UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K
(Mark
One)
☒
Annual Report Pursuant To Section 13 or 15(d) Of The Securities Exchange Act Of 1934
For
the fiscal year ended December 31 , 2025
or
☐
Transition Report Pursuant To Section 13 or 15(d) Of The Securities Exchange Act Of 1934
For
the transition period from _____ to _____
COMMISSION
FILE NUMBER: 001-36374
ACTINIUM
PHARMACEUTICALS, INC.
(Exact
name of registrant as specified in its charter)
Delaware 74-2963609
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
100
Park Ave., 23 rd Floor
New
York , NY 10017
(Address
of principal executive offices) (Zip Code)
(646)
677-3870
Registrant’s
telephone number, including area code
Securities
registered pursuant to Section 12(b) of the Act:
Title of each class Trading symbol Name of exchange on which registered
Common stock, par value $0.001 ATNM NYSE American
Securities
registered pursuant to Section 12(g) of the Act: None
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No
☒
Indicate
by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No
☒
Indicate
by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange
Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2)
has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate
by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule
405 of Regulation S-T (Section 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant
was required to submit such files). Yes ☒ No ☐
Indicate
by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting
company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,”
“smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer ☐ Accelerated filer ☐
Non-accelerated filer ☒ Smaller reporting company ☒
Emerging growth company ☐
If
an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying
with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate
by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness
of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered
public accounting firm that prepared or issued its audit report. ☐
If
securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant
included in the filing reflect the correction of an error to previously issued financial statements. ☐
Indicate
by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation
received by any of the registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐
Indicate
by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the act): Yes ☐ No ☒
The
aggregate market value of voting stock held by nonaffiliates of the registrant as of June 30, 2025, the last business day of the
registrant’s most recently completed second fiscal quarter, based on the closing price of the common stock on the NYSE American
on June 30, 2025 was $ 43,663,089 .
As of March 30, 2026, 31,374,994 shares of common stock, $0.001 par
value per share, were outstanding.
Table of
Contents
Item 1.
Business
1
Item 1A.
Risk Factors
33
Item 1B.
Unresolved Staff Comments
71
Item 1C.
Cybersecurity
71
Item 2.
Properties
72
Item 3.
Legal Proceedings
72
Item 4.
Mine Safety Disclosures
72
Item 5.
Market for Registrant’s Common Equity, Related Stockholders Matters, and Issuer Purchases of Equity Securities
73
Item 6.
Reserved
74
Item 7.
Management’s Discussion and Analysis of Financial Condition and Results of Operations
74
Item 7A.
Quantitative and Qualitative Disclosures About Market Risk
79
Item 8.
Financial Statements and Supplementary Data
F-1
Item 9.
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
80
Item 9A.
Controls and Procedures
80
Item 9B.
Other Information
80
Item 9C
Disclosure Regarding Foreign Jurisdictions That Prevent Inspections
80
Item 10.
Directors, Executive Officers and Corporate Governance
81
Item 11.
Executive Compensation
89
Item 12.
Security Ownership of Certain Beneficial Owners and Management
97
Item 13.
Certain Relationships and Related Transactions, and Director Independence
97
Item 14.
Principal Accountant Fees and Services
98
Item 15.
Exhibits, Financial Statement Schedules
99
Signature Page
103
i
CAUTIONARY
NOTE REGARDING FORWARD-LOOKING STATEMENTS
This
Annual Report on Form 10-K (this “Report”) contains forward-looking statements that involve risks and uncertainties, principally
in the sections entitled “Description of Business,” “Risk Factors,” and “Management’s Discussion
and Analysis of Financial Condition and Results of Operations.” All statements other than statements of historical fact contained
in this Report, including statements regarding future events, our future financial performance, business strategy and plans and objectives
of management for future operations, are forward-looking statements. We have attempted to identify forward-looking statements by terminology
including “anticipates,” “believes,” “can,” “continue,” “could,” “estimates,”
“expects,” “intends,” “may,” “plans,” “potential,” “predicts,”
“should,” or “will” or the negative of these terms or other comparable terminology. Although we do not make forward-looking
statements unless we believe we have a reasonable basis for doing so, we cannot guarantee their accuracy. These statements are only predictions
and involve known and unknown risks, uncertainties and other factors, including the risks outlined under “Risk Factors” or
elsewhere in this Report, which may cause our or our industry’s actual results, levels of activity, performance or achievements
expressed or implied by these forward-looking statements. Moreover, we operate in a very competitive and rapidly changing environment.
New risks emerge from time to time and it is not possible for us to predict all risk factors, nor can we address the impact of all factors
on our business or the extent to which any factor, or combination of factors, may cause our actual results to differ materially from
those contained in any forward-looking statements. All forward-looking statements included in this document are based on information
available to us on the date hereof, and we assume no obligation to update any such forward-looking statements.
You
should not place undue reliance on any forward-looking statement, each of which applies only as of the date of this Report. Before you
invest in our securities, you should be aware that the occurrence of the events described in the section entitled “Risk Factors”
and elsewhere in this Report could negatively affect our business, operating results, financial condition and stock price. Except as
required by law, we undertake no obligation to update or revise publicly any of the forward-looking statements after the date of this
Report to conform our statements to actual results or changed expectations.
ii
PART I
ITEM 1. BUSINESS.
Description of Our Business
We are a clinical-stage biopharmaceutical company pioneering the development
of targeted radiotherapies to address significant unmet medical needs in oncology. We are focused on employing a biology-driven approach
to develop differentiated, first-in-class radiopharmaceutical therapeutics for patients with solid tumors and hematologic malignancies.
Our mission is to transform cancer treatment by delivering innovative radioconjugates that maximize therapeutic efficacy while minimizing
toxicity to healthy tissue by combining our deep understanding of tumor biology and translational medicine with our expertise in radiochemistry.
Since our inception, we
have focused on developing innovative and differentiated radiotherapies. Our pipeline of both early and later stage development
programs is a testimony to our approach in three areas with: (1) two novel solid tumor product candidates, ATNM-400 and Actimab-A,
with pan-tumor potential, (2) Actimab-A, which is also being developed as a therapeutic backbone for acute myeloid leukemia (AML)
and myelodysplastic syndrome (MDS) in partnership with the National Cancer Institute (NCI), and (3) two targeted conditioning
agents, Iomab-B for bone marrow transplant and Iomab-ACT for cell & gene therapies. Our solid tumor asset, ATNM-400, targets a
novel, antigen which does not target PSMA, with demonstrated pre-clinical activity across metastatic castration-resistant prostate
cancer (mCRPC), non-small cell lung cancer (NSCLC), and breast cancer. Actimab-A, targets myeloid derived suppressor cells
(MDSC’s) and is being studied in multiple solid tumors in combination with immune checkpoint inhibitors where MDSC’s are
known to act as an efficacy deterrent for these agents. Our hematology franchise includes: Actimab-A, a CD33-targeted therapy; as
well as, Iomab-B and Iomab-ACT which are CD45-targeting conditioning agents. Both Actimab-A and Iomab-B are Phase 2/3 ready assets and are
supported by extensive validation in over 15 clinical trials in which more than 500 patients were treated.
The
radiopharmaceutical therapeutics market has experienced significant growth and validation in recent years. The FDA approval s of
Pluvicto ® (177Lu-PSMA-617) for prostate cancer and Lutathera ® (177Lu-DOTATATE) for gastroenteropancreatic
neuroendocrine tumors (GEP-NETs) ha ve demonstrated the transformative potential of targeted radiotherapy.
Pluvicto ® is the first radiopharmaceutical to achieve blockbuster status and generated approximately
$2 billion in sales in 2025 and is forecast by its sponsor Novartis to reach peak sales of $5 billion. Lutathera® is also
forecasted to attain blockbuster status by Novartis.
1
Many companies have entered the space, perhaps attracted by the success
of the aforementioned products and also the acquisitions of several companies in recent years. However, most companies have focused on
just a handful of targets. Consequently, we believe the radiopharmaceutical field remains in its early stages despite the number of companies
now developing radiotherapies. This is apparent as a majority of the radiotherapy industry development pipeline is clustered around a
handful of biological targets with most companies focused on prostate-specific membrane antigen (PSMA), somatostatin receptor type 2 (SSTR2)
antagonists/agonists and variations on the theme (NSTR2, NSTR3, etc), and fibroblast activation protein (FAP). Each of these targets features
multiple programs using different targeting moieties including but not limited to peptides, small molecules, antibodies as well as various
isotope payloads including beta emitters like Lutetium-177 and alpha emitters such as Actinium-225 and Lead-212.
In contrast, we see a significant opportunity to broaden the patient populations benefiting from targeted radiopharmaceuticals by coupling
our understanding of tumor biology and translational medicine with our expertise in radiochemistry to develop novel programs against differentiated
targets with multi-indication potential. From 2013 to 2023, there was approximately $17 billion in high-value mergers and acquisitions
focused on radiopharmaceutical assets, capabilities and infrastructure. Six major pharmaceutical companies have a established radiotherapy
presence via acquisitions, resulting in approximately 300,000 square feet of radiopharmaceutical manufacturing infrastructure which is
largely underutilized as there are just three approved radiopharmaceutical therapeutics. Since 2024, there has been $8 billion in strategic
investments and licensing transactions specifically targeting assets that offer novelty and differentiation in the radiotherapy space.
We believe this activity demonstrates both the validation of radiotherapies as a viable treatment modality and the larger companies urgent
need for truly differentiated assets to fill their pipelines.
2
Our Competitive Strengths
We believe we are well-positioned to capitalize on the radiopharmaceutical
opportunity based on the following competitive strengths:
Biology-Driven Approach to Radiopharmaceutical Development
We employ a
biology first approach to identify targets that are implicated in underlying tumor biology, disease
progression and/or treatment resistance. In doing so, we believe our targeted radiotherapies are
differentiated from the rest of the radiopharmaceutical industry pipeline and have first-in-class potential. The recent acquisitions and
licensing transactions in the radiopharmaceutical field have been driven by novel assets and platforms beyond targets such as PSMA, SSTR
and FAP. To our knowledge, ATNM-400 and Actimab-A MDSC are the only radiopharmaceuticals in development pursuing their respective targets
and indications. Similarly, Actimab-A , Iomab-B and Iomab-ACT, are the only CD33 and CD45 targeting
radiotherapies in clinical development to our knowledge. We will continue to identify and evaluate novel radiopharmaceutical assets leveraging
our biology-driven methodology.
Differentiated, First-in-Class Pan-Tumor Programs Addressing Large
Solid Tumor Indications
Our pipeline features multiple
first-in-class programs targeting novel antigens not currently addressed by existing radiopharmaceutical platforms. ATNM-400 represents
a differentiated approach in prostate cancer by targeting a non-PSMA antigen, potentially addressing patients who do not respond to or
progress after PSMA-targeted therapy such as Pluvicto®, as well as enabling earlier line combinations with androgen receptor pathway
inhibitors (ARPIs). With demonstrated pre-clinical efficacy across prostate cancer, NSCLC, and breast cancer, ATNM-400 has pan-tumor potential
addressing a combined patient population exceeding 800,000 in the United States. Our pre-clinical data demonstrate that ATNM-400 outperformed
leading approved therapies by 3-5 fold in EGFR-mutant NSCLC models as a monotherapy in terms of tumor growth inhibition, produced cures
in combination with Tagrisso®, and achieved complete tumor regression in combination with Herceptin® in HER2-resistant breast
cancer models.
Actimab-A represents another differentiation
opportunity through its mechanism of depleting CD33+ MDSCs , potentially unlocking synergy with PD-1
checkpoint inhibitors such as Keytruda® and Opdivo® in MDSC-rich solid tumors. This approach
addresses a well-documented mechanism of PD-1 resistance, with clinical data demonstrating that high MDSC levels correlate with poor outcomes
on PD-1 therapy. This positions Actimab-A to potentially expand the $40+ billion PD-1 inhibitor market.
De-Risked Late-Stage Hematology Franchise with Near-Term Partnership
Potential
Our hematology programs are supported by extensive clinical validation
and represent potential near-term value creation opportunities. Iomab-B has been evaluated in over 500 patients across multiple clinical
trials and has received FDA alignment on a Phase 2/3 trial design in an expanded relapsed/refractory (R/R) AML patient population. The
program benefits from composition of matter patents extending into 2037, an existing network of 24 clinical sites with continued interest
from the Study of Iomab-B in Elderly Relapsed Refractory AML (SIERRA) trial, and potential market expansion across six disease indications
representing approximately 150,000 addressable patients who can benefit from improved bone marrow transplant conditioning.
Actimab-A has demonstrated what we believe to be compelling clinical
data in combination with CLAG-M chemotherapy, achieving high rates of measurable residual disease (MRD) negativity and improved survival
outcomes in high-risk R/R AML patients. In Phase 1b clinical trials, patients treated with Actimab-A plus CLAG-M achieved a 24-month median
overall survival among the 70% who proceeded to bone marrow transplant, comparing favorably to the less than 2-4 month overall survival
typically observed in TP53-positive or prior venetoclax-treated patient populations. We have received FDA alignment on Phase 2/3 trial
design for Actimab-A in combination with CLAG-M for R/R AML patients and are actively seeking strategic partnerships to advance these
programs.
3
The targeted conditioning franchise,
including Iomab-B for bone marrow transplant and Iomab-ACT for cell and gene therapies, addresses the fundamental challenge of establishing
donor cell engraftment while reducing toxicities associated with traditional chemotherapy based myeloablative
conditioning regimens. Iomab-ACT has the potential to serve as a universal conditioning agent, improving patient access and outcomes for
CAR-T and other cell therapies, with three active clinical trials currently underway.
End-to-End Supply Chain and Demonstrated
Ability to Execute Complex Clinical Trials
Our clinical assets have been studied in over 500 patients to date
and we have executed multiple Phase 1 – 3 clinical trials across our Actimab-A, Iomab-ACT and Iomab-ACT programs. In doing so, we
have established and actively managed an end-to-end supply chain that encompasses sourcing of radioisotopes, manufacturing targeting agents,
production of final drug product candidates and their delivery to the point of care. We believe our demonstrated ability to execute radiopharmaceutical
trials at approximately 50 treatment centers including leading comprehensive cancer centers can be leveraged for our ongoing and planned
clinical development efforts. We executed a phase 3 trial of Iomab-B which utilized extremely high doses of Iodine-131 (I-131) which required
specialized handling. Additional operational parameters included the need for patient isolation in a transplant setting which added to
the complexity of the trial yet the company successfully executed the trial without missing a single dose. We are exploring improved methods for efficiently generating quality clinical data by working with centers of excellence both in and outside
the United States. We believe these capabilities
have strategic value to enable the successful and timely clinical execution of our own planned trials for product candidates we may in-license,
partner or acquire.
Vertically Integrated Capabilities and Infrastructure
We are in the process of establishing comprehensive end-to-end capabilities across the radiopharmaceutical value chain. We have invested
in establishing an operational radiopharmaceutical manufacturing facility expected to be commissioned in 2H:2026, which will provide clinical
supply capabilities by year-end. This facility, combined with our established distribution network to approximately 50 leading hospitals
and multiple redundant isotope supply agreements, positions us to serve patient demand at scale. Our proprietary cyclotron-based Ac-225
production technology for which we are seeking a partnership, can help us secure reliable isotope supply at commercial scale via an internal
back-up source. We believe our manufacturing process achieves radiochemical purity equivalent to the gold-standard thorium decay method
without generating long-lived radioactive contaminants. We have demonstrated leading-edge pre-clinical radiochemistry and translational
biology capabilities that enable rapid advancement from target selection through clinical development. This vertical integration provides
us with significant strategic flexibility and insulates us from supply chain disruptions that have historically challenged radiopharmaceutical
development.
Strong Intellectual Property Position
We have built an intellectual
property portfolio comprising approximately 250 issued patents and pending patent applications, including critical composition of matter
patents, method of use patents, and proprietary Ac-225 production technology. Our intellectual property estate provides extensive protection
for our product candidates and platform technologies across major global markets, with issued and pending patent coverage over key programs.
We believe our IP position creates substantial barriers to entry and positions our assets as attractive opportunities for strategic partnerships
and out-licensing.
4
Our Strategy
Our goal is to establish Actinium as
a leading, fully integrated targeted radiotherapy company delivering transformative medicines to cancer patients.
Key elements of our strategy include:
Rapidly Advance ATNM-400 Through Clinical Development Across Multiple
Indications
We are focused on rapidly advancing
ATNM-400 into clinical development, leveraging the pre-clinical validation we have established across multiple solid tumor indications.
In mCRPC, the pre-clinical dataset demonstrating mechanistic synergy with ARPI’s such as enzalutamide, superiority to both single-agent
enzalutamide and 177Lu-PSMA-617, and strong combination activity supports the therapeutic potential in this indication. Based on this
data, we believe ATNM-400, a non-PSMA targeting radioconjugate, demonstrates the potential to benefit patients who progress on or are
ineligible for PSMA-targeted therapy and potentially enable earlier-line combination approaches with ARPIs.
ATNM-400 also demonstrates clinical development
potential in EGFR-mutant NSCLC, where our pre-clinical data demonstrated 3-5 fold superiority compared
to approved EGFR inhibitors including osimertinib (Tagrisso ®), datopotamab deruxtecan (Dato-DXd),
and amivantamab, as well as 100% complete responses in combination with osimertinib. We have established mechanistic rationale for this
combination through demonstrated upregulation of the ATNM-400 target following osimertinib treatment. Furthermore, in pre-clinical
studies, both ATNM-400 monotherapy and ATNM-400 in combination with osimertinib is superior to an osimertinib combination with chemotherapy.
This positions ATNM-400 for potential development across first-, second-, and third-line EGFR-mutant NSCLC
treatment settings.
In breast cancer, we have demonstrated
efficacy across HR-positive, triple-negative breast cancer (TNBC), and HER2-resistant models, with complete tumor eradication observed
for ATNM-400 in combination with trastuzumab (Herceptin®) in trastuzumab-resistant models. The ATNM-400 target shows increased expression
in trastuzumab-resistant tumors, providing mechanistic support for clinical development in this setting. We believe ATNM-400 represents
a differentiated approach that can avoid the off-target toxicities such as interstitial lung disease observed with HER2 and TROP-2 antibody-drug
conjugates such as Ehertu® and Datroway®, respectively.
5
Establish Actimab-A MDSC in Combination with Checkpoint Inhibitors
We currently intend to conduct a basket trial evaluating Actimab-A
in combination with PD-1 inhibitors (Keytruda® or Opdivo®) across four MDSC-rich solid tumor types: head and neck squamous cell
carcinoma (HNSCC), NSCLC, glioblastoma (GBM), and high microsatellite instability (MSI-high) colorectal cancer. This trial, expected to
report initial data in 2H:2026, is supported by pre-clinical evidence demonstrating that Actimab-A selectively homes to and depletes tumor-resident
CD33+ MDSCs, which are primed for depletion and correlate with poor outcomes on PD-1 therapy. Our pre-clinical data show that Actimab-A
treatment is cytotoxic to patient-derived MDSCs ex vivo and enhances T-cell responses.
The trial design includes comprehensive
biomarker assessments to evaluate MDSC depletion patterns in both tumor microenvironment and peripheral blood, as well as T-cell activity
restoration. We will compare clinical outcomes including objective response rate (ORR), progression-free survival (PFS), and overall survival
(OS) against real-world data comparators. Success in this trial could position Actimab-A as a foundational combination partner for checkpoint
inhibitors across multiple solid tumor indications. In addition, we are evaluating the potential for further clinical evaluation of Actimab-A
in patients with GBM and NSCLC with other PD-1 inhibitors.
GBM has a unique microenvironment in which ~40% of the glioma mass is comprised of tumor associated myeloid (TAM’s) cells which
play an important role in immunosuppression and inhibition of anti-tumor responses. Selective eradication of these TAM’s which express
CD33 within the GBM tumor microenvironment with Actimab-A has the potential to enhance anti-tumor T-cell immunity thereby increasing the
effectiveness of immunotherapies for the treatment of GBM.
Execute Strategic Partnerships for Late-Stage Hematology Programs
We are actively seeking strategic partnerships to advance our Phase
2/3-ready hematology programs, Actimab-A and Iomab-B. These programs benefit from substantial clinical validation, clear regulatory pathways
following FDA alignment, and concentrated commercial markets focused on approximately 100 quaternary care centers in the United States
and Europe. The complementary nature of these programs—spanning AML/MDS therapeutics and targeted conditioning for bone marrow transplant
and cell/gene therapies—creates strong commercial synergies and represents blockbuster market opportunities.
Our partnership strategy prioritizes collaborations that can provide
the resources and infrastructure necessary to execute global pivotal trials while preserving meaningful economics for Actinium. We are
leveraging our existing relationship with the National Cancer Institute (NCI), which has established a Cooperative Research and Development
Agreement (CRADA) supporting Actimab-A development, to advance clinical programs in a cost-effective manner while retaining commercial
rights.
Build Fully Integrated cGMP Manufacturing and End-to-End Supply Chain
We are completing construction
of our internal cGMP radiopharmaceutical manufacturing facility, which is being designed to manufacture Ac-225 based radioconjugates and
provide drug product manufacturing to support clinical trials. This facility, expected to be operational in 2H:2026, will complement our
established network of hospital administration sites and isotope suppliers. Our hybrid internal-external manufacturing strategy is designed
to provide supply reliability, cost efficiency, and geographic flexibility to serve global patient populations at commercial scale. In
addition, we will opportunistically seek partnerships to manufacture Ac-225 utilizing our patented cyclotron production technology.
6
Continue Platform Innovation and Pipeline Expansion
We are committed to continued innovation
in radiopharmaceutical discovery and development. Our proven track record of generating highly differentiated programs positions us to
expand our pipeline through both internal discovery efforts and potential strategic acquisitions of complementary assets or technologies.
We maintain rigorous criteria for program advancement, requiring demonstration of clear differentiation, compelling pre-clinical
validation, and significant market opportunities before committing substantial resources to clinical development.
Our Pipeline
Solid Tumor Programs
ATNM-400: First-in-Class Pan-Tumor Radiotherapy
ATNM-400 is our lead solid tumor program,
representing a first-in-class Ac-225 antibody radioconjugate targeting a novel, undisclosed, non-PSMA targeting antigen with expression
across multiple solid tumor types. The ATNM-400 target is implicated
in disease biology during tumor progression and is also overexpressed when tumors become resistant
to many approved therapies in multiple solid tumors.
7
Our pre-clinical translational
data demonstrated that ATNM-400 is superior to:
● PSMA-targeted agents or ARPI’s in the mCRPC
setting of prostate cancer
● EGFR inhibitors (osimertinib), TROP-2 ADC (Dato-Dxd), and EGFR-cMET
bispecific (amivantamab) in EGFR-mutant NSCLC, and to
● HER2-therapy (trastuzumab) in HER2-resistant
breast cancer and endocrine therapy (tamoxifen) in tamoxifen-resistant breast cancer.
These data show that ATNM-400 works well as monotherapy but is even
better in combination in resistant settings where the target is overexpressed as part of the resistance mechanism. Evidence of target
expression has been observed ranging from 60%-80%+ in mCRPC, NSCLC, and breast cancer patient tumors, representing a significant addressable
population of over a hundred thousand patients in the United States based on our existing datasets. This number may expand as we continue
our work to demonstrate the potential of ATNM-400 in various additional disease and treatment settings.
Our pre-clinical development program has generated robust efficacy
and mechanism-of-action data across multiple indication-specific animal models:
Prostate Cancer: ATNM-400 demonstrated
specific tumor uptake and decreased tumor cell proliferation in pre-clinical models, with significantly
greater efficacy than both 177Lu-PSMA-617 (the active agent in Pluvicto ®) and next-generation
225Ac-PSMA-617 in PSMA-low 22Rv1 prostate cancer xenograft models that are resistant to ARPI therapy.
8
Importantly, ATNM-400 also demonstrated superior efficacy to enzalutamide
and 177Lu-PSMA-617 in ARPI-resistant prostate cancer models, with strong and durable combination activity when combined with enzalutamide.
This combination activity is mechanistically supported by our observation that enzalutamide resistance increases ATNM-400 target expression
in both prostate cancer models and mCRPC patient samples.
9
These
data support ATNM-400 development in post-Pluvicto® and post-ARPI patient populations. Between 45,000 to 55,000 patients will progress
on ARPI in the mCRPC and metastatic hormone sensitive prostate cancer (mHSPC) settings annually. With a potential of Pluvicto®
approval in mHSPC based on the Phase 3 PSMAddition study, the number of eligible patients nearly doubles from 44,000 patients in the
mCRPC population to 86,500 patients in both mHSPC and mCRPC. Given that the response rates for Pluvicto® in the VISION and PSMAfore
population are approximately 30% and 50%, respectively, a significant proportion of patients remain with few options following treatment.
Additionally, Pluvicto® refractory patients will receive as few as 2 cycles if no response is observed. The mechanistic synergy with
ARPIs also supports potential expansion to earlier treatment lines in combination with standard-of-care hormonal therapies, representing
an addressable population exceeding 100,000 patients across all lines of treatment in the mCRPC and mHSPC settings.
EGFR-Mutant NSCLC: ATNM-400 demonstrated 3-5 fold greater tumor growth
inhibition compared to approved EGFR-targeted therapies including osimertinib (first-line), datopotamab deruxtecan (second-line), and
amivantamab (third-line) in NCI-H1975 human lung cancer models harboring L858R and T790M EGFR mutations.
10
In combination with osimertinib, ATNM-400 achieved 100% complete responses
with durable efficacy extending throughout the study period.
We have established mechanistic support for ATNM-400 combinations with
EGFR inhibitors, demonstrating that osimertinib treatment increases ATNM-400 target expression both in vitro and in vivo. This mechanistic
synergy, combined with clinical data showing improved outcomes when osimertinib is combined with external beam radiotherapy, supports
ATNM-400 development across multiple EGFR-mutant NSCLC treatment settings.
11
EGFR-mutant
NSCLC represents approximately 30 ,000 U.S. patients annually, with current treatment dominated by
AstraZeneca’s Tagrisso ® (osimertinib) and Johnson & Johnson’s Rybrevant ®
(amivantamab) combinations. ATNM-400 offers a novel EGFR inhibitor plus radiotherapy combination approach
with potential differentiation across first-, second-, and third-line settings. Additionally, given tumor cell apoptosis driven by the
irreversible double-stranded DNA damage from actinium-225, ATNM-400 could potentially provide benefit for the approximately 200,000 NSCLC
patients diagnosed annually regardless of oncogenic driver mutation.
Breast Cancer: ATNM-400 demonstrated
robust anti-tumor activity and tumor regression as monotherapy and in combination with trastuzumab in pre-clinical breast
cancer models, including trastuzumab-resistant BT474-Clone5 model, HR+ breast cancer MCF-7 model and triple-negative breast cancer
(TNBC) and triple-negative MDA-MB-468 model . In the trastuzumab-resistant
setting, we observed increased expression of both the survival pathway marker p-AKT and the ATNM-400 target, with ATNM-400 treatment inducing
DNA double-strand breaks as measured by p-H2AX staining. ATNM-400 achieved 66% tumor growth inhibition as monotherapy and 103% tumor growth
inhibition (representing tumor regression) in trastuzumab-resistant models.
12
The ATNM-400 target is overexpressed in breast cancer, including tumors
resistant to endocrine therapies such as tamoxifen and HER2-targeted therapies, as well as in TNBC.
13
We believe that this broad expression pattern supports multi-lineage
development in breast cancer. Current second-line therapies in HER2-positive disease, including trastuzumab deruxtecan and sacituzumab
govitecan, are limited by off-target toxicities including interstitial lung disease. ATNM-400 represents a novel therapeutic approach
designed to avoid these toxicity concerns while providing efficacy across HR-positive, HER2-resistant, and TNBC patient populations representing
approximately 300,000 U.S. patients annually.
We have developed a theranostic strategy utilizing Zr-89 as a companion
imaging agent to enable patient selection and tumor visualization. This approach allows for non-invasive assessment of target expression
and drug biodistribution prior to therapeutic administration, potentially enhancing the therapeutic index by selecting patients most likely
to respond.
Success in our clinical program could position ATNM-400 as a differentiated
pan-tumor targeted radiotherapy across multiple large solid tumor indications, potentially addressing the several hundred thousand U.S.
patients with mCRPC, EGFR-mutant NSCLC, and all sub-types of breast cancer, while also establishing a first-in-class radioconjugate with broad combination potential and
attractive partnership and commercial potential in the rapidly growing radiopharmaceutical market.
Actimab-A for MDSC’s: Novel Immunomodulatory Approach in Solid
Tumors
Actimab-A (lintuzumab-Ac-225) is a CD33-targeted Ac-225 radioconjugate
that we are developing to enhance checkpoint inhibitor efficacy by depleting immunosuppressive CD33+ MDSCs in the tumor microenvironment.
MDSCs are a heterogeneous population of immature myeloid cells that
accumulate in solid tumors and suppress anti-tumor T-cell responses, representing a well-validated mechanism of resistance to PD-1/PD-L1
checkpoint inhibitors. Clinical studies have demonstrated that patients with high circulating MDSC levels have significantly reduced progression-free
and overall survival on PD-1 therapy compared to patients with low MDSC levels.
14
Low MDSC’s Associated with Statistically Significant
Improvement in PFS and OS
Source: 1) Bronte et al. High Levels of Circulating Monocytic Myeloid-Derived
Suppressive-Like Cells Are Associated With the Primary Resistance to Immune Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer:
An Exploratory Analysis https://pmc.ncbi.nlm.nih.gov/articles/PMC9043492/. Frontiers in Immunology. 2022 Apr 13;13:866561
Our pre-clinical studies
have demonstrated that Actimab-A: (1) selectively homes to tumor-resident CD33+ MDSCs in vivo; (2) is cytotoxic to patient-derived MDSCs
ex vivo; and (3) rescues T-cell proliferation and anti-tumor immune responses ex vivo following MDSC depletion. These data provide mechanistic
support for combining Actimab-A with PD-1 inhibitors to overcome MDSC-mediated resistance.
We intend to conduct a Phase 1b basket
trial evaluating Actimab-A in combination with pembrolizumab (Keytruda ®) or nivolumab (Opdivo ®)
in patients with R/R locally advanced or metastatic HNSCC, NSCLC, GBM, and MSI-high colorectal cancer. These
tumor types were selected based on high MDSC infiltration and limited response rates to PD-1 monotherapy. The trial design incorporates
comprehensive correlative biomarker assessments to evaluate MDSC depletion in both tumor microenvironment and peripheral blood, as well
as T-cell activity restoration.
Patients enrolled in the trial
must have MDSC-rich tumor types, be checkpoint inhibitor-naïve, be at least 18 years of age, and demonstrate PD-1/PD-L1 expression.
Primary endpoints include safety and tolerability of the combination, with secondary endpoints including ORR, PFS, and OS. Biomarker endpoints
will evaluate the pattern of CD33+ MDSC depletion and T-cell activity in both tumor tissue and peripheral blood samples. Clinical outcomes
will be compared against real-world data from similar patient populations treated with PD-1 monotherapy. We expect to report initial data
from this trial in 2H:2026. In addition, we are also evaluating clinical opportunities with other immune checkpoint inhibitors in GBM
and NSCLC.
15
We believe that success in this trial could position Actimab-A for
development across multiple solid tumor indications in combination with checkpoint inhibitors, potentially expanding the utility of the
$40+ billion PD-1/PD-L1 inhibitor market by addressing MDSC-mediated resistance.
Hematology Programs
Actimab-A: Backbone Therapy for AML and MDS
In hematologic malignancies, we are developing
Actimab-A as a mutation-agnostic backbone therapy for AML and high-risk MDS. CD33 is expressed on leukemic blasts in the majority of AML
patients and represents an established therapeutic target validated by the approval of gemtuzumab ozogamicin (Mylotarg ®). However,
antibody-drug conjugates like Mylotarg ® have limitations including hepatotoxicity and limited
efficacy in certain patient populations. Actimab-A, delivering the highly potent alpha-emitter Ac-225 to CD33+ cells, represents a differentiated
approach designed to provide superior efficacy while maintaining a favorable safety profile.
Actimab-A in combination with
CLAG-M for R/R AML: We have completed a Phase 1b clinical trial evaluating Actimab-A in combination with CLAG-M chemotherapy in R/R AML
patients , results of which were published in a peer-reviewed journal Leukemia in February 2025. The
trial enrolled high-risk patients including those with TP53 mutations, prior venetoclax treatment failure, and patients who had
prior allogeneic transplant. Results demonstrated high rates of MRD-negative complete remissions and improved
survival outcomes compared to historical controls.
Among patients treated with Actimab-A
plus CLAG-M, 70% of those deemed eligible for transplant proceeded to bone marrow transplant, and
this population achieved a 24-month median overall survival. These results compare highly favorably to published data showing less than
2-4 month median overall survival in TP53-mutated or prior venetoclax-treated R/R AML patient populations. The combination was well-tolerated
with a safety profile consistent with CLAG-M chemotherapy alone and no dose-limiting toxicities observed.
Based on these results, we have received FDA alignment on a Phase 2/3
trial design to evaluate Actimab-A plus CLAG-M in first or second salvage R/R AML patients.
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We are currently actively seeking a strategic partner to execute this
trial. The trial design allows for enrollment of a broad R/R AML population while enriching for patients most likely to benefit based
on Phase 1b results.
Actimab-A Development Programs:
Beyond R/R AML, we are developing Actimab-A in conjunction with the NCI across multiple AML and MDS treatment settings and exploring its
potential in additional areas:
● Frontline AML Triplet Combination:
Evaluating Actimab-A as a backbone therapy in combination with standard induction regimen of venetoclax and a hypomethylating
agent in newly diagnosed AML patients. This mutation-agnostic approach could provide benefit across the
broad frontline AML population.
● Combination with Targeted Therapies: Developing Actimab-A
combinations with FLT3 inhibitors, IDH1/2 inhibitors, and menin inhibitors in genomically-defined AML patient subsets. These combinations
leverage Actimab-A’s mutation-agnostic mechanism while potentially enhancing efficacy through complementary mechanisms of action.
● High-Risk MDS Monotherapy: Evaluating Actimab-A as monotherapy
in high-risk MDS patients who have failed hypomethylating agent therapy, representing a patient population with very limited treatment
options and poor outcomes.
● Maintenance
Therapy: The potential exists for Actimab-A as maintenance therapy following achievement of remission to prevent relapse in AML and MDS
patients.
The programs are supported
by our Cooperative Research and Development Agreement (CRADA) with the National Cancer Institute, which enables cost-effective clinical
development while retaining commercial rights to Actinium.
We believe that success in our hematology program could establish Actimab-A
as a mutation-agnostic backbone therapy for R/R AML and high-risk MDS, addressing a combined patient population with limited treatment
options, while generating important data to support regulatory approval and to enable a strategic partnership to commercialize Actimab-A
across the estimated $2+ billion AML/MDS therapeutics market.
Iomab-ACT: Universal Conditioning for Cell and Gene Therapies
Iomab-ACT is our CD45-targeted conditioning platform being developed
as a universal conditioning agent to improve access and outcomes for cell and gene therapies, including CAR-T, allogeneic hematopoietic
stem cell transplant, and gene therapy. The cell and gene therapy field has been limited by the need for lymphodepleting chemotherapy
conditioning, which is associated with significant toxicities and can limit the patient populations eligible for these potentially curative
treatments.
17
Iomab-ACT is designed to provide targeted
lymphodepletion and myeloablation when necessary while avoiding the off-target toxicities associated
with chemotherapy conditioning. By delivering targeted radiation specifically to CD45+ hematopoietic cells, Iomab-ACT aims to create an
optimal environment for therapeutic cell engraftment while minimizing treatment-related morbidity and mortality.
We currently have three active clinical trials evaluating Iomab-ACT:
● Phase 1/2 Trial in Commercial CAR-T: Evaluating Iomab-ACT as conditioning
prior to commercial CAR-T therapy in patients with relapsed/refractory non-Hodgkins lymphoma. This trial will assess the safety, tolerability,
and efficacy of Iomab-ACT conditioning. The primary endpoint is engraftment and key secondary endpoints are incidence of Cytokine Release
Syndrome (CRS) and Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) which are two potentially fatal adverse events associated
with CAR-T cell therapy.
