UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K/A
(Amendment
No. 1)
(Mark
One)
☒ ANNUAL
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For
the fiscal year ended December 31 , 2024
OR
☐ TRANSITION
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
Commission file number 00-50626
Bio
Green Med Solution, Inc.
CYCLACEL
PHARMACEUTICALS, INC.
(Exact
name of registrant as specified in its charter)
Delaware
91-1707622
(State
or Other Jurisdiction
(I.R.S.
Employer
of
Incorporation or Organization)
Identification
No.)
Level
10, Tower 11 , Avenue 5, No. 8
Jalan
Kerinchi , Kuala Lumpur , Malaysia
59200
(Address
of principal executive offices)
(Zip
Code)
Registrant’s
telephone number, including area code: (908) 955-0526
200
Connell Drive, Suite 1500, Berkeley Heights, New Jersey 07922
(Former
address, if changed since last report)
Securities
registered pursuant to section 12(b) of the Act:
Title
of each class
Trading
Symbol(s)
Name
of each exchange on which registered
Common
Stock, par value $0.001 per share
CYCC
The
Nasdaq Capital Market
Preferred
Stock, $0.001 par value
CYCCP
The
Nasdaq Capital Market
Securities
registered pursuant to section 12(g) of the Act: None.
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐
No ☒
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of
the Act. Yes ☐ No ☒
Indicate
by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange
Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2)
has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate
by check mark whether the registrant has submitted electronically, every Interactive Data File required to be submitted pursuant to Rule
405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant
was required to submit such files). Yes ☒ No ☐
Indicate
by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting
company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,”
“smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act:
Large
accelerated filer
☐
Accelerated
filer
☐
Non-accelerated
filer
☒
Smaller
reporting company
☒
Emerging
growth company
☐
If
an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying
with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate
by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness
of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered
public accounting firm that prepared or issued its audit report. ☐
If
securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant
included in the filing reflect the correction of an error to previously issued financial statements. ☐
Indicate
by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation
received by any of the registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐
Indicate
by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). ☐Yes ☒ No
The
aggregate market value of the registrant’s voting and non-voting common stock held by non-affiliates of the registrant (without
admitting that any person whose shares are not included in such calculation is an affiliate), as of June 30, 2024 (based upon the closing
sale price of $388.80 of such shares on The NASDAQ Capital Market on June 30, 2024), the last business day of the registrant’s
most recently completed second fiscal quarter, was $ 2,523,882 .
As
of March 27, 2025, there were 863,901 shares of the registrant’s common stock outstanding.
DOCUMENTS
INCORPORATED BY REFERENCE
The
following document (or parts thereof) are incorporated by reference into the following parts of this Form 10-K: Certain information required
in Part III of this Annual Report on Form 10-K is incorporated from the registrant’s definitive proxy statement for the 2025 annual
meeting of stockholders to be filed pursuant to Regulation 14A with the Securities and Exchange Commission within 120 days of the registrant’s
fiscal year ended December 31, 2024. Except with respect to information specifically incorporated by reference in this Form 10-K, the
Definitive Proxy Statement is not deemed to be filed as part of this Form 10-K.
EXPLANATORY
NOTE
This
Amendment No. 1 on Form 10-K/A (this “Amendment”) amends the Annual Report on Form 10-K of Cyclacel Pharmaceuticals, Inc.
(the “Company”) for the fiscal year ended December 31, 2024, as originally filed with the Securities and Exchange Commission
(the “SEC”) on April 2, 2025 (the “Original 10-K”). The purpose of this Amendment is to incorporate the report
of the current independent registered public accounting firm following their re-audit of both the full year 2024 and 2023 financial periods.
The re-audit of these periods was conducted at the request of management to bring about efficiencies and future cost savings by placing
reliance on a single audit firm to provide auditor consents for future registration statements and similar filings.
In
addition, except as otherwise indicated, all information in this Amendment assumes a 1-for-16 stock split effective May 7, 2025 of the
outstanding common stock of the Company and a 1-for-15 stock split effective July 2, 2025 of the outstanding common stock of the Company.
Furthermore,
on September 12, 2025, the Company changed its name to Bio Green Med Solution Inc. and this Amendment is being filed under this new name.
However, all Company name references within this document remain as Cyclacel Pharmaceuticals, Inc.
Except
as described above, no other changes have been made to the Original 10-K. The Original 10-K continues to speak as of the dates described
in the Original 10-K, and we have not updated the disclosures contained therein to reflect any events that occurred subsequent to such
dates. Accordingly, this Amendment should be read in conjunction with the Company’s filings made with the SEC subsequent to the
filing of the Original 10-K, as information in such filings may update or supersede certain information contained in this Amendment.
In accordance with Rule 12b-15 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), Part III, Item
12 of the Original 10-K is hereby amended and restated in its entirety and new certifications by our principal executive officer and
principal financial officer required by Rule 13a-14(a) under the Exchange Act are also being filed as exhibits to this Amendment. This
Amendment speaks as of the filing date of the Original 10-K, does not reflect events that may have occurred subsequent such date, and
does not amend or otherwise update any other information in the Original 10-K. Accordingly, this Amendment should be read in conjunction
with the Original 10-K and with our filings with the SEC subsequent to the Original 10-K.
In
this Amendment, unless the context specifically indicates otherwise, “the Company,” “we,” “us,” “our,”
and “Cyclacel” refer to Cyclacel Pharmaceuticals, Inc. and its subsidiaries.
TABLE OF CONTENTS
Page
PART I
Item
1.
Business
5
Item
1A.
Risk Factors
24
Item
1B.
Unresolved Staff Comments
63
Item
1C.
Cybersecurity
64
Item
2.
Properties
65
Item
3.
Legal Proceedings
65
Item
4.
Mine Safety Disclosures
65
PART II
Item
5.
Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
66
Item
6.
Reserved
66
Item
7.
Management’s Discussion and Analysis of Financial Condition and Results of Operations
67
Item
7A.
Quantitative and Qualitative Disclosures About Market Risk
77
Item
8.
Financial Statements and Supplementary Data
78
Item
9.
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
112
Item
9A.
Controls and Procedures
112
Item
9B.
Other Information
113
Item
9C.
Disclosure Regarding Foreign Jurisdictions that Prevent Inspections
113
PART III
Item
10.
Directors, Executive Officers and Corporate Governance
114
Item
11.
Executive Compensation
114
Item
12.
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
114
Item
13.
Certain Relationships and Related Transactions, and Director Independence
114
Item
14.
Principal Accountant Fees and Services
114
PART IV
Item
15.
Exhibits and Financial Statement Schedules
115
2
Table of Contents
Summary
of Principal Risk Factors
This
summary briefly lists the principal risks and uncertainties facing our business, which are only a select portion of those risks. A more
complete discussion of those risks and uncertainties is set forth in Part I, Item 1A of this Annual Report, entitled “Risk Factors”.
Additional risks not presently known to us or that we currently deem immaterial may also affect us. If any of these risks occur, our
business, financial condition or results of operations could be materially and adversely affected.
Our
business is subject to the following principal risks and uncertainties:
Risks
Associated with Development and Commercialization of Our Drug Candidates
● The
cost, time, and possibility of delays associated with clinical trials, which may be required
to continue beyond our available funding. We cannot be certain that we will be able to raise
sufficient funds to complete the development and commercialize our remaining product candidates
currently in clinical development, should they succeed.
● We
may suffer significant delays, setbacks or negative results in, or termination of, our clinical
trials.
● We
are making use of biomarkers, which are not scientifically validated, and our reliance on
biomarker data may thus cause us to direct our resources inefficiently.
● We
may be unable to directly control the timing, conduct and expense of our clinical trials,
due to our reliance on contract research organizations and other third parties to conduct
clinical trials.
● We
have no manufacturing capacity and will rely on third party manufacturers for the late-stage
clinical trials, development and commercialization of any drugs we may develop or sell.
● We
may encounter difficulties in managing our growth and expanding our operations successfully
as we evolve from a company primarily involved in discovery and development to one also involved
in the commercialization of drugs and devices.
● Our
drug candidates are subject to extensive regulation, which can be costly and time-consuming,
and we may not obtain approvals for the commercialization of any of our drug candidates.
● Even
if we successfully complete the clinical trials for our current product candidate, the product
candidate may fail for other reasons.
● We
face intense competition and our competitors may develop drugs that are less expensive, safer,
or more effective than our drug candidates.
● If
we fail to enter into and maintain successful strategic alliances for our drug candidates,
we may have to reduce or delay our drug candidate development or increase our expenditures.
● If
our drug candidates or distribution partners’ products fail to achieve market acceptance,
we may not be able to generate significant revenue and our business may suffer. Our business
may be affected by the efforts of government and third-party payors to contain or reduce
the cost of healthcare through various means.
● We
face potential product liability exposure, and if successful claims are brought against us,
we may incur substantial liability for a product candidate and may have to limit its commercialization.
● We
may be subject to numerous and varying privacy and security laws, and our failure to comply
could result in penalties and reputational damage.
3
Table of Contents
Risks
Related to Our Business and Financial Condition
● We
have a history of operating losses and we may never become profitable. Our stock is a highly
speculative investment.
● There
is substantial doubt regarding our ability to continue as a going concern. We will need to
raise additional capital in upcoming periods which may not be available to us on reasonable
terms, if at all.
● Unstable
market and economic conditions may have serious adverse consequences on our business, financial
condition and stock price.
● If
we fail to comply with the continued listing requirements of the Nasdaq Capital Market, our
common stock may be delisted and the price of our common stock and our ability to access
the capital markets could be negatively impacted.
● Funding
constraints may negatively impact our research and development activities, forcing us to
delay our efforts to develop our only current product candidate, plogosertib (“plogo”),
which may prevent us from commercializing our product candidate as quickly as possible.
● We
are experiencing an increasingly tight and competitive labor market with an increase in employee
turnover rates and higher compensation and hiring costs. This may have an adverse effect
on our ability to attract and retain skilled personnel and may harm our business.
Risks
Related to our Intellectual Property
● If
we fail to enforce adequately or defend our intellectual property rights, our business may
be harmed.
● We
may incur substantial costs as a result of litigation or other proceedings relating to patent
and other intellectual property rights.
Risks
Related to Securities Regulations and Investment in Our Securities
● Failure
to achieve and maintain internal controls in accordance with Sections 302 and 404 of the
Sarbanes-Oxley Act of 2002 could have a material adverse effect on our business and stock
price.
● We
incur increased costs and management resources as a result of being a public company, and
we may fail to comply with public company obligations.
● We
may have limited ability to pay cash dividends on our preferred stock, and there is no assurance
that future quarterly dividends will be declared.
● The
future sale of our common and convertible preferred stock and future issuances of our common
stock upon conversion of our preferred stock could negatively affect our stock price and
cause dilution to existing holders of our common stock.
● The
number of shares of common stock which are registered, including the shares to be issued
upon exercise of our outstanding warrants, is significant in relation to our currently outstanding
common stock and could cause downward pressure on the market price for our common stock.
● Our
management team will have broad discretion over the use of the net proceeds from any sale
of our securities.
4
Table of Contents
PART
I
Item
1. Business
The
following Business Section contains forward-looking statements. Our actual results could differ materially from those anticipated in
these forward-looking statements as a result of certain risks, uncertainties and other factors including the risk factors set forth in
Part I, Item 1A of this Annual Report on Form 10-K. In this report, “Cyclacel,” the “Company,” “we,”
“us,” and “our” refer to Cyclacel Pharmaceuticals, Inc.
Recent
Developments
In
December 2024 the Company announced that it was in the process of exploring and reviewing strategic alternatives on an expedited basis
in order to preserve the Company’s cash, including a potential transaction with investor David Lazar of Activist Investing, LLC,
or “Lazar”. The Company’s Board of Directors reviewed a range of appropriate strategies to realize value from its assets.
The Board directed management to reduce operating costs, which included the liquidation of the Company’s wholly owned United Kingdom
subsidiary Cyclacel Limited, or Subsidiary, while such alternatives were being explored. On January 2, 2025 the Company entered into
a securities purchase agreement with investor Lazar, pursuant to which he agreed to purchase from the Company 1,000,000 shares of Series
C Convertible Preferred Stock and 2,100,000 shares of Series D Convertible Preferred Stock of Cyclacel at a purchase price of $1.00 per
share for aggregate gross proceeds of $3.1 million, subject to the terms and conditions of the Agreement. The proceeds of the transaction
will be used to settle outstanding liabilities of the Company and other general corporate and operating purposes.
On
January 31, 2025, the creditors voluntary liquidation of Cyclacel Limited was announced in the London Gazette, one of the official public
records of the government of the United Kingdom. As part of the Company’s efforts to reduce operating costs it has determined to
focus on the development of the plogo clinical program only. On March 10, 2025, the Company entered into an Agreement for the Sale and
Purchase of certain assets related to plogo with Cyclacel Limited and the joint liquidator. Therefore, fadraciclib, the Subsidiary’s
other drug development program, is being marketed for sale by the joint liquidator through Hilco Appraisals Limited, a firm of professional
valuation agents and will no longer be part of the assets of the Company as of January 2025.
With
the commencement of the liquidation of the Subsidiary, the Company will no longer be considered to have control over the Subsidiary and
the financial results of the Subsidiary will be deconsolidated from those of the Company. The deconsolidation, which is anticipated to
increase stockholders’ equity by approximately $5.0 million, will be reported in the Company’s Form 10-Q for the three months
ended March 31, 2025.
5
Table of Contents
General
We
are a clinical-stage biopharmaceutical company working to develop innovative cancer medicines based on cell cycle, epigenetics and mitosis
biology. We are a pioneer company in the field of cancer cell cycle biology with a vision to improve patient healthcare by translating
insights in cancer biology into medicines that can overcome resistance and ultimately increase a patient’s overall survival.
The
epigenetic/anti-mitotic program is evaluating plogo, a PLK1 inhibitor, in solid tumors and hematological malignancies. Our strategy is
to build a diversified biopharmaceutical business based on a pipeline of novel drug candidates addressing oncology and hematology indications.
We
have retained rights to commercialize our clinical development candidates and our business objective is to enter into selective partnership
arrangements with these programs. Substantially all our efforts to date have been devoted to performing research and development, conducting
clinical trials, developing and acquiring intellectual property, raising capital and recruiting and training personnel.
As
part of the Company’s efforts to reduce operating costs, it has determined to focus on the development of plogo only.
Cell
Cycle Control Biology
Polo
Kinases and other mitotic kinases were first discovered in fruit flies by our former Chief Scientist, Professor David Glover, PhD. PLK1
is a serine/threonine kinase playing a central role in cell division, or mitosis. In particular, PLK1 regulates mitotic entry, spindle
formation, mitotic exit and cytokinesis and is an important regulator of the DNA damage checkpoint. Cancer cells are much more sensitive
to PLK1 depletion than normal cells with intact cell cycle checkpoints. Inhibiting PLK1 blocks proliferation by prolonged mitotic arrest
followed by onset of cancer cell death. The lead drug in our anti-mitotic program is plogosertib, or plogo (formerly known as CYC140).
Clinical
Development Pipeline
Our
pipeline of innovative medicines aims to provide safe and effective anticancer treatment options to patients combined with the convenience
of oral administration. Our preclinical and clinical studies suggests that daily dosing by the oral route is a preferred strategy for
both our drugs. We also conducted certain early clinical studies using intravenous (“i.v.”) administration. The aim of the
current streamlined studies is to assess safety and identify signals of clinical activity which may lead to registration-enabling outcomes.
6
Table of Contents
The
following table summarizes our development programs:
PROGRAM
INDICATION
PHASE
Mitosis
Regulation
Plogosertib
PLK* inhibitor (oral)
Solid
tumors – multiple cohorts defined by tumor histology and
a basket cohort
Phase
1/2 to achieve proof of concept #
*
PLK: polo-like kinase.
#
Study to resume recruitment following introduction of new oral formulation.
We
currently retain all global marketing rights to the compounds associated with our clinical-stage drug program.
Mitosis
Regulation Program
Polo-Like-Kinase
inhibitor — Plogosertib
In
our Polo-like Kinase, or PLK, inhibitor program, we have discovered potent and selective small molecule inhibitors of PLK1. Polo Kinase
was discovered by Professor David Glover, our former Chief Scientist.
PLK1
is a serine/threonine kinase with a central role in cell division, or the mitotic phase of the cell cycle, and is an important regulator
of the DNA damage checkpoint. PLK1 over-expressing tumors include colorectal, esophageal, gastric, leukemia, lung, lymphoma, ovarian
and squamous cell cancers, as well as MYC amplified cancers including breast. Recent data with another PLK1 inhibitor in clinical development,
suggest that PLK1 inhibition may be effective in KRAS-mutated metastatic colorectal cancer.
Plogo
is a novel, small molecule, selective, PLK1 inhibitor which has demonstrated an epigenetic mechanism, potent and selective target inhibition
(PLK1 IC50 approximately 3 nM) and impressive efficacy in human tumor xenografts at non-toxic doses. Plogo has improved pharmaceutical
properties over earlier, clinical stage, PLK inhibitors. Our translational biology program supports the development of plogo in solid
tumor and hematological malignancy indications.
Clinical
development
Phase
1/2 Study in advanced solid tumors and lymphomas (CYC140-101, orally dosed)
This
open-label Phase 1/2 registration-directed study uses a streamlined design and initially seeks to determine the RP2D for single-agent
oralplogo in a dose escalation stage. Once RP2D has been established, the study will enter into proof-of-concept, cohort stage, using
a Simon 2-stage design. In this stage plogo will be administered to patients in up to seven mechanistically relevant cohorts including
patients with bladder, breast, colorectal (including KRAS mutant), hepatocellular and biliary tract, and lung cancers (both small cell
and non-small cell), as well as lymphomas. An additional basket cohort will enroll patients with biomarkers relevant to the drug’s
mechanism, including MYC amplified tumors. The protocol allows for expansion of individual cohorts based on response which may allow
acceleration of the clinical development and registration plan for plogo.
Fifteen
patients have been treated at the first five dose escalation levels with no dose limiting toxicities observed. Stable disease has been
observed in pretreated patients with gastrointestinal, lung, and ovarian cancers. A new, alternative salt, oral formulation of plogo
with improved bioavailability is under development.
7
Table of Contents
Published
preclinical data
Preclinical
data presented at the 2016 28th EORTC-NCI-AACR Molecular Targets and Cancer Therapeutics Symposium and at the 2017 Annual Meeting of
the American Association of Cancer Research demonstrated the therapeutic potential of plogo as a targeted anti-cancer agent. The data
demonstrated that plogo is a selective PLK1 inhibitor which is highly active against both solid and liquid cancer models, preferentially
induces growth inhibition and cell death in malignant versus non-malignant cells.
Treatment
of proliferating cells with plogo resulted in reduced phosphorylation of the PLK1 substrate phospho-nucleophosmin, accumulation of cells
in mitosis and an increase in the proportion of mitotic cells with monopolar spindles, which are all features consistent with PLK1 inhibition.
In a cell line panel derived from esophageal cancer and various non-malignant solid tissues, plogo was preferentially cytotoxic to malignant
cells. Malignant cells which are sensitive to plogo undergo complete growth inhibition and induction of cell death in response to treatment.
In contrast, non-malignant cells are only temporarily arrested and normal cell cycle transit is restored.
Business
Strategy
Our
clinical development strategy is focused on our program in epigenetics/mitosis control biology. As part of the Company’s efforts
to reduce operating costs it has determined to focus on the development of the plogo clinical program only. Fadraciclib, the Subsidiary’s
other drug development program, is being marketed for sale by the joint liquidators through Hilco Appraisals Limited, a firm of professional
valuation agents and will no longer be part of the assets of the Company as of January 2025. We have retained worldwide rights to commercialize
plogo.
Focus
on the cell cycle and cancer
Our
core area of expertise is in cell cycle biology and our senior management team has extensive experience in research, preclinical and
clinical development and sales and marketing. The novel, mechanism-targeted cell cycle drugs we are developing are designed to be highly
selective in comparison to conventional chemotherapies, potentially inducing death in cancer cells while sparing most normal cells which
may give rise to fewer side-effects.
Thus,
we believe that we are well placed to exploit the significant opportunities that this area offers for new drug discovery and development.
Develop
anticancer drug candidates in all phases of the cell cycle and multiple compounds for particular cell cycle targets
Targeting
a broad development program focused on multiple phases of the cell cycle allows us to minimize risk while maximizing the potential for
success, and also to develop products that are complementary to one another.
Enter
into partnering arrangements selectively, while developing our own sales and marketing capability
We
currently retain virtually all marketing rights to the compounds associated with our clinical-stage drug programs. To optimize our commercial
return, we intend to enter into selected partnering arrangements and to retain co-promotion rights as appropriate. Generally we plan
to develop compounds through the Phase 2 proof-of-efficacy stage before seeking a partner. We may enter into partnering arrangements
earlier than Phase 2 proof-of-concept trials where appropriate, or in connection with drug programs outside our core competency in oncology.
Licenses
Some
of our programs are based on technology licensed from others. Our breach of an existing license or failure to obtain a license to technology
required to develop, test and commercialize our products may seriously harm our business. In March 2023, we terminated our license agreement
with Daiichi Sankyo Co., Ltd. for patents and patent applications covering sapacitabine for commercial reasons.
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Table of Contents
Patents
and Proprietary Technology
Plogosertib
Patents and Proprietary Rights
As
of December 31, 2024, we owned 2 patent granted in the United States, 2 granted by the European Patent Office, or EPO, and 6 granted
in other countries worldwide. We owned 2 patent applications filed in the United States, 2 filed at the EPO and 16 filed in other countries
worldwide.
As
of March 26, 2025, we have 2 patents granted in the United States, 1 granted by the European Patent Office, or EPO, and 6 granted in
other countries worldwide. We have 2 patent applications filed in the United States, 2 filed at the EPO and 16 filed in other countries
worldwide.
Intellectual
Property Strategy
We
consider intellectual property rights to be vital and use a variety of methods to secure, protect and evaluate these rights. These methods
include ownership and enforcement of patent rights, patent applications, license agreements with third parties, invention assignment,
confidentiality and non-compete agreements with key employees and consultants, material transfer agreements, and trademark protection.
We
give priority to obtaining substance of matter claims in the United States, the EPO, Japan and other important markets if such protection
is available. We prefer composition of matter claims because they provide us with rights to the compounds themselves, and not merely
a particular use. In addition to composition of matter claims, we seek coverage for solid state forms, polymorphic and crystalline forms,
medical uses, combination therapies, specific regimens, pharmaceutical forms of our compounds and synthetic routes where available and
appropriate. Claims covering combination therapies, specific regimens and pharmaceutical forms can be valuable because the therapeutic
effect of pharmaceuticals used in the anticancer field is often enhanced when individual therapeutics are used in particular combinations
or dosed in a certain way. The availability of protection in these areas can, however, vary from jurisdiction to jurisdiction and combination
claims are particularly difficult to obtain for many inventions.
Since
publications in scientific or patent literature often lag behind actual discoveries, we are not certain of being first to make the inventions
covered by each of our pending patent applications or the first to file those patent applications. Generally, patent applications are
maintained in secrecy for a period of 18 months or more, which increases the uncertainty we face. Moreover, the patent positions of biotechnology
and pharmaceutical companies are highly uncertain and involve complex legal and factual questions. As a result, we cannot predict the
breadth of claims allowed in biotechnology and pharmaceutical patents, or their enforceability. Third parties or competitors may challenge
or circumvent our patents or patent applications, if issued. Because of the extensive time required for development, testing and regulatory
review of a potential product, it is possible that before we commercialize any of our products, any related patent may expire, or remain
in existence for only a short period following commercialization, thus reducing any advantage of the patent and the commercial opportunity
of the product.
If
patents are issued to others containing valid claims that cover our compounds or their manufacture or use or screening assays related
thereto, we may be required to obtain licenses to these patents or to develop or obtain alternative technology. We are aware of several
published patent applications, and understand that others may exist, that could support claims that, if granted and held valid, would
cover various aspects of our developmental programs, including in some cases particular uses of our drug candidate plogo, or other therapeutic
candidates, or substances, processes and techniques that we use in the course of our research and development and manufacturing operations.
In
addition, we understand that other applications and patents exist relating to potential uses of plogo which are not part of our
current clinical programs for those compounds. Although we intend to continue to monitor the pending applications, it is not
possible to predict whether these claims will ultimately be allowed or if they were allowed what their breadth would be. In
addition, we may need to commence litigation to enforce any patents issued to us or to determine the scope and validity of
third-party proprietary rights. For example, in one case we opposed a European patent relating to human aurora kinase and the patent
was finally revoked (no appeal was filed). Litigation would create substantial costs. We are aware that other patents exist that
claim substances, processes, techniques and methods of use, which, if held valid, could potentially restrict the scope of our
research, development or manufacturing operations. If competitors prepare and file patent applications in the United States that
claim technology that we also claim, we may have to participate in interference proceedings in the United States Patent and
Trademark Office to determine which invention has priority. These proceedings could result in substantial costs, even if the
eventual outcome is favorable to us. An adverse outcome in litigation could subject us to significant liabilities to third parties
and require us to seek licenses of the disputed rights from third parties or to cease using the technology, even a therapeutic
product, if such licenses are unavailable or too expensive.
9
Table of Contents
Issued
patents for plogo cover the United States, EPO and six other countries.
Manufacturing
We
have no in-house manufacturing capabilities and have no current plans to establish manufacturing facilities for significant clinical
or commercial production. We have no direct experience in manufacturing commercial quantities of any of our products, and we currently
lack the resources or capability to manufacture any of our products on a clinical or commercial scale. As a result, we are dependent
on corporate partners, licensees or other third parties for the manufacturing of clinical (and eventually commercial) scale quantities
of all of our products. We believe that this strategy will enable us to direct operational and financial resources to the development
of our product candidate rather than diverting resources to establishing a manufacturing infrastructure.
Government
Regulation
The
FDA and comparable regulatory agencies in state and local jurisdictions, as well as in foreign countries, impose substantial regulatory
requirements upon the clinical development, manufacture, marketing and distribution of drugs. These agencies and other federal, state
and local authorities regulate research and development activities and the testing, manufacture, quality control, import, export, safety,
efficacy, labeling, packaging, storage, distribution, record keeping, approval, advertising, promotion, marketing, post-approval monitoring,
and post-approval reporting of drug products, such as those we are developing. Along with our third-party contractors, we will be required
to navigate the various preclinical, clinical and commercial approval requirements of the governing regulatory agencies of the countries
in which we wish to conduct studies or seek approval or licensure of plogo or any of its product candidates. The process of obtaining
regulatory approvals and the subsequent compliance with appropriate federal, state, local, and foreign statutes and regulations require
the expenditure of substantial time and financial resources.
For
example, in the United States, the FDA regulates drugs under the Federal Food, Drug and Cosmetic Act and its implementing regulations.
The process required by the FDA before our drug candidates may be marketed in the United States generally involves the following:
● completion
of extensive nonclinical laboratory tests, which may include animal studies and formulation
studies, all performed in accordance with the FDA’s good laboratory practice, or GLP,
regulations;
● submission
to the FDA of an investigational new drug application, or IND, which must become effective
before clinical trials may begin and must be updated annually or when significant changes
are made;
● approval
by an Institutional Review Board (“IRB”) or ethics committee at each clinical
site before the trial is initiated at such sites;
● performance
of adequate and well-controlled clinical trials in accordance with good clinical practice,
or GCP, and other clinical-trial related regulations to establish the safety and efficacy
of the drug candidate for each proposed indication;
● preparation
and submission of a new drug application (“NDA”), to the FDA;
● a
determination by the FDA within 60 days of its receipt of an NDA to file the application
for review;
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● satisfactory
completion of an FDA Advisory Committee review, if applicable;
● satisfactory
completion of an FDA pre-approval inspection of the manufacturing facilities at which the
product is produced to assess compliance with current good manufacturing practice requirements,
or cGMP, regulations;
● potential
audit of selected clinical trial sites to assess compliance with GCP and the integrity of
the clinical data submitted in support of the NDA; and
● FDA
review and approval of the NDA to permit commercial marketing of the drug product for particular
approved indications for use in the United States.
This
testing and approval process requires substantial time, effort and financial resources, and we cannot be certain that any approvals for
our drug candidates will be granted on a timely basis, if at all.
Preclinical
development
Before
testing any drug product candidate, including plogo, our sole current product candidate, in humans, the product candidate must undergo
rigorous preclinical testing. Preclinical and other nonclinical tests generally include laboratory evaluation of product chemistry, formulation
and stability, as well as studies to evaluate toxicity in animals. The Consolidated Appropriations Act for 2023, signed into law on December
29, 2022, (P.L. 117-328) amended the FDCA and the Public Health Service Act to specify that nonclinical testing for drugs may, but is
not required to, include in vivo animal testing. According to the amended language, a sponsor may fulfill nonclinical testing requirements
by completing various in vitro assays (e.g., cell-based assays, organ chips, or micro-physiological systems), in silico studies (i.e.,
computer modeling), other human or nonhuman biology-based tests (e.g., bioprinting), or in vivo animal tests. The conduct of preclinical
studies is subject to federal regulations and requirements, including GLP regulations for safety/toxicology studies. Some long-term preclinical
testing, such as animal tests of reproductive adverse events and carcinogenicity, may continue after an IND for an investigational drug
candidate is submitted to the FDA and human clinical trials have been initiated.
The
results of preclinical tests, together with manufacturing information and analytical data, are submitted as part of an IND to the FDA.
An IND must become effective before human clinical trials may begin. The IND automatically becomes effective 30 days after receipt by
the FDA, unless the FDA, within the 30-day time period, issues a notice expressly authorizing the proposed trial to proceed or raises
concerns or questions about the adequacy or safety of the preclinical testing or the proposed conduct of the clinical trial, including
concerns that human research subjects will be exposed to unreasonable health risks. If FDA raises concerns or places the trial on clinical
hold, the IND sponsor and the FDA must resolve any outstanding concerns before the clinical trial can begin. Our submission of an IND,
or those of our collaborators, may therefore not result in FDA authorization to commence a clinical trial. A separate submission to an
existing IND must also be made for each successive clinical trial conducted during product development. Further, an independent institutional
review board, or IRB, for each medical center proposing to conduct the clinical trial (or a central IRB) must review and approve the
plan for any clinical trial before such trial commences at that site and the designated IRB must monitor the clinical trial until completed.
The FDA or the clinical trial sponsor may suspend a clinical trial at any time on various grounds, including a finding that the subjects
or patients are being exposed to an unacceptable health risk. Clinical testing also must satisfy extensive good clinical practice, or
GCP, requirements, including those relating to informed consent.
Clinical
Trials
For
purposes of an NDA submission, clinical trials are typically conducted in the following three sequential phases, which may overlap:
Phase
1 : The clinical trials are initially conducted in a limited population to test the drug candidate for safety, dose tolerance,
absorption, metabolism, distribution and excretion in healthy humans. In the case of some products for severe or life-threatening
diseases, such as cancer, especially when the product may be too inherently toxic to ethically administer to healthy volunteers, the
initial human testing is often conducted in patients. Phase 1 clinical trials can be designed to evaluate the impact of the drug
candidate in combination with currently approved drugs.
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Phase
2: These clinical trials are generally conducted in a limited patient population to identify possible adverse effects and safety
risks, to evaluate preliminary efficacy of the drug candidate for specific targeted indications and to determine dose tolerance and optimal
dosage. Multiple Phase 2 clinical trials may be conducted by the sponsor to obtain information prior to beginning larger and more expensive
Phase 3 clinical trial.
Phase
3: These clinical trials are commonly referred to as pivotal clinical trials. If the Phase 2 clinical trials demonstrate that a dose
range of the drug candidate is effective and has an acceptable safety profile, Phase 3 clinical trials are then undertaken in large patient
populations to further evaluate dosage, to provide substantial evidence of clinical efficacy and to further test for safety in an expanded
and diverse patient population at multiple, geographically dispersed clinical trial sites. These trials are intended to establish the
overall risk-benefit ratio of the product candidate and provide, if appropriate, an adequate basis for product labeling. Phase 3 trials
typically include comparisons with placebo and/or other comparator treatments. The duration of treatment is often extended to mimic the
actual use of a product during marketing.
In
some cases, the FDA may condition approval of an NDA for a drug candidate on the sponsor’s agreement to conduct a Phase 4, which
includes additional clinical trials to further assess the drug’s safety and effectiveness after NDA approval.
In
the Consolidated Appropriations Act for 2023, Congress amended the FDCA to require sponsors of a Phase 3 clinical trial, or other “pivotal
study” of a new drug to support marketing authorization, to submit a diversity action plan for such clinical trial. The action
plan must include the sponsor’s diversity goals for enrollment, as well as a rationale for the goals and a description of how the
sponsor will meet them. A sponsor must submit a diversity action plan to FDA by the time the sponsor submits the trial protocol to the
agency for review. The FDA may grant a waiver for some or all of the requirements for a diversity action plan. It is unknown at this
time how the diversity action plan may affect Phase 3 trial planning and timing or what specific information FDA will expect in such
plans, but if FDA objects to a sponsor’s diversity action plan and requires the sponsor to amend the plan or take other actions,
it may delay trial initiation.
Progress
reports detailing the results of the clinical trials must be submitted at least annually to the FDA and more frequently if unexpected
serious adverse events, or SAEs, occur. The FDA or the sponsor may suspend or terminate a clinical trial at any time on various grounds,
including a finding that the research subjects or patients are being exposed to an unacceptable health risk. Similarly, an IRB can suspend
or terminate approval of a clinical trial at its institution if the clinical trial is not being conducted in accordance with the clinical
protocol, GCP, or other IRB requirements or if the drug has been associated with unexpected serious harm to patients.
NDA
Submission and Review by the FDA
Assuming
successful completion of all required testing in accordance with all applicable regulatory requirements, the results of product development,
preclinical studies and clinical trials are submitted to the FDA as part of an NDA requesting approval to market the product for one
or more indications. The NDA must contain proof of the product candidate’s safety and substantial evidence of effectiveness for
its proposed indication or indications in the form of relevant data available from pertinent preclinical and clinical studies, including
negative or ambiguous results as well as positive findings, together with detailed information relating to the product’s chemistry,
manufacturing, controls, and proposed labeling, among other things. In particular, a marketing application must demonstrate that the
manufacturing methods and quality controls used to produce the drug product are adequate to preserve the drug’s identity, strength,
quality, and purity. Data can come from company-sponsored clinical studies intended to test the safety and effectiveness of a use of
the product, or from a number of alternative sources, including studies initiated by investigators. FDA approval of an NDA must be obtained
before the corresponding drug may be marketed in the United States.
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The
FDA reviews all NDAs submitted to determine if they are substantially complete before it accepts them for filing and may request additional
information rather than accepting a submission for filing. The FDA must make a decision on accepting an NDA for filing within 60 days
of receipt and must inform the sponsor by the 74th day after the FDA’s receipt of the submission whether the application is sufficiently
complete to permit substantive review. The FDA may refuse to file any submission that it deems incomplete or not properly reviewable
at the time of submission and may request additional information. In this event, the marketing application must be resubmitted with the
additional information requested by the agency. The resubmitted application is also subject to review before the FDA accepts it for filing.
During
the review process, the FDA reviews the NDA to determine, among other things, whether the product is safe and effective and whether the
facility in which it is manufactured, processed, packed, or held meets standards designed to assure the product’s continued strength,
quality, and purity. The FDA may refer any NDA, including applications for novel drug candidates which present difficult questions of
safety or efficacy to an advisory committee to provide clinical insight on application review questions. Typically, an advisory committee
is a panel of independent experts, including clinicians and other scientific experts that reviews, evaluates and provides a recommendation
as to whether the application should be approved and under what conditions. The FDA is not bound by the recommendation of an advisory
committee, but it considers such recommendations carefully when making final decisions on approval.
