atnm-20260630
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM 10-Q
(Mark
One)
☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2026
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
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. ☒ Yes No ☐
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). ☒ Yes No ☐
Indicate
by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, 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 is a shell company (as defined in Rule 12b-2 of the Exchange Act). ☐ Yes ☒ No
Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of August 6, 2026: 31,441,436
Actinium
Pharmaceuticals, Inc.
Table
of Contents
INDEX
PART
I – FINANCIAL INFORMATION
Item 1.
Financial
Statements
1
Item 2.
Management’s
Discussion and Analysis of Financial Condition and Results of Operations
18
Item 3.
Quantitative
and Qualitative Disclosures About Market Risk
52
Item 4.
Controls
and Procedures
52
PART
II – OTHER INFORMATION
53
Item 1.
Legal
Proceedings
53
Item 1A.
Risk Factors
53
Item 2.
Unregistered
Sales of Equity Securities and Use of Proceeds
89
Item 3.
Defaults
Upon Senior Securities
89
Item 4.
Mine Safety
Disclosures
89
Item 5.
Other
Information
89
Item 6.
Exhibits
90
SIGNATURES
91
i
PART
I - FINANCIAL INFORMATION
ITEM
1. UNAUDITED FINANCIAL STATEMENTS
The
accompanying condensed consolidated financial statements have been prepared by Actinium Pharmaceuticals, Inc., or the Company, and are
unaudited. In the opinion of management, all adjustments (which include only normal recurring adjustments) necessary to present fairly
the financial position at June 30, 2026 and December 31, 2025, and the results of operations and cash flows for the three months and
six months ended June 30, 2026 and 2025, respectively, have been made. Certain information and footnote disclosures normally included
in financial statements prepared in accordance with accounting principles generally accepted in the United States of America have been
condensed or omitted. It is suggested that these financial statements be read in conjunction with the financial statements and notes
thereto included in the Company’s audited financial statements for the year ended December 31, 2025 in the Company’s Annual
Report on Form 10-K. The results of operations for the three months and six months ended June 30, 2026 are not necessarily indicative
of the operating results for the full year.
1
Actinium
Pharmaceuticals, Inc.
Condensed
Consolidated Balance Sheets
(Unaudited)
(amounts
in thousands, except share and per share data)
June
30,
2026
December 31,
2025
(Unaudited)
Assets
Current Assets:
Cash and cash equivalents $ 36,473 $ 47,998
Prepaid expenses and other current assets 1,267 1,383
Total Current Assets 37,740 49,381
Property and equipment, net of accumulated depreciation of $ 846 and $ 1,064 700 295
Restricted cash – long-term 339 335
Operating leases right-of-use assets, net 1,373 1,754
Finance leases right-of-use assets, net 5 10
Total Assets $ 40,157 $ 51,775
Liabilities
and Stockholders’ Equity
Current
Liabilities:
Accounts payable and accrued expenses $ 8,514 $ 7,247
Operating leases current liability 741 711
Finance leases current liability 5 11
Total Current Liabilities 9,260 7,969
Long-term license revenue deferred - 35,000
Long-term operating lease obligations 595 972
Total Liabilities 9,855 43,941
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; 31,441,436 and 31,195,891 shares issued and outstanding at June 30, 2026 and December 31, 2025, respectively 31 31
Additional paid-in capital 417,665 417,536
Accumulated other comprehensive loss ( 60 ) ( 20 )
Accumulated deficit ( 387,334 ) ( 409,713 )
Total Stockholders’ Equity 30,302 7,834
Total Liabilities and Stockholders’ Equity $ 40,157 $ 51,775
See
accompanying notes to the condensed consolidated financial statements.
2
Actinium
Pharmaceuticals, Inc.
Condensed
Consolidated Statements of Operations
(Unaudited)
(amounts
in thousands, except share and per share data)
For
the
Three Months Ended
June 30,
For
the
Six Months Ended
June 30,
2026
2025
2026
2025
Revenue
Revenue $ - $ - $ - $ -
Other revenue 35,000 - 35,000 -
Total revenue 35,000 - 35,000 -
Operating
expenses:
Research and development, net of reimbursements 5,377 4,879 9,578 12,579
General and administrative 2,058 2,624 3,760 11,562
Total operating expenses 7,435 7,503 13,338 24,141
Income/(Loss) from operations 27,565 ( 7,503 ) 21,662 ( 24,141 )
Other
income:
Interest income - net 336 625 717 1,325
Total other income 336 625 717 1,325
Income/(loss) before income taxes 27,901 ( 6,878 ) 22,379 ( 22,816 )
Income tax expense - - - -
Net income/(loss) $ 27,901 $ ( 6,878 ) $ 22,379 $ ( 22,816 )
Net income/(loss) per common share – basic $ 0.89 $ ( 0.22 ) $ 0.71 $ ( 0.73 )
Weighted average common shares outstanding – basic 31,399,086 31,195,891 31,318,830 31,195,891
Net income/(loss) per common share – fully diluted $ 0.89 $ ( 0.22 ) $ 0.71 $ ( 0.73 )
Weighted average common shares outstanding – fully diluted 31,406,740 31,195,891 31,322,144 31,195,891
See
accompanying notes to the condensed consolidated financial statements.
3
Actinium
Pharmaceuticals, Inc.
Consolidated Statements of Comprehensive Income/(Loss)
(amounts
in thousands)
For
the
Three Months Ended
June 30,
For
the
Six Months Ended
June 30,
2026
2025
2026
2025
Net Income/(Loss) $ 27,901 $ ( 6,878 ) $ 22,379 $ ( 22,816 )
Other
comprehensive loss:
Foreign currency translation adjustment ( 21 ) - ( 40 ) -
Comprehensive Income/(Loss) $ 27,880 $ ( 6,878 ) $ 22,339 $ ( 22,816 )
See
accompanying notes to the condensed consolidated financial statements.
4
Actinium
Pharmaceuticals, Inc.
Condensed
Consolidated Statement of Changes in Stockholders’ Equity
For
the Period from January 1, 2026 to June 30, 2026
(Unaudited)
(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, 2026 31,195,891 $ 31 $ 417,536 $ ( 20 ) $ ( 409,713 ) $ 7,834
Stock-based compensation 179,100 - 11 - - 11
Net loss - - - - ( 5,522 ) ( 5,522 )
Unrealized loss on foreign currency translation - - - ( 19 ) - ( 19 )
Balance, March 31, 2026 31,374,991 $ 31 $ 417,547 $ ( 39 ) $ ( 415,235 ) $ 2,304
Stock-based compensation 66,445 - 118 - - 118
Net income - - - - 27,901 27,901
Unrealized loss on foreign currency translation - - - ( 21 ) - ( 21 )
Balance, June 30, 2026 31,441,436 $ 31 $ 417,665 $ ( 60 ) $ ( 387,334 ) $ 30,302
See
accompanying notes to the condensed consolidated financial statements.
5
Actinium
Pharmaceuticals, Inc.
Condensed
Consolidated Statement of Changes in Stockholders’ Equity
For
the Period from January 1, 2025 to June 30, 2025
(Unaudited)
(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, 2025 31,195,891 $ 31 $ 408,553 $ - $ ( 375,826 ) $ 32,758
Stock-based compensation - - 8,874 - - 8,874
Net loss - - - - ( 15,938 ) ( 15,938 )
Balance, March 31, 2025 31,195,891 $ 31 417,427 - ( 391,764 ) 25,694
Stock-based compensation - - 197 - - 197
Net loss - - - - ( 6,878 ) ( 6,878 )
Balance, June 30, 2025 31,195,891 $ 31 $ 417,624 $ - $ ( 398,642 ) $ 19,013
See
accompanying notes to the condensed consolidated financial statements.
6
Actinium
Pharmaceuticals, Inc.
Condensed
Consolidated Statements of Cash Flows
(Unaudited)
(amounts
in thousands)
For
the
Six
Months Ended
June
30,
2026
2025
Cash Flows Used in Operating
Activities:
Net income/(loss) $ 22,379 $ ( 22,816 )
Adjustments to reconcile
net loss to net cash used in operating activities:
Stock-based compensation expense 129 9,071
Depreciation and amortization expenses 461 409
Changes in operating assets
and liabilities:
Prepaid expenses and other current assets 116 501
Accounts payable and accrued expenses 1,214 147
Operating lease liabilities ( 348 ) ( 278 )
Long-term license revenue deferred ( 35,000 ) -
Net Cash Used in Operating Activities ( 11,049 ) ( 12,966 )
Cash Flows Used in Investing
Activities:
Purchase of property and equipment ( 480 ) -
Net Cash Used in Investing Activities ( 480 ) -
Cash Flows Used in Financing
Activities:
Payments on finance leases ( 5 ) ( 5 )
Net Cash Used in Financing Activities ( 5 ) ( 5 )
Effect of foreign currency rates on cash 13 -
Net Change in Cash, Cash Equivalents and Restricted Cash ( 11,521 ) ( 12,971 )
Cash, cash equivalents and restricted cash at beginning of year 48,333 73,228
Cash, Cash Equivalents and Restricted Cash at End of Period $ 36,812 $ 60,257
See
accompanying notes to the condensed consolidated financial statements.
7
Actinium
Pharmaceuticals, Inc.
Notes
to Condensed Consolidated Financial Statements
(Unaudited)
Note 1 - Description of Business and Summary of Significant Accounting Policies
Nature of Business - Actinium Pharmaceuticals, Inc. is a clinical-stage biopharmaceutical company pioneering the development of targeted radiotherapies to address significant unmet medical needs in oncology.
Basis of Presentation - Unaudited Interim Financial Information - The accompanying unaudited interim condensed consolidated financial statements and related notes have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) for interim financial information, and in accordance with the rules and regulations of the United States Securities and Exchange Commission (the “SEC”) with respect to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by U.S. GAAP for complete financial statements. The unaudited interim condensed consolidated financial statements furnished reflect all adjustments (consisting of normal recurring adjustments) which are, in the opinion of management, necessary for a fair statement of the results for the interim periods presented. Interim results are not necessarily indicative of the results for the full year. These unaudited interim condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2025.
Principles of Consolidation - The basis of consolidation is unchanged from the disclosure in the Company’s Notes to the Consolidated Financial Statements section in its Annual Report on Form 10-K for the year ended December 31, 2025. The unaudited condensed consolidated financial statements include the Company’s accounts and those of the Company’s wholly owned subsidiaries.
Use of Estimates - The preparation of these unaudited interim condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the unaudited interim condensed 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 income/(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. Virtually all of the Company’s assets are located in the United States, with an immaterial amount held by its wholly owned Australian subsidiary, Actinium Pharmaceuticals Australia Pty Ltd, which supports certain international clinical development activities.’
Cash, Cash Equivalents and Restricted Cash - The Company considers all highly liquid accounts with original maturities of three months or less to be cash equivalents. The Company holds most of its cash equivalents in a money market account comprised of US Treasury notes. Balances held by the Company are typically in excess of Federal Deposit Insurance Corporation insured limits.
The following is a summary of cash, cash equivalents and restricted cash at June 30, 2026 and December 31, 2025:
(in thousands) June 30,
2026 December 31,
2025
Cash and cash equivalents $ 36,473 $ 47,998
Restricted cash – long-term 339 335
Cash, cash equivalents and restricted cash $ 36,812 $ 48,333
8
Restricted cash relates to a certificate of deposit held as collateral for a letter of credit issued in connection with the Company’s lease of corporate office space.
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.
9
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 three months and six months ended June 30, 2026 and June 30, 2025, respectively.