● Phase 1 Trial in experimental CAR-T: Evaluating Iomab-ACT
as conditioning prior to CD19 CAR-T cell therapy in patients with relapsed refractory B-cell malignancies (non-Hodgkins lymphoma, acute
lymphomablastic leukemia/lymphoma).
● Phase 1 Trial in Sickle Cell Disease BMT: Evaluating Iomab-ACT
as conditioning for allogeneic bone marrow transplant in patients with sickle cell disease. This trial addresses a critical unmet need
for safer conditioning regimens in non-malignant hematologic diseases.
The cell and gene therapy market represents a rapidly growing opportunity,
with over 30,000 patients annually receiving CAR-T or allogeneic transplant in the United States and Europe. Success in these trials could
position Iomab-ACT as a universal conditioning platform applicable across multiple cell and gene therapy modalities, potentially expanding
patient access to these curative therapies while improving safety and tolerability.
Iomab-B: Targeted Conditioning for Bone Marrow Transplant in R/R
AML
Iomab-B (apamistamab-I-131) is a CD45-targeted radioimmunotherapy designed
to enable bone marrow transplant in R/R AML patients who are ineligible for conventional myeloablative conditioning due to age, comorbidities,
or prior treatment-related toxicities. CD45 is expressed on all hematopoietic cells, enabling Iomab-B to deliver targeted radiation to
bone marrow while sparing non-hematopoietic organs from radiation exposure.
Conventional stem cell transplant
conditioning regimens utilize high-dose chemotherapy with or without total body irradiation to ablate the patient’s hematopoietic system
and create space for donor cell engraftment. These regimens are associated with significant toxicities including mucositis, hepatotoxicity,
pulmonary toxicity, and treatment-related mortality. Many elderly patients and those with comorbidities are deemed ineligible for these
intensive conditioning regimens, limiting access to potentially curative transplant therapy.
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Iomab-B has been evaluated in over 500
patients across multiple clinical trials, including the Phase 3 SIERRA trial in R/R AML patients. The SIERRA trial demonstrated that Iomab-B
enabled successful donor cell engraftment in elderly R/R AML patients who would otherwise be ineligible for conventional conditioning.
The study met the primary endpoint of durable complete remission
(dCR). While the study did not meet the secondary endpoint of OS due to the cross over of two-thirds of the patients from the control
arm to Iomab-B arm , it provided important insights into optimal patient selection and trial design for future
development.
We have received FDA alignment on a Phase
2/3 trial design in an expanded R/R AML patient population that includes all patients age 18 and older with R/R AML . This
expanded population reflects learnings from SIERRA regarding optimal patient selection. The trial design allows us to leverage both the
Phase 2 results and the SIERRA database to support regulatory submissions.
Iomab-B benefits from composition of matter patents extending to 2038,
a well-established network of 24 clinical sites from the SIERRA trial that maintains strong interest in the program, and potential for
market expansion beyond R/R AML. Pre-clinical and clinical data support potential development in five additional disease indications including
acute lymphoblastic leukemia, myelodysplastic syndromes, chronic myeloid leukemia, multiple myeloma, and lymphoma, representing a total
addressable market of approximately 150,000 patients who could benefit from improved bone marrow transplant conditioning.
We are actively seeking a strategic partner to advance Iomab-B through
pivotal development and commercialization.
We believe Actimab-A,
Iomab-B and Iomab-ACT collectively have the potential to be successful commercial products based on the high unmet needs of their addressable
patient segments. In total, we believe this opportunity exceeds 400,000 patients in the U.S. and EU.
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Our Platform and Capabilities
Radiochemistry and Translational Science Capabilities
We have assembled a team with expertise in radiopharmaceutical discovery
and development, spanning target selection, radioconjugate design, pre-clinical evaluation, and clinical development. Our capabilities
include:
● Target Selection and Validation:
Comprehensive target assessment including expression profiling in tumor versus normal, binding and internalization
kinetics, and competitive landscape analysis to identify optimal targets for radiopharmaceutical development.
● Radioconjugate Design and Optimization: Medicinal chemistry
expertise in chelator selection, linker design, and conjugation chemistry to optimize tumor uptake, retention, and biodistribution while
minimizing normal organ exposure.
● Pre-clinical Pharmacology: In
vitro and in vivo models to assess binding affinity, internalization, tumor penetration, radiation dosimetry, and anti-tumor efficacy
across diverse tumor types.
● Translational Biomarkers: Development of imaging companion
diagnostics, circulating biomarkers, and tissue-based assessments to enable patient selection and monitor treatment response.
These capabilities enable us to efficiently
advance programs from target selection through clinical development while maintaining high quality standards and generating comprehensive
translational data packages to guide clinical development and support
regulatory submissions and partnership discussions.
Ac-225 Production and Radiopharmaceutical Manufacturing
We have developed proprietary
cyclotron-based technology for commercial-scale production of Ac-225, one of the most critical bottlenecks in radiopharmaceutical development.
Our production method generates high-purity Ac-225 with radiochemical purity equivalent to the gold-standard thorium-229 decay method,
while avoiding the generation of long-lived radioactive contaminants such as Ac-227. This production technology is protected by patents
and if operationalized may represent a significant competitive and cost advantage.
We are currently completing
construction of a radiopharmaceutical manufacturing facility designed to manufacture Ac-225-based final drug products for clinical supply.
The facility, expected to be operational in 2H:2026, incorporates purpose-built infrastructure for alpha-emitter handling and a flexible
manufacturing suite capable of supporting multiple trials.
We have also established an end-to-end supply chain spanning isotope
production through patient administration. We maintain supply agreements with multiple redundant isotope suppliers, relationships with
multiple contract manufacturing organizations, and a distribution network to approximately 50 leading cancer centers amassed via the execution
of several Phase 1 – 3 clinical trials. This supply chain infrastructure provides geographic coverage across major metropolitan
areas, minimizes risk of supply disruption, and positions us to reliably serve patient demand at clinical scale.
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Competition
The radiopharmaceutical therapeutics field has experienced significant
growth in recent years, with numerous companies and academic institutions developing targeted radiotherapy programs. We face competition
from several categories of organizations:
Large Pharmaceutical Companies: Several
major pharmaceutical companies have entered the radiopharmaceutical space through acquisitions or internal development, including Novartis
(through acquisition of Advanced Accelerator Applications and Endocyte ), Eli Lilly (through acquisition
of Point Biopharma), Bristol Myers Squibb (through acquisition of RayzeBio), AstraZeneca (through acquisition of Fusion Pharmaceuticals ),
Bayer (through acquisition of Algeta Pharmaceuticals , Noria Therapeutics, and PSMA Therapeutics),
and Johnson & Johnson. These companies possess significantly greater financial resources, established
commercial infrastructure, and broader development pipelines than we do. However, many of these companies are focused on PSMA-targeted
therapies for prostate cancer or SSTR2-targeted therapies for neuroendocrine tumors and have stated a need for novel differentiated assets
to expand their radiopharmaceutical portfolios.
Clinical-Stage Radiopharmaceutical Companies:
We compete with several clinical-stage companies developing novel radiopharmaceutical approaches . A representative list of these
competitors include Telix Pharmaceuticals, Perspective Therapeutics, Clarity Pharmaceuticals, Cellectar Biosciences, Bicycle Therapeutics,
Molecular Partners, Ratio Therapeutics, Convergent Therapeutics, Aktis Oncology, Radiopharm Theranostics, and Plus Therapeutics. This
is not a comprehensive list and none of these or any other radiotherapeutics company currently compete
are directly with Actinium’s product candidates in terms of biological targets.
Antibody-Drug Conjugate Companies :
Particularly solid tumors, we may compete with companies developing antibody-drug conjugates (ADCs) that
deliver cytotoxic chemotherapy payloads to tumor cells. However, we believe radiopharmaceuticals offer potential advantages compared to
ADCs including the “crossfire” or “bystander” effect wherein alpha particles can kill neighboring tumor cells that
do not express the target antigen, potentially overcoming tumor heterogeneity. Additionally, radiopharmaceuticals enable non-invasive
imaging to assess target expression and drug biodistribution, potentially improving patient selection.
Therapeutic Area Competitor Companies: Several large pharmaceutical
companies are legacy areas in the therapeutic areas that our pipeline agents are being developed. In prostate cancer, several marketed
drugs are available from Johnson & Johnson, Astellas/Pfizer, Bayer, Novartis, and AstraZeneca/Merck. AstraZeneca, Johnson & Johnson,
Roche, and Daiichi Sankyo have approved agents in EGFR mutant NSCLC. As for breast cancer, Roche, Pfizer, Lilly, Novartis, and AstraZeneca/Daiichi
Sankyo have therapeutics available. AbbVie, Bristol Myers Squibb, Astellas, and Servier are primary companies with AML marketed agents.
In addition, these companies have active pipelines exploring a multitude of mechanisms of action to maintain or grow their positions in
these indications.
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We believe our competitive position is differentiated by: (1) our focus
on novel, first-in-class targets with pan-tumor potential rather than following validated targets already being pursued by multiple competitors;
(2) our vertically integrated capabilities that we intend to span isotope production through drug product manufacturing; (3) our late-stage
hematology programs with clear regulatory pathways; and (4) our comprehensive intellectual property position protecting our products and
platform technologies.
However, we face significant competitive
risks. Our competitors may develop therapies that are more effective, safer, more convenient, or more cost-effective than our product
candidates. Competitors may also obtain regulatory approval before we do, establish superior market positions, or render our technologies
obsolete. In the evolving landscape of targeted radiotherapies, mergers and acquisitions and collaborations can quickly reshape
the competitive landscape. Large radiopharmaceutical companies are increasingly partnering with and acquiring small biotechnology companies
in the field to access novel pipeline agents and manufacturing capabilities for radiopharmaceutical production and development. These
deals and partnerships, through increased access to capital, regulatory expertise, and global infrastructure, can expedite clinical development
timelines and hasten drug commercialization. The radiopharmaceutical field is characterized by rapid technological
change and intense competition, and we cannot guarantee that we will be able to maintain our competitive position.
Government Regulation
United States Regulation
In the United States,
pharmaceutical products are subject to extensive regulation by the FDA. The Federal Food, Drug, and Cosmetic Act (FDCA), and other
federal and state statutes and regulations, govern, among other things, the research, development, testing, manufacture, storage,
recordkeeping, approval, labeling, promotion and marketing, distribution, post-approval monitoring and reporting, sampling, and
import and export of pharmaceutical products. Failure to comply with applicable U.S. requirements may subject a company to a variety
of administrative or judicial sanctions, such as FDA refusal to approve pending new drug applications (NDAs) or biologics license
applications (BLAs), warning or untitled letters, product recalls, product seizures, total or partial suspension of production or
distribution, injunctions, fines, civil penalties, and criminal prosecution.
Pharmaceutical product development for a new product or certain changes
to an approved product in the United States typically involves completion of preclinical laboratory tests, animal studies and formulation
studies, all performed in accordance with the FDA’s Good Laboratory Practice (GLP) regulations, submission to the FDA of an IND which
must become effective before clinical trials may begin, adequate and well-controlled clinical trials to establish the safety and effectiveness
of the drug or biologic for each indication for which FDA approval is sought, and submission to the FDA of an NDA or BLA. FDA review is conducted the via NDA pathway for product candidates regulated as drugs and via the BLA pathway for product candidates
regulated as biologics. Both pathways require an IND for investigation. Our lead product candidates are regulated as biologics.
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Preclinical tests include laboratory evaluation of product chemistry,
formulation and toxicity, as well as animal trials to assess the characteristics and potential safety and efficacy of the product. The
conduct of the preclinical tests must comply with federal regulations and requirements including GLPs. The results of preclinical testing
are submitted to the FDA as part of an IND along with other information including information about product chemistry, manufacturing and
controls and a proposed clinical trial protocol. Long-term preclinical tests, such as animal tests of reproductive toxicity and carcinogenicity,
may continue after the IND is submitted.
A 30-day waiting period after the submission of each IND is required
prior to the commencement of clinical testing in humans. If the FDA has neither commented on nor questioned the IND within this 30-day
period, the clinical trial proposed in the IND may begin. If the FDA raises concerns or questions about the conduct of the trial, such
as whether human research subjects will be exposed to an unreasonable health risk, the IND sponsor and the FDA must resolve any outstanding
concerns before clinical trials can proceed.
Clinical trials involve the administration of the investigational drug
to human subjects under the supervision of qualified investigators in accordance with Good Clinical Practice (GCP) requirements, which
include the requirement that all research subjects provide their informed consent in writing before their participation in any clinical
trial. Clinical trials are conducted under protocols detailing, among other things, the objectives of the trial, the parameters to be
used in monitoring safety and the effectiveness criteria to be evaluated. A protocol for each clinical trial and any subsequent protocol
amendments must be submitted to the FDA as part of the IND.
The FDA may order the temporary, or permanent, discontinuation of a
clinical trial at any time, or impose other sanctions, if it believes that the clinical trial either is not being conducted in accordance
with FDA requirements or presents an unacceptable risk to the clinical trial patients. The study protocol and informed consent information
for patients in clinical trials must also be submitted to an institutional review board (IRB) for approval at each site at which the clinical
trial will be conducted. An IRB may also require the clinical trial at the site to be halted, either temporarily or permanently, for failure
to comply with the IRB’s requirements, or may impose other conditions.
Clinical trials to
support NDAs and BLAs for marketing approval are typically conducted in three sequential phases, but the phases may overlap. In
Phase 1, the drug is initially introduced into healthy human subjects or patients with the target disease or condition and tested
for safety, dosage tolerance, absorption, metabolism, distribution, excretion and, if possible, to gain an early indication of its
effectiveness and to determine optimal dosage. Phase 2 usually involves trials in a limited patient population to identify possible
adverse effects and safety risks, to determine the efficacy of the product for specific targeted diseases and to determine dosage
tolerance and optimal dosage. Phase 3 trials are undertaken to further evaluate dosage, to provide substantial evidence of clinical
efficacy and to further test for safety in an expanded patient population at geographically dispersed clinical trial sites.
23
After completion of the required
clinical testing, an NDA or BLA is prepared and submitted to the FDA. FDA approval of the NDA is required before marketing of the product
may begin in the United States. The NDA/BLA must include the results of all preclinical, clinical and other testing and a compilation
of data relating to the product’s pharmacology, chemistry, manufacture and controls. The cost of preparing and submitting an NDA/BLA is
substantial.
The FDA has 60 days from its receipt of an NDA/BLA to determine whether
the application will be accepted for filing based on the agency’s threshold determination that it is sufficiently complete to permit substantive
review. Once the submission is accepted for filing, the FDA begins an in-depth review. The FDA has agreed to certain performance goals
in the review of NDAs and BLAs. Most such applications for standard review drug products are reviewed within 10 months of submission;
most applications for priority review drugs are reviewed within six months of submission. Priority review can be applied to drugs that
the FDA determines offer major advances in treatment, or provide a treatment where no adequate therapy exists. The review process for
both standard and priority review may be extended by FDA for three additional months to consider certain late-submitted information, or
information intended to clarify information already provided in the submission.
The FDA may also refer
applications for novel drug products, or drug products that present difficult questions of safety or efficacy, to an advisory
committee—typically a panel that includes clinicians and other experts—for review, evaluation and a recommendation as to
whether the application should be approved. The FDA is not bound by the recommendation of an advisory committee, but it generally
follows such recommendations. Before approving an NDA or BLA, the FDA will typically inspect the facility or facilities where the
product is manufactured.
Radiopharmaceuticals face
additional regulatory considerations beyond conventional pharmaceuticals. Due to their radioactive nature, radiopharmaceuticals are also
regulated by the Nuclear Regulatory Commission (NRC) or Agreement States under the Atomic Energy Act. We must obtain appropriate licenses
for possession, use, and distribution of radioactive materials. These licenses impose requirements for radiation safety programs, personnel
training and monitoring, facility design and monitoring, waste disposal, and security. We must also comply with regulations governing
the transportation of radioactive materials, including such regulation by the US Department of Transportation.
The FDA has issued guidance documents specific to radiopharmaceuticals
that address topics including dosimetry assessments, clinical trial design, and manufacturing controls. Radiopharmaceutical development
programs typically require microdosing studies using imaging isotopes to assess biodistribution and dosimetry prior to therapeutic dose
administration. Manufacturing of radiopharmaceuticals must account for short half-lives necessitating distributed manufacturing networks,
specialized quality control testing, and just-in-time production and distribution systems.
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International Regulation
In addition to regulations in the United States, we are subject to
regulations in the foreign countries in which we conduct clinical trials or seek to market our products. Whether or not we obtain FDA
approval for a product, we must obtain approval by the comparable regulatory authorities of foreign countries or economic areas, such
as the European Union, before we may commence clinical trials or market products in those countries or areas. The approval process and
requirements governing the conduct of clinical trials, product licensing, pricing and reimbursement vary greatly from place to place,
and the time may be longer or shorter than that required for FDA approval.
The European Union has centralized procedures for approving pharmaceuticals
that allow companies to submit a single marketing authorization application (MAA) to the European Medicines Agency (EMA). Upon EMA approval,
this centralized procedure results in a single marketing authorization that is valid across the European Economic Area. The EMA has specific
guidelines for radiopharmaceuticals addressing dosimetry, manufacturing, and clinical development considerations similar to FDA guidance.
In many foreign countries, radiopharmaceuticals face additional complexities
related to reimbursement structures, nuclear medicine facility requirements, and isotope supply chains that differ significantly from
the U.S. market.
Intellectual Property
We strive to protect and enhance the proprietary technologies that
we believe are important to our business, including seeking, maintaining and defending patent rights, whether developed internally or
licensed from third parties. Our policy is to seek to protect our proprietary position by, among other methods, filing U.S. and foreign
patent applications related to our proprietary technology, inventions and improvements that are important for the development and implementation
of our business. We also rely on trade secrets, know-how, continuing technological innovation and in-licensing opportunities to develop,
strengthen and maintain our proprietary position.
Our intellectual property portfolio comprises approximately 250 patents
and patent applications across multiple jurisdictions. Our patent estate includes:
● Composition of Matter Patents: Covering our key product candidates
including Iomab-B, Iomab-ACT, and ATNM-400,
● Method of Use Patents: Covering specific therapeutic applications,
combination therapies, and treatment protocols for our product candidates Actimab-A. Iomab-B, Iomab-ACT, and ATNM-400, as well as preclinical
pipeline candidates
● Manufacturing and Process Patents: Protecting our cyclotron-based
Ac-225 production technology, radiopharmaceutical manufacturing processes, and formulation technologies.
● Platform Technology Patents: Protecting core technologies
applicable across multiple programs including chelator chemistry, targeting approaches, and bioconjugation methods.
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Our patents provide market exclusivity in major territories including
the United States, Europe, Canada, Japan, and key emerging markets. We actively monitor and enforce our intellectual property rights and
investigate potential infringement of our proprietary technologies.
In addition to patents, we maintain proprietary know-how and trade
secrets relating to our radiopharmaceutical development platform, manufacturing processes, and clinical development strategies. We seek
to protect this information through confidentiality agreements with employees, consultants, advisors, and collaborative partners.
We also rely on regulatory exclusivity to protect our products from
competition. In the United States, biologics such as our antibody radioconjugates may be eligible for 12 years of market exclusivity under
the Biologics Price Competition and Innovation Act. Additionally, therapies receiving orphan drug designation may be eligible for seven
years of market exclusivity in the United States, and similar exclusivity periods apply in other territories.
Manufacturing and Supply Chain
Our manufacturing strategy combines internal capabilities with external
partnerships to create a flexible, redundant, and cost-effective supply chain capable of supporting both clinical development and commercial
supply. This hybrid approach provides us with strategic flexibility, supply reliability, and the ability to scale production to meet patient
demand.
Internal Manufacturing Capabilities
We are completing construction of a state-of-the-art cGMP radiopharmaceutical
manufacturing facility located in New York, expected to be operational in 2H:2026. This facility has been purpose-built for alpha-emitter
handling and radiopharmaceutical production with the following capabilities:
● Therapeutic Drug Product Manufacturing: production suites
for radioconjugate synthesis, formulation, fill-finish, and quality control testing, designed to support multiple simultaneous programs.
● Quality Control and Analytics: Comprehensive analytical capabilities
including radiochemical purity testing, stability assessment, sterility testing, and release testing in accordance with regulatory requirements.
● Radiation Safety Infrastructure: Shielded manufacturing suites
and a comprehensive radiation safety program to protect personnel and environment.
The facility has been designed for clinical stage supply of radiolabeled
therapeutic drug product production .
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External Manufacturing Partnerships
We have established partnerships with multiple contract manufacturing
organizations providing geographic redundancy and production flexibility:
● Isotope Supply: We maintain supply agreements with multiple
domestic and international suppliers of Ac-225 and other radioisotopes, providing priority access and redundancy to ensure reliable supply.
Our suppliers include established radioisotope producers with proven track records of regulatory compliance and supply reliability.
● Contract Manufacturing: We have qualified multiple contract
manufacturers capable of producing our drug products under cGMP conditions. These partnerships provide backup capacity, geographic diversity,
and specialized capabilities complementing our internal manufacturing.
● Distribution Partners: We have established relationships with
specialized radiopharmaceutical logistics providers capable of cold-chain distribution, real-time tracking, and just-in-time delivery
to clinical sites and commercial administration centers.
Supply Chain Management
Our supply chain team has established systems and processes to coordinate
the complex logistics of radiopharmaceutical production and distribution:
● Demand Forecasting: Predictive models incorporating clinical
trial enrollment, commercial demand projections, and inventory optimization to ensure adequate supply while minimizing waste.
● Production Scheduling: Coordinated scheduling across isotope
production, drug product manufacturing, quality testing, and distribution to optimize efficiency and minimize decay losses.
● Real-Time Tracking: Systems to monitor location, temperature,
and radiation levels throughout the supply chain from production through patient administration.
● Regulatory Compliance: Procedures ensuring compliance with
FDA, NRC, Department of Transportation, and international regulations governing radioactive material handling, transportation, and administration.
Our manufacturing and supply chain capabilities position us to serve
patient populations at clinical and commercial scale while maintaining the flexibility to respond to changing demand and expand into new
geographic markets.
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Human Capital
As
of March 25, 2026, we had 25 full-time employees, 12 of whom have Ph.D. or M.D. degrees and 21
of whom are engaged in research and development and clinical development activities. We believe that we
have been successful to date in attracting skilled and experienced personnel despite the competitive hiring marketing in the industry.
Our employees are not covered by a collective bargaining agreement, and we believe that our relationship with our employees is excellent.
We continue to engage external consultants on an as-needed basis to temporarily supplement existing staff.
Corporate Information
We were incorporated under the laws of the State of Delaware in 2013.
Our principal executive offices are located at 100 Park Avenue, New York, NY 10017, and our telephone number is (646) 677-3870. Our website
address is www.actiniumpharma.com. The information contained on our website or that can be accessed through our website is not incorporated
by reference into this Report and should not be considered a part of this Report.
We make available free of
charge through our website our annual reports on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K, and any such
amendments to those reports as soon as reasonably practicable after we electronically file such material with or furnish such material
to the Securities and Exchange Commission (“SEC”). The SEC maintains a website at http://www.sec.gov that contains reports,
proxy and information statements and other information regarding companies that file electronically with the SEC.
Government Regulation
Regulatory Compliance
Our research and development
activities are all subject to stringent regulation, primarily by the FDA in the U.S. under the Federal Food, Drug, and Cosmetic Act (the
“FDCA”) and its implementing regulations, and the Public Health Service Act (“PHSA”) and its implementing regulations,
and by comparable authorities under similar laws and regulations in other countries. This includes research and development, testing,
and oversight of suppliers and contract manufacturers involved in the production of our product candidates we are developing, as well
as the design, manufacturing, safety, efficacy, handling, labeling, storage, record-keeping, advertising, promotion and marketing. If,
for any reason, we do not comply with applicable requirements, such noncompliance can result in adverse consequences, including delays
in approval of, or even the refusal to approve product licenses or other applications, the suspension or termination of clinical investigations,
the revocation of approvals previously granted, as well as fines, criminal prosecution, recall or seizure of products, injunctions against
shipping products and suspension of production and/or refusals of government contracts.
FDA Review Process and Product Approval
Our product candidates are
regulated as biologics and must be approved by the FDA before they may be marketed in the U.S. This process generally involves the following:
●
completion of preclinical studies in accordance with the FDA’s current Good Laboratory Practices (“GLP”) requirements;
●
submission to the FDA of an IND, which must become effective before human clinical trials may begin and must be updated annually;
●
approval by an independent Institutional Review Board (“IRB”) ethics committee at each clinical site before the trial is initiated;
●
performance of adequate and well-controlled clinical trials to establish the safety, purity and potency of the proposed biologic, and its safety and efficacy for each indication, in accordance with good clinical practice (“GCP”);
●
submission to the FDA of a Biologics License Application (“BLA”)
for a new biologic, after completion of all pivotal clinical trials;
●
a determination by the FDA within 60 days of its receipt of a BLA to file the application for review;
28
●
satisfactory completion of an FDA pre-approval inspection of the manufacturing facilities to assess compliance with applicable current Good Manufacturing Practice (“cGMP”) regulations;
●
potential FDA audit of the clinical trial sites that generated the data in support of the BLA; and
●
FDA review and approval of a BLA for a new biologic, prior to any commercial marketing or sale of the product in the U.S.
Clinical trials generally are conducted
in three sequential phases, although they may overlap or be combined.
●
Phase 1 studies are designed to evaluate the safety, dosage tolerance, metabolism and pharmacologic actions of the investigational product in humans, the side effects associated with increasing doses, and if possible, to gain early evidence on effectiveness
●
Phase 2 studies are conducted to preliminarily or further evaluate the effectiveness of the investigational product for a particular indication(s) in patients with the disease or condition under study, to determine dosage tolerance and optimal dosage, and to identify possible adverse side effects and safety risks associated with the product
●
Phase 3 clinical trials generally involve a large number of patients at multiple sites designed to provide the data required to demonstrate the effectiveness of the product for its intended use, safety and to establish the benefit-risk relationship of the product and provide an adequate basis for product labeling
The results of the preclinical
and clinical testing, along with information regarding the manufacturing of the product and proposed product labeling, are evaluated and,
if determined appropriate, submitted to the FDA through a BLA. Once the BLA submission has been accepted for filing, the FDA’s standard
goal is to review applications within ten months of the filing date or, if the application relates to a drug that treats a serious condition
and would provide a significant improvement in safety or effectiveness qualifying for Priority Review, six months from the filing date.
The review process is often significantly extended by FDA requests for additional information or clarification.
The FDA offers certain programs,
such as Breakthrough Designation (“BTD”) and Fast Track designation, designed to expedite the development and review of applications
for products intended for the treatment of a serious or life-threatening disease or condition. For BTD, preliminary clinical evidence
of the product indicates that it may demonstrate substantial improvement over existing therapies on one or more clinically significant
endpoints. The FDA may initiate review of sections of a BLA before the application is complete, and the product may be eligible for accelerated
approval. However, receipt of BTD or Fast Track designation does not ensure that a product will be developed or approved on an expedited
basis, or at all.
The FDA reviews the BLA to
determine, among other things, whether the proposed product is safe, pure and potent, which includes determining whether it is effective
for its intended use, and whether the product is being manufactured in accordance with cGMP, to assure and preserve the product’s
identity, strength, quality, potency and purity. The FDA may refer an application to an advisory committee for review, evaluation and
recommendation as to whether the application should be approved, and applications for new molecular entities and original BLAs are generally
discussed at advisory committee meetings unless the FDA determines that this type of consultation is not needed under the circumstances.
After the FDA evaluates the
BLA and conducts inspections of manufacturing facilities, it may issue an approval letter or a complete response letter (“CRL”).
An approval letter authorizes commercial marketing of the biologic with specific prescribing information for specific indications. A CRL
indicates that the review cycle of the application is complete, but the FDA cannot grant approval. A CRL may require additional inspections,
and/or other significant, expensive and time-consuming requirements related to clinical trials, preclinical studies or manufacturing.
The FDA could approve the BLA with a Risk Evaluation and Mitigation Strategy (“REMS”) to mitigate risks, which could include
medication guides, physician communication plans, or elements to assure safe use, such as restricted distribution methods, patient registries
and other risk minimization tools. The FDA also may condition approval on, among other things, changes to proposed labeling, development
of adequate controls and specifications, or a commitment to conduct one or more post-market studies or clinical trials. Such post-market
testing may include Phase 4 clinical trials and surveillance to further assess and monitor the product’s safety and effectiveness
after commercialization.
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Post-Approval Requirements
Any products manufactured
or distributed by us or on our behalf pursuant to FDA approvals are subject to continuing regulation by the FDA and certain state agencies,
including requirements for record-keeping, reporting of adverse experiences with the biologic, submitting biological product deviation
reports to notify the FDA of unanticipated changes in distributed products, establishment registration, compliance with cGMP standards,
and certain state licensing requirements.
Additionally, any significant
change in the approved product or in how it is manufactured, including changes in formulation or the site of manufacture, generally require
prior FDA approval. The packaging and labeling of all products developed by us are also subject to FDA approval and ongoing regulation.
Noncompliance with any regulatory requirements can result in, among other things, issuance of warning letters, civil and criminal penalties,
seizures, and injunctive action. Accordingly, manufacturers must continue to maintain compliance with cGMP and other aspects of regulatory
compliance. The commercial distribution of prescription drugs is subject to the Drug Supply Chain Security Act (“DSCSA”),
which regulates the distribution of the products at the federal level and sets certain standards for federal or state registration and
compliance of entities in the supply chain.
The DSCSA preempts certain
previously enacted state laws and the pedigree requirements of the Prescription Drug Marketing Act (“PDMA”). Trading partners
within the drug supply chain must ensure certain product tracing requirements are met, and are required to exchange transaction information,
transaction history, and transaction statements. Product identifier information (an aspect of the product tracing scheme) is also required.
The DSCSA requirements, development of standards, and the system for product tracing were phased in over a period of years through 2023.
In addition to new legislation, FDA regulations, guidance documents, and policies are often revised or reinterpreted by the agency in
ways that may significantly affect our business and our product candidates.
Orphan Drug Act
We have received Orphan Drug
designation for Iomab-B and Actimab-A for patients with AML. Under the Orphan Drug Act, FDA may grant Orphan Drug designation to drugs
intended to treat a rare disease or condition, which is generally defined as a disease or condition that affects fewer than 200,000 individuals
in the U.S. Orphan Drug designation must be requested before submitting a BLA. In the U.S., Orphan Drug designation entitles a party to
financial incentives such as opportunities for grant funding towards clinical trial costs, tax advantages, and user-fee waivers. Orphan
Drug designation does not convey any advantage in, or shorten the duration of, the regulatory review and approval process. The first BLA
applicant to receive FDA approval for a particular active ingredient to treat a particular disease with FDA Orphan Drug designation is
entitled to a seven-year exclusive marketing period in the U.S. for that product, for that indication. During the seven-year exclusivity
period, FDA may not approve any other applications to market the same drug for the same orphan indication, except in limited circumstances,
such as a showing of clinical superiority to the product with orphan exclusivity or where the manufacturer of the approved product cannot
assure sufficient quantities. As a result, there can be no assurance that our competitors will not receive approval of drugs or biologics
that have a different active ingredient for treatment of the diseases for which our products and product candidates are targeted.
Pediatric Information
Under the Pediatric Research
Equity Act (“PREA”), certain BLAs must contain data to assess the safety and efficacy of the drug or biologic for the claimed
indications in all relevant pediatric subpopulations and to support dosing and administration for each pediatric subpopulation for which
the product is safe and effective. The Food and Drug Administration Safety and Innovation Act (“FDASIA”), amended the FDCA
to require that a sponsor who is planning to submit a marketing application for a drug that includes a new active ingredient, new indication,
new dosage form, new dosing regimen or new route of administration submit an initial Pediatric Study Plan (“PSP”) within 60
days of an end of Phase 2 meeting or, if there is no such meeting, as early as practicable before the initiation of the Phase 3 or Phase
2/3 study. The initial PSP must include an outline of the pediatric study or studies that the sponsor plans to conduct or a justification
for not including such detailed information, and any request for a deferral of pediatric assessments or a full or partial waiver. The
FDA may grant deferrals for submission of pediatric data or full or partial waivers. A sponsor can submit amendments to an initial PSP
if changes to the pediatric plan need to be considered based on preclinical data collected, early phase clinical trials as well as other
clinical development programs.
30
Foreign Regulation
In addition to regulations
in the U.S., we are subject to foreign regulations governing clinical trials and commercial sales and distribution of our product candidates,
and products being marketed outside of the U.S. We must obtain approval by the comparable regulatory authorities of foreign countries
before we can commence clinical trials or marketing of our products in those countries. The approval process varies from country to country,
and the time may be longer or shorter than required by the FDA for BLA licensure. The requirements governing the conduct of clinical trials,
product licensing, pricing and reimbursement vary greatly from country to country. As in the U.S., we are subject to post-approval regulatory
requirements.
Other Regulatory Considerations
We are also subject to regulation
under the Occupational Safety and Health Act, the Toxic Substances Control Act, the Resource Conservation and Recovery Act, The Clean
Air Act, and other current and potential future federal, state, or local regulations. Our research and development activities involve
the controlled use of hazardous materials, chemicals, biological materials and various radioactive compounds. We believe that our procedures
comply with the standards prescribed by state and federal regulations; however, the risk of injury or accidental contamination cannot
be completely eliminated. We may also be subject to healthcare regulation and enforcement by the federal government and the states and
foreign governments where we may market our products and product candidates, if approved. These laws and regulations include, without
limitation, state and federal anti-kickback, fraud and abuse, false claims, data privacy and security, aggregate spend reporting, and
product price advertising.
The federal
Anti-Kickback Statute (“AKS), which prohibits, among other things, persons and entities including pharmaceutical manufacturers
from knowingly and willfully soliciting, receiving, offering or paying remuneration, directly or indirectly, overtly or covertly, in
case or in kind, to induce or reward, or in return for, or either the referral of an individual for, or the purchase, lease or order
or recommendation of an item or service reimbursable, in whole or in part, under a federal healthcare program, such as the Medicare
and Medicaid programs. The failure to meet all of the requirements of a particular applicable statutory exception or regulatory safe
harbor does not make the conduct per se illegal under the AKS. Instead, the legality of the arrangement
will be evaluated on a case-by-case basis based on a cumulative review of all of its facts and circumstances.
In addition, Patient Protection and Affordable Care Act of 2010, as
amended (“ACA”) codified as law that a claim including items or services resulting from a violation of the AKS constitutes a false or fraudulent claim for purposes of the federal civil False Claims Act (“FCA”). The FCA prohibits
individuals or entities from, among other things, knowingly presenting or causing the presentation of a claims for payment to, or approval
by, the federal government that are false, fictitious or fraudulent, or knowingly making, using or causing to be made or used, a false
record or statement material to a false or fraudulent claim to avoid, decrease or conceal an obligation to pay money to the federal government.
Our activities relating to the reporting of wholesaler or estimated retail prices for products we may commercialize in the future, the
reporting of prices used to calculate Medicaid rebate information and other information affecting federal, state and third-party reimbursement
for products we may commercialize in the future, and the sale and marketing of products we may commercialize in the future, will be subject
to scrutiny under the FCA. State statutes and regulations equivalent or substantially similar to the federal laws may extend to items
and services reimbursed by commercial insurers and/or by patients directly. State law equivalents to the AKS and FCA
may not have adopted exceptions and safe harbors available at the federal level and therefore, may implicate a broader range of activities.
31
The Health Insurance
Portability and Accountability Act of 1996 (“HIPAA”) imposes criminal and civil liability for knowingly and willfully executing,
or attempting to execute, a scheme to defraud or obtain, by any means of false or fraudulent pretenses, representations or promises, any
money or property owned by, or under the control or custody of, any healthcare benefit program, including private third-party payors,
and knowingly and willfully falsifying, concealing or covering up by trick, scheme or device, a material fact or making any materially
false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items or services. The
federal physician payment transparency requirements, sometimes referred to as the “Sunshine Act,” created
under the ACA, and its implementing regulations, which requires applicable manufacturers of covered drugs, devices, biologics and medical
supplies for which payment is available under Medicare, Medicaid or the State Children’s Health Insurance Program (with certain
exceptions) to annually report to the Department of Health and Human Services (“HHS”), information related to certain payments
or other transfers of value made or distributed to physicians and teaching hospitals, or to entities or individuals at the request of,
or designated on behalf of, the physicians and teaching hospitals, as well as ownership and investment interests held by physicians and
their immediate family members. Under recent legislation, the Sunshine Act will extend to payments and transfers of value to physician
assistants, nurse practitioners, and other mid-level healthcare providers. The Centers for Medicare and Medicaid Services (“CMS”)
has the potential to impose penalties for violations of the Sunshine Act, depending on the circumstances, and payments reported under
the Sunshine Act also have the potential to draw scrutiny on payments to and relationships with physicians and teaching hospitals, which
may have implications under the AKS and other healthcare laws.
