−Removed: a smaller reporting company, we are not required to provide disclosure pursuant to this item.
−Removed: However, in addition to other information
−Removed: set forth in this Quarterly Report, including the important information in the section entitled “Private Securities Litigation
−Removed: Reform Act,” you should carefully consider the “Risk Factors” discussed in our Annual Report on Form 10-K for the year
−Removed: ended December 31, 2020 and in Exhibit 99.4 to our Current Report on Form 8-K, filed with the SEC on April 8, 2021 for a discussion of
−Removed: important factors that could cause actual results to differ materially from the results described in or implied by the forward-looking
−Removed: statements contained in this Quarterly Report.
−Removed: Additional risks and uncertainties not currently known to us or that we currently deem
−Removed: to be immaterial might materially adversely affect our actual business, financial condition and/or operating results.
+Added: factors that could cause actual results to differ from our expectations and that could negatively impact our financial condition and
+Added: results of operations are summarized and discussed in more detail below, in each case including certain updates from those set forth
+Added: in our Annual Report on Form 10-K for the year ended December 31, 2021, which was previously filed with the SEC.
+Added: Additional risks and
+Added: uncertainties not presently known to us or that are currently not believed to be significant to our business may also affect our actual
+Added: results and could harm our business, financial condition and results of operations.
+Added: If any of the risks or uncertainties described below
+Added: or any additional risks and uncertainties actually occur, our business, results of operations and financial condition could be materially
+Added: and adversely affected.
+Added: of Risk Factors
+Added: have a limited operating history and we may never generate revenue or profit;
+Added: inability to raise additional capital on acceptable terms in the future may limit our ability to develop and commercialize our integrated
+Added: therapeutic (Rx) and companion diagnostic (CDx) strategy;
+Added: are currently conducting and will continue to conduct clinical trials.
+Added: Clinical trials are expensive and complex with uncertain outcomes,
+Added: which may prevent or delay commercialization of any drug product candidates or CELsignia tests;
+Added: COVID-19 pandemic may materially and adversely impact our business, including ongoing clinical trials;
+Added: future strategy is dependent on the success of our initial drug product, gedatolisib, as well as other drug products we may develop.
+Added: If we are unable to successfully complete clinical development of, obtain regulatory approval for or commercialize our drug products,
+Added: or if we experience delays in doing so, our business will be materially and adversely impacted;
+Added: successful development of biopharmaceuticals such as gedatolisib is highly uncertain;
+Added: were not involved in the early development of gedatolisib;
+Added: therefore, we are dependent on third parties having accurately generated,
+Added: collected, interpreted and reported data from certain preclinical and clinical trials;
+Added: an organization, we have never successfully completed any registrational clinical trials, and we may be unable to do so for any drug
+Added: candidates we may develop;
+Added: a new drug to be approved for marketing, the FDA in the United States and health authorities in other countries, must determine that
+Added: the drug is safe and effective.
+Added: Because all drugs can have adverse effects, the data from our Phase 3 clinical study must
+Added: demonstrate to the satisfaction of the FDA and other health authorities that the benefits of gedatolisib in combination with palbociclib
+Added: and fulvestrant, or gedatolisib in combination with fulvestrant, outweigh its risks.
+Added: Failure to demonstrate sufficient magnitude
+Added: of benefit, even if the benefit is found to be statistically significant, may not support regulatory approval;
+Added: we encounter difficulties enrolling patients in any of our clinical trials, our clinical development activities could be delayed
+Added: or otherwise adversely affected;
+Added: we are unable to obtain and maintain intellectual property protection for our products and technology, or if the scope of the intellectual
+Added: property protection obtained is not sufficiently broad, our competitors could develop and commercialize products or technology similar
+Added: or identical to ours, and our ability to successfully commercialize our technology and diagnostic tests may be impaired;
+Added: depend on intellectual property licensed from third parties, including from Pfizer for our lead product candidate, gedatolisib, and
+Added: termination of this license could result in the loss of significant rights, which would materially and adversely impact our business;
+Added: we fail to comply with our obligations under our patent license with Pfizer, we could lose certain license rights that are important
+Added: to our business;
+Added: success with CELsignia is heavily dependent on the success of our first CELsignia trials and we cannot be certain of the outcomes
+Added: of such trials;
+Added: may not be successful in finding pharmaceutical company partners for continuing development of additional CELsignia tests;
+Added: our CELsignia HER2 Pathway Activity Test and CELsignia Multi-Pathway Activity Test are commercially ready, we have not attempted
+Added: to market these to physicians or their patients as stand-alone tests and have no ability to determine if these tests or any of our
+Added: other tests will be commercially viable;
+Added: will be dependent on our ability to attract and retain key personnel;
+Added: face significant competition from other pharmaceutical and diagnostic companies.
+Added: Relating to Our Business
+Added: have a limited operating history and we may never generate revenue or profit.
+Added: are a clinical-stage biotechnology company that commenced activities in January 2012.
+Added: We only have a limited operating history and our
+Added: business plan has not been tested.
+Added: Since inception, we have had no revenue and have incurred significant operating losses.
+Added: We have financed
+Added: our operations primarily through equity and debt offerings.
+Added: To generate revenue and become and remain profitable, we must continue to
+Added: pursue our integrated companion diagnostic (CDx) and therapeutic (Rx) strategy that leverages our CELsignia CDx platform.
+Added: need to successfully complete our five existing clinical trial collaborations, continue to develop other CELsignia tests for other cancer
+Added: sub-types, cultivate partnerships with pharmaceutical companies, and develop and commercialize gedatolisib pursuant to our license agreement
+Added: We must also build operational and financial infrastructure to support commercial operations, train and manage employees,
+Added: and market and sell our CELsignia tests (as a companion diagnostic and/or as a stand-alone test) and, once fully developed and commercialized,
+Added: our anticipated drug products.
+Added: may never succeed in any of these activities and, even if we do, we may never generate revenue that is sufficient to achieve profitability.
+Added: We expect to continue to incur significant expenses and operating losses for the foreseeable future, and the net losses we incur may
+Added: fluctuate significantly from quarter to quarter.
+Added: Our failure to become and remain profitable would decrease our value and could impair
+Added: our ability to raise capital, maintain or expand our research and development efforts, expand our business, or continue our operations.
+Added: inability to raise additional capital on acceptable terms in the future may limit our ability to develop and commercialize our integrated
+Added: therapeutic (Rx) and companion diagnostic (CDx) strategy.
+Added: may require additional capital to finance capital expenditures and operating expenses over the next several years as we launch our integrated
+Added: therapeutic and companion diagnostic strategy and expand our infrastructure, commercial operations and research and development activities.
+Added: We may seek to raise additional capital through equity offerings, debt financings, collaborations or licensing arrangements.
+Added: funding may not be available to us on acceptable terms, or at all.
+Added: If we raise funds by issuing equity securities, dilution to our stockholders
+Added: could result.
+Added: Any equity securities issued may also provide for rights, preferences or privileges senior to those of holders of our existing
+Added: The incurrence of additional indebtedness or the issuance of certain equity securities could result in increased fixed payment
+Added: obligations and could also include restrictive covenants, such as limitations on our ability to incur additional debt or issue additional
+Added: equity, limitations on our ability to acquire or license intellectual property rights, and other operating restrictions that could adversely
+Added: affect our ability to conduct our business.