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. Revenue and related expenses are presented gross in the consolidated statements of operations. There was no grant revenue for the three months and six months ended June 30, 2026 and June 30, 2025, respectively.
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 includes 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.
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 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. License revenue for the three months and six months ended June 30, 2026 was $ 35.0 million, see Note 4. There was no license revenue for the six months ended June 30, 2025.
10
Research and Development Costs - Research and development costs are expensed as incurred. Research and development costs include clinical site operations, contract research organizations, manufacturing, isotope supply, investigational product logistics, regulatory support, pharmacovigilance and other development activities conducted in the United States and internationally. To the extent the Company becomes eligible for research and development tax incentives, including incentives available in Australia, such amounts will be recognized in accordance with applicable accounting guidance when realization is probable and the amount can be reasonably estimated.
Share-Based Payments - The Company estimates the fair value of each stock option award at the grant date by using the Black-Scholes option pricing model. The fair value determined represents the cost for the award and is recognized over the vesting period during which an employee is required to provide service in exchange for the award. The Company accounts for forfeitures of stock options as they occur.
Net Income/(Loss) Per Common Share - Basic net income and net loss per common share are computed by dividing the net income or net loss available to common stockholders by the weighted average number of shares of common stock outstanding during the reporting period. For periods with net income, diluted net income per common share is computed using the treasury stock method for stock options and warrants that are dilutive (i.e., where the exercise price is below the average market price of the Company’s common stock for the period). For periods with net loss, diluted net 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 three months and six months ended June 30, 2026, the Company included 284 thousand and 279 thousand stock options, respectively, in the computation of diluted net income per share using the treasury stock method. For the three months and six months ended June 30, 2025, all potentially dilutive shares, including outstanding common stock options, restricted stock units, and warrants, were excluded from the computation of diluted net loss per share as the result would have been anti-dilutive.
Three months ended Six months ended
(in thousands) June 30,
2026 June 30,
2025 June 30,
2026 June 30,
2025
Stock Options included in calculation of Fully diluted net income per share 284 - 279 -
Securities excluded as anti-dilutive (exercise price exceeds average market price):
Stock Options 95 240 100 240
Restricted Stock Units - 300 - 300
Warrants 7 7 7 7
Total 102 547 107 547
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 ASU 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.
11
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.
In December 2025, the FASB issued ASU 2025-11, Interim Reporting (Topic 270): Narrow-Scope Improvements. This update clarifies interim disclosure requirements and centralizes such requirements within Topic 270. Among other changes, ASU 2025-11 introduces a disclosure principle requiring entities to provide information about significant events or changes since the end of the last annual reporting period that have a material impact, clarifies when duplicative annual disclosures may be omitted from interim reports, and aligns interim reporting requirements with applicable SEC guidance for registrants. This guidance is effective for interim reporting periods within annual reporting periods beginning after December 15, 2027. Early adoption is permitted. The amendments in ASU 2025-11 should be applied prospectively. The Company is currently assessing the impact on its condensed consolidated financial statements and disclosures.
Note 2 - 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.
On June 25, 2024, the Company entered into an exclusive, worldwide license agreement with a third party for rights to develop and commercialize radiopharmaceutical products incorporating a licensed monoclonal antibody. Under the agreement, the Company made an upfront payment, which was recorded as research and development expense, and may be required to make future milestone and royalty payments upon the achievement of specified development, regulatory and commercial events and upon commercial sales.
12
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. 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.
As of June 30, 2026, the Company had contractual commitments of approximately $ 1.5 million related to the equipment purchase and construction of its newly leased manufacturing facility. Of this amount, approximately $ 0.6 million had been incurred through June 30, 2026, with the remaining $ 0.9 million anticipated to be incurred during the second half of 2026.
Note 3 - 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 its 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.
As of June 30, 2026, 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 five years and two months , with an expiration date of 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. The Company entered into a lease for manufacturing space effective as of 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.
13
The components of lease expense are as follows:
Three months ended Six months ended
(in thousands) June 30,
2026 June 30,
2025 June 30,
2026 June 30,
2025
Operating lease expense $ 218 $ 173 $ 437 $ 346
Finance lease cost
Amortization of right-to-use assets $ 2 $ 2 $ 5 $ 5
Interest on lease liabilities $ - $ - $ 1 $ 1
Total finance lease cost $ 2 $ 2 $ 6 $ 6
Supplemental cash flow information related to leases are as follows:
Cash flow information:
Six months ended
(in thousands) June 30,
2026 June 30,
2025
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flow use from operating leases $ 404 $ 313
Operating cash flow use from finance leases $ 5 $ 5
Financing cash flow use from finance leases $ 5 $ 5
Non-cash activity:
Right-of-use assets obtained in exchange for lease obligations:
Operating leases $ - $ -
Finance Leases $ - $ -
Weighted average remaining lease terms are as follows at June 30, 2026:
Weighted average remaining lease term:
Operating leases 2.7 years
Finance Leases 0.5 year
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 reflects 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 %
14
Maturities of lease liabilities are as follows:
(in thousands)
Year ending December 31, Operating
Leases Finance
Leases
2026 (excluding six months ended June 30, 2026) 410 5
2027 557 -
2028 182
2029 187
2030 193 -
Total lease payments $ 1,529 $ 5
Less imputed interest ( 193 ) -
Present value of lease liabilities $ 1,336 $ 5
Note 4 - Other revenue
The Company has a grant from a government-sponsored entity for research and development related activities that provides 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 performs services under this arrangement. Associated expenses are recognized when incurred as research and development expense. There was no grant revenue recognized for the three months and six months ended June 30, 2026 and 2025, respectively.
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 was eligible to receive certain regulatory and commercial milestone payments and royalties on net sales of the product in the licensed territories. The Company continues to retain commercialization rights in the United States and the rest of the world. The $ 35 million upfront payment was initially recorded as Long-term license revenue - deferred due to uncertainty regarding Immedica’s ability to obtain regulatory approval of the product by the European Medicines Agency. Subsequently, Immedica notified the Company that it would not pursue regulatory approval of Iomab-B in the licensed territories. In the current period, based on the facts and circumstances, the Company concluded that Immedica’s right to asserting a claim related to the $35 million had expired. Accordingly, the condition previously constraining recognition of the $ 35 million upfront payment no longer existed and that the non-refundable payment was no longer subject to a significant reversal. Therefore, the Company recognized the previously deferred $ 35 million upfront payment as revenue in June 2026.
Note 5 - 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 A&R Sales Agreement.
The Company did not sell any shares of common stock during the six months ended June 30, 2026 and 2025, respectively.
15
Stock Options
The following is a summary of stock option activity for the six months ended June 30, 2026:
(in thousands, except for per-share amounts) Number of
Shares Weighted
Average
Exercise
Price ($) Weighted
Average
Remaining
Contractual
Term
(in years) Aggregate
Intrinsic
Value
Outstanding, January 1, 2026 99 $ 5.89 7.66 $ -
Granted 284 1.15
Exercised - -
Cancelled ( 4 ) 43.05
Outstanding, June 30, 2026 379 1.99 9.25 -
Exercisable, June 30, 2026 50 6.57 5.95 -
During the six months ended June 30, 2026, the Company granted newly hired employees options to purchase 284 thousand shares of common stock with an exercise price ranging from $ 1.00 to $ 1.28 per share, a term of 10 years, and a vesting period of 4 years. The stock options had an aggregate fair value of $ 242 thousand 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 3.7 % to 4.2 %, (2) expected life of 6 years, (3) expected volatility range from 85.8 % to 87.3 %, and (4) zero expected dividends. During the six months ended June 30, 2025, the Company granted options to purchase 26 thousand shares.
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 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 $ 8.7 million in stock compensation expense for the six months ended June 30, 2025.
The fair values of all options issued and outstanding are being amortized over their respective vesting periods. The unrecognized compensation expense at June 30, 2026 was $ 0.3 million related to unvested stock options, which is expected to be expensed over a weighted average of 3.6 years.
Warrants
Following is a summary of warrant activity for the six months ended June 30, 2026:
(in thousands, except for per-share amounts) Number of
Shares Weighted
Average
Exercise
Price ($) Weighted
Average
Remaining
Contractual
Term
(in years) Aggregate
Intrinsic
Value
Outstanding, January 1, 2026 7 $ 17.33 3.45 $ -
Granted - -
Expired - -
Outstanding, June 30, 2026 7 $ 17.33 3.00 $ -
Exercisable, June 30, 2026 7 $ 17.33 3.00 $ -
16
Note 6 – Income Taxes
The Company accounts for income taxes under ASC 740, Income Taxes . Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases, as well as for net operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. A valuation allowance is established when it is more likely than not that all or a portion of a deferred tax asset will not be realized.
For interim periods, the Company estimates its annual effective income tax rate and applies that rate to year-to-date ordinary income or loss in determining the income tax provision or benefit for the period.
The Company’s estimated annual effective income tax rate for the year ending December 31, 2026 is 0 %. Although the Company recorded income before income taxes of $ 27.9 million and $ 22.4 million for the three and six months ended June 30, 2026, respectively, driven by the recognition of $ 35.0 million of revenue previously deferred in connection with the commercialization agreement with Immedica, no income tax expense was recorded as the Company has sufficient net operating losses that are available to offset net taxable income. The effective tax rate differs from the U.S. federal statutory rate of 21 % primarily because the Company maintains a full valuation allowance against its net deferred tax assets. As a result, no income tax benefit or expense is recognized on pre-tax income or loss for financial reporting purposes.
Since its inception, the Company has generated net operating losses in substantially all periods and has accumulated significant federal and state net operating loss carryforwards. Based on the weight of all available evidence, including the Company’s history of cumulative losses and the uncertainty of future taxable income sufficient to realize its deferred tax assets, management has determined that it is more likely than not that the net deferred tax assets will not be realized. Accordingly, a full valuation allowance has been maintained against all net deferred tax assets. The recognition of the $ 35.0 million of deferred revenue as income for the three months and six months ended June 30, 2026 does not, in isolation, constitute sufficient positive evidence to conclude that realization of the Company’s deferred tax assets is more likely than not, and therefore the full valuation allowance has been maintained as of June 30, 2026.
17
ITEM
2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATION
CAUTIONARY
STATEMENT REGARDING FORWARD-LOOKING STATEMENT NOTICE
This
Quarterly Report on Form 10-Q and other reports filed by the Company from time to time with the Securities and Exchange Commission contains
or may contain certain forward-looking statements and information that are based upon beliefs of, and information currently available
to the Company’s management as well as estimates and assumptions made by the Company’s management. Readers are cautioned
not to place undue reliance on these forward-looking statements, which are only predictions and speak only as of the date hereof. For
this purpose, any statements contained in this Quarterly Report on Form 10-Q that are not statements of historical fact may be deemed
to be forward-looking statements. Without limiting the foregoing, words such as “may,” “will,” “expect,”
“believe,” “anticipate,” “estimate” or “continue” or comparable terminology are intended
to identify forward-looking statements. These statements by their nature involve substantial risks and uncertainties, and actual
results may differ materially depending on a variety of factors, many of which are not within our control. These factors include
but are not limited to economic conditions generally and in the industries in which we may participate; competition within our chosen
industry, including competition from much larger competitors; technological advances and failure to successfully develop business relationships.
Although we believe that the expectations reflected in the forward-looking statements are reasonable, we cannot guarantee future results,
levels of activity, performance, or achievements. Except as required by applicable law, including the securities laws of the United States,
we do not intend to update any of the forward-looking statements to conform these statements to actual results.