Under
the Pediatric Research Equity Act, or PREA, amendments to the FDCA, an NDA or supplement to an NDA must contain data that are adequate
to assess the safety and efficacy of the product candidate for the claimed indications in all relevant pediatric populations and to support
dosing and administration for each pediatric population for which the product is safe and effective. The FDA may grant deferrals for
submission of pediatric data or full or partial waivers. The PREA requires a sponsor that is planning to submit a marketing application
for a product that includes a new active ingredient, new indication, new dosage form, new dosing regimen or new route of administration
to submit an initial Pediatric Study Plan, or PSP, within sixty days of an end-of-Phase 2 meeting or, if there is no such meeting, as
early as practicable before the initiation of the Phase 3 or Phase 2/3 clinical trial. The initial PSP must include an outline of the
pediatric study or studies that the sponsor plans to conduct, including trial objectives and design, age groups, relevant endpoints and
statistical approach, or a justification for not including such detailed information, and any request for a deferral of pediatric assessments
or a full or partial waiver of the requirement to provide data from pediatric studies along with supporting information. The FDA and
the sponsor must reach an agreement on the PSP. A sponsor can submit amendments to an agreed upon initial PSP at any time if changes
to the pediatric plan need to be considered based on data collected from pre-clinical studies, early-phase clinical trials or other clinical
development programs.
If
regulatory approval of a product is granted, such approval is limited to the conditions of use (e.g., patient population, indication)
described in the application and may entail further limitations on the indicated uses for which such product may be marketed. For example,
the FDA may approve the NDA with a Risk Evaluation and Mitigation Strategy, or REMS, plan to mitigate risks, which could include medication
guides, physician communication plans, or elements to assure safe use, such as restricted distribution methods, patient registries and
other risk minimization tools. The FDA determines the requirement for a REMS, as well as the specific REMS provisions, on a case-by-case
basis. If the FDA concludes a REMS plan is needed, the sponsor of the NDA must submit a proposed REMS. The FDA will not approve an NDA
without a REMS, if one is required. The FDA also may condition approval on, among other things, changes to proposed labeling (e.g., adding
contraindications, warnings or precautions) or the development of adequate controls and specifications. Once approved, the FDA may withdraw
the product approval if compliance with pre- and post-marketing regulatory standards is not maintained or if problems occur after the
product reaches the marketplace. The FDA may require one or more Phase 4 post-market studies and surveillance to further assess and monitor
the product’s safety and effectiveness after commercialization and may limit further marketing of the product based on the results
of these post-marketing studies. After approval, some types of changes to the approved product, such as adding new indications, manufacturing
changes and additional labeling claims, are subject to further testing requirements and FDA review and approval. In addition, new government
requirements, including those resulting from new legislation, may be established, or the FDA’s policies may change, which could
delay or prevent regulatory approval of our products under development.
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Fast
Track, Priority Review, and Breakthrough Therapy Designations
A
sponsor may seek approval of its product candidate under programs designed to accelerate FDA’s review and approval of new drugs
and biological products that meet certain criteria. Specifically, new drugs and biological products are eligible for fast track designation
if they are intended to treat a serious or life-threatening condition and demonstrate the potential to address unmet medical needs for
the condition. Fast track designation provides increased opportunities for sponsor interactions with the FDA during preclinical and clinical
development, in addition to the potential for rolling review once a marketing application is filed, meaning that the FDA may consider
for review sections of the NDA or BLA on a rolling basis before the complete application is submitted, if the sponsor provides a schedule
for the submission of the sections of the application, the FDA agrees to accept the sections and determines that the schedule is acceptable,
and the sponsor pays any required user fees upon submission of the first section of the application. A fast track designated product
candidate may also qualify for accelerated approval (described below) or priority review, under which the FDA sets the target date for
FDA action on the NDA or BLA at six months after the FDA accepts the application for filing.
Priority
review is granted when there is evidence that the proposed product would be a significant improvement in the safety or effectiveness
of the treatment, diagnosis, or prevention of a serious condition. Significant improvement may be illustrated by evidence of increased
effectiveness in the treatment of a condition, elimination or substantial reduction of a treatment-limiting drug reaction, documented
enhancement of patient compliance that may lead to improvement in serious outcomes, or evidence of safety and effectiveness in a new
subpopulation. If criteria are not met for priority review, the application is subject to the standard FDA review period of 10 months
after FDA accepts the application for filing.
In
addition, a sponsor may seek FDA designation of its product candidate as a breakthrough therapy if the product candidate is intended,
alone or in combination with one or more other drugs or biologics, to treat a serious or life-threatening disease or condition and preliminary
clinical evidence indicates that the therapy may demonstrate substantial improvement over existing therapies on one or more clinically
significant endpoints, such as substantial treatment effects observed early in clinical development. Breakthrough therapy designation
provides all the features of fast track designation in addition to intensive guidance on an efficient development program beginning as
early as Phase 1, and FDA organizational commitment to expedited development, including involvement of senior managers and experienced
review and regulatory staff in a proactive, collaborative, cross-disciplinary review, where appropriate. A drug designated as breakthrough
therapy is also eligible for accelerated approval if the relevant criteria are met.
Even
if a product qualifies for one or more of these programs, the FDA may later decide that the product no longer meets the conditions for
qualification or decide that the time period for FDA review or approval will not be shortened. fast track, priority review and breakthrough
therapy designations do not change the scientific or medical standards for approval or the quality of evidence necessary to support approval
but may expedite the development or approval process.
Accelerated
Approval
In
addition, products studied for their safety and effectiveness in treating serious or life-threatening illnesses and that provide meaningful
therapeutic benefit over existing treatments may receive accelerated approval from the FDA and may be approved on the basis of adequate
and well-controlled clinical trials establishing that the drug product has an effect on a surrogate endpoint that is reasonably likely
to predict clinical benefit. The FDA may also grant accelerated approval for such a drug or biologic when it has an effect on an intermediate
clinical endpoint that can be measured earlier than an effect on irreversible morbidity or mortality, or IMM, and that is reasonably
likely to predict an effect on IMM or other clinical benefit, taking into account the severity, rarity, or prevalence of the condition
and the availability or lack of alternative treatments. As a condition of approval, the FDA may require that a sponsor of a drug or biologic
receiving accelerated approval perform post-marketing clinical trials to verify and describe the predicted effect on IMM or other clinical
endpoint, and the product may be subject to expedited withdrawal procedures. Drugs and biologics granted accelerated approval must meet
the same statutory standards for safety and effectiveness as those granted traditional approval.
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The
accelerated approval pathway is usually contingent on a sponsor’s agreement to conduct, in a diligent manner, additional post-approval
confirmatory studies to verify and describe the product candidate’s clinical benefit. As a result, a product candidate approved
on this basis is subject to rigorous post-marketing compliance requirements, including the completion of Phase 4 or post-approval clinical
trials to confirm the effect on the clinical endpoint. Failure to conduct required post-approval studies, or to confirm the predicted
clinical benefit of the product during post-marketing studies, would allow the FDA to withdraw approval of the product. As part of the
Consolidated Appropriations Act for 2023, Congress provided FDA additional statutory authority to mitigate potential risks to patients
from continued marketing of ineffective drugs or biologics previously granted accelerated approval. Under the act’s amendments
to the FDCA, FDA may require the sponsor of a product granted accelerated approval to have a confirmatory trial underway prior to approval.
The sponsor must also submit progress reports on a confirmatory trial every six months until the trial is complete, and such reports
are published on FDA’s website. The amendments also give FDA the option of using expedited procedures to withdraw product approval
if the sponsor’s confirmatory trial fails to verify the claimed clinical benefits of the product.
All
promotional materials for product candidates being considered and approved under the accelerated approval program are subject to prior
review by the FDA.
Special
Protocol Assessment
If
a Phase 2 clinical trial is the subject of discussion at an end-of-Phase 2 meeting with the FDA, a sponsor may be able to request a Special
Protocol Assessment, or SPA, the purpose of which is to reach agreement with the FDA on the design of the Phase 3 clinical trial protocol
design and analysis that will form the primary basis of an efficacy claim. If such an agreement is reached, it will be documented and
made part of the administrative record, and it will be binding on the FDA and may not be changed unless the sponsor fails to follow the
agreed-upon protocol, data supporting the request are found to be false or incomplete, or the FDA determines that a substantial scientific
issue essential to determining the safety or effectiveness of the drug was identified after the testing began. Even if an SPA is agreed
to, approval of the NDA is not guaranteed because a final determination that an agreed-upon protocol satisfies a specific objective,
such as the demonstration of efficacy, or supports an approval decision, will be based on a complete review of all the data in the NDA.
Orphan
Drugs
Under
the Orphan Drug Act, the FDA may grant orphan drug designation to a drug intended to treat a rare disease or condition, defined as a
disease or condition with a patient population of fewer than 200,000 individuals in the United States, or a patient population greater
than 200,000 individuals in the United States and when there is no reasonable expectation that the cost of developing and making available
the drug in the United States will be recovered from sales in the United States for that drug. Orphan drug designation must be requested
before submitting a marketing application. After the FDA grants orphan drug designation, the generic identity of the therapeutic agent
and its potential orphan use are disclosed publicly by the FDA.
If
a drug product that has orphan drug designation subsequently receives the first FDA approval for a particular active ingredient for the
disease for which it has such designation, the product is entitled to orphan product exclusivity, which means that the FDA may not approve
any other applications, including a full NDA, to market the same drug for the same indication for seven years, except in limited circumstances,
such as a showing of clinical superiority to the product with orphan product exclusivity or if FDA finds that the holder of the orphan
product exclusivity has not shown that it can assure the availability of sufficient quantities of the orphan product to meet the needs
of patients with the disease or condition for which the drug was designated. Orphan product exclusivity does not prevent the FDA from
approving a different drug for the same disease or condition, or the same drug for a different disease or condition. Among the other
benefits of orphan drug designation are tax credits for certain research and a waiver of the NDA application user fee.
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Patent
term restoration
Depending
upon the timing, duration and specifics of FDA approval of the use of our product candidate, some of our United States patents may be
eligible for limited patent term extension under the Hatch-Waxman Act. The Hatch-Waxman Act permits a patent restoration term of up to
five years as compensation for patent term lost during product development and the FDA regulatory review process. However, patent term
restoration cannot extend the remaining term of a patent beyond a total of 14 years from the product candidate’s approval date.
The patent term restoration period is generally one half of the time between the effective date of an IND and the submission date of
an NDA, plus the time between the submission date of the NDA and the approval of that application, except that the review period is reduced
by any time during which the applicant failed to exercise due diligence. Only one patent applicable to an approved product candidate
is eligible for the extension and the application for extension must be made prior to expiration of the patent. The USPTO, in consultation
with the FDA, reviews and approves the application for any patent term extension or restoration. In the future, we intend to apply for
restorations of patent term for some of our currently owned or licensed patents to add patent life beyond their current expiration date,
depending on the expected length of clinical trials and other factors involved in the submission of the relevant NDA.
Post-approval
requirements
Following
approval of a new product, the manufacturer and the approved product are subject to pervasive and continuing regulation by the FDA, including,
among other things, monitoring and recordkeeping activities, reporting of adverse experiences with the product, product sampling and
distribution restrictions, complying with promotion and advertising requirements, which include restrictions on promoting drugs for unapproved
uses or patient populations (i.e., “off-label use”) and limitations on industry-sponsored scientific and educational activities.
The manufacturer and its products are also subject to similar post-approval requirements by regulatory authorities comparable to FDA
in jurisdictions outside of the United States where the products are approved. Although physicians may prescribe legally available products
for off-label uses, manufacturers may not market or promote such uses.
FDA
regulations require that products be manufactured in specific approved facilities and in accordance with cGMPs. The cGMP regulations
include requirements relating to organization of personnel, buildings and facilities, equipment, control of components and drug product
containers and closures, production and process controls, packaging and labeling controls, holding and distribution, laboratory controls,
records and reports and returned or salvaged products. The manufacturing facilities for our product candidate must meet applicable cGMP
requirements to the FDA’s or comparable foreign regulatory authorities’ satisfaction before any product is approved and our commercial
products can be manufactured. We rely, and expect to continue to rely, on third parties for the production of clinical (and ultimately
commercial) quantities of our products in accordance with cGMP regulations. These manufacturers must comply with cGMP regulations that
require, among other things, quality control and quality assurance, the maintenance of records and documentation and the obligation to
investigate and correct any deviations from cGMP. Manufacturers and other entities involved in the manufacture and distribution of approved
drugs are required to register their establishments with the FDA and certain state agencies and are subject to periodic prescheduled
or unannounced inspections by the FDA and certain state agencies for compliance with cGMP and other laws. Accordingly, manufacturers
must continue to expend time, money and effort in the area of production and quality control to maintain cGMP compliance. Future inspections
by the FDA and other regulatory agencies may identify compliance issues at the facilities of our CMOs that may disrupt production or
distribution or require substantial resources to correct. In addition, the discovery of conditions that violate these rules, including
failure to conform to cGMPs, could result in enforcement actions, and the discovery of problems with a product after approval may result
in restrictions on a product, manufacturer or holder of an approved NDA, including voluntary recall and regulatory sanctions as described
below.
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Once
an approval or clearance of a drug is granted, the FDA may withdraw the approval if compliance with regulatory requirements and standards
is not maintained or if problems occur after the product reaches the market. Later discovery of previously unknown problems with a product,
including adverse events of unanticipated severity or frequency, or with manufacturing processes, or failure to comply with regulatory
requirements, may result in mandatory revisions to the approved labeling to add new safety information; imposition of post-market or
clinical trials to assess new safety risks; or imposition of distribution or other restrictions under a REMS program. Other potential
consequences include, among other things:
● restrictions
on the marketing or manufacturing of the product, complete withdrawal of the product from
the market or product recalls;
● fines,
warning letters or other enforcement-related letters or clinical holds on post-approval clinical
trials;
● refusal
of the FDA to approve pending marketing applications or supplements to approved marketing
authorizations, or suspension or revocation of product approvals;
● product
seizure or detention, or refusal to permit the import or export of products;
● injunctions
or the imposition of civil or criminal penalties; and
● consent
decrees, corporate integrity agreements, debarment, or exclusion from federal health care
programs; or mandated modification of promotional materials and labeling and the issuance
of corrective information.
In
addition, the distribution of prescription pharmaceutical products is subject to the Prescription Drug Marketing Act, or PDMA, which
regulates the distribution of drugs and drug samples at the federal level and sets minimum standards for the registration and regulation
of drug distributors by the states. Both the PDMA and state laws limit the distribution of prescription pharmaceutical product samples
and impose requirements to ensure accountability in distribution. Most recently, the Drug Supply Chain Security Act, or DSCSA, was enacted
with the aim of building an electronic system to identify and trace certain prescription drugs distributed in the United States. The
DSCSA mandates phased-in and resource-intensive obligations for pharmaceutical manufacturers, wholesale distributors, and dispensers
over a 10-year period that was initially expected to culminate in November 2023. In August 2023, the FDA announced “a 1-year stabilization
period to accommodate additional time” needed by pharmaceutical supply chain stakeholders. Since then, the deadline has been pushed
further with an additional year into 2025. The DSCSA’s new 2025 deadline for manufacturers and repackagers is May 27, 2025. From
time to time, new legislation and regulations may be implemented that could significantly change the statutory provisions governing the
approval, manufacturing and marketing of products regulated by the FDA. It is impossible to predict whether further legislative or regulatory
changes will be enacted, whether FDA regulations, guidance or interpretations will be changed or what the impact of such changes, if
any, may be.
Other
U.S. health care laws and regulations
The
majority of states also have statutes or regulations similar to the aforementioned federal laws, some of which are broader in scope and
apply to items and services reimbursed under Medicaid and other state programs, or, in several states, apply regardless of the payor.
Some state laws require pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance guidelines,
or the relevant compliance guidance promulgated by the federal government, in addition to requiring drug manufacturers to report information
related to payments to physicians and other health care providers or marketing expenditures to the extent that those laws impose requirements
that are more stringent than the Physician Payments Sunshine Act. State and foreign laws also govern the privacy and security of health
information in some circumstances, many of which differ from each other in significant ways and often are not preempted by HIPAA, thus
complicating compliance efforts.
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Because
of the breadth of these laws and the narrowness of their exceptions and safe harbors, it is possible that business activities can be
subject to challenge under one or more of such laws. The scope and enforcement of each of these laws is uncertain and subject to rapid
change in the current environment of healthcare reform, especially in light of the lack of applicable precedent and regulations. Federal
and state enforcement bodies have recently increased their scrutiny of interactions between healthcare companies and healthcare providers,
which has led to a number of investigations, prosecutions, convictions and settlements in the healthcare industry.
Ensuring
that business arrangements with third parties comply with applicable healthcare laws and regulations is costly and time consuming. If
business operations are found to be in violation of any of the laws described above or any other applicable governmental regulations
a pharmaceutical manufacturer may be subject to penalties, including civil, criminal and administrative penalties, damages, fines, disgorgement,
individual imprisonment, exclusion from governmental funded healthcare programs, such as Medicare and Medicaid, contractual damages,
reputational harm, diminished profits and future earnings, additional reporting obligations and oversight if subject to a corporate integrity
agreement or other agreement to resolve allegations of non-compliance with these laws, and curtailment or restructuring of operations,
any of which could adversely affect a pharmaceutical manufacturer’s ability to operate its business and the results of its operations.
Regulation
outside of the United States
In
addition to regulations in the United States, we will be subject to a variety of foreign regulations governing clinical trials and commercial
sales and distribution of our products outside of the United States. Whether or not we obtain FDA approval for a product candidate, we
must obtain approval by the comparable regulatory authorities of foreign countries or economic areas, such as the 28-member European
Union, before we may commence clinical trials or market products in those countries or areas. The approval process and requirements governing
the conduct of clinical trials, product licensing, pricing and reimbursement vary greatly between countries and jurisdictions and can
involve additional testing and additional administrative review periods. The time required to obtain approval in other countries and
jurisdictions might differ from and be longer than that required to obtain FDA approval. Regulatory approval in one country or jurisdiction
does not ensure regulatory approval in another, but a failure or delay in obtaining regulatory approval in one country or jurisdiction
may negatively impact the regulatory process in others.
European
Union drug development, review and approval
In
the European Union, our product candidate also may be subject to extensive regulatory requirements. As in the United States, medicinal
products can be marketed only if a marketing authorization from the competent regulatory agencies has been obtained. Similar to the United
States, the various phases of pre-clinical and clinical research in the European Union are subject to significant regulatory controls.
The
Clinical Trials Directive 2001/20/EC, the Directive 2005/28/EC on GCP, and the related national implementing provisions of the individual
EU Member States govern the system for the approval of clinical trials in the European Union. Under this system, an applicant must obtain
prior approval from the competent national authority of the EU Member States in which the clinical trial is to be conducted. Furthermore,
the applicant may only start a clinical trial at a specific study site after the competent ethics committee has issued a favorable opinion.
The clinical trial application must be accompanied by, among other documents, an IMPD (the Common Technical Document) with supporting
information prescribed by Directive 2001/20/EC, Directive 2005/28/EC, and where relevant the implementing national provisions of the
individual EU Member States and further detailed in applicable guidance documents. All suspected unexpected serious adverse reactions
to the investigated drug that occur during the clinical trial have to be reported to the competent national authority and the Ethics
Committee of the Member State where they occurred.
Under
the EU’s new Clinical Trials Regulation, which took effect in January 2022, there will be a centralized application procedure
where one EU Member State’s competent authority takes the lead in reviewing part I of the application, which contains
scientific and medicinal product documentation, and the other national authorities only have limited involvement. Part II, which
contains the national and patient-level documentation, will be assessed individually by each EU Member State. Strict deadlines have
been established for the assessment of clinical trial applications. The role of the relevant ethics committees in the assessment
procedure will continue to be governed by the national law of the competent EU Member State. Any substantial changes to the trial
protocol or other information submitted with the CTA must be notified to or approved by the relevant competent authorities and
ethics committees. Medicines used in clinical trials must be manufactured in accordance with good manufacturing practices. Other
national and EU-wide regulatory requirements may also apply. Currently, the extent to which clinical trials will be governed by the
Clinical Trials Regulation will depend on when the clinical trial is initiated or on the duration of an ongoing trial. As of January
2023, all new clinical trials must comply with the Clinical Trials Regulation. In addition, any clinical trial that was already
under way as of January 1, 2023 and continues for more than three years from the day on which the Clinical Trials Regulation becomes
applicable (i.e., January 31, 2025), the Clinical Trials Regulation will at that time begin to apply to the clinical
trial.
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To
obtain a marketing authorization of a drug in the European Union, we may submit marketing authorization applications, or MAA, either
under the so-called centralized or national authorization procedures.
Centralized
procedure
The
centralized procedure provides for the grant of a single marketing authorization following a favorable opinion by the European Medicines
Agency, or EMA, that is valid in all EU member states, as well as Iceland, Liechtenstein and Norway. The centralized procedure is compulsory
for medicines produced by specified biotechnological processes, products designated as orphan medicinal products, advanced-therapy medicines
(such as gene-therapy, somatic cell-therapy or tissue-engineered medicines) and products with a new active substance indicated for the
treatment of specified diseases, such as HIV/AIDS, cancer, diabetes, neurodegenerative disorders or autoimmune diseases and other immune
dysfunctions and viral diseases. The centralized procedure is optional for products that represent a significant therapeutic, scientific
or technical innovation, or whose authorization would be in the interest of public health. Under the centralized procedure the maximum
timeframe for the evaluation of an MAA by the EMA is 210 days, excluding clock stops, when additional written or oral information is
to be provided by the applicant in response to questions asked by the Committee for Medicinal Products for Human Use, or the CHMP. Accelerated
assessment might be granted by the CHMP in exceptional cases, when a medicinal product is expected to be of a major public health interest,
particularly from the point of view of therapeutic innovation. The timeframe for the evaluation of an MAA under the accelerated assessment
procedure is 150 days, excluding stop-clocks.
National
authorization procedures
There
are also two other possible routes to authorize medicinal products in several EU countries, which are available for investigational medicinal
products that fall outside the scope of the centralized procedure:
Decentralized
procedure. Using the decentralized procedure, an applicant may apply for simultaneous authorization in more than one EU country of medicinal
products that have not yet been authorized in any EU country and that do not fall within the mandatory scope of the centralized procedure.
Mutual
recognition procedure. In the mutual recognition procedure, a medicine is first authorized in one EU Member State, in accordance with
the national procedures of that country. Following this, further marketing authorizations can be sought from other EU countries in a
procedure whereby the countries concerned agree to recognize the validity of the original, national marketing authorization.
Under
the above described procedures, before granting the marketing authorization, the EMA or the competent authorities of the Member States
of the EEA make an assessment of the risk-benefit balance of the product on the basis of scientific criteria concerning its quality,
safety and efficacy.
Conditional
approval
In
specific circumstances, E.U. legislation (Article 14(7) Regulation (EC) No 726/2004 and Regulation (EC) No 507/2006 on Conditional
Marketing Authorizations for Medicinal Products for Human Use) enables applicants to obtain a conditional marketing authorization
prior to obtaining the comprehensive clinical data required for an application for a full marketing authorization. Such conditional
approvals may be granted for product candidates (including medicines designated as orphan medicinal products) if (1) the
risk-benefit balance of the product candidate is positive, (2) it is likely that the applicant will be in a position to provide the
required comprehensive clinical trial data, (3) the product fulfills unmet medical needs and (4) the benefit to public health of the
immediate availability on the market of the medicinal product concerned outweighs the risk inherent in the fact that additional data
are still required. A conditional marketing authorization may contain specific obligations to be fulfilled by the marketing
authorization holder, including obligations with respect to the completion of ongoing or new studies, and with respect to the
collection of pharmacovigilance data. Conditional marketing authorizations are valid for one year, and may be renewed annually, if
the risk-benefit balance remains positive, and after an assessment of the need for additional or modified conditions or specific
obligations. The timelines for the centralized procedure described above also apply with respect to the review by the CHMP of
applications for a conditional marketing authorization.
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European
Union regulatory exclusivity
In
the European Union, new products authorized for marketing (i.e., reference products) qualify for eight years of data exclusivity and
an additional two years of market exclusivity upon marketing authorization. The data exclusivity period prevents generic or biosimilar
applicants from relying on the pre-clinical and clinical trial data contained in the dossier of the reference product when applying for
a generic or biosimilar marketing authorization in the European Union during a period of eight years from the date on which the reference
product was first authorized in the European Union. The market exclusivity period prevents a successful generic or biosimilar applicant
from commercializing its product in the EU until ten years have elapsed from the initial authorization of the reference product in the
EU. The ten-year market exclusivity period can be extended to a maximum of eleven years if, during the first eight years of those ten
years, the marketing authorization holder obtains an authorization for one or more new therapeutic indications which, during the scientific
evaluation prior to their authorization, are held to bring a significant clinical benefit in comparison with existing therapies.
European
Union orphan designation and exclusivity
The
criteria for designating an orphan medicinal product in the European Union, are similar in principle to those in the United States.
Under Article 3 of Regulation (EC) 141/2000, a medicinal product may be designated as orphan if (1) it is intended for the
diagnosis, prevention or treatment of a life-threatening or chronically debilitating condition;
(2) either (a) such condition affects no more than five in 10,000 persons in the European
Union when the application is made, or (b) the product, without the benefits derived from orphan status, would not generate
sufficient return in the European Union to justify investment; and (3) there exists no satisfactory method of diagnosis, prevention
or treatment of such condition authorized for marketing in the European Union, or if such a method exists, the product will be of
significant benefit to those affected by the condition, as defined in Regulation (EC) 847/2000. Orphan medicinal products are
eligible for financial incentives such as reduction of fees or fee waivers and are, upon grant of a marketing authorization,
entitled to ten years of market exclusivity for the approved therapeutic indication. The application for orphan designation must be
submitted before the application for marketing authorization. The applicant will receive a fee reduction for the marketing
authorization application if the orphan designation has been granted, but not if the designation is still pending at the time the
marketing authorization is submitted. Orphan designation does not convey any advantage in, or shorten the duration of, the
regulatory review and approval process.
The
ten-year market exclusivity in the European Union may be reduced to six years if, at the end of the fifth year, it is established that
the product no longer meets the criteria for orphan designation, for example, if the product is sufficiently profitable not justifying
maintenance of market exclusivity. Additionally, marketing authorization may be granted to a similar product for the same indication
at any time if:
● the
second applicant can establish that its product, although similar, is safer, more effective
or otherwise clinically superior;
● the
applicant consents to a second orphan medicinal product application; or
● the
applicant cannot supply enough orphan medicinal product.
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PRIME
designation
The
EMA grants access to the Priority Medicines, or PRIME, program to investigational medicines for which it determines there to be preliminary
data available showing the potential to address an unmet medical need and bring a major therapeutic advantage to patients. As part of
the program, the EMA provides early and enhanced dialogue and support to optimize the development of eligible medicines and speed up
their evaluation, aiming to bring promising treatments to patients sooner.
Periods
of authorization and renewals
A
marketing authorization is valid for five years in principle and the marketing authorization may be renewed after five years on the basis
of a re-evaluation of the risk-benefit balance by the EMA or by the competent authority of the authorizing member state. To this end,
the marketing authorization holder must provide the EMA or the competent authority with a consolidated version of the file in respect
of quality, safety and efficacy, including all variations introduced since the marketing authorization was granted, at least six months
before the marketing authorization ceases to be valid. Once renewed, the marketing authorization is valid for an unlimited period, unless
the European Commission or the competent authority decides on justified grounds relating to pharmacovigilance, to proceed with one additional
five-year renewal. Any authorization which is not followed by the actual placing of the drug on the E.U. market (in case of centralized
procedure) or on the market of the authorizing member state within three years after authorization ceases to be valid (the so-called
sunset clause).
Health
Care Reform
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 candidate. For example, Congress must reauthorize the FDA’s user fee
programs every five years and often makes changes to those programs in addition to policy or procedural changes that may be negotiated
between the FDA and industry stakeholders as part of this periodic reauthorization process. Congress most recently reauthorized the user
fee programs in September 2022 but without any substantive policy changes. 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 otherwise may have obtained and we may not achieve or sustain profitability, which would adversely affect our business, prospects,
financial condition and results of operations.
As
previously mentioned, the primary trend in the U.S. health care industry and elsewhere is cost containment. Government authorities and
other third-party payors have attempted to control costs by limiting coverage and the amount of reimbursement for particular medical
products and services, implementing reductions in Medicare and other health care funding and applying new payment methodologies. For
example, the ACA, among other things, increased the minimum Medicaid rebates owed by most manufacturers under the Medicaid Drug Rebate
Program; extended the Medicaid Drug Rebate Program to utilization of prescriptions of individuals enrolled in Medicaid managed care plans;
imposed mandatory discounts for certain Medicare Part D beneficiaries as a condition for manufacturers’ outpatient drugs coverage
under Medicare Part D; and established a Center for Medicare Innovation at the U.S. Centers for Medicare and Medicaid Services, or CMS,
to test innovative payment and service delivery models to lower Medicare and Medicaid spending.
We
expect that future changes or additions to the ACA, the Medicare and Medicaid programs and changes stemming from other healthcare reform
measures, especially with regard to healthcare access, financing or other legislation in individual states, could have a material adverse
effect on the health care industry in the United States.
In
addition, other legislative changes have been proposed and adopted in the United States since the ACA that affect health care expenditures.
These changes include aggregate reductions to Medicare payments to providers of up to 2% per fiscal year pursuant to the Budget Control
Act of 2011, which began in 2013 and was extended by the Consolidated Appropriations Act for 2023 and will remain in effect through 2032
unless additional Congressional action is taken.
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Moreover,
there has been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products, which
has resulted in several Congressional inquiries and proposed and enacted federal and state legislation designed to, among other things,
bring more transparency to product pricing, review the relationship between pricing and manufacturer patient programs, and reform government
program reimbursement methodologies for drug products. Notably, on December 20, 2019, the Further Consolidated Appropriations Act for
2020 was signed into law (P.L. 116-94) that includes a piece of bipartisan legislation called the Creating and Restoring Equal Access
to Equivalent Samples Act of 2019 (the “CREATES Act”), which provides a legislatively defined private right of action under
which eligible product developers can bring suit against companies who refuse to sell sufficient quantities of their branded products
on commercially reasonable, market-based terms to support such eligible product developers’ marketing applications. The CREATES
Act aims to address the concern articulated by both the FDA and others in the industry that some brand manufacturers have improperly
restricted the distribution of their products, including by invoking the existence of a REMS for certain products, to deny generic and
biosimilar product developers access to samples of brand products. Because generic and biosimilar product developers need samples to
conduct certain comparative testing required by the FDA, some have attributed the inability to timely obtain samples as a cause of delay
in the entry of generic and biosimilar products. To remedy this concern, the CREATES Act establishes a private cause of action that permits
a generic or biosimilar product developer to sue the brand manufacturer to compel it to furnish the necessary samples on “commercially
reasonable, market-based terms.” Whether and how generic and biosimilar product developments will use this new pathway, as well
as the likely outcome of any legal challenges to provisions of the CREATES Act, remain highly uncertain and its potential effects on
our future commercial products are unknown. We cannot currently predict the specific outcome or impact on our business of such regulatory
and legislative initiatives.
In
August 2022, the Inflation Reduction Act of 2022, or the IRA, was signed into law, which is a measure from the Biden administration aimed
at reducing prescription drug costs and increasing access to innovative cell and gene therapies for Medicaid recipients. Among other
things, the IRA has multiple provisions that may impact the prices of drug products that are both sold into the Medicare program and
throughout the United States. Starting in 2023, a manufacturer of a drug or biological product covered by Medicare Parts B or D must
pay a rebate to the federal government if the drug product’s price increases faster than the rate of inflation. This calculation
is made on a drug product by drug product basis and the amount of the rebate owed to the federal government is directly dependent on
the volume of a drug product that is paid for by Medicare Parts B or D. Additionally, starting in payment year 2026, CMS will negotiate
drug prices annually for a select number of single source Part D drugs without generic or biosimilar competition. CMS will also negotiate
drug prices for a select number of Part B drugs starting for payment year 2028. If a drug product is selected by CMS for negotiation,
it is expected that the revenue generated from such drug will decrease. In addition to the IRA’s drug price negotiation provisions,
Executive Order 14087, issued in October 2022, called for the CMS innovation center to prepare and submit a report to the White House
on potential payment and delivery modes that would complement to IRA, lower drug costs, and promote access to innovative drugs. On his
first day in office, President Donald Trump repealed Executive Order 14087, which introduces uncertainty in federal drug pricing strategies.
At
the state level, individual states are increasingly aggressive in passing legislation and implementing 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. In December 2020, the U.S. Supreme Court held unanimously that federal law does not preempt the states’
ability to regulate pharmacy benefit managers (PBMs) and other members of the healthcare and pharmaceutical supply chain, an important
decision that appears to be leading to further and more aggressive efforts by states in this area. The Federal Trade Commission in mid-2022
also launched sweeping investigations into the practices of the PBM industry that could lead to additional federal and state legislative
or regulatory proposals targeting such entities’ operations, pharmacy networks, or financial arrangements. Significant efforts
to change the PBM industry as it currently exists in the United States may affect the entire pharmaceutical supply chain and the business
of other stakeholders, including biopharmaceutical developers like us. In addition, regional healthcare authorities and individual hospitals
are increasingly using bidding procedures to determine what pharmaceutical products and which suppliers will be included in their prescription
drug and other healthcare programs. These measures could reduce the ultimate demand for our products, once approved, or put pressure
on our product pricing.
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We
expect that these and other healthcare reform measures that may be adopted in the future, may result in more rigorous coverage criteria
and in additional downward pressure on the price that we receive for any approved drug, which could have an adverse effect on customers
for our product candidate. Any reduction in reimbursement from Medicare or other government programs may result in a similar reduction
in payments from private payors.
There
have been, and likely will continue to be, legislative and regulatory proposals at the foreign, federal and state levels directed at
broadening the availability of healthcare and containing or lowering the cost of healthcare. The implementation of cost containment measures
or other healthcare reforms may prevent us from being able to generate revenue, attain profitability, or commercialize our products.
Such reforms could have an adverse effect on anticipated revenue from plogo and any of our future product candidates that we may successfully
develop and for which we may obtain regulatory approval and may affect our overall financial condition and ability to develop product
candidates.
Competition
The
biotechnology and biopharmaceutical industries are rapidly changing and highly competitive. We are seeking to develop and market drug
candidates that will compete with other products and therapies that currently exist or are being developed. Other companies are actively
seeking to develop products that have disease targets similar to those we are pursuing. We face competition from many different sources,
including commercial, pharmaceutical and biotechnology companies, academic institutions, government agencies and private and public research
institutions. Many of our competitors have significantly greater financial, manufacturing, marketing and drug development resources than
we do. Smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative arrangements
with large and established companies. Our commercial opportunity will be reduced or eliminated if our competitors develop and commercialize
products that are safer, more effective, have fewer side effects or are less expensive than any products that we may develop. In addition,
competitors compete in the areas of recruiting and retaining qualified scientific and management personnel, establishing clinical trial
sites and patient registration for clinical trials, as well as in acquiring technologies and technology licenses. Some of these factors
can delay completion of recruitment into our clinical trials.
A
large number of drug candidates are in development for the treatment of leukemia and lymphomas, MDS, gastrointestinal, genitourinary,
gynecological and thoracic cancers and other advanced solid tumors. Cardiff Oncology has a PLK1 inhibitor in clinical trials and we believe
that Arbutus, Boehringer Ingelheim, GlaxoSmithKline, Merck, Onconova, and Takeda have been and may continue to be evaluating PLK inhibitors
for hemato-oncology indications. Several companies are pursuing discovery and research activities in each of the other areas that are
the subject of our research and drug development program.