+Added: In the event that we enter into collaborations or licensing arrangements to raise capital,
+Added: we may be required to accept unfavorable terms.
+Added: If we are not able to secure additional funding when needed, we may have to delay, reduce
+Added: the scope of or eliminate one or more research and development programs or selling and marketing initiatives.
+Added: In addition, we may have
+Added: to work with a partner on one or more of our products or market development programs, which could lower the economic value of those programs
+Added: to our company.
+Added: will be dependent on our ability to attract and retain key personnel.
+Added: operations will be materially dependent upon the services of our officers and key employees, including Brian F.
+Added: Sullivan, our Chief Executive
+Added: Officer, and Dr.
+Added: Laing, our Chief Science Officer.
+Added: Successful implementation of our business plan will also require the services
+Added: of other consultants and additional personnel.
+Added: We cannot assure you that we will be able to attract and retain such persons as employees,
+Added: independent contractors, consultants or otherwise.
+Added: If we are not able to attract individuals with the skills required for our business,
+Added: or if we lose the services of either Mr.
+Added: Sullivan or Dr.
+Added: Laing, we may be unable to successfully implement our business plan.
+Added: COVID-19 pandemic may materially and adversely impact our business, including ongoing clinical trials.
+Added: outbreak of COVID-19 and government measures taken in response have had a significant impact on the global economy, with healthcare systems
+Added: particularly affected.
+Added: In response to the COVID-19 outbreak, public health measures have been implemented across much of the United States,
+Added: Europe and Asia, including in the locations of our offices, clinical trial sites, and partners.
+Added: a result of the COVID-19 pandemic, we have and may in the future experience disruptions that could materially and adversely impact our
+Added: clinical trials, business, financial condition and results of operations.
+Added: Potential disruptions include but are not limited to:
+Added: or difficulties in enrolling patients in clinical trials and obtaining the results of completed
+Added: clinical trials;
+Added: rates of patients withdrawing from clinical trials following enrollment as a result of quarantine
+Added: or concerns about COVID-19;
+Added: of healthcare resources away from the conduct of clinical trials;
+Added: in prospective clinical trial collaborations with pharmaceutical companies and sponsors;
+Added: ● interruption
+Added: or delays in the operations of the FDA or other regulatory authorities, which may impact
+Added: review and approval timelines;
+Added: ● limitations
+Added: on our ability to recruit and hire key personnel due to our inability to meet with candidates
+Added: because of travel restrictions;
+Added: ● limitations
+Added: on employee resources that would otherwise be focused on the conduct of clinical trials and
+Added: research as a result of focus addressing COVID-19 mitigation and loss of productivity from
+Added: the direct effect of the pandemic, COVID-19 has had broad economic effects.
+Added: The economic impact of COVID-19 may adversely affect us in
+Added: a variety of ways, including without limitation making our stock price more volatile, making it more difficult to raise additional capital
+Added: through offerings of equity or debt securities, and reducing the availability of bank loans.
+Added: As a result, we may face difficulties raising
+Added: capital and capital raising efforts may be on terms than are less favorable than would have been previously available.
+Added: of the effects of COVID-19 described herein are expected to apply to any future recurrences of COVID-19 and any other pandemics that
+Added: may occur in the future.
+Added: Related to Our Drug Product, Gedatolisib
+Added: future strategy is dependent on the success of our initial drug product, gedatolisib, as well as other drug products we may develop.
+Added: If we are unable to successfully complete clinical development of, obtain regulatory approval for or commercialize our drug products,
+Added: or if we experience delays in doing so, our business will be materially harmed.
+Added: date, we have not yet completed any registrational clinical trials or the development of any drug products.
+Added: Our future success and ability
+Added: to generate revenue from our drug products, which we do not expect will occur for several years, if ever, is dependent on our ability
+Added: to successfully develop, obtain regulatory approval for and commercialize one or more drug products.
+Added: We may not have the financial resources
+Added: to continue development of, or to modify existing or enter into new collaborations for, a drug product if we experience any issues that
+Added: delay or prevent regulatory approval of, or our ability to commercialize, our drug products, including:
+Added: inability to demonstrate to the satisfaction of the FDA or comparable foreign regulatory
+Added: authorities that our drug products are safe and effective;
+Added: ● insufficiency
+Added: of our financial and other resources to complete the necessary preclinical studies and clinical
+Added: or inconclusive results from our preclinical studies, clinical trials or the clinical trials
+Added: of others for drug products similar to ours, leading to a decision or requirement to conduct
+Added: additional preclinical studies or clinical trials or abandon a program;
+Added: ● product-related
+Added: adverse events experienced by subjects in our clinical trials or by individuals using drugs
+Added: or therapeutic biologics similar to our drug products;
+Added: in submitting applications, or delays or failure in obtaining the necessary approvals from
+Added: regulators to commence a clinical trial or a suspension or termination of a clinical trial
+Added: once commenced;
+Added: imposed by the FDA or comparable foreign regulatory authorities regarding the scope or design
+Added: of our clinical trials;
+Added: effectiveness of our drug products during clinical trials;
+Added: than expected performance of control arms, such as placebo groups, which could lead to negative
+Added: or inconclusive results from our clinical trials;
+Added: in enrolling subjects in clinical trials;
+Added: drop-out rates of subjects from clinical trials;
+Added: supply or quality of drug products or other materials necessary for the conduct of our clinical
+Added: than anticipated clinical trial or manufacturing costs;
+Added: ● unfavorable
+Added: FDA or comparable regulatory authority inspection and review of a clinical trial site;
+Added: of our third-party contractors or investigators to comply with regulatory requirements or
+Added: otherwise meet their contractual obligations in a timely manner, or at all;
+Added: and changes in regulatory requirements, policy and guidelines, including the imposition of
+Added: additional regulatory oversight around clinical testing generally or with respect to our
+Added: therapies in particular;
+Added: interpretations of data by the FDA and comparable foreign regulatory authorities.
+Added: preliminary efficacy and safety data reported for the B2151009 Phase 1b clinical trial was provided to us by Pfizer and is subject to
+Added: change once data cleansing and data verification activities are completed.
+Added: preliminary efficacy and safety data reported for the B2151009 Phase 1b clinical trial was provided to us by Pfizer.
+Added: Pfizer provided
+Added: this data as of a data cutoff date of January 11, 2021, before Pfizer had cleaned the data, locked the clinical database, and completed
+Added: preparation of a final Clinical Study Report.
+Added: We have not independently reviewed or verified the data, which includes case report forms
+Added: (CRF) for each patient and reconciliation with the data endpoints reported.
+Added: We may discover, upon performing the study close out activities
+Added: for B2151009, which includes reconciliation and adjudication of the endpoint reported data with the CRF, inconsistencies with the data
+Added: as originally provided by Pfizer to us.
+Added: As a result, the data presented as of the date hereof is subject to change once data cleaning
+Added: and verification activities have been completed and other study close-out procedures are completed.
+Added: were not involved in the early development of gedatolisib;
+Added: therefore, we are dependent on third parties having accurately generated,
+Added: collected, interpreted and reported data from certain preclinical and clinical trials gedatolisib.
