (distinct in the context of
+Added: the contract).
+Added: 606 requires us to allocate the arrangement consideration on a relative standalone selling price basis for each performance obligation
+Added: after determining the transaction price of the contract and identifying the performance obligations to which that amount should be allocated.
+Added: The relative standalone selling price is defined in the new revenue standard as the price at which an entity would sell a promised good
+Added: or service separately to a customer.
+Added: We then recognize as revenue the amount of the transaction price that is allocated to the respective
+Added: performance obligation as each performance obligation is satisfied, either at a point in time or over time, and if over time, recognition
+Added: is based on the use of an output or input method.
+Added: Collaborative
+Added: follow the accounting guidance for collaboration agreements, which requires that certain transactions between us and collaborators be
+Added: recorded in our consolidated statements of operations and comprehensive loss on either a gross basis or net basis, depending on the characteristics
+Added: of the collaborative relationship, and requires enhanced disclosure of collaborative relationships.
+Added: We evaluate our collaboration agreements
+Added: for proper classification in our consolidated statements of operations and comprehensive loss based on the nature of the underlying activity.
+Added: When we conclude that we have a customer relationship with one of our collaborators, we follow the guidance of ASC 606 .
+Added: entered into a product licensing agreement whereby we allowed a third party to commercialize a certain product in specified territories
+Added: using our trademarks.
+Added: The terms of this arrangement includes payment to us for a combination of one or more of the following:
+Added: license fees;
+Added: development, regulatory and sales-based milestone payments;
+Added: and royalties on net sales of licensed products.
+Added: We use judgment
+Added: to determine whether milestones or other variable consideration should be included in the transaction price.
+Added: license fees :
+Added: If the license to our intellectual property is determined to be distinct from the other performance obligations identified
+Added: in the arrangement, we will recognize revenue from upfront license fees allocated to the license when the license is transferred to the
+Added: licensee and the licensee is able to use and benefit from the license.
+Added: For licenses that are bundled with other promises, we determine
+Added: whether the combined performance obligation is satisfied over time or at a point in time.
+Added: regulatory or commercial milestone payments :
+Added: At the inception of each arrangement that includes payments based on the achievement
+Added: of certain development, regulatory and sales-based or commercial events, we evaluate whether the milestones are considered probable of
+Added: being achieved and estimate the amount to be included in the transaction price using the most likely amount method.
+Added: If it is probable
+Added: that a significant revenue reversal would not occur, the associated milestone value is included in the transaction price.
+Added: Milestone payments
+Added: that are not within our or the licensee’s control, such as regulatory approvals, are not considered probable of being achieved
+Added: until regulatory approval is received.
+Added: At the end of each subsequent reporting period, we will re-evaluate the probability of achieving
+Added: such development and regulatory milestones and any related constraint, and if necessary, adjust our estimate of the overall transaction
+Added: Any such adjustments are recorded on a cumulative catch-up basis and recorded as part of license revenues during the period of
+Added: milestone payments and royalties :
+Added: For arrangements that include sales-based royalties, including milestone payments based on the
+Added: volume of sales, we will determine whether the license is deemed to be the predominant item to which the royalties or sales-based milestones
+Added: relate and if such is the case, we will recognize revenue at the later of (i) when the related sales occur, or (ii) when the performance
+Added: obligation to which some or all of the royalty has been allocated has been satisfied (or partially satisfied).
+Added: payments and fees may require deferral of revenue recognition to a future period until we perform our obligations under these arrangements
+Added: or when it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty
+Added: associated with any variable consideration is subsequently resolved.
+Added: Amounts payable to us are recorded as accounts receivable when our
+Added: right to consideration is unconditional.
+Added: and Development Costs
+Added: and development costs are expensed as incurred.
+Added: These costs include the costs of manufacturing drug product, the costs of clinical trials,
+Added: costs of employees and associated overhead, and depreciation and amortization costs related to facilities and equipment.
+Added: development reimbursements are recorded by us as a reduction of research and development costs.
+Added: estimate the fair value of each stock option award at the grant date by using the Black-Scholes option pricing model.