Description
of 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, high-value, 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 distinct
from PSMA, with demonstrated preclinical activity across metastatic castration-resistant prostate cancer (mCRPC), non-small cell lung
cancer (NSCLC), and breast cancer. Actimab-A targets myeloid derived suppressor cells (MDSCs) and is being studied in multiple solid
tumors in combination with immune checkpoint inhibitors where MDSCs 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. We have several ongoing clinical studies across our pipeline. We expect to report data from ongoing company-
and investigator-sponsored clinical studies for ATNM-400, Actimab-A for MDSC’s and Iomab-ACT in 4Q:2026 and over the course of
2027.
18
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 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. We are developing ATNM-400 as
a potential pan-cancer, biology-driven therapy - alone or in combination with standard-of-care agents - for large, treatment
resistant-solid tumor populations across prostate, NSCLC, breast cancer and potentially other sizable cancer indications.
Our
translational data demonstrated that ATNM-400 is superior to the active ingredients in the many of the most commonly prescribed approved
therapies in prostate cancer, NSCLC and breast cancer when tested in a wide variety of preclinical models:
●
Prostate Cancer:
PSMA-targeted agents (177Lu-PSMA-617 (the active ingredient in Pluvicto ® ) and 225Ac-PSMA-617) and ARPIs (enzalutamide,
apalutamide, darolutamide) in the mCRPC setting of prostate cancer;
●
NSCLC: EGFR inhibitors (osimertinib),
osimertinib with chemotherapy, TROP-2 ADC (Dato-DXd), EGFR-cMET bispecific (amivantamab), HER3-EGFR bispecific antibody drug conjugate
(ADC) (izalontamab brengitecan, in development) in EGFR-mutant NSCLC, and KRAS-G12C inhibitors (sotorasib and adagrasib) in KRAS-G12C
mutant NSCLC; and
●
Breast
Cancer: HER2 therapies (trastuzumab and T-DXd) in HER2 resistant breast cancer and endocrine therapy (tamoxifen) in tamoxifen-resistant
breast cancer.
These
preclinical translational 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 of several of the approved standard-of-care drugs. Evidence of ATNM-400
target expression has been observed ranging from 60%-80% of mCRPC, >90% of NSCLC, and 50-70% of breast cancer patient tumors, representing
a significant addressable population of well over a hundred thousand patients in the United States based on existing datasets. We believe
this number may expand as we continue our work to demonstrate the potential of ATNM-400 in various additional disease and treatment settings.
In
addition, we have developed a theranostic strategy utilizing Zr-89 as a companion imaging agent to enable patient selection and tumor
visualization. We believe 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.
Market
Opportunity
ATNM-400
Is Designed to Address Large, Treatment Resistant Patient Populations Across Prostate, Lung and Breast Cancer - Indications in Which
Approved Targeted Therapies Generated More Than $30 Billion in Worldwide Sales in 2025
We
are developing ATNM-400 as a mutation- and pathway-agnostic radiotherapeutic - as a monotherapy or in combination with standard of
care - for large, treatment resistant solid tumor populations, with initial focus on prostate cancer, non-small cell lung
cancer (NSCLC) and breast cancer. These diseases have been selected for initial clinical development driven by a common scientific
and commercial rationale. Each disease represents a large, well-established market due to targeted agents and yet a major
underserved opportunity once their resistance to these therapies develops. The antigen targeted by ATNM-400 is expressed in all
these disease areas and its expression further increases in many cases as the existing therapies fail. Several of these therapies
have blockbuster sales generated by treating a large number of patients. ATNM-400 target expression is reported in a majority of
prostate cancer, NSCLC and breast cancer tumors based on immunohistochemistry datasets, which we estimate corresponds to an
addressable population of well over 350,000 patients per year in the United States across these three indications and considerably
more worldwide. We believe this addressable population may expand as we evaluate ATNM-400 in additional indications and treatment
settings.
19
Prostate
Cancer
Prostate
cancer is the most frequently diagnosed cancer in men in the United States. According to the American Cancer Society, approximately 333,830
men in the United States were estimated to be diagnosed with prostate cancer in 2026, representing approximately 30% of all cancer diagnoses
in men. While localized prostate cancer is frequently curable, metastatic disease is not: approximately 5% to 7% of patients present
with metastatic disease at initial diagnosis, and approximately 20% to 30% of patients initially diagnosed with localized disease subsequently
progress to metastatic disease, for which available therapies slow, but do not cure, disease progression.
Because
prostate cancer cells rely on androgens for growth, most patients receive androgen receptor pathway inhibitor (ARPI) therapy, including
enzalutamide (Xtandi ® ), apalutamide (Erleada ® ) and darolutamide (Nubeqa ® ), which generated
more than $6.3 billion, $3.6 billion and $2.7 billion in worldwide sales, respectively, in 2025. We estimate that up to approximately
50,000 to 60,000 men in the United States progress following ARPI therapy each year. Collectively, ARPIs generated more than $12 billion
in worldwide sales in 2025.
Since
the March 2022 approval of the PSMA-directed radioligand therapy Pluvicto ® (with active ingredient Lu177-PSMA-617),
targeted radiotherapy has become a prominent component of the metastatic castration-resistant prostate cancer (mCRPC) treatment
paradigm. Pluvicto ® , marketed by Novartis, generated approximately $2.0 billion in worldwide sales in 2025, and its
addressable population has expanded from approximately 44,000 patients toward approximately 86,500 patients with successive label
expansions into earlier lines of therapy. More than 30 PSMA-targeted radiotherapies are currently in various stages of development.
Notwithstanding this activity, we believe a significant unmet need remains: we estimate that approximately 30% of patients with
mCRPC have low or no PSMA expression and are therefore poorly served by PSMA-directed radioligand therapies, and re-treatment with
PSMA-directed agents may be limited by reduced PSMA surface expression and increased tumor heterogeneity following initial
PSMA-targeted therapy. In addition, because PSMA is expressed in the salivary glands, PSMA-directed radiotherapies are associated
with xerostomia, a quality-of-life limitation that is particularly relevant for Ac-225-based PSMA agents.
Because
ATNM-400 is directed against a novel, non-PSMA antigen and acts independently of both androgen receptor (AR) signaling and PSMA expression,
we believe it is positioned to address the full metastatic castration-resistant prostate cancer (mCRPC) treatment continuum. This includes
patients whose disease has progressed on androgen receptor pathway inhibitors (ARPIs), as well as patients with PSMA-low or PSMA-negative
tumors, for whom there are very limited commercially available targeted radiotherapy options. Together, these patient populations represent
a combined opportunity that we estimate exceeds 100,000 patients annually in the United States and may be addressable with ATNM-400 as
either a monotherapy or in combination with existing standards of care.
20
Non-Small
Cell Lung Cancer
Lung
cancer is the leading cause of cancer death worldwide. Approximately 229,410 new cases of lung cancer were estimated to be diagnosed
in the United States in 2026, and NSCLC accounts for approximately 85% of the more than two million lung cancer cases diagnosed globally
each year. Approximately 70% are either diagnosed with advanced/metastatic disease or progress to advanced metastatic disease. NSCLC
is a large and heterogeneous market in which no single mutation dominates. EGFR and KRAS mutations together account for approximately
50% to 60% of NSCLC cases, and existing therapies are segmented by mutation subtype and ultimately limited by acquired resistance.
Beyond
EGFR and KRAS Driver Mutations the NSCLC Market is Fragmented
Source:
Adapted from Fregni M, et al. Int J Mol Sci. 2022;23:7213, based on Skoulidis F and Heymach JV. Nat Rev Cancer. 2019;19:495–509
Current
targeted therapies illustrate both the scale of the market and the treatment resistant- unmet need. In EGFR-mutant NSCLC, nearly all
patients receive osimertinib (Tagrisso ® ) as first-line therapy; osimertinib generated approximately $7.3 billion in worldwide
sales in 2025. Disease progression on osimertinib is common and the resistance mechanisms are highly heterogeneous; in the second-line
setting, amivantamab (Rybrevant ® ) plus chemotherapy became a National Comprehensive Cancer Network (NCCN)- preferred regimen
following its September 2024 approval, and datopotamab deruxtecan (Datroway ® , a TROP-2 antibody-drug conjugate) received
accelerated approval in patients with prior platinum chemotherapy in June 2025, yet a significant unmet need remains for durable
options beyond chemotherapy. Separately, the KRAS-inhibitor class in NSCLC, led by sotorasib (Lumakras ® ) and adagrasib
(Krazati ® ), is conservatively projected to exceed $3 billion in peak sales by 2032.
We
believe ATNM-400 is well suited to this fragmented market. Based on prior immunohistochemistry studies, the antigen targeted by ATNM-400
is expressed in approximately 98% of NSCLC tumors, is highly expressed in approximately 70%, is conserved across EGFR-, KRAS- and other
driver-defined subgroups, and is further increased in tumors that have become resistant to EGFR, KRAS and immune-checkpoint therapies.
Because ATNM-400 addresses NSCLC as a broad, target-defined population rather than as another mutation-specific therapy for a single
molecular subset, we believe its mutation-agnostic profile positions it to participate in these large, established markets as a backbone
therapy - enhancing the standard of care in combination while also reaching the broader NSCLC population beyond any single mutation.
21
Breast
Cancer
Breast
cancer is the most frequently diagnosed cancer among women in the United States. The National Cancer Institute’s Surveillance,
Epidemiology, and End Results (SEER) Program estimates that approximately 321,910 women will be diagnosed with invasive breast cancer
in 2026. Approximately 200,000 women were living with metastatic breast cancer in the United States in 2025, a figure expected to grow
to approximately 250,000 by 2030.
Hormone
receptor-positive, HER2 negative (HR+/HER2−) breast cancer is the largest molecular subtype, accounting for approximately 70% of
newly diagnosed cases. Endocrine therapy is the backbone of treatment, with endocrine therapy plus a CDK4/6 inhibitor preferred for most
patients in the first-line metastatic setting. Approximately half of patients experience disease progression or death within two years,
and the substantial majority progress within five years. Following progression, treatment is guided by prior therapy and biomarkers such
as ESR1, PIK3CA, AKT1, PTEN, and germline BRCA1/2 alterations. Patients with ESR1-mutated disease may receive elacestrant, imlunestrant,
or vepdegestrant, which was approved in May 2026 as the first proteolysis-targeting chimera in oncology. Gedatolisib-based therapy provides
another pathway-targeted option for patients with PIK3CA-wild-type disease, while trastuzumab deruxtecan is approved following endocrine
therapy for HR+, HER2 low or HER2 ultralow disease. Although post-endocrine options have expanded, these approvals were based on progression-free
survival benefits generally measured in months. Median PFS across approved second-line regimens ranges from approximately four to thirteen
months, and substantially all patients ultimately progress. In later lines, datopotamab deruxtecan is approved following endocrine-based
therapy and chemotherapy, while sacituzumab govitecan is approved following endocrine therapy and at least two additional metastatic
systemic regimens. Despite these advances, substantial need remains for therapies that overcome resistance and provide more durable disease
control across successive lines of treatment.
HER2
positive (HER2+) breast cancer accounts for approximately 15% of breast cancers. Although HER2 directed therapies have substantially
improved outcomes, metastatic disease generally remains incurable, and resistance develops across successive regimens. Central
nervous system progression is a major unmet need, with up to 50% of patients developing brain metastases during the course of
disease. Trastuzumab deruxtecan plus pertuzumab was approved in December 2025 as a first-line treatment for unresectable or
metastatic HER2+ breast cancer. Taxane chemotherapy with trastuzumab and pertuzumab remains an option for selected patients.