Environmental
Social and Government (“ESG”) Matters
We
recognize the importance of ESG matters, with a specific focus on Human Capital Management, as integral to creating a sustainable foundation
for our long-term business strategy. We support professional development at all levels. We also take reports of suspected violations
of our codes of conduct and take seriously appropriate action.
As
we do not operate laboratories or manufacture products, we believe that our environmental impact is relatively small. We are involved
in office waste reduction practices.
Our
mostly remote workforce has further reduced our carbon footprint. We strive to offer excellent benefits and long-term incentives to help
retain our workforce.
Our
human capital resources and objectives include identifying, recruiting, retaining and incentivizing our existing and additional employees.
The principal purposes of our equity incentive plans are to attract, retain and reward personnel through the granting of equity-based
compensation awards in order to increase shareholder value and our success by motivating such individuals to perform to the best of their
abilities to achieve our objectives.
We
recognize that our industry is specialized and dynamic and a significant aspect of our success is our continued ability to execute our
human capital strategy of attracting, engaging, developing and retaining highly skilled talent. There is fierce competition both within
our industry and in the geographic locations in which we have offices for highly skilled talent, and we offer a robust set of benefits,
career-enhancing learning experiences and initiatives aligned with our mission, vision, and values in order to attract qualified prospective
employees and to retain and motivate our employees. We offer competitive compensation for our employees and strongly embrace a pay for
performance philosophy in setting and adjusting compensation.
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Our
codes of conduct clearly outline our commitment to diversity and inclusion, where all employees are welcomed in an environment designed
to make them feel comfortable, respected, and accepted regardless of their age, race, national origin, gender, religion, disability or
sexual orientation. We have a set of policies explicitly setting forth our expectations for nondiscrimination and a harassment-free work
environment. We are also a proud equal opportunity employer and cultivate a highly collaborative and entrepreneurial culture.
Item
1A. Risk Factors
In
analyzing our company, you should carefully consider the following risk factors. Factors that could cause or contribute to differences
in our actual results include those discussed in the following subsection, as well as those discussed below in “Management’s
Discussion and Analysis of Financial Condition and Results of Operations” and elsewhere throughout this Annual Report on Form 10-K.
Each of the following risk factors, either alone or taken together, could adversely affect our business, operating results and financial
condition, as well as adversely affect the value of an investment in our Company. The risks and uncertainties described below are not
the only ones we face. Additional risks not currently known to us or other factors not perceived by us to present significant risks to
our business at this time also may impair our business operations.
Risks
Associated with Development and Commercialization of Our Drug Candidates
Clinical
trials are expensive, time consuming, subject to delay and may be required to continue beyond our available funding and we cannot be
certain that we will be able to raise sufficient funds to complete the development and commercialize our remaining product candidate
currently in clinical development, should it succeed.
We
are a clinical-stage biopharmaceutical company with one product candidate in clinical development currently, plogosertib, a polo-like
kinase 1 (PLK 1) inhibitor for treatment of in esophageal cancer and acute leukemia (“plogo”). Clinical trials may also have
uncertain outcomes. We estimate that clinical trials of our drug candidate may be required to continue beyond our available funding and
may take several more years to complete. The designs used in some of our trials have not been used widely by other pharmaceutical companies.
We cannot guarantee that any clinical trials we undertake to conduct will be conducted as planned or completed on schedule or at all.
Failure can occur at any stage of the testing and we may experience numerous unforeseen events during, or as a result of, the clinical
trial process that could delay or prevent commercialization of our current or future drug candidates. The success of our product candidate
will depend on several factors, including, but not limited to:
● delays
in securing clinical investigators or trial sites for our clinical trials;
● delays
in obtaining institutional review board, or IRB, and regulatory approvals to commence a clinical
trial;
● failure
to obtain regulatory authority permission to conduct a clinical trial, after review of an
investigational new drug or equivalent foreign application or amendment;
● slower
than anticipated rates of subject recruitment and enrollment, or not reaching the targeted
number of subjects because of competition for patients from other trials;
● negative
or inconclusive results from clinical trials, as demonstrated by our announcement on February
24, 2017 that our SEAMLESS Phase 3 study failed to reach its primary endpoint;
● inability
to generate satisfactory preclinical or other nonclinical data, including, toxicology, or
other in vivo or in vitro data or diagnostics to support the initiation or
continuation of clinical trials;
● unforeseen
safety issues;
● failure
by clinical sites or contract research organizations, or CROs, or other third parties to
adhere to clinical trial requirements, GCP, or other applicable regulatory requirements;
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● subjects
discontinuing participating in our clinical trials at a greater than expected rate;
● imposition
by the FDA of a clinical hold or the requirement by other similar regulatory agencies that
one or more clinical trials be delayed or halted;
● uncertain
dosing issues that may or may not be related to incompletely explored pharmacokinetic and
pharmacodynamics behaviors;
● approval
and introduction of new therapies or changes in standards of practice or regulatory guidance
that render our clinical trial endpoints or the targeting of our proposed indications less
attractive;
● inability
to monitor patients adequately during or after treatment or problems with investigator or
patient compliance with the trial protocols;
● inability
to replicate in large, controlled studies safety and efficacy data obtained from a limited
number of patients in uncontrolled trials;
● the
ultimate affordability of the cost of clinical trials of our product candidate;
● effectively
launching commercial sales of our product candidate, if approved, whether alone or in collaboration
with others;
● achieving
acceptance of our product candidate, if approved, by patients, the medical community and
third-party payors;
● effectively
competing with other therapies;
● if
our product candidate is approved, obtaining and maintaining coverage and adequate reimbursement
by third-party payors, including government payors, for our product candidate;
● complying
with all applicable regulatory requirements, including FDA current Good Clinical Practices
(“GCP”), current Good Manufacturing Practices (“cGMP”), and standards,
rules and regulations governing promotional and other marketing activities;
● changes
in regulatory requirements and guidance that require amending or submitting new clinical
protocols or performing additional nonclinical studies; and
● unavailability
of clinical trial supplies.
Any
inability to successfully complete clinical development and obtain regulatory approval for our product candidate could result in additional
costs to us or impair our ability to generate revenue. In addition, if we make manufacturing or formulation changes to our product candidate,
we may need to conduct additional nonclinical studies and/or clinical trials, or the results obtained from such new formulation may not
be consistent with previous results obtained. Clinical trial delays could also shorten any anticipated periods of patent exclusivity
for our product candidate and may allow competitors to develop and bring products to market before we do, which could impair our ability
to successfully commercialize our product candidate and may harm our business and results of operations.
If
we experience delays or difficulties in the enrollment of research subjects in clinical trials, those clinical trials could take longer
than expected to complete and our receipt of necessary regulatory approvals could be delayed or prevented.
We
may not be able to initiate or continue clinical trials for our drug candidates if we are unable to locate and enroll a sufficient number
of research subjects to participate in these trials. In particular, for some diseases and conditions we are or will be focusing on, our
pool of suitable patients may be smaller and more selective and our ability to enroll a sufficient number of suitable patients may be
limited or take longer than anticipated. In addition, some of our competitors have ongoing clinical trials for drug candidates that treat
the same indications as our drug candidates, and volunteers or patients who would otherwise be eligible for our clinical trials may instead
enroll in clinical trials of our competitors’ drug candidates. The timing of our clinical trials depends in part on the rate at
which we can recruit patients to participate in clinical trials of our product candidate, and we may experience delays in our clinical
trials if we encounter difficulties in enrollment. If we experience delays in our clinical trials, the timeline for obtaining regulatory
approval of our product candidate will most likely be delayed.
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Many
factors may affect our ability to identify, enroll and maintain qualified patients for any of our clinical trials may also be affected
by other factors, including without limitation:
the
size and nature of the target patient population;
● the
severity of the disease under investigation;
● the
subject eligibility criteria for the clinical trial in question;
● our
ability to recruit clinical trial investigators with the appropriate competencies and experience;
● size
and nature of the patient population;
● patients’
perceptions as to risks and benefits of the product candidate under study and the participation
in a clinical trial generally in relation to other available therapies, including any new
drugs that may be approved for the indications we are investigating regarding the drug candidate
under study in the clinical trial;
● the
approval and availability of other therapies to treat the disease or disorder that is being
investigated in the clinical trial;
● the
extent of the efforts to facilitate timely enrollment in clinical trials;
● patients
who do not complete the trials for personal reasons;
● severity
of the disease under investigation;
● the
patient referral practices of physicians;
● the
ability to monitor volunteers or subjects adequately during and after treatment;
● the
presence of other drug candidates in clinical development for the same indication or against
the same target; and
● the
proximity and availability of clinical trial sites for prospective subjects.
In
addition, our clinical trials will compete with other clinical trials for product candidates that are in the same therapeutic areas as
our product candidate, and this competition will reduce the number and types of patients available to us, because some patients who might
have opted to enroll in our trials may instead opt to enroll in a trial being conducted by one of our competitors. Because the number
of qualified clinical investigators is limited, we may conduct some of our clinical trials at the same clinical trial sites that some
of our competitors use, which will reduce the number of patients who are available for our clinical trials at such clinical trial sites.
Moreover, because our product candidate represent a departure from more commonly used methods for cancer treatment, potential patients
and their doctors may be inclined to use conventional therapies rather than enroll patients in any future clinical trial.
Our
inability to enroll a sufficient number of subjects for our clinical trials would result in significant delays and could require us to
abandon one or more clinical trials altogether. Enrollment delays in our clinical trials may result in increased development costs for
our drug candidates, and we may not have or be able to obtain sufficient cash to fund such increased costs when needed, which could result
in the further delay or termination of clinical trials. If we experience delays in the completion of, or termination of, any clinical
trials of our product candidate, the commercial prospects of our product candidate could be harmed, and our ability to generate product
revenue from plogo could be delayed or prevented. In addition, any delays in completing our clinical trials would likely increase our
overall costs, impair product candidate development and jeopardize our ability to obtain regulatory approval relative to our current
plans. Any of these occurrences may harm our business, financial condition, and prospects significantly.
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The
outcome of preclinical testing and early clinical trials may not be predictive of the success of later clinical trials, and the results
of our clinical trials may not satisfy the requirements of the FDA or comparable foreign regulatory authorities.
We
currently have no products approved for sale and we cannot guarantee that we will ever have marketable products. Clinical failure can
occur at any stage of clinical development. Clinical trials may produce negative or inconclusive results, and we or any future collaborators
may decide, or regulatory authorities may require us, to conduct additional clinical trials or nonclinical studies. We will be required
to demonstrate with substantial evidence through well-controlled, adequate clinical trials that plogo is safe and effective for use in
a diverse population before we can seek marketing approvals for their commercial sale. Success in preclinical studies and early-stage
clinical trials does not mean that future larger registration clinical trials will be successful. This is because product candidates
in later-stage clinical trials may fail to demonstrate sufficient safety and efficacy to the satisfaction of the FDA and comparable foreign
regulatory authorities despite having progressed through nonclinical studies and early-stage clinical trials.
From
time to time, we may publish or report interim or preliminary data from our clinical trials. Interim or preliminary data from clinical
trials that we may conduct may not be indicative of the final results of such trials and are subject to the risk that one or more of
the clinical outcomes may materially change as subject enrollment continues and more data from the trials become available. Efficacy
data from prospectively designed trials may differ significantly from those obtained from retrospective subgroup analyses. If later-stage
clinical trials do not produce favorable results, our ability to achieve regulatory approval for our product candidate may be adversely
impacted. Even if we believe that we have adequate data to support an application for regulatory approval to market our current product
candidate, plogo, or any future product candidates, the FDA or other regulatory authorities may not agree and may require that we conduct
additional clinical trials. Interim or preliminary data also remain subject to audit and verification procedures that may result in the
final data being materially different from the interim or preliminary data. As a result, interim or preliminary data should be viewed
with caution until the final data are available.
We
are making use of biomarkers, which are not scientifically validated, and our reliance on biomarker data may thus cause us to direct
our resources inefficiently.
We
are making use of biomarkers in an effort to facilitate our drug development and to optimize our clinical trials. Biomarkers are proteins
or other substances whose presence in the blood can serve as an indicator of specific cell processes. We believe that these biological
markers serve a useful purpose in helping us to evaluate whether our drug candidates are having their intended effects through their
assumed mechanisms, and that they may thus enable us to identify more promising drug candidates at an early stage and to direct our resources
efficiently. We also believe that biomarkers may eventually allow us to improve patient selection in connection with clinical trials
and monitor patient compliance with trial protocols.
For
most purposes, however, the biomarkers we are currently evaluating have not been scientifically validated. If our understanding and use
of biomarkers is inaccurate or flawed, or if our reliance on them is otherwise misplaced, then we will not only fail to realize any benefits
from using biomarkers but may also be led to invest time and financial resources inefficiently in attempting to develop inappropriate
drug candidates.
Moreover,
although the FDA has issued for comment a draft guidance document on the potential use of biomarker data in clinical development, such
data are not currently accepted by the FDA or other regulatory agencies in the United States, the European Union or elsewhere in applications
for regulatory approval of drug candidates, and there is no guarantee that such data will ever be accepted by the relevant authorities
in this connection. Our biomarker data should not be interpreted as evidence of efficacy.
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The
review processes of regulatory authorities are lengthy, time consuming, expensive and inherently unpredictable. If we are unable to obtain
approval for our drug candidates from applicable regulatory authorities, we will not be able to market and sell those drug candidates
in those countries or regions and our business could be substantially harmed.
The
research, testing, manufacturing, labeling, approval, sale, marketing and distribution of drug products are, and will remain, subject
to extensive regulation by the FDA in the United States and by the respective regulatory authorities in other countries where regulations
differ. Clinical testing is expensive and can take many years to complete, with the outcome inherently uncertain. Failure can occur at
any time during the clinical trial process. Before obtaining approval from regulatory authorities for the sale of our product candidate,
we must conduct extensive clinical trials to demonstrate the safety and efficacy of our product candidate in humans. Prior to initiating
clinical trials, a sponsor must complete extensive preclinical testing of a product candidate, including, in most cases, preclinical
efficacy experiments as well as IND-enabling toxicology studies. These experiments and studies may be time-consuming and expensive to
complete. We are not permitted to market plogo or any of our future product candidates in the United States until we receive the respective
approval of a new drug applications (an “NDA”) from the FDA, or in any foreign countries until we receive the requisite approval
from the respective regulatory authorities in such countries. The time required to obtain approval, if any, by the FDA, EMA and comparable
foreign authorities is unpredictable, but typically takes many years following the commencement of clinical trials, if approval is obtained
at all, and depends upon numerous factors, including the substantial discretion of the regulatory authorities and the type, complexity
and novelty of the product candidates involved. Regulatory authorities have substantial discretion in the approval process and may refuse
to accept any application or may decide that our data are insufficient for approval and require additional nonclinical studies or clinical
trials. We have not submitted a marketing application such as an NDA to the FDA, an MAA to the EMA or any similar application to any
other jurisdiction. We have limited experience in planning and conducting the clinical trials required for marketing approvals, and we
have relied, and expect to continue to rely on third-party CROs to assist us in this process. Obtaining marketing approval requires the
submission of extensive nonclinical and clinical data and supporting information to regulatory authorities for each therapeutic indication
to establish the product candidate’s safety and effectiveness. Securing marketing approval also requires the submission of information
about the product manufacturing process, and in many cases the inspection of manufacturing, processing and packaging facilities by the
regulatory authorities. Our product candidate, plogo, may not be effective, may be only moderately effective or may prove to have undesirable
or unintended side effects, toxicities or other characteristics that may preclude our obtaining marketing approval or prevent or limit
commercial use, or there may be deficiencies in cGMP compliance by us or by our contract manufacturers that could result in the candidate
not being approved. Moreover, we have not obtained regulatory approval for any drug candidate in any jurisdiction and it is possible
that none of our existing drug candidates or any drug candidates we may seek to develop in the future will ever obtain regulatory approval.
In
addition, plogo could fail to receive, or could be delayed in receiving, regulatory approval for many reasons, including any one or more
of the following:
● the
FDA, EMA or comparable foreign regulatory authorities may disagree with the design or implementation
of our clinical trials;
● we
may be unable to demonstrate to the satisfaction of the FDA, EMA or comparable foreign regulatory
authorities that a drug candidate is safe and effective for its proposed indication;
● the
results of clinical trials may not meet the level of statistical significance required by
the FDA, EMA or comparable foreign regulatory authorities for approval;
● delay
or failure in obtaining IRB approval or the approval of other reviewing entities, including
comparable foreign regulatory authorities, to conduct a clinical trial at each site;
● we
may be unable to demonstrate that a drug candidate’s clinical and other benefits outweigh
its safety risks;
● the
FDA, EMA or comparable foreign regulatory authorities may disagree with our interpretation
of data from preclinical studies or clinical trials;
● failure
of our third-party clinical trial managers, CROs, clinical trial sites, contracted laboratories
or other third-party vendors to satisfy their contractual duties, meet expected deadlines
or return trustworthy data;
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● a
decision by the FDA, the IRB, a comparable foreign regulatory authority, or us to suspend
or terminate clinical trials at any time for safety issues or for any other reason;
● lack
of adequate funding to continue a trial, including the incurrence of unforeseen costs due
to enrollment delays, requirements to conduct additional studies or increased expenses associated
with the services of our CROs and other third parties
● the
data collected from clinical trials of our drug candidates may not be sufficient to support
the submission of an NDA or other submission or to obtain regulatory approval in the United
States or elsewhere;
● upon
review of our clinical trial sites and data, the FDA or comparable foreign regulatory authorities
may find our record keeping or the record keeping of our clinical trial sites to be inadequate;
● the
manufacturing processes or facilities of third-party manufacturers with which we contract
for clinical and commercial supplies may fail to meet the requirements of the FDA, EMA or
comparable foreign regulatory authorities;
● the
FDA, EMA or comparable foreign regulatory authorities may fail to approve the companion diagnostics
we contemplate developing internally or with partners; and
● the
change of the medical standard of care or the approval policies or regulations of the FDA,
EMA or comparable foreign regulatory authorities may significantly change in a manner that
renders our clinical data insufficient for approval.
If
we experience delays in the completion or termination of any clinical trial of our product candidate, the approval and commercial prospects
of our product candidate will be harmed, delaying our ability to generate product revenues from such product candidate and our costs
will most likely increase. The required regulatory approvals may also be delayed, thereby jeopardizing our ability to commence product
sales and generate revenues and the period of commercial exclusivity for our product may be decreased. Regulatory approval of our product
candidate may be denied for the same reasons that caused the delay. The time and expense of the approval process, as well as the unpredictability
of future clinical trial results and other contributing factors, may result in our failure to obtain regulatory approval to market any
of our product candidate in one or more jurisdictions, which would significantly harm our business, results of operations and prospects.
In such cases, we may also not have the resources to conduct new clinical trials and/or we may determine that further clinical development
of any such drug candidate is not justified and may discontinue any such programs.
In
addition, even if we were to obtain regulatory approval in one or more jurisdictions, regulatory authorities may approve any of our drug
candidates for fewer or more limited indications than we request, may not approve prices we may propose to charge for our products, may
grant approval contingent on the performance of costly post-marketing clinical trials (referred to as “conditional” or “accelerated”
approval depending on the jurisdiction), or may approve a drug candidate with a label that does not include the labeling claims necessary
or desirable for the successful commercialization of that drug candidate. Any of the foregoing circumstances could materially harm the
commercial prospects for our drug candidates.
Our
product candidate may cause undesirable side effects that could delay or prevent their marketing approval, limit their commercial potential,
or result in significant negative consequences following marketing approval, if marketing approval is obtained.
Undesirable
side effects caused by our product candidate, plogo, could cause us or the FDA or other regulatory authorities to interrupt, delay or
halt our clinical trials and could result in a more restrictive label or the delay or denial of marketing approval by the FDA or other
applicable regulatory authorities. In the event that our clinical trials produce undesirable side effects, our trials could be suspended
or terminated and the FDA or comparable foreign regulatory authorities could order us to cease further development of or deny approval
of our product candidate for any or all targeted indications. In addition to this, the product-related side effects could affect patient
recruitment or the ability of enrolled patients to complete the trial or result in potential product liability claims.
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Clinical
trials by their nature utilize a sample of the potential patient population. With a limited number of patients, rare and severe side
effects of our product candidate may only be uncovered with a significantly larger number of patients exposed to the product candidate.
If plogo receives marketing approval and we or others identify undesirable side effects caused by plogo after such approval, a number
of potentially significant negative consequences could result, including:
● regulatory
authorities may withdraw or limit their approval of plogo;
● regulatory
authorities may require the addition of labeling statements, specific warnings or a contraindication;
● we
may be required to create a medication guide outlining the risks of such side effects for
distribution to patients, or we may be required to implement a REMS to ensure that the benefits
of the product outweigh the risks;
● we
may be required to change the way plogo is distributed or administered, or change the labeling
of plogo;
● we
may be required to conduct post-marketing studies;
● we
may be subject to regulatory investigations and government enforcement actions;
● the
FDA or a comparable foreign regulatory authority may require us to conduct additional clinical
trials or costly post-marketing testing and surveillance to monitor the safety and efficacy
of the product;
● we
may decide to recall plogo from the marketplace after it is approved;
● we
could be sued and held liable for injury caused to individuals exposed to or taking plogo;
and
● our
reputation may suffer.
Any
of these events could prevent us from achieving or maintaining market acceptance of plogo and could substantially increase the costs
of its commercializing, if approved, and significantly impact our ability to successfully commercialize plogo and generate revenues.
Our
product development may not uncover all possible adverse events that patients who take our product candidate may experience. The number
of subjects exposed to our product candidate and the average exposure time in the clinical development program may be inadequate to detect
rare adverse events or chance findings that may only be detected once the product is administered to more patients and for greater periods
of time.
Clinical
trials by their nature utilize a sample of the potential patient population. However, with a limited number of subjects and limited duration
of exposure, we cannot be fully assured that rare and severe side effects of our product candidate will be uncovered. Such rare and severe
side effects may only be uncovered with a significantly larger number of patients exposed to our product candidate. If such safety problems
occur or are identified after our product candidate reaches the market, the FDA or other regulatory body may require that we amend the
labeling of the product or recall the product or may even withdraw approval for the product.
As
we evolve from a company primarily involved in discovery and development to one also involved in the commercialization of drugs and devices,
we may encounter difficulties in managing our growth and expanding our operations successfully.
In
order to execute our business strategy, we will need to expand our development, control and regulatory capabilities and develop financial,
manufacturing, marketing and sales capabilities or contract with third parties to provide these capabilities for us. If our operations
expand, we expect that we will need to manage additional relationships with various collaborative partners, suppliers and other third
parties. Our ability to manage our operations and any growth will require us to make appropriate changes and upgrades, as necessary,
to our operational, financial and management controls, reporting systems and procedures wherever we may operate. Any inability to manage
growth could delay the execution of our business plan or disrupt our operations.
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Our
applications for regulatory approval could be delayed or denied due to problems with studies conducted before we licensed the rights
to some of our product candidates.
We
may now or in the future license some of the compounds and current and future drug candidates used in our research programs from third
parties. Our present research involving these compounds relies upon previous research conducted by third parties over whom we had no
control and before we in-licensed the drug candidates. In order to receive regulatory approval of a drug candidate, we must present all
relevant data and information obtained during our research and development, including research conducted prior to our licensure of the
drug candidate. Although we are not currently aware of any such problems, any problems that emerge with preclinical research and testing
conducted prior to our in-licensing may affect future results or our ability to document prior research and to conduct clinical trials,
which could delay, limit or prevent regulatory approval for our drug candidates.
Even
if we obtain regulatory approval for a product candidate, we will remain subject to ongoing regulatory requirements.
Our
business is dependent on our ability to obtain regulatory approval for our product candidate in a timely manner. We cannot commercialize
our product candidate in the U.S. without first obtaining regulatory approval for the product from the FDA. Similarly, we cannot commercialize
our product candidate outside of the U.S. without obtaining regulatory approval from comparable foreign regulatory authorities. Before
obtaining regulatory approvals for the commercial sale of our product candidate for a target indication, we must demonstrate with substantial
evidence gathered in preclinical studies and clinical trials that the product candidate is safe and effective for use for that target
indication and that the manufacturing facilities, processes and controls are adequate with respect to such product candidate.
The
time required to obtain approval by the FDA and comparable foreign regulatory authorities is unpredictable but typically takes many years
following the commencement of preclinical studies and clinical trials and depends upon numerous factors, including the substantial discretion
of the regulatory authorities. In addition, approval policies, regulations, or the type and amount of clinical data necessary to gain
approval may change during the course of a product candidate’s clinical development and may vary among jurisdictions.
Even,
if plogo is approved for marketing, we will be subject to ongoing regulatory requirements, including with respect to manufacturing, labeling,
packaging, storage, advertising, promotion, sampling, record-keeping, conduct of post-marketing clinical trials, and submission of safety,
efficacy and other post-approval information, including both federal and state requirements in the United States and requirements of
comparable foreign regulatory authorities.
Manufacturers
and manufacturers’ facilities are required to continuously comply with FDA and comparable foreign regulatory authority requirements,
including ensuring that quality control and manufacturing procedures conform to cGMP regulations and corresponding foreign regulatory
manufacturing requirements. As such, we and our contract manufacturers will be subject to continual review and inspections to assess
compliance with cGMP and adherence to commitments made in any marketing application. Accordingly, we and others with whom we work must
continue to expend time, money, and effort in all areas of regulatory compliance, including manufacturing, production, and quality control.
Any
regulatory approvals that we receive for plogo may be subject to limitations on the approved indicated uses for which the product may
be marketed or to the conditions of approval, or contain requirements for potentially costly post-marketing testing, including Phase
4 clinical trials, and surveillance to monitor the safety and efficacy of the product candidate. The FDA may also require a REMS program
as a condition of approval of our product candidate, which could entail requirements for long-term patient follow-up, 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 candidate,
we will have to comply with requirements including submissions of safety and other post-marketing information and reports, registration,
as well as continued compliance with cGMP and GCP for any clinical trials that we conduct post-approval.
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The
FDA strictly regulates marketing, labeling, advertising, and promotion of products that are placed on the market. Drugs may be promoted
only for the approved indications and in accordance with the provisions of the approved label. Advertising and promotion of any product
candidate that obtains approval in the U.S. is heavily scrutinized by the FDA, the Department of Justice, the Office of Inspector General
of Health and Human Services, state attorneys general, members of Congress and the public. A company can make only those claims relating
to safety and efficacy, purity and potency that are approved by the FDA and in accordance with the provisions of the approved label.
Additionally, advertising and promotion of any product candidate that obtains approval outside of the U.S. is heavily scrutinized by
comparable foreign regulatory authorities. Violations, including actual or alleged promotion of our product for unapproved or off-label
uses, are subject to enforcement letters, inquiries and investigations, and civil and criminal sanctions by the FDA, as well as prosecution
under the federal False Claims Act. Any actual or alleged failure to comply with labeling and promotion requirements may have a negative
impact on our business. In addition, the FDA and other agencies actively enforce the laws and regulations prohibiting the promotion of
off-label uses, and a company that is found to have improperly promoted off-label uses may be subject to significant liability.
Failure
to comply with regulatory requirements may result in revisions to the approved labeling to add new safety information; imposition of
post-market studies or clinical studies to assess new safety risks; or imposition of distribution restrictions or other restrictions
under a REMS program. Other potential consequences include, among other things:
● restrictions
on the marketing or manufacturing of the product, complete withdrawal of the product from
the market or product recalls;
● fines,
warning letters or other enforcement-related letters or clinical holds on post-approval clinical
trials;
● refusal
of the FDA to approve pending NDAs or supplements to approved NDAs, or suspension or revocation
of product approvals;
● product
seizure or detention, or refusal to permit the import or export of products;
● injunctions
or the imposition of civil or criminal penalties; and
● consent
decrees, corporate integrity agreements, debarment, or exclusion from federal health care
programs; or mandated modification of promotional materials and labeling and the issuance
of corrective information.
The
policies of the FDA and of other regulatory authorities may change and additional government regulations may be enacted that could prevent,
limit or delay regulatory approval of our product candidate. 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.
Obtaining
and maintaining marketing approval of our current and future product candidates in one jurisdiction does not mean that we will be successful
in obtaining marketing approval of our current and future therapeutic product candidates in other jurisdictions.
Obtaining
and maintaining marketing approval of our remaining product candidate, and any future product candidates, in one jurisdiction does not
guarantee that we will be able to obtain or maintain marketing approval in any other jurisdiction, while a failure or delay in obtaining
marketing approval in one jurisdiction may have a negative effect on the marketing approval process in others. For example, even if the
FDA grants marketing approval of a product candidate, comparable foreign regulatory authorities in foreign jurisdictions must also approve
the manufacturing, marketing and promotion of the product candidate in those countries. Approval procedures vary among jurisdictions
and can involve requirements and administrative review periods different from, and greater than, those in the United States, including
additional nonclinical studies or clinical trials in the event that certain nonclinical studies or clinical trials conducted in one jurisdiction
are not accepted by regulatory authorities in other jurisdictions. In many jurisdictions outside the United States, a product candidate
must be approved for reimbursement before it can be approved for sale in that jurisdiction. In some cases, the price that we intend to
charge for our future products will also be subject to approval.
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We
may submit marketing applications in other countries in addition to the United States. Regulatory authorities in jurisdictions outside
of the United States have requirements for approval of product candidates with which we must comply prior to marketing in those jurisdictions.
Obtaining foreign marketing approvals and compliance with foreign regulatory requirements could result in significant delays, difficulties
and costs for us, and could delay or prevent the introduction of our products in certain countries. If we fail to comply with the regulatory
requirements in international markets and/or receive applicable marketing approvals, our target market will be reduced and our ability
to realize the full market potential of our product candidate will be harmed.
Even
if we successfully complete the clinical trials for Plogo, the product candidate may fail for other reasons.
Even
if we successfully complete the clinical trials for our product candidate, the product candidate may fail for other reasons, including,
without limitation, the possibilities that the product candidate will:
● fail
to receive the regulatory approvals required to market them as drugs;
● be
subject to proprietary rights held by others requiring the negotiation of a license agreement
prior to marketing;
● be
difficult or expensive to manufacture on a commercial scale;
● have
adverse side effects that make their use less desirable; or
● fail
to compete effectively with product candidates or other treatments commercialized by our
competitors.
If
we are unable to receive the required regulatory approvals, secure our intellectual property rights, minimize the incidence of any adverse
side effects or if we fail to compete with our competitors’ products, our business, financial condition, and results of operations
may be materially and adversely affected.
We
face intense competition and our competitors may develop drugs that are less expensive, safer, or more effective than our drug candidates.
A
large number of drug candidates are in development for the treatment of leukemia, solid tumors including breast, endometrial/uterine
and ovarian cancers and lymphomas. Several pharmaceutical and biotechnology companies have PLK1 inhibitors or other products on the market
or in clinical trials which may be competitive to our drug in both hematological and oncology indications. Our competitors, either alone
or together with collaborators, may have substantially greater financial resources and research and development staff. Our competitors
may also have more experience:
● developing
drug candidates;
● conducting
preclinical and clinical trials;
● obtaining
regulatory approvals; and
● commercializing
product candidates.
Our
competitors may succeed in obtaining patent protection and regulatory approval and may market drugs before we do. If our competitors
market drugs that are less expensive, safer, more effective or more convenient to administer than our potential drugs, or that reach
the market sooner than our potential drugs, we may not achieve commercial success. Scientific, clinical or technical developments by
our competitors may render our drug candidates obsolete or noncompetitive. We anticipate that we will face increased competition in the
future as new companies enter the markets and as scientific developments progress. If our drug candidates obtain regulatory approvals,
but do not compete effectively in the marketplace, our business will suffer.
Our
future product candidates, if any, for which we obtain approval may face competition sooner than anticipated.
Even
if we are successful in achieving regulatory approval to commercialize a product candidate ahead of our competitors, our future pharmaceutical
products may face direct competition from generic and other follow-on drug products. plogo, or future product candidates, if any, that
may achieve regulatory approval in the future may face competition from follow-on products earlier or more aggressively than anticipated,
depending upon how well such approved products perform in the U.S. prescription drug market.
Our
ability to compete may also be affected in many cases by insurers or other third-party payors seeking to encourage the use of generic
products.
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The
Hatch-Waxman Amendments to the FDCA authorized the FDA to approve generic drugs that are the same as drugs previously approved for marketing
under the NDA provisions of the statute pursuant to abbreviated new drug applications (“ANDAs”) and, in addition, created
the Section 505(b)(2) NDA pathway. An ANDA relies on the preclinical and clinical testing conducted for a previously approved reference
listed drug and must demonstrate to the FDA that the generic drug product is identical to the RLD with respect to the active ingredients,
the route of administration, the dosage form, and the strength of the drug and also that it is “bioequivalent” to the reference
listed drug. In contrast, Section 505(b)(2) enables the applicant to rely, in part, on the FDA’s prior findings of safety and efficacy
data for an existing product, or published literature, in support of its application. Section 505(b)(2) provides an alternate path to
FDA approval for new or improved formulations or new uses of previously approved products; for example, a follow-on applicant may be
seeking approval to market a previously approved drug for new indications or for a new patient population that would require new clinical
data to demonstrate safety or effectiveness. Such products, if approved and depending upon the scope of the changes made to the reference
drug, may also compete with any product candidate for which we receive approval.
The
FDA is prohibited by statute from approving an ANDA or 505(b)(2) NDA when certain marketing or data exclusivity protections apply to
the reference listed drug. However, if any competitor or third party is able to demonstrate bioequivalence without infringing our patents,
then such competitor or third party may then be able to gain approval of an ANDA and introduce a competing generic product onto the market.
Furthermore,
the CREATES Act established a private cause of action that permits a generic product developer to sue the brand manufacturer to compel
it to furnish necessary samples of an RLD on “commercially reasonable, market-based terms.” If generic developers request
samples of any product candidate for which we receive marketing approval in order to conduct comparative testing to support one or more
ANDAs for a generic version of our products, and we refuse any such request, we may be subject to litigation under the CREATES Act. Although
lawsuits have been filed under the CREATES Act since its enactment, those lawsuits have been settled privately; therefore, to date, no
federal court has reviewed or opined on the statutory language and there continues to be uncertainty regarding the scope and application
of the law.
We
cannot predict the interest of potential follow-on competitors or how quickly others may seek to come to market with competing products,
whether approved as a direct ANDA competitor or as a Section 505(b)(2) NDA referencing one of our future product candidates, if any,
beyond plogo. If the FDA approves generic versions of any of our products in the future, should they be approved for commercial marketing,
such competitive products may be able to immediately compete with us in each indication for which our product has received approval,
which could negatively impact our future revenue, profitability and cash flow and substantially limit our ability to obtain a return
on our investments.
The
commercial success of our drug candidates depends upon their market acceptance among physicians, patients, healthcare providers and payors
and the medical community.
If
our drug candidates are approved, or are approved by the FDA or EMA, together with another agent such as decitabine, the resulting drugs,
if any, must still gain market acceptance among physicians, healthcare providers and payors, patients and the medical community. The
degree of market acceptance of any of our approved drugs will depend on a variety of factors, including:
● timing
of market introduction, number and clinical profile of competitive drugs;
● our
ability to provide acceptable evidence of safety and efficacy;
● relative
convenience and ease of administration;
● pricing
and cost-effectiveness, which may be subject to regulatory control;
● availability
of coverage, reimbursement and adequate payment from health maintenance organizations and
other third-party payors; and
● prevalence
and severity of adverse side effects; and other potential advantages over alternative treatment
methods.
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If
any product candidate that we develop does not provide a treatment regimen that is at least as beneficial as the current standard of
care or otherwise does not provide some additional patient benefit over the current standard of care, that product will not achieve market
acceptance and we will not generate sufficient revenues to achieve profitability.