+Added: had no involvement with or control over the initial preclinical and clinical development of gedatolisib.
+Added: We are dependent on third parties
+Added: having conducted their research and development in accordance with the applicable protocols and legal, regulatory and scientific standards;
+Added: having accurately reported the results of all preclinical studies and clinical trials conducted with respect to such drug product;
+Added: having correctly collected and interpreted the data from these trials.
+Added: If these activities were not compliant, accurate or correct, the
+Added: clinical development, regulatory approval or commercialization of our drug product will be adversely affected.
+Added: an organization, we have never successfully completed any registrational clinical trials, and we may be unable to do so for any drug
+Added: candidates we may develop.
+Added: will need to successfully complete registrational clinical trials in order to obtain the approval of the FDA or comparable foreign regulatory
+Added: authorities to market our drug products.
+Added: Carrying out clinical trials, including later-stage registrational clinical trials, is a complicated
+Added: As an organization, we have not previously completed any registrational clinical trials.
+Added: In order to do so, we will need to
+Added: build and expand our clinical development and regulatory capabilities, and we may be unable to recruit and train qualified personnel.
+Added: We also expect to continue to rely on third parties to conduct our clinical trials.
+Added: If these third parties do not successfully carry
+Added: out their contractual duties, meet expected deadlines or comply with regulatory requirements, we may not be able to obtain regulatory
+Added: approval of or commercialize any potential product candidates.
+Added: Consequently, we may be unable to successfully and efficiently execute
+Added: and complete necessary clinical trials in a way that leads to submission and approval of our drug products.
+Added: We may require more time
+Added: and incur greater costs than our competitors and may not succeed in obtaining regulatory approval of any drug products that we develop.
+Added: Failure to commence or complete, or delays in, our planned clinical trials, could prevent us from or delay us in commercializing our
+Added: drug products.
+Added: we encounter difficulties enrolling patients in any of our clinical trials, our clinical development activities could be delayed or otherwise
+Added: adversely affected.
+Added: timely completion of clinical trials in accordance with their protocols depends, among other things, on our ability to enroll a sufficient
+Added: number of patients who remain in the trial until its conclusion.
+Added: We may experience difficulties in patient enrollment in our clinical
+Added: trials for a variety of reasons, including:
+Added: patient eligibility and exclusion criteria defined in the protocol;
+Added: size of the patient population required for analysis of the clinical trial’s primary
+Added: proximity of patients to clinical trial sites;
+Added: design of the clinical trial;
+Added: ability to recruit clinical trial investigators with the appropriate competencies and experience,
+Added: and the ability of these investigators to identify and enroll suitable patients;
+Added: of the safety profile of our drug products;
+Added: ability to obtain and maintain patient consents;
+Added: risk that patients enrolled in clinical trials will drop out of the trials before completion.
+Added: in patient enrollment may result in increased costs or may affect the timing or outcome of our clinical trials, which could prevent completion
+Added: of these trials and adversely affect our ability to advance the development of our product candidates.
+Added: development involves a lengthy and expensive process, with an uncertain outcome.
+Added: We may incur additional costs or experience delays in
+Added: completing, or ultimately be unable to complete, the development and commercialization of our product candidates.
+Added: obtain the requisite regulatory approvals to commercialize any drug products, we must demonstrate through extensive preclinical studies
+Added: and clinical trials that such drug product is safe and effective in humans.
+Added: Clinical testing is expensive and can take many years to
+Added: complete, and its outcome is inherently uncertain.
+Added: We may be unable to establish clinical endpoints that applicable regulatory authorities
+Added: would consider clinically meaningful, and a clinical trial can fail at any stage of testing.
+Added: in trial design between early-stage clinical trials and later-stage clinical trials make it difficult to extrapolate the results of earlier
+Added: clinical trials to later clinical trials.
+Added: Moreover, clinical data are often susceptible to varying interpretations and analyses, and
+Added: many companies that have believed their product candidates performed satisfactorily in clinical trials have nonetheless failed to obtain
+Added: marketing approval of their products.
+Added: Additionally, we are conducting and plan to conduct some open-label trials, where both the patient
+Added: and investigator know whether the patient is receiving the investigational product candidate or either an existing approved drug or placebo.
+Added: Most typically, open-label clinical trials test only the investigational product candidate and sometimes may do so at different dose
+Added: Open-label clinical trials are subject to various limitations that may exaggerate any therapeutic effect as patients in those
+Added: trials are aware when they are receiving treatment.
+Added: Open-label clinical trials may be subject to a “patient bias” where patients
+Added: perceive their symptoms to have improved merely due to their awareness of receiving an experimental treatment.
+Added: In addition, open-label
+Added: clinical trials may be subject to an “investigator bias” where those assessing and reviewing the outcomes of the clinical
+Added: trials are aware of which patients have received treatment and may interpret the information of the treated group more favorably given
+Added: this knowledge.
+Added: Where a randomized, placebo-controlled clinical trial is designed to allow enrolled subjects to cross-over to the treatment
+Added: arm, there may be a risk of inadvertent unblinding of subjects prior to cross-over, which may limit the clinical meaningfulness of those
+Added: data and may require the conduct of additional clinical trials.
+Added: As such, the results from an open-label trial may not be predictive of
+Added: future clinical trial results with any of our product candidates for which we include an open-label clinical trial when studied in a
+Added: controlled environment with a placebo or active control.
+Added: completion of clinical trials is a prerequisite to submitting a new drug application, or NDA, to the FDA and similar marketing applications
+Added: to comparable foreign regulatory authorities for each drug product and, consequently, the ultimate approval and commercial marketing
+Added: of any drug products.
+Added: We may experience delays in initiating our Phase 3 clinical trial due to requests from the FDA for additional information,
+Added: including additional nonclinical or clinical data, or for requests to amend the clinical trial protocol.
+Added: Additional delays may be incurred
+Added: once the Phase 3 clinical trial is initiated if it takes longer than expected to activate the targeted number of clinical sites, if the
+Added: enrollment of patients is negatively affected by COVID-19, by staffing shortages at clinical sites, or by other unanticipated factors,
+Added: or if the FDA and other regulatory authorities require us to pause our Phase 3 clinical trial due to unexpected safety issues.
+Added: may experience numerous unforeseen events during, or as a result of, any future clinical trials that we could conduct that could delay
+Added: or prevent our ability to receive marketing approval or commercialize our current product candidates or any future product candidates.
+Added: Our costs will increase if we experience delays in clinical testing or marketing approvals.
+Added: We do not know whether any of our clinical
+Added: trials will begin as planned, will need to be reassigned or will be completed on schedule, or at all.
+Added: Significant clinical trial delays
+Added: also could shorten any periods during which we may have the exclusive right to commercialize our product candidates and may allow our
+Added: competitors to bring products to market before we do, potentially impairing our ability to successfully commercialize our product candidates
+Added: and harming our business and results of operations.
+Added: Any delays in our clinical development programs may harm our business, financial
+Added: condition and results of operations significantly.
+Added: a new drug to be approved for marketing, the FDA and other regulatory authorities, must determine that the drug is safe and effective.