We may also be subject to
data privacy and security regulation by both the federal government and the state governments in which we conduct our business. HIPAA,
as amended by the Health Information Technology and Clinical Health Act of 2009 (“HITECH”) and their respective implementing
regulations, imposes, among other things, obligations, including mandatory contractual terms with respect to safeguarding the privacy,
security and transmission of individually identifiable health information held by certain healthcare providers, health plans and healthcare
clearinghouses, known as covered entities, and business associates. The HHS Office of Civil Rights (“OCR”) has increased its
focus on compliance and continues to train state attorneys general for enforcement purposes. Even where HIPAA does not apply, according
to the U.S. Federal Trade Commission (“FTC”), failing to take appropriate steps to keep consumers’ personal information
secure constitutes unfair acts or practices in or affecting commerce in violation of Section 5(a) of the Federal Trade Commission Act
(“FTCA”), 15 U.S. Code §45(a). Medical data is considered sensitive data that merits stronger safeguards. There are numerous
other laws and legislative and regulatory initiatives at the federal and state levels addressing privacy and security concerns, and some
state privacy laws apply in broader circumstances than HIPAA.
We are subject to the U.S.
Foreign Corrupt Practices Act (“FCPA”), which prohibits corporations and individuals from engaging in certain activities to
obtain or retain business or to influence a person working in an official capacity. Our present and future business has been and will
continue to be subject to various other laws and regulations.
32
ITEM
1A. RISK FACTORS
In
analyzing our company, you should consider carefully the following risk factors, together with all of the other information included
in this Annual Report on Form 10-K. Factors that could cause or contribute to differences in our actual results include those discussed
in the following subsection, as well as those discussed below in “Management’s Discussion and Analysis of Financial Condition
and Results of Operations” and elsewhere throughout this Annual Report on Form 10-K. The following are material factors that
make an investment in our company speculative or risky. The risks and uncertainties described below are not the only ones we face. Additional
risks not currently known to us or other factors not perceived by us to present significant risks to our business at this time also may
impair our business operations.
Summary
of Risk Factors
We
are providing the following summary of the risk factors contained in this Annual Report on Form 10-K to enhance the readability and accessibility
of our risk factor disclosures. We encourage you to carefully review the full risk factors contained in this Annual Report on Form 10-K
in their entirety for additional information regarding the material factors that make an investment in our securities speculative or
risky. These risks and uncertainties include, but are not limited to, the following:
●
We are a clinical-stage
company and have generated no revenue from commercial sales to date;
●
We have incurred net
losses every year since our inception and anticipate that we will continue to incur net losses in the future;
●
If we fail to obtain additional
financing, we will be unable to continue or complete our product development or product commercialization and you will likely lose
your entire investment;
●
We are highly dependent
on the clinical, regulatory and commercial success of ATNM-400, Actimab-A, Iomab-ACT, ATNM-400 and other pipeline candidates which
we may never achieve;
●
We are highly dependent on our key personnel, and the demand for talent
in the biotechnology industry is highly competitive; if we are not successful in attracting and retaining highly qualified personnel,
we may not be able to successfully implement or execute our business strategy;
●
We continuously evaluate
our business strategy and may modify our strategy as necessary to respond to developments in our business and other factors, and
any such modification such as a divestiture, spin-off, spin-out, merger or acquisition, if not successful, could have a material
adverse effect on our business, financial condition, and results of operations;
●
We may expand our business through the acquisition
of rights to new product candidates that could disrupt our business, harm our financial condition and may also dilute current stockholders’
ownership interests in our company;
●
Our business could be adversely
affected by the effects of future health epidemics;
●
Our business is subject
to cybersecurity risk;
●
We have not demonstrated
that any of our products are safe or effective for any indication and will continue to expend substantial time and resources on clinical
development before any of our current or future product candidates will be eligible for FDA approval, if ever;
●
Our clinical trials may
fail to demonstrate adequately the efficacy and safety of our product candidates, which would prevent or delay regulatory approval
and commercialization;
●
Preliminary, Interim, and
“top-line” data from our clinical trials that we announce or publish from time to time may change as more data become
available and are subject to audit and verification procedures that could result in material changes in the final data;
33
●
Healthcare legislative
reform measures intended to increase pressure to reduce prices of pharmaceutical products paid for by Medicare or, otherwise, affect
the regulation of the U.S. healthcare system could have a material adverse effect on our business, future revenue, if any, and results
of operations;
●
Changes in the healthcare
industry and in healthcare spending could adversely affect our grant funded clinical programs, business, financial condition and
results of operations;
●
We may rely on third parties
to conduct certain aspects of our clinical trials. If these third parties do not successfully carry out their contractual duties
or meet expected deadlines or comply with regulatory requirements, we may not be able to obtain regulatory approval for or commercialize
our product candidates;
●
We currently depend on
single third-party manufacturers to produce our pre-clinical and clinical trial drug supplies. Any disruption in the operations of
our current third-party manufacturers, or other third-party manufacturers we may engage in the future, could adversely affect our
business and results of operations;
●
Our product candidates
may cause undesirable side effects or have other properties that could halt their clinical development, prevent their regulatory
approval, limit their commercial potential, or result in significant negative consequences;
●
Disruptions at the FDA
and other government agencies caused by leadership changes, changes to regulatory approach, layoffs, funding shortages or global
health concerns could negatively impact our business;
●
Our ability to advance clinical development of trials under our CRADA,
obtain regulatory interactions/approvals, or secure government-funded grants may be delayed or disrupted by federal government shutdowns
such as the shutdown that began October 1, 2025 and ended on November 12, 2025, as it curtailed operations of key agencies such as the
FDA and the National Institutes of Health (“NIH”);
●
Our patent position is
highly uncertain and involves complex legal and factual questions;
●
The use of hazardous materials,
including radioactive and biological materials, in our research and development efforts imposes certain compliance costs on us and
may subject us to liability for claims arising from the use or misuse of these materials;
●
Certain provisions of our
Certificate of Incorporation and Bylaws and Delaware law make it more difficult for a third party to acquire us and make a takeover
more difficult to complete, even if such a transaction were in our stockholders’ interest; and
●
Our ability to utilize
our net operating loss carryforwards and certain other tax attributes may be limited.
Risks
Related to Our Business
We
are a clinical-stage company and have generated no revenue from commercial sales to date.
We
are a clinical-stage biopharmaceutical company with a limited operating history. We have no products approved for commercial sale and
have not generated any revenue from product sales to date. We will encounter risks and difficulties frequently experienced by early-stage
companies in rapidly evolving fields. If we do not address these risks successfully, our business will suffer.
34
We
have incurred net losses every year since our inception and anticipate that we will continue to incur net losses in the future.
We are not profitable and
have incurred losses in each period since our inception. As of December 31, 2025 and December 31, 2024, we had an accumulated deficit
of $409.7 million and $375.8 million, respectively. We reported a net loss of $33.9 million and $38.2 million for the years ended December
31, 2025 and 2024, respectively. We expect to continue to operate at a net loss as we continue our research and development efforts, continue
to conduct clinical trials and develop manufacturing, sales, marketing and distribution capabilities. There can be no assurance that the
products under development by us will be approved for sale in the United States or elsewhere. Furthermore, there can be no assurance that
if such products are approved, they will be successfully commercialized, which would have an adverse effect on our business prospects,
financial condition and results of operation.
If
we fail to obtain additional financing, we will be unable to continue or complete our product development and you will likely lose your
entire investment.
As
of the date of filing this report, we expect that our existing resources will be sufficient to fund our planned operations for more than
12 months following the date of this report.
Our
business or operations may change in a manner that would consume available funds more rapidly than anticipated and substantial additional
funding may be required to maintain operations, fund expansion, develop new or enhanced products, acquire complementary products, business
or technologies or otherwise respond to competitive pressures and opportunities, such as a change in the regulatory environment or a
change in preferred cancer treatment modalities. However, we may not be able to secure funding when we need it or on favorable terms
or indeed on any terms. In addition, from time to time, we may not be able to secure enough capital in a timely enough manner which may
cause the generation of a going-concern opinion from our auditors which can and may impair our stock market valuation and also our ability
to finance on favorable terms or indeed on any terms.
To
raise additional capital, we may in the future offer additional shares of our common stock or other securities convertible into or exchangeable
for our common stock. We cannot assure you that we will be able to sell shares or other securities in any other offering at a price per
share that is equal to or greater than the price per share paid by investors, and investors purchasing shares or other securities in
the future could have rights superior to existing stockholders.
If
we cannot raise adequate funds to satisfy our capital requirements, we will have to delay, scale back or eliminate our research and development
activities, clinical studies, or future operations. We may also be required to obtain funds through arrangements with collaborators,
which arrangements may require us to relinquish rights to certain technologies or products that we otherwise would not consider relinquishing,
including rights to future product candidates or certain major geographic markets. We may further have to license our technology to others.
This could result in sharing revenues which we might otherwise have retained for ourselves. Any of these actions may harm our business,
financial condition, and results of operations.
The
amount of funding we will need depends on many factors, including the progress, timing and scope of our product development programs;
the progress, timing and scope of our preclinical studies and clinical trials; the time and cost necessary to obtain regulatory approvals;
the time and cost necessary to further develop manufacturing processes and arrange for contract manufacturing; our ability to enter into
and maintain collaborative, licensing and other commercial relationships; and our partners’ commitment of time and resources to
the development and commercialization of our products.
We
have limited access to the capital markets and even if we can raise additional funding, we may be required to do so on unfavorable terms.
We
have limited access to the capital markets to raise funds. The capital markets have been unpredictable in the recent past for development
stage radiopharmaceutical and other biotechnology companies and unprofitable companies such as ours. In addition, it is generally difficult
for development-stage companies to raise capital under current market conditions. The amount of capital that a company such as ours is
able to raise often depends on variables that are beyond our control. As a result, we may not be able to secure financing on terms attractive
to us, or at all. If we are able to consummate a financing arrangement, the amount raised may not be sufficient to meet our future needs.
If adequate funds are not available on acceptable terms, or at all, our business, including our technology licenses, results of operations,
financial condition and our continued viability will be materially adversely affected.
35
We
are highly dependent on the clinical, regulatory and commercial success of ATNM-400, Actimab-A, Iomab-ACT, ATNM-400 and other pipeline
candidates which we may never achieve
None
of the drug candidates we are developing, or have developed, have received regulatory approval. Based on the current status of our pipeline
candidates, it will likely take several years and additional clinical studies before we can seek approval for any drug candidate.
ATNM-400 is currently being studied preclinically and has not yet been
studied in human subjects. There can be no assurances that we will advance ATNM-400 into clinical trials and even if we are successful
in doing so, our preclinical results to date may not translate in connection with human subjects. Our Actimab-A drug candidate was studied
in a Phase 2 clinical trial as a monotherapy, and we are now studying it in combination with other therapies. We believe we have aligned
with the FDA on a Phase 2/3 trial that is intended to support a BLA filing. There can be no assurance that the Phase 2 portion of the
trial will be successful and support advancing to the Phase 3 portion of the trial. In addition, our Iomab-ACT drug candidate has only
been studied in a limited number of human subjects in a Phase 1 trial with a novel CAR-T therapy. While we believe the initial results
from this trial were encouraging, there can be no assurance that future results with Iomab-ACT from the commercial CAR-T trial at UTSW
or sickle cell conditioning trial at Columbia will be positive.
As
for Iomab-B in particular, as previously disclosed, we completed the Phase 3 SIERRA trial (Study of Iomab-B in Elderly Relapsed
or Refractory AML) and presented the trial results in February 2023, which were expected to support a BLA filing. The SIERRA trial met
the primary endpoint of dCR with statistical significance (p-value<0.0001) but did not meet the secondary endpoint in achieving a
statistically significant improvement in OS in the intent to treat population. On August 5, 2024, we announced that the FDA determined
that the SIERRA trial alone is not adequate to support a BLA filing and is requiring an additional randomized head-to-head clinical trial
to demonstrate an OS benefit in an intent to treat population. Further, the FDA is also requiring an additional dose optimization trial
to calculate the dose of Iomab-B based on absorbed dose by the bone marrow, rather than the maximum tolerable dose of 24 Gy of radiation
to the liver as was done in the SIERRA trial based on several interactions with the FDA prior to the start of the SIERRA trial. Based
on this revised approach now required by the FDA, the safety and efficacy data generated from all Iomab-B studies, including the SIERRA
trial, are inadequate to seek regulatory approval for Iomab-B, as dosing based on maximum tolerable dose of 24 Gy to the liver will lead
to variable doses to the bone marrow (the target organ), result in underdosing or overdosing of patients and translate to a global patient
safety risk. We are seeking a strategic partner for the U.S. in order to conduct the additional studies required by the FDA; however,
we may not be successful in our efforts to find such a partner, or the trials and studies may not be successful. Further, there are no
assurances that we can satisfy all of the FDA’s requests, and there could be additional regulatory hurdles that may result in either
non-acceptance or non-approval of a future BLA filing. The U.S. commercial opportunity for Iomab-B may thus never be realized.
As
previously disclosed and noted above, Actinium has licensed to Immedica the exclusive product rights for commercialization of Iomab-B
in the EUMENA region. We are evaluating the impact of the FDA’s 2024 determination of the SIERRA trial results in the context of
global regulatory submissions for Iomab-B. At this time, filings for regulatory approval, obtaining regulatory approvals, and successful
commercialization of Iomab-B in the EUMENA region and on a global basis are highly uncertain and may never be realized.
36
We are highly dependent on our key personnel,
and if we are not successful in attracting and retaining highly qualified personnel, we may not be able to successfully implement our
business strategy.
Our future operations and
successes depend in large part upon the continued service of key members of our senior management team whom we are highly dependent upon
to manage our business. If any member of our current senior management terminates his or her employment with us and we are unable to find
a suitable replacement quickly, the departure could have a material adverse effect on our business.
In February 2026, Steve
O’Loughlin tendered his resignation as the Chief Financial Officer of our Company. To fill this executive vacancy, our Board
appointed Sandesh Seth, the current Chairman and Chief Executive Officer of the Company, to serve as our principal financial
officer. In the second quarter of 2025, we conducted a workforce optimization that reduced our headcount by approximately
fourteen percent and announced a strategic pipeline prioritization which led to further departures from the workforce in 2025. In the third quarter of 2024, our overall headcount was reduced
by approximately twenty percent, with a majority of departures coming from our clinical and CMC groups. We do not expect these
departures to have a material impact on our operations or ability to execute our operating plan and are actively seeking a strategic
partner for Actimab-A and Iomab-B in the U.S. to advance the registrational Phase 2/3 trials required by the FDA.
An overall tightening and
increasingly competitive labor market has been observed in the U.S. employment market generally. Specific to the biotechnology industry
in which we operate, there is significant demand and competition for highly specialized talent that we require. A sustained labor shortage
or increased turnover rates within our employee base as a result of general macroeconomic factors of force majeure events, or due
to dynamics within our industry, could lead to increased costs, such as increased wage rates to attract and retain employees, and could
negatively affect our ability to efficiently conduct our clinical development, R&D, business development and potential regulatory
and commercial activities. If we are unable to hire and retain employees capable of performing at a high-level, or if mitigation measures
we may take to respond to a decrease in labor availability, have unintended negative effects, our business could be adversely affected.
An overall labor shortage, lack of skilled labor, increased turnover or labor inflation, general macroeconomic factors or as a result
of biotechnology industry dynamics could have a material adverse impact on our operations, results of operations, liquidity or cash flows.
Our future success also depends
on our ability to identify, attract, hire, or engage, retain, and motivate other well-qualified managerial, technical, clinical and regulatory
personnel. This activity is likely to create additional demands on the time and attention of our senior management personnel as they identify,
hire, and train external and internal candidates to fill the sizable number of positions required to execute our business plans, including
submitting a BLA and building a commercial organization. The market for talent in our industry is very competitive. Many of the other
biopharmaceutical companies we compete against for qualified personnel have greater financial and other resources, more favorable risk
profiles and a longer operating history in the biopharmaceutical industry than we do. They also may provide more diverse opportunities
and better chances for career advancement. Some of these opportunities may be more appealing to high-quality candidates than what we have
to offer. There can be no assurance that such professionals will be available in the market, or that we will be able to retain existing
professionals or meet or continue to meet their compensation requirements. Furthermore, the cost base in relation to such compensation,
which may include equity compensation, may increase significantly, which could have a material adverse effect on us. Failure to establish
and maintain an effective management team and workforce could adversely affect our ability to operate, grow and manage our business.
37
Disruptions
at the FDA and other government agencies caused by government shutdowns, leadership changes, changes to regulatory approach, layoffs,
funding shortages or global health concerns could negatively impact our business
The ability of the FDA to review proposed clinical trials or approve
new products can be affected by a variety of factors, including government budget and funding levels, statutory, regulatory, and policy
changes, the FDA’s ability to hire and retain key personnel and accept the payment of user fees, and other events that may otherwise
affect the FDA’s ability to perform routine functions. In addition, government funding of other government agencies that fund research
and development activities is subject to the political process, including executive and congressional priorities, the impacts of which
are inherently fluid and unpredictable. Disruptions at the FDA and other agencies may slow the time necessary for new product candidates
to be reviewed and/or approved, which would adversely affect our business. In the recent past, the U.S. government shutdown on October
1, 2025 to November 12, 2025, which curtailed operations at key agencies such as the FDA and NIH. Based on this shutdown, we expect trials
under our CRADA with the NCI to be delayed. There can be no assurances that additional shutdowns will occur in the future or how long
such shutdowns may last. For example, over the last several years, including for 35 days beginning on December 22, 2018, the U.S. government
has shut down several times and certain regulatory agencies, such as the FDA, have had to furlough critical FDA employees and stop critical
activities. In addition, the current administration has enacted and continues to propose substantial reductions in force at various government
agencies including the FDA, which could significantly reduce the FDA’s capacity to perform its functions in a manner consistent
with its past practices and could delay reviews and negatively impact our business. There has been significant turnover and changes in
senior leadership at the FDA and other government agencies including the Center for Biologics Evaluation and Research (“CBER”),
which is the division of the FDA that would oversee and review biologics-based targeted radiotherapies like those we currently develop
and plan to continue to develop. We believe these changes could result in changes in the FDA’s perception of the approvability of
therapies, the perceived value of certain therapies or therapeutic modalities, which could create material challenges for our development
efforts. As of the date of this Report, there is significant uncertainty and risks associated with future FDA regulatory policies and
actions that could have a material negative impact on our business. Any or all of these factors could cause us to amend, suspend or terminate
the development of certain of our preclinical or clinical programs, which could have material adverse impacts on our business, our product
candidates or our ability to continue operations.
We
may be unable to establish sales, marketing and commercial supply capabilities.
We
do not currently have, nor have we ever had, commercial sales and marketing capabilities. If any of our product candidates ultimately
become approved and we do not secure a commercial partner, we would have to build and establish these capabilities in order to commercialize
our approved product candidates. The process of establishing commercial capabilities will be expensive and time consuming. Even if we
are successful in building sales and marketing capabilities, we may not be successful in commercializing any of our product candidates.
Any delays in commercialization or failure to successfully commercialize any product candidate may have material adverse impacts on our
business and ability to continue operations.
Our
business could be adversely affected by the effects of future health epidemics.
Our
business could be adversely impacted by the effects of future pandemics, epidemics or infectious disease outbreaks. The full impact of
such an event cannot be predicted at this time, and could depend on numerous factors, including vaccination rates among the population
and the response by governmental bodies and regulators. Given the ongoing and dynamic nature of the circumstances, it is difficult to
predict the impact of a future pandemic on our business.
A
future pandemic could adversely affect our clinical trial operations, including our ability to conduct the trials on the expected timelines
and recruit and retain patients and principal investigators and site staff who, as healthcare providers, may have heightened exposure
to a future pandemic if their geography is impacted by the pandemic. Further, future pandemics could result in delays in our clinical
trials due to prioritization of hospital resources toward the pandemic, restrictions in travel, potential unwillingness of patients to
enroll in trials, or the inability of patients to comply with clinical trial protocols if quarantines or travel restrictions are implemented
that impede patient movement or interrupt healthcare services. In addition, we rely on independent clinical investigators, contract research
organizations and other third-party service providers to assist us in managing, monitoring and otherwise carrying out our preclinical
studies and clinical trials, and a future pandemic may affect their ability 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 our ability to collect data from our clinical trials.
Additionally, a future pandemic may result in delays in receiving approvals
from local and foreign regulatory authorities, delays in necessary interactions with IRB, local and foreign regulators, ethics committees
and other important agencies and contractors due to limitations in employee resources or forced furlough of government employees.
38
Our
business is subject to cybersecurity risks.
Our
operations are increasingly dependent on information technologies and services. Threats to information technology systems associated
with cybersecurity risks and cyber incidents or attacks continue to grow, and include, among other things, storms and natural disasters,
terrorist attacks, utility outages, theft, viruses, phishing, malware, design defects, human error, and complications encountered as
existing systems are maintained, repaired, replaced, or upgraded. Risks associated with these threats include, among other things:
●
theft or misappropriation
of funds;
●
loss, corruption, or misappropriation
of intellectual property, or other proprietary, confidential or personally identifiable information (including supplier, clinical
data or employee data);
●
disruption or impairment
of our and our business operations and safety procedures;
●
damage to our reputation
with our potential partners, patients and the market;
●
exposure to litigation;
and
●
increased costs to prevent,
respond to or mitigate cybersecurity events.
Although
we utilize various procedures and controls to mitigate our exposure to such risk, cybersecurity attacks and other cyber events are evolving
and unpredictable. Moreover, we have no control over the information technology systems of third parties conducting our clinical trials,
our suppliers, and others with which our systems may connect and communicate. As a result, the occurrence of a cyber incident could go
unnoticed for a period time.
We
have cybersecurity insurance coverage in the event we become subject to various cybersecurity attacks, however, we cannot ensure that
it will be sufficient to cover any particular losses we may experience as a result of such cyberattacks. Any cyber incident could have
a material adverse effect on our business, financial condition and results of operations.
Risks
Related to Regulation
The
FDA, EMA or comparable foreign regulatory authorities may disagree with our regulatory plans and we may fail to obtain regulatory approval
of our product candidates.
Our
products are subject to rigorous regulation by the FDA, EMA and numerous other federal, state and foreign governmental authorities. The
process of seeking regulatory approval to market an antibody radiation-conjugate product is expensive and time-consuming, and, notwithstanding
the effort and expense incurred, approval is never guaranteed. If we are not successful in obtaining timely approval of our products
from the regulators, we may never be able to generate significant revenue and may be forced to cease operations. In particular, the FDA
permits commercial distribution of a new antibody radiation-conjugate product only after a BLA for the product has received FDA approval.
The BLA process is costly, lengthy and inherently uncertain. Any BLA filed by us will have to be supported by extensive data, including,
but not limited to, technical, preclinical, clinical trial, chemistry, manufacturing and controls and labeling data, to demonstrate to
the FDA’s satisfaction the safety and efficacy of the product for its intended use. The lengthy approval process as well as the
unpredictability of future clinical trial results may result in our failing to obtain regulatory approval to market our product candidates,
which would significantly harm our business, results of operations and prospects. In addition, even if we were to obtain approval, regulatory
authorities may approve any of our product candidates for fewer or more limited indications than we request, may not obtain the price
we intend to charge for our products, may grant approval contingent on the performance of costly post-marketing clinical trials, or may
approve a product candidate with a label that does not include the labeling claims necessary or desirable for the successful commercialization
of that product candidate. Any of the foregoing scenarios could materially harm the commercial prospects for our product candidates.
39
For
instance, as for Iomab-B, despite the Phase SIERRA 3 trial meeting the primary endpoint of durable Complete Remission (dCR) with statistical
significance (p-value<0.0001), the FDA has determined that demonstrating an OS benefit in a randomized head-to-head trial is required
for a BLA filing. In addition, the FDA is also requiring that an additional dose optimization trial demonstrating safety and efficacy
be completed to calculate the dose of Iomab-B based on absorbed dose by the bone marrow, rather than the maximum tolerable dose of 24
Gy of radiation to the liver as was done in the SIERRA trial based on several interactions we had with the FDA before starting the SIERRA
trial. The head-to-head Phase 3 trial will evaluate allogeneic bone marrow transplant (BMT) using Iomab-B plus a reduced intensity conditioning
regimen of fludarabine and total body irradiation (Flu/TBI) versus allogeneic BMT using reduced intensity conditioning comprised of cyclophosphamide
plus Flu/TBI. This is different from the SIERRA trial, which allowed physician’s choice of salvage therapies and heterogenous conditioning
regimens in the control arm. However, there are no assurances that the additional trials will be completed or successful or that we can
satisfy all of the FDA’s requests. There could also be additional regulatory hurdles that may result in either non-acceptance or
non-approval of a future BLA filing.
As previously disclosed and noted above, Actinium has licensed to Immedica
the exclusive product rights for commercialization of Iomab-B in the Europe, Middle East, and North Africa (EUMENA) region. We are evaluating
the impact of the FDA’s 2024 determination of the SIERRA trials results referred to above in the context of global regulatory submission
for Iomab-B. At this time, filings for regulatory approval, obtaining regulatory approvals, and successful commercialization of Iomab-B
in the EUMENA region and on a global basis are highly uncertain and may never be realized.
We
are also evaluating Iomab-ACT, which uses a lower dose I-131 for conditioning prior to cellular therapies such as CAR-T and gene therapies.
We are currently studying Iomab-ACT in three clinical trials including two investigator sponsored studies.
Our
Actimab-A (lintuzumab-Ac-225) product candidate has also been studied in several Phase 1 and 2 trials under our sponsorship and investigator-initiated
trials in patients with r/r AML and we plan to continue to study Actimab-A in clinical trials. Actimab-A is also being developed under
a cooperative research and development agreement (CRADA) with the National Cancer Institute (NCI) and we expect clinical trials to be
initiated that will study Actimab-A as a single agent or in combination with other therapies. Product candidates utilizing the lintuzumab
antibody would require BLA approval before they can be marketed in the United States. We are in the early stages of evaluating other
product candidates consisting of conjugates of Ac-225 with human or humanized antibodies for pre-clinical and clinical development in
other types of cancer such as ATNM-400. The FDA may not approve these products for the indications that are necessary or desirable for
successful commercialization. The FDA may fail to approve any IND, BLA or NDA we submit for new product candidates or for new intended
uses or indications for approved products or future product candidates. Failure to obtain FDA approval for our products in the proposed
indications would have a material adverse effect on our business prospects, financial condition and results of operations.
The
approval process in the United States and in other countries could result in unexpected and significant costs for us and consume management’s
time and other resources. The FDA, EMA and other foreign regulatory agencies could ask us to supplement our submissions, collect non-clinical
data, conduct additional clinical trials or engage in other time-consuming actions, or it could simply deny our applications. In addition,
even if we obtain approval to market our products in the United States or in other countries, the approval could be revoked, or other
restrictions imposed if post-market data demonstrates safety issues or lack of effectiveness. We cannot predict with certainty how, or
when, the FDA, EMA or other regulatory authorities will act. If we are unable to obtain the necessary regulatory approvals, our financial
condition and cash flow may be materially adversely affected, and our ability to grow domestically and internationally may be limited.
Additionally, even if we obtain approval, regulatory authorities may approve any of our product candidates for fewer or more limited
indications that we request. The Company’s products may not be approved for the specific indications that are most necessary or
desirable for successful commercialization or profitability.
40
Disruptions at the FDA and other agencies may slow the time necessary
for new product candidates to be reviewed and/or approved, which would adversely affect our business and may cause us to amend our business
strategy or. From October 1, 2025 until November 12, 2025, the U.S federal government was shutdown, which curtailed operations of key
agencies such as the FDA and the NIH. Our ability to advance clinical development, obtain regulatory interactions/approvals, or secure
government-funded grants may be delayed or disrupted by the aformentioned federal government shutdown. For example, the NCI with whom
we have a CRADA with for the development of Actimab-A was not operating during the shutdown. As a result, trials active and planned under
our CRADA are expected to be delayed. For example, over the last several years, including for 35 days beginning on December 22, 2018,
the U.S. government has shut down several times and certain regulatory agencies, such as the FDA, have had to furlough critical FDA employees
and stop critical activities. In addition, the current administration has enacted and continues to propose substantial reductions in force
at various government agencies including the FDA, which could significantly reduce the FDA’s capacity to perform its functions in
a manner consistent with its past practices and could delay reviews and negatively impact our business. There has been significant turnover
and changes in senior leadership at the FDA and other government agencies including the Center for Biologics Evaluation and Research (“CBER”),
which is the division of the FDA that would oversee and review biologics based targeted radiotherapies like those we currently develop
and plan to continue to develop. We believe these changes could result in changes in the FDA’s perception of the approvability of
therapies, the perceived value of certain therapies or therapeutic modalities, which could create material challenges for our development
efforts. At this time, there is significant uncertainty and risks associated with future FDA regulatory policies and actions that could
have a material negative impact on our business. Any or all of these factors could cause us to amend, suspend or terminate the development
of certain of our preclinical or clinical programs, which could have material adverse impacts on our business, our product candidates
or our ability to continue operations.
We
have not demonstrated that any of our products are safe or effective for any indication and will continue to expend substantial time
and resources on clinical development before any of our current or future product candidates will be eligible for FDA approval, if ever.
We
expect that a substantial portion of our efforts and expenditures over the next few years will be devoted to development of our existing
and contemplated biological product candidates. Accordingly, our business currently depends heavily on the successful development, FDA
approval, and commercialization of such candidates, which may never receive FDA approval or be successfully commercialized even if FDA
approval is received. The research, testing, manufacturing, labeling, approval, sale, marketing, and distribution of our biological product
candidates are, and will remain, subject to extensive regulation by the FDA and other regulatory authorities in the United States and
other countries, as applicable. We are currently not permitted to market any of our current or future product candidates in the United
States until we receive FDA approval (of each) via the BLA process. To date, we have three product candidates in clinical development
and have not-yet submitted a BLA for any of our candidates and, for many such candidates, do not expect to be in a position to do so
for the foreseeable future, as there are numerous developmental steps that must be completed before we can prepare and submit a BLA.
In
the United States, the FDA regulates pharmaceutical and biological product candidates under the Federal Food, Drug, and Cosmetic Act
(“FDCA”) and the Public Health Service Act (“PHSA”), as well as their respective implementing regulations. Such
products and product candidates are also subject to other federal, state, and local statutes and regulations. The process of obtaining
regulatory approvals and the subsequent compliance with appropriate federal, state, local, and foreign statutes and regulations requires
the expenditure of substantial time and financial resources. The process required by the FDA before a drug or biological product may
be marketed in the United States generally involves the following:
●
completion of preclinical
laboratory tests and animal studies in accordance with FDA’s good laboratory practices (“GLPs”) and applicable
requirements for the humane use of laboratory animals or other applicable regulations;
●
submission to the FDA of
an Investigational New Drug (“IND”) application, which must become effective before human clinical trials in the United
States may begin;
●
performance of adequate
and well-controlled human clinical trials in accordance with FDA’s IND regulations, good clinical practices (“GCPs”),
and any additional requirements for the protection of human research subjects and their health information, to establish the safety
and efficacy of the proposed biological product for its intended use;
●
submission to the FDA of
a BLA for marketing approval that meets applicable requirements to ensure the continued safety, purity, and potency of the product
that is the subject of the BLA based on results of preclinical testing and clinical trials;
41
●
satisfactory completion
of an FDA inspection of the manufacturing facility or facilities where the biological product is produced, to assess compliance with
current good manufacturing practices (“cGMPs”) and assure that the facilities, methods and controls are adequate to preserve
the biological product’s identity, strength, quality and purity;
●
potential FDA audit of
the nonclinical study and clinical trial sites that generated the data in support of the BLA; and
●
FDA review and approval,
or denial, of the BLA.
Before
testing any biological product candidate in humans, the product candidate enters the preclinical testing stage. Preclinical tests include
laboratory evaluations of product chemistry, toxicity and formulation, as well as animal studies to assess the potential safety and activity
of the product candidate. The conduct of the preclinical tests must comply with federal regulations and requirements including GLPs.
The clinical trial sponsor must submit the results of the preclinical tests, together with manufacturing information, analytical data,
any available clinical data or literature and a proposed clinical protocol, to the FDA as part of the IND application. Some preclinical
testing may continue even after the IND application is submitted. The IND application automatically becomes effective 30 days after receipt
by the FDA, unless the FDA raises concerns or questions regarding the proposed clinical trials and places the trial on a clinical hold
within that 30-day time period. In such a case, the IND sponsor and the FDA must resolve any outstanding concerns before the clinical
trial can begin. The FDA may also impose clinical holds on a biological product candidate at any time before or during clinical trials
due to safety concerns or non-compliance. If the FDA imposes a clinical hold, trials may not recommence without FDA authorization and
then only under terms authorized by the FDA. Accordingly, we cannot be sure that submission of an IND application will result in the
FDA allowing clinical trials to begin or that, for those that have already commenced under an active IND application, that issues will
not arise that suspend or terminate such trials.
Clinical trials involve the administration of the biological product
candidate to healthy volunteers or patients under the supervision of qualified investigators, generally physicians not employed by or
under the trial sponsor’s control. Clinical trials are conducted under protocols detailing, among other things, the objectives of
the clinical trial, dosing procedures, subject selection and exclusion criteria, and the parameters to be used to monitor subject safety,
including stopping rules that assure a clinical trial will be stopped if certain adverse events should occur. Each protocol and any amendments
to the protocol must be submitted to the FDA as part of the IND application. Clinical trials must be conducted and monitored in accordance
with the FDA’s regulations composing the GCP requirements, including the requirement that all research subjects provide informed
consent. Further, each clinical trial must be reviewed and approved by an IRB, at or servicing each institution at which the clinical
trial will be conducted. An IRB is charged with protecting the welfare and rights of trial participants and considers such items as whether
the risks to individuals participating in the clinical trials are minimized and are reasonable in relation to anticipated benefits. The
IRB also approves the form and content of the informed consent that must be signed by each clinical trial subject or his or her legal
representative and must monitor the clinical trial until completed. Human clinical trials are typically conducted in three sequential
phases that may overlap or be combined:
●
Phase 1. The biological
product is initially introduced into healthy human subjects and tested for safety. In the case of some products for severe or life-threatening
diseases, especially when the product may be too inherently toxic to ethically administer to healthy volunteers, the initial human
testing is often conducted in subjects.
●
Phase 2. The biological
product is evaluated in a limited patient population to identify possible adverse effects and safety risks, to preliminarily evaluate
the efficacy of the product for specific targeted diseases and to determine dosage tolerance, optimal dosage and dosing schedule.
●
Phase 3. Clinical trials
are undertaken to further evaluate dosage, clinical efficacy, potency, and safety in an expanded patient population at geographically
dispersed clinical trial sites. These clinical trials are intended to establish the overall risk to benefit ratio of the product
and provide an adequate basis for product labeling.
42
Post-approval
clinical trials, sometimes referred to as Phase 4 clinical trials, may be conducted after initial marketing approval. These clinical
trials are used to gain additional experience from the treatment of patients in the intended therapeutic indication, particularly for
long-term safety follow-up.
After
the completion of clinical trials of a biological product, FDA approval of a BLA must be obtained before commercial marketing of the
biological product. The BLA must include results of product development, laboratory and animal studies, human trials, information on
the manufacture and composition of the product, proposed labeling and other relevant information. The FDA may grant deferrals for submission
of data, or full or partial waivers. The testing and approval processes require substantial time and effort and there can be no assurance
that the FDA will accept the BLA for filing and, even if filed, that any approval will be granted on a timely basis, if at all. Before
approving a BLA, the FDA will inspect the facilities at which the product is manufactured. The FDA will not approve the product unless
it determines that the manufacturing processes and facilities are in compliance with cGMP requirements and adequate to assure consistent
production of the product within required specifications. Additionally, before approving a BLA, the FDA will typically inspect one or
more clinical sites to assure that the clinical trials were conducted in compliance with IND trial requirements and GCP requirements.