+Added: The fair value
+Added: determined represents the cost for the award and is recognized over the vesting period during which an employee is required to provide
+Added: service in exchange for the award.
We account for forfeitures of stock options as they occur.
−Removed: Accounting Standards Recently Adopted
−Removed: In May 2021, FASB issued
−Removed: ASU 2021-04, Earnings Per Share (topic 260), Debt — Modifications and Extinguishments (Subtopic 470-50), Compensation –
−Removed: Stock Compensation (Topic 718) and Derivatives and Hedging – Contracts in an Entity’s Own Equity (Subtopic 815-40) –
−Removed: Issuer’s Accounting for Certain Modifications or Exchanges of Freestanding Equity-Classified Written Call Options , which provides
−Removed: guidance of a modification or an exchange of a freestanding equity-classified written call option that remains equity classified after
−Removed: modification or exchange as (1) an adjustment to equity and, if so, the related earnings per share (EPS) effects, if any, or (2) an expense
−Removed: and, if so, the manner and pattern of recognition.
−Removed: The amendments in this ASU are effective January 1, 2022, including interim periods.
−Removed: We adopted this standard effective January 1, 2022 and the standard did not have a material effect on our financial statements.
−Removed: In November 2021, the FASB
−Removed: issued ASU 2021-10, Government Assistance (Topic 832), Disclosures by Business Entities about Government Assistance , which provides
−Removed: guidance on disclosure requirements to entities other than not-for-profit entities about transaction with a government that are accounted
−Removed: for by applying a grant or contribution accounting model by analogy.
−Removed: ASU 2021-10 requires an entity to make annual disclosures related
−Removed: to (1) the nature of the transactions and the related accounting policy used to account for the government transactions, (2) quantification
−Removed: and disclosure of amounts related to the government transactions included in balance sheet and income statement financial statement line
−Removed: items, and (3) significant terms and conditions of the government transactions, including commitments and contingencies.
+Added: Standards Recently Adopted
+Added: May 2021, FASB issued ASU 2021-04, Earnings Per Share (topic 260), Debt — Modifications and Extinguishments (Subtopic 470-50),
+Added: Compensation – Stock Compensation (Topic 718) and Derivatives and Hedging – Contracts in an Entity’s Own Equity (Subtopic
+Added: 815-40) – Issuer’s Accounting for Certain Modifications or Exchanges of Freestanding Equity-Classified Written Call Options ,
+Added: which provides guidance of a modification or an exchange of a freestanding equity-classified written call option that remains equity
+Added: classified after modification or exchange as (1) an adjustment to equity and, if so, the related earnings per share (EPS) effects, if
+Added: any, or (2) an expense and, if so, the manner and pattern of recognition.
+Added: The amendments in this ASU are effective January 1, 2022, including
+Added: interim periods.
+Added: We adopted this standard effective January 1, 2022 and the standard did not have a material effect on our financial
+Added: In November 2021, the FASB issued
+Added: ASU 2021-10, Government Assistance (Topic 832), Disclosures by Business Entities about Government Assistance , which provides guidance
+Added: on disclosure requirements to entities other than not-for-profit entities about transaction with a government that are accounted for by
+Added: applying a grant or contribution accounting model by analogy.
+Added: ASU 2021-10 requires an entity to make annual disclosures related to (1)
+Added: the nature of the transactions and the related accounting policy used to account for the government transactions, (2) quantification and
+Added: disclosure of amounts related to the government transactions included in balance sheet and income statement financial statement line items,
+Added: and (3) significant terms and conditions of the government transactions, including commitments and contingencies.
+Added: The amendments of ASU
+Added: 2021-10 are effective January 1, 2022, including interim periods.
+Added: We adopted this standard effective January 1, 2022 and the standard
+Added: did not have a material impact on our financial statements.
+Added: Standards Recently Issued
+Added: October 2021, FASB issued ASU 2021-08, Business Combinations (Topic 805), Account for Contract Assets and Contract Liabilities from
+Added: Contracts with Customers , which provides guidance on accounting for contract assets and contract liabilities acquired in a business
+Added: combination in accordance ASC 606.