+Added: Because all drugs can have adverse effects, the data from our Phase 3 clinical study must demonstrate to the satisfaction of the FDA
+Added: and other health authorities that the benefits of gedatolisib in combination with palbociclib and fulvestrant, or gedatolisib in combination
+Added: with fulvestrant, outweigh its risks.
+Added: Failure to demonstrate sufficient magnitude of benefit, even if the benefit is found to be statistically
+Added: significant, may not support regulatory approval.
+Added: a drug meets its primary efficacy endpoint objective in a Phase 3 clinical trial, and the drug sponsor has additional nonclinical and
+Added: clinical data required by the FDA or other regulatory authorities, the drug sponsor may submit an NDA seeking marketing approval.
+Added: submission of an NDA, these health authorities perform a benefit-risk assessment that considers the strength and quality of evidence
+Added: available and takes remaining uncertainties into account.
+Added: These considerations include an assessment of the strengths and limitations
+Added: of clinical trials, including design, and potential implications for assessing drug efficacy, the magnitude of benefit and interpretation
+Added: of clinical importance, the benefit attributed to the drug when studied in combination with other therapies, and the clinical relevance
+Added: of the study endpoints.
+Added: We have sought feedback from the FDA and other regulatory authorities on the design of our Phase 3 clinical trial
+Added: with the goal of addressing these considerations in the clinical trial’s design.
+Added: However, due to the complexity of clinical trials,
+Added: the uncertainty of outcomes, and the uncertainty of how the FDA and other regulatory authorities may balance benefits and risks in their
+Added: review of an NDA, it may not be practical or possible to address all benefit-risk assessment considerations in a Phase 3 clinical trial
+Added: so that sufficient evidence is generated to support a marketing approval, even if the primary endpoint objective is achieved.
+Added: or other regulatory authorities may require us to redesign or conduct additional unplanned clinical trials before granting any approval
+Added: and we may not get approval at all.
+Added: If we are required to conduct additional clinical trials or other testing of our drug candidates
+Added: beyond those that we currently contemplate, if we are unable to successfully complete clinical trials or other testing of our product
+Added: candidates, or if the results of these trials or tests are not positive or are only modestly positive or if there are safety concerns,
+Added: delayed in obtaining marketing approval for our such product candidates or not obtain marketing
+Added: approval at all;
+Added: approval for indications or patient populations that are not as broad as intended or desired;
+Added: approval with labeling that includes significant use or distribution restrictions or safety
+Added: warnings, including boxed warnings;
+Added: subject to changes in the way the product is administered;
+Added: required to perform additional clinical trials to support approval or be subject to additional
+Added: post-marketing testing requirements;
+Added: regulatory authorities withdraw, or suspend, their approval of the product or impose restrictions
+Added: on its distribution in the form of a REMS or through modification to an existing REMS;
+Added: damage to our reputation.
+Added: successful development of biopharmaceuticals is highly uncertain.
+Added: development of biopharmaceuticals is highly uncertain and is dependent on numerous factors, many of which are beyond our control.
+Added: candidates that appear promising in the early phases of development may fail to reach the market for several reasons including, among
+Added: other things, that clinical trial results may show the product candidates to be less effective than expected or to have unacceptable
+Added: side effects or toxicities;
+Added: we may fail to receive the necessary regulatory approvals or there may be a delay in receiving such approvals;
+Added: or the proprietary rights of others and their competing products and technologies that may prevent our product candidates from being
+Added: commercialized.
+Added: length of time necessary to complete clinical trials and to submit an application for marketing approval for a final decision by a regulatory
+Added: authority varies significantly from one drug product to the next and from one country to the next and may be difficult to predict.
+Added: if we are successful in obtaining marketing approval, commercial success of any approved products will also depend in large part on the
+Added: availability of coverage and adequate reimbursement from third-party payors, including government payors such as the Medicare and Medicaid
+Added: programs and managed care organizations in the U.S.
+Added: or country specific governmental organizations in foreign countries, which may be
+Added: affected by existing and future healthcare reform measures designed to reduce the cost of healthcare.
+Added: Third-party payors could require
+Added: us to conduct additional studies, including post-marketing studies related to the cost effectiveness of a product, to qualify for reimbursement,
+Added: which could be costly and divert our resources.
+Added: If government and other healthcare payors were not to provide coverage and adequate reimbursement
+Added: for our products once approved, market acceptance and commercial success would be reduced.
+Added: addition, if any of our drug products receive marketing approval, we will be subject to significant post-approval regulatory obligations.
+Added: In addition, there is always the risk that we, a regulatory authority or a third party might identify previously unknown problems with
+Added: a product post-approval, such as adverse events of unanticipated severity or frequency.
+Added: Compliance with these requirements is costly,
+Added: and any failure to comply or other issues with our drug products post-approval could adversely affect our business, financial condition
+Added: and results of operations.
+Added: face significant competition from other biopharmaceutical companies, and our operating results will suffer if we fail to compete effectively.
+Added: biopharmaceutical industry is characterized by intense competition and rapid innovation.
+Added: Our competitors may be able to develop other
+Added: compounds or drugs that are able to achieve similar or better results.
+Added: Our potential competitors include major multinational pharmaceutical
+Added: companies, established biotechnology companies, specialty pharmaceutical companies and universities and other research institutions.
+Added: Many of our competitors have substantially greater financial, technical and other resources, such as larger research and development
+Added: staff and experienced marketing and manufacturing organizations and well-established sales forces.
+Added: Smaller or early-stage companies may
+Added: also prove to be significant competitors, particularly as they develop novel approaches to treating disease indications that our product
+Added: candidates are also focused on treating.
+Added: Established pharmaceutical companies may also invest heavily to accelerate discovery and development
+Added: of novel therapeutics or to in-license novel therapeutics that could make the product candidates that we develop obsolete.
+Added: acquisitions in the biotechnology and pharmaceutical industries may result in even more resources being concentrated in our competitors.
+Added: Competition may increase further as a result of advances in the commercial applicability of technologies and greater availability of
+Added: capital for investment in these industries.
+Added: Our competitors, either alone or with collaboration partners, may succeed in developing,
+Added: acquiring or licensing on an exclusive basis drug or biologic products that are more effective, safer, more easily commercialized or
+Added: less costly than our product candidates or may develop proprietary technologies or secure patent protection that we may need for the
+Added: development of our technologies and products.
+Added: We believe the key competitive factors that will affect the development and commercial
+Added: success of our product candidates are efficacy, safety, tolerability, reliability, convenience of use, price and reimbursement.
+Added: if we obtain regulatory approval of drug products, the availability and price of our competitors’ products could limit the demand
+Added: and the price we are able to charge for our product candidates.
+Added: We may not be able to implement our business plan if the acceptance of
+Added: our product candidates is inhibited by price competition or the reluctance of physicians to switch from existing methods of treatment
+Added: to our product candidates, or if physicians switch to other new drug or biologic products or choose to reserve our product candidates
+Added: for use in limited circumstances.
+Added: if any drug product we develop receives marketing approval, it may fail to achieve the degree of market acceptance by physicians, patients,
+Added: third-party payors and others in the medical community necessary for commercial success.
+Added: any future drug product we develop receives marketing approval, whether as a single agent or in combination with other therapies, it
+Added: may nonetheless fail to gain sufficient market acceptance by physicians, patients, third-party payors and others in the medical community.