To assure cGMP and GCP compliance, an applicant must incur significant expenditure of time, money and effort in the areas of training,
record keeping, production, and quality control.
Notwithstanding
the submission of relevant data and information, the FDA may ultimately decide that the BLA does not satisfy its regulatory criteria
for approval and deny approval. Data obtained from clinical trials are not always conclusive and the FDA may interpret data differently
than we interpret the same data. We cannot predict with any certainty if or when we might submit a BLA for regulatory approval for our
product candidates or whether any such BLA will be approved by the FDA. Human clinical trials are very expensive and difficult to design
and implement, in part because they are subject to rigorous regulatory requirements. For example, the FDA may not agree with our proposed
endpoints for any clinical trial we propose, which may delay the commencement of our clinical trials. The clinical trial process is also
lengthy and requires substantial time, effort and expense.
We
expect that the clinical trials we need to conduct to be in a position to submit BLAs for our product candidates currently in-development
will take, at least, several years to complete. Moreover, failure can occur at any stage of the trials, and we could encounter problems
that cause us to abandon or repeat clinical trials. Also, the results of early preclinical and clinical testing may not be predictive
of the results of subsequent clinical trials. A number of companies in the biopharmaceutical industry have suffered significant setbacks
in advanced clinical trials due to lack of efficacy or adverse safety profiles, notwithstanding promising results in earlier studies,
and preclinical and clinical data are often susceptible to multiple interpretations and analyses. Many companies that have believed their
product candidates performed satisfactorily in preclinical studies and clinical trials have, nonetheless, failed to obtain marketing
approval of their products. Success in preclinical testing and early clinical trials does not ensure that later clinical trials, which
involve many more subjects, and the results of later clinical trials may not replicate the results of prior clinical trials and preclinical
testing. Any failure or substantial delay in our product development plans may have a material adverse effect on our business.
We
may encounter substantial delays in our clinical trials or may not be able to conduct our trials on the timelines we expect.
We
cannot predict whether we will encounter problems with any of our ongoing or planned clinical trials that will cause us or regulatory
authorities to delay, suspend, or discontinue clinical trials or to delay the analysis of data from ongoing clinical trials. Any of the
following could delay or disrupt the clinical development of our product candidates and potentially cause our product candidates to fail
to receive regulatory approval:
●
conditions imposed on us
by the FDA or comparable foreign authorities regarding the scope or design of our clinical trials;
●
delays in receiving, or
the inability to obtain, required approvals from IRBs or other reviewing entities at clinical sites selected for participation in
our clinical trials;
●
delays in enrolling patients
into clinical trials;
43
●
a lower than anticipated
retention rate of patients in clinical trials;
●
the need to repeat or discontinue
clinical trials as a result of inconclusive or negative results or unforeseen complications in testing or because the results of
later trials may not confirm positive results from earlier preclinical studies or clinical trials;
●
inadequate supply, delays
in distribution, deficient quality of, or inability to purchase or manufacture drug product, comparator drugs or other materials
necessary to conduct our clinical trials;
●
unfavorable FDA or other
foreign regulatory inspection and review of a clinical trial site or records of any clinical or preclinical investigation;
●
serious and unexpected
drug-related side effects experienced by participants in our clinical trials, which may occur even if they were not observed in earlier
trials or only observed in a limited number of participants;
●
a finding that the trial
participants are being exposed to unacceptable health risks;
●
Funding cuts to the NCI,
which could delay and/or pauses or termination of our ongoing and planned clinical trials under our CRADA;
●
the placement by the FDA
or a foreign regulatory authority of a clinical hold on a trial; or
●
delays in obtaining regulatory
agency authorization for the conduct of our clinical trials.
We
may suspend, or the FDA or other applicable regulatory authorities may require us to suspend, clinical trials of a product candidate
at any time if we or they believe the patients participating in such clinical trials, or in independent third-party clinical trials for
drugs based on similar technologies, are being exposed to unacceptable health risks including but not limited to unacceptable or suboptimal
factors related to toxicity, clinical efficacy, imbalances in safety and efficacy profiles or for other reasons.
Further,
individuals involved with our clinical trials may serve as consultants to us from time to time and receive stock options or cash compensation
in connection with such services. If these relationships and any related compensation to the clinical investigator carrying out the study
result in perceived or actual conflicts of interest, or the FDA concludes that the financial relationship may have affected interpretation
of the study, the integrity of the data generated at the applicable clinical trial site may be questioned and the utility of the clinical
trial itself may be jeopardized. The delay, suspension or discontinuation of any of our clinical trials, or a delay in the analysis of
clinical data for our product candidates, for any of the foregoing reasons, could adversely affect our efforts to obtain regulatory approval
for and to commercialize our product candidates, increase our operating expenses and have a material adverse effect on our financial
results.
Clinical
trials may also be delayed or terminated as a result of ambiguous or negative interim results. In addition, a clinical trial may be suspended
or terminated by us, the FDA, the IRBs at the sites where the IRBs are overseeing a trial, or a data safety monitoring board, or DSMB
(Data Safety Monitoring Board)/DMC (Data Monitoring Committee), overseeing the clinical trial at issue, or other regulatory authorities
due to a number of factors, including:
●
failure to conduct the
clinical trial in accordance with regulatory requirements or our clinical protocols;
●
inspection of the clinical
trial operations or trial sites by the FDA or other regulatory authorities resulting in the imposition of a clinical hold;
●
varying interpretation
of data by the FDA or similar foreign regulatory authorities;
●
failure to achieve primary
or secondary endpoints or other failure to demonstrate efficacy;
●
unforeseen safety issues;
or
●
lack of adequate funding
to continue the clinical trial.
44
Modifications
to our product candidates may require federal approvals.
The
BLA application is the vehicle through which the company may formally propose that the FDA approve a new pharmaceutical for sale and
marketing in the United States. Once a particular product candidate receives FDA approval, expanded uses or uses in new indications of
our products may require additional human clinical trials and new regulatory approvals, including additional IND and BLA submissions
and premarket approvals before we can begin clinical development, and/or prior to marketing and sales. If the FDA requires new approvals
for a particular use or indication, we may be required to conduct additional clinical studies, which would require additional expenditures
and harm our operating results. If the products are already being used for these new indications, we may also be subject to significant
enforcement actions.
Conducting
clinical trials and obtaining approvals is a time-consuming process, and delays in obtaining required future approvals could adversely
affect our ability to introduce new or enhanced products in a timely manner, which in turn would have an adverse effect on our business
prospects, financial condition and results of operation.
Clinical
trials necessary to support approval of our product candidates are time-consuming and expensive.
Initiating
and completing clinical trials necessary to support FDA approval of a BLA for ATNM-400, Actimab-A, Iomab-ACT, Iomab-B, and other product
candidates, is a time-consuming and expensive process, and the outcome is inherently uncertain. Moreover, the results of early clinical
trials are not necessarily predictive of future results, and any product candidate we advance into clinical trials may not have favorable
results in later clinical trials.
For
instance, we worked with the FDA to develop the SIERRA clinical trial to test the safety and efficacy of Iomab-B in patients with r/r
AML who are aged 55 and above prior to a BMT. Even though the SIERRA trial met the primary endpoint of dCR with statistical significance
(p-value<0.0001), the FDA has determined that the analyses from the SIERRA trial do not support a BLA filing for Iomab-B. The FDA
now requires an additional head-to-head Phase 3 clinical study. We have further discussed the specifics of this additional clinical trial
with the FDA. Based on these discussions, Actinium believes it has aligned with the FDA on the patient population for this additional
clinical trial, which can include all adult patients aged 18 and above with active AML with blasts counts greater than 5% and less than
20%. This is a broader patient population than the patients enrolled on the SIERRA trial, which only enrolled patients aged 55 and above.
Further, the FDA is also requiring that an additional dose optimization trial demonstrating safety and efficacy be completed to calculate
the dose of Iomab-B based on absorbed dose by the bone marrow, rather than the maximum tolerable dose of 24 Gy of radiation to the liver
as was done in the SIERRA trial based on several interactions we had with the FDA before starting the SIERRA trial. We are seeking a
strategic partner for Iomab-B in the U.S. to advance these additional trials. Even if we are able to secure a partner, there are no assurances
that the additional trials will be successful or that we can satisfy all of the FDA’s requests. There could also be additional
regulatory hurdles that may result in either non-acceptance or non-approval of a future BLA.
Preliminary,
Interim, and “top-line” data from our preclinical studies and clinical trials that we announce or publish from time to time
may change as more patient data become available and are subject to audit and verification procedures that could result in material changes
in the final data.
From
time to time, we may publicly disclose preliminary, interim, and top-line data from our clinical trials, which is based on a preliminary
analysis of then-available data, and the results and related findings and conclusions are subject to change as more patient data become
available or following a more comprehensive review of the data related to the particular study or trial. We may also make assumptions,
estimations, calculations and conclusions as part of our analyses of data, and we may not have received or had the opportunity to fully
and carefully evaluate all data. Our clinical trials may be open label studies and certain of our clinical development and/or operations
staff may review interim or preliminary safety or efficacy data during routine data collection, cleaning and analysis from time to time.
Interim or preliminary results that we report may differ from future results of the same studies, or different conclusions or considerations
may qualify such results once additional data have been received and fully evaluated. Preliminary, interim or top-line data also remain
subject to audit and verification procedures that may result in the final data being materially different from the top-line, interim
or preliminary data we previously published. As a result, top-line, interim and preliminary data should be viewed with caution until
the final data are available.
45
From
time to time, we may also disclose interim data from our preclinical studies and clinical trials. Interim data from preclinical studies
are not necessarily predictive of future success in clinical trials. Interim data from clinical trials that we may complete are subject
to the risk that one or more of the clinical outcomes may materially change as patient enrollment continues and more patient data become
available. Adverse differences between interim data and final data could significantly harm our business prospects. Further, disclosure
of interim data by us or by our competitors could result in volatility in the price of our common stock.
Further,
others, including regulatory agencies, may not accept or agree with our assumptions, estimates, calculations, conclusions, or analyses
or may interpret or weigh the importance of data differently, which could impact the value of the particular program, the approvability
or commercialization of the particular product candidate or product and our company in general. In addition, the information we choose
to publicly disclose regarding a particular study or clinical trial is based on what is typically extensive information, and you or others
may not agree with what we determine is material or otherwise appropriate information to include in our disclosure.
If
the interim, top-line or preliminary data that we report differ from final results, or if others, including regulatory authorities, disagree
with the conclusions reached, our ability to obtain approval for, and commercialize, our product candidates may be harmed, which could
harm our business, operating results, prospects or financial condition.
Even
if our preclinical studies or early clinical trials are favorable, later clinical trials may fail to demonstrate adequately the efficacy
and safety of our product candidates, which would prevent or delay regulatory approval and commercialization.
Even
if our preclinical studies are favorable and our clinical trials are completed as planned, we cannot be certain that their results will
support our product candidate claims or that the FDA or foreign authorities will agree with our conclusions regarding them. Success in
pre-clinical studies and early clinical trials does not ensure that later clinical trials will be successful, and we cannot be sure that
the later trials will replicate the results of prior trials and pre-clinical studies. The clinical trial process may fail to demonstrate
that our product candidates are safe and effective for the proposed indicated uses. If the FDA concludes that any current or future clinical
trials for ATNM-400, Actimab-A, Iomab-ACT, Iomab-B or any other product candidate for which we might seek approval, have failed to demonstrate
safety and effectiveness, we would not receive FDA approval to market that product candidate in the United States for the indications
sought. In addition, such an outcome could cause us to abandon the product candidate and might delay the development of others. Any delay
or termination of our clinical trials will delay or preclude the filing of any submissions with the FDA and, ultimately, our ability
to commercialize our product candidates and generate revenues. It is also possible that patients enrolled in clinical trials will experience
adverse side effects that are not currently part of a product candidate’s profile.
The
intellectual property related to certain antibodies we have licensed has expired or likely expired.
The
key patents related to the humanized antibody lintuzumab, which we use in our Actimab-A product candidate, have expired. It is generally
possible that others may be eventually able to use an antibody with the same sequence, and we will then need to rely on additional patent
protection covering alpha particle drug products comprising Ac-225. Our final drug construct, Actimab-A, consists of the lintuzumab antibody
labeled with the isotope Ac-225. We currently own issued and pending patents relating to methods of manufacturing Actimab-A, methods
of treatment using Actimab-A and production of the Ac-225 isotope. In addition, we possess trade secrets and know how related to the
manufacturing and use of isotopes. Any competing product based on the lintuzumab antibody is likely to require several years of development
before achieving our product candidate’s current status and may be subject to significant regulatory hurdles, but such development
by others is nevertheless a possibility that could negatively impact our business in the future. We own 4 issued U.S. patents, 2 issued
Canadian patents, 2 issued European patent (each validated as a national patent in several countries) and 1 issued Japanese patent that
relate to the composition of our Iomab-B product candidate. Patent applications relating to Iomab-B are also pending in the U.S. and
internationally. We have and may continue to file patents related to Iomab-B that can provide barriers to entry but there is no certainty
that these patents will be granted or such granting thereof will adequately prevent others from seeking to replicate and use the apamistamab
antibody or the construct. Our patent portfolio includes pending applications related to radioimmunoconjugate composition, formulation
administration, and methods of use in treating solid or liquid cancers. This subject matter includes composition, administration, and
methods of treatment for our product candidates Actimab-A and Iomab-B. Any competing product based on the antibody used in Iomab-B is
likely to require several years of development before achieving our product candidate’s current status and may be subject to significant
regulatory hurdles. Further, if approved, Iomab-B would be entitled to 12 years of market exclusivity in the U.S. and 10 years in Europe,
during which time no generic biologic or biosimilar product referencing Iomab-B can be granted marketing approval.
46
Our
Actimab-A program clinical trials are testing the same drug construct.
Our
Actimab-A program is comprised of several clinical trials conducted under the CRADA with NCI, Actinium sponsored trials, investigator-initiated
trials in AML and other myeloid indications and solid tumors that will study the same drug construct consisting of lintuzumab-Ac-225.
Negative results from any of these trials could adversely impact our ability to enroll or complete our other trials studying lintzumab-Ac-225,
including future studies conducted under our CRADA with the NCI. Additionally, negative outcomes including safety concerns, may result
in the FDA requiring amendment to certain clinical trials, placing a clinical hold on certain or all clinical trials or discontinuing
other trials utilizing lintuzumab-Ac-225.
We
are currently developing, and in the future may develop, product candidates in combination with other therapies and that may expose us
to additional risks.
We
are currently developing, and may develop future product candidates, for use in combination with one or more currently approved therapies.
For example, Actimab-A is expected to be tested in combination with KEYTRUDA ® and OPDIVO ® for treating
HNSCC and NSCLC. If any of the approved therapies we currently or may, in the future, use in combination with a current or future product
candidate is found defective, removed from the market, or otherwise becomes unavailable, our clinical trials may face significant delays,
be suspended, or terminated. Any such events would likely have a material impact on our operations and the development of the affected
product candidate(s) and may ultimately prevent the approval of such product candidate or render continued development efforts too costly
to proceed.
Even
if a current or future product candidate were to receive FDA approval to be commercialized in the U.S. for use in combination with one
or more existing therapies, we would continue to be subject to the risk that the FDA or similar foreign regulatory authorities could
revoke approval of the therapy used in combination with our product candidate or that safety, efficacy, manufacturing or supply issues
could arise with any such existing therapies. This could result in our own products being removed from the market or cause material delays
in, or the suspension or discontinuation, of our production and/or distribution of the applicable product, as our ability to market any
such product will be limited to the extent specified in the FDA’s approval, if granted.
We
may be unable to obtain a sufficient supply of isotopes to support clinical development or at commercial scale.
Iodine-131
is a key component of our Iomab-B drug candidate. We source medical grade I-131 from multiple suppliers, including two leading global
manufacturers. Currently, we believe there is sufficient supply of I-131 to support additional trials we may undertake utilizing I-131
and for future commercialization of potential I-131 based products. We continually evaluate I-131 manufacturers and suppliers. While
we consider I-131 to be commoditized and obtainable through several suppliers, there can be no guarantee that we will be able to secure
I-131 or obtain I-131 on terms that are acceptable to us.
Actinium-225
is a key component of our Actimab-A product candidate, technology platform, preclinical R&D programs including ATNM-400 and other
drug candidates that we might consider for development with the Ac-225 payload. We have secured multiple suppliers that are expected
to provide cGMP Ac-225 for our planned clinical trials. There are adequate quantities of Ac-225 available today to meet our current needs
via our present supplier, the Department of Energy (“DOE”), who has been our primary supplier of Ac-225 historically. The
Ac-225 currently supplied for our clinical trials from the DOE is derived from the natural decay of thorium-229 from so-called ‘thorium-cows’
and is able to produce sufficient quantities that are several multiples of the amount of Ac-225 we require to supply our clinical programs
through to the early commercialization phase. The DOE is also producing Ac-225 from a recently developed alternative route for Ac-225
production via a linear accelerator that is currently being evaluated by us. Initial preclinical and modelling results have indicated
that the linear accelerator sourced Ac-225 does not impact labelling efficiency and expected distribution. In accordance with representations
made by the DOE, the capacity of Ac-225 from this route is expected to be sufficient to supply all of Actinium’s pipeline and commercial
Ac-225 needs and support new program expansion by not just Actinium but also other companies that are developing Ac-225 based products.
Additional routes of Ac-225 production are being pursued by the DOE including the generation of new thorium cows and production via a
cyclotron. The cyclotron production method for Ac-225 production leverages Actinium’s proprietary technology and know-how and presents
an additional path towards production of high-quality Ac-225 at a scale that would be able to satisfy commercial needs. In addition,
we are aware of at least ten other government and non-government entities globally including the U.S., Canada, Russia, Belgium, France
and Japan that have, or expect to have, ability to supply Ac-225 or equipment for its production within the timeframes relevant to the
potential first commercial approval of our Ac-225-based drug candidate.
47
Our
contract for supply of this isotope from the DOE must be renewed yearly, and we renewed our contract to extend through the end of 2025.
While we expect this contract will continue to be renewed at the end of its term as it has since 2009, there can be no assurance that
the DOE will renew the contract or that change its policies that allow for the sale of isotope to us. There can be no assurance that
the DOE or our other suppliers will be able to supply all of the quantities of Ac-225 we request in the future. Failure to acquire sufficient
quantities of medical grade Ac-225 would make it impossible to effectively complete clinical trials and to commercialize any Ac-225 based
drug candidates that we may develop and would materially harm our business.
Our
ability to conduct clinical trials to advance our drug candidates is dependent on our ability to obtain the radioisotopes I-131, Ac-225
and other isotopes we may choose to utilize in the future. Currently, we are dependent on third party manufacturers and suppliers for
our isotopes. These suppliers may not perform their contracted services or may breach or terminate their agreements with us. Our suppliers
are subject to regulations and standards that are overseen by regulatory and government agencies and we have no control over our suppliers’
compliance to these standards. Failure to comply with regulations and standards may result in their inability to supply isotopes and
could result in delays in our clinical trials, which could have a negative impact on our business. We have developed intellectual property,
know-how and trade secrets related to the manufacturing process of Ac-225. While we have manufactured medical grade Ac-225 of a purity
compared to the cyclotron sourced material in the past, this activity was terminated due to operating cost reasons, and we currently
do not have experience in manufacturing medical grade Ac-225 and may not obtain the resources necessary to establish our own manufacturing
capabilities in the future. Our inability to build out and establish our own manufacturing facilities would require us to continue to
rely on third party suppliers as we currently do. However, based on our current third-party suppliers and potential future suppliers
of Ac-225 we expect to have adequate isotope supply to support our current ongoing clinical trials, current and planned preclinical R&D
activities and commercialization should our drug candidates receive regulatory approval.
If
we encounter difficulties enrolling patients in our clinical trials, our clinical development activities could be delayed or otherwise
adversely affected.
The
timely completion of clinical trials in accordance with their protocols depends on our ability to enroll a sufficient number of patients
who remain in the trial until its conclusion. We may experience difficulties in patient enrollment in our clinical trials for a variety
of reasons, including:
●
the size and nature of
the patient population;
●
the patient eligibility
criteria defined in the protocol;
●
the size of the study population
required for analysis of the trial’s primary endpoints;
●
the proximity of patients
to trial sites;
●
the design of the trial;
●
our ability to recruit
clinical trial investigators with the appropriate competencies and expertise;
48
●
competing clinical trials
for similar or alternate therapeutic treatments;
●
clinician’s and patients’
perceptions as to the potential advantages and side effects of the product candidate being studied in relation to other available
therapies;
●
our ability to obtain and
maintain patient consents; and
●
the risk that patients
enrolled in clinical trials will not complete a clinical trial.
In
addition, refractory patients, which several of our trials have or are expected to enroll, participating in clinical trials are seriously
and often terminally ill and therefore may not complete the clinical trial due to reasons including comorbid conditions or occurrence
of adverse medical events related or unrelated to the investigational products, or death. Even if we are able to enroll a sufficient
number of patients in our clinical trials, delays in patient enrollment will result in increased costs or affect the timing of our planned
trials, which could adversely affect our ability to advance the development of our product candidates.
FDA
may take actions that would prolong, delay, suspend, or terminate clinical trials of our product candidates, which may delay or prevent
us from commercializing our product candidates on a timely basis.
There
can be no assurance that the data generated in our clinical trials will be acceptable to the FDA or that if future modifications during
the trial are necessary, that any such modifications will be acceptable to the FDA. Certain modifications to a clinical trial protocol
made during the course of the clinical trial have to be submitted to the FDA. This could result in the delay or halt of a clinical trial
while the modification is evaluated. In addition, depending on the quantity and nature of the changes made, the FDA could take the position
that some or all of the data generated by the clinical trial is not usable because the same protocol was not used throughout the trial.
This might require the enrollment of additional subjects, which could result in the extension of the clinical trial and the FDA delaying
approval of a product candidate. If the FDA believes that its prior approval is required for a particular modification, it can delay
or halt a clinical trial while it evaluates additional information regarding the change.
Any
delay or termination of our current or future clinical trials as a result of the risks summarized above, including delays in obtaining
or maintaining required approvals from IRBs, delays in patient enrollment, the failure of patients to continue to participate in a clinical
trial, and delays or termination of clinical trials as a result of protocol modifications or adverse events during the trials, may cause
an increase in costs and delays in the filing of any submissions with the FDA, delay the approval and commercialization of our product
candidates or result in the failure of the clinical trial, which could adversely affect our business, operating results and prospects.
Lengthy delays in obtaining regulatory approval for Iomab-B or completion of our ongoing or planned clinical trials would adversely affect
our business and prospects and could cause us to cease operations.
We
have obtained orphan drug designation from the FDA for two of our current product candidates and intend to pursue such designation for
other candidates and indications in the future, but we may be unable to obtain such designations or to maintain the benefits associated
with any orphan drug designations we have received or may receive in the future.
We
have received orphan drug designation for Actimab-A and Iomab-B for treatment of AML in both the United States and the EU. Under the
Orphan Drug Act, the FDA may grant orphan designation to a drug or biologic intended to treat a rare disease or condition, which is a
disease or condition that affects fewer than 200,000 individuals in the United States, or if it affects more than 200,000 individuals
in the United States, there is no reasonable expectation that the cost of developing and making available a drug or biologic for this
type of disease or condition will be recovered from sales in the United States for that drug or biologic. Similarly, the EMA grants orphan
drug designation to promote the development of products that are intended for the diagnosis, prevention, or treatment of a life-threatening
or chronically debilitating condition affecting not more than five in 10,000 persons in the EU.
49
Orphan
drug designation neither shortens the development time or regulatory review time of a drug or biologic nor gives the drug or biologic
any advantage in the regulatory review or approval process. In the United States, orphan drug designation entitles a party to financial
incentives, such as opportunities for grant funding towards clinical trial costs, tax advantages, and application fee waivers. In addition,
if a product candidate receives the first FDA approval for the indication for which it has orphan designation, such product is entitled,
upon approval, to seven years of orphan-drug exclusivity, during which the FDA may not approve any other application to market the same
drug for the same indication, unless a subsequently approved product is clinically superior to orphan drug or where the manufacturer
is unable to assure sufficient product quantity in the applicable patient population. In the EU, orphan drug designation entitles a party
to financial incentives such as reduction of fees or fee waivers and ten years of market exclusivity following drug or biological product
approval. This period may be reduced to six years if the orphan drug designation criteria are no longer met, including where it is shown
that the product is sufficiently profitable not to justify maintenance of market exclusivity.
Even
if we obtain (or have obtained) orphan drug designation for certain product candidates, we may not be the first to obtain marketing approval
for such candidates for the applicable indications due to the uncertainties inherent in the development of novel biologic products, and,
an orphan drug candidate may not receive orphan-drug exclusivity upon approval if such candidate is approved for a use that is broader
than the indication for which it received orphan designation. In addition, exclusive marketing rights in the United States may be lost
if the FDA later determines that the request for designation was materially defective or if the manufacturer is unable to assure sufficient
quantities of the product to meet the needs of patients with the rare disease or condition.
Finally,
even if we successfully obtain orphan-drug exclusivity for an orphan drug candidate upon approval, such exclusivity may not effectively
protect the product from competition because (i) different drugs with different active moieties can be approved for the same condition;
and (ii) the FDA or EMA can also subsequently approve a subsequent product with the same active moiety and for the same indication as
the orphan drug if the later-approved drug if deemed clinically superior to the orphan drug.
Even
if we receive regulatory approval of our product candidates, we will be subject to ongoing regulatory obligations and continued regulatory
review.
Any
regulatory approvals that we receive for our product candidates will require surveillance to monitor the safety and efficacy of the product
candidate. The FDA may also require a REMS in order to approve our product candidates, which could entail requirements for a medication
guide, physician communication plans or additional elements to ensure safe use, such as restricted distribution methods, patient registries
and other risk minimization tools. In addition, if the FDA or a comparable foreign regulatory authority approves our product candidates,
the manufacturing processes, labeling, packaging, distribution, adverse event reporting, storage, advertising, promotion, import, export
and recordkeeping for our product candidates will be subject to extensive and ongoing regulatory requirements. These requirements include
submissions of safety and other post-marketing information and reports, registration, as well as continued compliance with cGMPs and
GCPs for any clinical trials that we conduct post-approval. In addition, the FDA could require us to conduct another study to obtain
additional safety or biomarker information. Later discovery of previously unknown problems with our product candidates, including adverse
events of unanticipated severity or frequency, or with our third-party suppliers or manufacturing processes, or failure to comply with
regulatory requirements, may result in, among other things:
●
restrictions on the marketing
or manufacturing of our product candidates, withdrawal of the product from the market, or voluntary or mandatory product recalls;
●
fines, warning letters
or holds on clinical trials;
●
refusal by the FDA to approve
pending applications or supplements to approved applications filed by us or suspension or revocation of license approvals;
●
product seizure or detention,
or refusal to permit the import or export of our product candidates; and
●
injunctions or the imposition
of civil or criminal penalties.
The
FDA’s and other regulatory authorities’ policies may change, and additional government regulations may be enacted that could
prevent, limit or delay regulatory approval of our product candidates. We cannot predict the likelihood, nature or extent of government
regulation that may arise from future legislation or administrative action, either in the United States or abroad. If we are slow or
unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we are not able to maintain
regulatory compliance, we may lose any marketing approval that we may have obtained, and we may not achieve or sustain profitability.
50
Coverage
and reimbursement may be limited or unavailable in certain market segments for our product candidates which could limit our sales of
our product candidates, if approved.
The
commercial success of our product candidates in both domestic and international markets will be substantially dependent on whether third-party
coverage and reimbursement is available for patients that use our products. However, the availability of insurance coverage and reimbursement
for newly approved cancer therapies is uncertain, and therefore, third-party coverage may be particularly difficult to obtain even if
our products are approved by the FDA as safe and efficacious. Patients using existing approved therapies are generally reimbursed all
or part of the product cost by Medicare or other third-party payors. Medicare, Medicaid, health maintenance organizations and other third-party
payors are increasingly attempting to contain healthcare costs by limiting both coverage and the level of reimbursement of new drugs,
and, as a result, they may not cover or provide adequate payment for these products. Submission of applications for reimbursement approval
generally does not occur prior to the filing of a BLA for that product and may not be granted until many months after BLA approval. In
order to obtain coverage and reimbursement for these products, we or our commercialization partners may have to agree to a net sales
price lower than the net sales price we might charge in other sales channels. The continuing efforts of government and third-party payors
to contain or reduce the costs of healthcare may limit our revenue. Initial dependence on the commercial success of our products may
make our revenues particularly susceptible to any cost containment or reduction efforts.
Healthcare
legislative reform measures intended to increase pressure to reduce prices of pharmaceutical products paid for by Medicare or, otherwise,
affect the regulation of the U.S. healthcare system could have a material adverse effect on our business, future revenue, if any, and
results of operations.
In
the United States, there have been a number of legislative and regulatory initiatives focused on containing the cost of healthcare. The
Affordable Care Act, for example, substantially changed the way healthcare is financed by both governmental and private insurers. The
Affordable Care Act contains a number of provisions that could impact our business and operations, primarily, once we obtain FDA approval
to commercialize one of our product candidates in the United States, if ever. The Affordable Care Act may also affect our operations
in ways we cannot currently predict. Affordable Care Act provisions that may affect our business include, among others, those governing
enrollment in federal healthcare programs, reimbursement changes, rules regarding prescription drug benefits under health insurance exchanges,
expansion of the 340B program, expansion of state Medicaid programs, fees and increased discount and rebate obligations, transparency
and reporting requirements, and fraud and abuse enforcement. Such changes may impact existing government healthcare programs, industry
competition, formulary composition, and may result in the development of new programs, including Medicare payment for performance initiatives,
health technology assessments, and improvements to the physician quality reporting system and feedback program.
There
have been significant judicial, administrative, executive, and legislative initiatives to modify, limit, replace, or repeal the Affordable
Care Act since its enactment. For example, during his first term, President Trump issued several Executive Orders and other directives
designed to delay the implementation of certain provisions of the Affordable Care Act or otherwise circumvent some of the requirements
for health insurance mandated by the Affordable Care Act. Concurrently, Congress considered legislation that would repeal or replace
all or part of the Affordable Care Act. While Congress has not passed comprehensive repeal legislation, several bills affecting the implementation
of the Affordable Care Act have been passed. For example, the Tax Cuts and Jobs Act of 2017 eliminated the Affordable Care Act provision
requiring individuals to purchase and maintain health coverage, or the “individual mandate,” by reducing the associated penalty
to zero, beginning in 2019. In December 2018, a district court in Texas held that the individual mandate is unconstitutional and that
the rest of the Affordable Care Act is, therefore, invalid. On appeal, the Fifth Circuit Court of Appeals affirmed the holding on the
individual mandate but remanded the case back to the lower court to reassess whether and how such holding affects the validity of the
rest of the Affordable Care Act. The Fifth Circuit’s decision on the individual mandate was appealed to the U.S. Supreme Court.
On June 17, 2021, the Supreme Court held that the plaintiffs (comprised of the state of Texas, as well as numerous other states and certain
individuals) did not have standing to challenge the constitutionality of the Affordable Care Act’s individual mandate and, accordingly,
vacated the Fifth Circuit’s decision and instructed the district court to dismiss the case. As a result, the Affordable Care Act
remained in effect in its then-current form; however, we cannot predict what additional challenges may arise in the future, the outcome
thereof, or the impact any such actions may have on our business. This uncertainty has become even greater given the new Trump administration
and its proposed agenda.
51
In
addition to the Affordable Care Act, there have been numerous other Congressional initiatives and proposed and enacted federal and state
legislation designed to, among other things, bring more transparency to drug pricing, review the relationship between pricing and manufacturer
patient programs, and reform government program reimbursement methodologies for drug products. Pharmaceutical product prices have been
the focus of increased scrutiny by the government, including certain state attorneys general, members of Congress and the United States
Department of Justice. State or federal healthcare reform measures or other social or political pressure to lower the cost of pharmaceutical
products could have a material adverse impact on our business, results of operations and financial condition.
The
Biden administration also introduced various measures in 2021 focusing on healthcare and drug pricing, in particular. For example, on
January 28, 2021, former President Biden issued an executive order that initiated a special enrollment period for purposes of obtaining
health insurance coverage through the Affordable Care Act marketplace, which began on February 15, 2021, and remained open through August
15, 2021. The executive order also instructed certain governmental agencies to review and reconsider their existing policies and rules
that limit access to healthcare, including among others, reexamining Medicaid demonstration projects and waiver programs that include
work requirements and policies that create unnecessary barriers to obtaining access to health insurance coverage through Medicaid or
the Affordable Care Act. On the legislative front, the American Rescue Plan Act of 2021 was signed into law on March 11, 2021, which,
in relevant part, eliminates the statutory Medicaid drug rebate cap, currently set at 100% of a drug’s average manufacturer price,
for single source drugs and innovator multiple source drugs, which began on January 1, 2024. And, in July 2021, the Biden administration
released an executive order entitled, “Promoting Competition in the American Economy,” with multiple provisions aimed at
prescription drugs. In response, on September 9, 2021, the Department of Health and Human Services (“HHS”) released a “Comprehensive
Plan for Addressing High Drug Prices” that outlines principles for drug pricing reform and sets out a variety of potential legislative
policies that Congress could pursue as well as potential administrative actions HHS can take to advance these principles.
On
August 16, 2022, former President Biden signed into law the Inflation Reduction Act of 2022 (the “IRA”),
which, among other provisions, included several measures intended to lower the cost of prescription drugs and related healthcare reforms.
Specifically, the IRA authorizes and directs the HHS to set drug price caps for certain high-cost Medicare Part B and Part D qualified
drugs, with the initial list of drugs announced on August 29, 2023, and the first year of maximum price applicability beginning in 2026.
The IRA further authorizes the HHS to penalize pharmaceutical manufacturers that increase the price of certain Medicare Part B and Part
D drugs faster than the rate of inflation. The IRA creates significant changes to the Medicare Part D benefit design by capping Part
D beneficiaries’ annual out-of-pocket spending at $2,000 beginning in 2025. Further, on July 4, 2025, President Trump signed the
One Big Beautiful Bill Act into law which, among other things, is expected to reduce funding to federal healthcare programs, imposes
additional requirements to be eligible for healthcare, and clarifies exclusions for orphan drugs under IRA’s Drug Price Negotiation
Program
The current Trump
Administration is also pursuing policies intended to, among other things, reduce regulations and expenditures across government
(including at the HHS, FDA, NIH, CMS, and other related agencies), lower prescription drug prices, and enhance drug price
transparency. These actions, such as those directed by executive orders, may propose policy changes that create additional
uncertainty for our business. For example, on April 15, 2025, the Trump Administration released an executive order entitled,
“Lower Drug Prices by Once Again Putting Americans First,” which among other things, included multiple directives to
various agencies aimed at lowering prescription drug prices. Further, in May 2025, the Trump Administration released two executive
orders aimed to promote domestic production of critical medicines and to establish a most-favored-nation (“MFN”) drug
pricing policy that would tie U.S. drug prices to the prices paid for drugs in other countries. Other recent actions and proposals
include, for example, (1) reducing federal agencies workforces; (2) directing program cuts; (3) rescinding a Biden administration
executive order tasking the Center for Medicare and Medicaid Innovation to consider new payment and healthcare models to limit drug
spending and eliminating the Biden administration’s executive order that directed HHS to establishing an AI task force and
developing a strategic plan; (4) directing certain federal agencies to enforce existing law regarding hospital and price plan price
transparency and by standardizing prices across hospitals and health plans; (5) as part of the Make America Healthy Again (MAHA)
Commission’s recent Strategy Report, working across government agencies to increase enforcement on direct-to-consumer
pharmaceutical advertising; (6) announcing a new payment initiative called the GENErating cost Reductions fOr U.S. Medicaid Model
(“GENEROUS Model”) where drug manufacturers may voluntarily offer supplemental rebates to participating state Medicaid
programs; (7) directing HHS and other agencies to lower prescription drug costs for Medicare through a variety of initiatives,
including by improving upon the Medicare Drug Price Negotiation Program and proposing two rules to incorporate MFN pricing into
federal reimbursement for drugs including the Global Benchmark for Efficient Drug Pricing Model (“GLOBE Model”) for
Medicare Part B and Guarding U.S. Medicare Against Rising Drug Costs (“GUARD Model”) for Medicare Part D; (8) launching
the TrumpRx direct-to-consumer platform designed to have drug manufacturers offer consumers prescription drug MFN pricing equal to
or lower than those paid in other developed nations; and (9) calling on Congress to enact the “The Great Healthcare
Plan” to, among other things, codify and expand MFN pricing, lower government subsidies to private insurance companies,
increase healthcare price transparency, expand pharmaceutical drugs available for over-the-counter purchase, and enact restrictions
on pharmacy benefit managers. These actions and policies may significantly reduce drug prices, potentially impacting
manufacturers’ drug pricing strategies and profitability, while increasing operational costs and compliance risks.