Trastuzumab deruxtecan plus pertuzumab achieved a median PFS of 40.7 months, compared with 26.9 months for the taxane-based regimen.
Nevertheless, approximately 30% of patients experienced progression or death within two years, and half were expected to do so
within approximately three and a half years. For patients with HR+, HER2+ disease controlled after induction therapy, palbociclib
with trastuzumab, endocrine therapy, and optional pertuzumab was approved in June 2026 as maintenance treatment. Following
progression, treatment depends on prior HER2 directed therapy and the presence or risk of central nervous system disease.
Trastuzumab deruxtecan remains an established second-line option after first-line taxane, trastuzumab, and pertuzumab. However, the
optimal sequence after progression on a first-line trastuzumab deruxtecan-containing regimen has not been established. Later-line
options include tucatinib with trastuzumab and capecitabine, particularly for patients with brain metastases, and other HER2
directed regimens. New agents are needed that remain active following resistance to HER2 directed antibody-drug conjugates and
across successive lines of treatment.
Triple-negative
breast cancer (TNBC), defined by the absence of estrogen receptor, progesterone receptor, and HER2 overexpression or amplification,
accounts for approximately 10% to 15% of breast cancers. TNBC is more aggressive than HR+ breast cancer, carries a higher risk of
early distal recurrence, and lacks endocrine and HER2 directed treatment options. First-line treatment is informed by PD-L1
expression and germline BRCA1/2 mutation status. For patients with PD-L1-positive disease, immune-checkpoint inhibition combined
with systemic therapy is a common strategy. In June 2026, sacituzumab govitecan was approved with pembrolizumab for PD-L1-positive
unresectable locally advanced or metastatic TNBC and as monotherapy for patients who are not candidates for PD-1- or PD-L1-directed
therapy. Datopotamab deruxtecan was also approved in May 2026 for patients who are not candidates for checkpoint inhibition. Despite
these advances, more than half of patients are expected to experience progression or death within one year of starting first-line
treatment. With TROP-2-directed antibody-drug conjugates now used in the first-line setting, no prospectively validated preferred
sequence has been established after progression. Subsequent treatment may include chemotherapy, PARP inhibition for eligible
patients with germline BRCA1/2 mutations, or clinical trials. This sequencing gap and the biological heterogeneity of TNBC support
the need for therapies with mechanisms distinct from TROP-2-directed cytotoxic delivery.
The
antigen targeted by ATNM-400 is expressed across multiple breast cancer subtypes, including HR+/HER2−, HER2+ (including HR+ and
HR-), and triple-negative disease. Based on our preclinical findings, target expression is also retained or increased in tumor models
that have developed resistance to selected standard therapies. We believe ATNM-400’s target-driven, subtype-agnostic profile could
position it to address treatment-resistant breast cancer populations as either a monotherapy or in combination with established standards
of care.
ATNM-400
Positioned to Address HR+/HER2-, HER2+ and TNBC Breast Cancer Subtypes After Resistance to Standard of Care
Source:
American Cancer Society, Cancer Facts & Figures 2026 (Atlanta: American Cancer Society, 2026), estimated new cases of invasive breast
cancer in U.S. women, 2026. Subtype distribution derived from age-adjusted incidence rates for 2019–2023, National Cancer Institute,
SEER Cancer Stat Facts: Female Breast Cancer Subtypes.
22
ATNM-400
Preclinical Data in Large Solid Tumor Indications
Our
preclinical development program has generated encouraging efficacy and mechanism-of-action data across multiple indication-specific animal
models of solid tumors including prostate cancer, NSCLC and breast cancer:
ATNM-400
in Prostate Cancer
ATNM-400
is a first-in-class Ac-225 antibody radioconjugate directed against a novel, non-PSMA antigen implicated in aggressive prostate cancer
biology and overexpressed as tumors progress and develop resistance to standard-of-care therapies. Because ATNM-400 acts independently
of both androgen-receptor signaling and PSMA expression, we believe it has the potential to address patients across the metastatic castration-resistant
prostate cancer, or mCRPC, treatment continuum.
Key
Findings and Therapeutic Positioning in Metastatic Castration-Resistant Prostate Cancer
● Broad
monotherapy activity across PSMA expression levels. ATNM-400 demonstrated anti-tumor
activity in PSMA-high, PSMA-low and PSMA-negative mCRPC models. It showed greater efficacy
than 177Lu-PSMA-617 across these models, including in PSMA-low and PSMA-negative disease
where PSMA-directed therapies may have limited activity, and greater efficacy than 225Ac-PSMA-617
in the PSMA-low model.
● Strong
activity in PSMA-high disease with no xerostomia limitation expected. In the PSMA-high
model, ATNM-400 demonstrated activity comparable to 225Ac-PSMA-617 and achieved comparable
tumor control to 177Lu-PSMA-617 at approximately one-thousandth of the administered radioactivity.
However, since the ATNM-400 target is not expressed in the salivary glands, we do not expect
ATNM-400 to cause the xerostomia associated with PSMA-directed therapies.
● Activity
following PSMA-directed therapy. ATNM-400 retained anti-tumor activity after progression
on 177Lu-PSMA-617 and produced more durable tumor control and prolonged survival relative
to 177Lu-PSMA-617, supporting its potential use in patients who have exhausted PSMA-directed
radioligand therapy.
● Activity
in ARPI-resistant disease. ATNM-400 demonstrated greater tumor growth inhibition than
the approved ARPIs enzalutamide, apalutamide and darolutamide in ARPI-resistant models and
retained activity following progression on enzalutamide.
● Enhanced
activity in combination with ARPIs. Combinations of ATNM-400 with enzalutamide, apalutamide
or darolutamide produced enhanced tumor growth inhibition, tumor regression and durable complete
responses. These findings are supported by evidence that ARPI resistance increases ATNM-400
target expression, providing a mechanistic rationale for the observed combination activity.
We
believe these findings support the potential development of ATNM-400 as a monotherapy or in combination with ARPIs across a broad mCRPC
population, including patients with ARPI-resistant, PSMA-low or PSMA-negative disease, as well as patients with PSMA-high disease who
may benefit from a differentiated safety profile.
23
Supporting
Data in Metastatic Resistant Prostate Cancer Models
ATNM-400
Is Directed Against a Non-PSMA Target With the Potential to Treat More Patients Across Lines of Prostate Cancer Therapy
ATNM-400
Demonstrated Robust Tumor Growth Inhibition and was Superior to PSMA-Targeted Agents Across PSMA-High (C4-2), PSMA-Low (22Rv1) and PSMA-Negative
(DU145) Prostate Cancer Models
ATNM-400
had robust efficacy in prostate cancer xenograft mouse models with high, low and no PSMA and was superior to 177-Lu-PSMA-617 in all the
models and to 225Ac-PSMA-617 in the Low-PSMA model. ATNM-400 had comparable efficacy to 225Ac-PSMA-617 in the High-PSMA model. Given
that 30% mCRPC patients have low or no PSMA expression and up to 70% of patients do not respond to Pluvicto ® and nearly
all patients progress on Pluvicto ® in <12 months, our data in 177-Lu-PSMA-617, the active ingredient in Pluvicto ® ,
suggests that ATNM-400 has the potential to treat a broader population of mCRPC patients.
ATNM-400
retained anti-tumor activity in prostate cancer models after tumors had progressed on 177Lu-PSMA-617. Following tumor progression on
177Lu-PSMA-617, ATNM-400 produced continued tumor growth inhibition, supporting its potential to treat patients who have exhausted PSMA-directed
radioligand therapy.
24
ATNM-400
Demonstrated Robust Efficacy After 177Lu-PSMA-617 Failure in Prostate Cancer Model
Beyond
tumor growth inhibition, ATNM-400 conferred a survival benefit relative to PSMA-directed radioligand therapy. In preclinical prostate
cancer models, animals treated with ATNM-400 survived longer than those treated with 177Lu-PSMA-617, consistent with the greater and
more durable tumor control described above and achieved it at approximately one-thousandth of the administered radioactivity.
ATNM-400
Improved Survival vs 177Lu-PSMA-617 in Prostate Cancer Model
ATNM-400
demonstrated activity in prostate cancer cells and tumors resistant to all three approved
androgen-receptor pathway inhibitors (ARPIs) - enzalutamide, apalutamide, and darolutamide.
Across these studies, ATNM-400 delivered tumor control as either a single-bolus or repeat-dose
regimen with a consistent safety profile and minimal off-target toxicity, which we believe
indicates dosing flexibility and a wide therapeutic window.
25
In
an ARPI-resistant model, ATNM-400 as a monotherapy and in combination with enzalutamide produced greater tumor growth inhibition and
prolonged survival than enzalutamide alone that correlated well with overall survival. In the combination arm, 40% of the mice had complete
cures that were durable up to 100 days post- treatment. The latter can be explained by mechanistic synergy since it has been published
that enzalutamide resistance increases ATNM-400 target expression in prostate cancer models and in tumor biopsies from mCRPC patients.
ATNM-400
Monotherapy Demonstrated Superiority to Enzalutamide in ARPI-resistant Prostate Cancer Model and Had Complete Cures with Combination
Activity
ATNM-400
Showed Survival Benefit vs Enzalutamide
Monotherapy and Combination
26
Following
disease progression on enzalutamide, ATNM-400 produced continued tumor growth inhibition, supporting its potential to treat patients
who have exhausted ARPIs.
ATNM-400
Displayed Strong Efficacy After Enzalutamide Failure
In
data presented at the Society of Nuclear Medicine and Molecular Imaging (SNMMI) 2026 Annual Meeting in June 2026, as a monotherapy in
the ARPI-resistant 22Rv1 model, ATNM-400 achieved 94% tumor growth inhibition, compared with 32% for apalutamide and 5% for darolutamide,
and in combination with either apalutamide or darolutamide achieved 107% tumor growth inhibition (representing tumor regression), with
durable complete responses in a majority of treated animals.
ATNM-400
Monotherapy Had Strong Tumor Growth Inhibition in the ARPI-Resistant 22Rv1 Prostate Cancer Model Resistant to Darolutamide and Apalutamide
ATNM-400
Combination with Darolutamide or Apalutamide Demonstrated Strong Tumor Growth Inhibition and Achieved Complete Responses (CRs) in the
ARPI-Resistant 22Rv1 Prostate Cancer Model
27
ATNM-400
in Non-Small Cell Lung Cancer (NSCLC)
ATNM-400
is being developed as a potential mutation-agnostic targeted radiotherapy for non-small cell
lung cancer (NSCLC). Its target is broadly expressed across NSCLC, including EGFR- and KRAS-mutant
disease, and is further increased following resistance to targeted therapies. Because ATNM-400
acts independently of a tumor’s driver mutation or signaling pathway, we believe it
has the potential to address a broad, target-defined NSCLC population.
Key
Findings and Therapeutic Positioning in Non-Small Cell Lung Cancer
● Target-specific
activity across major NSCLC driver mutations. ATNM-400 demonstrated target-specific binding,
internalization and tumor uptake across EGFR-mutant and multiple KRAS-mutant models, supporting
activity driven by target expression rather than by a particular driver mutation.
● Greater
activity than therapies used across EGFR-mutant treatment settings. In an EGFR-mutant
model, ATNM-400 demonstrated greater tumor growth inhibition than the active ingredient in
the key approved therapies used across first-, second- and third-line settings, including
osimertinib, amivantamab and datopotamab deruxtecan.