+Added: If the product candidates we develop do not achieve an adequate level of acceptance, we may not generate significant product revenues
+Added: and we may not become profitable.
+Added: The degree of market acceptance of any product candidate, if approved for commercial sale, will depend
+Added: on a number of factors, including:
+Added: and potential advantages compared to other treatments;
+Added: ability to offer our products, if approved, for sale at competitive prices;
+Added: ● convenience
+Added: and ease of administration compared to other treatments;
+Added: willingness of the target patient population to try new therapies and of physicians to prescribe
+Added: these therapies;
+Added: strength of marketing and distribution support;
+Added: ability to obtain sufficient third-party coverage, market access and adequate reimbursement;
+Added: prevalence and severity of any side effects.
+Added: Related to Intellectual Property for Gedatolisib
+Added: depend on intellectual property licensed from third parties, including from Pfizer for our lead product candidate, and termination of
+Added: this license could result in the loss of significant rights, which would harm our business.
+Added: are dependent on patents, know-how and proprietary technology, both our own and licensed from others.
+Added: All patents covering gedatolisib
+Added: and any combination therapies using our product candidates are licensed from third parties.
+Added: Any termination of a product license could
+Added: result in the loss of significant rights and would cause material adverse harm to our ability to commercialize our product candidates.
+Added: may also arise between us and our licensors regarding intellectual property subject to a license agreement, including:
+Added: scope of rights granted under the license agreement and other interpretation-related issues;
+Added: and the extent to which our technology and processes infringe on intellectual property of
+Added: the licensor that is not subject to the licensing agreement;
+Added: right to sublicense patent and other rights to third parties under collaborative development
+Added: relationships;
+Added: diligence obligations with respect to the use of licensed technology in relation to our development
+Added: and commercialization of our product candidates and what activities satisfy those diligence
+Added: ownership of inventions and know-how resulting from the joint creation or use of intellectual
+Added: property by our licensors and us and our partners.
+Added: disputes over intellectual property that we have licensed prevent or impair our ability to maintain our current licensing arrangements
+Added: on acceptable terms, we may be unable to successfully develop and commercialize the affected product candidates.
+Added: are generally also subject to all of the same risks with respect to protection of intellectual property that we own, as we are for intellectual
+Added: property that we license.
+Added: If we or our licensors fail to adequately protect this intellectual property, our ability to commercialize
+Added: products could materially suffer.
+Added: we fail to comply with our obligations under our patent license with Pfizer, we could lose license rights that are important to our business.
+Added: are a party to a license agreement with Pfizer pursuant to which we in-license key patents for our gedatolisib.
+Added: This license imposes
+Added: various diligence, milestone payment, royalty, insurance and other obligations on us.
+Added: If we fail to comply with these obligations, Pfizer
+Added: may have the right to terminate the license, in which event we would not be able to develop or market the products covered by such licensed
+Added: intellectual property.
+Added: We may have limited control over the maintenance and prosecution of these in-licensed rights, activities or any
+Added: other intellectual property that may be related to our in-licensed intellectual property.
+Added: For example, we cannot be certain that such
+Added: activities by these licensors have been or will be conducted in compliance with applicable laws and regulations or will result in valid
+Added: and enforceable patents and other intellectual property rights.
+Added: We have limited control over the manner in which our licensors initiate
+Added: an infringement proceeding against a third-party infringer of the intellectual property rights, or defend certain of the intellectual
+Added: property that is licensed to us.
+Added: It is possible that the licensors’ infringement proceeding or defense activities may be less vigorous
+Added: than had we conducted them ourselves.
+Added: may not be successful in obtaining or maintaining necessary rights to develop any future product candidates on acceptable terms.
+Added: our programs may involve additional product candidates that may require the use of proprietary rights held by third parties, the growth
+Added: of our business may depend in part on our ability to acquire, in-license or use these proprietary rights.
+Added: We may be unable to acquire
+Added: or in-license any compositions, methods of use, processes or other third-party intellectual property rights from third parties that we
+Added: identify as necessary or important to our business operations.
+Added: We may fail to obtain any of these licenses at a reasonable cost or on
+Added: reasonable terms, if at all, which could harm our business.
+Added: We may need to cease use of the compositions or methods covered by such third-party
+Added: intellectual property rights, and may need to seek to develop alternative approaches that do not infringe on such intellectual property
+Added: rights which may entail additional costs and development delays, even if we were able to develop such alternatives, which may not be
+Added: Even if we are able to obtain a license, it may be non-exclusive, thereby giving our competitors access to the same technologies
+Added: licensed to us.
+Added: In that event, we may be required to expend significant time and resources to develop or license replacement technology.
+Added: licensing and acquisition of third-party intellectual property rights is a competitive area, and companies, which may be more established,
+Added: or have greater resources than we do, may also be pursuing strategies to license or acquire third-party intellectual property rights
+Added: that we may consider necessary or attractive in order to commercialize our product candidates.
+Added: More established companies may have a
+Added: competitive advantage over us due to their size, cash resources and greater clinical development and commercialization capabilities.
+Added: There can be no assurance that we will be able to successfully complete such negotiations and ultimately acquire the rights to the intellectual
+Added: property surrounding the additional product candidates that we may seek to acquire.
+Added: Related to Government Regulation for Gedatolisib
+Added: may not obtain the necessary regulatory approvals to commercialize our product candidate.
+Added: will need FDA approval to commercialize our product candidate in the U.S.
+Added: In order to obtain FDA approval, we must submit to the FDA
+Added: a new drug application, or NDA, demonstrating that the drug product is safe for humans and effective for its intended use.
+Added: This demonstration
+Added: requires significant research and animal tests, which are referred to as pre-clinical studies, as well as human tests, which are referred
+Added: to as clinical trials.
+Added: Satisfaction of the FDA’s regulatory requirements typically takes many years, depends upon the type, complexity
+Added: and novelty of the drug product and requires substantial resources for research, development and testing.
+Added: We cannot predict whether our
+Added: research and clinical approaches will result in a drug that the FDA considers safe for humans and effective for indicated uses.
+Added: has substantial discretion in the drug approval process and may require us to conduct additional pre-clinical and clinical testing or
+Added: to perform post-marketing studies.
+Added: The approval process may also be delayed by changes in government regulation, future legislation or
+Added: administrative action or changes in FDA policy that occur prior to or during our regulatory review.
+Added: Delays in obtaining regulatory approvals
+Added: may delay commercialization of, and our ability to derive product revenues from, our drug product;
+Added: impose costly procedures on us;
+Added: diminish any competitive advantages that we may otherwise enjoy.
+Added: Even if we comply with all FDA requests, the FDA may ultimately reject
+Added: We cannot be sure that we will ever obtain regulatory clearance for our drug product.
+Added: Failure to obtain FDA approval of our
+Added: drug product will severely undermine our business by reducing our number of salable products and, therefore, corresponding product revenues.
+Added: FDA or comparable foreign regulatory authorities may disagree with our regulatory plan for our product candidates.
+Added: general approach for FDA approval of a new drug is dispositive data from one or more well-controlled Phase 3 clinical trials of the product
+Added: candidate in the relevant patient population.