52
At
the state level, legislatures have increasingly passed legislation and implemented regulations designed to control pharmaceutical and
biological product pricing, including price or patient reimbursement constraints, discounts, restrictions on certain product access and
marketing cost disclosure and transparency measures, and, in some cases, designed to encourage importation from other countries and bulk
purchasing.
Current
and future legislative and regulatory changes aimed to further reform healthcare or reduce healthcare costs may limit coverage of or
lower reimbursement for healthcare products and treatments. Any reduction in coverage or reimbursement from Medicare, Medicaid, or other
government programs may result in similar actions taken by private payors such as reductions in payments. The implementation of cost
containment measures or other healthcare reforms may prevent us from being able to generate revenue, attain profitability, or commercialize
our product candidates.
Changes
in the healthcare industry and in healthcare spending could adversely affect our grant funded clinical programs, business, financial
condition and results of operations.
Our
business and research efforts rely, in part, on funding and support from U.S. government agencies such as the NIH, NCI and HHS. Government
funding for these programs is subject to annual budgetary decisions, which can be unpredictable and influenced by shifting political
and economic priorities. Reductions in government support for cancer research or other healthcare initiatives could limit grants, contracts,
or other financial resources that we or our research collaborators depend on, potentially delaying our clinical programs and increasing
our reliance on alternative funding sources. From October 1, 2025 until November 12, 2025, the U.S federal government was shutdown, which
curtailed operations of key agencies such as the FDA and the NIH. The NCI, with whom we have a CRADA with for the development of Actimab-A,
was not operating during the shutdown. As a result, our ability to advance clinical development, obtain regulatory interactions/approvals,
or secure government-funded grants may be delayed or disrupted by the federal government shutdown. For example, active and planned trials
under our CRADA are expected to be delayed.
Additionally, in December
2025, the National Defense Authorization Act for Fiscal Year 2026 (“NDAA”) was enacted, which included legislation commonly
referred to as the “BIOSECURE Act.” The BIOSECURE Act restricts government agencies from procuring certain biotechnology equipment
or services from, or entering into contracts with, entities that use biotechnology equipment or services from designated “biotechnology
companies of concern,” (“BCCs”) and from expending certain federal loan or grant funds for such equipment or services.
BCCs include those that are identified on the Department of Defense’s annual List of Chinese Military Companies, also known as the
1260H List, and the government also has the ability to designate entities as BCCs through a separate designation process. While the BIOSECURE
Act has not yet been fully implemented through final regulations, there remains a continued policy interest in limiting U.S. companies’
relationships with biotechnology providers with relationships with foreign adversaries.
If any of our current or future
vendors, or their affiliates, are designated as a BCC or placed on other U.S. restricted party lists, such designation could impact and
potentially restrict our ability to purchase equipment or services from such vendors and could adversely affect our existing government-funded
grants and our ability to secure future grants. These disruptions could also have adverse effects on the development of our product candidates
and our business operations.
Moreover,
with the change in presidential administration that recently occurred in the United States, government spending programs have become
even more difficult to predict and may be subject to greater risk. Considerable uncertainty exists regarding how future budget and
program decisions will unfold, including the spending priorities of the new U.S. presidential administration and Congress and what
challenges budget reductions may present for our industry generally or for our company. For example, President Trump recently
attempted to place a widespread freeze on most federal grants and loans. Any freeze, reduction, recission, change in eligibility or
compliance requirements, or other actions affecting government support for our products, programs, or studies could significantly
impair our research and development activities, business, and operations.
Disruptions
at the FDA, the SEC and other government agencies or comparable regulatory authorities caused by government shutdowns, funding shortages
or global health concerns, in addition to substantial uncertainty regarding the new Administration’s initiatives and how these
might impact the FDA, its implementation of laws, regulations, policies and guidance, and its personnel, could hinder government agencies’
ability to hire and retain key leadership and other personnel, or otherwise prevent new products and services from being developed or
commercialized in a timely manner, or otherwise prevent those agencies from performing normal business functions on which our business
operations rely, including timely reviews, which could negatively impact our business.
The ability of the FDA or comparable foreign regulatory authorities
to review and approve new products can be affected by a variety of factors, including government shutdowns, which recently occurred from
October 1, 2025 until November 12, 2025, budget and funding levels, ability to hire and retain key personnel and accept the payment of
user fees, and statutory, regulatory, and policy changes that may otherwise affect the FDA’s or comparable foreign regulatory authorities’
ability to perform routine functions. In addition, government funding of the SEC and other government agencies or comparable foreign regulatory
authorities on which our operations may rely, including those that fund research and development activities, is subject to the political
process, which is inherently fluid and unpredictable. Future government shutdowns could impact our ability to access the public markets
and obtain necessary capital in order to properly capitalize and continue to fund our operations.
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Disruptions
at the FDA and other agencies, including substantial leadership, personnel, and policy changes, may also slow the time necessary for
new drugs to be reviewed and/or approved by necessary government agencies, which would harm our business. Changes in FDA staffing could
result in delays in the FDA’s responsiveness or in its ability to review submissions or applications, issue regulations or guidance,
or implement or enforce regulatory requirements in a timely fashion or at all. Similar consequences would also result in the event of
another significant shutdown of the federal government. For example, over the last several years, the U.S. government has shut down several
times and certain regulatory agencies, such as the FDA, have had to furlough critical FDA employees and stop critical activities. If
a prolonged government shutdown occurs, or if geopolitical or global health concerns prevent the FDA or other regulatory authorities
from conducting their regular inspections, reviews, or other regulatory activities, it could significantly impact the ability of the
FDA to timely review and process our regulatory submissions, which could materially adversely affect our business, financial condition,
results of operations and prospects. Such changes could significantly impact the ability of the FDA to timely review and take action
on our regulatory submissions, which could have a material adverse effect on our business. Further, in our operations as a public company,
future government shutdowns or substantial leadership, personnel, and policy changes could impact our ability to access the public markets
and obtain necessary capital in order to properly capitalize and continue our operations. If the FDA is constrained in its ability to
engage in oversight and implementation activities in the normal course, our business may be negatively impacted.
With the change in the U.S. Presidential Administration in 2025, there
is substantial uncertainty as to whether and how the new administration will seek to modify or revise the requirements and policies of
the FDA and other regulatory agencies with jurisdiction over our product candidates. This uncertainty could present new challenges and/or
opportunities as we navigate development of our product candidates. Some of these efforts have manifested to date in the form of personnel
measures that could impact the FDA’s ability to hire and/or retain key personnel, which could result in delays or limitations on
our ability to obtain guidance from the FDA on our product candidates in development and obtain the requisite regulatory approvals in
the future. Moreover, the new Administration has proposed action to freeze or reduce the budget of the NIH, as related to its funding
for medical research, which could decrease the ability of facilities that rely on NIH funding to enroll and conduct clinical trials or
increase the costs to us of conducting clinical trials. There remains general uncertainty regarding future activities. The new Administration could
issue or promulgate executive orders, regulations, policies or guidance that adversely affect us or create a more challenging or costly
environment to pursue the development of new therapeutic products. Alternatively, state governments may attempt to address or react to
changes at the federal level with changes to their own regulatory frameworks in a manner that is adverse to our operations. If we become
negatively impacted by future governmental orders, regulations, policies or guidance as a result of the new Administration, there could
be a material adverse effect on us and our business.
Our
relationships with customers, health care professionals and third-party payors may be subject to applicable healthcare laws, which could
expose us to penalties, including administrative, civil or criminal penalties, damages, fines, imprisonment, exclusion from participation
in federal healthcare programs such as Medicare and Medicaid, reputational harm, the curtailment or restructuring of our operations and
diminished future profits and earnings.
Healthcare
professionals and third-party payors will play a primary role in the recommendation and prescription of any product candidates for which
we obtain marketing approval. Our current and future arrangements with customers, healthcare professionals and third-party payors may
expose us to broadly applicable fraud and abuse and other healthcare laws and regulations that may constrain the business or financial
arrangements and relationships through which we conduct research, market, sell and distribute any products for which we obtain marketing
approval. Federal and state healthcare laws and regulations that may affect our operations, directly or indirectly, include the following,
among others:
●
the federal Anti-Kickback
Statute, which prohibits persons and entities from, among other things, knowingly and willfully soliciting, offering, receiving or
providing remuneration, directly or indirectly, in cash or in kind, to induce or reward either the referral of an individual for,
or the purchase, lease, order or recommendation of, any good, facility, item or service, for which payment may be made under federal
and state healthcare programs such as Medicare and Medicaid;
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●
the federal false claims laws, including civil whistleblower or qui
tam actions under the FCA, which impose criminal and civil penalties against individuals or entities for, among other things, knowingly
presenting, or causing to be presented, to the federal government, claims for payment that are false or fraudulent or making a false statement
to avoid, decrease or conceal an obligation to pay money to the federal government;
●
HIPAA, as amended by HITECH,
which imposes criminal and civil liability for, among other things, executing a scheme to defraud any healthcare benefit program or making
false statements relating to healthcare matters and also imposes obligations, including mandatory contractual terms, on covered entities,
including certain healthcare providers, health plans, and healthcare clearinghouses, and their respective business associates that create,
receive, maintain or transmit individually identifiable health information for or on behalf of the covered entity as well as their covered
subcontractors, with respect to safeguarding the privacy, security and transmission of individually identifiable health information;
●
the federal Civil Monetary
Penalties Law, which prohibits, among other things, the offering or transfer of remuneration to a Medicare or state healthcare program
beneficiary if the person knows or should know it is likely to influence the beneficiary’s selection of a particular provider,
practitioner, or supplier of services reimbursable by Medicare or a state healthcare program, unless an exception applies;
●
the federal Physician Payments
Sunshine Act, created under the Affordable Care Act, and its implementing regulations, which requires certain manufacturers of drugs,
devices, biologicals and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health
Insurance Program (with certain exceptions) to report annually information related to certain payments or other transfers of value
provided to physicians and any ownership and investment interests held by physicians or their immediate family members. Beginning
in 2022, applicable manufacturers also will be required to report such information regarding payments and other transfers of value
to physician assistants, nurse practitioners, clinical nurse specialists, anesthesiologist assistants, certified registered nurse
anesthetists and certified nurse midwives during the previous year; and
●
analogous state laws and
regulations, including (among others) state anti-kickback and false claims laws, which may apply to our business practices, including,
but not limited to, research, distribution, sales and marketing arrangements and claims involving healthcare items or services reimbursed
by any third-party payor, including private insurers; state laws that require pharmaceutical companies to comply with the pharmaceutical
industry’s voluntary compliance guidelines and the relevant compliance guidance promulgated by the United States federal government,
or otherwise restrict payments that may be made to healthcare providers and other potential referral sources; state laws and regulations
that require drug manufacturers to file reports relating to pricing and marketing information and that require tracking gifts and
other remuneration and items of value provided to healthcare professionals and entities; state and local laws that require the registration
of pharmaceutical sales representatives; and state laws governing the privacy and security of health information in certain circumstances,
many of which differ from each other in significant ways and often are not preempted by federal law, thus complicating compliance
efforts.
Efforts
to comply with applicable healthcare laws and regulations will involve substantial costs. Interpretations of standards of compliance
under these laws and regulations are rapidly changing and subject to varying interpretations and it is possible that governmental authorities
will conclude that our business practices may not comply with current or future statutes, regulations or case law involving applicable
fraud and abuse or other healthcare laws and regulations. If our operations are found to be in violation of any of these laws or any
other laws that may apply to us, we may be subject to significant civil, criminal and administrative penalties, damages, fines, exclusion
from government funded healthcare programs, such as Medicare and Medicaid, reputational harm, imprisonment, additional reporting obligations
and oversight (if we become subject to a corporate integrity agreement or other agreement to resolve allegations of non-compliance with
these laws), and the curtailment or restructuring of our operations, any of which could diminish our future profits or earnings. If any
of the physicians or other providers or entities with whom we expect to do business are found to be not in compliance with applicable
laws, they may be subject to criminal, civil or administrative sanctions, including exclusions from government funded healthcare programs.
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Third-party
payors may not adequately reimburse customers for any product candidates that we may commercialize or promote and may impose coverage
restrictions or limitations such as prior authorizations and step edits that affect their use.
Our
ability to commercialize any product candidates successfully also will depend in part on the extent to which coverage and adequate reimbursement
for these products and related treatments will be available from government health programs, private health insurers, integrated delivery
networks and other third-party payors. Third-party payors decide which medications they will pay for and establish reimbursement levels.
A significant trend in the United States healthcare industry and elsewhere is cost containment. Government authorities and third-party
payors have attempted to control costs by limiting coverage and the amount of payment for particular medications. Increasingly, third-party
payors are requiring that drug companies provide predetermined discounts from list prices and are challenging the prices charged for
medical products. Coverage and reimbursement may not be available for any product that we commercialize and, if reimbursement is available,
the level of reimbursement may not be sufficient for commercial success. Coverage and reimbursement may impact the demand for, or the
price of, any product candidate for which we obtain marketing approval. If coverage and reimbursement is not available or is available
only to limited levels, we may not be able to successfully commercialize any product candidate for which we obtain marketing approval.
Obtaining
reimbursement approval for any product candidate for which we obtain marketing approval from any government or other third-party payor
is a time-consuming and costly process. There may be significant delays in obtaining coverage and adequate reimbursement for newly approved
products. Moreover, eligibility for coverage and reimbursement does not imply that any product will be paid for in all cases or at a
rate that covers our costs, including research, development, manufacture, sale and distribution. Even when a payor determines that a
product that we may commercialize or promote is eligible for reimbursement under its criteria, the payor may impose coverage limitations
that preclude payment for some uses that are approved by the FDA, or may impose restrictions, such as prior authorization requirements,
or may simply deny coverage altogether. Interim reimbursement levels for new drugs, if applicable, may also not be sufficient to cover
our costs and may not be made permanent. Coverage and reimbursement rates may vary according to the use of the drug and the medical circumstances
under which it is used may be based on reimbursement levels already set for lower cost products or procedures or may be incorporated
into existing payments for other services. Net prices for drugs may be reduced by mandatory discounts or rebates required by government
healthcare programs or private payors and by any future relaxation of laws that presently restrict imports of drugs from countries where
they may be sold at lower prices than in the United States. Furthermore, the Centers for Medicare and Medicaid Services frequently change
product descriptors, coverage policies, product and service codes, payment methodologies and reimbursement values. Commercial third-party
payors often rely upon Medicare coverage policies and payment limitations in setting their own reimbursement policies. Our inability
to promptly obtain and maintain coverage and profitable payment rates from both government-funded programs and private payors for any
approved products that we develop could have a material adverse effect on our operating results, our ability to raise capital needed
to commercialize our approved products and our overall financial condition.
In
the U.S. and some jurisdictions outside the U.S., there have been a number of legislative and regulatory changes and proposed changes
regarding the healthcare system that could impact our business. Generally, there has been increasing legislative and enforcement interest
in the U.S. with respect to drug pricing, including specialty drug pricing practices, in light of the rising cost of prescription drugs
and biologics. Specifically, there have been U.S. Congressional inquiries and federal and state legislative activity designed to, among
other things, bring more transparency to drug pricing, review the relationship between pricing and manufacturer patient programs, reduce
the price of drugs under Medicare, and reform government program reimbursement methodologies for drugs and biologics. In addition, the
concept of most-favored nation pricing has been raised that would seek to establish drug prices in the U.S. to the lowest level paid
by comparable countries. Such policy action could cause us to amend, suspend or terminate the development of any or all of our product
candidates if a viable commercial market did not exist, which could have a material adverse impact on our business and ability to operate.
56
If
future legislation were to impose direct governmental price controls and access restrictions, it could have a significant adverse impact
on our business and financial results. Managed care organizations, as well as Medicaid and other government authorities, continue to
seek price discounts. At the state level, legislatures have increasingly passed legislation and implemented regulations designed to control
pharmaceutical and biologic product pricing, including price or patient reimbursement constraints, discounts, restrictions on certain
product access and marketing cost disclosure and transparency measures, and, in some cases, to encourage importation from other countries
and bulk purchasing. Due to the volatility in the current economic and market dynamics, we are unable to predict the impact of any unforeseen
or unknown legislative, regulatory, payor or policy actions, which may include cost containment and healthcare reform measures. Such
policy actions could have a material adverse impact on our business and ability to operate.
Risks
Related to Third Parties
We
may rely on third parties to conduct our clinical trials. If these third parties do not successfully carry out their contractual duties
or meet expected deadlines or comply with regulatory requirements, we may not be able to obtain regulatory approval for or commercialize
our product candidates.
We
do not have the ability to independently conduct our clinical trials for our product candidates and we must rely on third parties, such
as contract research organizations, medical institutions, clinical investigators and contract laboratories to conduct such trials. Our
reliance on these third parties for clinical development activities results in reduced control over these activities. Moreover, the FDA
requires us to comply with regulations and standards, commonly referred to as GCPs (good clinical practices), for conducting, recording
and reporting the results of clinical trials to assure that data and reported results are credible and accurate and that the trial participants
are adequately protected. Our reliance on third parties does not relieve us of these responsibilities and requirements. If we or any
of our third-party contractors fail to comply with applicable GCPs, the clinical data generated in our clinical trials may be deemed
unreliable and the FDA or comparable foreign regulatory authorities may require us to perform additional clinical trials before approving
our marketing applications. We cannot assure you that upon inspection by a given regulatory authority, such regulatory authority will
determine that any of our clinical trials complies with GCP regulations. In addition, our clinical trials must be conducted with product
produced under current good manufacturing practice, or cGMP, regulations. Our failure to comply with these regulations may require us
to repeat clinical trials, which would delay the regulatory approval process.
If
our consultants, contract research organizations and other similar entities with which we are working do not successfully carry out their
contractual duties, meet expected deadlines, or comply with applicable regulations, we may be required to replace them. Although we believe
that there are a number of other third-party contractors we could engage to continue these activities, we may not be able to enter into
arrangements with alternative third-party contractors or to do so on commercially reasonable terms, which may result in a delay of our
planned clinical trials and delayed development of our product candidates.
In
addition, our third-party contractors are not our employees, and except for remedies available to us under our agreements with such third-party
contractors, we cannot control whether or not they devote sufficient time and resources to our programs. If these third parties do not
successfully carry out their contractual duties or regulatory obligations or meet expected deadlines, or if the quality or accuracy of
the data they obtain is compromised due to the failure to adhere to our clinical protocols or regulatory requirements or for other reasons,
our pre-clinical development activities or clinical trials may be extended, delayed, suspended or terminated, and we may not be able
to obtain regulatory approval for, or successfully commercialize, our product candidates on a timely basis, if at all, and our business,
operating results and prospects would be adversely affected.
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The
protection against generic competition for our biologic drug candidates and reimbursement by CMS may be subject to future change
We
are not aware of any existing or pending regulations or legislation that pertains to generic radiopharmaceutical products such as our
targeted radiotherapy product candidates. Our ARC product candidates are regulated by the FDA as biologic products, and we intend to
seek approval for these products pursuant to the BLA pathway. The Biologics Price Competition and Innovation Act of 2009, or BPCIA, created
an abbreviated pathway for the approval of biosimilar and interchangeable biologic products. The abbreviated regulatory pathway establishes
legal authority for the FDA to review and approve biosimilar biologics, including the possible designation of a biosimilar as “interchangeable”
based on its similarity to an existing brand product. Under the BPCIA, an application for a biosimilar product cannot be approved by
the FDA until 12 years after the original branded product was approved under a BLA and in Europe a biosimilar product cannot be approved
until 10 years after the original branded product was approved. The law is complex and as a result, its ultimate impact, implementation,
and meaning are subject to uncertainty. Even if a biosimilar gets approved for one of the antibodies that we use, the final constructs
of our drug candidates consist of an antibody, radioisotope and in some cases a linker and we are not aware of any regulations that would
require us to provide the final constructs or components to third parties or potential competitors. Therefore, based on the current regulations,
we do not believe that the final drug product of our candidates can be subject to competition from a biosimilar as outlined in BPCIA
for at least 12 years in the U.S. and 10 years in the EU. We are aware that generic versions of certain radiopharmaceuticals utilizing
peptides have been submitted to the FDA via the Abbreviated New Drug Application (“ANDA”) pathway, however, those products
are not covered under the BPCIA and therefore that generic pathway is not applicable to Iomab-B or Actimab-A. We expect this would also
apply to other biologic drug candidates we may seek to develop in the future based on the current provisions of the BPCIA. Additionally,
the Inflation Reduction Act (“IRA”) that was enacted in August 2022, states that reimbursement by the Centers for Medicare&
Medicaid Services (“CMS”) for high-expenditure single-source biologic drugs, which we expect Iomab-B and Actimab-A to be,
can only be negotiated after at least 11 years following approval compared to 7 years for non-biologic drugs with negotiated prices taking
effect two years after selection. Therefore, we currently believe that our antibody radiation conjugates (“ARCs”) are less likely than small molecules to face pricing
pressure and negotiation from IRA. Further, a drug or biological product that has an orphan drug designation, which Iomab-B and Actimab-A
both have, for only one rare disease or condition will be excluded from the IRA’s price negotiations requirements until such
time the biological products has designations for more than one rare disease or condition, or if is approved for an indication that is
not within that single designated rare disease or condition, unless such additional designation or such disqualifying approvals are withdrawn
by the time CMS evaluates the drug for selection for negotiation. In August 2023, 10 initial drugs were identified with negotiated prices
that went into effect January 1, 2026. In 2027 and 2028, it is expected that CMS will establish negotiated prices for 15 additional
drugs in each respective year. We do not believe there is a high likelihood that Iomab-B or Actimab-A would be identified by CMS for
negotiated pricing under IRA but there is potential that IRA and other additional state and federal healthcare reform measures will be
adopted in the future and the implementation of cost-containment measures or other healthcare reforms may prevent us from being able
to generate revenue, attain profitability or successfully commercialize our product candidates.
Our
product candidates may never achieve market acceptance.
Actimab-A,
Iomab-ACT, ATNM-400, Iomab-B and future product candidates that we may develop may never gain market acceptance among physicians, patients
and the medical community. The degree of market acceptance of any of our products will depend on a number of factors, including the actual
and perceived effectiveness and reliability of the product; the results of any long-term clinical trials relating to use of the product;
the availability, relative cost and perceived advantages and disadvantages of alternative technologies; the degree to which treatments
using the product are approved for reimbursement by public and private insurers; the strength of our marketing and distribution infrastructure;
and the level of education and awareness among physicians and hospitals concerning the product.
We
believe that oncologists and other physicians will not widely adopt a product candidate unless they determine, based on experience, clinical
data, and published peer-reviewed journal articles, that the use of that product candidate provides an effective alternative to other
means of treating specific cancers. Patient studies or clinical experience may indicate that treatment with our product candidates does
not provide patients with sufficient benefits in extension of life or quality of life. We believe that recommendations and support for
the use of each product candidate from influential physicians will be essential for widespread market acceptance. Our product candidates
are still in the development stage, and it is premature to attempt to gain support from physicians at this time. We can provide no assurance
that such support will ever be obtained. If our product candidates do not receive such support from these physicians and from long-term
data, physicians may not use or continue to use, and hospitals may not purchase or continue to purchase, them.
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Failure
of Actimab-A, Iomab-ACT, ATNM-400, Iomab-B or any of our other product candidates to significantly penetrate current or new markets would
negatively impact our business financial condition and results of operations.
We
may be subject to claims that our third-party service providers, consultants or current or former employees have wrongfully used or disclosed
confidential information of third parties.
We
have received confidential and proprietary information from third parties. In addition, we employ individuals who were previously employed
at other biotechnology or pharmaceutical companies. We may be subject to claims that we or our employees, consultants or independent
contractors have inadvertently or otherwise used or disclosed confidential information of these third parties or our employees’
former employers. Litigation may be necessary to defend against these claims. Even if we are successful in defending against these claims,
litigation could result in substantial cost and be a distraction to our management and employees.
We
currently depend on single third-party manufacturers to produce our pre-clinical and clinical trial drug supplies. Any disruption in
the operations of our current third-party manufacturers, or other third-party manufacturers we may engage in the future, could adversely
affect our business and results of operations.
We
do not currently operate manufacturing facilities for pre-clinical or clinical production of any of our product candidates. We rely on
third-party manufacturers to supply, store, and distribute pre-clinical and clinical supply of the components of our drug product candidates
including monoclonal antibodies, linkers and radioisotopes, as well as the final construct which comprises our drug product candidates.
We expect to continue to depend on third-party manufacturers for the foreseeable future. Any performance failure on the part of our existing
or future manufacturers could delay clinical development, cause us to suspend or terminate development or delay or prohibit regulatory
approval of our product candidates or commercialization of any approved products. Further avenues of disruption to our clinical or eventual
commercial supply may also occur due to the sale, acquisition, business reprioritization, bankruptcy or other unforeseen circumstances
that might occur at any of our suppliers or contract manufacturing partners including an inability to come to terms on renewal of existing
contracts or new contracts.
We
currently rely on single manufacturers to manufacture our pre-clinical and clinical trial drug supplies. With a view to maintaining business
continuity we are evaluating alternatives and second and even third sources of supply or manufacturing for our core suppliers and manufacturing
partners, however there can be no assurances that we will be able to identify such suppliers or partners and assuming we did, that we
would be able to enter into contracts that are on favorable terms or on terms that will enable sufficient supply to ensure business continuity
and support our growth plans.
Our
product candidates require precise, high-quality manufacturing. Failure by our current contract manufacturer or other third-party manufacturers
we may engage in the future to achieve and maintain high manufacturing standards could result in patient injury or death, product recalls
or withdrawals, delays or failures in testing or delivery, cost overruns, or other problems that could seriously hurt our business. Contract
manufacturers may encounter difficulties involving production yields, quality control, and quality assurance. These manufacturers are
subject to ongoing periodic and unannounced inspections by the FDA and corresponding state and foreign agencies to ensure strict compliance
with cGMPs and other applicable government regulations and corresponding foreign standards; we do not have control over third-party manufacturers’
compliance with these regulations and standards.
We
currently plan to build out a manufacturing facility in the future to operate for the purposes of manufacturing our own products. We
have never built, owned or operated a manufacturing facility. There can be no assurances that we will be able to successfully accomplish
this and in doing so we may experience delays, cost overruns, or other problems that could seriously hurt our business. Even if we successfully
build out our planned manufacturing facility, we may not realize the expected benefits of these efforts.
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We
depend on vendors with specialized operations, equipment and know-how to manufacture the respective components of our drug candidates.
We have entered into manufacturing and supply agreements with these third-parties, and in some instances, we have agreed that such vendor
be the exclusive manufacturer and supplier. If any of the third-parties we depend on encounter difficulties in their operations, fail
to comply with required regulations or breach their contractual obligations it may be difficult, or we may be unable to identify suitable
alternative third-party manufacturers. While we identify and evaluate third-party manufacturers from time to time, even if we do identify
suitable alternative third-parties, we may fail to reach agreement on contractual terms, it may be prohibitively expensive and there
can be no assurance that we can successfully complete technology transfer and development work necessary, or complete the necessary work
in a timely manner. Any of which could prevent us from commencing manufacturing with third-parties which could cause delays or suspension
of our clinical trials and pre-clinical work that may have a negative impact on our business.
Furthermore,
these third-party contractors, whether foreign or domestic, may experience regulatory compliance difficulty, mechanical shutdowns, employee
strikes, or any other unforeseeable acts that may delay or limit production. Our inability to adequately establish, supervise and conduct
(either ourselves or through third parties) all aspects of the formulation and manufacturing processes, and the inability of third-party
manufacturers to consistently supply quality product when required would have a material adverse effect on our ability to develop or
commercialize our products. We have faced delays and risks associated with reliance on key third party manufacturers in the past and
may be faced with such delays and risks in the future. Any future manufacturing interruptions or related supply issues could have an
adverse effect on our company, including delays in clinical trials.
If
we are successful in obtaining marketing approval from the FDA and/or other regulatory agencies for any of our product candidates, we
anticipate continued reliance on third-party manufacturers.
To
date, our product candidates have been manufactured in small quantities for preclinical and clinical testing by third-party manufacturers.
If the FDA or other regulatory agencies approve any of our product candidates for commercial sale, we expect that we would continue to
rely, at least initially, on third-party specialized manufacturers to produce commercial quantities of approved products. These manufacturers
may not be able to successfully increase the manufacturing capacity for any approved product in a timely or economic manner, or at all.
Significant scale-up of manufacturing may require additional validation studies, which the FDA must review and approve. Scale-up for
commercial product may require financial commitment or investment by us, which we may not have sufficient capital for or may elect not
to undertake. If third party manufacturers are unable to successfully increase the manufacturing capacity for a product candidate, or
we are unable to establish our own manufacturing capabilities, the commercial launch of any approved products may be delayed or there
may be a shortage in supply, which in turn could have a material adverse effect on our business.
In
addition, the facilities used by our contract manufacturers to manufacture our product candidates must be approved by the FDA pursuant
to inspections that will be conducted after we submit a BLA to the FDA. We do not control the manufacturing process of, and are completely
dependent on, our contract manufacturing partners for compliance with cGMPs. If our contract manufacturers cannot successfully manufacture
material that conforms to our specifications and the strict regulatory requirements of the FDA or other regulatory authorities, they
will not be able to secure and/or maintain regulatory approval for their manufacturing facilities. If the FDA or a comparable foreign
regulatory authority does not approve these facilities for the manufacture of our product candidates or if it withdraws any such approval
in the future, we may need to find alternative manufacturing facilities, which would significantly impact our ability to develop, obtain
regulatory approval for or market our product candidates, if approved.
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We
may have conflicts with our partners that could delay or prevent the development or commercialization of our product candidates.
We
may have conflicts with our partners, such as conflicts concerning the interpretation of preclinical or clinical data, pertaining to
the global patient safety profile or efficacy results of our products, the achievement of milestones, the interpretation of contractual
obligations, payments for services, development obligations or the ownership of intellectual property developed during our collaboration.
We may seek to amend, modify or terminate agreements with partners, suppliers or service providers related to ATNM-400, Actimab-A, Iomab-ACT
or Iomab-B, but there can be no assurance that we can do so successfully or negotiate terms that are favorable to us. Failure of which
can increase the risk of or result in litigation or alternative dispute resolution options taken against us. Further, we may exercise
our decision-making authority under certain circumstances pertaining to global patient safety related to our products, which our partners
may disagree with and may result in potential conflicts and public disclosure of our rationale and position. If any conflicts arise with
any of our partners, such partner may act in a manner that is adverse to our best interests. Any such disagreement could result in one
or more of the following, each of which could delay or prevent the development or commercialization of our product candidates, and in
turn prevent us from generating revenues: unwillingness on the part of a partner to pay us milestone payments or royalties we believe
are due under a collaboration; uncertainty regarding ownership of intellectual property rights arising from our collaborative activities,
which could prevent us from entering into additional collaborations; unwillingness by the partner to cooperate in the development or
manufacture of the product, including providing us with product data or materials; unwillingness on the part of a partner to keep us
informed regarding the progress of its development and commercialization activities or to permit public disclosure of the results of
those activities; initiating litigation or alternative dispute resolution options by either party to resolve the dispute; or attempts
by either party to terminate the agreement. Litigation or alternative dispute resolution options can be lengthy and expensive, require
significant time and attention from our management and are highly uncertain. There can be no assurance that if we pursue, or a partner
pursues litigation or alternative dispute resolution options, that we will prevail. Monetary and equitable damages awarded against us
could have a material adverse effect on our business.
If
in the future we are unable to establish U.S. or global sales and marketing capabilities or enter into agreements with third parties
to sell and market our product candidates, we may not be successful in commercializing our product candidates if they are approved and
we may not be able to generate any revenue.
We
currently do not have a marketing or sales team for the marketing, sales and distribution of any of our product candidates that may receive
regulatory approval. In order to commercialize any product candidates after approval, we must build on a territory-by-territory basis
marketing, sales, distribution, managerial and other non-technical capabilities or make arrangements with third parties to perform these
services, and we may not be successful in doing so. If our product candidates receive regulatory approval, we may decide to establish
an internal sales or marketing team with technical expertise and supporting distribution capabilities to commercialize our product candidates,
which will be expensive and time-consuming and will require significant attention of our executive officers to manage. Any failure or
delay in the development of our internal sales, marketing and distribution capabilities would adversely impact the commercialization
of any of our product candidates that we obtain approval to market.
With
respect to the commercialization of all or certain of our product candidates, we may choose to collaborate, either globally or on a territory-by-territory
basis, with third parties that have direct sales forces and established distribution systems, either to augment our own sales force and
distribution systems or in lieu of our own sales force and distribution systems. If we are unable to enter into or maintain such arrangements
when needed on acceptable terms, or at all, we may not be able to successfully commercialize any of our product candidates that receive
regulatory approval or any such commercialization may experience delays or limitations. If we are not successful in commercializing our
product candidates, either on our own or through collaborations with one or more third parties, our future product revenue will suffer
and we may incur significant additional losses.
We
face significant competition from other biotechnology and pharmaceutical companies.
Our
product candidates face, and will continue to face, intense competition from large pharmaceutical and biotechnology companies, as well
as academic and research institutions. We compete in an industry that is characterized by (i) rapid technological change, (ii) evolving
industry standards, (iii) emerging competition and (iv) new product introductions. Our competitors have existing products and technologies
that will compete with our product candidates and technologies and may develop and commercialize additional products and technologies
that will compete with our product candidates and technologies. Because several competing companies and institutions have greater financial
resources than us, they may be able to (i) provide broader services and product lines, (ii) make greater investments in research and
development, or R&D, and (iii) carry on broader R&D initiatives. Our competitors also have greater development capabilities than
we do and have substantially greater experience in undertaking preclinical and clinical testing of product candidates, obtaining regulatory
approvals, and manufacturing and marketing pharmaceutical products. They also have greater name recognition and better access to customers
than us.
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Our
product candidates may cause undesirable side effects or have other properties that could halt their clinical development, prevent their
regulatory approval, limit their commercial potential, or result in significant negative consequences.
Undesirable
side effects caused by our product candidates could cause us or regulatory authorities to interrupt, delay or halt clinical trials and
could result in a more restrictive label or the delay or denial of regulatory approval by the FDA or other comparable foreign authorities.
The drug-related side effects could affect patient recruitment or the ability of enrolled patients to complete the trial or result in
potential product liability claims. Any of these occurrences may harm our business, financial condition and prospects significantly.
Even if any of our product candidates receives marketing approval, as greater numbers of patients use a product following its approval,
an increase in the incidence of side effects or the incidence of other post-approval problems that were not seen or anticipated during
pre-approval clinical trials could result in a number of potentially significant negative consequences, including:
●
regulatory authorities
may withdraw their approval of the product;
●
regulatory authorities
may require the addition of labeling statements, such as warnings or contraindications;
●
we may be required to change
the way the product is administered, conduct additional clinical trials or change the labeling of the product;
●
we may elect, or we may
be required, to recall or withdraw product from the market;
●
we could be sued and held
liable for harm caused to patients; and
●
our reputation may suffer.
Any
of these events could substantially increase the costs and expenses of developing, commercializing and marketing any such product candidates
or could harm or prevent sales of any approved products.
Risks
Related to Our Intellectual Property
We
depend upon securing and protecting critical intellectual property.
We
are dependent on obtaining and maintaining patents, trade secrets, copyright and trademark protection of our technologies in the United
States and other jurisdictions, as well as successfully enforcing this intellectual property and defending this intellectual property
against third-party challenges. The degree of future protection of our proprietary rights is uncertain for product candidates that are
currently in the early stages of development because we cannot predict which of these product candidates will ultimately reach the commercial
market or whether the commercial versions of these product candidates will incorporate proprietary technologies.