● Enhanced
activity in combination with osimertinib. Combining ATNM-400 with osimertinib produced
tumor regression and complete responses exceeding either agent alone. Osimertinib increased
ATNM-400 target expression, providing a mechanistic rationale for the observed combination
activity.
● Monotherapy
and combination activity across KRAS-mutant disease. ATNM-400 demonstrated activity in
both KRAS G12C- and KRAS G13D-mutant models, including greater activity than approved KRAS
G12C inhibitors and tumor regression in combination with sotorasib and adagrasib. Sotorasib
and adagrasib also increased ATNM-400 target expression, supporting the potential for combination
use.
We
believe these findings support the potential development of ATNM-400 as a monotherapy or combination backbone across EGFR- and KRAS-mutant
NSCLC and potentially the broader target-positive NSCLC population.
ATNM-400
vs Standard of Care Therapies Across EGFR- and KRAS-Mutant NSCLC Models
28
Supporting
Data in NSCLC
In
an EGFR-mutant model (NCI-H1975, harboring L858R and T790M mutations), ATNM-400 monotherapy achieved 75% tumor growth inhibition, compared
with 40% for osimertinib, and the combination of ATNM-400 plus osimertinib achieved 107% tumor growth inhibition (representing tumor
regression) with complete cures in 100% of treated animals.
ATNM-400
Monotherapy Showed Strong Tumor Growth Inhibition and Combination with Osimertinib Achieved Complete Responses in the EGFR-Mutant NSCLC
Model
Osimertinib
treatment increased ATNM-400 target expression both in vitro and in vivo, which we believe provides a mechanistic rationale for why the
combination of osimertinib with ATNM-400 works even better than ATNM-400 monotherapy alone. Furthermore, in vitro studies also demonstrated
that Osimertinib upregulated the ATNM-400 target in NCI-H1975 cells, enhancing ATNM-400 cytotoxicity when dosed in combination.
Increased
Target Expression
Post-Osimertinib Treatment
ATNM-400
Post-Osimertinib
29
In
the same EGFR-mutant model, ATNM-400 monotherapy also demonstrated greater anti-tumor activity than the approved agents datopotamab deruxtecan
(a TROP-2 antibody drug conjugate), amivantamab (an EGFR-cMET bispecific antibody), and izalontamab brengitecan (a HER3-EGFR bispecific
antibody-drug conjugate that is currently in development).
ATNM-400
Demonstrated 3-5x Greater Tumor Growth Inhibition vs Osimertinib or Dato-DXd or Amivantamab in EGFR-mutant NSCLC Model
ATNM-400
Demonstrated Superior Tumor Growth Inhibition Compared to Dato-DXd or Izalontamab Brengitecan in EGFR-mutant NSCLC Model
30
In
data presented at the Society of Nuclear Medicine and Molecular Imaging (SNMMI) 2026 Annual Meeting in June 2026, ATNM-400 demonstrated
activity across KRAS-mutant NSCLC models spanning distinct KRAS alleles. In a KRAS G12C model (NCI-H358), ATNM-400 monotherapy achieved
92% tumor growth inhibition, compared with 0% for the approved KRAS G12C inhibitor sotorasib, and the combination of ATNM-400 plus sotorasib
achieved 90% tumor growth inhibition. In the same G12C model, the combination of ATNM-400 with adagrasib achieved 110% tumor growth inhibition
(indicating regression) compared to 71% for adagrasib alone.
ATNM-400
Showed Superior Efficacy versus Approved KRAS G12C Inhibitors in KRAS G12C-Mutant NSCLC Model
Treatment
with the approved KRAS G12C inhibitors sotorasib and adagrasib increased ATNM-400 target expression by up to approximately 3.5- and 3.8-fold,
respectively (p<0.0001). The addition of ATNM-400 reduced cancer-cell viability beyond KRAS G12C inhibitors alone - demonstrating
the same target-expression-increasing, synergy-enabling biology previously observed with the EGFR inhibitor osimertinib.
Sotorasib
and Adagrasib Increase ATNM-400 Target Expression in a Dose-Dependent Manner in the KRAS G12C-Mutant NCI-H358 NSCLC Model
31
Positron-emission-tomography
imaging of Zr-89-labeled ATNM-400 confirmed target-specific tumor uptake in a KRAS G12C model with low uptake in healthy normal tissues.
Zr-89-ATNM-400
PET Imaging Showed Tumor-specific Uptake that is Blocked by Unlabeled Cold Antibody Demonstrating Specificity in the KRAS G12C-Mutant
NSCLC Model
In
a target-positive KRAS G13D-mutant NSCLC model (Calu-3), single doses of 20 uCi/kg or 40
uCi/kg of ATNM-400 reduced tumor volume below baseline, corresponding to 124% and 135% tumor
growth inhibition which translates to tumor regression. The unlabeled antibody produced minimal
tumor growth inhibition relative to vehicle - indicating that anti-tumor activity is driven
by the Ac-225 payload rather than by antibody-mediated target engagement alone.
ATNM-400
Had Dose-Dependent Tumor Growth Inhibition in the KRAS G13D-Mutant NSCLC Model
32
ATNM-400
in Breast Cancer
ATNM-400’s
target antigen is overexpressed across breast cancer subtypes, including HR+/HER2-, HER2+ (including HR+ and HR-), and triple-negative
breast cancer, and is retained or increased following resistance to endocrine and HER2+-directed therapies. Because ATNM-400 acts through
a pathway-independent mechanism, we believe it has the potential to address multiple treatment-resistant breast cancer populations as
a monotherapy or in combination with existing standards of care. In addition, we do not believe ATNM-400 carries the risks of interstitial
lung disease (ILD) associated with ADCs carrying the deruxtecan payload.
Key
Findings and Therapeutic Positioning in Breast Cancer
●
Activity
in treatment-resistant HER2+ disease. In a trastuzumab-resistant HER2+ model, ATNM-400 demonstrated strong monotherapy activity
and enhanced activity in combination with trastuzumab, with efficacy comparable to trastuzumab deruxtecan in the evaluated model.
Increased ATNM-400 target expression in HER2 resistant disease provides a mechanistic rationale for this activity.
● Activity
in triple-negative breast cancer. ATNM-400 monotherapy produced tumor regression in a
TNBC model, supporting its potential in a disease subtype with limited targeted treatment
options.
●
Activity
following HER2 directed therapy failure. ATNM-400 retained durable anti-tumor activity after trastuzumab progression and demonstrated
greater activity than trastuzumab deruxtecan in the post-trastuzumab-failure setting without the risks of ILD associated with ADCs
addressing the indication.
● Activity
in endocrine-resistant HR+ disease. ATNM-400 demonstrated dose-dependent activity in
an endocrine-resistant HR+ model, supporting activity independent of HER2 status and endocrine
sensitivity.
● Combination
activity in endocrine treatment-resistant disease. Following
tamoxifen failure, sequential treatment with ATNM-400 drove a dose-dependent, near-complete
loss of cancer-cell viability, supporting ATNM-400's potential to deepen response after endocrine
therapy failure.
We
believe these findings support the potential development of ATNM-400 across breast cancer subtypes, with particularly differentiated
opportunities in TNBC and treatment-resistant HER2+ disease, as well as additional potential in endocrine-resistant HR+ disease.
Supporting
Data in Breast Cancer Models
In
a trastuzumab-resistant HER2+ model (BT474-Clone5), ATNM-400 monotherapy achieved 97% tumor growth inhibition and, in combination with
trastuzumab, achieved 100% tumor growth inhibition (representing tumor regression) - comparable to the approved HER2 antibody-drug conjugate
trastuzumab deruxtecan, without the higher risks of interstitial lung disease associated with ADC with the deruxtecan payload. ATNM-400
monotherapy drove tumor regression (103% tumor growth inhibition) in a triple-negative model (MDA-MB-468). Similar to referenced KRAS
G13D studies in NSCLC, unlabeled antibody produced minimal tumor growth inhibition relative to vehicle – again indicating that
anti-tumor activity is driven by ATNM-400’s Ac-225 payload versus antibody-mediated target engagement.
ATNM-400
Monotherapy and Combinations Eradicate Trastuzumab-Resistant Tumors and Triple-Negative Breast Cancer (TNBC)
Trastuzumab-Resistant
HER2+ Model BT474-Clone5
MDA-MB-468
(TNBC) Breast Cancer Model
In
the post-trastuzumab-failure setting, ATNM-400 retained durable anti-tumor activity (93%
tumor growth inhibition), exceeding trastuzumab deruxtecan (64%), further demonstrating utility
after resistance to approved drugs.
33
ATNM-400
Demonstrated Efficacy After Trastuzumab and HER2-DXd Failures in Trastuzumab-resistant Breast Cancer Model
ATNM-400
demonstrated dose-dependent activity in an endocrine-resistant HR+ model (MCF7), consistent with activity that is independent of HER2
status and endocrine sensitivity.
ATNM-400
Showed Dose-Dependent Tumor Growth Inhibition in MCF7 (HR+) Breast Cancer
In
an endocrine-resistant (HR+) setting modeling patients who have failed prior tamoxifen, ATNM-400, when given sequentially after tamoxifen
exposure, drove a tamoxifen dose-dependent, near-complete loss of cancer-cell viability - reducing viability to as low as approximately
3%.
ATNM-400
Significantly Decreased Cancer Cell Viability Post-Tamoxifen Failures
34
Actimab-A
for MDSCs: Novel Immunomodulatory Approach in Solid Tumors
Actimab-A
(lintuzumab-Ac-225) is a CD33-targeted actinium-225 radioconjugate that we are developing to enhance checkpoint inhibitor efficacy by
depleting immunosuppressive CD33+ myeloid-derived suppressor cells (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. By selectively eliminating these suppressive cells with targeted alpha-particle therapy,
Actimab-A is designed to dismantle this barrier and restore an environment in which checkpoint blockade can drive meaningful Tcell–mediated
tumor killing. This positions Actimab-A as a differentiated immunomodulatory approach intended to expand the population of patients who
benefit from checkpoint inhibitors, including those with tumors historically considered immunologically “cold.”
Actimab-A
Depletion of MDSCs: Resensitizing PD-1 Inhibitors for T Cell Activation
35
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.
Low
MDSCs Associated With Statistically Significant Improvement in PFS and OS
(Bronte
et al., Frontiers in Immunology 2022)
Our
preclinical studies have suggested that Actimab-A: (1) selectively homes to tumor-resident CD33+ MDSCs in vivo; (2) are cytotoxic to
patient-derived MDSCs ex vivo; and (3) rescue T-cell proliferation and anti-tumor immune responses ex vivo following MDSC depletion.
We believe these data provide mechanistic support for combining Actimab-A with PD-1 inhibitors to overcome MDSC-mediated resistance.
Actimab-A
(Lintuzumab-Ac225) was shown to deplete MDSCs in our studies. Actimab-A was also shown to restore T-cell proliferation in a dose dependent
manner .
Actimab-A Depletes Human
MDSCs In Vivo
Actimab-A
Facilitates T cell Proliferation
36
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 head and neck squamous cell carcinoma (HNSCC), NSCLC, glioblastoma
(GBM), and microsatellite instability (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
eligible to be 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 or 1H:2027. In addition, we are also evaluating clinical
opportunities with other immune checkpoint inhibitors in GBM and NSCLC.