+Added: Phase 3 clinical trials typically involve a large number of patients, have significant
+Added: costs and take years to complete.
+Added: clinical trial results may not support approval of our product candidates.
+Added: In addition, our product candidates could fail to receive
+Added: regulatory approval, or regulatory approval could be delayed, for many reasons, including the following:
+Added: FDA or comparable foreign regulatory authorities may disagree with the dosing regimen, design
+Added: or implementation of our clinical trials;
+Added: may be unable to demonstrate to the satisfaction of the FDA or comparable foreign regulatory
+Added: authorities that our product candidates are safe and effective for any of their proposed
+Added: may encounter safety or efficacy problems caused by the COVID-19 pandemic;
+Added: results of clinical trials may not meet the level of statistical significance required by
+Added: the FDA or comparable foreign regulatory authorities for approval;
+Added: may be unable to demonstrate that our product candidates’ clinical and other benefits
+Added: outweigh their safety risks;
+Added: FDA or comparable foreign regulatory authorities may disagree with our interpretation of
+Added: data from preclinical studies or clinical trials;
+Added: data collected from clinical trials of our product candidates may not be sufficient to the
+Added: satisfaction of the FDA or comparable foreign regulatory authorities to support the submission
+Added: of an NDA or other comparable submission in foreign jurisdictions or to obtain regulatory
+Added: approval in the U.S.
+Added: or elsewhere;
+Added: FDA or comparable foreign regulatory authorities may fail to approve the manufacturing processes
+Added: or facilities of third-party manufacturers with which we contract for clinical and commercial
+Added: approval policies or regulations of the FDA or comparable foreign regulatory authorities
+Added: may significantly change in a manner rendering our clinical data insufficient for approval.
+Added: Therapy Designation or Fast Track Designation from the FDA may not actually lead to a faster development or regulatory review or approval
+Added: have received Fast Track Designation and may seek Breakthrough Therapy Designation for our product candidates.
+Added: If a product is intended
+Added: for the treatment of a serious or life-threatening condition and the product demonstrates the potential to address unmet medical needs
+Added: for this condition, the product sponsor may apply for Fast Track Designation.
+Added: The FDA has broad discretion whether or not to grant this
+Added: designation, so even if we believe one of our product candidates is eligible for this designation, we cannot assure you that the FDA
+Added: would decide to grant it.
+Added: Even if we do receive Fast Track Designation, we may not experience a faster development process, review or
+Added: approval compared to conventional FDA procedures.
+Added: The FDA may withdraw Fast Track Designation if it believes that the designation is
+Added: no longer supported by data from our clinical development program.
+Added: breakthrough therapy is defined as a product that is intended, alone or in combination with one or more other products, to treat a serious
+Added: or life-threatening disease or condition, and preliminary clinical evidence indicates that the product may demonstrate substantial improvement
+Added: over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical
+Added: For products that have been designated as breakthrough therapies, interaction and communication between the FDA and the
+Added: sponsor of the trial can help to identify the most efficient path for clinical development while minimizing the number of patients placed
+Added: in ineffective control regimens.
+Added: as a breakthrough therapy is within the discretion of the FDA.
+Added: Accordingly, even if we believe one of our product candidates meets the
+Added: criteria for designation as a breakthrough therapy, the FDA may disagree and instead determine not to make such designation.
+Added: In any event,
+Added: the receipt of a Breakthrough Therapy Designation may not result in a faster development process, review or approval compared to products
+Added: considered for approval under conventional FDA procedures and does not assure ultimate approval by the FDA.
+Added: In addition, even if a product
+Added: candidate qualifies as a breakthrough therapy, the FDA may later decide that the product no longer meets the conditions for qualification
+Added: and rescind the Breakthrough Therapy Designation.
+Added: and maintaining regulatory approval of our product candidates in one jurisdiction does not mean that we will be successful in obtaining
+Added: regulatory approval of our product candidates in other jurisdictions.
+Added: and maintaining regulatory approval of our product candidates in one jurisdiction does not guarantee that we will be able to obtain or
+Added: maintain regulatory approval in any other jurisdiction, while a failure or delay in obtaining regulatory approval in one jurisdiction
+Added: may have a negative effect on the regulatory approval process in others.
+Added: For example, even if the FDA grants marketing approval of a
+Added: product candidate, a comparable foreign regulatory authority must also approve the manufacturing, marketing and promotion of the product
+Added: candidate in those countries.
+Added: procedures vary among jurisdictions and can involve requirements and administrative review periods different from, and greater than,
+Added: those in the U.S., including additional preclinical studies or clinical trials, as clinical trials conducted in one jurisdiction may
+Added: not be accepted by regulatory authorities in other jurisdictions.
+Added: In many jurisdictions outside the U.S., a product candidate must be
+Added: approved for reimbursement before it can be approved for sale in that jurisdiction.
+Added: In some cases, the price that we intend to charge
+Added: for our products is also subject to approval.
+Added: may also submit marketing applications in other countries.
+Added: Regulatory authorities in jurisdictions outside of the U.S.
+Added: have requirements
+Added: for approval of product candidates with which we must comply prior to marketing in those jurisdictions.
+Added: Obtaining foreign regulatory
+Added: approvals and compliance with foreign regulatory requirements could result in significant delays, difficulties and costs for us and could
+Added: delay or prevent the introduction of our products in certain countries.
+Added: If we fail to comply with the regulatory requirements in international
+Added: markets and/or receive applicable marketing approvals, our target market will be reduced and our ability to realize the full market potential
+Added: of our product candidates will be harmed.
+Added: if we receive regulatory approval of any product candidates, we will be subject to ongoing regulatory obligations and continued regulatory
+Added: review, which may result in significant additional expense and we may be subject to penalties if we fail to comply with regulatory requirements
+Added: or experience unanticipated problems with our product candidates.
+Added: any of our product candidates are approved, they will be subject to ongoing regulatory requirements for manufacturing, labeling, packaging,
+Added: storage, advertising, promotion, sampling, record-keeping, conduct of post-marketing studies and submission of safety, efficacy and other
+Added: post-marketing information, including both federal and state requirements in the U.S.
+Added: and requirements of comparable foreign regulatory
+Added: In addition, we will be subject to continued compliance with requirements for any clinical trials that we conduct post-approval.
+Added: Manufacturers
+Added: and manufacturers’ facilities are required to comply with extensive FDA and comparable foreign regulatory authority requirements.
+Added: Accordingly, we and others with whom we work must continue to expend time, money and effort in all areas of regulatory compliance, including
+Added: manufacturing, production and quality control.
+Added: regulatory approvals that we receive for our product candidates may be subject to limitations on the approved indicated uses for which
+Added: the product may be marketed or to the conditions of approval, or contain requirements for potentially costly post-marketing testing,
+Added: including Phase 4 clinical trials and surveillance to monitor the safety and efficacy of the product candidate.
+Added: Certain endpoint data
+Added: we hope to include in any approved product labeling also may not make it into such labeling, including exploratory or secondary endpoint
+Added: data such as patient-reported outcome measures.
+Added: The FDA may impose consent decrees or withdraw approval if compliance with regulatory
+Added: requirements and standards is not maintained or if problems occur after the product reaches the market.