Our
patent position is highly uncertain and involves complex legal and factual questions.
Accordingly,
we cannot predict the breadth of claims that may be allowed or enforced under our patents or in third-party patents. For example, we
or our licensors might not have been the first to make the inventions covered by each of our pending patent applications and issued patents;
we or our licensors might not have been the first to file patent applications for these inventions; others may independently develop
similar or alternative technologies or duplicate any of our technologies; it is possible that none of our pending patent applications
or the pending patent applications of our licensors will result in issued patents; our issued patents and issued patents of our licensors
may not provide a basis for commercially viable technologies, or may not provide us with any competitive advantages, or may be challenged
and invalidated by third parties; and, we may not develop additional proprietary technologies that are patentable.
Furthermore,
the issuance of a patent, while presumed valid and enforceable, is not conclusive as to its validity or its enforceability and it may
not provide us with adequate proprietary protection or competitive advantages against competitors with similar products. Competitors
may also be able to design around our patents. Other parties may develop and obtain patent protection for more effective technologies,
designs or methods. We may not be able to prevent the unauthorized disclosure or use of our technical knowledge or trade secrets by consultants,
vendors, former employees and current employees.
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Patent
rights are territorial, and patent protection extends only to those countries where we have issued patents. Filing, prosecuting and defending
patents on our products and product candidates in all countries and jurisdictions throughout the world would be prohibitively expensive,
and our intellectual property rights in some countries outside the United States could be less extensive than those in the United States.
Many countries, however, do not protect intellectual property to the same extent as the U.S. or Europe, and their litigation processes
differ. Competitors may successfully challenge or avoid our patents, or manufacture products in countries where we have not applied for
patent protection. Changes in the patent laws in the U.S. or other countries may diminish the value of our patent rights. As a result
of these and other factors, the scope, validity, enforceability, and commercial value of our patent rights are uncertain and unpredictable.
Indeed,
several companies have encountered significant problems in protecting and defending intellectual property rights in foreign jurisdictions.
The legal systems of some countries do not favor the enforcement of patents and other intellectual property rights, which could make
it difficult for us to stop the infringement, misappropriation or other violation of our intellectual property rights generally. Proceedings
to enforce our intellectual property rights in foreign jurisdictions could result in substantial costs and divert our efforts and attention
from other aspects of our business, could put our patents at risk of being invalidated or interpreted narrowly and our patent applications
at risk of not issuing and could provoke third parties to assert claims against us. We may not prevail in any lawsuits that are initiated,
and the damages or other remedies awarded, if any, may not be commercially meaningful.
The
patent positions of pharmaceutical companies, including our patent position, involve complex legal and factual questions, and, therefore,
the issuance, scope, validity and enforceability of any patent claims that we may obtain cannot be predicted with certainty. Patents,
if issued, may be challenged, deemed unenforceable, invalidated, or circumvented. A third-party may submit prior art, or we may become
involved in opposition, derivation, reexamination, inter partes review, post-grant review, supplemental examination, or interference
proceedings challenging our patent rights or the patent rights of our licensors or development partners. The costs of defending or enforcing
our proprietary rights in these proceedings can be substantial, and the outcome can be uncertain. An adverse determination in any such
submission or proceeding could reduce the scope of, or invalidate, our patent rights, allow third parties to commercialize our technology
or products and compete directly with us, or reduce our ability to manufacture or commercialize products. Furthermore, if the scope or
strength of protection provided by our patents and patent applications is threatened, it could discourage companies from collaborating
with us to license, develop or commercialize current or future products. The ownership of our proprietary rights could also be challenged.
As
a result, our owned and licensed patents may be held invalid, and we may not be able to obtain and enforce patents and to maintain trade
secret protection for the full commercial extent of our technology. The extent to which we are unable to do so could materially harm
our business.
We
or our licensors have applied for and will continue to apply for patents for certain products and methods. Such applications may not
result in the issuance of any patents, and any patents now held or that may be issued may not provide us with adequate protection from
competition. Furthermore, it is possible that patents issued or licensed to us may be challenged successfully. In that event, if we have
a preferred competitive position because of such patents, such preferred position would be lost. If we are unable to secure or to continue
to maintain a preferred position, we could become subject to competition from the sale of generic products. Failure to receive, inability
to protect, or expiration of our patents for medical use, manufacture, conjugation and labeling of Ac-225, the antibodies that we license
from third parties, or subsequent related filings, would adversely affect our business and operations.
Patents
issued or licensed to us may be infringed by the products or processes of others. Our ability to enforce our patent rights depends on
our ability to detect infringement. It is difficult to detect infringers who do not advertise the components that are used in their products.
Moreover, it may be difficult or impossible to obtain evidence of infringement in a competitor’s or potential competitor’s
product, particularly in litigation in countries other than the U.S. that do not provide an extensive discovery procedure. Any litigation
to enforce or defend our patent rights, if any, even if we were to prevail, could be costly and time-consuming and would divert the attention
of our management and key personnel from our business operations. We may not prevail in any lawsuits that we initiate and the damages
or other remedies awarded if we were to prevail may not be commercially meaningful.
63
The
cost of enforcing our patent rights against infringers, if such enforcement is required, could be significant, and we may not have the
financial resources to fund such litigation. Further, such litigation can go on for years and the time demands could interfere with our
normal operations. There has been substantial litigation and other proceedings regarding patent and other intellectual property rights
in the pharmaceutical industry. We may become a party to patent litigation and other proceedings. The cost to us of any patent litigation,
even if resolved in our favor, could be substantial. Some of our competitors may be able to sustain the costs of such litigation more
effectively than we can because of their substantially greater financial resources. Litigation may also absorb significant management
time.
Unpatented
trade secrets, improvements, confidential know-how and continuing technological innovation are important to our scientific and commercial
success. Although we attempt to and will continue to attempt to protect our proprietary information through reliance on trade secret
laws and the use of confidentiality agreements with our partners, collaborators, employees and consultants and other appropriate means,
these measures may not effectively prevent disclosure of our proprietary information, and, in any event, others may develop independently,
or obtain access to, the same or similar information. In addition, we cannot guarantee that we have executed these agreements with each
party that may have or have had access to our trade secrets. Furthermore, if the employees and consultants who are parties to these agreements
breach or violate the terms of these agreements, we may not have adequate remedies for any such breach or violation, and we could lose
our trade secrets through such breaches or violations.
Certain
of our patent rights are licensed to us by third parties. If we fail to comply with the terms of these license agreements, our rights
to those patents may be terminated, and we may be unable to conduct our business.
If
we are found to be infringing patents or trade secrets owned by others, we may be forced to cease or alter our product development efforts,
obtain a license to continue the development or sale of our products, and/or pay damages.
We
may not have identified all patents, published applications or published literature that affect our business either by blocking our ability
to commercialize our products, by preventing the patentability of one or more aspects of our products to us or our licensors, or by covering
the same or similar technologies that may affect our ability to market our products. For example, we (or our licensors) may not have
conducted a patent clearance search sufficient to identify potentially obstructing third party patent rights. Moreover, patent applications
in the United States are maintained in confidence for up to 18 months after their filing. In some cases, however, patent applications
remain confidential in the U.S. Patent and Trademark Office, or the USPTO, for the entire time prior to issuance as a U.S. patent. Patent
applications filed in countries outside of the United States are not typically published until at least 18 months from their first filing
date. Similarly, publication of discoveries in the scientific or patent literature often lags behind actual discoveries. We cannot be
certain that we or our licensors were the first to invent, or the first to file, patent applications covering our products and candidates.
We also may not know if our competitors filed patent applications for technology covered by our pending applications or if we were the
first to invent the technology that is the subject of our patent applications. Competitors may have filed patent applications or received
patents and may obtain additional patents and proprietary rights that block or compete with our patents.
Our
manufacturing processes and potential products may violate proprietary rights of patents that have been or may be granted to competitors,
universities or others, or the trade secrets of those persons and entities. As the pharmaceutical industry expands and more patents are
issued, the risk increases that our processes and potential products may give rise to claims that they infringe the patents or trade
secrets of others. These other persons could bring legal actions against us claiming damages and seeking to enjoin clinical testing,
manufacturing and marketing of the affected product or process. If any of these actions are successful, in addition to any potential
liability for damages, we could be required to obtain a license in order to continue to conduct clinical tests, manufacture or market
the affected product or use the affected process. Required licenses may not be available on acceptable terms, if at all, and the results
of litigation are uncertain. If we become involved in litigation or other proceedings, it could consume a substantial portion of our
financial resources and the efforts of our personnel.
64
In
addition to infringement or other intellectual property claims against us, we may become a party to other patent litigation or proceedings
before regulatory agencies, including post-grant review, inter parties review, interference or re-examination proceedings filed with
the U.S. Patent and Trademark Office (or similar proceedings before corresponding tribunals in other jurisdictions) that challenge our
patent rights or the patent rights of our licensors. The costs and efforts of defending our patents or enforcing our proprietary rights
in post-issuance administrative proceedings can be substantial and the outcome can be uncertain. An adverse determination in these proceedings
could weaken or invalidate the patent claims that cover our technology, which adverse determination could harm our business significantly
and dissuade companies from collaborating with us or permit third parties to directly compete with the same technology.
Our
ability to protect and enforce our patents does not guarantee that we will secure the right to commercialize our potential products and
respective patents.
A
patent is a limited monopoly right conferred upon an inventor, and his successors in title, in return for the making and disclosing of
a new and non-obvious invention. This monopoly is of limited duration but, while in force, allows the patent holder to prevent others
from making, using and/or selling its invention. While a patent gives the holder this right to exclude others, it is not a license to
commercialize an invention covered by the patent where other permissions may be required for commercialization to occur. For example,
a drug cannot be marketed without the appropriate authorization from the FDA, regardless of the existence of a patent covering the product.
Further, the invention, even if patented itself, cannot be commercialized if it infringes the valid patent rights of another party.
We
rely on confidentiality agreements to protect our trade secrets. If these agreements are breached by our employees or other parties,
our trade secrets may become known to our competitors.
We
rely on trade secrets that we seek to protect through numerous measures, including non-compete and confidentiality agreements with our
employees and other parties. If these agreements are breached, our competitors may obtain and use our trade secrets to gain a competitive
advantage over us. Any remedies that may be available to us may not be adequate to protect our business or compensate us for the damaging
disclosure. In addition, we may have to expend resources to protect our interests from possible infringement by others.
We
may be subject to damages resulting from claims that we or our employees have wrongfully used or disclosed alleged trade secrets of their
former employers.
Our
employees may have been previously employed at other companies in the industry, including our competitors or potential competitors. Although
we are not aware of any claims currently pending against us, we may be subject to claims that these employees or we have inadvertently
or otherwise used or disclosed trade secrets or other proprietary information of the former employers of our employees. Litigation may
be necessary to defend against these claims. Even if we are successful in defending against these claims, litigation could result in
substantial costs and be a distraction to management. If we fail in defending such claims, in addition to paying money claims, we may
lose valuable intellectual property rights or personnel. A loss of key personnel or their work product could hamper or prevent our ability
to commercialize product(s), which would materially adversely affect our commercial development efforts.
Obtaining
and maintaining patent protection depends on compliance with various procedures and other requirements, and our patent protection could
be reduced or eliminated in case of non-compliance with these requirements.
Periodic
maintenance fees, renewal fees, annuity fees and various other governmental fees on patents and/or applications will be due to the relevant
patent agencies in several stages over the lifetime of the patents and /or applications. The relevant patent agencies require compliance
with a number of procedural, documentary, fee payment and other provisions during the patent application process. In many cases, an inadvertent
lapse can be cured by payment of a late fee or by other means in accordance with the applicable rules. However, there are situations
in which the failure to comply with the relevant requirements can result in the abandonment or lapse of the patent or patent application,
resulting in partial or complete loss of patent rights in the relevant jurisdiction. In such an event, our competitors might be able
to use our technologies and know-how which could have a material adverse effect on our business, prospects, financial condition and results
of operation.
65
Risks Related to Our Operations
Managing
our growth as we expand operations may strain our resources.
We
expect to need to grow rapidly in order to support additional, larger, and potentially international, pivotal clinical trials of our
product candidates as well as potential commercial operations in the future, which will place a significant strain on our financial,
managerial and operational resources. In order to achieve and manage growth effectively, we must continue to improve and expand our operational
and financial management capabilities. Moreover, we will need to increase staffing and to train, motivate and manage our employees. All
of these activities will increase our expenses and may require us to raise additional capital sooner than expected. Failure to manage
growth effectively could materially harm our business, financial condition or results of operations.
The
use of hazardous materials, including radioactive and biological materials, in our research and development efforts imposes certain compliance
costs on us and may subject us to liability for claims arising from the use or misuse of these materials.
Our
research, development and manufacturing activities involve the controlled use of hazardous materials, including chemicals, radioactive
and biological materials, such as radioactive isotopes. We are subject to federal, state, local and foreign environmental laws and regulations
governing, among other matters, the handling, transportation, storage, use and disposal of these materials and some waste products. Our
radiopharmaceutical operations depend on NRC/Agreement State licenses, hazardous-materials shipping permissions, and third-party radioactive
waste services; loss or disruption of any of these could halt clinical supply or commercialization. We cannot completely eliminate the
risk of contamination or injury from these materials, and we could be held liable for any damages that result, which could exceed our
financial resources. We currently maintain insurance coverage for injuries resulting from the hazardous materials we use; however, future
claims may exceed the amount of our coverage. Also, we do not have insurance coverage for pollution cleanup and removal. Currently the
costs of complying with such federal, state, local and foreign environmental regulations are not significant, and consist primarily of
waste disposal expenses. However, they could become expensive, and current or future environmental laws or regulations may impair our
research, development, production and commercialization efforts.
We
may undertake international operations, which will subject us to risks inherent with operations outside of the United States.
Although
we do not have any international operations at this time, we intend to seek market clearances in foreign markets that we believe will
generate significant opportunities. However, even with the cooperation of a commercialization partner, conducting drug development in
foreign countries involves inherent risks, including, but not limited to difficulties in staffing, funding and managing foreign operations;
unexpected changes in regulatory requirements; export restrictions; tariffs and other trade barriers; difficulties in protecting, acquiring,
enforcing and litigating intellectual property rights; fluctuations in currency exchange rates; and potentially adverse tax consequences.
If
we were to experience any of the difficulties listed above, or any other difficulties, any international development activities and our
overall financial condition may suffer and cause us to reduce or discontinue our international development and registration efforts.
We
expect to expand our development and regulatory capabilities and potentially implement sales, marketing and distribution capabilities,
and, as a result, we may encounter difficulties in managing our growth, which could disrupt our operations.
We
expect to experience growth in the number of our employees and the scope of our operations, particularly in the areas of product candidate
development, regulatory affairs and, if any of our product candidates receives marketing approval, sales, marketing, and distribution.
We
currently do not have a marketing or sales team for the marketing, sales and distribution of any of our product candidates that are potentially
able to obtain regulatory approval. In order to commercialize any product candidates, we must build on a territory-by-territory basis
marketing, sales, distribution, managerial and other non-technical capabilities or make arrangements with third parties to perform these
services, and we may not be successful in doing so. If our product candidates receive regulatory approval, we intend to establish an
internal sales or marketing team with technical expertise and supporting distribution capabilities to commercialize our product candidates,
which will be expensive and time consuming and will require significant attention of our executive officers to manage. We will also have
to compete with other pharmaceutical and biotechnology companies to recruit, hire, train and retain marketing and sales personnel. Any
failure or delay in the development of our internal sales, marketing and distribution capabilities would adversely impact the commercialization
of any of our product candidates that we obtain approval to market.
To
manage our anticipated future growth, we must continue to implement and improve our managerial, operational, and financial systems, expand
our facilities, and continue to recruit and train additional qualified personnel. Due to our limited financial resources and the limited
experience of our management team in managing a public company with such anticipated growth, we may not be able to effectively manage
the expansion of our operations or recruit and train additional qualified personnel. The expansion of our operations may lead to significant
costs and may divert our management and business development resources. Any inability to manage growth could delay the execution of our
business plans or disrupt our operations.
66
We
continuously evaluate our business strategy and may modify our strategy as necessary to respond to developments in our business and other
factors, and any such modification such as a divestiture, spin-off, spin-out, merger or acquisition, if not successful, could have a
material adverse effect on our business, financial condition, and results of operations.
We
continuously evaluate our business strategy and modify our plans as necessary to achieve our objectives in response to changing circumstances.
As part of such a process, we may delay, modify or discontinue the development of certain of our drug candidates and choose alternative
approaches if we believe such changes would be in our best interest. We may also expand or alter our research and development activities
from time to time and redirect allocation of our resources. We have implemented such changes in our business strategy and may continue
to do so in the future. There can be no assurances that any product development or other changes that we implement will be successful
or that, after implementation of any such changes, that we will not refocus our efforts on new or different objectives.
We
may expand our business through the acquisition of rights to new product candidates that could disrupt our business, harm our financial
condition and may also dilute current stockholders’ ownership interests in our company.
Our
business strategy includes expanding our products and capabilities, and we may seek acquisitions of product candidates, antibodies or
technologies to do so. Acquisitions involve numerous risks, including substantial cash expenditures; potentially dilutive issuance of
equity securities; incurrence of debt and contingent liabilities, some of which may be difficult or impossible to identify at the time
of acquisition; difficulties in assimilating acquired technologies or the operations of the acquired companies; diverting our management’s
attention away from other business concerns; risks of entering markets in which we have limited or no direct experience; and the potential
loss of our key employees or key employees of the acquired companies.
We
can make no assurances that any acquisition will result in short-term or long-term benefits to us. We may incorrectly judge the value
or worth of an acquired product, company or business. In addition, our future success would depend in part on our ability to manage the
rapid growth associated with some of these acquisitions. We cannot assure that we will be able to make the combination of our business
with that of acquired products, businesses or companies work or be successful. Furthermore, the development or expansion of our business
or any acquired products, business or companies may require a substantial capital investment by us. We may not have these necessary funds,
or they might not be available to us on acceptable terms or at all. We may also seek to raise funds by selling shares of our preferred
or common stock, which could dilute each current stockholder’s ownership interest in the Company.
Risks
Related to Ownership of Our Common Stock
The
sale of securities by us in any equity or debt financing could result in dilution to our existing stockholders and have a material adverse
effect on our earnings.
We
have financed our operations primarily through sales of stock and warrants. It is likely that during the next twelve months we will seek
to raise additional capital through the sales of stock and warrants in order to expand our level of operations to continue our research
and development efforts.
Any
sale of common stock by us in a future offering could result in dilution to our existing stockholders as a direct result of our issuance
of additional shares of our capital stock. In addition, our business strategy may include expansion through internal growth or by establishing
strategic relationships with targeted customers and vendors. In order to do so, or to finance the cost of our other activities, we may
issue additional equity securities that could dilute our stockholders’ stock ownership. We may also assume additional debt and
incur impairment losses related to goodwill and other tangible assets if we acquire another company and this could negatively impact
our earnings and results of operations.
67
Our
common stock is subject to price volatility which could lead to losses by stockholders and potential costly security litigation.
The
trading volume of our common stock has been and may continue to be extremely limited and sporadic. We expect the market price of our
common stock to fluctuate substantially due to a variety of factors, including market perception of our ability to achieve our planned
growth, quarterly operating results of other companies in the same industry, trading volume in our common stock, changes in general conditions
in the economy and the financial markets or other developments affecting our competitors or us. This volatility has had a significant
effect on the market price of securities issued by many companies for reasons unrelated to their operating performance and could have
the same effect on our common stock.
The
trading price of our common stock may be highly volatile and could fluctuate in response to factors such as:
●
actual or anticipated variations
in our operating results;
●
announcements of developments
by us or our competitors;
●
the timing of IND and/or
BLA approval, the completion and/or results of our clinical trials;
●
regulatory actions regarding
our products;
●
announcements by us or
our competitors of significant acquisitions, strategic partnerships, joint ventures or capital commitments;
●
adoption of new accounting
standards affecting our industry;
●
additions or departures
of key personnel;
●
introduction of new products
by us or our competitors;
●
sales of our common stock
or other securities in the open market;
●
inaccurate or unfavorable
reports from securities or industry analysts; and
●
other events or factors,
many of which are beyond our control.
The stock market is subject to significant price and volume fluctuations.
In the past, following periods of volatility in the market price of a company’s securities, securities class action litigation has
often been initiated against such a company. Litigation initiated against us, such as the matters further described under “Legal
Proceedings”, whether or not successful, could result in substantial costs and diversion of our management’s attention and
our resources, which could harm our business and financial condition.
We
do not intend to pay dividends on our common stock, so any returns will be determined by the value of our common stock.
We
have never declared or paid any cash dividends on our common stock. For the foreseeable future, it is expected that earnings, if any,
generated from our operations will be used to finance the growth of our business, and that no dividends will be paid to holders of our
common stock. As a result, the success of an investment in our common stock will depend upon any future appreciation in its value. There
is no guarantee that our common stock will appreciate in value.
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Certain
provisions of our Certificate of Incorporation and Bylaws and Delaware law make it more difficult for a third party to acquire us and
make a takeover more difficult to complete, even if such a transaction were in our stockholders’ interest.
Provisions
of our Certificate of Incorporation and Bylaws may delay or discourage transactions involving an actual or potential change in our control
or change in our management, including transactions in which stockholders might otherwise receive a premium for their shares, or transactions
that our stockholders might otherwise deem to be in their best interests. Therefore, these provisions could adversely affect the price
of our stock. Among other things, the certificate of incorporation and Bylaws:
●
provide that the authorized
number of directors may be changed by resolution of the Board of Directors;
●
provide that all vacancies,
including newly-created directorships, may, except as otherwise required by law, be filled by the affirmative vote of a majority
of directors then in office, even if less than a quorum;
●
divide the Board of Directors
into three classes;
●
provide that stockholders
seeking to present proposals before a meeting of stockholders or to nominate candidates for election as directors at a meeting of
stockholders must provide notice in writing in a timely manner, and meet specific requirements as to the form and content of a stockholder’s
notice;
In
addition, we are governed by Section 203 of the Delaware General Corporation Law. In general, Section 203 prohibits a public Delaware
corporation from engaging in a “business combination” with an “interested stockholder” for a period of three
years after the date of the transaction in which the person became an interested stockholder, unless the business combination is approved
in a prescribed manner. A “business combination” includes mergers, asset sales or other transactions resulting in a financial
benefit to the stockholder. An “interested stockholder” is a person who, together with affiliates and associates, owns, or
within three years, did own, 15% or more of the corporation’s outstanding voting stock. These provisions may have the effect of
delaying, deferring or preventing a change in our control.
General
Risk Factors
We
face risks associated with litigation and claims.
We
are subject to certain legal proceedings, as further described under “Legal Proceedings.” In addition, from time to time,
we may become involved in various claims, disputes and legal or regulatory proceedings that arise in the ordinary course of business
and relate to contractual and other obligations. Due to the uncertainties of litigation, we can give no assurance that we will prevail
on any claims made against us in any such lawsuit. Also, we can give no assurance that any other lawsuits or claims brought in the future
will not have an adverse effect on our financial condition, liquidity, or operating results. Adverse outcomes in some or all of these
claims may result in significant monetary damages that could adversely affect our ability to conduct our business.
Compliance
with the reporting requirements of federal securities laws can be expensive.
We are subject to the information and reporting requirements of the
Securities Exchange Act (the “Exchange Act”) and other federal securities laws, and the compliance obligations of the Sarbanes-Oxley
Act. The costs of preparing and filing annual and quarterly reports and other information with the SEC and furnishing audited reports
to stockholders are substantial. In addition, we will incur substantial expenses in connection with the preparation of registration statements
and related documents with respect to any offerings of our common stock.
Our
ability to utilize our net operating loss carryforwards and certain other tax attributes may be limited.
Our
ability to utilize our federal net operating loss and tax credit carryforwards may be limited under Sections 382 and 383 of the Internal
Revenue Code of 1986, as amended, or the Code. The limitations apply if we experience an “ownership change”, generally
defined as a greater than 50 percentage point change in the ownership of our equity by certain stockholders over a rolling three-year
period. Similar provisions of state tax law may also apply. We have not assessed whether such an ownership change has previously
occurred. If we have experienced an ownership change at any time since our formation, we may already be subject to limitations on
our ability to utilize our existing net operating losses and other tax attributes to offset taxable income. In addition, future changes
in our stock ownership, which may be outside of our control, may trigger an ownership change and, consequently, the limitations under
Sections 382 and 383 of the Code. As a result, if or when we earn net taxable income, our ability to use our pre-change net operating
loss carryforwards and other tax attributes to offset such taxable income may be subject to limitations, which could adversely affect
our future cash flows.
69
Failure
to establish and maintain adequate finance infrastructure and accounting systems and controls could impair our ability to comply with
the financial reporting and internal controls requirements for publicly traded companies.
As
a public company, we operate in an increasingly demanding regulatory environment, including with respect to more complex accounting rules.
Company responsibilities required by the Sarbanes-Oxley Act of 2002, as amended, or the Sarbanes-Oxley Act, include establishing and
maintaining corporate oversight and adequate internal control over financial reporting and disclosure controls and procedures. Effective
internal controls are necessary for us to produce reliable financial reports and are important to help prevent financial fraud.
Our
compliance with Section 404 of the Sarbanes-Oxley Act requires that we incur substantial accounting expense and expend significant management
efforts. We complied with Section 404 at December 31, 2025 and 2024 and while our testing did not reveal any material weaknesses in our
internal controls, any material weaknesses in our internal controls in the future would be required us to remediate in a timely manner
so as to be able to comply with the requirements of Section 404 each year. If we are not able to comply with the requirements of Section
404 in a timely manner each year, we could be subject to sanctions or investigations by the SEC, NYSE American or other regulatory authorities
which would require additional financial and management resources and could adversely affect the market price of our common stock. Furthermore,
if we cannot provide reliable financial reports or prevent fraud, our business and results of operations could be harmed, and investors
could lose confidence in our reported financial information.
If
securities or industry analysts do not publish research or publish inaccurate or unfavorable research about our business, the price of
our common stock and trading volume could decline.
The
trading market for our common stock will depend in part on the research and reports that securities or industry analysts publish about
us or our business. Multiple securities and industry analysts currently cover us. If one or more of the analysts downgrade our common
stock or publish inaccurate or unfavorable research about our business, the price of our common stock would likely decline. If one or
more of these analysts cease coverage of us or fail to publish reports on us regularly, demand for our common stock could decrease, which
could cause the price of our common stock and trading volume to decline.
Our
Bylaws designate the U.S. federal district courts as the exclusive forum for the resolution of any complaint
asserting a cause of action arising under the Securities Act of 1933, as amended.
Our Bylaws provide that,
unless we consent in writing to the selection of an alternative forum, the federal district courts of the United States of America will
be the exclusive forum for resolving any complaint asserting a cause of action arising under the Securities Act of 1933, as amended.
In addition, our Bylaws state that any person purchasing or otherwise acquiring any interest in our security shall be deemed to have
notice of and to have consented to such provision. Such choice of forum provision may limit a stockholder’s ability to bring a
claim in a judicial forum that it finds favorable for disputes with us or our directors, officers or other employees, which may discourage
such lawsuits, if successful, might benefit our stockholders. Stockholders who do bring a claim in the federal district courts of the
United States of America could face additional litigation costs in pursuing any such claim.
The uncertainty of tariff policies and potential
countermeasures could increase our costs and disrupt our global supply chain, which could negatively impact the results of our operations.
President Trump has increased, and has indicated his willingness to
continue to increase, the use of tariffs by the U.S. to accomplish certain U.S. policy goals. In February 2026, the U.S. Supreme Court
ruled that tariffs imposed under the International Emergency Economic Powers Act (IEEPA) are unauthorized. In response, the presidential
administration announced its intention to invoke other laws to collect tariffs and announced new tariffs on imports from all countries
under Section 122 of the Trade Act of 1974, in addition to any existing non-IEEPA tariffs. The administration could additionally take
action to invoke other laws to collect tariffs also. Such tariffs and any countermeasures could increase the cost of raw materials and
components necessary for our operations, disrupt our global supply chain and create additional operational challenges. Further, it is
possible that government policy changes and related uncertainty about policy changes could increase market volatility. Because of these
dynamics, we cannot predict the impact of any future changes to the U.S.’s or other countries’ trading relationships or the
impact of new laws or regulations adopted by the U.S. or other countries on our business. Such changes in tariffs and trade regulations
could have a material adverse effect on our financial condition, results of operations and cash flows.
70
ITEM
1B. UNRESOLVED STAFF COMMENTS.
None.
ITEM
1C. CYBERSECURITY.
The
Company operates in the biotechnology sector and is subject to various cybersecurity risks that could adversely affect the Company’s
business, financial condition or results of operations, including intellectual property theft, fraud, extortion, harm to employees, collaborators
or vendors, violation of privacy laws and other litigations, legal and reputational risk.
The
Company acknowledges that an actual or perceived breach of its information assets could damage its reputation, interfere with the progress
of clinical trials, or interfere with efforts to pursue regulatory approvals for its product candidates. The Company also recognizes
that an actual or perceived breach of its information assets could impact the Company’s business strategy, operations, or financial
condition, as well as subject Actinium to third–party lawsuits, regulatory fines or other actions or liabilities, any of which
could adversely affect the Company. For further information, see “Risk Factors—Our business is subject to cybersecurity risks”
in Item 1A of this Annual Report on Form 10–K.
Actinium’s
Risk Management Strategy:
The
Company recognizes the critical importance of developing, implementing, and maintaining robust cybersecurity measures to safeguard its
information systems and protect the confidentiality, integrity, and availability of its data. With that objective, the Company undertook
a focused cybersecurity assessment conducted by an independent cybersecurity advisory firm to better understand the current cybersecurity
threats and risks necessary to establish the foundation of a cybersecurity risk assessment framework appropriate for its current business
operations and needs. The Company has also engaged well-known and established technology suppliers to support its key technology processes
and operating technical security management activities including threat, vulnerability, and network security management.
The Company has established an Incident Response Policy and recovery
plans to address its response to a cybersecurity incident, including those related to the third-party service providers engaged by the
Company and such plans are tested and evaluated on a regular basis. This includes continuous security operation centers monitoring of
the Company’s systems and accounts.
The
Company proactively mitigates its financial exposure to cybersecurity incidents by maintaining a cyber liability insurance policy. However,
the Company’s cyber liability insurance may be inadequate or may not be available in the future on acceptable terms, or at all.
In addition, the Company’s cyber liability insurance policy may not cover all claims made against the Company. Defending a suit,
regardless of its merit, could be costly and divert management’s attention from the Company’s business and operations.
To
date, Actinium has not experienced any material cybersecurity incident that affected the Company’s operations or financial condition.
Governance:
We rely on a multidisciplinary team including third-party service providers
to assess how identified cybersecurity threats could impact our business. The Company’s cybersecurity function is managed by the
Company’s Principal Financial Officer, who assumes the overall responsibility and accountability of the function and with select
members of the Company’s management is collectively responsible for the day–to–day assessment and management of cybersecurity
risks, their prevention, mitigation, detection, and remediation. Our Principal Financial Officer and other members of management have
undergone various briefings from our cybersecurity advisory firm to prepare them to effectively assess and manage material risks from
cybersecurity threats. Additionally, members of the third-party service providers have cybersecurity experience and/or certifications.
71
The
Company’s Board is involved in overseeing our risk management processes and policies that may be implemented from time to time.
The Audit Committee will coordinate these activities through regular interactions with the Company’s management including but not
limited to: presentations regarding recent developments, potential risks associated with third parties, emerging trends, any relevant
findings or any incident that rises to the level of established thresholds .
The
risk factors discussed in this document should be considered together with information included elsewhere in the Annual Report on Form
10–K and should not be considered as the only risks to which the Company is exposed.
ITEM
2. PROPERTIES.
We do not own any real property. We have leased offices at 100 Park
Avenue, New York, NY 10017, which serves as our corporate headquarters, effective June 1, 2022. The lease has a term of 5 years 2 months,
with an expiration date in 2027, and a current annual rate of $636 thousand. We are also responsible for certain other costs, such as
insurance, taxes, utilities and maintenance. We issued a letter of credit in connection with the lease and as of December 31, 2025, maintain
a $335 thousand certified deposit as collateral for the letter of credit.
We lease lab space and office space at Albert Einstein College of Medicine,
1300 Morris Park Avenue, Bronx, NY 10461. The lease has a term of twelve months, expiring August 31, 2026, with a current annual rate
of $149 thousand. We have leased manufacturing space at the same site, effective December 1, 2025. The lease has a term of five years
and one month, expiring December 31, 2030, with a current annual rate of $171 thousand.
ITEM
3. LEGAL PROCEEDINGS.
From
time to time, we may become involved in various lawsuits and legal proceedings, which arise in the ordinary course of business. Litigation
is subject to inherent uncertainties, and an adverse result in these or other matters may arise from time to time that may harm business.
On March
27, 2025, a putative class action complaint (the “Securities Complaint”) was filed by alleged stockholder Nitin Kohil against
the Company and executives Sandesh Seth, Avinash Desai, Madhuri Vusirikala, and Sergio Giralt (the “Defendants”), styled Kohil
v. Actinium Pharmaceuticals, Inc., et al ., Case No. 1:25-cv-02553 in the United States District Court for the Southern District of
New York, (“the Court”). The Securities Complaint alleges that the Defendants made material misrepresentations and omissions
concerning the Iomab-B Phase 3 Sierra Trial during a proposed class period of October 31, 2022 to August 2, 2024 and asserts claims under
Sections 10(b) and 20(a) of the Securities Exchange Act of 1934. Plaintiff sought unspecified damages. On June 24, 2025, the court in
the securities action appointed lead plaintiffs pursuant to the Private Securities Litigation Reform Act of 1995 and re-captioned the
case as In re Actinium Pharmaceuticals, Inc. Securities Litigation . Lead Plaintiffs filed an amended complaint on August 25, 2025.
On October 27, 2025, Defendants moved to dismiss the amended complaint; on December 19, 2025, Lead Plaintiffs filed their opposition;
and on February 2, 2026, Defendants filed their reply in support. The parties are currently awaiting the Court’s decision on Defendants’
motion
On May
5, 2025, a shareholder complaint captioned Georges v. Seth et al. , Case No. 1:25-cv-03738-JPO was filed against certain of the
Company’s directors and officers, alleging derivative liability based on the same factual allegations made in the securities class
action. On May 13, 2025, a second substantially identical derivative complaint captioned Robinson v. Seth et al ., Case No. 1:25-cv-04012-JPO
was filed. On June 24, 2025, the Court consolidated the derivative cases and, on July 29, 2025, the parties to the derivative cases filed
a stipulation with the Court to stay those matters pending resolution of the motion that defendants will file in the securities class
action. The Court so-ordered that stipulation on July 30, 2025, and re-captioned the case as In re Actinium Pharmaceuticals, Inc. Derivative
Litigation.
On June
17, 2025, a purported shareholder served Actinium with a demand for books and records pursuant to Section 220 of the Delaware General
Corporation Law. In general, the demand seeks documents relating to the facts at issue in the above-described securities class action
and derivative cases. The Company rejected the shareholder demand by letter dated July 8, 2025. The parties continue to discuss the demand,
though the shareholder has not followed up on his demand since October 2025.
The
Company and other Defendants intend to defend vigorously against such claims, however, there can be no assurances as to the outcome.
ITEM
4. MINE SAFETY DISCLOSURES.
Not
Applicable.
72
PART
II
ITEM
5. MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDERS MATTERS, AND ISSUER PURCHASE OF EQUITY SECURITIES.
Market
Information
Our
common stock is listed for quotation on the NYSE American under the symbol “ATNM”.
Holders
As of March 30, 2026, there were 31,175,949 shares of common stock issued
and outstanding, which were held by approximately 100 holders of record. There are no shares of preferred stock outstanding.
Dividends
We
have never declared or paid any cash dividends on our common stock. For the foreseeable future, it is expected that earnings, if any,
generated from our operations will be used to finance the growth of our business, and that no dividends will be paid to holders of our
common stock. The decision to pay dividends is at the discretion of our Board of Directors and depends upon our financial condition,
results of operations, capital requirements, and other factors that our Board of Directors deems relevant.