If
our drug candidates or distribution partners’ products fail to achieve market acceptance, we may not be able to generate significant
revenue and our business would suffer, and our business may be affected by the efforts of government and third-party payors to contain
or reduce the cost of healthcare through various means.
Reimbursement
decisions by third-party payors may have an adverse effect on pricing and market acceptance. If there is not sufficient reimbursement
for our products, it is less likely that they will be widely used. Market acceptance and sales of Plogo that we develop, if approved,
will depend on reimbursement policies, and may be affected by future healthcare reform measures. Government authorities and third-party
payors, such as private health insurers and health maintenance organizations, decide which drugs they will cover and establish payment
levels. We cannot be certain that reimbursement will be available for our product candidate. Also, we cannot be certain that reimbursement
policies will not reduce the demand for, or the price paid for, our products. If reimbursement is not available or is available on a
limited basis, we may not be able to successfully commercialize plogo our any of our future product candidates.
Even
if we succeed in bringing one or more products to the market, these products may not be considered medically necessary and/or cost-effective,
and the amount reimbursed for any products may be insufficient to allow us to sell our products on a competitive basis. At this time,
we are unable to determine their cost effectiveness or the likely level or method of reimbursement for plogo or any of our future product
candidates. Increasingly, third-party payors, such as government and private insurance plans, are requiring that biopharmaceutical companies
provide them with predetermined discounts from list prices and are seeking to reduce the prices charged or the amounts paid for biopharmaceutical
products. If the price we are able to charge for any products we develop, or the payments provided for such products, is inadequate in
light of our development and other costs, our return on investment could be adversely affected.
Discussions
continue at the federal level regarding policies that would require manufacturers to pay higher rebates in Medicare Part D, give states
more flexibility on drugs that are covered under the Medicaid program, and other policy proposals that could impact reimbursement for
our products. The efforts of governments and third-party payors to contain or reduce the cost of health care and legislative and regulatory
proposals to broaden the availability of health care will continue to affect the business and financial condition of pharmaceutical and
biopharmaceutical companies. A number of legislative and regulatory changes in the health care system in the United States and other
major health care markets have been proposed and/or adopted in the recent past, and such efforts have expanded substantially in the past
several years.
Our
business may be affected by the efforts of government and third-party pairs to contain or reduce the cost of healthcare through various
means.
The
failure to attract and retain skilled personnel and key relationships could impair our drug development and commercialization efforts.
We
are highly dependent on our senior management and key clinical development, scientific and technical personnel. The loss of the services
of any member of our senior management, clinical development, scientific or technical staff may significantly delay or prevent the achievement
of drug development and other business objectives and could have a material adverse effect on our business, operating results and financial
condition. We also rely on consultants and advisors to assist us in formulating our strategy. All of our consultants and advisors are
either self-employed or employed by other organizations, and they may have conflicts of interest or other commitments, such as consulting
or advisory contracts with other organizations, that may affect their ability to contribute to us. We intend to expand and develop new
drug candidates. We will need to hire additional employees in order to continue our clinical trials and market our drug candidates. This
strategy will require us to recruit additional executive management and clinical development, scientific, technical and sales and marketing
personnel. There is currently intense competition for skilled executives and employees with relevant clinical development, scientific,
technical and sales and marketing expertise, and this competition is likely to continue. The inability to attract and retain sufficient
clinical development, scientific, technical and managerial personnel could limit or delay our product development efforts, which would
adversely affect the development of our drug candidates and commercialization of our potential drugs and growth of our business.
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With
the unemployed-to-job-openings ratio remaining under 1 at 0.9, the labor shortage continues to cause the Company to experience a tight
and competitive labor market and cause us to face unforeseen challenges in the availability of labor. A sustained labor shortage or increased
turnover rates within our employee base as a result of general macroeconomic factors have led and, in the future, could lead to increased
costs, such as increased overtime to meet demand and increased wages to attract and retain employees. We have also been negatively affected
and could continue to be negatively affected by labor shortages or constraints experienced by our partners. Failure to achieve and maintain
a diverse workforce and leadership team, compensate our employees competitively and fairly, maintain a safe and inclusive environment
or promote the well-being of our employees could affect our reputation and also result in lower performance and an inability to retain
valuable employees.
We
may be exposed to product liability claims that cause us to incur substantial liabilities and we may be required to limit commercialization
of our drugs that may damage our reputation and we may not be able to obtain adequate insurance.
We
face an inherent risk of product liability as a result of the clinical testing and will face an even greater risk if we commercialize
our drugs. For example, we may be sued if our drugs allegedly causes injury or is found to be otherwise unsuitable during product testing,
manufacturing, marketing or sale. Any such product liability claims may include allegations of defects in manufacturing, defects in design,
a failure to warn of dangers inherent in the product, negligence, strict liability and a breach of warranties. Claims could also be asserted
under state consumer protection acts. We believe that we have obtained reasonably adequate product liability insurance coverage for our
trials. We cannot predict, however, the possible harm or side effects that may result from our clinical trials. Such claims may damage
our reputation and we may not have sufficient resources to pay for any liabilities resulting from a claim excluded from, or beyond the
limit of, our insurance coverage or if the amount of the insurance coverage is insufficient to meet any liabilities resulting from any
claims.
We
may also be exposed to additional risks of product liability claims. These risks exist even with respect to drugs that are approved for
commercial sale by the FDA or other regulatory authorities in the United States, the European Union or elsewhere and manufactured in
facilities licensed and regulated by the FDA, EMA or other such regulatory authorities. We have secured limited product liability insurance
coverage but may not be able to maintain such insurance on acceptable terms with adequate coverage, or at a reasonable cost. There is
also a risk that third parties that we have agreed to indemnify could incur liability. Even if we were ultimately successful in product
liability litigation, the litigation would consume substantial amounts of our financial and managerial resources and may exceed insurance
coverage creating adverse publicity, all of which would impair our ability to generate sales of the litigated product as well as our
other potential drugs.
If
a supplier upon whom we rely fails to produce on a timely basis the finished goods in the volumes that we require or fails to meet quality
standards and maintain necessary licensure from regulatory authorities, we may be unable to meet demand for our products, potentially
resulting in lost revenues.
If
any third-party manufacturer service providers do not meet our or our licensor’s requirements for quality, quantity or timeliness,
or do not achieve and maintain compliance with all applicable regulations, demand for our products or our ability to continue supplying
such products could substantially decline. As the third-party manufacturers are the sole supplier of the products, any delays may impact
our sales.
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In
all the countries where we may sell our products, governmental regulations exist to define standards for manufacturing, packaging, labeling
and storing. All of our suppliers of raw materials and contract manufacturers must comply with these regulations. Failure to do so could
result in supply interruptions. In the United States, the FDA requires that all suppliers of pharmaceutical bulk material and all manufacturers
of pharmaceuticals for sale in or from the United States achieve and maintain compliance with the FDA’s cGMP. Similar requirements
exist in the European Union through the EMA. Failure of our third-party manufacturers to comply with applicable regulations could result
in sanctions being imposed on them or us, including fines, injunctions, civil penalties, disgorgement, suspension or withdrawal of approvals,
license revocation, seizures or recalls of products, operating restrictions and criminal prosecutions, any of which could significantly
and adversely affect supplies of our products. In addition, before any product batch produced by our manufacturers can be shipped, it
must conform to release specifications for the content of the pharmaceutical product. If the operations of one or more of our manufacturers
were to become unavailable for any reason, any required FDA or EMA review and approval of the operations of an alternative supplier could
cause a delay in the manufacture of our products.
The
commercialization of our products will be substantially dependent on our ability to develop effective sales and marketing capabilities.
One
of our primary commercialization strategies for the development of our product candidate in the future, is to develop compounds through
the Phase 2 stage of clinical testing and then market or co-promote certain of our drugs, if any. We currently have no sales, marketing
or distribution capabilities or any drugs ready for market. When and if we reach a commercialization stage, we will depend primarily
on strategic alliances with third parties, which have established distribution systems and sales forces, to commercialize our drugs.
To the extent that we are unsuccessful in commercializing any drugs ourselves or through a strategic alliance, product revenues may suffer,
we may incur significant additional losses, and our share price would be negatively affected.
We
face potential product liability exposure, and if successful claims are brought against us, we may incur substantial liability for a
product candidate and may have to limit its commercialization.
The
use of our product candidate in clinical trials and the sale of any product for which we may obtain marketing approval expose us to the
risk of product liability claims. Product liability claims may be brought against us or our collaborators by participants enrolled in
our clinical trials, patients, health care providers or others using, administering or selling our products. If we cannot successfully
defend ourselves against any such claims, we would incur substantial liabilities. Regardless of merit or eventual outcome, product liability
claims may result in:
● withdrawal
of clinical trial participants;
● termination
of clinical trial sites or entire trial programs;
● costs
of related litigation;
● substantial
monetary awards to patients or other claimants;
● decreased
demand for our product candidate and loss of revenues;
● impairment
of our business reputation;
● loss
of revenue;
● product
recalls;
● decline
in our stock price;
● diversion
of management and scientific resources from our business operations; and
● the
inability to commercialize our product candidate.
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We
have obtained limited product liability insurance coverage for our clinical trials in the United States and in selected other jurisdictions
where we are conducting clinical trials. Our primary product liability insurance coverage for clinical trials in the United States is
at least $10.0 million and outside of the United States, we have coverage for lesser amounts that vary by country. As such, our insurance
coverage may not reimburse us or may not be sufficient to reimburse us for any expenses or losses we may suffer. Moreover, insurance
coverage is becoming increasingly expensive, and, in the future, we may not be able to maintain insurance coverage at a reasonable cost
or in sufficient amounts to protect us against losses due to product liability. We intend to expand our insurance coverage for products
to include the sale of commercial products if we obtain marketing approval for our product candidate in development, but we may be unable
to obtain commercially reasonable product liability insurance for any products approved for marketing. Large judgments have been awarded
in class action lawsuits based on drugs that had unanticipated side effects. A successful product liability claim or series of claims
brought against us, particularly if judgments exceed our insurance coverage, could decrease our cash resources and adversely affect our
business.
Healthcare
legislative reform measures may have a material adverse effect on our business, financial condition or results of operations.
In
the United States, there have been and continue to be a number of legislative initiatives to contain healthcare costs. For example, the
ACA substantially changed the way healthcare is financed by both governmental and private insurers and significantly impacted the U.S.
pharmaceutical industry. The ACA, among other things, increased the minimum Medicaid rebates owed by manufacturers under the Medicaid
Drug Rebate Program and extended the rebate program to individuals enrolled in Medicaid managed care organizations, established annual
fees and taxes on manufacturers of certain branded prescription drugs and biologics, and created a new Medicare Part D coverage gap discount
program, in which manufacturers must agree to offer 70% (increased from 50% pursuant to the Bipartisan Budget Act of 2018, effective
as of 2019) point-of-sale discounts off negotiated prices of applicable brand drugs and biologics to eligible beneficiaries during their
coverage gap period, as a condition for the manufacturer’s outpatient drugs or biologics to be covered under Medicare Part D.
Since
its enactment, there have been judicial, executive and Congressional challenges to certain aspects of the ACA. On June 17, 2021, the
U.S. Supreme Court dismissed the most recent judicial challenge to the ACA without specifically ruling on the constitutionality of the
ACA. Prior to the Supreme Court’s decision, an executive order was issued to initiate a special enrollment period from February
15, 2021 through August 15, 2021 for purposes of obtaining health insurance coverage through the ACA marketplace. 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 ACA.
Other
legislative changes have been proposed and adopted since the ACA was enacted, including aggregate reductions of Medicare payments to
providers, which went into effect on April 1, 2013 and, due to subsequent legislative amendments to the statute, will remain in effect
through 2031, with the exception of a temporary suspension from May 1, 2020 through March 31, 2022, unless additional Congressional action
is taken. On January 2, 2013, the American Taxpayer Relief Act of 2012 was signed into law, which, among other things, reduced Medicare
payments to several providers, including hospitals, and increased the statute of limitations period for the government to recover overpayments
to providers from three to five years. More recently, on March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, which
eliminates the statutory cap on the Medicaid drug rebate, currently set at 100% of a drug’s AMP, beginning January 1, 2024.
We
expect that future changes or additions to the ACA, the Medicare and Medicaid programs and changes stemming from other healthcare reform
measures, especially with regard to healthcare access, financing or other legislation in individual states, could have a material adverse
effect on the health care industry in the United States.
Over
the past several years there has been heightened governmental scrutiny over the manner in which biopharmaceutical manufacturers set prices
for their marketed products, which has resulted in several U.S. Congressional inquiries and proposed and enacted federal and state legislation
designed to, among other things, bring more transparency to product pricing, review the relationship between pricing and manufacturer
patient programs, and reform government program reimbursement methodologies for drug products. The probability of success of these newly
announced policies, many of which have been subjected to legal challenge in the federal court system, and their potential impact on the
U.S. prescription drug marketplace is unknown. There are likely to be continued political and legal challenges associated with implementing
these reforms as they are currently envisioned. For example, in July 2021, President Biden issued a sweeping executive order on promoting
competition in the American economy that included several mandates pertaining to the pharmaceutical and health care insurance industries
and called on HHS to release a comprehensive plan to combat high prescription drug prices. The drug pricing plan released by HHS in September
2021 in response to the executive order makes clear that the Biden Administration supports aggressive action to address rising drug prices,
including allowing HHS to negotiate the cost of Medicare Part B and D drugs, but such significant changes will require either new legislation
to be passed by Congress or time-consuming administrative actions.
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There
have been several Congressional inquiries and proposed bills designed to, among other things, bring more transparency to product pricing,
review the relationship between pricing and manufacturer patient programs, and reform government program reimbursement methodologies
for drug products. Most recently, in August 2022, President Biden signed into law the Inflation Reduction Act of 2022, or the IRA. Among
other things, the IRA has multiple provisions that may impact the prices of drug products that are both sold into the Medicare program
and throughout the United States. Starting in 2023, a manufacturer of a drug or biological product covered by Medicare Parts B or D must
pay a rebate to the federal government if the product’s price increases faster than the rate of inflation. This calculation is
made on a drug product by drug product basis and the amount of the rebate owed to the federal government is directly dependent on the
volume of a drug product that is paid for by Medicare Parts B or D. Additionally, starting in payment year 2026, CMS will negotiate drug
prices annually for a select number of single source Part D drugs without generic or biosimilar competition. CMS will also negotiate
drug prices for a select number of Part B drugs starting for payment year 2028. If a drug product is selected by CMS for negotiation,
it is expected that the revenue generated from such drug will decrease. Additional state and federal health care reform measures are
expected to be adopted in the future, any of which could limit the amounts that federal and state governments will pay for health care
products and services, which could result in reduced demand for certain biopharmaceutical products or additional pricing pressures. The
IRA permits the Secretary of the Department of Health and Human Services (HHS) to implement many of these provisions through guidance,
as opposed to regulation, for the initial years. For that and other reasons, it is currently unclear how the IRA will be effectuated.
In
addition to the IRA’s drug price negotiation provisions, President Biden’s Executive Order 14087, issued in October 2022,
called for the CMS Innovation Center to prepare and submit a report to the White House on potential payment and delivery modes that would
complement to IRA, lower drug costs, and promote access to innovative drugs. In February 2023, CMS published its report which described
three potential models focusing on affordability, accessibility and feasibility of implementation for further testing by the CMS Innovation
Center. On his first day in office, President Donald Trump repealed Executive Order 14087, which introduces uncertainty in federal drug
pricing strategies.
Individual
states in the United States have increasingly passed legislation and implemented regulations designed to control pharmaceutical product
pricing, including price or patient reimbursement constraints, discounts, restrictions on certain product access, marketing cost disclosure
and other transparency measures, and, in some cases, measures designed to encourage importation from other countries and bulk purchasing.
In addition, regional healthcare authorities and individual hospitals are increasingly using bidding procedures to determine what pharmaceutical
products and which suppliers will be included in their prescription drug and other healthcare programs. Furthermore, there has been increased
interest by third party payors and governmental authorities in reference pricing systems and publication of discounts and list prices.
These reforms could reduce the ultimate demand for our products, if approved, or put pressure on our product pricing, which could negatively
affect our business, results of operations, financial condition and prospects. The effects of these efforts remain uncertain pending
the outcomes of several federal lawsuits challenging state authority to regulate prescription drug payment limits.
In
December 2020, the U.S. Supreme Court also held unanimously that federal law does not preempt the states’ ability to regulate pharmaceutical
benefit managers, or PBMs, and other members of the healthcare and pharmaceutical supply chain, an important decision that appears to
be leading to further and more aggressive efforts by states in this area. The Federal Trade Commission in mid-2022 also launched sweeping
investigations into the practices of the PBM industry that could lead to additional federal and state legislative or regulatory proposals
targeting such entities’ operations, pharmacy networks, or financial arrangements. Significant efforts to change the PBM industry
as it currently exists in the United States may affect the entire pharmaceutical supply chain and the business of other stakeholders,
including biopharmaceutical developers like us. Legally mandated price controls on payment amounts by third-party payors or other restrictions
could harm our business, results of operations, financial condition and prospects. In addition, regional healthcare authorities and individual
hospitals are increasingly using bidding procedures to determine what pharmaceutical products and which suppliers will be included in
their prescription drug and other healthcare programs. This could reduce the ultimate demand for our product candidate, if approved,
or put pressure on our product pricing, which could negatively affect our business, results of operations, financial condition and prospects.
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In
the European Union, similar political, economic and regulatory developments may affect our ability to profitably commercialize our products.
In addition to continuing pressure on prices and cost containment measures, legislative developments at the European Union or EU member
state level may result in significant additional requirements or obstacles that may increase our operating costs.
We
cannot predict the likelihood, nature or extent of government regulation that may arise from future legislation or administrative or
executive action. We expect that additional federal and state health care reform measures will be adopted in the future, any of which
could limit the amounts that federal and state governments will pay for health care products and services, which could result in limited
coverage and reimbursement and reduced demand for our products, once approved, or additional pricing pressures.
We
may be subject, directly or indirectly, to federal and state healthcare fraud and abuse laws, false claims laws, and health information
privacy and security laws. If we are unable to comply, or have not fully complied with such laws, we could face substantial penalties.
If
we obtain FDA approval for plogo and begin commercializing those products in the United States, our operations may be subject to various
federal and state fraud and abuse laws, including, without limitation, the federal Anti-Kickback Statute, the federal False Claims Act,
and physician payments sunshine laws and regulations. These laws may impact, among other things, our proposed sales, marketing, and education
programs. In addition, we may be subject to patient privacy regulation by both the federal government and the states in which we conduct
our business. The laws that may affect our ability to operate include:
● The
federal Anti-Kickback Statute, which prohibits, among other things, persons from knowingly
and willfully soliciting, receiving, offering or paying remuneration, directly or indirectly,
to induce, or in return for, the purchase or recommendation of an item or service reimbursable
under a federal healthcare program, such as the Medicare and Medicaid programs;
● Federal
civil and criminal false claims laws and civil monetary penalty laws, which prohibit, among
other things, individuals or entities from knowingly presenting, or causing to be presented,
claims for payment from Medicare, Medicaid, or other government payors that are false or
fraudulent or making a false statement to avoid, decrease or conceal an obligation to pay
money to the federal government;
● The
federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), which created
new federal criminal statutes that prohibit executing a scheme to defraud any healthcare
benefit program and making false statements relating to healthcare matters;
● HIPAA,
as amended by the Health Information Technology and Clinical Health Act, and its implementing
regulations, which imposes specified requirements relating to the privacy, security, and
transmission of individually identifiable health information;
● The
federal physician payments sunshine requirements under the ACA require manufacturers of drugs,
devices, biologics, and medical supplies to report annually to the CMS information related
to payments and other transfers of value to physicians, certain advanced non-physician healthcare
providers, and teaching hospitals, and ownership and investment interests held by physicians
and other healthcare providers and their immediate family members; and
● State
law equivalents of each of the above federal laws, such as anti-kickback and false claims
laws that may apply to items or services reimbursed by any third-party payor, including governmental
and private payors, to comply with the pharmaceutical industry’s voluntary compliance
guidelines and the relevant compliance guidance promulgated by the federal government, or
otherwise restrict payments that may be made to healthcare providers and other potential
referral sources; state laws that require drug manufacturers to report information related
to payments and other transfers of value to physicians and other healthcare providers or
marketing expenditures, and state laws governing the privacy and security of health information
in specified circumstances, many of which differ from each other in significant ways and
may not have the same effect, thus complicating compliance efforts.
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Because
of the breadth of these laws and the narrowness of the statutory exceptions and safe harbors available, it is possible that some of our
business activities could be subject to challenge under one or more such laws. In addition, recent health care reform legislation has
strengthened these laws. For example, the ACA, among other things, amended the intent requirement of the federal anti-kickback and criminal
healthcare fraud statutes. A person or entity no longer needs to have actual knowledge of this statute or specific intent to violate
it. Moreover, the ACA provides that the U.S. government may assert that a claim including items or services resulting from a violation
of the federal anti-kickback statute constitutes a false or fraudulent claim for purposes of the False Claims Act.
If
our operations are found to be in violation of any of the laws described above or any other governmental regulations that apply to us,
we may be subject to penalties, including civil and criminal penalties, damages, fines, exclusion from participation in government health
care programs, such as Medicare and Medicaid, imprisonment, and the curtailment or restructuring of our operations, any of which could
adversely affect our ability to operate our business and our results of operations.
We
may be subject to, or may in the future become subject to, U.S. federal and state, and international laws and regulations imposing obligations
on how we collect, use, disclose, store and process personal information. Our actual or perceived failure to comply with such obligations
could result in liability or reputational harm and could harm our business. Ensuring compliance with such laws could also impair our
efforts to maintain and expand our customer base and thereby decrease our revenue.
In
many activities, including the conduct of clinical trials, we are subject to laws and regulations governing data privacy and the protection
of health-related and other personal information. The regulatory framework for collecting, using, safeguarding, sharing, transferring
and other processing of information worldwide is rapidly evolving and is likely to remain uncertain for the foreseeable future. The withdrawal
of the United Kingdom from the European Union and the subsequent separation of the data protection regimes of these territories means
we are required to comply with separate data protection laws in the European Union and the United Kingdom, which may lead to additional
compliance costs and could increase our overall risk. Similar laws and regulations govern our processing of personal data, including
the collection, access, use, analysis, modification, storage, transfer, security breach notification, destruction and disposal of personal
data. For example, the collection, use, disclosure, transfer, or other processing of personal data regarding individuals in the European
Union, including personal health data, is subject to the General Data Protection Regulation, or GDPR, which took effect across all Member
States of the European Economic Area, or EEA, on May 25, 2018, and as still in effect in the United Kingdom as the UK GDPR.
On
June 28, 2021, the EU Commission adopted decisions on the UK’s adequacy under the EU GDRP, and the UK continues to operate under
this adequacy decision. The GDPR imposed a broad data protection framework that expanded the scope of EU and UK data protection law,
including to non-EU and non-UK entities meeting the jurisdictional requirements that process, or control the processing of personal data
relating to individuals located in the EU or UK, including clinical trial data. The GDPR sets out a number of requirements for controllers
and/or processors, as applicable, that must be complied with when handling the personal data of EU or UK based data subjects, including:
providing expanded disclosures about how their personal data will be used; higher standards for organizations to demonstrate that they
have obtained valid consent or have another legal basis in place to justify their data processing activities; the obligation to appoint
data protection officers in certain circumstances; new rights for individuals to be “forgotten” and rights to data portability,
as well as enhanced current rights (e.g., access requests); the principal of accountability and demonstrating compliance through policies,
procedures, training and audit; and a new mandatory data breach regime. In particular, medical or health data, genetic data and biometric
data are all classified as “special category” data under the GDPR and afford greater protection and require additional compliance
obligations.
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Further,
the UK and EU member states have a broad right to impose additional conditions—including restrictions—on these data categories.
This is because the GDPR allows EU member states to derogate from the requirements of the GDPR mainly in regard to specific processing
situations (including special category data and processing for scientific or statistical purposes). We must comply with laws and regulations
associated with the international transfer of personal data based on the location in which the personal data originates and the location
in which it is processed and/or controlled. Although there are legal mechanisms to facilitate the transfer of personal data from the
UK, EEA, and Switzerland to the United States, the decision of the Court of Justice of the EU (CJEU) that invalidated the safe harbor
framework has increased uncertainty around compliance with EU privacy law requirements. As a result of the decision, it was no longer
possible to rely on safe harbor certification as a legal basis for the transfer of personal data from the European Union to entities
in the United States. However, on July 10, 2023, the European Commission adopted an adequacy decision for a new mechanism for transferring
data from the EU to the United States – the EU-U.S. Data Privacy Framework, which provides EU individuals with several new rights,
including the right to obtain access to their data, or obtain correction or deletion of incorrect or unlawfully handled data. That being
said, we have not yet self-certified under the Data Privacy Framework. The GDPR only permits exports of personal data outside of the
EU to “non-adequate” countries where there is a suitable data transfer mechanism in place to safeguard personal data (e.g.,
the EU Commission approved Standard Contractual Clauses or certification under the newly-adopted Data Privacy Framework).
On
July 16, 2020, the Court of Justice of the EU, or the CJEU, issued a landmark opinion in the case Maximilian Schrems vs. Facebook (Case
C-311/18) (Schrems II). This decision calls into question certain data transfer mechanisms as between the EU member states and the U.S.
The CJEU is the highest court in Europe and the Schrems II decision heightened the burden to assess U.S. national security laws on their
business, and future actions of EU data protection authorities are difficult to predict at this time. While the newly-adopted Data Privacy
Framework was meant to address the concerns raised by the CJEU in Schrems II, it will likely be subject to future legal challenges. Consequently,
there is some risk of any data transfers from the EU being halted. If we have to rely on third parties to carry out services for us,
including processing personal data on our behalf, we are required under GDPR to enter into contractual arrangements to flow down or help
ensure that these third parties only process such data according to our instructions and have sufficient security measures in place.
Any security breach or non-compliance with our contractual terms or breach of applicable law by such third parties could result in enforcement
actions, litigation, fines and penalties or adverse publicity and could cause customers to lose trust in us, which would have an adverse
impact on our reputation and business. Any contractual arrangements requiring the processing of personal data from the EU to us in the
U.S. will require greater scrutiny and assessments as required under Schrems II and may have an adverse impact on cross-border transfers
of personal data or increase costs of compliance. The GDPR provides an enforcement authority to impose large penalties for noncompliance,
including the potential for fines of up to €20 million or 4% of the annual global revenues of the noncompliant company, whichever
is greater. Some customers or other service providers may respond to these evolving laws and regulations by asking us to make certain
privacy or data-related contractual commitments that we are unable or unwilling to make. This could lead to the loss of current or prospective
customers or other business relationships.
The
privacy and security of personally identifiable information stored, maintained, received or transmitted, including electronically, is
subject to significant regulation in the United States and abroad. While we strive to comply with all applicable privacy and security
laws and regulations, legal standards for privacy continue to evolve and any failure or perceived failure to comply may result in proceedings
or actions against us by government entities or others, or could cause reputational harm, which could have a material adverse effect
on our business.
Numerous
foreign, federal and state laws and regulations govern collection, dissemination, use and confidentiality of personally identifiable
health information, including state privacy and confidentiality laws (including state laws requiring disclosure of breaches); federal
and state consumer protection and employment laws; HIPAA; and European and other international data protection laws. These laws and regulations
are increasing in complexity and number, may change frequently and sometimes conflict.
HIPAA,
as amended by the Health Information Technology for Economic and Clinical Health Act (HITECH), establishes a set of U.S. national privacy
and security standards for the protection of individually identifiable health information, including protected health information, or
PHI, by health plans, certain healthcare clearinghouses and healthcare providers that submit certain covered transactions electronically,
or covered entities, and their “business associates,” which are persons or entities that perform certain services for, or
on behalf of, a covered entity that involve creating, receiving, maintaining or transmitting PHI. While we are not currently a covered
entity or business associate under HIPAA, we may receive identifiable information from these entities. Failure to receive this information
properly could subject us to HIPAA’s criminal penalties, which may include fines up to $50,000 per violation and/or imprisonment.
In addition, responding to government investigations regarding alleged violations of these and other laws and regulations, even if ultimately
concluded with no findings of violations or no penalties imposed, can consume company resources and impact our business and, if public,
harm our reputation.
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In
the United States, various federal and state regulators, including governmental agencies like the Federal Trade Commission, have promulgated,
or are considering promulgating, regulations concerning personal information and data security. In addition to fines and penalties imposed
upon violators, some of these state laws also afford private rights of action to individuals who believe their personal information has
been misused. California’s patient privacy laws, for example, provide for penalties of up to $250,000 and permit injured parties
to sue for damages. In addition, The California Consumer Privacy Act (“CCPA”) went into effect January 1, 2020, and is one
of the most restrictive state privacy laws, protecting a wide variety of personal information and granting significant rights to California
residents with respect to their personal information. Regulations under CCPA have been modified several times and continue to be modified.
Additionally, a new privacy law, the California Privacy Rights Act, (“CPRA”) was approved by California voters in the election
of November 3, 2020 and went into effect in January of 2023. The CPRA modified the CCPA significantly, and may result in further uncertainty,
additional costs and expenses stemming from efforts to comply with this law and increases the potential for harm and liability for failure
to comply. Among other things, the CPRA established a new regulatory authority, the California Privacy Protection Agency, which is enacting
new regulations and has expanded enforcement authority. Other states have implemented similar laws protecting identifiable health and
personal information, and most such laws differ from each other in significant ways and may not be preempted by HIPAA, thus complicating
compliance efforts. In addition, various states, such as California, Colorado, Connecticut, New Jersey, Delaware, Utah, Virginia, Oregon,
Indiana, Iowa, Tennessee, Montana, Florida and Texas, have implemented similar privacy laws and regulations.
The
interplay of federal and state laws may be subject to varying interpretations by courts and government agencies, creating complex compliance
issues for us and our clients and potentially exposing us to additional expense, adverse publicity and liability. Further, as regulatory
focus on privacy issues continues to increase and laws and regulations concerning the protection of personal information expand and become
more complex, these potential risks to our business could intensify.
The
legislative and regulatory landscape for privacy and data security continues to evolve, and there has been an increasing focus on privacy
and data security issues which may affect our business. Failure to comply with current and future laws and regulations could result in
government enforcement actions (including the imposition of significant penalties), criminal and civil liability for us and our officers
and directors, private litigation and/or adverse publicity that negatively affects our business.
Defending
against claims relating to improper handling, storage or disposal of hazardous chemical, radioactive or biological materials could be
time consuming and expensive.
Our
research and development involves the controlled use of hazardous materials, including chemicals, radioactive and biological materials
such as chemical solvents, phosphorus and bacteria. In some cases, these hazardous materials and various wastes resulting from their
use will be stored at our contractors or manufacturers’ facilities pending use and disposal. Although we expect that the safety
procedures utilized by our third-party contractors and manufacturers for handling and disposing of these materials will generally comply
with the standards prescribed by these laws and regulations, we cannot guarantee that this will be the case or eliminate the risk of
accidental contamination or injury from these materials. In such an event, we may be held liable for any resulting damages and such liability
could exceed our resources. We do not currently carry biological or hazardous waste insurance coverage and any future property and casualty,
and general liability insurance policies may exclude coverage for damages and fines arising from biological or hazardous waste exposure
or contamination. We cannot eliminate the risk of accidental contamination or discharge and any resultant injury from those materials,
which could cause injury to our employees and others, environmental damage resulting in costly cleanup and liabilities under applicable
laws and regulations governing the use, storage, handling and disposal of these materials and specified waste products. Various laws
and regulations govern the use, manufacture, storage, handling and disposal of hazardous materials. We may be sued for any injury or
contamination that results from our use or the use by third parties of these materials. Compliance with environmental laws and regulations
may be expensive, and current or future environmental regulations may impair our research, development and production efforts.
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Our
business and operations would suffer in the event of system failures.
Despite
the implementation of security measures, our internal computer systems, and those of our CROs and other third parties on which we rely,
are vulnerable to damage from computer viruses, unauthorized access, natural disasters, terrorism, war and telecommunication and electrical
failures. If such an event were to occur and cause interruptions in our operations, it could result in a material disruption of our drug
development programs. For example, the loss of clinical trial data from completed or ongoing or planned clinical trials could result
in delays in our regulatory approval efforts and significantly increase our costs to recover or reproduce the data. To the extent that
any disruption or security breach were to result in a loss of or damage to our data or applications, or inappropriate disclosure of confidential
or proprietary information, we could incur liability and the further development of our product candidate could be delayed.
Risks
Related to Our Business and Financial Condition
We
have a history of operating losses, and we expect to incur losses for the foreseeable future. We may never become profitable. Our stock
is a highly speculative investment.
We
have incurred operating losses in each year since beginning operations in 1996 due to costs incurred in connection with our research
and development activities and selling, general and administrative costs associated with our operations, wed expect to incur significant
losses for the next several years and we may never achieve profitability. As of December 31, 2024 and December 31, 2023, our accumulated
deficit was $439.5 million and $428.3 million, respectively. Our net loss was $11.2 million and $22.5 million for the years ended December
31, 2024 and 2023, respectively. Our drug candidates are in the early- to mid-stages of clinical testing and we must conduct significant
additional clinical trials before we can seek the regulatory approvals necessary to begin commercial sales of our drugs. We expect to
incur continued losses for several years as we continue our research and development of our drug candidates, seek regulatory approvals
and commercialize any approved drugs. If our remaining drug candidate is unsuccessful in clinical trials or we are unable to obtain regulatory
approvals, or if our drugs are unsuccessful in the market, we will not be profitable. If we fail to become and remain profitable, or
if we are unable to fund our continuing losses, particularly in light of the current economic conditions, you could lose all or part
of your investment.
There
is substantial doubt regarding our ability to continue as a going concern. Our ability to raise additional capital in the future may
not be available to us on reasonable terms, if at all, when or as we require additional funding. If we issue additional shares of our
common stock or other securities that may be convertible into, or exercisable or exchangeable for, our common stock, our existing stockholders
would experience further dilution. If we fail to obtain additional funding, we may be unable to complete the development and commercialization
of our lead drug candidates or continue to fund our research and development programs.
We
have funded all of our operations and capital expenditures with proceeds from the issuance of public equity securities, private placements
of our securities, interest on investments, licensing revenue, government grants, research and development tax credits and product revenue.
In order to conduct the lengthy and expensive research, preclinical testing and clinical trials necessary to complete the development
and marketing of our drug candidates, we will require substantial additional funds. We may have insufficient public equity available
for issue to raise the required additional substantial funds to implement our operating plan and we may not be able to obtain the appropriate
stockholder approvals necessary to increase our available public equity for issuance within a time that we may require additional funding.
As
of December 31, 2024, our cash and cash equivalents were $3.1 million. Based on our current operating plan, there is substantial doubt
regarding our ability to continue as a going concern for a period of one year after the date that our financial statements for the year
ended December 31, 2024 are issued. To meet our long-term financing requirements, we may raise funds through public or private equity
offerings, debt financings or strategic alliances.
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Raising
additional funds by issuing equity or convertible debt securities may cause our stockholders to experience substantial dilution in their
ownership interests and new investors may have rights superior to the rights of our other stockholders. To the extent equity valuations,
including the trading price of our common stock, are depressed as a result of economic disruptions or other uncertainties, for example
due to rising inflationary pressures, ongoing military conflicts or other factors, the potential magnitude of this dilution will increase.
Raising additional funds through debt financing, if available, may involve covenants that restrict our business activities and options.
To the extent that we raise additional funds through collaborations and licensing arrangements, we may have to relinquish valuable rights
to our drug discovery and other technologies, research programs or drug candidates, or grant licenses on terms that may not be favorable
to us. Additional funding may not be available to us on favorable terms, or at all, particularly in light of the current economic conditions.