+Added: Later discovery of previously
+Added: unknown problems with our product candidates, including adverse events of unanticipated severity or frequency, or with our third-party
+Added: manufacturers or manufacturing processes, or failure to comply with regulatory requirements, may result in revisions to the approved
+Added: labeling to add new safety information, imposition of post-marketing studies or clinical trials to assess new safety risks or imposition
+Added: of distribution restrictions or other restrictions under a REMS program.
+Added: Other potential consequences include, among other things:
+Added: ● restrictions
+Added: on the marketing or manufacturing of our products, withdrawal of the product from the market
+Added: or voluntary or mandatory product recalls;
+Added: warning letters or holds on clinical trials;
+Added: by the FDA to approve pending applications or supplements to approved applications filed
+Added: by us or suspension or revocation of license approvals;
+Added: seizure or detention or refusal to permit the import or export of our product candidates;
+Added: ● injunctions
+Added: or the imposition of civil or criminal penalties.
+Added: FDA strictly regulates marketing, labeling, advertising and promotion of products that are placed on the market.
+Added: Products may be promoted
+Added: only for the approved indications and in accordance with the provisions of the approved label.
+Added: The policies of the FDA and comparable
+Added: foreign regulatory authorities may change, and additional government regulations may be enacted that could prevent, limit or delay regulatory
+Added: approval of our product candidates.
+Added: We cannot predict the likelihood, nature or extent of government regulation that may arise from future
+Added: legislation or administrative action, either in the U.S.
+Added: If we are slow or unable to adapt to changes in existing requirements
+Added: or the adoption of new requirements or policies, or if we are not able to maintain regulatory compliance, we may lose any marketing approval
+Added: that we may have obtained and we may not achieve or sustain profitability.
+Added: Related to Our CELsignia Tests
+Added: success with CELsignia is heavily dependent on the success of our first CELsignia trials.
+Added: business strategy is focused on attracting pharmaceutical company partnerships that provide revenue from the sale of CELsignia tests
+Added: during clinical trials, from milestone payments during clinical trials, from sales of our CELsignia tests as companion diagnostics or
+Added: stand-alone tests thereafter, and, potentially, from royalties on the incremental drug revenues our tests enable.
+Added: Our ability to obtain
+Added: such partnerships and generate such revenue depends in part on the ability of our first CELsignia tests to demonstrate the potential
+Added: incremental opportunity available for pharmaceutical companies.
+Added: We do not expect to receive the first interim results for our prospective
+Added: clinical trials for the CELsignia HER2 Pathway Activity Test until the first half of 2023 and with final results expected approximately
+Added: nine months later.
+Added: Success of the clinical trials using the CELsignia HER2 Pathway Activity Test or CELsignia Multi-Pathway Activity
+Added: Test will depend on many factors, such as successfully enrolling patients, meeting trial endpoint goals, and completing the trial in
+Added: a timely manner.
+Added: Our ability to complete the trial could be delayed or prevented for several reasons that are out of our control, such
+Added: as the FDA withdrawing its authorization and approval to perform the study, NSABP, West Cancer Center, Massachusetts General Hospital,
+Added: MD Anderson Cancer Center, or University of Rochester determining that the human and/or toxicology test results do not support continuing
+Added: the trial, or participants having adverse reactions or side-effects to the drugs administered in the study.
+Added: If we are unable to demonstrate
+Added: that the CELsignia HER2 Pathway Activity Test or CELsignia Multi-Pathway Activity Test is suitable as a companion diagnostic for the
+Added: targeted therapy, we will likely not be able to generate future revenue from our CELsignia HER2 Pathway Activity Test or CELsignia Multi-Pathway
+Added: Activity test and may not be able to attract other pharmaceutical companies to partner with us for the development and commercialization
+Added: of other CELsignia tests.
+Added: Further, potential pharmaceutical company partners may delay negotiating development agreements until results
+Added: of the first clinical trial using our CELsignia HER2 Pathway Activity Test trial are available.
+Added: Even if the ultimate outcome of the first
+Added: clinical trial using a CELsignia HER2 Pathway Activity Test trial is positive, any delays could materially and adversely affect our business.
+Added: may not be successful in finding pharmaceutical company partners for continuing development of additional CELsignia tests.
+Added: intend to develop strategic partnerships with pharmaceutical companies for developing additional CELsignia tests.
+Added: Many of the potential
+Added: partners are global, multi-billion-dollar pharmaceutical companies with sophisticated research and development organizations and multiple
+Added: We may not be successful in our efforts to establish such a strategic partnership or other alternative arrangements for our
+Added: CELsignia tests because, among other things, our research and development pipeline may be insufficient, such tests may be deemed to be
+Added: at too early of a stage of development for collaborative effort, or third parties may not view such tests as having the requisite potential
+Added: to demonstrate efficacy.
+Added: In addition, we may be restricted under collaboration agreements from entering into future agreements with other
+Added: Even if we are able to find suitable partners, we may not be successful in negotiating development agreements with such partners
+Added: that provide revenue from the sale of our CELsignia tests, from milestone payments, and/or from royalties on the incremental drug revenues
+Added: that our tests enable.
+Added: If we are unable to reach agreements with suitable strategic partners on a timely basis, on acceptable terms or
+Added: at all, we may have to curtail the development of additional CELsignia tests, our expected revenue opportunities may be significantly
+Added: smaller than expected and our business may fail.
+Added: our CELsignia HER2 Pathway Activity Test and CELsignia Multi-Pathway Activity Test are commercially ready, we have not attempted to market
+Added: these to physicians or their patients as stand-alone tests and have no ability to determine if these tests or any of our other tests
+Added: will be commercially viable.
+Added: our CELsignia HER2 Pathway Activity Test and CELsignia Multi-Pathway Activity Test are analytically validated, conducted in our CLIA
+Added: certified and CAP accredited laboratory, and currently ready for commercial use as an LDT, we have not attempted to market them to physicians
+Added: or their patients.
+Added: Furthermore, we have commenced only limited communications with KOLs to build awareness and credibility of our CELsignia
+Added: diagnostic platform and CELsignia tests.
+Added: Accordingly, we have no ability to determine whether our CELsignia HER2 Pathway Activity Test,
+Added: CELsignia Multi-Pathway Activity Test or any other future CELsignia tests, will be commercially viable as stand-alone tests.
+Added: be successful in generating revenue from our CELsignia tests as stand-alone tests, and if we are unable to build pharmaceutical partnerships
+Added: that enable us to market the CELsignia HER2 Pathway Activity Test, the CELsignia Multi-Pathway Activity Test, and other tests as companion
+Added: diagnostic tests, we may never generate any revenue and our business may fail.
+Added: our CELsignia tests involves a lengthy and complex process that may not be successful.
+Added: CELsignia tests may take several years to develop from the time they are discovered to the time they are available for patient use, if
+Added: In order to develop additional CELsignia tests into commercially ready products, we need to successfully complete a variety of
+Added: activities, including, among others, conducting substantial research and development, conducting extensive analytical testing, and maintaining
+Added: our CLIA certified and CAP accredited laboratory.
+Added: In addition, our business strategy is focused on our CELsignia tests being sold as
+Added: companion diagnostics.