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 ® can 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. Supporting
this backbone positioning, preclinical and translational studies have demonstrated that Actimab-A is cytotoxic in primary AML patient
samples irrespective of FLT3, KMT2A, NPM1, IDH1, or TP53 mutation status. The combinations of Actimab-A with agents from each of the
three major classes of AML standard-of-care therapies, including the menin inhibitor revumenib, the FLT3 inhibitor gilteritinib, and
the hypomethylating agent azacitidine, potentiate AML cell death, supporting a backbone strategy. Actimab-A was shown to produce consistent
transcriptional reprogramming, including activation of p53-associated stress response and apoptosis pathways and downregulation of proliferative
programs such as MYC targets and G2/M checkpoint signatures.
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 measurable residual disease (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 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.
We
have discussed with the Food and Drug Administration (FDA) and believe we are aligned on a Phase 2/3 trial design to evaluate Actimab-A
plus CLAG-M in R/R AML patients eligible for first or second salvage therapy. We are actively seeking a strategic partner to execute
this trial. We believe 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.
37
Actimab-A
+ CLAG-M Phase 2/3 Trial Design
Actimab-A
Development Programs: Beyond R/R AML, we are developing Actimab-A in conjunction with the National Cancer Institute, or 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 NCI, which enables cost-effective clinical
development while retaining commercial rights to Actimab-A.
On
April 21, 2026, preclinical translational data with Actimab-A were presented at the AACR Annual Meeting in San Diego, California. The
presentation highlighted the following:
Transcriptional
Reprogramming as a Key Mechanism for Actimab-A Combination Activity
●
Combination
treatment produced consistent pathway-level changes compared with monotherapy, with gene set enrichment analysis (GSEA) showing enhanced
myeloid differentiation signatures when Actimab-A was added to revumenib, gilteritinib, and azacitidine, agents from each of the
three major classes of AML standard-of-care therapies.
●
Across
models, combinations were associated with downregulation of proliferative programs, including MYC target genes, E2F targets, and
G2/M checkpoint signatures, together with enrichment of p53-associated stress response and apoptosis pathways.
●
We believe
these findings indicate that Actimab-A combinations reprogram AML cells from proliferation toward differentiation and apoptosis,
potentially providing a mechanistic basis for deeper and more durable MRD-negative responses and supporting Actimab-A’s role
as a universal combination backbone across AML treatment settings.
38
Gene
Set Enrichment Analysis Demonstrated Broad Activity of Actimab-A Combinations Versus AML Standard of Care Therapies Alone
Combinations
with Revumenib and Azacitidine Sensitize AML Cells to Actimab-A and Support Frontline Triplet Rationale
39
●
Actimab-A
demonstrated robust cytotoxicity in primary AML patient samples independent of FLT3, KMT2A, NPM1, IDH1, IDH2, or TP53 mutation status,
supporting its potential applicability across the full AML patient population, including TP53-mutant patients who lack effective
targeted options.
●
Combining
Actimab-A with standard-of-care therapies, including revumenib (menin inhibitor), gilteritinib (FLT3 inhibitor), and azacitidine
(hypomethylating agent), enhanced anti-leukemic efficacy across models, demonstrating synergy with agents representing each of the
three pillars of modern AML care and, we believe, further support Actimab-A’s positioning as a combination partner across frontline,
relapsed/refractory, and unfit AML populations.
Actimab-A
Combination with SOC Enhance Cytotoxicity in Primary AML Patient Samples
40
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.
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-Hodgkin’s lymphoma. 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.
●
Phase
1 Trial in Sickle Cell Disease BMT: Evaluating Iomab-ACT as conditioning for allogeneic bone marrow transplant in patients with sickle
cell disease.
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.
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 the Iomab-B arm, it provided important
insights into optimal patient selection and trial design for future development.
We
have discussed our Phase 2/3 trial design with FDA and, based on the feedback, we believe we are aligned 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. We believe 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. Preclinical 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.
41
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,
preclinical 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.
●
Preclinical
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.
We
believe 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.
Clinical
Development Operations
We
conduct company-sponsored clinical development activities through a combination of internal personnel and third-party service providers
in the United States and selected international jurisdictions where we operate through subsidiaries and/or contract research organizations.
Our clinical development capabilities include clinical trial planning and execution, regulatory affairs, clinical monitoring, pharmacovigilance,
medical oversight, data management, biostatistics and investigational product logistics. We work with contract research organizations,
clinical investigators, central laboratories and other specialized vendors to support patient enrollment, study execution and regulatory
compliance across our development programs.
We
believe this operating model provides flexibility to efficiently advance multiple clinical programs while maintaining quality oversight,
operational scalability and regulatory compliance. We expect to report data from ongoing company- and investigator-sponsored clinical
studies for ATNM-400, Actimab-A for MDSC’s and Iomab-ACT in 4Q:2026 and over the course of 2027.
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. Our clinical development
infrastructure supports company-sponsored clinical development activities conducted in the United States and selected international jurisdictions
through relationships with isotope suppliers, contract development and manufacturing organizations and specialized radiopharmaceutical
logistics providers. 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.
42
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.
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. If any of our product candidates are approved for orphan indications, we may
be eligible for seven years of market exclusivity in the United States, and similar exclusivity periods 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.
43
External
Manufacturing Partnerships
We
have established partnerships with multiple contract manufacturing organizations providing geographic redundancy and production flexibility
to support company-sponsored clinical development activities in the United States and selected international jurisdictions. These partnerships,
together with relationships with specialized isotope suppliers and radiopharmaceutical logistics providers, support investigational product
manufacturing, distribution and clinical supply while providing operational redundancy and continuity of supply as the Company expands
its internal manufacturing capabilities:
●
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.
●
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 support ongoing clinical development activities conducted in multiple jurisdictions
and future commercial operations while maintaining flexibility to respond to changing demand.
44
Human
Capital
As
of August 6, 2026, we had 27 full-time employees, 13 of whom have Ph.D. or M.D. degrees and 23 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 environment 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 supplement
existing staff.
Results
of Operations - Three Months Ended June 30, 2026 Compared to Three Months Ended June 30, 2025
The
following table sets forth, for the periods indicated, data derived from our statements of operations:
For the
Three Months Ended
June 30
(in thousands)
2026
2025
Revenue:
Revenue
$ -
$ -
Other
revenue
35,000
-
Total
revenue
35,000
-
Operating expenses:
Research and development,
net of reimbursements
5,377
4,879
General
and administrative
2,058
2,624
Total
operating expenses
7,435
7,503
Other income:
Interest
income – net
336
625
Total
other income
336
625
Income/(loss) before income taxes
27,901
(6,878 )
Income tax expense
-
-
Net income/(loss)
$ 27,901
$ (6,878 )
45
Revenue
We
recorded no commercial revenue for the three months ended June 30, 2026 and June 30, 2025, respectively.
Other
revenue
On
April 7, 2022, we entered into a License Agreement with Immedica, 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 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 the rest of the world. The $35 million upfront
payment was initially recorded as Long-term license revenue - deferred due to uncertainty regarding Immedica’s ability to obtain
regulatory approval of the product by the European Medicines Agency. Subsequently, Immedica notified us that it would not pursue regulatory
approval of Iomab-B in the licensed territories. In the current period, based on the facts and circumstances, we concluded that Immedica’s
right to asserting a claim related to the $35 million had expired. Accordingly, the condition previously constraining recognition of
the $35 million upfront payment no longer existed and that the non-refundable payment was no longer subject to a significant reversal.
Therefore, we recognized the previously deferred $35 million upfront payment as revenue in June 2026.
Research
and development expense, net of reimbursements
Research
and development expenses include costs associated with preclinical and clinical development activities conducted in the United States
and selected international jurisdictions, including clinical site costs, contract research organizations, manufacturing, isotope supply,
investigational product logistics, regulatory support and pharmacovigilance. Certain international clinical development activities are
conducted through the Company’s wholly owned Australian subsidiary, Actinium Pharmaceuticals Australia Pty Ltd. The Company has
applied for available Australian research and development tax incentives associated with qualifying research activities.
Research
and development expenses, net of reimbursements, of $5.4 million for the three months ended June 30, 2026 increased by $0.5 million from
$4.9 million for the three months ended June 30, 2025, primarily due to increased preclinical expenses of $0.3 million, increased Chemistry,
manufacturing and controls, or CMC, expenses and clinical expenses of $0.6 million, partially offset by lower compensation expense of
$0.4 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 which resulted in additional departures in 2025.
General
and administrative expense
General
and administrative expense of $2.1 million for the three months ended June 30, 2026 decreased by $0.5 million from $2.6 million for the
three months ended June 30, 2025 primarily due to a decrease in compensation expense of $0.4 million due to lower headcount and a decrease
in non-cash stock-based compensation expense of $0.1 million.
Other
income
Other
income is comprised of net interest income in both reporting periods. The amount for the three months ended June 30, 2026 of $0.3 million
decreased from $0.6 million for the three months ended June 30, 2025 primarily due to a lower average cash balance during the three months
ended June 30, 2026 compared to the prior-year period.
Income
tax expense
Income
tax expense was $0 for the three months ended June 30, 2026 and 2025. Despite reporting profit before income taxes of $27.9 million for
the three months ended June 30, 2026, no income tax expense was recorded as we have sufficient net operating losses that are available
to offset net taxable income. The Company’s estimated annual effective income tax rate is 0%, compared to the U.S. federal statutory
rate of 21%. The difference is attributable to the full valuation allowance maintained against the Company’s net deferred tax assets.
Based on the Company’s history of cumulative losses and the uncertainty of generating sufficient future taxable income to utilize
its deferred tax assets, management has determined that it is more likely than not that the net deferred tax assets will not be realized.
46
Net income
/ (loss)
Net
income of $27.9 million for the three months ended June 30, 2026 increased by $34.8 million from a net loss of $6.9 million for the three
months ended June 30, 2025 driven by the recognition of $35.0 million of revenue previously deferred in connection with the commercialization
agreement with Immedica.
Results
of Operations – Six Months Ended June 30, 2026 Compared to Six Months Ended June 30, 2025
The
following table sets forth, for the periods indicated, data derived from our statements of operations:
For the
Six Months Ended
June 30,
(in thousands)
2026
2025
Revenue:
Revenue
$ -
$ -
Other
revenue
35,000
-
Total
revenue
35,000
-
Operating expenses:
Research and development,
net of reimbursements
9,578
12,579
General
and administrative
3,760
11,562
Total
operating expenses
13,338
24,141
Other income:
Interest
income – net
717
1,325
Total
other income
717
1,325
Income/(loss) before income taxes
22,379
(22,816 )
Income tax expense
-
-
Net income/(loss)
$ 22,379
$ (22,816 )
Revenue
We
recorded no commercial revenue for the six months ended June 30, 2026 and June 30, 2025, respectively.
Other
revenue
As
noted above, we recognized $35 million as revenue in the six months ended June 30, 2026 related to the Immedica collaboration.
Stock-based
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 our 2019 Stock Plan. The cancellation of these stock options resulted in the recording of $8.7 million in non-cash stock compensation
expense for the six months ended June 30, 2025, $2.1 million in Research and development expense and $6.6 million in General and administrative
expense.
47
Research
and development expense, net of reimbursements
Research
and development expenses, net of reimbursements, of $9.6 million for the six months ended June 30, 2026 decreased by $3.0 million from
$12.6 million for the six months ended June 30, 2025. The cancellation of stock options in March 2025 described above resulted in lower
non-cash stock-based compensation expense of $2.1 million for the six months ended June 30, 2026 compared with the six months ended June
30, 2025. In addition, there was lower compensation cost of $0.9 million due to lower headcount.