If we are unable to obtain additional funds, we may be forced to delay or terminate our current clinical trials and the development and
marketing of our remaining drug candidate.
Unstable
market and economic conditions may have serious adverse consequences on our business, financial condition and stock price.
Concerns
over energy costs, geopolitical issues, the U.S. mortgage market and a deteriorating real estate market, unstable global credit markets
and financial conditions, and volatile oil prices have led to periods of significant economic instability, diminished liquidity and credit
availability, declines in consumer confidence and discretionary spending, diminished expectations for the global economy and expectations
of slower global economic growth, increased unemployment rates, and increased credit defaults in recent years. Our general business strategy
may be adversely affected by any such economic downturns, volatile business environments and continued unstable or unpredictable economic
and market conditions. There can be no assurance that further deterioration in credit and financial markets and confidence in economic
conditions will not continue to occur. Our general business strategy may be adversely affected by any such economic downturn, volatile
business environment or continued unpredictable and unstable market conditions. If the current financial markets deteriorate, or do not
improve, it may make any necessary financing more difficult, more costly, and more dilutive. Failure to secure any necessary financing
in a timely manner and on favorable terms could have a material adverse effect on our growth strategy, financial performance and stock
price and could require us to delay or abandon clinical development or other operating or strategic plans for our business.
Our
ability to use net operating loss and tax credit carryforwards and certain built-in losses to reduce future tax payments is limited by
provisions of the Internal Revenue Code and may be subject to further limitation as a result of the transactions completed in connection
with our initial public offering.
Under
Section 382 of the Internal Revenue Code of 1986, as amended, if a corporation undergoes an “ownership change” (generally
defined as a greater than 50% change (by value) in its equity ownership over a three-year period), the corporation’s ability to
use its pre-change net operating loss carryforwards and other pre-change tax attributes to offset its post-change income may be limited.
As a result of our most recent private placement and other transactions that have occurred over the past three years, we may have experienced
an “ownership change.” We may also experience ownership changes in the future as a result of subsequent shifts in our stock
ownership. As of December 31, 2024, we had federal and state net operating loss carryforwards of approximately $3.5 million and $16.9
million, respectively. There were no federal or state research and development credits.
Furthermore,
under U.S. tax legislation enacted in December 2017, although the treatment of tax losses generated before December 31, 2017 has generally
not changed, tax losses generated in calendar year 2018 and beyond do not expire but may only offset 80% of our taxable income. This
change may require us to pay federal income taxes in future years despite generating a loss for federal income tax purposes in prior
years.
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Inadequate
funding for the FDA, the SEC and other government agencies could hinder their ability to hire and retain key leadership and other personnel,
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 the operation of our business may rely, which could negatively impact our business.
The
ability of the FDA to review and approve new products can be affected by a variety of factors, including government budget and funding
levels, ability to hire and retain key personnel and accept the payment of user fees, and statutory, regulatory, and policy changes.
Average review times at the agency have fluctuated in recent years as a result. In addition, government funding of the SEC and other
government agencies 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.
Disruptions
at the FDA and other agencies may also slow the time necessary for new drugs to be reviewed and/or approved by necessary government agencies,
which would adversely affect our business. If a prolonged government shutdown occurs, it could significantly impact the ability of the
FDA to timely review and process our regulatory submissions, which could have a material adverse effect on our business. Further, upon
completion of this offering and in our operations as a public company, future government shutdowns could impact our ability to access
the public markets and obtain necessary capital in order to properly capitalize and continue our operations.
Our
employees, independent contractors, principal investigators, contract research organizations, consultants or vendors may engage in misconduct
or other improper activities, including noncompliance with regulatory standards and requirements.
We
are exposed to the risk that our employees, independent contractors, principal investigators, contract research organizations, consultants
or vendors may engage in fraudulent or other illegal activity. Misconduct by these parties could include intentional, reckless and/or
negligent conduct or disclosure of unauthorized activities to us that violates: FDA regulations, including those laws requiring the reporting
of true, complete and accurate information to the FDA; manufacturing standards; federal and state health care fraud and abuse laws and
regulations; or laws that require the true, complete and accurate reporting of financial information or data. In addition, sales, marketing
and business arrangements in the health care industry are subject to extensive laws and regulations intended to prevent fraud, kickbacks,
self-dealing and other abusive practices. These laws and regulations may restrict or prohibit a wide range of pricing, discounting, marketing
and promotion, sales commission, customer incentive programs and other business arrangements. Activities subject to these laws also involve
the improper use or misrepresentation of information obtained in the course of clinical trials or creating fraudulent data in our nonclinical
studies or clinical trials, which could result in regulatory sanctions and serious harm to our reputation.
It
is not always possible to identify and deter misconduct by our employees and other third parties, and the precautions we take to detect
and prevent this activity may not be effective in controlling unknown or unmanaged risks or losses or in protecting us from governmental
investigations or other actions or lawsuits stemming from a failure to be in compliance with such laws or regulations. Additionally,
we are subject to the risk that a person could allege such fraud or other misconduct, even if none occurred. If any such actions are
instituted against us, and we are not successful in defending ourselves or asserting our rights, those actions could have a significant
impact on our business, including the imposition of civil, criminal and administrative penalties, damages, monetary fines, possible exclusion
from participation in Medicare, Medicaid and other federal health care programs, contractual damages, reputational harm, diminished potential
profits and future earnings, and curtailment of our operations, any of which could adversely affect our business, financial condition,
results of operations or prospects.
If
we are unable to compete successfully in our marketplace, it will harm our business.
There
are existing products in the marketplace that compete with our products. Companies may develop new products that compete with our products.
Certain competitors and potential competitors have longer operating histories, substantially greater product development capabilities
and financial, scientific, marketing and sales resources. Competitors and potential competitors may also develop products that are safer,
more effective or have other potential advantages compared to our products. In addition, research, development and commercialization
efforts by others could render our products obsolete or non-competitive. Certain competitors and potential competitors have broader product
offerings and extensive customer bases, allowing them to adopt aggressive pricing policies that would enable them to gain market share.
Competitive pressure could result in price reductions, reduced margins and loss of market share. We could encounter potential customers
that, due to existing relationships with our competitors, are committed to products offered by those competitors. As a result, those
potential customers may not consider purchasing our products.
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We
are at an early stage of development as a company and we do not have, and may never have, any products that generate significant revenues.
We
are at an early stage of development as a company and have a limited operating history on which to evaluate our business and prospects.
We cannot guarantee that our sole product candidate currently in development will ever become marketable. We must demonstrate that our
drug candidate satisfies rigorous standards of safety and efficacy for their intended uses before the FDA, EMA and other regulatory authorities
in the United States, the European Union and elsewhere. Significant additional research, preclinical testing and clinical testing is
required before we can file applications with the FDA or EMA for approval of plogo or any of our future drug candidates. In addition,
to compete effectively, our drugs must be easy to administer, cost-effective and economical to manufacture on a commercial scale. We
may not achieve any of these objectives. We cannot be certain that the clinical development of our drug candidates in preclinical testing
or clinical development will be successful, that we will receive regulatory approvals required to commercialize them or that any of our
other research and drug discovery programs will yield a drug candidate suitable for investigation through clinical trials. Our commercial
revenues from our product candidate currently in development, if any, will be derived from sales of drugs that will not become marketable
for several years, if at all.
If
we fail to comply with the continued listing requirements of the Nasdaq Capital Market, our common stock may be delisted and the price
of our common stock and our ability to access the capital markets could be negatively impacted.
Our
common stock is currently listed for trading on the Nasdaq Capital Market (“Nasdaq”). We must satisfy Nasdaq’s continued
listing requirements, including, among other things, a minimum stockholders’ equity of $2.5 million and a minimum bid price
for our common stock of $1.00 per share, or risk delisting, which would have a material adverse effect on our business. In order
to maintain our listing, we must also maintain continued business operations so that we are not characterized as a “public shell
company.”
A
delisting of our common stock from the Nasdaq Capital Market could materially reduce the liquidity of our common stock and result in
a corresponding material reduction in the price of our common stock. In addition, delisting could harm our ability to raise capital through
alternative financing sources on terms acceptable to us, or at all, and may result in the potential loss of confidence by investors,
suppliers, customers and employees and fewer business development opportunities.
We
effected a 15:1 reverse stock split of our common stock on December 18, 2023 (the “Reverse Stock Split”), which enabled us
to regain compliance with Nasdaq’s minimum bid price requirements.
On
February 25, 2025, Nasdaq notified the Company that it has regained compliance with the equity requirement in Listing Rule 5550(b)(1)
(the “Equity Rule”), as required by the Nasdaq Hearing Panel’s decision dated October 22, 2024. As previously reported
by the Company on Form 8-K, filed with the SEC on October 24, 2024, on October 15, 2024, the Company met with the Nasdaq Hearings Panel
regarding its potential delisting from Nasdaq as a result of its non-compliance with the Equity Rule. On October 22, 2024, the Company
received the Nasdaq Hearings Panel decision which granted the Company until December 24, 2024 to regain compliance with the Equity Rule.
Following the Company’s regaining compliance with the Equity Rule pursuant to the February 25, 2025, the Company will be subject
to a Mandatory Panel Monitor for a period of one year from February 25, 2025 pursuant to Listing Rule 5815(d)(4)(B).
Notwithstanding
the Reverse Stock Split and our compliance with the Equity Rule, we cannot be sure that our share price will continue to comply with
the requirements for continued listing of our common stock on the Nasdaq Capital Market in the future, or that we will continue to comply
with the other continued listing requirements. If our shares of common stock lose their status on the Nasdaq Capital Market, we believe
that our shares of common stock would likely be eligible to be quoted on the inter-dealer electronic quotation and trading system operated
by Pink OTC Markets Inc., commonly referred to as the Pink Sheets and now known as the OTCQB market. Our shares of common stock may also
be quoted on the Over-the-Counter Bulletin Board, an electronic quotation service maintained by the Financial Industry Regulatory Authority.
These markets are generally not considered to be as efficient as, and not as broad as, the Nasdaq Capital Market. Selling our shares
of common stock on these markets could be more difficult because smaller quantities of shares would likely be bought and sold, and transactions
could be delayed. In addition, in the event our shares of common stock are delisted, broker-dealers have certain regulatory burdens imposed
upon them, which may discourage broker-dealers from effecting transactions in our common stock, further limiting the liquidity of our
common stock. These factors could result in lower prices and larger spreads in the bid and ask prices for our common stock.
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To
the extent we elect to fund the development of a drug candidate or the commercialization of a drug at our expense, we will need substantial
additional funding.
We
plan to market drugs on our own, with or without a partner, that can be effectively commercialized and sold in concentrated markets that
do not require a large sales force to be competitive. To achieve this goal, we will need to establish our own specialized sales force,
marketing organization and supporting distribution capabilities. The development and commercialization of our drug candidates is very
expensive. To the extent we elect to fund the full development of a drug candidate or the commercialization of a drug at our expense,
we will need to raise substantial additional funding to:
● fund
research and development and clinical trials connected with our research;
● fund
clinical trials and seek regulatory approvals;
● build
or access manufacturing and commercialization capabilities;
● implement
additional internal control systems and infrastructure;
● commercialize
and secure coverage, payment and reimbursement of our drug candidates, if any such candidates
receive regulatory approval;
● maintain,
defend and expand the scope of our intellectual property; and
● hire
additional management, sales and scientific personnel.
Our
future funding requirements will depend on many factors, including:
● the
scope, rate of progress and cost of our clinical trials and other research and development
activities;
● the
costs and timing of seeking and obtaining regulatory approvals;
● the
costs of filing, prosecuting, defending and enforcing any patent claims and other intellectual
property rights;
● the
costs associated with establishing sales and marketing capabilities;
● the
costs of acquiring or investing in businesses, products and technologies;
● the
effect of competing technological and market developments; and
● the
payment, other terms and timing of any strategic alliance, licensing or other arrangements
that we may establish.
If
we are not able to secure additional funding when needed, especially in light of the current economic conditions and financial market
turmoil, we may have to delay, reduce the scope of or eliminate one or more of our clinical trials or research and development programs
or future commercialization efforts.
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Our
insurance policies are expensive and only protect us from some business risks, which will leave us exposed to significant uninsured liabilities.
We
do not carry insurance for all categories of risk that our business may encounter. Some of the policies we currently maintain include
property, general liability, employment benefits liability, workers’ compensation, products liability and clinical trials (U.S.
and foreign), and directors’ and officers’, employment practices and fiduciary liability insurance. We do not know, however,
if we will be able to maintain insurance with adequate levels of coverage. Any significant uninsured liability may require us to pay
substantial amounts, which would adversely affect our financial position and results of operations.
Funding
constraints may negatively impact our research and development, forcing us to delay our efforts to develop Plogo, which may prevent us
from commercializing our product candidate as quickly as possible.
Research
and development is an expensive process. As part of our operating plan, we have decided to concentrate our clinical development strategy
on our single remaining product candidate, Plogo, an ongoing, hemato-oncology clinical program in transcriptional regulation and mitosis
control biology, which include our areas of historical expertise in PLK inhibitor. Because we have to prioritize our development candidate
as a result of budget constraints, we may not be able to fully realize the value of our product candidate in a timely manner, if at all.
We
are exposed to risks related to foreign currency exchange rates.
Some
of our costs and expenses are denominated in foreign currencies. Most of our foreign expenses are associated with our research and development
expenditures, including the operating costs of our United Kingdom-based wholly owned subsidiary. When the United States dollar weakens
against the British pound or the Euro, the United States dollar value of the foreign currency denominated expense increases, and when
the United States dollar strengthens against the British pound or the Euro, the United States dollar value of the foreign currency denominated
expense decreases. Consequently, changes in exchange rates, and in particular a weakening of the United States dollar, may adversely
affect our results of operations.
Security
incidents, loss of data and other disruptions could compromise sensitive information related to our business or prevent us from accessing
critical information and expose us to liability, which could adversely affect our business and our reputation. Our business and operations
would suffer in the event of system failures.
In
the ordinary course of our business, we collect and store sensitive data, intellectual property and proprietary business information
owned or controlled by ourselves or our customers. This data encompasses a wide variety of business-critical information including research
and development information, commercial information, and business and financial information. We face four primary risks related to protecting
this critical information: loss of access; unauthorized disclosure; unauthorized modification; and inadequate monitoring of our controls
over the first three risks.
We
utilize information technology, or IT, systems and networks to process, transmit and store electronic information in connection with
our business activities. The secure processing, storage, maintenance, and transmission of this critical information is vital to our operations
and business strategy, and we devote significant resources to protecting such information. As use of digital technologies has increased,
cyber incidents, including deliberate attacks and attempts to gain unauthorized access to computer systems and networks, have increased
in frequency and sophistication. These threats pose a risk to the security of our systems and networks and the confidentiality, availability
and integrity of our data. There can be no assurance that we will be successful in preventing cybersecurity incidents or successfully
mitigating their effects.
Despite
the implementation of security measures, our internal and cloud-based computer systems and those of our contractors and consultants are
vulnerable to damage from such cybersecurity incidents, including computer viruses, social engineering, unauthorized access, natural
disasters, terrorism, war and telecommunication and electrical failures. Such an event could cause interruption of our operations. For
example, the loss of data from ongoing or completed clinical trials for our product candidate could result in delays in our regulatory
approval efforts and significantly increase our costs. In addition, there can be no assurance that we will promptly detect any such disruption
or security breach, if at all. To the extent that any disruption or security breach were to result in a loss of or damage to our data,
or inappropriate disclosure of confidential or proprietary information, we could suffer material legal claims and liability, damage to
our reputation, suffer loss or harm to our intellectual property rights and the further research, development and commercial efforts
of our products and product candidate could be delayed. The loss of drug development or clinical trial data could result in delays in
our regulatory approval efforts and significantly increase our costs to recover or reproduce the data and could adversely impact our
business and operations, and could result in financial, legal, operational or reputational harm to us, loss of competitive advantage
or loss of consumer confidence.
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Risks
Related to our Reliance on Third Parties
We
rely, and expect to continue to rely, on third parties to conduct some aspects of our product formulation, research, preclinical, and
clinical studies, and those third parties may not perform satisfactorily, including by failing to meet deadlines for the completion of
such formulation, research or testing.
We
have relied upon and plan to continue to rely upon third parties, including independent clinical investigators, contracted laboratories
and third-party CROs, to conduct our preclinical studies and clinical trials, as well as certain product candidate discovery and development
activities, in accordance with applicable regulatory requirements and to monitor and manage data for our ongoing preclinical and clinical
programs. We rely on these parties for execution of our preclinical studies and clinical trials, and control only certain aspects of
their activities. Nevertheless, we are responsible for ensuring that each of our studies and trials is conducted in accordance with the
applicable protocol, legal and regulatory requirements and scientific standards, and our reliance on these third parties does not relieve
us of our regulatory responsibilities. We and our third-party contractors and CROs are required to comply with GLP and GCP requirements,
as applicable, which are regulations and guidelines enforced by the FDA, the EMA and other comparable foreign regulatory authorities
for all of our products in clinical development. Regulatory authorities enforce these GLP and GCP regulations through periodic inspections
of laboratories conducting GLP studies, and clinical trial sponsors, principal investigators, CROs, and trial sites when auditing for
GCP compliance. If we, our investigators or any of our CROs or contracted laboratories fail to comply with applicable GLP and GCP regulations,
as applicable, the data generated in our preclinical studies and clinical trials may be deemed unreliable and the FDA, the EMA or other
comparable foreign regulatory authorities may require us to perform additional preclinical studies or clinical trials before approving
our marketing applications for our therapeutic product candidates. We cannot assure you that upon inspection by a given regulatory authority,
such regulatory authority will determine that any of our preclinical studies or clinical trials comply with applicable GLP or GCP regulations.
In addition, our clinical trials must be conducted with product manufactured in compliance with applicable cGMP regulations. Our failure
to comply with these regulations may require us to repeat preclinical studies or clinical trials, which would delay the regulatory approval
process.
Further,
these laboratories, investigators and CROs are not our employees, and we will not be able to control, other than by contract, the amount
of resources, including time which they devote to plogo or and of our future product candidate and clinical trials. If independent laboratories,
investigators or CROs fail to devote sufficient resources to the development of our product candidate, or if their performance is substandard,
it may delay or compromise the prospects for approval and commercialization of plogo or any future product candidates that we develop.
In addition, the use of third-party service providers requires us to disclose our proprietary information to these parties, which could
increase the risk that this information will be misappropriated.
There
is a limited number of third-party service providers that specialize or have the expertise required to achieve our business objectives.
If any of our relationships with these third-party laboratories, CROs or clinical investigators terminate, we may not be able to enter
into arrangements with alternative laboratories, CROs or investigators or to do so in a timely manner or on commercially reasonable terms.
If laboratories, CROs or clinical investigators do not successfully carry out their contractual duties or obligations or meet expected
deadlines, if they need to be replaced or if the quality or accuracy of the clinical data they obtain is compromised due to the failure
to adhere to our preclinical or clinical protocols, regulatory requirements or for other reasons, our preclinical studies or clinical
trials may be extended, delayed or terminated and we may not be able to obtain regulatory approval for or successfully commercialize
our product candidate. As a result, our results of operations and the commercial prospects for our product candidate would be harmed,
our costs could increase and our ability to generate revenues could be delayed.
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Switching
or adding additional laboratories or CROs (or investigators) involves additional costs and requires management time and focus. In addition,
there is a natural transition period when a new laboratory or CRO commences work. As a result, delays occur, which can materially impact
our ability to meet our desired clinical development timelines. Though we carefully manage our relationships with our contracted laboratories
and CROs, there can be no assurance that we will not encounter similar challenges or delays in the future or that these delays or challenges
will not have a material adverse impact on our business, financial condition and results of operations.
In
addition, clinical investigators may serve as scientific advisors or consultants to us from time to time and may receive cash compensation
in connection with such services. If these relationships and any related compensation result in perceived or actual conflicts of interest,
or the FDA concludes that the financial relationship may have affected the interpretation of the preclinical study or clinical trial,
the integrity of the data generated at the applicable preclinical study or clinical trial site may be questioned and the utility of the
preclinical study or clinical trial itself may be jeopardized, which could result in the delay or rejection by the FDA. Any such delay
or rejection could prevent us from commercializing our clinical-stage product candidate or any future therapeutic product candidates
it may develop.
We
rely on third-party supply and manufacturing partners for drug supplies for our late-stage clinical activities and may do the same for
any commercial supplies of our product candidate.
We
rely on third-party contract manufacturing organizations, or CMOs, for our preclinical and future clinical trial product materials and
commercial supplies. We do not intend to produce any meaningful quantity of plogo or any of our future product candidates for preclinical
and clinical development through our internal resources, and we do not currently own manufacturing facilities for producing such supplies.
While we intend to try to avoid sole-source arrangements with any of our manufacturing, supply and testing vendors, it may not always
be possible to do so. We cannot assure you that our preclinical or future clinical development product supplies and commercial supplies
will not be limited or interrupted, especially with respect to any sole source third-party manufacturing and supply partners or will
be of satisfactory quality or continue to be available at acceptable prices. In particular, any replacement of our manufacturers could
require significant effort and expertise because there may be a limited number of qualified replacements.
In
complying with the manufacturing regulations of the FDA and other comparable foreign regulatory authorities, we and our third-party suppliers
must spend significant time, money and effort in the areas of design and development, testing, production, record-keeping and quality
control to assure that the products meet applicable specifications and other regulatory requirements. Suppliers and manufacturers must
meet applicable manufacturing requirements and undergo rigorous facility and process validation tests required by regulatory authorities
in order to comply with regulatory standards, such as cGMP. Although our agreements with our CMOs require them to perform according to
certain cGMP requirements such as those relating to quality control, quality assurance and qualified personnel, we cannot control the
conduct of our CMOs to implement and maintain these standards. In the event that any of our current or future manufacturers fails to
comply with such requirements or to perform its obligations to us in relation to quality, timing or otherwise, or if our supply of components
or other materials becomes limited or interrupted for other reasons, we may be forced to manufacture the materials ourselves, for which
we currently do not have the capabilities or resources, or enter into an agreement with another third party, which we may not be able
to do on commercially reasonable terms, or at all. In some cases, the technical skills or technology required to manufacture our future
product candidates may be unique or proprietary to the original manufacturer and we may have difficulty transferring such skills or technology
to another third party and a feasible alternative may not exist. These factors would increase our reliance on such manufacturer or require
us to obtain a license from such manufacturer in order to have another third party manufacture our product candidate. If we are required
to change manufacturers for any reason, we will be required to verify that the new manufacturer maintains facilities and procedures that
comply with quality standards and with all applicable regulations and guidelines. The delays associated with the verification of a new
manufacturer could negatively affect our ability to develop product candidate in a timely manner or within budget.
In
addition, our CMOs are subject to inspection and approval by regulatory authorities before we can commence the manufacture and sale of
any of plogo and thereafter are subject to ongoing inspection from time to time. Our CMOs may not be able to comply with applicable cGMP
regulations or similar regulatory requirements outside of the United States. Our failure, or the failure of our third-party manufacturers,
to comply with applicable regulations could result in regulatory actions, such as the issuance of FDA Form 483 notices of observations,
warning letters or sanctions being imposed on us, including clinical holds, fines, injunctions, civil penalties, delays, suspension or
withdrawal of approvals, license revocation, seizures or recalls of product candidates or drugs, operating restrictions and criminal
prosecutions, any of which could significantly and adversely affect supplies of our products. Any such failure by us or any of our CMOs
would significantly impact our ability to develop, obtain regulatory approval for or, if approved, market our product candidate.
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We
may rely on third-party manufacturers if we receive regulatory approval for any product candidate. To the extent that we have existing,
or enter into future, manufacturing arrangements with third parties, we will depend on these third parties to perform their obligations
in a timely manner consistent with contractual and regulatory requirements, including those related to quality control and assurance.
If we are unable to obtain or maintain third-party manufacturing for product candidate, or to do so on commercially reasonable terms,
we may not be able to develop and commercialize our product candidate successfully. Our or a third-party’s failure to execute our
manufacturing requirements could adversely affect our business in a number of ways, including:
● an
inability to initiate or continue clinical trials of plogo under development, which may impact
our potential economic benefits;
● delay
in submitting regulatory applications, or receiving regulatory approvals, for plogo or any
future product candidate;
● loss
of the cooperation of a collaborator;
● subjecting
plogo or any future of our product candidate to additional inspections by regulatory authorities;
● requirements
to cease distribution or to recall batches of plogo or any future of our product candidate;
and
● in
the event of approval to market and commercialize plogo or any future product candidate,
an inability to meet commercial demands for our products.
If
we fail to enter into and maintain successful strategic alliances for our drug candidates, we may have to reduce or delay our drug candidate
development or increase our expenditures.
An
important element of our strategy for developing, manufacturing and commercializing our drug candidates is entering into strategic alliances
with pharmaceutical companies, research institutions or other industry participants to advance our programs and enable us to maintain
our financial and operational capacity.
We
face significant competition in seeking appropriate alliances. We may not be able to negotiate alliances on acceptable terms, if at all.
In addition, these alliances may be unsuccessful. If we fail to create and maintain suitable alliances, we may have to limit the size
or scope of, or delay, one or more of our drug development or research programs. If we elect to fund drug development or research programs
on our own, we will have to increase our expenditure and will need to obtain additional funding, which may be unavailable or available
only on unfavorable terms.
To
the extent we are able to enter into strategic transactions, we will be exposed to risks related to those collaborations and alliances.
We
expect to enter into strategic transactions to complete the development and commercialization of some of our drug candidates, including
but not limited to after the Phase 2 stage of clinical testing. These arrangements may place the development of our drug candidates outside
our control, may require us to relinquish important rights, or may otherwise be on terms unfavorable to us.
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Dependence
on collaborative arrangements or strategic alliances will subject us to a number of risks, including the risks that:
● we
may not be able to control the amount and timing of resources that our collaborators may
devote to the drug candidates;
● our
collaborators may experience financial difficulties;
● we
may be required to relinquish important rights such as marketing and distribution rights;
● business
combinations or significant changes in a collaborator’s business strategy may also
adversely affect a collaborator’s willingness or ability to complete its obligations
under any arrangement;
● a
collaborator could independently move forward with a competing drug candidate developed either
independently or in collaboration with others, including our competitors; and
● collaborative
arrangements are often terminated or allowed to expire, which would delay development and
may increase the cost of developing our drug candidates.
Risks
Related to our Intellectual Property
If
we fail to enforce adequately or defend our intellectual property rights, our business may be harmed.
Our
commercial success depends in large part on obtaining and maintaining patent and trade secret protection for our drug candidates, the
methods used to manufacture those drug candidates and the methods for treating patients using those drug candidates.
Our
ability to obtain patents is uncertain because legal means afford only limited protections and may not adequately protect our rights
or permit us to gain or keep any competitive advantage. Some legal principles remain unresolved and the breadth or interpretation of
claims allowed in patents in the United States, the European Union or elsewhere can still be difficult to ascertain or predict. In addition,
the specific content of patents and patent applications that are necessary to support and interpret patent claims is highly uncertain
due to the complex nature of the relevant legal, scientific and factual issues. Changes in either patent laws or in interpretations of
patent laws in the United States, the European Union or elsewhere may diminish the value of our intellectual property or narrow the scope
of our patent protection. Our existing patents and any future patents we obtain may not be sufficiently broad to prevent others from
practicing our technologies or from developing competing products and technologies. In addition, we generally do not control the patent
prosecution of subject matter that we license from others and have not controlled the earlier stages of the patent prosecution. Accordingly,
we are unable to exercise the same degree of control over this intellectual property as we would over our own.
Even
if patents are issued regarding our drug candidates or methods of using them, those patents can be challenged by our competitors who
may argue such patents are invalid and/or unenforceable. Patents also will not protect our drug candidates if competitors devise ways
of making or using plogo or any future of our product candidates without legally infringing our patents. The FDA and FDA regulations
and policies and equivalents in other jurisdictions provide incentives to manufacturers to challenge patent validity or create modified,
non-infringing versions of a drug in order to facilitate the approval of abbreviated new drug applications for generic substitutes. These
same types of incentives encourage manufacturers to submit NDAs that rely on literature and clinical data not prepared for or by the
drug sponsor.
Proprietary
trade secrets and unpatented know-how are also very important to our business. We rely on trade secrets to protect our technology, especially
where we do not believe that patent protection is appropriate or obtainable. However, trade secrets are difficult to protect. Our employees,
consultants, contractors, outside scientific collaborators and other advisors may unintentionally or willfully disclose our confidential
information to competitors, and confidentiality agreements may not provide an adequate remedy in the event of unauthorized disclosure
of confidential information. Enforcing a claim that a third-party obtained illegally and is using trade secrets is expensive and time
consuming, and the outcome is unpredictable. Moreover, our competitors may independently develop equivalent knowledge, methods and know-how.
Failure to obtain or maintain trade secret protection could adversely affect our competitive business position.
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If
we do not obtain protection under the Hatch-Waxman Act and similar legislation outside of the United States by extending the patent terms
and obtaining data exclusivity for our product candidate, our business may be materially harmed.
Depending
upon the timing, duration and specifics of FDA marketing approval of our product candidate, if any, one or more of our United States
patents may be eligible for limited patent term extension under the Drug Price Competition and Patent Term Restoration Act of 1984, referred
to as the Hatch-Waxman Act. The Hatch-Waxman Act permits a patent term extension of up to five years as compensation for patent term
lost during product development and the FDA regulatory review process. However, we may not be granted an extension because, for example,
of failing to apply within applicable deadlines, failing to apply prior to expiration of relevant patents or otherwise failing to satisfy
applicable requirements. Moreover, the applicable time period or the scope of patent protection afforded could be less than we request.
If we are unable to obtain patent term extension or the term of any such extension is less than what we request, the period during which
we will have the right to exclusively market our product will be shortened and our competitors may obtain approval of competing products
following our patent expiration, and our revenue could be reduced, possibly materially.
We
may be subject to damages resulting from claims that our employees or we have wrongfully used or disclosed alleged trade secrets of former
employers.
Many
of our employees were previously employed at universities or other biotechnology or pharmaceutical companies, including our competitors
or potential competitors. Although no claims against us are currently pending, 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 their former employers. Litigation
may be necessary to defend against these claims. If we fail in defending such claims, in addition to paying monetary damages, we may
lose valuable intellectual property rights or personnel. A loss of key research personnel or their work product could hamper or prevent
our ability to commercialize certain potential drugs, which could severely harm our business. Even if we are successful in defending
against these claims, litigation could result in substantial costs and be a distraction to management.
Confidentiality
agreements with employees and others may not adequately prevent disclosure of our trade secrets and other proprietary information and
may not adequately protect our intellectual property, which could limit our ability to compete.
Because
we operate in the highly technical field of drug discovery and development of small molecule drugs, we rely in part on trade secret protection
in order to protect our proprietary technology and processes. However, trade secrets are difficult to protect. We enter into confidentiality
and intellectual property assignment agreements with our corporate partners, employees, consultants, outside scientific collaborators,
sponsored researchers, and other advisors. These agreements generally require that the other party keep confidential and not disclose
to third parties all confidential information developed by the party or made known to the party by us during the course of the party’s
relationship with us. These agreements also generally provide that inventions conceived by the party in the course of rendering services
to us will be our exclusive property. However, these agreements may not be honored and may not effectively assign intellectual property
rights to us. Enforcing a claim that a party illegally obtained and is using our trade secrets is difficult, expensive and time consuming,
and the outcome is unpredictable. In addition, courts outside the United States may be less willing to protect trade secrets. The failure
to obtain or maintain trade secret protection could adversely affect our competitive position.
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Intellectual
property rights of third parties may increase our costs or delay or prevent us from being able to commercialize our drug candidates.
There
is a risk that we are infringing or will infringe on the proprietary rights of third parties because patents and pending applications
belonging to third parties exist in the United States, the European Union and elsewhere in the world in the areas of our research. Others
might have been the first to make the inventions covered by each of our or our licensors’ pending patent applications and issued
patents and might have been the first to file patent applications for these inventions. We are aware of several published patent applications,
and understand that others may exist, that could support claims that, if granted and held valid, could cover various aspects of our developmental
programs, including in some cases particular uses of our drug candidate, plogo, or substances, processes and techniques that we use in
the course of our research and development and manufacturing processes. We are aware that other patents exist that claim substances,
processes, techniques and methods of use, which, if held valid, could potentially restrict the scope of our research, development or
manufacturing operations. In addition, we understand that other applications and patents exist relating to potential uses of plogo that
are not part of our current clinical programs for these compounds. Numerous third-party United States and foreign issued patents and
pending applications exist in the area of kinases, including PLK for which we have a research program. For example, some pending patent
applications contain broad claims that could represent freedom to operate limitations for some of our kinase programs should they be
issued unchanged. Although we intend to continue to monitor these applications, we cannot predict what claims will ultimately be allowed
and if allowed what their scope would be. In addition, because the patent application process can take several years to complete, there
may be currently pending applications, unknown to us, which may later result in issued patents that cover the production, manufacture,
commercialization or use of our drug candidates. If we wish to use the technology or compound claimed in issued and unexpired patents
owned by others, we will need to obtain a license from the owner, enter into litigation to challenge the validity of the patents or incur
the risk of litigation in the event that the owner asserts that we infringe its patents. In one case we have opposed a European patent
relating to human aurora kinase and the patent was finally revoked (with no appeal filed).
There
has been substantial litigation and other proceedings regarding patent and other intellectual property rights in the pharmaceutical and
biotechnology industries. Defending against third party claims, including litigation in particular, would be costly and time-consuming
and would divert management’s attention from our business, which could lead to delays in our development or commercialization efforts.
If third parties are successful in their claims, we might have to pay substantial damages or take other actions that are adverse to our
business. As a result of intellectual property infringement claims, or to avoid potential claims, we might:
● be
prohibited from selling or licensing any product that we may develop unless the patent holder
licenses the patent to us, which it is not required to do;
● be
required to pay substantial royalties or grant a cross license to our patents to another
patent holder; decide to locate some of our research, development or manufacturing operations
outside of Europe or the United States;
● be
required to pay substantial damages for past infringement, which we may have to pay if a
court determines that our product candidate or technologies infringe a competitor’s
patent or other proprietary rights; or
● be
required to redesign the manufacturing process or formulation of a drug candidate so it does
not infringe, which may not be possible or could require substantial funds and time.
We
may incur substantial costs as a result of litigation or other proceedings relating to patent and other intellectual property rights.
If
we choose to go to court to stop another party from using the inventions claimed in any patents we obtain, that individual or company
has the right to ask the court to rule that such patents are invalid or should not be enforced against that third party. These lawsuits
are expensive and would consume time and resources and divert the attention of managerial and scientific personnel even if we were successful
in stopping the infringement of such patents. In addition, there is a risk that the court will decide that such patents are not valid
and that we do not have the right to stop the other party from using the inventions.
There
is also a risk that, even if the validity of such patents is upheld, the court will refuse to stop the other party on the ground that
such other party’s activities do not infringe our rights to such patents. In addition, the United States Supreme Court has recently
modified some tests used by the United States Patent and Trademark Office (“ USPTO”), in granting patents over the past 20
years, which may decrease the likelihood that we will be able to obtain patents and increase the likelihood of challenge of any patents
we obtain or license.
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Obtaining
and maintaining our patent protection depends on compliance with various procedural, document submission, fee payment and other requirements
imposed by governmental patent agencies, and our patent protection could be reduced or eliminated for 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 be paid
to the USPTO and various governmental patent agencies outside of the United States in several stages over the lifetime of the patents
and/or applications. We have systems in place to remind us to pay these fees, and we employ an outside firm and rely on our outside counsel
to pay these fees. The USPTO and various non-United States governmental patent agencies require compliance with a number of procedural,
documentary, fee payment and other similar provisions during the patent application process. We employ reputable law firms and other
professionals to help us comply, and 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 noncompliance can result in 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 enter the market and this circumstance would have a material adverse effect on our business.