Securities
Authorized for Issuance under Equity Compensation Plans
We
currently have one equity compensation plan. The Company’s 2019 Amended and Restated Stock Plan, (the “2019 Plan”)
has an expiration date of October 18, 2029 and the number of shares of our common stock authorized under the plan for grant to employees,
directors and consultants is 9,333,333 shares.
The
following table indicates shares of common stock authorized for issuance under our equity compensation plan as of December 31, 2025:
Plan category
Number of
securities to
be issued
upon exercise
of outstanding
options and restricted stock units
Weighted-
average
exercise
price of
outstanding
options
Number of
securities
remaining
available
for future
issuance
Equity compensation plans approved by security holders
398,898
$ 5.89
8,882,721
Equity compensation plans not approved by security holders
-
-
-
Total
398,898
$ 5.89
8,882,721
73
ITEM
6. RESERVED.
ITEM
7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.
The
information and financial data discussed below is derived from the audited consolidated financial statements of Actinium Pharmaceuticals,
Inc. for its fiscal years ended December 31, 2025 and 2024. The consolidated financial statements of Actinium Pharmaceuticals, Inc.
were prepared and presented in accordance with generally accepted accounting principles in the United States. The information and financial
data discussed below is only a summary and should be read in conjunction with the historical financial statements and related notes of
Actinium Pharmaceuticals, Inc. contained elsewhere in this Report. The financial statements contained elsewhere in this Report fully
represent Actinium Pharmaceuticals, Inc.’s financial condition and operations; however, they are not indicative of the Company’s
future performance. See “Cautionary Note Regarding Forward-Looking Statements” above for a discussion of forward-looking
statements and the significance of such statements in the context of this Report. See also “Risk Factors” in Part I,
Item 1A of this Report for a discussion of risks and uncertainties that could impact Actinium Pharmaceuticals, Inc.’s future financial
condition, operations and performance.
Actinium
Pharmaceuticals, Inc. (“Actinium”, the “Company”, or “we”) is a pioneer in the development of targeted
radiotherapies intended to meaningfully improve outcomes for patients with relapsed or refractory cancer who have failed existing therapies.
We operate as a single operating segment focused on research, discovery, and clinical development of targeted radiotherapies.
Results
of Operations – Year Ended December 31, 2025 Compared to the Year Ended December 31, 2024
The
following table sets forth, for the periods indicated, data derived from our statements of operations:
For the years ended
December 31,
Increase
(amounts in thousands)
2025
2024
(Decrease)
Revenue:
Revenue
$ -
$ -
$ -
Other revenue
90
-
90
Total revenue
90
-
90
Operating expenses:
Research and development, net of reimbursements
21,124
30,045
(8,921 )
General and administrative
15,213
12,076
3,137
Total operating expenses
36,337
42,121
(5,784 )
Other income:
Interest income – net
2,360
3,878
(1,518 )
Total other income
2,360
3,878
(1,518 )
Net loss
$ (33,887 )
$ (38,243 )
$ (4,356 )
74
Revenues
We
recorded no commercial revenues for the years ended December 31, 2025 and 2024, respectively.
Other
revenue
The
National Institutes of Health awarded us a Small Business Technology Transfer cost reimbursable grant to support a clinical collaboration
with Memorial Sloan Kettering Cancer Center, or MSK, to study Iomab-ACT, our CD45-targeting Antibody Radio-Conjugate, for targeted conditioning
to achieve lymphodepletion prior to administration of a CD19-targeted CAR T-cell therapy developed at MSK. We recognized other revenue
during the year ended December 31, 2025 of $0.1 million from this grant.
On April 7, 2022, we entered into a License Agreement with Immedica,
(the License Agreement), pursuant to which Immedica licensed the exclusive product rights for commercialization of Iomab-B in certain
countries in the EUMENA region. Upon signing, we were entitled to an upfront, non-refundable payment of $35.0 million from Immedica, which
was received in May 2022. Under the terms of the License Agreement, we are eligible to receive certain regulatory and commercial milestone
payments and royalties on net sales of the product in certain countries that may result from the License Agreement. We continue to retain
commercialization rights in the U.S. and rest of the world.
Our
contract liabilities are recorded within Other revenue deferred – current liability or Long-term license revenue deferred in our
condensed consolidated balance sheets depending on the short-term or long-term nature of the payments to be recognized. Our contract
liabilities primarily consist of advanced payments from licensees. Long-term license revenue deferred was $35.0 million at December 31,
2025 and December 31, 2024, resulting from the receipt from Immedica; this deferred revenue will be recognized upon the European Union’s
regulatory approval of Iomab-B or provision of definitive feedback that Iomab-B will not receive approval in the European Union.
Stock
Option Compensation Expense
On March 31, 2025, our Board of Directors approved the cancellation of
certain stock options to purchase an aggregate of 4.9 million shares of common stock held by certain current employees and directors that
were initially granted under our Amended and Restated 2013 Stock Plan and 2019 Stock Plan. Such cancellations were subject to the consent
of the applicable holders of the stock options.
The cancellation of stock options on March 31, 2025, described above,
resulted in a significant increase in non-cash stock-based compensation for the year ended December 31, 2025 compared to its prior-year
period due to recognition of previously unrecognized stock-based compensation cost at the cancellation. During the years ended December
31, 2025 and December 31, 2024, total non-cash stock-based compensation expense, including stock option compensation expense, was $9.2
million and $5.3 million, respectively. No stock options or restricted stock units were granted during 2025 to existing employees or Board
members.
Research
and Development Expenses, net of reimbursements
Research
and development expenses decreased by $8.9 million to $21.1 million for the year ended December 31, 2025, compared to $30.0 million for
the year ended December 31, 2024. The decrease was primarily driven by a decline in outside CRO services and other preclinical R&D
expenses of $5.5 million and lower compensation of $4.3 million due to lower headcount. In the second quarter of 2025, we conducted a
workforce optimization that reduced our headcount by approximately fourteen percent and announced a strategic pipeline prioritization.
These decreases were partially offset by higher non-cash stock-based compensation of $1.0 million, resulting from the cancellation of
stock options described above.
75
General
and Administrative Expenses
General and administrative
expenses increased by $3.1 million to $15.2 million for the year ended December 31, 2025, compared to $12.1 million for the year ended
December 31, 2024. Higher non-cash compensation expense of $2.9 million resulting from the cancellation of stock options described above
and higher consulting fees and legal fees of $0.7 million were partially offset by lower compensation expense of $0.5 million, due to
lower headcount.
Other
Income
Other income is comprised of net interest income in both reporting periods.
Other income for the year ended December 31, 2025 was $2.4 million, a decrease of $1.5 million from $3.9 million for the year ended December
31, 2024, primarily due to a lower average cash balance during 2025 compared to the prior year.
Net
Loss
Net loss decreased by $4.4
million to $33.9 million for the year ended December 31, 2025, compared to $38.2 million for the year ended December 31, 2024, primarily
due to lower research and development expenses of $8.9 million for the year ended December 31, 2025. This decrease was partially offset
by higher general and administrative expenses of $3.1 million, attributable to higher non-cash stock-based compensation expense of $2.9
million resulting from the cancellation of stock options described above, along with lower other income.
Liquidity
and Capital Resources
Historically,
we have financed our operations primarily through sales of our common stock and common stock equivalents. The following tables sets forth
selected cash flow information for the periods indicated:
For the years ended
December 31,
(amounts in thousands)
2025
2024
Cash used in operating activities
$ (24,580 )
$ (33,072 )
Cash used in investing activities
(104 )
(11 )
Cash used in/provided by financing activities
(217 )
29,321
Effect of foreign currency rates on cash
6
-
Net change in cash, cash equivalents and restricted cash
$ (24,895 )
$ (3,762 )
Net
cash used in operating activities for the year ended December 31, 2025 was $24.6 million, representing a decrease of $8.5 million compared
to $33.1 million in the prior-year period. This reduction was primarily driven by lower cash compensation of $4.8 million due to reduced
headcount and a $5.5 million decline in outside CRO services and other preclinical R&D expenses, partially offset by lower interest
income of $1.5 million and a $1.0 million decrease in net operating assets.
Net
cash used in investing activities was $104 thousand for the year ended December 31, 2025 as we began construction to create modular removable
manufacturing space, with an estimated cost of $1.4 million to be incurred in 2026. For the year ended December 31, 2024, net cash used
in investing activities was $11 thousand for the purchase of equipment for our laboratory space.
Net cash used in financing activities was $217 thousand for the year ended
December 31, 2025 related to restricted stock units withheld to cover tax withholding obligations. Net cash provided by financing activities
of $29.3 million in 2024 was primarily from the sale of shares of common stock.
76
In August 2020, we entered into the Capital on Demand™ Sales Agreement
with JonesTrading Institutional Services LLC, or JonesTrading, pursuant to which we are able to sell, from time to time, through or to
JonesTrading, up to an aggregate of $200 million of our common stock. On June 28, 2022, we entered into an Amendment and Restated Capital
on Demand™ Sales Agreement, or the Amended Sales Agreement, with JonesTrading and B. Riley Securities, Inc. (“B. Riley”).
The Amended Sales Agreement modifies the original Capital on Demand™ Sales Agreement to include B. Riley as an additional sales
agent thereunder. Shares of common stock were offered pursuant to a shelf registration statement on Form S-3 (File No. 333-242322) filed
with the SEC on August 7, 2020 (the “Prior Shelf Registration Statement”). On August 11, 2023, we filed a registration statement
on Form S-3 (File No. 333-273911), and amended on February 2, 2024, which was declared effective on February 5, 2024, to replace the Prior
Shelf Registration Statement, including a base prospectus which covers the offering, issuance and sale of up to $500 million of common
stock, preferred stock, warrants, units and/or subscription rights; and a sales agreement prospectus covering the offering, issuance and
sale of up to a maximum aggregate offering price of $200 million of common stock that may be issued and sold under the Amended Sales Agreement.
There was no sale of shares of common stock during the year ended December 31, 2025, pursuant to the Amended Sales Agreement. For the
year ended December 31, 2024, we sold 3.5 million shares of common stock, resulting in gross proceeds of $29.9 million and net proceeds
of $29.3 million under the Amended Sales Agreement.
We
entered into a lease for corporate office space effective June 1, 2022. The lease has a term of five years and two months, with an expiration
date in 2027, and current annual rent of $0.6 million. We are also responsible for certain other costs, such as insurance, utilities
and maintenance. We issued a letter of credit in connection with the lease and as of December 31, 2025 maintain a $0.3 million certified
deposit as collateral for the letter of credit.
We
entered into a lease for manufacturing space effective December 1, 2025. The lease has a term of five years and one month, with an expiration
date in 2030, and current annual rent of $0.2 million. We are also responsible for certain other costs, such as insurance, utilities
and maintenance.
We will require additional funds to conduct clinical and non-clinical trials,
achieve regulatory approvals, and, subject to such approvals, commercially launch our product candidates, and will need to secure additional
financing in the future to support our operations. As of the date of filing this report, we expect that our existing resources will be
more than sufficient to fund our planned operations for more than 12 months following the date of this report. We base this belief on
assumptions that are subject to change, and we may be required to use our available cash and cash equivalent resources sooner than we
currently expect. In the long-term, we intend to continue to fund our operations through the sales of our common stock and common stock
equivalents, noting our actual future capital requirements will depend on many factors, including the progress and results of our ongoing
clinical trials, the duration and cost of discovery and preclinical development, laboratory testing and clinical trials for our pipeline
candidates, the timing and outcome of regulatory review of our product candidates, the costs involved in preparing, filing, prosecuting,
maintaining, defending, and enforcing patent claims and other intellectual property rights, the number and development requirements of
other pipeline candidates that we pursue, and the costs of commercialization activities, including product marketing, sales, and distribution.
We
expect to continue to operate at a net loss as we continue our research and development efforts, continue to conduct clinical trials
and develop manufacturing, sales, marketing and distribution capabilities. There can be no assurance that the products under development
by us will be approved for sale in the United States or elsewhere. Our ability to obtain additional capital may depend on prevailing
economic conditions and financial, business, and other factors beyond our control. Current economic conditions have been, and continue
to be, volatile. Continued instability in these market conditions may limit our ability to access the capital necessary to fund and grow
our business.
Off-Balance
Sheet Arrangements
We
do not have any off-balance sheet arrangements.
Critical
Accounting Estimates
Our management’s discussion and analysis of financial condition and
results of operations is based on our consolidated financial statements, which have been prepared in accordance with accounting principles
generally accepted in the United States (“GAAP”). The preparation of these financial statements requires us to make estimates
and judgments that affect the reported amounts of assets, liabilities and expenses and the disclosure of contingent assets and liabilities
in our consolidated financial statements during the reporting periods. These items are monitored and analyzed by us for changes in facts
and circumstances, and material changes in these estimates could occur in the future. We base our estimates on historical experience,
known trends and events, and on various other factors that we believe are reasonable under the circumstances, the results of which form
the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Changes
in estimates are reflected in reported results for the period in which they become known. Actual results may differ materially from these
estimates under different assumptions or conditions. The Company does not have any critical accounting estimates that are likely to have
a material impact on our financial condition or results of operation.
77
Recently
Adopted Accounting Pronouncements
In December 2023, the Financial Accounting Standards Board (“FASB”)
issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, to enhance the transparency and decision usefulness
of income tax disclosures. The amendments in ASU 2023-09 provide improvements primarily related to the rate reconciliation and income
taxes paid information included in income tax disclosures. We are required to disclose additional information regarding reconciling items
equal to or greater than five percent of the amount computed by multiplying pretax income (loss) by the applicable statutory tax rate.
Similarly, we are required to disclose income taxes paid (net of refunds received) equal to or greater than five percent of total income
taxes paid (net of refunds received). The amendments in ASU 2023-09 were effective January 1, 2025 to be applied on a prospective basis,
with retrospective application permitted. We adopted ASU 2023-09 on a retrospective basis and it did not have a material impact on our
consolidated financial statements.
In
July 2025, the One Big Beautiful Bill Act (“OBBBA”) was enacted in the U.S. The OBBBA includes significant provisions, such
as the permanent extension of certain expiring provisions of the Tax Cuts and Jobs Act, modifications to the international tax framework
and the restoration of favorable tax treatment for certain business provisions. The legislation has multiple effective dates, with certain
provisions effective in 2025 and others implemented through 2027. We have evaluated the impact of the OBBBA and determined that it does
not have a material impact on our consolidated financial position and results of operations.
Recently
Issued Accounting Pronouncements
In September 2025, the FASB issued ASU 2025-07, Derivatives and Hedging
(Topic 815) and Revenue from Contracts with Customers (Topic 606): Derivatives Scope Refinements and Scope Clarification for Share-Based
Noncash Consideration from a Customer in a Revenue Contract , which excludes from derivative accounting non-exchange-traded contracts
with underlying terms that are based on operations or activities specific to one of the parties to the contract. However, this scope exception
does not apply to (1) variables based on a market rate, market price, or market index, (2) variables based on the price or performance
of a financial asset or financial liability of one of the parties to the contract, (3) contracts (or features) involving the issuer’s
own equity that are evaluated under the guidance in Subtopic 815-40, Derivatives and Hedging—Contracts in Entity’s Own
Equity, and (4) call options and put options on debt instruments. We can apply the amendments in AUS 2025-07 either (1) prospectively
to new contracts entered into on or after the date of adoption or (2) on a modified retrospective basis through a cumulative-effect adjustment
to the opening balance of retained earnings as of the beginning of the annual reporting period of adoption for contracts existing as of
the beginning of the annual reporting period of adoption. The amendments in ASU 2025-07 are effective January 1, 2027, for annual reporting
periods, including interim periods within annual reporting periods. Early adoption is permitted. We are evaluating the impact of ASU 2025-07
on our financial statements.
In
May 2025, FASB issued ASU 2025-04, Compensation—Stock Compensation (Topic 718) and Revenue from Contracts with Customers (Topic
606): Clarifications to Share-Based Consideration Payable to a Customer , which revises the Master Glossary definition of the term
“performance condition” for share-based consideration payable to a customer to include conditions, such as vesting conditions,
that are based on the volume or monetary amount of a customer’s purchases or potential purchases of goods or services from the
grantor, including over a specified period of time. The revised definition also incorporates performance targets based on purchases made
by other parties that purchase the grantor’s goods or services from the grantor’s customers. The revised definition of the
term performance condition cannot be applied by analogy to awards granted to employees and nonemployees in exchange for goods or services
to be used or consumed in the grantor’s own operations. ASU 2025-04 eliminates the policy election permitting a grantor to account
for forfeitures as they occur for share-based awards granted to a customer. Separate policy elections for forfeitures remain available
for share-based payment awards with service conditions granted to employees and nonemployees in exchange for goods or services to be
used or consumed in the grantor’s own operations. ASU 2025-04 further clarifies that a grantor should not apply the guidance in
Topic 606 on constraining estimates of variable consideration to share-based consideration payable to a customer. ASU 2025-04 permits
a grantor to apply the new guidance on either a modified retrospective or a retrospective basis. The amendments in ASU 2025-04 are effective
January 1, 2027, for annual reporting periods, including interim periods within annual reporting periods. We are evaluating the impact
of ASU 2025-04 on our financial statements.
78
In
November 2024, FASB issued ASU 2024-03, Income Statement-Reporting Comprehensive Income-Expense Disaggregation Disclosures (Subtopic
220-40), to improve the disaggregation of expenses within the consolidated statement of operations. The amendments in ASU 2024-03 require
disclosures in the notes to the consolidated financial statements and specified information about certain costs and expenses. The amendments
require that at each interim and annual reporting period an entity disclose (a) employee compensation, (b) depreciation, and (c) intangible
asset amortization included in each relevant expense caption; include certain amounts that are already required to be disclosed under
current GAAP in the same disclosure as the other disaggregation requirements; and disclose a qualitative description of the amounts remaining
in relevant expense captions that are not separately disaggregated quantitatively. The amendments in ASU 2024-03 are effective January
1, 2027 and effective for interim periods beginning January 1, 2028, either on a prospective or retrospective basis. We are evaluating
the impact of ASU 2024-03 on our financial statements.
Known
Trends, Events and Uncertainties
The Company is subject to risks and uncertainties common to companies in
the biopharmaceutical industry, including but not limited to, risks associated with completing preclinical studies and clinical trials,
receiving regulatory approvals for product candidates, development by competitors of new biopharmaceutical products, dependence on key
personnel, protection of proprietary technology, compliance with government regulations and the ability to secure additional capital to
fund operations. In addition, the consequences of the ongoing geopolitical conflicts, such as the ongoing conflict between Russia and
Ukraine and the ongoing conflicts in the Middle East, including related sanctions and countermeasures, and the effects of rising global
inflation, are difficult to predict, and could adversely impact geopolitical and macroeconomic conditions, the global economy, and contribute
to increased market volatility, which may in turn adversely affect our business and operations. In the past, U.S. federal government shutdowns,
such as the shutdown that began on October 1, 2025 and ended on November 12, 2025, have curtailed operations of key agencies such as the
FDA and the NIH, which includes the NCI. Future shutdowns may result in delays or disrupt our ability to advance clinical development
of the current and planned clinical trials under our CRADA, obtain regulatory interactions/approvals, or secure government-funded grants.
Additionally, changes to U.S. policy implemented by the U.S. Congress, the Trump administration or any new administration have impacted
and may in the future impact, among other things, the U.S. and global economy, tariffs, international trade relations, unemployment, immigration,
healthcare, taxation, the U.S. regulatory environment, inflation and other areas. Although we cannot predict the impact, if any, of these
changes to our business, they could adversely affect our business. For a further discussion of factors that may affect future operating
results see the sections entitled “Risk Factors” and “Cautionary Statement Regarding Forward-Looking Statement Notice.”
Other
than as discussed above and elsewhere in this report, we are not aware of any trends, events or uncertainties that are likely to have
a material effect on our financial condition.
Subsequent
Event
In February 2026, the Chief Financial Officer of our Company tendered
his resignation. To fill this executive vacancy, our Board appointed Sandesh Seth, the current Chairman and Chief Executive Officer of
the Company, to serve as our Principal Financial Officer.
ITEM
7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.
We
are a smaller reporting company as defined by Rule 12b-2 of the Exchange Act and are not required to provide the information required
under this item.
79
ITEM
8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA.
REPORT
OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
To
the Stockholders and Board of Directors of
Actinium
Pharmaceuticals, Inc.
Opinion
on the Financial Statements
We have audited the accompanying consolidated balance
sheet of Actinium Pharmaceuticals, Inc. (the “Company”) as of December 31, 2025, the related consolidated statements of operations,
comprehensive loss, changes in stockholders’ equity, and cash flows for the year ended December 31, 2025, and the related notes
(collectively referred to as the “financial statements”). In our opinion, the financial statements present fairly, in all
material respects, the financial position of the Company as of December 31, 2025, and the results of its operations and its cash flows
for the year ended December 31, 2025, in conformity with accounting principles generally accepted in the United States of America.
As discussed in Notes 1 and 8 to the financial statements,
the Company adopted Accounting Standards Update (ASU) 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures (“ASU
2023-09”). We have also audited the adjustments to the 2024 financial statements to retrospectively adjust the disclosures for the
adoption of ASU 2023-09 in 2025. In our opinion, such retrospective adjustments are appropriate and have been properly applied. We were
not engaged to audit, review, or apply any procedures to the 2024 financial statements of the Company other than with respect to these
retrospective adjustments, and accordingly, we do not express an opinion or any other form of assurance on the 2024 financial statements
taken as a whole.
Basis for Opinion
These financial statements are the responsibility
of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audit. We
are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (“PCAOB”) and are
required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and
regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audit in accordance with the standards
of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements
are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform,
an audit of its internal control over financial reporting. As part of our audit, we are required to obtain an understanding of internal
control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control
over financial reporting. Accordingly, we express no such opinion.
Our audit included performing procedures to assess
the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond
to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements.
Our audit also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating
the overall presentation of the financial statements. We believe that our audit provides a reasonable basis for our opinion.
Critical Audit Matters
Critical audit matters are matters arising from the
current period audit of the financial statements that were communicated or required to be communicated to the audit committee and that:
(1) relate to accounts or disclosures that are material to the financial statements and (2) involved our especially challenging, subjective,
or complex judgments. We determined that there are no critical audit matters.
/s/ CBIZ CPAS P.C .
CBIZ CPAs P.C.
We have served as the Company’s auditor since
2012 (such date takes into account the acquisition of the attest business of Marcum LLP by CBIZ CPAs P.C. effective November 1, 2024).
Houston, Texas
March 30, 2026
F- 1
REPORT OF INDEPENDENT REGISTERED
PUBLIC ACCOUNTING FIRM
To the Stockholders and Board of Directors of
Actinium Pharmaceuticals, Inc.
Opinion on the Financial Statements
We have audited, before the effects of the retrospective
adjustments to the disclosures for the adoption of Accounting Standards Update (ASU) 2023-09, Income Taxes (Topic 740): Improvements to
Income Tax Disclosures (“ASU 2023-09”) as discussed in Notes 1 and 8 to the consolidated financial statements, the accompanying
consolidated balance sheet of Actinium Pharmaceuticals, Inc. (the “Company”) as of December 31, 2024, the related consolidated
statements of operations, changes in stockholders’ equity and cash flows for the year ended December 31, 2024, and the related notes
(collectively referred to as the “financial statements”) (the 2024 financial statements before the effects of the adjustments
discussed in Notes 1 and 8 to the financial statements are not presented herein). In our opinion, the financial statements, before the
effects of the retrospective adjustments to the disclosures for the adoption of ASU 2023-09 as discussed in Notes 1 and 8 to the financial
statements, present fairly, in all material respects, the financial position of the Company as of December 31, 2024, and the results of
its operations and its cash flows for the year ended December 31, 2024, in conformity with accounting principles generally accepted in
the United States of America.
We were not engaged to audit, review, or apply any
procedures to the retrospective adjustments to the disclosures for the adoption of ASU 2023-09 as discussed in Notes 1 and 8 to the financial
statements and, accordingly, we do not express an opinion or any other form of assurance about whether such adjustments are appropriate
and have been properly applied. Those retrospective adjustments were audited by CBIZ CPAs P.C.
Basis for Opinion
These financial statements are the responsibility
of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audit. We
are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (“PCAOB”) and are
required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and
regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audit in accordance with the standards
of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements
are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform,
an audit of its internal control over financial reporting. As part of our audit, we are required to obtain an understanding of internal
control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control
over financial reporting. Accordingly, we express no such opinion.
Our audit included performing procedures to assess
the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond
to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements.
Our audit also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating
the overall presentation of the financial statements. We believe that our audit provides a reasonable basis for our opinion.
Critical Audit Matters
Critical audit matters are matters arising from the
current period audit of the financial statements that were communicated or required to be communicated to the audit committee and that:
(1) relate to accounts or disclosures that are material to the financial statements and (2) involved our especially challenging, subjective,
or complex judgments. We determined that there are no critical audit matters.
/s/ Marcum LLP
Marcum LLP
We have served as the Company’s auditor from
2012 through 2025.
Houston, Texas
March 31, 2025
F- 2
Actinium
Pharmaceuticals, Inc.
Consolidated Balance Sheets
(amounts
in thousands, except share and per share data)
December 31,
2025
December 31,
2024
Assets
Current Assets:
Cash and cash equivalents
$ 47,998
$ 72,904
Prepaid expenses and other current assets
1,383
1,602
Total Current Assets
49,381
74,506
Property and equipment, net of accumulated depreciation of $ 1,064 and $ 891
295
364
Restricted cash – long term
335
324
Operating lease right-of-use assets
1,754
1,685
Finance leases right-of-use assets
10
20
Total Assets
$ 51,775
$ 76,899
Liabilities and Stockholders’ Equity
Current Liabilities:
Accounts payable and accrued expenses
$ 7,247
$ 7,568
Operating leases current liability
711
569
Finance leases current liability
11
11
Total Current Liabilities
7,969
8,148
Long-term license revenue deferred
35,000
35,000
Long-term operating lease obligations
972
984
Long-term finance lease obligations
-
9
Total Liabilities
43,941
44,141
Commitments and contingencies
Stockholders’ Equity:
Preferred stock, $ 0.001 par value; 50,000,000 shares authorized, 0 shares issued and outstanding
-
-
Common stock, $ 0.001 par value; 1,000,000,000 shares authorized; 31,195,891 shares issued and outstanding at December 31, 2025 and 2024, respectively
31
31
Additional paid-in capital
417,536
408,553
Accumulated other comprehensive loss
( 20 )
-
Accumulated deficit
( 409,713 )
( 375,826 )
Total Stockholders’ Equity
7,834
32,758
Total Liabilities and Stockholders’ Equity
$ 51,775
$ 76,899
See
accompanying notes to the consolidated financial statements.
F- 3
Actinium
Pharmaceuticals, Inc.
Consolidated Statements of Operations
(amounts
in thousands, except share and per share data)
For the Year ended
December 31,
2025
2024
Revenue
Revenue
$ -
$ -
Other Revenue
90
-
Total revenue
90
-
Operating expenses:
Research and development, net of reimbursements
21,124
30,045
General and administrative
15,213
12,076
Total operating expenses
36,337
42,121
Loss from operations
( 36,247 )
( 42,121 )
Other income:
Interest income – net
2,360
3,878
Total other income
2,360
3,878
Net loss
$ ( 33,887 )
$ ( 38,243 )
Net loss per common share – basic and diluted
$ ( 1.09 )
$ ( 1.27 )
Weighted average common shares outstanding – basic and diluted
31,195,891
30,070,028
See
accompanying notes to the consolidated financial statements.
F- 4
Actinium
Pharmaceuticals, Inc.
Consolidated Statements of Comprehensive Loss
(amounts
in thousands)
For the Year ended
December 31,
2025
2024
Net loss
$ ( 33,887 )
( 38,243 )
Other comprehensive loss:
Foreign currency translation adjustment
( 20 )
-
Comprehensive loss
$ ( 33,907 )
$ ( 38,243 )
See
accompanying notes to the consolidated financial statements.
F- 5
Actinium
Pharmaceuticals, Inc.
Consolidated Statements of Changes in Stockholders’ Equity
For the Years Ended December 31, 2025 and 2024
(amounts in thousands, except share amounts)
Accumulated
Additional
Other
Common Stock
Paid-In
Comprehensive
Accumulated
Stockholders’
Shares
Amount
Capital
Loss
Deficit
Equity
Balance, January 1, 2024
27,634,213
$ 28
$ 373,934
$ -
$ ( 337,583 )
$ 36,379
Stock-based compensation
13,394
-
5,292
-
-
5,292
Sale of common stock, net of offering costs
3,538,136
3
29,252
-
-
29,255
Issuance of common stock from exercise of stock options
10,148
-
75
-
75
Net loss
-
-
-
-
( 38,243 )
( 38,243 )
Balance, December 31, 2024
31,195,891
$ 31
$ 408,553
$ -
$ ( 375,826 )
$ 32,758
Stock-based compensation
-
-
9,190
-
-
9,190
Restricted stock units withheld to cover tax obligations
-
-
( 207 )
-
-
( 207 )
Net loss
-
-
-
-
( 33,887 )
( 33,887 )
Unrealized loss on foreign currency translation
-
-
-
( 20 )
-
( 20 )
Balance, December 31, 2025
31,195,891
$ 31
$ 417,536
$ ( 20 )
$ ( 409,713 )
$ 7,834
See
accompanying notes to the consolidated financial statements.
F- 6
Actinium
Pharmaceuticals, Inc.
Consolidated Statements of Cash Flows
(amounts
in thousands)
For the Year ended
December 31,
2025
2024
Cash Flows from Operating Activities:
Net loss
$ ( 33,887 )
$ ( 38,243 )
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation expense
9,190
5,292
Depreciation expense
173
197
Amortization of right-of-use assets
648
614
Changes in operating assets and liabilities:
Prepaid expenses and other current assets
219
( 15 )
Accounts payable and accrued expenses
( 346 )
( 387 )
Operating lease liabilities
( 577 )
( 530 )
Net Cash Used In Operating Activities
( 24,580 )
( 33,072 )
Cash Flows Used in Investing Activities:
Purchase of property and equipment
( 104 )
( 11 )
Net Cash Used In Investing Activities
( 104 )
( 11 )
Cash Flows From Financing Activities:
Payments on finance leases
( 10 )
( 9 )
Proceeds from sales of shares of common stock, net of offering costs
-
29,255
Restricted stock units withheld to cover tax obligations
( 207 )
-
Proceeds from the exercise of stock options
-
75
Net Cash (Used In) Provided By Financing Activities
( 217 )
29,321
Effect of foreign currency rates on cash
6
-
Net Change in Cash, Cash Equivalents and Restricted Cash
( 24,895 )
( 3,762 )
Cash, cash equivalents and restricted cash at beginning of year
73,228
76,990
Cash, Cash Equivalents and Restricted Cash at End of Year
$ 48,333
$ 73,228
Supplemental Disclosure of Non-cash Investing and Financing Activities:
Right-of-use assets obtained in exchange for lease liabilities
$ 708
$ -
See
accompanying notes to the consolidated financial statements.
F- 7
Actinium
Pharmaceuticals, Inc.
Notes to Consolidated Financial Statements
Note
1 - Description of Business and Summary of Significant Accounting Policies
Nature
of Business - Actinium Pharmaceuticals, Inc. is a biopharmaceutical company developing ARCs and other targeted radiotherapies to
deliver cancer-killing radiation with cellular level precision to treat patients with high unmet medical needs.
Principles
of Consolidation - The consolidated financial statements include the Company’s accounts and those of the Company’s wholly
owned subsidiaries. All significant intercompany accounts and transactions have been eliminated.
Use
of Estimates in Financial Statement Presentation - The preparation of these consolidated financial statements in conformity with
accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect
the reported amounts of assets and liabilities at the date of the consolidated financial statements and the reported amounts of expenses
during the reporting period. Actual results could differ from those estimates.
Segment
Information - The Company operates as a single operating and reportable segment for the purposes of assessing performance and allocating
resources. The Company’s chief operating decision maker is its Chief Executive Officer, who reviews total assets in the consolidated
balance sheets and net loss and its components in the consolidated statements of operations: research and development expenses, general
and administrative expenses, and interest income, for the purposes of making operating decisions, assessing financial performance, and
allocating resources. All assets are in the United States.
Cash
and Cash Equivalents and Restricted Cash - The Company considers all highly liquid accounts with original maturities of three months
or less to be cash equivalents. The Company holds most of its cash equivalents in a Money Market account comprised of U.S. Treasury notes.
Balances held by the Company are typically in excess of Federal Deposit Insurance Corporation insured limits.
Following
is a summary of cash, cash equivalents and restricted cash at December 31, 2025 and December 31, 2024:
(in thousands)
December 31,
2025
December 31,
2024
Cash and cash equivalents
$ 47,998
$ 72,904
Restricted cash – long-term
335
324
Cash, cash equivalents and restricted cash
$ 48,333
$ 73,228
Restricted
cash relates to certificates of deposit held as collateral for letters of credit issued in connection with the Company’s leases
of corporate office spaces.
Property
and Equipment - Machinery and equipment are recorded at cost and depreciated on a straight-line basis over estimated useful lives
of three to five years . Furniture and fixtures are recorded at cost and depreciated on a straight-line basis over estimated useful lives
of seven years. When assets are retired, the cost and related accumulated depreciation are removed from the accounts, and any related
gain or loss is reflected in operations. Repairs and maintenance expenditures are charged to operations when incurred. Capitalized lease
assets are recorded at the lesser of the present value of minimum lease payments or fair value and amortized over the estimated useful
life of the related property or term of the lease. Construction in progress represents costs incurred for assets that are not yet ready
for their intended use. These costs include construction-related expenditures and are not depreciated until the asset is placed in service.
Upon completion, construction in progress is reclassified to the appropriate property and equipment category and depreciation begins.
F- 8
Leases
- The Company has an operating lease for corporate office space, an operating lease for manufacturing space and a finance lease
for office equipment located at the corporate office space. Leases with an initial term of 12 months or less are not recorded on the
balance sheet; lease expense for these leases is recognized on a straight-line basis over the lease term.
Fair
Value Measurement - Fair value is defined as the price that would be received to sell an asset, or paid to transfer a liability,
in an orderly transaction between market participants. A fair value hierarchy has been established for valuation inputs that gives the
highest priority to quoted prices in active markets for identical assets or liabilities and the lowest priority to unobservable inputs.
Revenue
Recognition - The Company recognizes revenue in accordance with Accounting Standards Codification (ASC) Topic 606, Revenue From
Contracts With Customers (“ASC 606”). Under ASC 606, an entity recognizes revenue when its customer obtains control of
promised goods or services, in an amount that reflects the consideration that the entity expects to receive in exchange for those goods
or services. To determine revenue recognition for arrangements within the scope of ASC 606, the entity performs the following five steps:
(i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction
price, including variable consideration, if any; (iv) allocate the transaction price to the performance obligations in the contract;
and (v) recognize revenue as the entity satisfies a performance obligation. The Company only applies the five-step model to contracts
when it is probable that the entity will collect the consideration to which it is entitled in exchange for the goods or services it transfers
to the customer.
At
contract inception, once the contract is determined to be within the scope of ASC 606, the Company assesses whether the promised goods
or services promised within each contract are distinct and, therefore, represent a separate performance obligation. Goods and services
that are determined not to be distinct are combined with other promised goods and services until a distinct bundle is identified. In
determining whether goods or services are distinct, the Company evaluates certain criteria, including whether (i) the customer can
benefit from the good or service either on its own or together with other resources that are readily available to the customer (capable
of being distinct) and (ii) the good or service is separately identifiable from other goods or services in the contract (distinct
in the context of the contract).
The
Company then determines the transaction price, which is the amount of consideration it expects to be entitled from a customer in exchange
for the promised goods or services for each performance obligation and recognizes the associated revenue as each performance obligation
is satisfied. The Company’s estimate of the transaction price for each contract includes all variable consideration to which it
expects to be entitled. Variable consideration includes payments in the form of collaboration milestone payments. If an arrangement includes
collaboration milestone payments, the Company evaluates whether the milestones are considered probable of being reached and estimates
the amount to be included in the transaction price using the most likely amount method. If it is probable that a significant revenue
reversal would not occur, the associated milestone value is included in the transaction price.
ASC
606 requires the Company to allocate the arrangement consideration on a relative standalone selling price basis for each performance
obligation after determining the transaction price of the contract and identifying the performance obligations to which that amount should
be allocated. The relative standalone selling price is defined in the revenue standard as the price at which an entity would sell a promised
good or service separately to a customer. The Company then recognizes as revenue the amount of the transaction price that is allocated
to the respective performance obligation as each performance 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 method.