General
and administrative expense
General
and administrative expense of $3.8 million for the six months ended June 30, 2026 decreased by $7.8 million from $11.6 million for the
six months ended June 30, 2025. Lower non-cash stock-based compensation expense of $6.9 million for the six months ended June 30, 2026
compared with the same period in 2025 was primarily driven by the cancellation of stock options in March 2025, discussed above. In addition,
in comparison to the prior-year period, compensation expense decreased $0.9 million due to lower headcount.
Other
income
Other
income is comprised of net interest income in both reporting periods. The amount for the six months ended June 30, 2026 of $0.7 million
decreased from $1.3 million for the six months ended June 30, 2025 primarily due to a lower average cash balance during the six months
ended June 30, 2026 compared to the prior-year period.
Income
tax expense
Income
tax expense was $0 for the six months ended June 30, 2026 and 2025. Despite reporting income before income taxes of $22.4 million for
the six months ended June 30, 2026, no income tax expense was recorded. The Company’s estimated annual effective income tax rate
is 0%, compared to the U.S. federal statutory rate of 21%.
Net income/(loss)
Net
income of $22.4 million for the six months ended June 30, 2026 increased by $45.2 million from a net loss of $22.8 million for the six
months ended June 30, 2025, driven by the recognition of $35.0 million of revenue previously deferred in connection with the commercialization
agreement with Immedica, lower stock-based compensation of $9.0 million discussed above and lower compensation expense of $1.8 million
due to lower headcount, slightly offset by lower other income of $0.6 million.
Liquidity
and Capital Resources
The
following table sets forth selected cash flow information for the periods indicated:
For the
Six Months Ended
June 30,
(in thousands)
2026
2025
Cash used in operating activities
$ (11,049 )
$ (12,966 )
Cash used in investing activities
(480 )
-
Cash used in financing activities
(5 )
(5 )
Effect of foreign currency
rates on cash
13
-
Net change in cash,
cash equivalents and restricted cash
$ (11,521 )
$ (12,971 )
48
Net
cash used in operating activities for the six months ended June 30, 2026 was $11.0 million, a decrease of $2.0 million from $13.0 million
in the prior-year period, primarily resulting from lower compensation expense as a result of lower headcount for the six months ended
June 30, 2026 compared to the prior-year period.
Cash
used in investing activities for the six months ended June 30, 2026 was $0.5 million related to the construction of modular removable
manufacturing improvements within our leased manufacturing facility. There was no cash used in investing activities for the six months
ended June 30, 2025.
Cash
used in financing activities for the six months ended June 30, 2026 and June 30, 2025 was $5 thousand and $5 thousand, respectively.
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 Amended and Restated Capital on Demand™ Sales Agreement, or 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 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), which 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 A&R Sales Agreement. There was no sale of shares of common stock during the
six months ended June 30, 2026 and 2025, respectively.
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.
Notice
of Delisting or Failure to Satisfy a Continued Listing Rule or Standard
On
May 27, 2026, the Company received a notice from NYSE American LLC indicating that we are not in compliance with the continued listing
standards set forth in Section 1003(a)(ii) of the NYSE American Company Guide, which requires a listed company to maintain stockholders’
equity of $4.0 million or more if it has reported losses from continuing operations and/or net losses in three of its four most recent
fiscal years. As of March 31, 2026, the Company reported stockholders’ equity of $2.3 million and had net losses in its last five
fiscal years ended December 31, 2025. As of June 30, 2026, the Company reported stockholders’ equity of $30.3 million.
In
connection with its non-compliance with Sections 1003(a)(ii) and (iii) of the Company Guide, the Company was required to submit a plan
by June 26, 2026, advising of actions it has taken or will take to regain compliance with the continued listing standards by November
27, 2027, or the Plan Period Deadline. If NYSE Regulation determines to accept the plan, we will be notified in writing and will be subject
to periodic reviews including quarterly monitoring for compliance with the plan. Note that typically, NYSE considers a company compliant
if it meets the listing requirements for two consecutive quarters. Subsequent to filing of this current Form 10-Q, we expect to be in
technical compliance based on our stockholder equity and expect to remain so thereafter.
On
June 18, 2026, we submitted our compliance plan to NYSE American, outlining certain actions management intends to take in effort to restore
compliance with applicable listing standards. If the plan is not accepted, delisting proceedings will commence. Furthermore, if the plan
is accepted but the Company is not in compliance with the continued listing standards by the Plan Period Deadline, or if the Company
does not make progress consistent with the plan during the plan period, NYSE American staff will initiate delisting proceedings as appropriate.
The Company may appeal a staff delisting determination in accordance with Section 1010 and Part 12 of the Company Guide.
The
Notice has no immediate effect on the listing or trading of the Company’s common stock, which will continue to trade on NYSE American
under the symbol “ATNM,” subject to the Company’s compliance with the other continued listing requirements of NYSE
American, and will continue to trade with a “.BC” indicator to denote that the Company is below compliance.
49
There
can be no assurance that the Company will be able to regain or maintain compliance with the applicable continued listing standards, that
NYSE American will accept the Company’s Plan, that the Company will be able to comply with the terms of any accepted Plan, or that
the Company will be able to maintain the listing of its common stock on NYSE American.
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.
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 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. We are evaluating the impact
of ASU 2025-04 on our financial statements.
50
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.
In
December 2025, the FASB issued ASU 2025-11, Interim Reporting (Topic 270): Narrow-Scope Improvements. This update clarifies interim
disclosure requirements and centralizes such requirements within Topic 270. Among other changes, ASU 2025-11 introduces a disclosure
principle requiring entities to provide information about significant events or changes since the end of the last annual reporting period
that have a material impact, clarifies when duplicative annual disclosures may be omitted from interim reports, and aligns interim reporting
requirements with applicable SEC guidance for registrants. This guidance is effective for interim reporting periods within annual reporting
periods beginning after December 15, 2027. Early adoption is permitted. The amendments in ASU 2025-11 should be applied prospectively.
We are currently assessing the impact on its condensed consolidated financial statements and disclosures.
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.
51
ITEM
3. 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.
ITEM
4. CONTROLS AND PROCEDURES.
Evaluation
of Disclosure Controls and Procedures . Under the supervision and with the participation of our management, including our principal
executive officer and principal financial officer, we conducted an evaluation of the effectiveness, as of June 30, 2026, of our disclosure
controls and procedures, as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended, or the Exchange
Act. Based upon such evaluation, our principal executive officer and principal financial officer have concluded that, as of June 30,
2026, our disclosure controls and procedures were effective to provide reasonable assurance that the information we are required to disclose
in our filings with the Securities and Exchange Commission, or SEC, under the Exchange Act (i) is recorded, processed, summarized and
reported within the time periods specified in the SEC’s rules and forms and (ii) accumulated and communicated to our management,
including our principal executive officer and principal financial and accounting officer, as appropriate to allow timely decisions regarding
required disclosure.
Changes
in Internal Control over Financial Reporting . There were no changes in our internal controls over financial reporting during the
period covered by this Quarterly Report on Form 10-Q that has materially affected, or are reasonably likely to materially affect, our
internal control over financial reporting.
52
PART
II – OTHER INFORMATION
ITEM
1. 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 our 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 Exchange Act. Plaintiff sought unspecified damages. On June 24, 2025, the court in the securities
action appointed lead plaintiffs (the “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.
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
1A. RISK FACTORS
In
analyzing our company, you should consider carefully the following risk factors, together with all of the other information included
in this Quarterly Report on Form 10-Q. Factors that could cause or contribute to differences in our actual results include those
discussed in the following subsection, as well as those discussed above in “Management’s Discussion and Analysis of Financial
Condition and Results of Operations” and in our Annual Report on Form 10-K for the year ended December 31, 2025. Each of the following
risk factors, either alone or taken together, could adversely affect our business, operating results and financial condition, as well
as adversely affect the value of an investment in our company. The risks and uncertainties described below are not the only ones we face.
Additional risks not currently known to us, or other factors not perceived by us to present significant risks to our business at this
time also may impair our business operations.
53
Summary
of Risk Factors
We
are providing the following summary of the risk factors contained in this Quarterly Report on Form 10-Q to enhance the readability and
accessibility of our risk factor disclosures. We encourage you to carefully review the full risk factors contained in this Quarterly
Report on Form 10-Q 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;
● Limitations
under General Instructions I.B.6 of Form S-3 (the “baby shelf limitation) may restrict
our ability to raise additional capital;
●
We are highly dependent
on the clinical, regulatory and commercial success of ATNM-400, Actimab-A, Iomab-ACT, and other pipeline candidates which we may
never achieve;
●
We are highly dependent
on our key personnel, most importantly our CEO who we consider a key employee, 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;
●
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;
54
●
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 preclinical 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.
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 June 30, 2026 and December 31, 2025, we had an
accumulated deficit of $387.3 million and $409.7 million, respectively. We reported net income of $22.4 million for the six months ended
June 30, 2026 and a net loss of $22.8 million for the six months ended June 30, 2025. 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.
55
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.
Limitations
under General Instructions I.B.6 of Form S-3 (the “baby shelf” limitation) may restrict our ability to raise additional capital.
Although
we may continue to offer and sell shares of common stock under our existing at-the-market offering program up to the amount covered by
the related prospectus supplement, our ability to conduct new or expanded primary offerings under Form S-3 may be limited while the aggregate
market value of our voting and non-voting common equity held by non-affiliates remains below $75 million. Under General Instruction I.B.6
of Form S-3, we generally may not sell securities in primary offerings under Form S-3 having an aggregate market value exceeding one-third
of our public float during any 12-calendar-month period. These limitations could reduce our flexibility to raise additional capital after
the capacity under our existing at-the-market offering program is exhausted or otherwise unavailable and could require us to pursue alternative
financing transactions that may be more costly, more dilutive or otherwise less favorable.
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.
56
We
are highly dependent on the clinical, regulatory and commercial success of ATNM-400, Actimab-A, Iomab-ACT, 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 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.
We
are highly dependent on Sandesh Seth, our Chairman and Chief Executive Officer, and the loss of his services could be significantly more
disruptive and costly to remediate than the loss of other members of management.
Mr.
Seth has served as our Chairman since October 2013 and as our Chief Executive Officer since June 2017, and as a director since March
2012. He has over 25 years of experience spanning investment banking, equity research, and the pharmaceutical industry, including business
development, strategic planning, and regulatory affairs, and holds a Regulatory Affairs Certification signifying proficiency with U.S.
FDA regulations. In addition to leading our executive team, Mr. Seth is also a named inventor of over 30 issued and pending U.S. and
international patents and patent applications which are foundationally applicable to ATNM-400, Actimab-A combined with MDSC’s and
Iomab-ACT which are our important pipeline candidates.
Following
the workforce reductions described below and the departure of other members of senior management, including our former Chief Financial
Officer in February 2026 and our former Chief Strategy Officer, and Chief Medical Officer (position filled June 2026) as well as senior
technical and clinical development personnel in 2025, Mr. Seth has assumed broad management responsibilities and has direct involvement
with technical operations. Importantly, Mr. Seth possesses institutional knowledge of our scientific platform, regulatory strategy, intellectual
property portfolio, key relationships, and capital markets history that cannot be duplicated by the rest of employees in their totality
within our organization at this time.
We
do not currently maintain key person life insurance on Mr. Seth. There can be no assurance that a suitable successor could be identified,
recruited, or transitioned into his role without material disruption to our business, our ongoing regulatory and commercial strategy,
or our relationships with investors, collaborators, and regulators.
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.
57
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. 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.
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.
58
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 on 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.
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.
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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 of 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.
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 trial 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.
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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 preclinical 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.