The
patent applications of pharmaceutical and biotechnology companies involve highly complex legal and factual questions, which, if determined
adversely to us, could negatively impact our patent position.
The
patent positions of pharmaceutical and biotechnology companies can be highly uncertain and involve complex legal and factual questions.
The U.S. Patent and Trademark Office’s, or USPTO’s, standards are uncertain and could change in the future. Consequently,
the issuance and scope of patents cannot be predicted with certainty. Patents, if issued, may be challenged, invalidated or circumvented.
U.S.
patents and patent applications may also be subject to interference proceedings, and U.S. patents may be subject to Inter Partes
Review (IPR), Post Grant Review (PGR) or reexamination proceedings in the USPTO (and foreign patents may be subject to opposition or
comparable proceedings in the corresponding foreign patent office), which proceedings could result in either loss of the patent or denial
of the patent application or loss or reduction in the scope of one or more of the claims of the patent or patent application. Similarly,
opposition or invalidity proceedings could result in loss of rights or reduction in the scope of one or more claims of a patent in foreign
jurisdictions. In addition, such interference, reexamination and opposition proceedings may be costly. Accordingly, rights under any
issued patents may not provide us with sufficient protection against competitive products or processes.
If
we fail to obtain and maintain patent protection and trade secret protection of Plogo or any of our future product candidates, proprietary
technologies and their uses, we could lose our competitive advantage and competition we face would increase, reducing our potential revenues
and adversely affecting our ability to attain or maintain profitability.
Risks
Related to Securities Regulations and Investment in Our Securities
Failure
to achieve and maintain internal controls in accordance with Sections 302 and 404 of the Sarbanes-Oxley Act of 2002 could have a material
adverse effect on our business and stock price.
Section
404 of the Sarbanes-Oxley Act of 2002 requires that we maintain internal control over financial reporting that meets applicable standards.
As with many smaller companies with small staff, material weaknesses in our financial controls and procedures may be discovered. If we
fail to maintain our internal controls or fail to implement required new or improved controls, as such control standards are modified,
supplemented or amended from time to time, we may not be able to conclude on an ongoing basis that we have effective internal controls
over financial reporting. Effective internal controls are necessary for us to produce reliable financial reports and are important in
the prevention of financial fraud. If we cannot produce reliable financial reports or prevent fraud, our business and operating results
could be harmed.
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We
incur increased costs and management resources as a result of being a public company, and we may fail to comply with public company obligations.
As
a public company, we face and will continue to face increased legal, accounting, administrative and other costs and expenses that we
would not incur as a private company. Compliance with the Sarbanes Oxley Act of 2002, as well as other rules of the SEC, the Public Company
Accounting Oversight Board and Nasdaq resulted in a significant initial cost to us as well as an ongoing compliance cost. As a public
company, we are subject to Section 404 of the Sarbanes Oxley Act relating to internal control over financial reporting. We have completed
a formal process to evaluate our internal controls for purposes of Section 404, and we concluded that as of December 31, 2024, our internal
control over financial reporting was effective. As our business grows and changes, there can be no assurances that we can maintain the
effectiveness of our internal controls over financial reporting. In addition, our independent certified public accounting firm has not
provided an opinion on the effectiveness of our internal controls over financial reporting for the year ended December 31, 2024 because
we are a smaller reporting company. In the event our independent auditor is required to provide an opinion on such controls in the future,
there is a risk that the auditor would conclude that such controls are ineffective.
Effective
internal controls over financial reporting are necessary for us to provide reliable financial reports and, together with adequate disclosure
controls and procedures, are designed to prevent fraud. If we cannot provide reliable financial reports or prevent fraud, our operating
results could be harmed. We have completed a formal process to evaluate our internal control over financial reporting. However, guidance
from regulatory authorities in the area of internal controls continues to evolve and substantial uncertainty exists regarding our on-going
ability to comply by applicable deadlines. Any failure to implement required new or improved controls, or difficulties encountered in
their implementation, could harm our operating results or cause us to fail to meet our reporting obligations. Ineffective internal controls
could also cause investors to lose confidence in our reported financial information, which could have a negative effect on the trading
price of our common stock.
An
active trading market for our common stock has not developed and it may have a volatile public trading price, thus, purchasers of our
common stock could incur substantial losses.
An
active public market for our common stock has not developed. Our stock can trade in small volumes, which may make the price of our stock
highly volatile. The last reported price of our stock may not represent the price at which you would be able to buy or sell the stock.
The market prices for securities of companies comparable to us have been highly volatile. Often, these stocks have experienced significant
price and volume fluctuations for reasons that are both related and unrelated to the operating performance of the individual companies.
In addition, the stock market as a whole and biotechnology and other life science stocks in particular have experienced significant recent
volatility. Like our common stock, these stocks have experienced significant price and volume fluctuations for reasons unrelated to the
operating performance of the individual companies. Factors giving rise to this volatility may include:
● disclosure
of actual or potential clinical results with respect to the product candidate we are developing;
● regulatory
developments in both the United States and abroad;
● developments
concerning proprietary rights, including patents and litigation matters;
● public
concern about the safety or efficacy of our product candidate or technology, or related technology,
or new technologies generally;
● concern
about the safety or efficacy of our product candidate or technology, or related technology,
or new technologies generally;
● public
announcements by our competitors or others; and
● general
market conditions and comments by securities analysts and investors.
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Fluctuations
in our operating losses could adversely affect the price of our common stock.
Our
operating losses may fluctuate significantly on a quarterly basis. Some of the factors that may cause our operating losses to fluctuate
on a period-to-period basis include the status of our preclinical and clinical development programs, level of expenses incurred in connection
with our preclinical and clinical development programs, implementation or termination of collaboration, licensing, manufacturing or other
material agreements with third parties, non-recurring revenue or expenses under any such agreement, and compliance with regulatory requirements.
Period-to-period comparisons of our historical and future financial results may not be meaningful, and investors should not rely on them
as an indication of future performance. Our fluctuating losses may fail to meet the expectations of securities analysts or investors.
Our failure to meet these expectations may cause the price of our common stock to decline.
If
securities or industry analysts do not publish research or reports about us, if they change their recommendations regarding our stock
adversely or if our operating results do not meet their expectations, our stock price and trading volume could decline.
The
trading market for our common stock is influenced by the research and reports that industry or securities analysts publish about us.
If analysts do not publish research reports or one or more of these analysts who were publishing research cease coverage of us or fail
to regularly publish reports on us, we could lose visibility in the financial markets, which in turn could cause our stock price or trading
volume to decline. Moreover, if one or more of the analysts who cover us downgrade our stock or if our operating results do not meet
their expectations, our stock price could decline.
We
may not be able to facilitate our growth strategy by identifying or completing transactions with attractive acquisition candidates, which
could limit our revenues and profitability. Future acquisitions may result in significant transaction expenses and may involve significant
costs. We may experience integration and consolidation risks associated with future acquisitions.
An
element of our growth strategy is to selectively pursue, on an opportunistic basis, acquisitions of businesses or assets of businesses
that complement our existing business and footprint. We may also consider other potential strategic transactions, including dispositions,
which are also subject to claims by third parties and by the buyers under the terms of our disposition agreements. We have no current
agreement for any acquisition of a business or assets. The success of this element of our growth strategy depends, in part, on selecting
strategic acquisition candidates at attractive prices and effectively integrating their businesses into our own, including with respect
to financial reporting and regulatory matters. We cannot assure you that we will be able to identify attractive acquisition candidates
or complete the acquisition of any identified candidates at favorable prices and upon advantageous terms and conditions, including financing
alternatives. We expect to face competition for acquisition candidates, which may limit the number of acquisition opportunities and lead
to higher acquisition costs. We may not have the financial resources necessary to consummate any acquisitions or the ability to obtain
the necessary funds on satisfactory terms. Any acquisitions in the future may result in significant transaction expenses and risks associated
with entering new markets and dilution for our existing stockholders. We may also be subject to claims by third parties related to the
operations of these businesses prior to our acquisition and by sellers under the terms of our acquisition agreements.
Anti-takeover
provisions in our charter documents and provisions of Delaware law may make an acquisition more difficult and could result in the entrenchment
of management.
We
are incorporated in Delaware. Anti-takeover provisions of Delaware law and our amended and restated certificate of incorporation and
amended and restated bylaws may make a change in control or efforts to remove management more difficult. Also, under Delaware law, our
Board of Directors may adopt additional anti-takeover measures.
We
have the authority to issue up to 5 million shares of preferred stock and to determine the terms of those shares of stock without any
further action by our stockholders. If the Board of Directors exercises this power to issue preferred stock, it could be more difficult
for a third party to acquire a majority of our outstanding voting stock and vote the stock they acquire to remove management or directors.
Our amended and restated certificate of incorporation and amended and restated bylaws also provides staggered terms for the members of
our Board of Directors. Under Section 141 of the Delaware General Corporation Law, our directors may be removed by stockholders only
for cause and only by vote of the holders of a majority of voting shares then outstanding. These provisions may prevent stockholders
from replacing the entire board in a single proxy contest, making it more difficult for a third party to acquire control of us without
the consent of our Board of Directors. These provisions could also delay the removal of management by the Board of Directors with or
without cause. In addition, our directors may only be removed for cause and amended and restated bylaws limit the ability of our stockholders
to call special meetings of stockholders.
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As
at December 31, 2024, we had 135,273 shares of 6% Convertible Exchangeable Preferred Stock and 264 shares of Series A Preferred Stock
issued and outstanding.
Under
Section 203 of the Delaware General Corporation Law, a corporation may not engage in a business combination with any holder of 15% or
more of its capital stock until the holder has held the stock for three years unless, among other possibilities, the Board of Directors
approves the transaction. Our Board of Directors could use this provision to prevent changes in management. The existence of the foregoing
provisions could limit the price that investors might be willing to pay in the future for shares of our common stock.
In
the event of an acquisition of our common stock, we cannot assure our common stockholders that we will be able to negotiate terms that
would provide for a price equivalent to, or more favorable than, the price at which our shares of common stock may be trading at such
time.
We
may not effect a consolidation or merger with another entity without the vote or consent of the holders of at least a majority of the
shares of our preferred stock (in addition to the approval of our common stockholders), unless the preferred stock that remains outstanding
and its rights, privileges and preferences are unaffected or are converted into or exchanged for preferred stock of the surviving entity
having rights, preferences and limitations substantially similar, but no less favorable, to our convertible preferred stock.
In
addition, in the event a third party seeks to acquire our company or acquire control of our company by way of a merger, but the terms
of such offer do not provide for our preferred stock to remain outstanding or be converted into or exchanged for preferred stock of the
surviving entity having rights, preferences and limitations substantially similar, but no less favorable, to our preferred stock, the
terms of the Certificate of Designations of our preferred stock provide for an adjustment to the conversion ratio of our preferred stock
such that, depending on the terms of any such transaction, preferred stockholders may be entitled, by their terms, to receive up to $10.00
per share in common stock, causing our common stockholders not to receive as favorable a price as the price at which such shares may
be trading at the time of any such transaction.
As
of December 31, 2024, there were 135,273 shares of our 6% Convertible Exchangeable Preferred Stock issued and outstanding. If the transaction
were one in which proceeds were received by us for distribution to stockholders, and the terms of the Certificate of Designations governing
the preferred stock were strictly complied with, approximately $1.7 million would be paid to the preferred holders before any distribution
to the common stockholders, although the form of transaction could affect how the holders of preferred stock are treated. In such an
event, although such a transaction would be subject to the approval of our holders of common stock, we cannot assure our common stockholders
that we will be able to negotiate terms that would provide for a price equivalent to, or more favorable than, the price at which our
shares of common stock may be trading at such time. Thus, the terms of our preferred stock might hamper a third party’s acquisition
of our company.
Our
certificate of incorporation and bylaws and certain provisions of Delaware law may delay or prevent a change in our management and make
it more difficult for a third-party to acquire us.
Our
amended and restated certificate of incorporation and bylaws contain provisions that could delay or prevent a change in our Board of
Directors and management teams.
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Some
of these provisions:
● authorize
the issuance of preferred stock that can be created and issued by the Board of Directors
without prior stockholder approval, commonly referred to as “blank check” preferred
stock, with rights senior to those of our common stock;
● provide
for the Board of Directors to be divided into three classes; and
● require
that stockholder actions must be effected at a duly called stockholder meeting and prohibit
stockholder action by written consent.
In
addition, because we are incorporated in Delaware, we are governed by the provisions of Section 203 of the Delaware General Corporation
Law, which limits the ability of large stockholders to complete a business combination with, or acquisition of, us. These provisions
may prevent a business combination or acquisition that would be attractive to stockholders and could limit the price that investors would
be willing to pay in the future for our stock.
These
provisions also make it more difficult for our stockholders to replace members of our Board of Directors. Because our Board of Directors
is responsible for appointing the members of our management team, these provisions could in turn affect any attempt to replace our current
management team. Additionally, these provisions may prevent an acquisition that would be attractive to stockholders and could limit the
price that investors would be willing to pay in the future for our common stock.
We
may have limited ability to pay cash dividends on our preferred stock, and there is no assurance that future quarterly dividends will
be declared.
Delaware
law may limit our ability to pay cash dividends on our preferred stock. Under Delaware law, cash dividends on our preferred stock may
only be paid from surplus or, if there is no surplus, from the corporation’s net profits for the current or preceding fiscal year.
Delaware law defines “surplus” as the amount by which the total assets of a corporation, after subtracting its total liabilities,
exceed the corporation’s capital, as determined by its board of directors.
Since
we are not profitable, our ability to pay cash dividends will require the availability of an adequate surplus. Even if adequate surplus
is available to pay cash dividends on our preferred stock, we may not have sufficient cash to pay dividends on the preferred stock or
we may choose not to declare the dividends.
Our
common and preferred stock may experience extreme price and volume fluctuations, which could lead to costly securities-related litigation,
including securities class action litigation or securities-related investigations, which could make an investment in us less appealing.
You
should consider an investment in our common stock and preferred stock to be risky, and you should invest in our common stock and preferred
stock only if you can withstand a significant loss and wide fluctuations in the market value of your investment. Some factors that may
cause the market price of our common stock to fluctuate, in addition to the other risks mentioned in this “Risk Factors”
section and elsewhere in this Annual Report on Form 10-K, are:
● announcements
of technological innovations or new products or services by us or our competitors; announcements
concerning our competitors or the biotechnology industry in general;
● new
regulatory pronouncements and changes in regulatory guidelines;
● general
and industry-specific economic conditions;
● additions
to or departures of our key personnel;
● sale
of our common stock or preferred stock by our stockholders, executives and directors;
● volatility
and limitations in trading volumes of our shares;
● our
ability to obtain financings to conduct and complete research and development activities
including, but not limited to, our clinical trials, and other business activities;
● analyst
research reports, recommendation and changes in recommendations, price targets, and withdrawals
of coverage;
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● our
ability to secure resources and the necessary personnel to conduct clinical trials on our
desired schedule;
● any
delay in our submission for studies or product approvals or adverse regulatory decisions,
including failure to receive regulatory approval for our product candidate;
● announcements
and events surrounding financing efforts, including debt and equity securities;
● announcements
of acquisitions, partnerships, collaborations, joint ventures, new products, capital commitments,
or other events by us or our competitors;
● disputes
and litigations related to intellectual properties, proprietary rights, and contractual obligations;
● changes
in financial estimates or recommendations by securities analysts;
● variations
in our quarterly results;
● announcements
about our collaborators or licensors;
● changes
in accounting principles or in applicable laws, rules, regulations; and
● other
events or factors, many of which may be out of our control.
The
stock markets have from time-to-time experienced significant price and volume fluctuations that have affected the market prices for publicly
traded securities. The market prices of the securities of biotechnology companies, particularly companies like us without product revenues
and earnings, have been highly volatile and are likely to remain highly volatile in the future. This volatility has often been unrelated
to the performance of particular companies. In the past, companies that experience volatility in the market price of their securities
have often faced securities class action and derivative litigation, and as a public company, we could be subject to sanctions or investigations
by Nasdaq, the SEC or other regulatory authorities. Moreover, market prices for stocks of biotechnology-related and technology companies
frequently reach levels that bear no relationship to the performance of these companies. These market prices generally are not sustainable
and are highly volatile.
Whether
or not meritorious, litigation brought against us could result in substantial costs, divert our management’s attention and resources
and harm our financial condition and results of operations.
The
future sale of our common and convertible preferred stock and future issuances of our common stock upon conversion of our preferred stock
could negatively affect our stock price and cause dilution to existing holders of our common stock.
If
our common or preferred stockholders sell substantial amounts of our stock in the public market, or the market perceives that such sales
may occur, the market price of our common and preferred stock could fall. If additional holders of convertible preferred stock elect
to convert their shares to shares of common stock at renegotiated prices, such conversion as well as the sale of substantial amounts
of our common stock, could cause dilution to existing holders of our common stock, thereby also negatively affecting the price of our
common stock.
If
we exchange the convertible preferred stock for debentures, the exchange will be taxable, but we will not provide any cash to pay any
tax liability that any convertible preferred stockholder may incur.
An
exchange of convertible preferred stock for debentures, as well as any dividend make-whole or interest make-whole payments paid in our
common stock, will be taxable events for United States federal income tax purposes, which may result in tax liability for the holder
of convertible preferred stock without any corresponding receipt of cash by the holder. In addition, the debentures may be treated as
having original issue discount, a portion of which would generally be required to be included in the holder’s gross income even
though the cash to which such income is attributable would not be received until maturity or redemption of the debenture. We will not
distribute any cash to the holders of the securities to pay these potential tax liabilities.
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If
we automatically convert the convertible preferred stock, there is a substantial risk of fluctuation in the price of our common stock
from the date we elect to automatically convert to the conversion date.
We
may automatically convert the convertible preferred stock into common stock if the closing price of our common stock exceeds $888,300
per share. There is a risk of fluctuation in the price of our common stock between the time when we may first elect to automatically
convert the preferred and the automatic conversion date.
We
do not intend to pay cash dividends on our common stock in the foreseeable future.
We
do not anticipate paying cash dividends on our common stock in the foreseeable future. Any payment of cash dividends will depend on our
financial condition, results of operations, capital requirements, the outcome of the review of our strategic alternatives and other factors
and will be at the discretion of our Board of Directors. Accordingly, investors will have to rely on capital appreciation, if any, to
earn a return on their investment in our common stock. Furthermore, we may in the future become subject to contractual restrictions on,
or prohibitions against, the payment of dividends.
The
number of shares of common stock which are registered, including the shares to be issued upon exercise of our outstanding warrants, is
significant in relation to our currently outstanding common stock and could cause downward pressure on the market price for our common
stock.
The
number of shares of common stock registered for resale, including those shares which are to be issued upon exercise of our outstanding
warrants, is significant in relation to the number of shares of common stock currently outstanding. If the security holder determines
to sell a substantial number of shares into the market at any given time, there may not be sufficient demand in the market to purchase
the shares without a decline in the market price for our common stock. Moreover, continuous sales into the market of a number of shares
in excess of the typical trading volume for our common stock, or even the availability of such a large number of shares, could depress
the trading market for our common stock over an extended period of time.
If
persons engage in short sales of our common stock, including sales of shares to be issued upon exercise of our outstanding warrants,
the price of our common stock may decline.
Selling
short is a technique used by a stockholder to take advantage of an anticipated decline in the price of a security. In addition, holders
of options and warrants will sometimes sell short knowing they can, in effect, cover through the exercise of an option or warrant, thus
locking in a profit. A significant number of short sales or a large volume of other sales within a relatively short period of time can
create downward pressure on the market price of a security. Further sales of common stock issued upon exercise of our outstanding warrants
could cause even greater declines in the price of our common stock due to the number of additional shares available in the market upon
such exercise, which could encourage short sales that could further undermine the value of our common stock. You could, therefore, experience
a decline in the value of your investment as a result of short sales of our common stock.
We
are exposed to risks related to the marketable securities we may purchase.
We
may invest cash that is not required to meet short-term obligations in short term marketable securities. We may purchase securities in
United States government, government-sponsored agencies and highly rated corporate and asset-backed securities subject to an approved
investment policy. Historically, investment in these securities has been highly liquid and has experienced only very limited defaults.
However, recent volatility in the financial markets has created additional uncertainty regarding the liquidity and safety of these investments.
Although we believe our marketable securities investments are safe and highly liquid, we cannot guarantee that our investment portfolio
will not be negatively impacted by recent or future market volatility or credit restrictions.
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Claims
for indemnification by our directors and officers may reduce our available funds to satisfy successful stockholder claims against us
and may reduce the amount of money available to us.
As
permitted by Section 102(b)(7) of the Delaware General Corporation Law, our restated certificate of incorporation limits the liability
of our directors to the fullest extent permitted by law. In addition, as permitted by Section 145 of the Delaware General Corporation
Law, our restated certificate of incorporation and restated bylaws provide that we shall indemnify, to the fullest extent authorized
by the Delaware General Corporation Law, each person who is involved in any litigation or other proceeding because such person is or
was a director or officer of our company or is or was serving as an officer or director of another entity at our request, against all
expense, loss or liability reasonably incurred or suffered in connection therewith. Our restated certificate of incorporation provides
that the right to indemnification includes the right to be paid expenses incurred in defending any proceeding in advance of its final
disposition, provided, however, that such advance payment will only be made upon delivery to us of an undertaking, by or on behalf of
the director or officer, to repay all amounts so advanced if it is ultimately determined that such director is not entitled to indemnification.
If
we do not pay a proper claim for indemnification in full within 60 days after we receive a written claim for such indemnification, except
in the case of a claim for an advancement of expenses, in which case such period is 20 days, our restated certificate of incorporation
and our restated bylaws authorize the claimant to bring an action against us and prescribe what constitutes a defense to such action.
Section
145 of the Delaware General Corporation Law permits a corporation to indemnify any director or officer of the corporation against expenses
(including attorney’s fees), judgments, fines and amounts paid in settlement actually and reasonably incurred in connection with
any action, suit or proceeding brought by reason of the fact that such person is or was a director or officer of the corporation, if
such person acted in good faith and in a manner that he reasonably believed to be in, or not opposed to, the best interests of the corporation,
and, with respect to any criminal action or proceeding, if he or she had no reason to believe his or her conduct was unlawful. In a derivative
action, (i.e., one brought by or on behalf of the corporation), indemnification may be provided only for expenses actually and reasonably
incurred by any director or officer in connection with the defense or settlement of such an action or suit if such person acted in good
faith and in a manner that he or she reasonably believed to be in, or not opposed to, the best interests of the corporation, except that
no indemnification shall be provided if such person shall have been adjudged to be liable to the corporation, unless and only to the
extent that the court in which the action or suit was brought shall determine that the defendant is fairly and reasonably entitled to
indemnity for such expenses despite such adjudication of liability.
The
rights conferred in the restated certificate of incorporation and the restated bylaws are not exclusive, and we are authorized to enter
into indemnification agreements with our directors, officers, employees and agents and to obtain insurance to indemnify such persons.
We have entered into indemnification agreements with each of our officers and directors.
The
above limitations on liability and our indemnification obligations limit the personal liability of our directors and officers for monetary
damages for breach of their fiduciary duty as directors by shifting the burden of such losses and expenses to us. Although we obtained
coverage under our directors’ and officers’ liability insurance, certain liabilities or expenses covered by our indemnification
obligations may not be covered by such insurance or the coverage limitation amounts may be exceeded. As a result, we may need to use
a significant amount of our funds to satisfy our indemnification obligations, which could severely harm our business and financial condition
and limit the funds available to stockholders who may choose to bring a claim against our company.
Item
1B. Unresolved Staff Comments
None.
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Item
1C. Cybersecurity
We
recognize the critical importance of maintaining the trust and confidence of business partners, employees and patients, toward our business
and are committed to protecting the confidentiality, integrity and availability of our business operations and systems. Our board of
directors is actively involved in oversight of our risk management activities, and cybersecurity represents an important element of our
overall approach to risk management. Our cybersecurity policies, standards, processes and practices are based on recognized frameworks
established by the UK governments’ National Cyber Security Centre and other applicable industry standards. In general, we seek
to address cybersecurity risks through a comprehensive, cross-functional approach that is focused on preserving the confidentiality,
security and availability of the information that we collect and store by identifying, preventing and mitigating cybersecurity threats
and effectively responding to cybersecurity incidents when they occur.
Cybersecurity
Risk Management and Strategy; Effect of Risk
We
face risks related to cybersecurity such as unauthorized access, cybersecurity attacks and other security incidents, including as perpetrated
by hackers and unintentional damage or disruption to hardware and software systems, loss of data, and misappropriation of confidential
information. To identify and assess material risks from cybersecurity threats, we maintain a comprehensive cybersecurity program to ensure
our systems are effective and prepared for information security risks, including regular oversight of our programs for security monitoring
for internal and external threats to ensure the confidentiality and integrity of our information assets. We consider risks from cybersecurity
threats alongside other company risks as part of our overall risk assessment process. We employ a range of tools and services, including
regular network and endpoint monitoring, audits, vulnerability assessments, and penetration testing to inform our risk identification
and assessment. As discussed in more detail under “Cybersecurity Governance” below, our audit committee provides oversight
of our cybersecurity risk management and strategy processes, which are led by our Chief Financial Officer.
We
also identify our cybersecurity threat risks by comparing our processes to standards set by the UK governments’ National Cyber
Security Centre. To provide for the availability of critical data and systems, maintain regulatory compliance, manage our material risks
from cybersecurity threats, and protect against and respond to cybersecurity incidents, we undertake the following activities:
● monitor
emerging data protection laws and implement changes to our processes that are designed to
comply with such laws;
● through
our policies, practices and contracts (as applicable), require employees, as well as third
parties that provide services on our behalf, to treat confidential information and data with
care;
● employ
technical safeguards that are designed to protect our information systems from cybersecurity
threats, including firewalls, intrusion prevention and detection systems, anti-malware functionality
and access controls, which are evaluated and improved through vulnerability assessments and
cybersecurity threat intelligence;
● provide
regular training for our employees regarding cybersecurity threats as a means to equip them
with effective tools to address cybersecurity threats, and to communicate our evolving information
security policies, standards, processes and practices;
● leverage
the National Cyber Security Centre incident handling framework to help us identify, protect,
detect, respond and recover when there is an actual or potential cybersecurity incident;
and
● carry
information security risk insurance that provides protection against the potential losses
arising from a cybersecurity incident.
Our
response to an incident involves the coordination of activities to detect, respond to and recover from cybersecurity incidents, which
include processes to triage, assess severity for, escalate, contain, investigate and remediate the incident, as well as to comply with
potentially applicable legal obligations and mitigate damage to our business and reputation.
As
part of the above processes, we regularly engage with consultants, auditors and other third parties , including having a third-party independent
qualified and accredited advisor review our cybersecurity program to help identify areas for continued focus, improvement and compliance.
Our
processes also address cybersecurity threat risks associated with our use of third-party service providers, including our suppliers and
manufacturers or who have access to patient and employee data or our systems. In addition, cybersecurity considerations affect the selection
and oversight of our third-party service providers. We perform diligence on third parties that have access to our systems, data or facilities
that house such systems or data, and continually monitor cybersecurity threat risks identified through such diligence. Additionally,
we would require those third parties, although there are currently none, that could introduce significant cybersecurity risk to us to
agree by contract to manage their cybersecurity risks in specified ways, and to agree to be subject to cybersecurity audits, which we
conduct as appropriate.
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We
describe whether and how risks from identified cybersecurity threats, including as a result of any previous cybersecurity incidents,
have materially affected or are reasonably likely to materially affect us, including our business strategy, results of operations, or
financial condition, under the risk factor heading “ Security incidents, loss of data and other disruptions could compromise
sensitive information related to our business or prevent us from accessing critical information and expose us to liability ”
which disclosures are incorporated by reference herein.
We
have no t experienced any material cybersecurity incidents and the expenses we have incurred from cybersecurity incidents were immaterial.
Cybersecurity
Governance; Management
Cybersecurity
is an important part of our risk management processes and an area of focus for our board of directors and management. The audit committee
of our board of directors is responsible for the oversight of risks from cybersecurity threats.
At
least annually, our audit committee receives an update from management of our cybersecurity threat risk management and strategy processes.
In such sessions, our audit committee generally receives materials that include a cybersecurity dashboard and other materials discussing
current and emerging material cybersecurity threat risks, and describing our ability to mitigate those risks, as well as recent developments,
evolving standards, technological developments and information security considerations arising with respect to our peers and third parties.
Our audit committee also receive prompt and timely information regarding any cybersecurity incident that meets establishing reporting
thresholds, as well as ongoing updates regarding any such incident until it has been addressed. To date, we have not experienced any
cyber security incident.
Members
of our audit committee are also encouraged to regularly engage in conversations with management on cybersecurity-related news events
and discuss any updates to our cybersecurity risk management and strategy programs. Material cybersecurity threat risks are also considered
during separate board meeting discussions of important matters like enterprise risk management, operational budgeting, business continuity
planning, mergers and acquisitions, brand management, and other relevant matters.
Our
cybersecurity risk management and strategy processes, which are discussed in greater detail above, are led by our Chief Financial Officer.
Our Chief Financial Officer has been responsible for our IT functions for 20 years and has managed the IT function of companies generally
for the last 35 years. The management team members are informed about and monitor the prevention, mitigation, detection, and remediation
of cybersecurity incidents through their management of, and participation in, the cybersecurity risk management and strategy processes
described above, including the operation of our incident response plan. As discussed above, the management team members report to the
audit committee of our board of directors about cybersecurity threat risks, among other cybersecurity related matters, periodically.
Item
2. Properties
We
previously leased our corporate headquarters in Berkeley Heights, New Jersey. In December 2024, the Company terminated this lease, effective
as of January 31, 2025. Effective March 1, 2025, the Company entered into a two year lease agreement for our corporate headquarters at
Level 10, Tower 11, Avenue 5, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur, Malaysia, which we believe will be adequate to accommodate our
business needs.
Item
3. Legal Proceedings
From
time to time, we may be involved in routine litigation incidental to the conduct of our business. As of December 31, 2024, we were not
a party to any material legal proceedings.
Item
4. Mine Safety Disclosures
Not
applicable.
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PART
II
Item
5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
Market
Information
Our
common stock is traded on The Nasdaq Capital Market, or Nasdaq, under the symbol “CYCC”. Our 6% convertible exchangeable
preferred stock currently trades on Nasdaq under the symbol “CYCCP”.
Holders
of Common Stock
We
effected a 15:1 reverse stock split of our common stock on December 18, 2023 (the “Reverse Stock Split”). All share and per
share information has been retroactively adjusted to give effect to the Reverse Stock Split for all periods presented, unless otherwise
indicated.
On
March 24, 2025, we had approximately 14 registered holders of record of our 863,901 shares of common stock outstanding. On March 24,
2025, the closing sale price of our common stock as reported by Nasdaq was $76.80 per share.
Dividends
We
have never declared nor paid any cash dividends on our common stock and do not currently anticipate declaring or paying any cash dividends
on our outstanding shares of common stock in the foreseeable future. We are, however, required to make or accrue quarterly dividend payments
on our Preferred Stock. Except for dividends that may be paid on the Preferred Stock, we currently intend to retain all of our future
earnings, if any, to finance operations. Any future determination relating to our dividend policy will be made at the discretion of our
Board of Directors and will depend on a number of factors, including future earnings, capital requirements, financial conditions, future
prospects, contractual restrictions and other factors that our Board of Directors may deem relevant.
Unregistered
Sales of Securities
None.
Issuer
Purchases of Equity Securities
None.
Item
6. [Reserved]
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Item
7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Cautionary
Statement Regarding Forward-Looking Statements
This
report contains certain statements that may be deemed ‘forward-looking statements’ within the meaning of United States securities
laws. All statements, other than statements of historical fact, that address activities, events or developments that we intend, expect,
project, believe or anticipate will or may occur in the future are forward-looking statements. Such statements are based upon certain
assumptions and assessments made by our management in light of their experience and their perception of historical trends, current conditions,
expected future developments and other factors they believe to be appropriate. Certain factors that could cause results to differ materially
from those projected or implied in the forward-looking statements are set forth in this Annual Report on Form 10-K for the year ended
December 31, 2024 under the caption “Item 1A — Risk factors”.
We
encourage you to read those descriptions carefully. We caution you not to place undue reliance on the forward-looking statements contained
in this report. These statements, like all statements in this report, speak only as of the date of this report (unless an earlier date
is indicated) and we undertake no obligation to update or revise the statements except as required by law. Such forward-looking statements
are not guarantees of future performance and actual results will likely differ, perhaps materially, from those suggested by such forward-looking
statements.
We
effected a 15:1 reverse stock split of our common stock on December 18, 2023 (the “Reverse Stock Split”). All share and per
share information has been retroactively adjusted to give effect to the Reverse Stock Split for all periods presented, unless otherwise
indicated.
Recent
developments
In
December 2024 the Company announced that it was in the process of exploring and reviewing strategic alternatives on an expedited basis
in order to preserve the Company’s cash, including a potential transaction with investor David Lazar of Activist Investing, LLC,
or “Lazar”. The Company’s Board of Directors (the “Board”) reviewed a range of appropriate strategies to
realize value from its assets. The Board directed management to reduce operating costs, which included the potential liquidation of the
Company’s wholly owned United Kingdom subsidiary Cyclacel Limited, or Subsidiary, while such alternatives were being explored.
On January 2, 2025 the Company entered into a securities purchase agreement with investor Lazar, pursuant to which he agreed to purchase
from the Company 1,000,000 shares of Series C Convertible Preferred Stock and 2,100,000 shares of Series D Convertible Preferred Stock
of Cyclacel at a purchase price of $1.00 per share for aggregate gross proceeds of $3.1 million, subject to the terms and conditions
of the Agreement. The proceeds of the transaction will be used to settle outstanding liabilities of the Company and other general corporate
and operating purposes.
On
January 2, 2025 the Company entered into a securities purchase agreement with investor Lazar, pursuant to which he agreed to purchase
from the Company 1,000,000 shares of Series C Convertible Preferred Stock and 2,100,000 shares of Series D Convertible Preferred Stock
of Cyclacel at a purchase price of $1.00 per share for aggregate gross proceeds of $3.1 million, subject to the terms and conditions
of the Agreement. The proceeds of the transaction will be used to settle outstanding liabilities of the Company and other general corporate
and operating purposes.
On
January 2, 2025, the Company entered into settlement agreements with the Resigning Directors effective as of the signing of the Purchase
Agreement. Pursuant to the terms of the Director Settlement Agreements, each Resigning Director resigned his or her position as a member
of the Board of Directors, and any positions held on committees of the Board of Directors. Each Resigning Director has received his or
her accrued Board fees in full consideration of the release of claims against the Company and other promises and covenants set forth
in the Director Settlement Agreements.
On
January 2, 2025, the Company entered into a settlement agreement with Mr. Spiro Rombotis (the “Rombotis Settlement Agreement”).
Pursuant to the terms of the Rombotis Settlement Agreement, Mr. Rombotis resigned his position as President and Chief Executive Officer
of the Company effective as of the signing of the Purchase Agreement, and agreed to provide transition services to the Company in his
capacity as a member of the Board of Directors through the filing of the Company’s Annual Report on Form 10-K for the year ended
2024. On January 2, 2025, the Company also entered into a settlement agreement with Paul McBarron (together with Mr. Rombotis, the “Resigning
Officers”) effective immediately following the Initial Closing, as such term is defined in the Purchase Agreement (the “McBarron
Settlement Agreement” and together with the Rombotis Settlement Agreement, the “Executive Officer Settlement Agreements”
and together with the Director Settlement Agreements, the “Settlement Agreements”).