+Added: To achieve this, an acquirer may assess how the acquiree applied ASC 606 to determine what to record
+Added: for the acquired revenue contracts.
+Added: Generally, this should result in an acquirer recognizing and measuring the acquired contract assets
+Added: and contract liabilities consistent with how they were recognized and measured in the acquiree’s financial statements.
The amendments
of ASU 2021-08 are effective January 1, 2023, including interim periods.
−Removed: We adopted this standard effective January 1, 20212 and the
−Removed: standard did not have a material impact on our financial statements.
−Removed: Accounting Standards Recently Issued
−Removed: In October 2021, FASB issued
−Removed: ASU 2021-08, Business Combinations (Topic 805), Account for Contract Assets and Contract Liabilities from Contracts with Customers ,
−Removed: which provides guidance on accounting for contract assets and contract liabilities acquired in a business combination in accordance ASC
−Removed: To achieve this, an acquirer may assess how the acquiree applied ASC 606 to determine what to record for the acquired revenue contracts.
−Removed: Generally, this should result in an acquirer recognizing and measuring the acquired contract assets and contract liabilities consistent
−Removed: with how they were recognized and measured in the acquiree’s financial statements.
−Removed: The amendments of ASU 2021-08 are effective
−Removed: January 1, 2023, including interim periods.
−Removed: Early adoption is permitted, including adoption in an interim period.
−Removed: We will evaluate the
−Removed: impact of ASU 2021-08 on any future business combinations that we may enter in the future.
−Removed: Subsequent Events
−Removed: On April 7, 2022, we entered into
−Removed: a license and supply agreement (the “License Agreement”) with Immedica Pharma AB (“Immedica”), pursuant to which
−Removed: Immedica licensed the exclusive product rights for commercialization of Iomab-B (I-131 apamistamab) in the European Economic Area, Middle
−Removed: East and North Africa (EUMENA) including Algeria, Andorra, Bahrain, Cyprus, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libya.
−Removed: Monaco, Morocco, Oman, Palestine, Qatar, San Marino, Saudi Arabia, Switzerland, Syria, Tunisia, Turkey, the United Arab Emirates, the
−Removed: United Kingdom, the Vatican City and Yemen.
−Removed: Upon signing, we were entitled to an upfront payment of $35 million from Immedica, which was
−Removed: received in May 2022.
−Removed: Under the terms of the License Agreement, we are eligible to receive aggregate regulatory and commercial milestone
−Removed: payments of up to approximately $417 million, subject to future currency exchange rates.
−Removed: Additionally, we are entitled to receive royalties
−Removed: in the mid-20 percent range on net sales of the product in certain countries that may result from the License Agreement.
−Removed: We will continue
−Removed: to be responsible for certain clinical development activities and the manufacturing of Iomab-B and will retain commercialization rights
−Removed: and rest of the world.
−Removed: Since March 31, 2022, we
−Removed: have sold 1.6 million shares of common stock under our Capital on Demand™ Sales Agreement with JonesTrading, resulting in net proceeds
−Removed: of $11.1 million.
−Removed: The cumulative effect of these
−Removed: subsequent events has been to increase our cash position by $46.1 million, resulting in an unaudited cash position as of May 13, 2022,
−Removed: of approximately $115 million.
+Added: Early adoption is permitted, including adoption in an interim
+Added: We will evaluate the impact of ASU 2021-08 on any future business combinations that we may enter in the future.
+Added: June 30, 2022, we have sold 0.3 million shares of common stock under our A&R Sales Agreement, resulting in net proceeds of $1.4 million.
+Added: August 2, 2022, warrants to purchase an aggregate of 0.6 million shares of common stock expired.
+Added: These warrants were issued on August
+Added: 2, 2017, when we completed an underwritten offering of 0.7 million shares of our common stock and warrants to purchase an aggregate of
+Added: 0.6 million shares of our common stock at a price of $22.50 per share and related warrant.
+Added: The warrants were exercisable for a period
+Added: of 5 years at an exercise price of $31.50 per share.
+Added: As of August 12, 2022, we have 1.4 million warrants outstanding.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.