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. From October 1, 2025 until November 12, 2025, the U.S federal government
was shut down, 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 aforementioned federal government
shutdown. For example, the NCI with whom we have a CRADA 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.
61
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;
●
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.
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●
Phase 2. The biological
product is evaluated in a limited patient population to identify possible adverse effects and safety risks, to preliminarily evaluate
the efficacy of the product for specific targeted diseases and to determine dosage tolerance, optimal dosage and dosing schedule.
●
Phase 3. Clinical trials
are undertaken to further evaluate dosage, clinical efficacy, potency, and safety in an expanded patient population at geographically
dispersed clinical trial sites. These clinical trials are intended to establish the overall risk to benefit ratio of the product
and provide an adequate basis for product labeling.
Post-approval
clinical trials, sometimes referred to as Phase 4 clinical trials, may be conducted after initial marketing approval. These clinical
trials are used to gain additional experience from the treatment of patients in the intended therapeutic indication, particularly for
long-term safety follow-up.
After
the completion of clinical trials of a biological product, FDA approval of a BLA must be obtained before commercial marketing of the
biological product. The BLA must include results of product development, laboratory and animal studies, human trials, information on
the manufacture and composition of the product, proposed labeling and other relevant information. The FDA may grant deferrals for submission
of data, or full or partial waivers. The testing and approval processes require substantial time and effort and there can be no assurance
that the FDA will accept the BLA for filing and, even if filed, that any approval will be granted on a timely basis, if at all. Before
approving a BLA, the FDA will inspect the facilities at which the product is manufactured. The FDA will not approve the product unless
it determines that the manufacturing processes and facilities are in compliance with cGMP requirements and adequate to assure consistent
production of the product within required specifications. Additionally, before approving a BLA, the FDA will typically inspect one or
more clinical sites to assure that the clinical trials were conducted in compliance with IND trial requirements and GCP requirements.
To assure cGMP and GCP compliance, an applicant must incur significant expenditure of time, money and effort in the areas of training,
record keeping, production, and quality control.
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;
63
●
delays in enrolling patients
into clinical trials;
●
a lower than anticipated
retention rate of patients in clinical trials;
●
the need to repeat or discontinue
clinical trials as a result of inconclusive or negative results or unforeseen complications in testing or because the results of
later trials may not confirm positive results from earlier preclinical studies or clinical trials;
●
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 pause or cause the 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;
64
●
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.
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.
65
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
preclinical 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 preclinical 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 patents (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.
66
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 lintuzumab-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 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.
67
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 2026.
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 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;
●
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.
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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.
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.
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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.
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.
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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.
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.
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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.
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.
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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 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, rescission, 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;
●
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;
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●
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 became 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.
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 are 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.
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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.
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.
Certain
of our company-sponsored clinical development activities are conducted outside the United States through subsidiaries, clinical trial
sites, contract research organizations, investigators and other third-party service providers. Conducting clinical development internationally
may subject us to additional risks, including differences in regulatory requirements, ethics committee processes, patient recruitment
and retention, clinical site performance, data collection standards, import and export controls, foreign currency fluctuations, local
tax requirements, and operational or logistical disruptions. Any failure by our international service providers or clinical sites to
comply with applicable requirements or meet expected timelines could delay patient enrollment, dosing, data readouts or regulatory submissions.
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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 preclinical development activities or clinical trials may be extended, delayed, suspended or terminated, and we may not be able to
obtain regulatory approval for, or successfully commercialize, our product candidates on a timely basis, if at all, and our business,
operating results and prospects would be adversely affected.
The
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.
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We
believe that oncologists and other physicians will not widely adopt a product candidate unless they determine, based on experience, clinical
data, and published peer-reviewed journal articles, that the use of that product candidate provides an effective alternative to other
means of treating specific cancers. Patient studies or clinical experience may indicate that treatment with our product candidates does
not provide patients with sufficient benefits in extension of life or quality of life. We believe that recommendations and support for
the use of each product candidate from influential physicians will be essential for widespread market acceptance. Our product candidates
are still in the development stage, and it is premature to attempt to gain support from physicians at this time. We can provide no assurance
that such support will ever be obtained. If our product candidates do not receive such support from these physicians and from long-term
data, physicians may not use or continue to use, and hospitals may not purchase or continue to purchase, them.
Failure
of 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 preclinical 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 preclinical or clinical production of any of our product candidates. We rely on
third-party manufacturers to supply, store, and distribute preclinical 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.
Our
product candidates require specialized radiopharmaceutical manufacturing, isotope procurement, release testing and time-sensitive distribution
to clinical sites, including sites located outside the United States. International clinical supply may require coordination among isotope
suppliers, contract development and manufacturing organizations, couriers, customs brokers, clinical sites and regulatory authorities.
Delays or disruptions in isotope availability, manufacturing slots, quality release, customs clearance, import/export approvals, transportation
of radioactive materials or site scheduling could result in missed dosing windows, increased costs, product waste due to radioactive
decay, protocol deviations or delays in clinical trial enrollment and data generation.
We
currently rely on single manufacturers to manufacture our preclinical 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 preclinical 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.
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.
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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.
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;
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●
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.
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.
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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.
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.
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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.
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 partes 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.
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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.
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.
‘These
requirements may be more complex when radioactive materials or radiopharmaceutical products are transported internationally, including
requirements relating to import/export authorizations, customs clearance, local radiation safety rules, chain-of-custody procedures and
specialized courier qualifications. Any failure to comply with such requirements, or any delay in obtaining required approvals or clearances,
could delay clinical trial activities, increase costs or result in regulatory enforcement actions.
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We
may undertake international operations, which will subject us to risks inherent with operations outside of the United States.
We
conduct certain clinical development activities outside the United States, including through our wholly owned Australian subsidiary and
third-party service providers, and we may conduct additional international development, regulatory, manufacturing, supply chain or commercialization
activities in the future. Conducting operations outside the United States involves inherent risks, including, but not limited to, difficulties
in staffing, funding and managing foreign operations; unexpected changes in regulatory requirements; differences in clinical trial, ethics
committee, privacy, data protection, tax and healthcare requirements; export restrictions; tariffs and other trade barriers; import/export
controls and customs requirements applicable to radioactive materials; difficulties in protecting, acquiring, enforcing and litigating
intellectual property rights; difficulties in collecting accounts receivable; longer payment cycles; changes in tax laws; laws and business
practices favoring local companies; compliance with tax, employment, immigration and labor laws for employees or contractors living or
traveling abroad; the need to obtain required approvals from foreign governmental authorities; foreign currency fluctuations; and the
potential imposition of restrictions on currency conversion or the transfer of funds.
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.
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.
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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.
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.
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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.
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.
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Compliance
with the reporting requirements of federal securities laws can be expensive.
We
are subject to the information and reporting requirements of the Exchange Act and other federal securities laws, and the compliance obligations
of the Sarbanes-Oxley Act. The costs of preparing and filing annual and quarterly reports and other information with the 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 (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.
We
may not receive expected benefits from research and development tax incentives, including Australian research and development tax incentives,
and any such benefits may be delayed, reduced, denied or subject to recapture.
We
have applied for Australian research and development tax incentives associated with qualifying research activities conducted through
our Australian subsidiary. Eligibility for such incentives depends on satisfaction of applicable requirements, including requirements
relating to qualifying activities, eligible expenditures, documentation, registration, tax filings, and review by Australian governmental
authorities. There can be no assurance that we will qualify for, receive, or retain any anticipated incentive amounts, or that such amounts
will be received on the timing expected. Any denial, reduction, delay, audit adjustment or recapture of such incentives could adversely
affect our cash flows, results of operations or financial condition. Changes in Australian tax laws, administrative practices or governmental
funding policies could also reduce or eliminate the availability of such incentives in the future.
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.
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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.
ITEM
2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS.
None.
ITEM
3. DEFAULTS UPON SENIOR SECURITIES.
None.
ITEM
4. MINE SAFETY DISCLOSURES.
None.
ITEM
5. OTHER INFORMATION.
None .
89
ITEM
6. EXHIBITS
Copies
of the following documents are included as exhibits to this report pursuant to Item 601 of Regulation S-K.
Exhibit No.
Description
3.1
Certificate
of Incorporation of Actinium Pharmaceuticals, Inc. (incorporated by reference to Exhibit 3.1 of the Company’s Form 8-K filed
with the SEC on April 17, 2013).
3.2
Certificate
of Amendment to Certificate of Incorporation, as amended, filed January 7, 2014 (incorporated by reference to Exhibit 3.5 to Form
S-1 filed on January 31, 2014).
3.3
Certificate
of Amendment to Certificate of Incorporation, as amended, filed February 3, 2014. (incorporated by reference to Exhibit 3.1 to Form
8-K filed on February 7, 2014).
3.4
Certificate
of Amendment to Certificate of Incorporation, as amended, filed on February 26, 2015 (incorporated by reference to Exhibit 3.1 to
Form 8-K filed on March 4, 2015).
3.5
Certificate
of Amendment to Certificate of Incorporation, as amended, filed on February 26, 2018 (incorporated by reference to Exhibit 3.1 to
Form 8-K filed on February 26, 2018).
3.6
Certificate
of Amendment to Certificate of Incorporation, as amended, filed on March 6, 2019 (incorporated by reference to Exhibit 3.7 to Form
10-K filed on March 15, 2019).
3.7
Certificate
of Amendment to Certificate of Incorporation, as amended, filed on June 16, 2020 (incorporated by reference to Exhibit 3.1 to Form
8-K filed on June 16, 2020).
3.8
Certificate
of Amendment to Certificate of Incorporation, as amended, filed on August 10, 2020 (incorporated by reference to Exhibit 3.1 to Form
8-K filed on August 14, 2020).
3.9
Amended
and Restated Bylaws, dated August 9, 2018 (incorporated by reference to Exhibit 3.1 to Form 10-Q filed on August 9, 2018).
3.10
Amendment
to Amended and Restated Bylaws, dated August 6, 2020 (incorporated by reference to Exhibit 3.1 to Form 8-K filed on May 5, 2020).
10.1*
Exclusive
License Agreement, dated June 25, 2024, by and between ISU ABXIS Co., Ltd. and Actinium Pharmaceuticals, Inc.
31.1*
Certification
of Principal Executive Officer and Principal Financial Officer, pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section
302 of the Sarbanes-Oxley Act of 2002.
32.1**
Certification
of Principal Executive Officer and Principal Financial Officer, pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section
906 of the Sarbanes-Oxley Act of 2002.
101.INS*
Inline XBRL Instance Document
101.SCH*
Inline XBRL Taxonomy Schema
Document
101.CAL*
Inline XBRL Taxonomy Calculation
Linkbase Document
101.DEF*
Inline XBRL Taxonomy Definition
Linkbase Document
101.LAB*
Inline XBRL Taxonomy Label
Linkbase Document
101.PRE*
Inline XBRL Taxonomy Presentation
Linkbase Document
104*
Cover Page Interactive
Data File (formatted as Inline XBRL and contained in Exhibit 101).
*
Filed herewith.
**
Furnished herewith.
90
SIGNATURES
Pursuant
to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by
the undersigned thereunto duly authorized.
ACTINIUM PHARMACEUTICALS, INC.
Date: August 7, 2026
By:
/s/ Sandesh
Seth
Sandesh Seth
Chairman and Chief Executive Officer
(Duly Authorized Officer, Principal Executive Officer, Principal Financial Officer)
91
Text extracted from the filing as submitted to EDGAR. Formatting, tables and exhibits are simplified for reading; the original document is authoritative for anything you rely on.