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Pursuant
to the terms of the McBarron Settlement Agreement, Mr. McBarron agreed to provide transition services to the Company in his capacity
as a member of the Board of Directors through the filing of the Company’s Annual Report on Form 10-K for the year ended 2024. Pursuant
to the Executive Officer Settlement Agreements, and subject to the Purchase Agreement, the Company will pay to Mr. Rombotis and Mr. McBarron
payments of $279,415.50 and $165,164.50, respectively, as soon as practicable, and three months later a further one-time payment of $279,415.50
and $165,164.50 either in cash or through the issuance of common stock, respectively, in full consideration of the release of claims
against the Company and other promises and covenants set forth in the Executive Officer Settlement Agreements (the “Settlement
Payments”) and the Purchase Agreement.
Pursuant
to the terms of the Settlement Agreements, the Company will provide continuing indemnification to the Resigning Directors and Resigning
Officers in a manner consistent with that which was in place as of the effective date of the Settlement Agreements, and will cause to
be maintained in effect the Company’s existing director and officer liability insurance pursuant to the Company’s tail insurance
coverage and will not modify its governing documents to modify the Resigning Directors’ and Resigning Officers’ rights under
such policy, as further set forth in the Settlement Agreements. The Settlement Agreements contain a mutual non-disparagement clause.
On
January 31, 2025, the creditors voluntary liquidation of Cyclacel Limited was announced in the London Gazette, one of the official public
records of the government of the United Kingdom. As part of the Company’s efforts to reduce operating costs it has determined to
focus on the development of the Plogo clinical program only and therefore fadraciclib, the Subsidiary’s other drug development
program, is being marketed for sale by the joint liquidator through Hilco Appraisals Limited, a firm of professional valuation agents
and will no longer be part of the assets of the Company as of January 2025. On March 10, 2025, the Company entered into an Agreement
for the Sale and Purchase of certain assets related to plogosertib (“Plogo”) with Cyclacel Limited and the joint liquidator.
On
February 26, 2025, the Company entered into settlement agreements with Dr. Barker. Pursuant to the terms of the settlement agreement,
Dr. Barker resigned his position as a member of the Board of Directors, and any positions held on committees of the Board of Directors.
In addition, Dr. Barker will receive his accrued Board fees in full consideration of the release of claims against the Company and other
promises and covenants set forth in the settlement agreement. Pursuant to the terms of the settlement agreement, the Company will provide
continuing indemnification to Dr. Barker in a manner consistent with that which was in place as of the effective date of the settlement
agreement, and will cause to be maintained in effect the Company’s existing director and officer liability insurance pursuant to
the Company’s tail insurance coverage and will not modify its governing documents to modify Dr. Barker’s rights under such
policy, as further set forth in the settlement agreement. The settlement agreement contains a mutual non-disparagement clause.
With
the commencement of the liquidation of the Subsidiary, the Company will no longer be considered to have control over the Subsidiary and
the financial results of the Subsidiary will be deconsolidated from those of the Company. The deconsolidation, which is anticipated to
increase stockholders’ equity by approximately $5.0 million, will be reported in the Company’s Form 10-Q for the three months
ended March 31, 2025.
Overview
We
are a clinical-stage biopharmaceutical company incorporated in the State of Delaware on January 5, 1996 that has focused on the development
of innovative cancer medicines based on cell cycle, transcriptional regulation, epigenetics and mitosis control biology. Our principal
executive office is now located at Level 10, Tower 11, Avenue 5, No. 8, Jalan Kerinchi, Kuala Lumpur, Malaysia, and our telephone number
is (908) 517-7330. Our website address is www.cyclacel.com. The information contained on, or that can be accessed through, our website
is not part of, and is not incorporated by reference into, this Annual Report.
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During
2024, our primary focus has been on our transcriptional regulation program, which evaluated fadraciclib, a CDK2/9 inhibitor, in solid
tumors and hematological malignancies. The epigenetic/anti-mitotic program is evaluating Plogo, a PLK1 inhibitor, in advanced cancers.
We
currently retain all marketing rights worldwide to our product candidate Plogo.
Revenue
We
have not generated any revenues from product sales to date. Our product candidates will require significant additional research and development
efforts, including extensive preclinical and clinical testing. Plogo and any future product candidates that we advance to clinical testing
will require regulatory approval prior to commercial use and will require significant costs for commercialization. We have recognized
revenue of $43,000 for the year ended December 31, 2024 related to the recovery of clinical manufacturing costs associated with an investigator
sponsored study managed by Cedars Sinai Medical Center. We recognized $0.4 million of revenue for the year ended December 31, 2023. We
do not expect to report revenue for the foreseeable future.
Funding
Requirements and Going Concern
As
of December 31, 2024, we had cash and cash equivalents of $3.1 million We have incurred losses since our inception and as of December
31, 2024, we had an accumulated deficit of $439.5 million. We expect to continue to incur substantial operating losses in the future.
We
do not currently have sufficient funds to complete development and commercialization of any of our drug candidates. Current business
and capital market risks could have a detrimental effect on the availability of sources of funding and our ability to access them in
the future, which may delay or impede our progress of advancing our drugs currently in the clinical pipeline to approval by the FDA or
EMA for commercialization. Additionally, we plan to continue to evaluate in-licensing and acquisition opportunities to gain access to
new drugs or drug targets that would fit with our strategy. Any such transaction would likely increase our funding needs in the future.
Our
future funding requirements will depend on many factors, including but not limited to:
● the
rate of progress and cost of our clinical trials, preclinical studies and other discovery
and research and development activities;
● the
costs associated with establishing manufacturing and commercialization capabilities;
● the
costs of acquiring or investing in businesses, Plogo or any of our future product candidates
and technologies;
● the
costs of filing, prosecuting, defending and enforcing any patent claims and other intellectual
property rights;
● the
costs and timing of seeking and obtaining FDA and EMA approvals;
● the
effect of competing technological and market developments; and
● the
economic and other terms and timing of any collaboration, licensing or other arrangements
into which we may enter.
Until
we can generate a sufficient amount of product revenue to finance our cash requirements, which we may never do, we expect to finance
future cash needs primarily through public or private equity offerings, debt financings or strategic collaborations. Although we are
not reliant on institutional credit finance and therefore not subject to debt covenant compliance requirements or potential withdrawal
of credit by banks, we are reliant on the availability of funds and activity in equity markets. We do not know whether additional funding
will be available on acceptable terms, or at all. If we are not able to secure additional funding when needed, we may have to delay,
reduce the scope of or eliminate one or more of our clinical trials or research and development programs or make changes to our operating
plan. In addition, we may have to partner one or more of our product candidate programs at an earlier stage of development, which would
lower the economic value of those programs to us.
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Since
our inception, we have relied primarily on the proceeds from sales of common and preferred equity securities to finance our operations
and internal growth. Additional funding has come through research and development tax credits, government grants, the sale of product
rights, interest on investments, licensing revenue, royalty income, and a limited amount of product revenue from operations discontinued
in September 2012.
As
discussed in Note 1 of the Notes to the Consolidated Financial Statements accompanying this Annual Report on Form 10-K, under ASC Topic
205-40, Presentation of Financial Statements - Going Concern , management is required at each reporting period to evaluate whether
there are conditions and events, considered in the aggregate, that raise substantial doubt about an entity’s ability to continue
as a going concern within one year after the date that the financial statements are issued. This evaluation initially does not take into
consideration the potential mitigating effect of management’s plans that have not been fully implemented as of the date the financial
statements are issued.
Based
on our current operating plan, we anticipate that our cash and cash equivalents of $3.1 million as of December 31, 2024, will allow us
to meet our liquidity requirements into the second quarter of 2025. As of March 24, 2025, our cash balance on hand was approximately
$3.5 million. We continue to work to raise additional capital however as of the date of the Consolidated Financial Statements accompanying
this Annual Report on Form 10-K, there is no guarantee that we will be able to raise additional funds to extend operations beyond the
second quarter of 2025. Our history of losses, our negative cash flows from operations, our liquidity resources currently on hand, and
our dependence on the ability to obtain additional financing to fund our operations after the current resources are exhausted, about
which there can be no certainty, have resulted in our assessment that there is substantial doubt about our ability to continue as a going
concern for a period of at least twelve months from the issuance date of this Annual Report on Form 10-K. While we have plans in place
to mitigate this risk, which primarily consist of raising additional capital through a combination of public or private equity or debt
financings or by entering into partnership agreements for further development of our drug candidates, there is no guarantee that we will
be successful in these mitigation efforts.
Agreements
to Sell Securities
On
November 13, 2024, Cyclacel Pharmaceuticals, Inc. (the “Company”) entered into a letter agreement (the “Warrant Exercise
and Reload Agreement”) with the holder (the “Holder”) of its issued and outstanding Series B Warrants (the “Prior
Warrants”) to purchase an aggregate of 20,703 shares of common stock of the Company offering the Holder the opportunity to exercise
all of its Prior Warrants for cash at a reduced exercise price equal to $99.60 per share provided the Prior Warrants were exercised in
full for cash on or before 12:30 P.M. Eastern Time on the date of the Warrant Exercise and Reload Agreement. In consideration for the
exercise of the Prior Warrants, the Holder received new unregistered Series C Warrants (the “Series C Warrants”) exercisable
for up to an aggregate of 41,407 shares of common stock (the “Series C Warrant Shares”) and new unregistered Series D Warrants
(the “Series D Warrants” and, together with the Series C Warrants, the “New Warrants”) exercisable for up to
an aggregate of 41,407 shares of common stock (the “Series D Warrant Shares” and, together with the Series C Warrant Shares,
the “New Warrant Shares”). The Series C Warrants are exercisable beginning on the date upon which the Company receives stockholder
approval of the issuance of the New Warrant Shares and the Placement Agent Warrant Shares (the “Stockholder Approval Date”)
for a period of five and one-half (5.5) years following the Stockholder Approval Date and the Series D Warrants are exercisable beginning
on the Stockholder Approval Date for a period of eighteen (18) months following the Stockholder Approval Date. The New Warrants each
have an exercise price of $99.60 per share. The shares of common stock issued upon exercise of the Prior Warrants are registered pursuant
to an effective registration statement on Form S-1 (No. 333-279157).
On
April 30, 2024, the Company entered into a securities purchase agreement (the “Purchase Agreement”) with an institutional
investor (the “Purchaser”) for the issuance and sale in a private placement (the “Private Placement”) of (i)
604 shares of the Company’s common stock, (ii) pre-funded warrants to purchase up to 20,099 shares of common stock (the “Pre-Funded
Warrants”), (iii) series A warrants to purchase up to 20,703 shares of common stock (the “Series A Warrants”), and
(iv) series B warrants to purchase up to 20,703 shares of common stock (the “Series B Warrants” and together with the Series
A Warrants, the “Common Warrants”). The purchase price of each share of common stock and associated Common Warrants was $386.40
and the purchase price of each Pre-Funded Warrant and associated Common Warrants was $386.38.
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The
Common Warrants are exercisable immediately upon issuance at an exercise price of $326.40 per share. The Series A Warrants will expire
five and one-half years from the date of issuance and the Series B Warrants will expire eighteen months from the date of issuance. The
Pre-Funded Warrants are exercisable immediately upon issuance at an exercise price of $0.024 per share and may be exercised at any time
until the Pre-Funded Warrants are exercised in full. A holder of Pre-Funded Warrants or Common Warrants (together with its affiliates)
may not exercise any portion of such warrants to the extent that the holder would own more than 4.99% (or, at the election of the holder
9.99%) of the Company’s outstanding common stock immediately after exercise.
In
connection with the Private Placement, the Company entered into a registration rights agreement (the “Registration Rights Agreement”),
dated as of April 30, 2024, with the Purchaser, pursuant to which the Company agreed to prepare and file a registration statement with
the Securities and Exchange Commission (the “SEC”) registering the resale of the securities issued in the Private Placement.
On
December 21, 2023, we entered into a securities purchase agreement (the “Securities Purchase Agreement”) with certain institutional
investors (the “Purchasers”). Pursuant to the Securities Purchase Agreement, we agreed to sell in a registered direct offering
(“Registered Direct Offering”) 702 shares (“Shares”) of our common stock and pre-funded warrants (“Pre-Funded
Warrants”) to purchase up to 915 shares of common stock. The Pre-Funded Warrants have an exercise price of $0.24 per share and
are immediately exercisable and can be exercised at any time after their original issuance until such Pre-Funded Warrants are exercised
in full. Each Share was sold at a price of $795.60 and each Pre-Funded Warrant was sold at a price of $795.36 (equal to the purchase
price per Share minus the exercise price of the Pre-Funded Warrant).
Pursuant
to the Securities Purchase Agreement, in a concurrent private placement (together with the Registered Direct Offering, the “Offerings”),
we also agreed to issue to the Purchasers unregistered warrants (“Common Warrants”) to purchase up to 1,617 shares of common
stock. Each Common Warrant has an exercise price of $765.60 per share, is exercisable immediately following their original issuance and
will expire seven years from the original issuance date. The closing of the offering occurred on December 26, 2023, and the net proceeds
to us were approximately $1.0 million, after deducting placement agent fees and other offering expenses payable by us. Ladenburg Thalmann
& Co. Inc. (the “Placement Agent”) acted as the exclusive placement agent for the Offerings, pursuant to a placement
agency agreement dated December 21, 2023, by and between us and the Placement Agent.
On
December 21, 2023, in a separate concurrent insider private placement (the “Insider Private Placement”), we also entered
into a Securities Purchase Agreement with certain of our executive officers (the “Insider Securities Purchase Agreement”)
pursuant to which we agreed to sell in a private placement (i) 25 shares of common stock and warrants to purchase 25 shares of common
stock on the same terms as the Common Warrants issued to the Purchasers in the Offerings to Spiro Rombotis, our Chief Executive Officer,
and (ii) 7 shares of common stock and warrants to purchase 7 shares of common stock on the same terms as the Common Warrants issued
to the Purchasers in the Offerings to Paul McBarron, our Executive Vice President-Finance, Chief Financial Officer and Chief Operating
Officer. Each such share of common stock and accompanying warrant was sold at a purchase price of $795.60, which was the same purchase
price for the Shares sold in the Registered Direct Offering.
On
August 12, 2021, we entered into a Controlled Equity Offering Sales Agreement (the “Sales Agreement”) with Cantor Fitzgerald
& Co. (“Cantor”), pursuant to which we could issue and sell, from time to time, shares of our common stock having an
aggregate offering price of up to $50.0 million through Cantor as the sales agent. Cantor could sell our common stock by any method permitted
by law deemed to be an “at the market offering” as defined in Rule 415(a)(4) of the Securities Act.
On
August 12, 2022, we became aware that the shelf registration statement on Form S-3 (file number 333-231923) (the “Registration
Statement”) associated with this Sales Agreement had expired on June 21, 2022. Prior to becoming aware of the expiration, but following
the expiration, we sold an aggregate of 551 shares of our common stock at market prices for aggregate proceeds of approximately $2,721,187.
The sale of these shares were subject to potential rescission rights by certain stockholders. As a result of these rescission rights,
we classified 865 shares (including 313 previously issued and outstanding shares sold for which the Company did not receive proceeds
and which were reclassified to temporary equity as of September 30, 2022), with an aggregate redemption value of $4,494,496 of our common
stock as stock outside stockholders equity. We also restated our loss per share as a result of $135,000 of associated fees not initially
accounted for as accretion to the maximum redemption amount of the shares subject to potential rescission. During the third quarter of
2023, upon expiration of the rescission rights and with no claims or demands to exercise such rights, we reclassified all 865 shares
back to permanent equity. In all periods presented, the shares subject to the rescission rights were treated as issued and outstanding
for purposes of earnings per share and general financial reporting.
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Dividend
on Preferred Stock
On
January 29, 2025, the Board of Directors of Cyclacel Pharmaceuticals, Inc. (the “Company”) passed a resolution to suspend
payment of the quarterly cash dividend on the Company’s 6% Convertible Exchangeable Preferred Stock (the “Preferred Stock”)
scheduled for February 1, 2025. The quarterly cash dividend payments were suspended for payments scheduled for May 1, 2024, August 1,
2024 and November 1, 2024. The Board of Directors will continue to evaluate the payment of a quarterly cash dividend on a quarterly basis.
Results
of Operations
Years
Ended December 31, 2024 and 2023
Results
of Continuing Operations
Revenues
The
following table summarizes the revenues for years ended December 31, 2024 and 2023 (in thousands except percentages):
Year ended December 31,
Difference
2024
2023
$
%
Clinical trial supply
43
420
(377 )
(90 )
Total Revenue
$ 43
$ 420
$ (377 )
(90 )
We
recognize recognized $43,000 of revenue for the year ended December 31, 2024. This revenue relates to recovery of clinical manufacturing
costs associated with an investigator sponsored study managed by Cedars-Sinai Medical Center. We recognized $420,000 of revenue for the
comparative period in 2023.
We
do not expect to report revenue for the foreseeable future.
Research
and development
We
expense all research and development costs as they are incurred. Research and development expenses primarily include:
● Clinical
trial and regulatory-related costs;
● Payroll
and personnel-related expenses, including consultants and contract research organizations;
● Preclinical
studies and materials;
● Technology
license costs;
● Stock-based
compensation; and
● Rent
and facility expenses for our office.
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The
following table provides information with respect to our research and development expenditures for the years ended December 31, 2024
and 2023 (in thousands except percentages):
Year Ended December 31,
Difference
2024
2023
$
%
Transcriptional Regulation (fadraciclib)
$ 4,970
$ 13,358
$ (8,388 )
(63 )
Anti-mitotic (plogo)
1,566
4,987
(3,421 )
(69 )
Other research and development expenses
119
810
(691 )
(85 )
Total research and development expenses
$ 6,655
$ 19,155
$ (12,500 )
(65 )
Research
and development expenses represented 55% and 74% of our operating expenses for the years ended December 31, 2024 and 2023, respectively.
Research
and development expenses decreased by $12.5 million from $19.2 million for the year ended December 31, 2023 to $6.7 million for the year
ended December 31, 2024. Expenditure for the transcriptional regulation program decreased by $8.4 million for the year ending December
31, 2024 relative to the respective comparative period. This decrease was primarily due to a decrease in clinical trial costs of $2.4
million associated with the temporary halt in the Phase 1/2 study in hematological malignancies, the completion of a bioequivalence and
tox studies during the prior year of $2.1 million, reduction in manufacturing costs of $3.5 million and other non-clinical expenditure
of $0.4 million. Research and development expenses relating to Plogo decreased by $3.4 million for the year ending December 31, 2024
relative to the respective comparative period. This decrease was primarily due to a decrease in clinical trial costs of $1.6 million
associated with the progression of clinical trials for the evaluation of Plogo in Phase 1/2 studies, a decrease in manufacturing costs
of $0.5 million, employment costs of $0.6 million and other non-clinical expenditure of $0.7 million.
The
future
We
anticipate that overall research and development expenses for the year ended December 31, 2025 will decrease significantly compared to
the year ended December 31, 2024 as we focus on our Plogo clinical program. There will be no expenditure related to fadraciclib as the
program is being marketed for sale by the joint liquidator of the Subsidiary.
General
and administrative
General
and administrative expenses include costs for administrative personnel, legal and other professional expenses and general corporate expenses.
The following table summarizes the total general and administrative expenses for the years ended December 31, 2024 and 2023 (in thousands
except percentages):
Year Ended December 31,
Difference
2024
2023
$
%
Total general and administrative expenses
$ 5,392
$ 6,718
$ (1,326 )
(20 )
Total
general and administrative expenses represented 45% and 26% of our operating expenses for the years ended December 31, 2024 and 2023,
respectively.
Our
general and administrative expenditures decreased by $1.3 million from $6.7 million for the year ended December 31, 2023 to $5.4 million
for the year ended December 31, 2024. This decrease was primarily due to reduction in stock compensation costs of $0.5 million, employment
related costs of $0.2 million, corporate reporting costs of $0.2 million and investor relation costs of $0.2 million against the comparative
prior period.
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The
future
We
expect general and administrative expenditures for the year ended December 31, 2025 to reduce significantly compared to the year ended
December 31, 2024 following the deconsolidation of the UK Subsidiary and elimination of related expenditures.
Other
expense, net
The
following table summarizes the other income (expense) for years ended December 31, 2024 and 2023 (in thousands except percentages):
Year Ended December 31,
Difference
2024
2023
$
%
Foreign exchange losses
$ (54 )
$ (414 )
$ 360
(87 )
Interest income
12
266
(254 )
(95 )
Other income, net
52
50
2
4
Total other income (expense), net
$ 10
(98 )
$ 108
(110 )
Total
other expense, net, increased by $108,000 from an expense of $98,000 for the year ended December 31, 2023 to an income of $10,000 for
the year ended December 31, 2024. The decrease in other expense, net primarily relates to a reduction in interest income of $254,000
as a direct result of holding lower cash balances during 2024. Other income, net relates to royalties receivable under a December 2005
Asset Purchase Agreement, or APA, whereby Xcyte Therapies, Inc., or Xcyte (a business acquired by us in March 2006) sold through the
APA and other related agreements certain assets and intellectual property which are not related to our product development plans to ThermoFisher
Scientific Company, or TSC. Accordingly, we presented $52,000 and $50,000 as other income received from TSC during the years ended December
31, 2024 and 2023 respectively. We have no knowledge of TSC’s activities and cannot predict when we may receive income under the
APA, if any.
Foreign
exchange losses
Foreign
exchange losses increased by $360,000 to a loss of $54,000 for the year ended December 31, 2024 compared to a loss of $414,000 for the
year ended December 31, 2023.
We
have intercompany loans in place between our parent company based in New Jersey and our subsidiary based in Scotland. The intercompany
loans outstanding are not expected to be repaid in the foreseeable future and the nature of the funding advanced is of a long-term investment
nature. Therefore, all unrealized foreign exchange gains or losses arising on the intercompany loans are recognized in other comprehensive
income until repayment of the intercompany loan becomes foreseeable. Unfavorable unrealized foreign exchange movements related to intercompany
loans resulted in a loss of $2.9 million for the year ended December 31, 2024 compared to a gain of $12.6 million for the year ended
December 31, 2023.
The
future
Other
income (expense), net will continue to be impacted by changes in foreign exchange rates and the receipt of income under the APA. As we
are not in control of sales made by TSC, we are unable to estimate the level and timing of income under the APA, if any.
As
a result of the liquidation of the UK subsidiary in January 2025, the intercompany loans will be written off as part of the deconsolidation
process. The accumulated translation adjustments currently recorded in other comprehensive income within equity will be reversed and
recorded as part of the gain/loss from deconsolidation of the subsidiary.
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Income
tax benefit
We
record research and development tax credits within income taxes. Credit is taken for research and development tax credits, which are
claimed from the United Kingdom’s taxation and customs authority (HMRC), in respect of qualifying research and development costs
incurred.
The
following table summarizes total income tax benefit from such credits for the years ended December 31, 2024 and 2023 (in thousands except
percentages):
Year Ended December 31,
Difference
2024
2023
$
%
Total income tax benefit
$ 782
$ 2,996
$ (2,214 )
(74 )
The
income tax benefit decreased significantly by approximately $2.2 million, from $3.0 million for the year ended December 31, 2023 to $0.8
million for the year ended December 31, 2024, due to the ineligibility to recover qualifying research and developments expenditure incurred
during 2024. The $0.8 million tax benefit in 2024 relates to a deferred claim based on 2023 qualifying research and development expenditure.
The level of tax credits recoverable is linked directly to qualifying research and development expenditure incurred in any one year and
the availability of trading losses.
The
future
We
do not expect to continue to be eligible to receive United Kingdom research and development tax credits for the year ending December
31, 2025
Liquidity
and Capital Resources
The
following is a summary of our key liquidity measures as of December 31, 2024 and 2023 (in thousands):
December 31,
2024
2023
Cash and cash equivalents
$ 3,137
$ 3,378
Working capital:
Current assets
$ 3,674
$ 7,444
Current liabilities
(6,268 )
(8,161 )
Total working capital deficit
$ (2,594 )
$ (717 )
Cash
Flows
Cash
provided by (used in) operating, investing and financing activities for the years ended December 31, 2024 and 2023 is summarized as follows
(in thousands):
Year Ended December 31,
2024
2023
Net cash used in operating activities
$ (7,990 )
$ (16,112 )
Net cash used in investing activities
—
(6 )
Net cash provided by financing activities
7,822
848
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Operating
activities
Net
cash used in operating activities decreased by $8.1 million, from $16.1 million for the year ended December 31, 2023 to $8.0 million
for the year ended December 31, 2024. The decrease in cash used by operating activities was primarily the result of a decrease in net
loss of $11.3 million, offset by a change in working capital of $2.3 million and stock based compensation of $0.9 million. The $2.3 million
change in working capital was primarily due to receivables for research and development tax credits. A cash receipt of approximately
$3.7 million in research and development tax credit was received during the year ended December 31, 2024.
Investing
activities
There
was no net cash used in investing activities for the year ended December 31, 2024 and $6,000 in capital expenditures on information technology
(“IT”) during the respective comparative period.
Financing
activities
Net
cash provided by financing activities was $7.8 million for the year ended December 31, 2024 as a direct result of receiving approximately:
- $6.2
million, net of expenses, from the issuance of common stock and warrants under a Securities
Purchase Agreement with an institutional investor,
- $1.6
million in net proceeds from a warrant exercise and reload agreement
Net
cash provided by financing activities was $0.8 million for the year ended December 31, 2023 as a direct result of receiving approximately:
- $1.0
million in net proceeds from the issuance of common stock and pre-funded warrants pursuant
to the Registered Direct Offering,
- offset
by dividend payments of approximately $0.2 million to the holders of our 6% Convertible Exchangeable
Preferred Stock in 2023 that were not paid in 2024.
Contractual
Obligations
The
following table summarizes our long-term contractual obligations as of December 31, 2024 (in thousands):
Payments Due by Period
Total
Less than
1 year
1 – 3 years
3 – 5 years
More than
5 years
Operating Lease Obligations (1)
$ 5
$ 5
$ —
$ —
$ —
(1) Operating
lease obligations relates to leasing office space at our Berkeley Heights, New Jersey location.
The lease for our Berkeley Heights location, which was entered into in April 2022, has been
terminated, effective January 31, 2025. Effective March 1, 2025, the Company entered into
a two year lease agreement for our corporate headquarters at Level 10, Tower 11, Avenue 5,
No. 8, Jalan Kerinchi, 59200 Kuala Lumpur, Malaysia.
Off-Balance
Sheet Arrangements
Since
our inception, we have not had any off-balance sheet arrangements or relationships with unconsolidated entities or financial partnerships,
such as entities often referred to as structured finance or variable interest entities, which are typically established for the purpose
of facilitating off-balance sheet arrangements or other contractually narrow or limited purposes.
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Recently
Issued Accounting Pronouncements
Please
see Note 2 to the consolidated financial statements for a discussion of the potential effects that recently issued, but not yet effective,
accounting standards will have on our financial statements when adopted in a future period.
Critical
Accounting Policies and Estimates
Our
discussion and analysis of our financial condition and results of operations is based on our financial statements, which have been prepared
in accordance with accounting principles generally accepted in the United States. The preparation of these financial statements requires
us to make estimates and judgments that affect the reported amounts of assets, liabilities and expenses and related disclosure of contingent
assets and liabilities. We review our estimates on an ongoing basis. We base our estimates on historical experience and on various other
factors that we believe to be reasonable under the circumstances. Actual results may differ from these estimates. We believe the judgments
and estimates required by the following accounting policies to be critical in the preparation of our consolidated financial statements.
Our
significant accounting policies are more fully described in Note 2 to our consolidated financial statements included elsewhere in this
report. We believe the following critical accounting policies reflect our more significant estimates and assumptions used in the preparation
of our consolidated financial statements.
Accrued
Research and Development Costs
Accrued
research and development costs comprise our best estimates related to the cost of clinical trials, laboratory, and manufacturing activities
that were incurred, but not paid or invoiced, as of the end of a reporting period.
Data
management and monitoring of our clinical trials are performed with the assistance of contract research organizations, or CROs, or clinical
research associates, or CRAs, in accordance with our standard operating procedures. Typically, CROs and CRAs bill monthly for services
performed, or based upon milestones achieved. We accrue unbilled clinical trial expenses based on estimates of the level of services
performed each period. Moreover, clinical trial costs related to patient enrollment are accrued as patients are entered into and progress
through the trial.
We
also perform outsourced laboratory and manufacturing activities. We accrue for unbilled laboratory and manufacturing activities performed
by third parties based on estimates of their progress towards completing the requested tasks.
As
of December 31, 2024, we accrued $1.3 million research and development costs, that we have estimated to have been incurred as of year-end
but had not been invoiced. This represents approximately 20% of our total research and development expense for the year ended December
31, 2024. As of December 31, 2023, we accrued $3.7 million research and development costs, that we have estimated to have been incurred
as of year-end but had not been invoiced. This represents approximately 19% of our total research and development expense for the year
ended December 31, 2023.
When
recording these accruals, we must make judgments about the progress of our various clinical activities. We (as well as our CROs and CRAs)
are reliant on information being provided timely and accurately by the multitude of clinics and hospitals where the studies are being
conducted, some of which are located internationally. We must also make estimates about the progress our third-party vendors are making
towards completing laboratory and manufacturing activities.
Stock-based
Compensation
We
grant stock options, restricted stock units and restricted stock to officers, employees, directors and consultants under our 2018 Equity
Incentive Plan (the 2018 Plan) and the 2020 Inducement Equity Incentive Plan. We measure compensation cost for all stock-based awards
at fair value on date of grant and recognize compensation over the requisite service period. The fair value of restricted stock and restricted
stock units is determined based on the number of shares granted and the quoted price of our common stock on the date of grant. The determination
of grant-date fair value for stock option awards is estimated using an option-pricing model, which includes variables such as the expected
volatility of our share price, the anticipated exercise behavior of our employees, interest rates, and dividend yields. These variables
are projected based on our historical data, experience, and other factors. Changes in any of these variables could result in significant
adjustments to the costs recognized for share-based payments.
Item
7A. Quantitative and Qualitative Disclosures About Market Risk
As
a smaller reporting company, we are not required to provide information response to this item.
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Item
8. Financial Statements and Supplementary Data
INDEX
TO CYCLACEL PHARMACEUTICALS, INC. FINANCIAL STATEMENTS
Page
Report of Independent Registered Public Accounting Firm (PCAOB ID: 7167)
79
Consolidated Balance Sheets as of December 31, 2024 and 2023
81
Consolidated Statements of Operations (Loss) for the years ended December 31, 2024 and 2023
82
Consolidated Statements of Comprehensive Loss for the years ended December 31, 2024 and 2023
83
Consolidated Statements of Stockholders’ Equity for the years ended December 31, 2024 and 2023
84
Consolidated Statements of Cash Flows for the years ended December 31, 2024 and 2023
85
Notes to Consolidated Financial Statements
86
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REPORT
OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
To
the Board of Directors and the Stockholders of Bio Green Med Solution, Inc. (Formerly known as Cyclacel Pharmaceuticals, Inc.)
Opinion
on the Consolidated Financial Statements
We
have audited the accompanying consolidated balance sheet of Bio Green Med Solution, Inc. (Formerly known as Cyclacel Pharmaceuticals,
Inc.) and its subsidiary (collectively, the “Company”) as of December 31, 2024 and 2023, and the related consolidated statements
of operations (loss) and other comprehensive loss, stockholders’ equity and cash flows for each of the years ended December 31,
2024 and 2023, and the related notes (collectively referred to as the “consolidated financial statements”). In our opinion,
the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December
31, 2024 and 2023, and the results of its operations and its cash flows for each of the years ended December 31, 2024 and 2023, in conformity
with accounting principles generally accepted in the United States of America.
Substantial
doubt about the Company’s ability to continue as a going concern
The
accompanying consolidated financial statements have been prepared assuming that the Company will continue as a going concern. As discussed
in Note 1 to the financial statements, the Company does not currently have sufficient funds to complete development and commercialization
and has a limited cash balance as of December 31, 2024 and 2023. This raises substantial doubt about the Company’s ability to continue
as a going concern. Management’s plans in regard to these matters are also described in Note 1. The financial statements do not
include any adjustments that might result from the outcome of this uncertainty.
Basis
for Opinion
These
consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion
on the Company’s consolidated financial statements based on our audits. We are a public accounting firm registered with the Public
Company Accounting Oversight Board (United States) (“PCAOB”) and are required to be independent with respect to the Company
in accordance with the United States federal securities laws and the applicable rules and regulations of the Securities and Exchange
Commission and the PCAOB.
We
conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud.
The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part
of our audits, we are required to obtain an understanding of internal control over financial reporting, but not for the purpose of expressing
an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.
Our
audits included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether
due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence
regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles
used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements.
We believe that our audits provide a reasonable basis for our opinion.
Critical
Audit Matters
The
critical audit matter communicated below is a matter arising from the current period audit of the financial statements that were communicated
or required to be communicated to the audit committee and that: (1) relate to accounts or disclosures that are material to the financial
statements and (2) involved our especially challenging, subjective or complex judgments. The communication of critical audit matters
does not alter in any way our opinion on the financial statements, taken as a whole, and we are not, by communicating the critical audit
matters below, providing separate opinions on the critical audit matters or on the accounts or disclosures to which they relate.
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CRITICAL
TRIAL ACCRUAL AND EXPENSES
As
discussed in Notes 2 and 9 of the consolidated financial statements, the Company’s total accrued expenses for research and development
were $1.3 million at December 31, 2024, which included the estimated obligation for pre-clinical and clinical trial expenses incurred
as of December 31, 2024, but not paid as of that date. The Company’s clinical trial expenses are based on the Company’s estimates
of the level of services performed each period pursuant agreements with third parties that conduct research and development on the Company’s
behalf, which results in an accrual or prepaid at period end.
We
identified the Company’s accrued clinical trial expenses as a critical audit matter because auditing the application of significant
management judgment over the estimate of services provided but not yet invoiced required significant audit effort and a high degree of
auditor judgment and subjectivity to evaluate the audit evidence obtained. Specifically, the amount of accrued clinical trial expenses
recognized is dependent on the availability of information to make the estimate, including information from multiple sources, the level
of effort expended as of the balance sheet date and the associated cost of such services. Additionally, due to the timing of invoicing
received from third parties, the actual amounts incurred are not typically known on the date the Company issues its financial statements.
Our
audit procedures to evaluate the Company’s estimate of services incurred as of period end pursuant to its clinical trials included,
among others:
● We
tested the accuracy and completeness of the underlying data used in the estimates and evaluated
the significant assumptions stated above that are used by management to estimate the recorded
amounts.
● To
evaluate the completeness and valuation of the accrual clinical trial expenses, we compared
invoices received by the Company subsequent to December 31, 2024, to the amounts recognized
by the Company as of that date.
● We
inspected the Company’s contracts with third parties and any pending change orders
to assess the impact to the amounts recorded.
/s/
SFAI Malaysia PLT
We
have served as the Company’s auditor since 2025.
Malaysia
November
26, 2025
PCAOB
ID Number 7167
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Table of Contents
CYCLACEL
PHARMACEUTICALS, INC.