Collaborative Arrangements
- The Company follows the accounting guidance for collaboration agreements with third parties, which requires that certain transactions
between the Company and collaborators be recorded in its consolidated statements of operations on either a gross basis or net basis,
depending on the characteristics of the collaborative relationship, and requires enhanced disclosure of collaborative relationships.
The Company evaluates its collaboration agreements for proper classification in its consolidated statements of operations based on the
nature of the underlying activity. When the Company has concluded that it has a customer relationship with one of its collaborators,
the Company follows the guidance of ASC 606 . There was no revenue from collaborative arrangements for the years ended December
31, 2025 and December 31, 2024, respectively.
F- 9
Grant
Revenue - The Company has a grant from a government-sponsored entity for research
and development related activities that provides for payments for reimbursed costs, which included overhead and general and administrative
costs as well as an administrative fee. The Company recognizes revenue from grants as it performed services under this arrangement. Associated
expenses are recognized when incurred as research and development expense. The Company concluded that payments received under these grants
represent conditional, nonreciprocal contributions, as described in ASC 958, Not-for-Profit Entities, and that the grants are not within
the scope of ASC 606, Revenue from Contracts with Customers, as the organizations providing the grants do not meet the definition of a
customer. Revenue and related expenses are presented gross in the consolidated statements of operations. Grant revenue is recorded as
Other Revenue in the statement of operations and was $ 90 thousand for the year ended December 31, 2025, there was no grant revenue recognized
for the year ended December 31, 2024.
License
Revenue - The Company entered into a product licensing agreement whereby the Company allowed a third party to commercialize a certain
product in specified territories using the Company’s trademarks. The terms of this arrangement include payment to the Company for
a combination of one or more of the following: upfront license fees; development, regulatory and sales-based milestone payments; and
royalties on net sales of licensed products. The Company uses its judgment to determine whether milestones or other variable consideration
should be included in the transaction price. There was no license revenue recognized for the years ended December 31, 2025 and December
31, 2024, respectively.
Upfront
license fees : If the license to the Company’s intellectual property is determined
to be distinct from the other performance obligations identified in the arrangement, the Company will recognize revenue from upfront license
fees allocated to the license when the license is transferred to the licensee and the licensee is able to use and benefit from the license.
For licenses that are bundled with other promises, the Company determines whether the combined performance obligation is satisfied over
time, in which case the customer will simultaneously receive and consume the benefit from the license as the performance occurs, or at
a point in time.
Development,
regulatory or commercial milestone payments : At the inception of each arrangement that includes payments based on the achievement
of certain development, regulatory and sales-based or commercial events, the Company evaluates whether the milestones are considered
probable of being achieved and estimates the amount to be included in the transaction price using the most likely amount method. If it
is probable that a significant revenue reversal would not occur, the associated milestone value is included in the transaction price.
Milestone payments that are not within the Company’s or the licensee’s control, such as regulatory approvals, are not considered
probable of being achieved until regulatory approval is received. At the end of each subsequent reporting period, the Company will re-evaluate
the probability of achieving such development and regulatory milestones and any related constraint, and if necessary, adjust the Company’s
estimate of the overall transaction price. Any such adjustments are recorded on a cumulative catch-up basis and recorded as part of license
revenue during the period of adjustment.
Sales-based
milestone payments and royalties : For arrangements that include sales-based royalties, including milestone payments based on the
volume of sales, the Company will determine whether the license is deemed to be the predominant item to which the royalties or sales-based
milestones relate and if such is the case, the Company will recognize revenue at the later of (i) when the related sales occur, or (ii)
when the performance obligation to which some or all of the royalty has been allocated has been satisfied (or partially satisfied).
Upfront
payments and fees may require deferral of revenue recognition to a future period until the Company performs its obligations under these
arrangements or when it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur or when
the uncertainty associated with any variable consideration is subsequently resolved. Amounts payable to the Company are recorded as accounts
receivable when the Company’s right to consideration is unconditional.
Research
and Development Costs - Research and development costs are expensed as incurred. These costs include the costs of manufacturing drug
product, the costs of clinical trials, costs of employees and associated overhead, and depreciation and amortization costs related to
facilities and equipment. Research and development reimbursements are recorded by the Company as a reduction of research and development
costs.
Share-Based
Payments - The Company estimates the fair value of each stock option award at the grant date by using the Black-Scholes option pricing
model. The fair value determined represents the cost for the award and is recognized over the vesting period during which an employee
is required to provide service in exchange for the award. The Company accounts for forfeitures of stock options as they occur.
Income
Taxes - The Company accounts for income taxes in accordance with ASC 740 Income Taxes , which requires the asset and liability
method to calculate deferred taxes. Deferred taxes are recognized based on the differences between the financial reporting and income
tax bases of assets and liabilities using the enacted tax rates and laws that will be in effect when the differences are expected to
reverse. The Company reviews deferred tax assets for a valuation allowance based upon whether it is more likely than not that the deferred
tax asset will be fully realized.
F- 10
ASC
740 prescribes guidance for the financial statement recognition, measurement and disclosure of uncertain tax positions. Tax positions
must meet a “more-likely-than-not” recognition threshold to be recognized. There were no tax positions for which it is considered
reasonably possible that the total amounts of unrecognized tax benefits will significantly increase or decrease within the next year.
The Company recognizes interest related to unrecognized tax benefits in interest expense and penalties in operating expenses.
Net
Loss Per Common Share - Basic loss per common share is computed by dividing the net loss available to common stockholders by the
weighted average number of common shares outstanding during the reporting period. For periods of net loss, diluted loss per share is
calculated similarly to basic loss per share because the impact of all potential dilutive common shares is anti-dilutive.
For
the years ended December 31, 2025 and 2024, the Company’s potentially dilutive shares, which include outstanding common stock options,
restricted stock units and warrants, have not been included in the computation of diluted net loss per share as the result would have
been anti-dilutive.
(in thousands)
December 31,
2025
December 31,
2024
Stock Options
99
5,137
Restricted Stock Units
-
300
Vested unissued shares of common stock
179
-
Warrants
7
7
Total
285
5,444
Subsequent
Events - The Company’s management reviewed all material events through the date the consolidated financial statements were
issued for subsequent event disclosure consideration.
Recently
Adopted Accounting Pronouncements
In December 2023, the Financial Accounting Standards Board, (the “FASB”),
issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures , to enhance the transparency and decision
usefulness of income tax disclosures. The amendments in ASU 2023-09 provide improvements primarily related to the rate reconciliation
and income taxes paid information included in income tax disclosures. The Company is required to disclose additional information regarding
reconciling items equal to or greater than five percent of the amount computed by multiplying pretax income (loss) by the applicable statutory
tax rate. Similarly, the Company is required to disclose income taxes paid (net of refunds received) equal to or greater than five percent
of total income taxes paid (net of refunds received). The amendments in ASU 2023-09 are effective
January 1, 2025 to be applied on a prospective basis, with retrospective application permitted. The Company adopted ASU 2023-09 on a retrospective
basis and it did not have a material impact on the Company’s consolidated financial statements.
In
July 2025, the One Big Beautiful Bill Act (“OBBBA”) was enacted in the U.S. The OBBBA includes significant provisions, such
as the permanent extension of certain expiring provisions of the Tax Cuts and Jobs Act, modifications to the international tax framework
and the restoration of favorable tax treatment for certain business provisions. The legislation has multiple effective dates, with certain
provisions effective in 2025 and others expected to be implemented through 2027. The Company has evaluated the impact of the OBBBA and
determined that it does not have a material impact on the Company’s consolidated financial position and results of operations.
F- 11
Recently
Issued Accounting Pronouncements
In September 2025, the FASB issued ASU 2025-07, Derivatives and
Hedging (Topic 815) and Revenue from Contracts with Customers (Topic 606): Derivatives Scope Refinements and Scope Clarification for Share-Based
Noncash Consideration from a Customer in a Revenue Contract , which excludes from derivative accounting non-exchange-traded contracts
with underlying terms that are based on operations or activities specific to one of the parties to the contract. However, this scope exception
does not apply to (1) variables based on a market rate, market price, or market index, (2) variables based on the price or performance
of a financial asset or financial liability of one of the parties to the contract, (3) contracts (or features) involving the issuer’s
own equity that are evaluated under the guidance in Subtopic 815-40, Derivatives and Hedging—Contracts in Entity’s Own
Equity, and (4) call options and put options on debt instruments. The Company can apply the amendments in AUS 2025-07 either (1) prospectively
to new contracts entered into on or after the date of adoption or (2) on a modified retrospective basis through a cumulative-effect adjustment
to the opening balance of retained earnings as of the beginning of the annual reporting period of adoption for contracts existing as of
the beginning of the annual reporting period of adoption. The amendments in ASU 2025-07 are effective January 1, 2027, for annual reporting
periods, including interim periods within annual reporting periods. Early adoption is permitted. The Company is evaluating the impact
of ASU 2025-07 on its financial statements.
In
May 2025, FASB issued ASU 2025-04, Compensation—Stock Compensation (Topic 718) and Revenue from Contracts with Customers (Topic
606): Clarifications to Share-Based Consideration Payable to a Customer , which revises the Master Glossary definition of the term
“performance condition” for share-based consideration payable to a customer to include conditions, such as vesting conditions,
that are based on the volume or monetary amount of a customer’s purchases or potential purchases of goods or services from the
grantor, including over a specified period of time. The revised definition also incorporates performance targets based on purchases made
by other parties that purchase the grantor’s goods or services from the grantor’s customers. The revised definition of the
term performance condition cannot be applied by analogy to awards granted to employees and non-employees in exchange for goods or services
to be used or consumed in the grantor’s own operations. ASU 2025-04 eliminates the policy election permitting a grantor to account
for forfeitures as they occur for share-based awards granted to a customer. Separate policy elections for forfeitures remain available
for share-based payment awards with service conditions granted to employees and non-employees in exchange for goods or services to be
used or consumed in the grantor’s own operations. ASU 2025-04 further clarifies that a grantor should not apply the guidance in
Topic 606 on constraining estimates of variable consideration to share-based consideration payable to a customer. ASU 2025-04 permits
a grantor to apply the new guidance on either a modified retrospective or a retrospective basis. The amendments in ASU 2025-04 are effective
January 1, 2027 for annual reporting periods, including interim periods within annual reporting periods. The Company is evaluating the
impact of ASU 2025-04 on its financial statements.
In
November 2024, FASB issued ASU 2024-03, Income Statement-Reporting Comprehensive Income-Expense Disaggregation Disclosures (Subtopic
220-40), to improve the disaggregation of expenses within the consolidated statement of operations. The amendments in ASU 2024-03 require
disclosures in the notes to the consolidated financial statements and specified information about certain costs and expenses. The amendments
require that at each interim and annual reporting period an entity disclose (a) employee compensation, (b) depreciation, and (c) intangible
asset amortization included in each relevant expense caption; include certain amounts that are already required to be disclosed under
current GAAP in the same disclosure as the other disaggregation requirements; and disclose a qualitative description of the amounts remaining
in relevant expense captions that are not separately disaggregated quantitatively. The amendments in ASU 2024-03 are effective January
1, 2027 and effective for interim periods beginning January 1, 2028, either on a prospective or retrospective basis. The Company is evaluating
the impact of ASU 2024-03 on its financial statements.
Note
2 - Prepaid Expenses and Other Current Assets
Prepaid
expenses and other current assets consisted of the following at December 31, 2025 and 2024:
December 31,
December 31,
2025
2024
Prepaid insurance
$ 591
$ 608
Prepaid clinical trial expenses
624
637
Other prepaid expenses and other current assets
168
357
Total prepaid expenses and other current assets
$ 1,383
$ 1,602
F- 12
Note
3 - Property and Equipment
Property
and equipment consisted of the following at December 31, 2025 and 2024:
December 31,
December 31,
(in thousands)
Lives
2025
2024
Construction in Progress
$ 104
$ -
Lab equipment
5 years
817
817
Office equipment and furniture
3 - 7 years
438
438
Less: accumulated depreciation
( 1,064 )
( 891 )
Property and equipment, net
$ 295
$ 364
The Company entered into an agreement with a contractor for equipment
in newly leased manufacturing space, effective December 1, 2025 and construction in progress was $ 104 thousand at December 31, 2025.
Depreciation
expense consisted of the following for the years ended December 31, 2025 and 2024, respectively:
December 31,
December 31,
(in thousands)
2025
2024
Research and development
$ 139
$ 161
General and administrative
34
36
Total depreciation expense
$ 173
$ 197
Note
4 - Leases
The
Company determines if an arrangement is a lease at inception. This determination generally depends on whether the arrangement conveys
to the Company the right to control the use of a fixed asset for a period of time in exchange for consideration. Control of an underlying
asset is conveyed to the Company if the Company obtains the rights to direct the use of and to obtain substantially all of the economic
benefits from using the underlying asset. The Company has lease agreements which include lease and non-lease components, which the Company
has elected to account for as a single lease component for all classes of underlying assets. Lease expense for variable lease components
are recognized when the obligation is probable. The Company made an accounting policy election to exclude from balance sheet reporting
those leases with initial terms of 12 months or less.
Right-of-use
assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. ASC 842
requires a lessee to discount its unpaid lease payments using the interest rate implicit in the lease or, if that rate cannot be readily
determined, its incremental borrowing rate. As an implicit interest rate was not readily determinable in the Company’s leases,
the incremental borrowing rate was used based on the information available at commencement date in determining the present value of lease
payments.
The
lease term for all of the Company’s leases includes the non-cancellable period of the lease plus any additional periods covered
by either a Company option to extend (or not to terminate) the lease that the Company is reasonably certain to exercise, or an option
to extend (or not to terminate) the lease controlled by the lessor. Options for lease renewals have been excluded from the lease term
(and lease liability) for the Company’s leases as the reasonably certain threshold is not met.
F- 13
As
of December 31, 2025, the Company has three leases which have been capitalized in accordance with ASC 842, one for corporate office space,
one for manufacturing space and one for office equipment. The Company entered into a lease for corporate office space effective June
1, 2022. The lease has a term of 5 years and 2 months , with an expiration date on July 30, 2027 and current annual rent of $ 0.6 million.
The Company is also responsible for certain other costs, such as insurance, utilities and maintenance. As noted above, the Company entered
into a lease for manufacturing space effective December 1, 2025. The lease has a term of five years and one month , with an expiration
date of December 31, 2030 and current annual rent of $ 0.2 million. The Company is also responsible for certain other costs, such as insurance,
utilities and maintenance.
The
components of lease expense are as follows:
(in thousands)
Year ended
December 31,
2025
Year ended
December 31,
2024
Operating lease expense
$ 707
$ 691
Finance lease cost
Amortization of right-to-use assets
$ 10
$ 10
Interest on lease liabilities
$ 1
$ 2
Total finance lease cost
11
$ 12
Supplemental
cash flow information related to leases are as follows:
Year ended
(in thousands)
December 31,
2025
December 31,
2024
Cash flow information:
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flow use from operating leases
$ 645
$ 618
Operating cash flow use from finance leases
$ 11
$ 11
Financing cash flow use from finance leases
$ 10
$ 9
Non-cash activity:
Right-of-use assets obtained in exchange for lease obligations:
Operating leases
$ 707
$ -
Finance leases
$ -
$ -
Weighted
average remaining lease terms are as follows at December 31, 2025:
Weighted average remaining lease term:
Operating leases 2.9 years
Finance leases 1.0 years
As
the interest rate implicit in the leases was not readily determinable at the time that the leases were evaluated, the Company used its
incremental borrowing rate based on the information available in determining the present value of lease payments. The Company’s
incremental borrowing rate was based on the term of the lease, the economic environment of the lease and reflect the rate the Company
would have had to pay to borrow on a secured basis. Below is information on the weighted average discount rates used at the time that
the leases were evaluated:
Weighted average discount rates:
Operating leases
6.0 %
Finance leases
6.2 %
F- 14
Maturities
of lease liabilities are as follows:
Year
ending December 31,
Operating
Leases
Finance
Leases
2026
814
11
2027
557
-
2028
182
-
2029
187
-
2030
193
-
Total
lease payments
$ 1,933
$ 11
Less
imputed interest
( 250 )
(- )
Present
value of lease liabilities
$ 1,683
$ 11
Note
5 - Other Revenue
The
Company has a grant from a government-sponsored entity for research and development related activities that provides for payments for
reimbursed costs, which includes overhead and general and administrative costs as well as an administrative fee. The Company recognized
revenue from grants as it performed services under this arrangement. Associated expenses are recognized when incurred as research and
development expense. Other revenue recognized from this grant during the year ended December 31, 2024 was $ 0.1 million.
On
April 7, 2022, the Company entered into a license and supply agreement (the “License Agreement”) with Immedica Pharma AB
(“Immedica”), pursuant to which Immedica licensed the exclusive product rights for commercialization of Iomab-B (I-131 apamistamab)
in the European Economic Area, Middle East and North Africa (“EUMENA”), including Algeria, Andorra, Bahrain, Cyprus, Egypt,
Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libya, Monaco, Morocco, Oman, Palestine, Qatar, San Marino, Saudi Arabia, Switzerland, Syria,
Tunisia, Turkey, the United Arab Emirates, the United Kingdom, the Vatican City and Yemen. Upon signing, the Company was entitled to
an upfront, non-refundable payment of $ 35 million from Immedica, which was received in May 2022. Under the terms of the License Agreement,
the Company is eligible to receive certain regulatory and commercial milestone payments and royalties on net sales of the product in
certain countries that may result from the License Agreement. The Company continues to retain commercialization rights in the U.S. and
rest of the world.
The Company’s contract
liabilities are recorded within Other revenue deferred – current liability or Long-term license revenue deferred in its consolidated
balance sheets, depending on the short-term or long-term nature of the payments to be recognized. The Company’s contract liabilities
primarily consist of advanced payments from licensees. Long-term license revenue deferred was $ 35.0 million at December 31, 2025 and
December 31, 2024; this deferred revenue will be recognized upon European Union’s regulatory approval of Iomab-B or provision of
definitive feedback that Iomab-B will not receive approval in the European Union.
Note
6 - Commitments and Contingencies
On
June 15, 2012, the Company entered into a license and sponsored research agreement with Fred Hutchinson Cancer Research Center (“FHCRC”)
to build upon previous and ongoing clinical trials with apamistamab (licensed antibody). FHCRC has completed both a Phase 1 and Phase
2 clinical trial with apamistamab. The Company has been granted exclusive rights to the antibody and related master cell bank developed
by FHCRC. A milestone payment of $ 1 million will be due to FHCRC upon FDA approval of the first drug utilizing the licensed antibody.
Upon commercial sale of the drug, royalty payments of 2 % of net sales will be due to FHCRC.
As
of December 31, 2025, the Company had contractual commitments of approximately $ 1.5 million related to the construction of its modular
removable manufacturing space in its newly leased manufacturing space, with $ 1.4 million expected to be incurred in 2026.
On
March 27, 2025, a putative class action complaint (the “Securities Complaint”) was filed by alleged stockholder Nitin Kohil
against the Company and executives Sandesh Seth, Avinash Desai, Madhuri Vusirikala, and Sergio Giralt (the “Defendants”),
styled Kohil v. Actinium Pharmaceuticals, Inc., et al ., Case No. 1:25-cv-02553 in the United States District Court for the
Southern District of New York, (“the Court”). The Securities Complaint alleges that the Defendants made material misrepresentations
and omissions concerning the Iomab-B Phase 3 Sierra Trial during a proposed class period of October 31, 2022 to August 2, 2024 and asserts
claims under Sections 10(b) and 20(a) of the Securities Exchange Act of 1934. Plaintiff sought unspecified damages. On June 24, 2025,
the court in the securities action appointed lead plaintiffs pursuant to the Private Securities Litigation Reform Act of 1995 and re-captioned
the case as In re Actinium Pharmaceuticals, Inc. Securities Litigation . Lead Plaintiffs filed an amended complaint on August 25,
2025. On October 27, 2025, Defendants moved to dismiss the amended complaint; on December 19, 2025, Lead Plaintiffs filed their opposition;
and on February 2, 2026, Defendants filed their reply in support. The parties are currently awaiting the Court’s decision on Defendants’
motion
F- 15
On
May 5, 2025, a shareholder complaint captioned Georges v. Seth et al. , Case No. 1:25-cv-03738-JPO was filed against certain of
the Company’s directors and officers, alleging derivative liability based on the same factual allegations made in the securities
class action. On May 13, 2025, a second substantially identical derivative complaint captioned Robinson v. Seth et al ., Case No.
1:25-cv-04012-JPO was filed. On June 24, 2025, the Court consolidated the derivative cases and, on July 29, 2025, the parties to the derivative
cases filed a stipulation with the Court to stay those matters pending resolution of the motion that defendants will file in the securities
class action. The Court so-ordered that stipulation on July 30, 2025, and re-captioned the case as In re Actinium Pharmaceuticals,
Inc. Derivative Litigation.
On
June 17, 2025, a purported shareholder served Actinium with a demand for books and records pursuant to Section 220 of the Delaware General
Corporation Law. In general, the demand seeks documents relating to the facts at issue in the above-described securities class action
and derivative cases. The Company rejected the shareholder demand by letter dated July 8, 2025. The parties continue to discuss the demand,
though the shareholder has not followed up on his demand since October 2025.
The
Company and other Defendants intend to defend vigorously against such claims, however, there can be no assurances as to the outcome.
Note
7 - Equity
In
August 2020, the Company entered into the Capital on Demand™ Sales Agreement with JonesTrading Institutional Services LLC, “JonesTrading”,
pursuant to which the Company may sell, from time to time, through or to JonesTrading, up to an aggregate of $ 200 million of its common
stock. On June 28, 2022, the Company entered into an Amended and Restated Capital on Demand™ Sales Agreement (the “A&R
Sales Agreement”) with JonesTrading and B. Riley Securities, Inc. (“B. Riley”). The A&R Sales Agreement modifies
the original Capital on Demand™ Sales Agreement to include B. Riley Securities as an additional sales agent thereunder. Shares
of common stock were offered pursuant to a shelf registration statement on Form S-3 (File No. 333-242322) filed with the SEC on August
7, 2020 (the “Prior Shelf Registration Statement”). On August 11, 2023, the Company filed a registration statement on Form
S-3 (File No. 333-273911), which registration statement was amended on February 2, 2024, and declared effective on February 5, 2024,
to replace the Prior Shelf Registration Statement, including a base prospectus which covers the offering, issuance and sale of up to
$ 500 million of common stock, preferred stock, warrants, units and/or subscription rights; and a sales agreement prospectus covering
the offering, issuance and sale of up to a maximum aggregate offering price of $ 200 million of common stock that may be issued and sold
under the Amended Sales Agreement.
The Company did not sell any shares of common stock during the year ended
December 31, 2025 under the A&R Sales Agreement. During the year ended December 31, 2024, the Company sold 3.5 million shares of common
stock, resulting in gross proceeds of $ 29.9 million and net proceeds of $ 29.3 million under the A&R Sales Agreement.
The Company presently has one equity compensation plan, the 2019 Stock
Plan. The 2019 Plan has an expiration date of October 18, 2029 and the number of shares of our common stock authorized under the
plan for grant to employees, directors and consultants is 9,333,333 shares.
Stock
Options
Following
is a summary of stock option activity for the years ended December 31, 2025 and 2024:
(in thousands, except for per-share amount) Number of
Options Weighted
Average
Exercise
Price ($) Weighted
Average
Remaining
Contractual
Term
(in years) Aggregate
Intrinsic
Value ($)
Outstanding, January 1, 2024 5,445 6.80 8.70 373
Granted 154 5.47
Exercised ( 10 ) 7.39
Cancelled ( 452 ) 10.04
Outstanding, December 31, 2024 5,137 6.48 7.04 -
Granted 61 1.42
Exercised -
-
Cancelled ( 5,099 ) 6.43
Outstanding, December 31, 2025 99 5.89 7.66 -
Exercisable, December 31, 2025 48 9.42 6.03 -
During
2025, the Company granted newly hired employees options to purchase 0.1 million shares of common stock with an exercise price ranging
from $ 1.06 to $ 1.55 per share, a term of 10 years , and a vesting period of 4 years. The options have an aggregated fair value of
$ 0.1 million that was calculated using the Black-Scholes option-pricing model. Variables used in the Black-Scholes option-pricing model
include: (1) discount rate range from 3.76 % to 4.46 % (2) expected life of 6 years, (3) expected volatility range from 88.0 % to 90.7 %,
and (4) zero expected dividends.
F- 16
During
2024, the Company granted newly hired employees options to purchase 0.2 million shares of common stock with an exercise price ranging
from $ 7.20 to $ 8.15 per share, a term of 10 years , and a vesting period of 4 years. The options have an aggregated fair value of
$ 0.6 million that was calculated using the Black-Scholes option-pricing model. Variables used in the Black-Scholes option-pricing model
include: (1) discount rate range from 4.19 % to 4.45 % (2) expected life of 6 years, (3) expected volatility range from 80.5 % to 90.5 %,
and (4) zero expected dividends.
On
March 31, 2025, the Board of Directors approved of the cancellation of stock options to purchase an aggregate of 4.9 million shares of
common stock held by certain current employees and directors that were initially granted under the Amended and Restated 2013 Stock Plan
and the 2019 Amended and Restated Stock Plan. Such cancellations were subject to the consent of the applicable holders of the stock options,
which the Company received. The cancellation of these stock options resulted in the recording of $ 8.8 million in stock option compensation
expense for the year ended December 31, 2025. During the year ended December 31, 2024, the Company recorded stock option compensation
expense of $4.6 million.
The
fair values of all options issued and outstanding are being amortized over their respective vesting periods. The unrecognized compensation
expense at December 31, 2025 was $ 0.1 million related to unvested options, which is expected to be expensed over a weighted average of
2.4 years.
Restricted
Stock Units
Following
is a summary of restricted stock unit (“RSUs”) activity for the years ended December 31, 2025 and 2024:
(in thousands, except for per-share amount)
RSUs
Weighted
Average
Grant
Date Fair
Value Per Share ($)
Outstanding, January 1, 2024
305
5.89
Granted
-
-
Vested
-
-
Cancelled
( 5 )
8.31
Outstanding, December 31, 2024
300
5.85
Granted
-
-
Vested
( 300 )
-
Cancelled
-
-
Outstanding, December 31, 2025
-
-
The
RSUs vested on August 18, 2025. The fair value of the RSUs, $ 1.8 million, was determined based on the stock price on the date of the
grants and was recognized over three years. During the years ended December 31, 2025 and 2024, the Company recorded compensation expense
related to RSUs of $ 0.4 million and $ 0.6 million, respectively.
Warrants
Following
is a summary of warrant activities for the years ended December 31, 2025 and 2024:
(in thousands, except for per-share amounts) Number of
Warrants Weighted
Average
Exercise
Price Weighted
Average
Remaining
Contractual
Term
(in years) Aggregate
Intrinsic
Value
Outstanding, January 1, 2024 1,442 16.42 0.34 -
Granted -
-
Exercised -
-
Expired ( 1,435 ) 16.42
Outstanding, December 31, 2024 7 17.33 4.46 -
Granted -
-
Exercised -
-
Expired -
-
Outstanding, December 31, 2025 7 17.33 3.45 -
Exercisable, December 31, 2025 7 17.33 3.45 -
F- 17
On
April 23, 2024, warrants to purchase an aggregate of 1.4 million shares of common stock expired. These warrants were issued on April
23, 2019, when the Company completed an underwritten offering of 1.4 million shares of common stock and warrants to purchase 1.4 million
shares of common stock at a price of $ 11.55 per share and related warrant. The warrants were exercisable for a period of 5 years at an
exercise price of $ 15.00 per share.
During
the years ended December 31, 2025 and 2024, the Company recorded stock-based compensation expense related to warrants of $ 3 thousand
and $ 5 thousand, respectively.
Note
8 - Income Taxes
The
following table presents the domestic and foreign components of loss before income taxes for the years ended December 31, 2025 and 2024,
respectively:
(in
thousands)
2025
2024
Loss before Income Taxes
United States
$ ( 33,289 )
$ ( 38,243 )
Foreign
( 598 )
-
Total
$ ( 33,887 )
$ ( 38,243 )
The components of income tax provision consist of the following for the
years ended December 31, 2025 and 2024, respectively:
(in thousands)
2025
2024
Income Tax Expense
Current
Federal
$ -
$ -
State & Local
-
-
Foreign
-
-
Total
$ -
$ -
Deferred Tax Expense
Federal
$ -
$ -
State & Local
-
-
Foreign
-
-
Total
$ -
$ -
Net Income Tax Expense
$ -
$ -
No income taxes were paid during
the years ended December 31, 2025 and 2024, respectively.
Deferred income taxes reflect
the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and
the amounts used for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities at December
31, 2025 and 2024 are as follows:
(in thousands)
2025
2024
Deferred tax assets:
Net operating losses carry forward
$ 62,548
$ 47,875
Deferred revenue
8,546
8,217
Share-based compensation
14
1,572
Research and development/orphan drug credits
24,811
23,296
Capitalized research and development expenses
20,131
20,664
Lease liabilities
414
369
Others
44
20
Total gross deferred tax assets
116,508
102,013
Less: valuation allowance
( 116,077 )
( 101,613 )
Deferred tax assets, net
431
400
Deferred tax liabilities:
Lease right-of-use assets
( 431 )
( 400 )
Total gross deferred tax assets
( 431 )
( 400 )
Deferred tax assets, net
$ -
$ -
In assessing the realizability
of the net deferred tax assets, the Company considers all relevant positive and negative evidence to determine whether it is more likely
than not that some portion of the deferred income tax will not be realized. The realization of gross deferred tax assets is dependent
on several factors, including the generation of sufficient taxable income prior to expiration of the net operating loss carryforwards.
At December 31, 2025 and 2024, the Company has recorded a full valuation allowance against its net deferred tax assets of approximately
$ 116.1 million and $ 101.6 million respectively. The change in the valuation allowance during the year ended December 31, 2025 was $ 14.5
million.
F- 18
At December 31, 2025, the Company
had federal net operating loss (NOL) carryforwards of $ 218.9 million At December 31, 2025, the Company had foreign NOL carryforwards of
$ 48 thousand. At December 31, 2025 the Company had federal research and development and Orphan drug credit credits of $ 24.8 million. Federal
NOL carryforwards of $ 104.8 million generated prior to 2018 will begin to expire if unused beginning in 2026, when $ 3.6 million in NOLs
are due to expire. The Company’s largest NOLs will begin to expire in 2034 - 2037, with each year in excess of $ 15 million. NOLs
generated in 2018 and later years of $ 114.6 million have an indefinite life, but will be limited to 80 % of their value.
Sections 382 and 383 of the Internal
Revenue Code of 1986 subject the future utilization of net operating losses and certain other tax attributes, such as research and experimental
tax credits, to an annual limitation in the event of certain ownership changes. The Company may be subject to the net operating loss utilization
provision of Section 382 of the Internal Revenue Code. The effect of an ownership change would be the imposition of an annual limitation
of the use of NOL carryforwards attributable to periods before the change. The amount of the annual limitation depends upon the value
of the Company immediately before the change, changes to the Company’s capital during a specified period prior to the change, and
the federal published interest rate. Although the Company has not completed an analysis under Section 382 of the Code, it is likely that
the utilization of the NOLs will be limited.
For state income tax purposes,
the Company has $ 204.6 million of unused NOLs at December 31, 2025 available for carry forward to future years. These NOLs will begin
to expire in 2035 if unused.
The
Company has federal research and development tax credits of $ 8.1 million at December 31, 2025, which will begin to expire in 2033 if
unused and orphan drug credits of $ 16.7 million which will begin to expire in 2037 if unused.
The
difference between the income tax provision and the amount that would result if the U.S. Federal statutory rates were applied to pre-tax
losses for the year ended December 31, 2025 and 2024 after the adoption of ASU 2023-09 are as follows:
(in thousands)
December 31,
2025
December 31,
2024
Federal statutory income taxes
$ ( 7,116 )
( 21.0 )%
$ ( 8,031 )
( 21.0 )%
State income taxes
-
-
%
( 1,275 )
( 3.3 )%
Foreign tax effects
126
0.4 %
-
-
%
Research and development/orphan drug tax credit
( 1,514 )
( 4.5 )%
( 2,787 )
( 7.3 )%
Stock-based compensation
2,089
6.2 %
259
0.7 %
Non-taxable or nondeductible items:
Other
347
1.0 %
788
2.0 %
162M- disallowed salary
1,003
2.9 %
-
-
%
Change in valuation allowance
5,065
15.0 %
11,046
28.9 %
Provision for income tax
$ -
-
$ -
-
Entities
are also required to evaluate, measure, recognize and disclose any uncertain income tax provisions taken on their income tax returns.
The Company has analyzed its tax positions and has concluded that as of December 31, 2025 there were no uncertain positions. The Company’s
U.S. federal and state net operating losses have occurred since its inception in 2009 and as such, tax years subject to potential tax
examination could apply from that date. This is because the utilization of net operating losses from prior years opens the relevant year
to audit by the IRS and/or state taxing authorities. Interest and penalties, if any, as they relate to income taxes assessed, are included
in the income tax provision. The Company did not have any unrecognized tax benefits and has not accrued any interest or penalties for
the years ended December 31, 2025 and 2024.
Note
9 – Subsequent Event
In February 2026, the Chief Financial Officer of the Company tendered
his resignation. To fill this executive vacancy, the Board of Directors of the Company appointed Sandesh Seth, the current Chairman and
Chief Executive Officer, to serve as the Principal Financial Officer.
F- 19
ITEM
9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE.
None.
ITEM
9A. CONTROLS AND PROCEDURES.
Disclosure
controls and procedures. The Company, under the supervision and with the participation of its management,
including the Company’s principal executive officer and principal financial and accounting officer, evaluated the effectiveness
of the Company’s “disclosure controls and procedures,” as such term is defined in Rule 13a-15(e) and 15d-15(e) under
the Exchange Act, as of the end of the period covered by this Annual Report on Form 10-K. Based on that evaluation, the Company’s
principal executive officer and principal financial and accounting officer have concluded that the Company’s disclosure controls
and procedures are effective as of December 31, 2025 to ensure that information required to be disclosed by the Company in reports that
it files or submits under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in SEC rules
and forms, and includes controls and procedures designed to ensure that information required to be disclosed by the Company in such reports
is accumulated and communicated to the Company’s management, including the Company’s principal executive officer and principal
financial and accounting officer, as appropriate, to allow timely decisions regarding required disclosure.
Management’s
Annual Report on Internal Control Over Financial Reporting. The Company’s management is responsible for establishing
and maintaining adequate internal control over financial reporting. The Company’s internal control over financial reporting is
a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial
statements for external purposes in accordance with generally accepted accounting principles.
The
Company’s internal control over financial reporting includes policies and procedures that (1) pertain to the maintenance of
records that, in reasonable detail, accurately and fairly reflect transactions and dispositions of assets; (2) provide reasonable
assurances that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted
accounting principles, and that receipts and expenditures are being made only in accordance with authorizations of management and the
directors of the Company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition,
use or disposition of the Company’s assets that could have a material effect on our financial statements.
Because
of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of
any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions,
or that the degree of compliance with the policies or procedures may deteriorate.
Management
assessed the effectiveness of the Company’s internal control over financial reporting as of December 31, 2025. In making this assessment,
management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (COSO) in Internal Control-Integrated
Framework (2013). Based on its assessment and those criteria, management concluded that as of December 31, 2025, the Company’s
internal control over financial reporting was effective.
This
Annual Report on Form 10-K does not include an attestation report from our registered public accounting firm regarding internal control
over financial reporting. Our internal control over financial reporting was not subject to such attestation as we are a non-accelerated
filer.
Changes
in internal controls over financial reporting . There were no changes in the Company’s internal controls over financial
reporting that occurred during the fourth quarter of the fiscal year covered by this Annual Report on Form 10-K that have materially
affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.
ITEM
9B. OTHER INFORMATION.
None .
ITEM
9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.
Not
applicable.
80
PART
III
ITEM
10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE
Directors
and Executive Officers
The
names, positions and ages of our directors and executive officers as of March 25, 2026, are as follows:
Name
Age
Position
Sandesh Seth
61
Chairman and Chief Executive Officer
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