CONSOLIDATED
BALANCE SHEETS
(In
thousands, except share and per share amounts)
December 31,
December 31,
2024
2023
ASSETS
Current assets:
Cash and cash equivalents
$ 3,137
$ 3,378
Prepaid expenses and other current assets
537
4,066
Total current assets
3,674
7,444
Property and equipment, net
3
9
Right-of-use lease asset
5
93
Non-current deposits
412
1,259
Total assets
$ 4,094
$ 8,805
LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT)
Current liabilities:
Accounts payable
$ 4,599
$ 3,543
Accrued and other current liabilities
1,669
4,618
Total current liabilities
6,268
8,161
Lease liability
—
37
Total liabilities
6,268
8,198
Stockholders’ equity (deficit):
Preferred stock, $ 0.001 par value; 5,000,000 shares authorized at December 31, 2024 and December 31,
2023; 6 % Convertible Exchangeable preferred stock; 135,273 shares issued and outstanding at December 31, 2024 and 335,273
shares issued and outstanding at December 31, 2023. Aggregate preference in liquidation of $ 1,697,676 as of December 31,
2024 and $ 4,006,512 as of December 31, 2023
—
—
Series A convertible preferred stock, $ 0.001 par value; 264 shares issued and outstanding at December 31, 2024 and
December 31, 2023
—
—
Series B convertible preferred stock, $ 0.001 par value; 0 shares issued and outstanding at December 31, 2024 and 119,000
shares issued and outstanding at December 31, 2023
—
—
Preferred stock, value
—
—
Common stock, $ 0.001 par value; 100,000,000 shares authorized at December 31, 2024 and December 31, 2023; 36,913
shares issued and outstanding at December 31, 2024 and 4,412 shares issued and outstanding at December 31, 2023
—
—
Additional paid-in capital
438,211
429,797
Accumulated other comprehensive loss
( 891 )
( 908 )
Accumulated deficit
( 439,494 )
( 428,282 )
Total stockholders’ equity (deficit)
( 2,174 )
607
Total liabilities and stockholders’ equity (deficit)
$ 4,094
$ 8,805
The
accompanying notes are an integral part of these consolidated financial statements.
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CYCLACEL
PHARMACEUTICALS, INC.
CONSOLIDATED
STATEMENTS OF OPERATIONS (LOSS)
(In
thousands, except share and per share amounts)
2024
2023
Year Ended
December 31,
2024
2023
Revenues:
Clinical trial supply
$ 43
$ 420
Revenues
43
420
Operating expenses:
Research and development
6,655
19,155
General and administrative
5,392
6,718
Total operating expenses
12,047
25,873
Operating loss
( 12,004 )
( 25,453 )
Other expense:
Foreign exchange losses
( 54 )
( 414 )
Interest income
12
266
Other income, net
52
50
Total other income (expense), net
10
( 98 )
Loss before taxes
( 11,994 )
( 25,551 )
Income tax benefit
782
2,996
Net loss
( 11,212 )
( 22,555 )
Dividend on convertible exchangeable preferred shares
—
( 201 )
Net loss applicable to common shareholders
$ ( 11,212 )
$ ( 22,756 )
Basic and diluted earnings per common share:
Net loss per share – basic and diluted (common shareholders)
$ ( 504.30 )
$ ( 6,419.18 )
The
accompanying notes are an integral part of these consolidated financial statements.
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CYCLACEL
PHARMACEUTICALS, INC.
CONSOLIDATED
STATEMENTS OF COMPREHENSIVE LOSS
(In
thousands)
2024
2023
Year Ended
December 31,
2024
2023
Net loss
$ ( 11,212 )
$ ( 22,555 )
Translation adjustment
2,916
( 12,142 )
Unrealized foreign exchange gain (loss) on intercompany loans
( 2,899 )
12,550
Comprehensive loss
$ ( 11,195 )
$ ( 22,147 )
The
accompanying notes are an integral part of these consolidated financial statements.
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CYCLACEL
PHARMACEUTICALS, INC.
CONSOLIDATED
STATEMENTS OF STOCKHOLDERS’ EQUITY
(In
thousands, except share amounts)
Shares
Amount
Shares
Amount
Capital
Loss
Deficit
Equity
Additional
Accumulated
Other
Total
Preferred Stock
Common Stock
Paid-in
Comprehensive
Accumulated
Stockholders’
Shares
Amount
Shares
Amount
Capital
Loss
Deficit
Equity
Balances at December 31, 2022
573,282
$ —
2,617
$ 0
$ 422,982
$ ( 1,316 )
$ ( 405,727 )
$ 15,939
Issue of common stock and pre-funded warrants in
Securities Purchase Agreement In Registered
—
—
735
—
1,049
—
—
1,049
Direct Offering, net of expenses
Issue of common stock and pre-funded warrants in Securities Purchase Agreement In
Registered Direct Offering, net of expenses
—
—
735
—
1,049
—
—
1,049
Conversion of series B Preferred stock
( 118,745 )
—
165
—
—
—
—
—
Reclassification of redeemable common stock
—
—
866
—
4,494
—
—
4,494
Stock-based compensation
—
—
29
—
1,473
—
—
1,473
Preferred stock dividends
—
—
—
—
( 201 )
—
—
( 201 )
Unrealized foreign exchange on intercompany
—
—
—
—
—
12,550
—
12,550
loans
Translation adjustment
—
—
—
—
—
( 12,142 )
—
( 12,142 )
Loss for the period
—
—
—
—
—
—
( 22,555 )
( 22,555 )
Balances at December 31, 2023
454,537
$ —
4,412
$ 0
$ 429,797
$ ( 908 )
$ ( 428,282 )
$ 607
Balance
454,537
$ —
4,412
$ 0
$ 429,797
$ ( 908 )
$ ( 428,282 )
$ 607
Issue of common stock, preferred stock and
associated warrants on underwritten offering, net of
—
—
2,944
-
6,209
—
—
6,209
expenses
Issue of common stock, preferred stock and associated warrants on underwritten
offering, net of expenses
—
—
2,944
-
6,209
—
—
6,209
Conversion of series B Preferred stock
( 119,000 )
—
165
—
—
—
—
—
Conversion of series 6 % Convertible Exchangeable
( 200,000 )
—
-
—
—
—
—
—
Preferred
Conversion of series 6%
Convertible Exchangeable Preferred
( 200,000 )
—
-
—
—
—
—
—
Warrant Exercises
—
—
29,391
-
1,613
—
—
1,613
Stock-based compensation
—
—
—
—
592
—
—
592
Unrealized foreign exchange on intercompany
—
—
—
—
—
( 2,899 )
—
( 2,899 )
loans
Unrealized foreign exchange on intercompany loans
—
—
—
—
—
( 2,899 )
—
( 2,899 )
Translation adjustment
—
—
—
—
—
2,916
—
2,916
Loss for the period
—
—
—
—
—
—
( 11,212 )
( 11,212 )
Balances at December 31, 2024
135,537
$ —
36,913
$ -
$ 438,211
$ ( 891 )
$ ( 439,494 )
$ ( 2,174 )
Balance
135,537
$ —
36,913
$ -
$ 438,211
$ ( 891 )
$ ( 439,494 )
$ ( 2,174 )
The
accompanying notes are an integral part of these consolidated financial statements.
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CYCLACEL
PHARMACEUTICALS, INC.
CONSOLIDATED
STATEMENTS OF CASH FLOWS
(In
thousands)
2024
2023
Year Ended December 31,
2024
2023
Operating activities:
Net loss
$ ( 11,212 )
$ ( 22,555 )
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation
6
31
Stock-based compensation
592
1,473
Changes in lease liability
( 37 )
( 69 )
Changes in operating assets and liabilities:
Prepaid expenses and other assets
4,472
4,712
Accounts payable, accrued and other current liabilities
( 1,811 )
296
Net cash used in operating activities
( 7,990 )
( 16,112 )
Investing activities:
Purchase of property, plant and equipment
—
( 6 )
Net cash used in investing activities
—
( 6 )
Financing activities:
Proceeds, net of issuance costs, from issuing common stock and pre-funded warrants, net
6,209
1,049
Proceeds from the exercise of stock options and warrants, net of issuance costs
1,613
—
Payment of preferred stock dividend
—
( 201 )
Net cash provided by (used) in financing activities
7,822
848
Effect of exchange rate changes on cash and cash equivalents
( 73 )
303
Net increase (decrease) in cash and cash equivalents
( 241 )
( 14,967 )
Cash and cash equivalents, beginning of period
3,378
18,345
Cash and cash equivalents, end of period
$ 3,137
$ 3,378
Supplemental cash flow information:
Cash received during the period for:
Interest
$ 96
$ 266
Research & development tax credits
$ 3,715
$ 4,846
Cash paid during the period for:
Taxes
$ 2
$ 2
Non cash financing activities:
Accrual of preferred stock dividends
$ —
$ 50
The
accompanying notes are an integral part of these consolidated financial statements.
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CYCLACEL
PHARMACEUTICALS, INC.
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Subsequent
Events
Preferred
Stock
On
January 29, 2025, the Board of Directors of Cyclacel Pharmaceuticals, Inc. (the “Company”) passed a resolution to suspend
payment of the quarterly cash dividend on the Company’s 6 % Convertible Exchangeable Preferred Stock (the “Preferred Stock”)
scheduled for February 1, 2025. The Board of Directors will continue to evaluate the payment of a quarterly cash dividend on a quarterly
basis.
Financing
and Restructuring Activities
On
January 2, 2025 the Company entered into a securities purchase agreement with investor David Lazar, pursuant to which he agreed to purchase
from the Company 1,000,000 shares of Series C Convertible Preferred Stock and 2,100,000 shares of Series D Convertible Preferred Stock
of Cyclacel at a purchase price of $ 1.00 per share for aggregate gross proceeds of $ 3.1 million, subject to the terms and conditions
of the Agreement. The proceeds of the transaction will be used to settle outstanding liabilities of the Company and other general corporate
and operating purposes.
On
January 31, 2025, the creditors voluntary liquidation of Cyclacel Limited was announced in the London Gazette, one of the official public
records of the government of the United Kingdom. As part of the Company’s efforts to reduce operating costs it has determined to
focus on the development of the Plogo clinical program only. Therefore fadraciclib, the Subsidiary’s other drug development program,
is being marketed for sale by the liquidators through Hilco Appraisals Limited, a firm of professional valuation agents and will no longer
be part of the assets of the Company as of January 2025. With the commencement of the liquidation of the Subsidiary, the Company will
no longer be considered to have control over the Subsidiary and the financial results of the Subsidiary will be deconsolidated from those
of the Company. The deconsolidation, which is anticipated to increase stockholders’ equity by approximately $ 5.6 million, will
be reported in the Company’s Form 10-Q for the three months ended March 31, 2025.
On
February 4, 2025, the Company entered into a securities purchase agreement with investor David Lazar, for the issuance and sale in a
private placement of up to $ 8,000,000 of shares of common stock, par value $ 0.001 per share of the Company. The Company shall have the
right, but not the obligation, to direct the Purchaser, by delivering written notice thereof from time to time and until September 30,
2026, to purchase up to the Aggregate Purchase Price of Shares at a purchase price equal to the greater of (i) the consolidated closing
bid price immediately prior to the entry of this Agreement and (ii) the consolidated closing bid price on the business day immediately
preceding the applicable purchase date. Unless otherwise agreed by the Company and the Purchaser, the Company’s right to cause
the Purchaser to purchase the Shares pursuant to the Lazar Purchase Agreement must be exercised in either $ 1,000,000 or $ 2,000,000 increments.
On
February 5, 2025, the Company entered into a securities purchase agreement with Helena Special Opportunities 1 Ltd. (“Helena”),
pursuant to which the Company, subject to the restrictions and satisfaction of the conditions in the purchase agreement, has the right,
but not the obligation, to sell to Helena, and Helena is obligated to purchase, up to the lesser of (i) $ 25 million of newly issued shares
of the Company’s Common Stock and (ii) the Exchange Cap (as defined in the agreement).
The
Company held a special meeting of stockholders (the “ Special Meeting ”) on February 6, 2025 at which, among other matters,
the Company’s stockholders approved an amendment to the Company’s Amended and Restated Certificate of Incorporation to effect
a reverse stock split at a ratio not less than 1:4 and not more than 1:16 (the “2025 Reverse Stock Split”) such ratio and
the implementation and timing of such Reverse Stock Split to be determined in the discretion of the Company’s Board of Directors
(the “Board”). The 2025 Reverse Stock Split is expected to be implemented by the Board in or around May 2025.
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Table of Contents
On
February 26, 2025, David Lazar, the Company’s interim Chief Executive Officer, interim principal financial officer, interim principal
accounting officer, and Secretary, provided notice of his resignation as Chief Executive Officer and Secretary of the Company effective
February 26, 2025. Mr. Lazar will continue his role as co-principal financial officer and co-principal accounting officer to assist with
the transition of the Company’s new Chief Financial Officer, as discussed below. Mr Lazar’s resignation was not the result
of any disagreement between Mr. Lazar and the Company on any matter relating to the Company’s operations, policies or practices.
In connection with Mr. Lazar’s departure, he will not be eligible to receive any severance benefits or any performance based bonus
compensation for the 2025 partial year.
On
February 11, 2025, David E. Lazar (the “Seller”), the interim Chief Executive Officer and Secretary of the Company, entered
into a securities purchase agreement (the “Purchase Agreement”) with an investor, Datuk Dr. Doris Wong Sing Ee (the “Investor”)
pursuant to which the Investor agreed to purchase 1,000,000 shares of Series C Convertible Preferred Stock of the Company, $ 0.0001 par
value per share (the “Series C”) and such number of the 2,100,000 shares of Series D Convertible Preferred Stock of the Company,
$ 0.0001 par value per share (the “Series D”) currently held by Seller so that Purchaser shall hold seventy percent ( 70 %)
of the issued and outstanding shares of the Company, which resulted in the issuance of 1,745,262 shares of Series D (collectively, the
Series C and Series D are the “Securities”). The transaction contemplated by the Purchase Agreement closed on February 26,
2025 (the “Closing Date”). Additionally, the Investor purchased and succeeded to all of the Seller’s rights and interests
under that certain securities purchase agreement between the Seller and the Company dated January 2, 2025. On the Closing Date, the Seller
issued written notice to the Company to exercise the conversion rights related to the Series C and Series D shares into Common Stock
of the Company registered in the Investor’s name, as follows: (i) the conversion of 1,000,000 shares of Series C into 11,041 shares
of Common Stock of the Company; and (ii) the conversion of 1,745,262 shares of Series D into 799,911 shares of Common Stock of the Company.
Effective
as of February 26, 2025, the Board appointed Datuk Dr. Doris Wong Sing Ee, as Chief Executive Officer and, in such role, she will serve
as the Company’s principal executive officer. Datuk Dr. Doris Wong Sing Ee was also elected to the Board of the Company as of that
date.
Effective
as of February 26, 2025, the Board appointed Kiu Cu Seng, as Chief Financial Officer and, in such role, he will serve as the Company’s
co-principal financial officer and co-principal accounting officer along with David Lazar until the effective date of his resignation
on the earlier of the filing date of the Company’s annual report on Form 10-K for the fiscal year ended December 31, 2024 or March
31, 2025, as discussed above. The Company’s Board also appointed Mr. Kiu as Executive Director and Secretary.
On
March 10, 2025, the Company entered into an agreement for the Sale and Purchase of Certain Assets (the “Purchase Agreement”)
with Cyclacel Limited, a United Kingdom-based wholly owned subsidiary of the Company that is currently in liquidation (“Cyclacel
Limited”), along with the joint liquidator of Cyclacel Limited effective as of January 24, 2025 (the “Liquidators”).
Under the terms of the Purchase Agreement, the Company agreed to purchase, and Cyclacel Limited agreed to sell, with the approval of
the Liquidators, certain assets (the “Assets”) of Cyclacel Limited related to Plogosertib, a polo-like kinase 1 (PLK 1) inhibitor
for treatment of advanced cancers and hematological malignancies (“Plogo”), for a purchase price of £ 250,000 (exclusive
of VAT).
On
March 21, 2025 the Company entered into securities purchase agreements with a consortium of investors, pursuant to which they agreed
to purchase from the Company 1,000,000 shares of Series E Convertible Preferred Stock of Cyclacel at a purchase price of $ 1.00 per share
for aggregate gross proceeds of $ 1.0 million, subject to the terms and conditions of the Agreements. The proceeds of the transactions
will be used for general corporate and operating purposes.
Stock-Based
Compensation
On
January 2, 2025, Mr. Spiro Rombotis resigned as Chief Executive Officer of the Company and the Board of Directors appointed Mr. Lazar
as interim Chief Executive Officer of the Company, effective as of the signing of the Purchase Agreement. Mr. Lazar will serve as the
Company’s principal executive officer and principal financial officer until his successor is appointed. On this date, the Board
also appointed Messrs. David Natan and Avraham Ben-Tzvi as members of the Board of Directors. Dr. Robert Spiegel, Dr. Christopher Henney,
Dr. Brian Schwartz, Dr. Kenneth Ferguson and Ms. Karin Walker (together, the “Resigning Directors”) resigned effective as
of January 2, 2025.
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On
January 2, 2025, the Company entered into settlement agreements with the Resigning Directors effective as of the signing of the Purchase
Agreement. Pursuant to the terms of the Director Settlement Agreements, each Resigning Director resigned his or her position as a member
of the Board of Directors, and any positions held on committees of the Board of Directors. Each Resigning Director has received his or
her accrued Board fees in full consideration of the release of claims against the Company and other promises and covenants set forth
in the Director Settlement Agreements.
On
January 2, 2025, the Company entered into a settlement agreement with Mr. Spiro Rombotis (the “Rombotis Settlement Agreement”).
Pursuant to the terms of the Rombotis Settlement Agreement, Mr. Rombotis resigned his position as President and Chief Executive Officer
of the Company effective as of the signing of the Purchase Agreement, and agreed to provide transition services to the Company in his
capacity as a member of the Board of Directors through the filing of the Company’s Annual Report on Form 10-K for the year ended
2024. On January 2, 2025, the Company also entered into a settlement agreement with Paul McBarron (together with Mr. Rombotis, the “Resigning
Officers”) effective immediately following the Initial Closing, as such term is defined in the Purchase Agreement (the “McBarron
Settlement Agreement” and together with the Rombotis Settlement Agreement, the “Executive Officer Settlement Agreements”
and together with the Director Settlement Agreements, the “Settlement Agreements”). Pursuant to the terms of the McBarron
Settlement Agreement, Mr. McBarron agreed to provide transition services to the Company in his capacity as a member of the Board of Directors
through the filing of the Company’s Annual Report on Form 10-K for the year ended 2024.
Pursuant
to the Executive Officer Settlement Agreements, and subject to the Purchase Agreement, the Company will pay to Mr. Rombotis and Mr. McBarron
payments of $ 279,415.50 and $ 165,164.50 , respectively, as soon as practicable, and three months later a further one-time payment of $ 279,415.50
and $ 165,164.50 either in cash or through the issuance of common stock, respectively, in full consideration of the release of claims
against the Company and other promises and covenants set forth in the Executive Officer Settlement Agreements (the “Settlement
Payments”) and the Purchase Agreement.
Pursuant
to the terms of the Settlement Agreements, the Company will provide continuing indemnification to the Resigning Directors and Resigning
Officers in a manner consistent with that which was in place as of the effective date of the Settlement Agreements, and will cause to
be maintained in effect the Company’s existing director and officer liability insurance pursuant to the Company’s tail insurance
coverage and will not modify its governing documents to modify the Resigning Directors’ and Resigning Officers’ rights under
such policy, as further set forth in the Settlement Agreements. The Settlement Agreements contain a mutual non-disparagement clause.
On
February 26, 2025, the Company entered into settlement agreements with Dr. Barker. Pursuant to the terms of the settlement agreement,
Dr. Barker resigned his position as a member of the Board of Directors, and any positions held on committees of the Board of Directors.
In addition, Dr. Barker will receive his accrued Board fees in full consideration of the release of claims against the Company and other
promises and covenants set forth in the settlement agreement. Pursuant to the terms of the settlement agreement, the Company will provide
continuing indemnification to Dr. Barker in a manner consistent with that which was in place as of the effective date of the settlement
agreement, and will cause to be maintained in effect the Company’s existing director and officer liability insurance pursuant to
the Company’s tail insurance coverage and will not modify its governing documents to modify Dr. Barker’s rights under such
policy, as further set forth in the settlement agreement. The settlement agreement contains a mutual non-disparagement clause.
On
February 26, 2025, the following directors of the Company tendered their resignation or notice of resignation from the Board: (i) Dr.
Samuel L. Barker resigned as an independent director effectively immediately; (ii) Avraham Ben-Tzvi provided notice that his resignation
as an independent director will be effective upon the earlier of the filing date of the Company’s annual report on Form 10-K for
the fiscal year ended December 31, 2024 or March 31, 2025; (iii) Paul McBarron resigned as a non-independent director effective immediately;
(iv) David Natan provided notice that his resignation as an independent director will be effective upon the earlier of the filing date
of the Company’s annual report on Form 10-K for the fiscal year ended December 31, 2024 or March 31, 2025; and (iv) Spiro Rombotis
resigned as a non-independent director effective immediately.
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All
nonvested stock based compensation awards were (or will be) forfeited immediately as of the dates of resignation. As the Company accounts
for forfeitures as they occur, the Company will report an adjustment to compensation expense in the first quarter of 2025 to reflect
the difference between the compensation expense recorded to date and the cost that should have been recorded given the number of awards
that ultimately vested. The Company does not expect the amount of this adjustment to be significant.
1. Organization of the Company and Basis of Presentation
Cyclacel
Pharmaceuticals, Inc. (“Cyclacel” or “the Company”) is a clinical-stage biopharmaceutical company developing
innovative cancer medicines based on cell cycle and mitosis control biology. Cyclacel is a pioneer company in the field of cancer cell
cycle biology with a vision to improve patient healthcare by translating insights in cancer biology into medicines that can overcome
resistance and ultimately increase a patient’s overall survival.
As
of December 31, 2024, substantially all efforts of the Company to date have been devoted to performing research and development, conducting
clinical trials, developing and acquiring intellectual property, raising capital and recruiting and training personnel.
The
Company is subject to risks and uncertainties common to early-stage companies in the biopharmaceutical industry, including, but not limited
to, the fact that drug candidates developed by the Company typically will require approvals or clearances from the U.S. Food and Drug
Administration, the European Medicines Agency or other similar regulatory agencies in other countries prior to commercial sales. There
can be no assurance that the Company’s drug candidates will receive any of the required approvals or clearances. If any of the
Company’s drug candidates are denied approval or clearance or such approval is delayed, or if the Company is unable to obtain the
necessary financing to complete development and approval, there will be a material adverse impact on the Company’s financial condition
and results of operations.
Through
December 31, 2024, the Company has funded all of its operations and capital expenditures with proceeds from the issuance of public equity
securities, private placements of securities, government grants, research and development tax credits, interest on investments, royalty
income, product revenue and licensing revenue. The Company has incurred recurring losses since its inception, including net losses of
$ 11.2 million and $ 22.6 million for the years ended December 31, 2024 and 2023, respectively. As of December 31, 2024, the Company had
an accumulated deficit of $ 439.5 million. The Company expects to continue to generate operating losses for the foreseeable future due
to, among other things, costs related to the clinical development of its drug candidate, its preclinical programs and its administrative
organization.
Going
Concern
Pursuant
to the requirements of Accounting Standard Codification (ASC) 205-40, Presentation of Financial Statements-Going Concern , management
is required at each reporting period to evaluate whether there are conditions or events, considered in the aggregate, that raise substantial
doubt about an entity’s ability to continue as a going concern within one year after the date that the financial statements are
issued. This evaluation initially does not take into consideration the potential mitigating effect of management’s plans that have
not been fully implemented as of the date the financial statements are issued. When substantial doubt exists under this methodology,
management evaluates whether the mitigating effects of its plans sufficiently alleviate the substantial doubt about the Company’s
ability to continue as a going concern. The mitigating effect of management’s plans, however, is only considered if both (1) it
is probable that the plans will be effectively implemented within one year after the date that the financial statements are issued, and
(2) it is probable that the plans, when implemented, will mitigate the relevant conditions or events that raise substantial doubt about
the entity’s ability to continue as a going concern for one year after the date that these financial statements are issued. In
performing its analysis, management excluded certain elements of its operating plan that cannot be considered probable. Under ASC 205-40,
the future receipts of potential funding from future equity or debt issuances or by entering into partnership agreements cannot be considered
probable at this time because these plans are not entirely within
the Company’s control nor have they been approved by the Board of Directors as of the date of these consolidated financial statements.
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Based
on the Company’s current operating plan, it is anticipated that cash and cash equivalents of $ 3.1 million as of December 31, 2024
will allow it to meet liquidity requirements into the second quarter of 2025. The Company continues to work to raise additional capital
however as of the date of these financial statements there is no guarantee that the Company will be able to raise additional funds to
extend operations beyond the second quarter of 2025. The Company’s history of losses, negative cash flows from operations, liquid
resources currently on hand, and dependence on the ability to obtain additional financing to fund its operations, about which there can
be no certainty, have resulted in the assessment that there is substantial doubt about the Company’s ability to continue as a going
concern for a period of at least twelve months from the issuance date of these financial statements. While the Company has plans in place
to mitigate this risk, which primarily consist of raising additional capital through a combination of public or private equity or debt
financings or by entering into partnership agreements for further development of our drug candidates, there is no guarantee that it will
be successful in these mitigation efforts.The accompanying consolidated financial statements have been prepared on a going concern basis,
which contemplates realization of assets and the satisfaction of liabilities in the normal course of business.
Basis
of Presentation
The
accompanying consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the
United States of America, or GAAP and include the financial statements of Cyclacel Pharmaceuticals, Inc. and all of the Company’s
wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated.
Reverse
Stock Split
The
Company effected a 15:1 reverse stock split of the Company’s common stock on December 18, 2023 (the “Reverse Stock Split”).
All share and per share information has been adjusted to give effect to the Reverse Stock Split for all periods presented, unless otherwise
indicated.
The
Company held a special meeting of stockholders (the “ Special Meeting ”) on February 6, 2025 at which, among other matters,
the Company’s stockholders approved an amendment to the Company’s Amended and Restated Certificate of Incorporation to effect
a reverse stock split at a ratio not less than 1:4 and not more than 1:16 (the “2025 Reverse Stock Split”) such ratio and
the implementation and timing of such Reverse Stock Split to be determined in the discretion of the Company’s Board of Directors
(the “Board”). The 2025 Reverse Stock Split is expected to be implemented by the Board in or around May 2025.
2. Summary of Significant Accounting Policies
Use
of Estimates
The
preparation of financial statements in accordance with GAAP requires management to make estimates and assumptions that affect the reported
amounts of assets, liabilities and related disclosures of contingent assets and liabilities at the date of the financial statements and
the reported expenses during the reporting period. Critical estimates include inputs used to determine clinical trial accruals and stock-based
compensation expense. Cyclacel reviews its estimates on an ongoing basis. The estimates are based on historical experience and on various
other assumptions that the Company believes to be reasonable under the circumstances. Actual results may differ from these estimates.
Cyclacel believes the judgments and estimates required by the following accounting policies to be significant in the preparation of the
Company’s consolidated financial statements.
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Foreign
Currency and Currency Translation
Transactions
that are denominated in a foreign currency are remeasured into the functional currency at the current exchange rate on the date of the
transaction. Any foreign currency-denominated monetary assets and liabilities are subsequently remeasured at current exchange rates,
with gains or losses recognized as foreign exchange (losses) gains in the statement of operations.
The
assets and liabilities of the Company’s international subsidiary are translated from its functional currency into United States
dollars at exchange rates prevailing at the balance sheet date. Average rates of exchange during the period are used to translate the
statement of operations, while historical rates of exchange are used to translate any equity transactions. Translation adjustments arising
on consolidation due to differences between average rates and balance sheet rates, as well as unrealized foreign exchange gains or losses
arising from translation of intercompany loans for which settlement is not planned or anticipated in the foreseeable future and that
are of a long-term-investment nature, are recorded in other comprehensive loss. As discussed in the subsequent events note, the foreign
subsidiary will be liquidated. Upon loss of control of the foreign subsidiary, the accumulated translation adjustments currently recorded
in other comprehensive income within equity will be reversed and recorded as part of the gain/loss from deconsolidation of the subsidiary.
Cash
and Cash Equivalents
Financial
instruments that potentially expose the Company to concentrations of credit risk consist primarily of cash and cash equivalents. The
Company considers all highly liquid investments with an original maturity of three months or less at the time of initial purchase to
be cash equivalents. The objectives of the Company’s cash management policy are to safeguard and preserve funds, to maintain sufficient
liquidity to meet Cyclacel’s cash flow requirements and to attain a market rate of return. The Company deposits its cash in financial
institutions that it believes have high credit quality and has not experienced any losses on such accounts and does not believe it is
exposed to any significant credit risk on cash and cash equivalents.
The
Company’s cash and cash equivalents balance at December 31, 2024 was $ 3.1 million and it maintains its cash accounts in several
entities both within the United States and the United Kingdom. The cash balances for amounts held in the United States are insured by
the Federal Deposit Insurance Corporation, or FDIC up to $ 250,000 per account. The Company has cash balances exceeding the balance insured
by the FDIC that totaled approximately $ 2.8 million at December 31, 2024. The cash balances for amounts held in the United Kingdom are
insured by the UK Government Financial Services Compensation Scheme, or FSCS up to £ 85,000 per account. The Company does not have
cash balances exceeding the balance insured by the FSCS at December 31, 2024.
Property
and Equipment
The
components of property and equipment are stated at cost and depreciated on a straight-line basis over the estimated useful lives of
the related assets, which are generally 3 three to five
years . Amortization of leasehold improvements is performed using the straight-line method over the shorter of the remaining
lease term or the estimated useful life of the related assets. Upon sale or retirement of assets, the costs and related accumulated
depreciation and amortization are removed from the balance sheet and the resulting gain or loss on sale is reflected as a component
of operating income or loss. Expenditures for maintenance and repairs are charged to operating expenses as incurred.
Impairment
of Long-lived Assets
The
Company reviews property and equipment for impairment whenever events or changes in business circumstances indicate that the carrying
amount of the assets may not be fully recoverable. The Company assesses the recoverability of the potentially affected long-lived assets
by determining whether the carrying value of such assets can be recovered through undiscounted future operating cash flows.
Impairment,
if any, is measured as the amount by which the carrying amount of a long-lived asset or asset group exceeds its fair value.
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Fair
Value of Financial Instruments
Fair
value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal
or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date.
Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs.
Assets and liabilities measured at fair value are classified and disclosed in one of the following three levels of the fair value hierarchy,
of which the first two are considered observable and the last is considered unobservable:
● Level
1 — Quoted prices in active markets for identical assets or liabilities.
● Level
2 — Observable inputs (other than Level 1 quoted prices), such as quoted
prices in active markets for similar assets or liabilities, quoted prices in markets that
are not active for identical or similar assets or liabilities, or other inputs that are observable
or can be corroborated by observable market data.
● Level
3 — Unobservable inputs that are supported by little or no market activity
that are significant to determining the fair value of the assets or liabilities, including
pricing models, discounted cash flow methodologies and similar techniques.
The
carrying values of cash and cash equivalents, other receivables, accounts payable and accrued expenses approximate their fair values
due to the short-term nature of these assets and liabilities.
Segments
The
Company is managed and operated as one business which is focused on using cell cycle, transcriptional regulation and mitosis control
biology to develop innovative, targeted medicines for cancer and other proliferative diseases. The entire business is managed by a single
management team that reports to the Chief Executive Officer. Historically, the Company has not operated separate lines of business with
respect to any of its products or product candidates and the Company did not prepare discrete financial information with respect to separate
products or product candidates or by location through December 31, 2024. Accordingly, the Company has viewed its business historically
as one reportable operating segment with development operations in two geographic areas, namely the United States and the United Kingdom.
With the commencement of the liquidation of the Subsidiary, the Company will no longer be considered to have control over the Subsidiary
and the financial results of the Subsidiary will be deconsolidated from those of the Company commencing with its first quarter 2025.
Revenue
Recognition
The
Company recognizes revenue in accordance with Accounting Standards Codification (ASC) 606, Revenue from Contracts with Customers .
The
Company has not generated any revenues from product sales to date. However, the Company recognized $ 43,000 of revenue for the year ended
December 31, 2024. This revenue relates to recovery of clinical manufacturing costs associated with an investigator sponsored study managed
by Cedars-Sinai Medical Center (“CSMC”). There were $ 420,000 of revenues recognized for the comparative period in 2023. All
revenues from this customer are recognized at the point in time that the related clinical supply are transferred to CSMC and CSMC obtains
control over the goods. The arrangements with CSMC comprise a single performance obligation.
The
Company has not recognized any other sources of revenue during the years ended December 31 2024 and 2023.
The
Company invoices CSMC following the transfer of the clinical supply and provides CSMC with typical payment terms. The Company has collected
all amounts due from CSMC. As of December 31, 2024, December 31, 2023, and January, 1, 2023, the Company has not recognized any accounts
receivable from CSMC, credit loss allowances, contract assets, contract liabilities, or warranty provisions. There were no remaining
performance obligations outstanding as of December 31, 2024; however, CSMC may place additional orders for clinical supply in 2025 and
beyond.
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Other
Income
Other
income is primarily related to royalty income received under a historical Asset Purchase Agreement for activities which are not part
of the Company’s ongoing operations and activities.
Research
and Development Costs
Research
and development expenses consist primarily of costs associated with the development of the Company’s product candidates, including
upfront fees, milestones, compensation and other expenses for research and development personnel, supplies and development materials,
costs for consultants and related contract research, facility costs and depreciation. Expenditures relating to research and development
are expensed as incurred.
Clinical
Trial Accounting
Data
management and monitoring of the Company’s clinical trials are performed with the assistance of contract research organizations,
or CROs or clinical research associates, or CRAs in accordance with the Company’s standard operating procedures. Typically, CROs
and CRAs bill monthly for services performed, and others bill based upon milestones achieved. The Company accrues unbilled clinical trial
expenses based on estimates of the level of services performed each period. Clinical trial costs related to patient enrollment are accrued
as patients are entered into and progress through the trial.
Patent
Costs
Patent
prosecution costs are charged to general and administrative expenses as incurred as recoverability of such expenditure is uncertain.
Leases
The
Company accounts for lease contracts in accordance with ASC 842. As of December 31, 2024 and 2023, all of the Company’s leases
are classified as operating leases.
The
Company recognizes an asset for the right to use an underlying leased asset for the lease term and records lease liabilities based on
the present value of the Company’s obligation to make lease payments under the lease. As the Company’s leases do not indicate
an implicit rate, the Company uses a best estimate of its incremental borrowing rate to discount the future lease payments. The Company
estimates its incremental borrowing rate based on observable information about risk-free interest rates that are the same tenure as the
lease term, adjusted for various factors, including the effects of assumed collateral, the nature of how a loan would be repaid (e.g.,
amortizing versus bullet), and the Company’s credit risk.
The
Company evaluates options included in its lease agreements to extend or terminate the lease. The Company will reflect the effects of
exercising those options in the lease term when it is reasonably certain that the Company will exercise that option. In assessing whether
it is reasonably certain that the Company will exercise an option, the Company considers factors such as:
● The
lease payments due in any optional period;
● Penalties
for failure to exercise (or not exercise) the option;
● Market
factors, such as the availability of similar assets and current rental rates for such assets;
● The
nature of the underlying leased asset and its importance to the Company’s operations;
and
● The
remaining useful lives of any related leasehold improvements.
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Lease
expense for the Company’s operating leases is recognized on a straight-line basis over the lease term and is reported as a component
of general and administrative expense. Variable lease payments, if any, are recognized in the period when the obligation to make those
payments is incurred. Lease incentives received prior to lease commencement are recorded as a reduction in the right-of-use asset. Fixed
lease incentives received after lease commencement reduce both the lease liability and the right-of-use asset.
The
Company has elected an accounting policy to account for the lease and non-lease components as a single lease component.
Stock-based
Compensation
The
Company measures all stock options and other stock-based awards granted to employees and directors based on the fair value on the
date of the grant and recognizes compensation expense of those awards over the requisite service period, which for the Company is
the period between the grant date and the date the award vests or becomes exercisable. Many awards granted by the Company vest
ratably over 3 three
or four
years . However, certain awards granted to members of the Company’s Board of Directors vest in their entirety on the 1
one-year anniversary following the date of grant.
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