+Added: This will require obtaining and maintaining partnerships with pharmaceutical companies and successfully completing
+Added: clinical studies that demonstrate the suitability of the applicable CELsignia test as a companion diagnostic for their targeted therapies.
+Added: activities will require us to expend significant resources.
+Added: Based on comparable companies in this industry, few research and development
+Added: projects result in commercially viable products, and success in early clinical studies often is not replicated in later studies.
+Added: point, we may abandon development of a product candidate for several reasons, such as a clinical validation study failing to demonstrate
+Added: the prospectively defined endpoints of the study.
+Added: We may also be required to expend considerable resources repeating clinical studies,
+Added: which would adversely affect the timing for generating potential revenue from a new product and our ability to invest in other products
+Added: in our pipeline.
+Added: trials are expensive and complex with uncertain outcomes, which may prevent or delay commercialization of our CELsignia tests.
+Added: our CELsignia tests to become a companion diagnostic for a matching targeted therapy, we must conduct clinical trials to demonstrate
+Added: that patients who have an abnormal signaling pathway, as identified by our CELsignia tests, respond to treatment with a matching targeted
+Added: Clinical testing is expensive, is difficult to design and implement, and can take many years to complete, and its outcome is
+Added: inherently uncertain.
+Added: As a company, we have limited experience in conducting or participating in clinical trials.
+Added: We cannot be certain
+Added: that any future clinical trials will conclusively demonstrate that any CELsignia test is effective as a companion diagnostic.
+Added: trials do not yield positive results, we may be unable to maintain the pharmaceutical company partnerships we build or find additional
+Added: partners, we may not be able to successfully commercialize our CELsignia tests or generate any revenue, our business may fail, and you
+Added: may lose part or all of your investment.
+Added: cannot be certain that our existing clinical trial or future clinical trials, if any, will begin or be completed on time, if at all.
+Added: We may experience numerous unforeseen events during, or as a result of, clinical trials that could delay or prevent our ability to commercialize
+Added: our CELsignia tests, such as:
+Added: or failure in reaching agreement on acceptable clinical trial contracts or clinical trial
+Added: protocols with planned trial sites and/or strategic partners;
+Added: or failure in reaching agreement with the FDA or a comparable foreign regulatory authority
+Added: on a trial design, in obtaining authorization from such authorities to commence the trial,
+Added: and/or in complying with conditions or other requirements imposed by such regulatory authorities
+Added: with respect to the trial;
+Added: or failure in recruiting and enrolling suitable subjects to participate in one or more clinical
+Added: trials, or in such participants completing a trial or returning for follow-up during or after
+Added: sites, investigators or other third-parties deviating from the trial protocol, failing to
+Added: conduct the trial in accordance with regulatory and contractual requirements, and/or dropping
+Added: out of a trial;
+Added: imposition of a clinical hold for any of our clinical trials, where a clinical hold in a
+Added: trial in one indication would result in a clinical hold for clinical trials in other indications;
+Added: in governmental regulations or administrative actions.
+Added: nonclinical or clinical trial delays could prevent us from maintaining and/or developing new pharmaceutical company partnerships.
+Added: could also shorten any periods during which we may have the exclusive right to commercialize our CELsignia tests or allow our competitors
+Added: to bring products to market before we do.
+Added: As such, any delays could impair our ability to successfully commercialize our CELsignia tests
+Added: and may materially and adversely affect our business, financial condition, results of operations and prospects.
+Added: if our CELsignia tests achieve positive clinical trial results, they may fail to achieve the degree of market acceptance by physicians,
+Added: patients, third-party payors and others in the medical community necessary for commercial success.
+Added: any of our potential CELsignia tests, including our first CELsignia HER2 Pathway Activity Test and CELsignia Multi-Pathway Activity Test,
+Added: achieve positive clinical trial results, they may nonetheless fail to gain sufficient market acceptance by physicians, patients, third-party
+Added: payors and others in the medical community necessary for commercial success.
+Added: For example, conventional genomic- or proteomic-based analyses
+Added: are commonly used today to diagnose cancer and prescribe cancer medications, and physicians may continue to rely on these diagnostic
+Added: tests instead of adopting the use of a CELsignia test.
+Added: The degree of market acceptance of our CELsignia tests will depend on a number
+Added: of factors, including:
+Added: efficacy and other potential advantages compared to alternative diagnostic tests;
+Added: ability to offer them for sale at competitive prices;
+Added: convenience and ease of obtaining patient specimens compared to alternative diagnostics;
+Added: willingness of the target patient population to try new diagnostics and of physicians to
+Added: initiate such diagnostics;
+Added: strength of marketing and distribution support;
+Added: availability of third-party coverage and adequate reimbursement for our diagnostic tests;
+Added: ability to partner with pharmaceutical companies to develop companion diagnostic programs
+Added: for the new cancer sub-types we discover.
+Added: our CELsignia tests do not achieve an adequate level of acceptance, we may never generate significant product revenues and we may not
+Added: become profitable.
+Added: CELsignia related business, operational and financial goals may not be attainable if the market opportunities for our CELsignia tests
+Added: or our pharmaceutical company partners are smaller than we expect.
+Added: Our internal research and estimates on market opportunities have not
+Added: been verified by independent sources, and we have not independently verified market and industry data from third-parties that we have
+Added: total market opportunities that we believe exist are based on a variety of assumptions and estimates, including the number of potential
+Added: companion diagnostic programs we will be able to successfully pursue, the amount of potential milestone payments that we could receive
+Added: in companion diagnostic programs, the number of patients we will test in clinical trials, the price we will be able to charge for our
+Added: tests and the total annual number of cancer patients with undiagnosed abnormal cell signaling.
+Added: In addition, we have relied on third-party
+Added: publications, research, surveys and studies for information related to determining market opportunities, including without limitation,
+Added: information on the number of cancer patients and those receiving various forms of treatment, the cost of drug therapy, the amount of
+Added: revenue generated from various types of drug therapy, the objective response rates of drug therapies, the number of deaths caused by
+Added: cancer and the expected growth in cancer drug therapy and diagnostic markets.
+Added: Our internal research and estimates on market opportunities
+Added: have not been verified by independent sources, and we have not independently verified market and industry data from third-parties that
+Added: we have relied on.
+Added: Any or all of our assumptions and/or estimates may prove to be incorrect for several reasons, such as inaccurate reports
+Added: or information that we have relied on, potential patients or providers not being amenable to using our CELsignia platform for diagnostic
+Added: testing or such patients becoming difficult to identify and access, limited reimbursement for companion diagnostics, pricing pressure
+Added: due to availability of alternative diagnostic tests, or an inability of the CELsignia tests’ companion drugs to obtain the necessary
+Added: regulatory approvals for new indications.
+Added: If any or all of our assumptions and estimates prove inaccurate, we and our companion diagnostic
+Added: pharmaceutical partners may not attain our business, operational and financial goals.
+Added: expected selling price range of our CELsignia tests is an estimate.
+Added: We have not yet sold any such tests and the actual price we are able
+Added: to charge may be substantially lower than our expected price range.
+Added: have estimated the selling price range of our CELsignia tests based on the pricing of other diagnostic tests currently available and
+Added: assumptions regarding the efficacy and market acceptance of our tests.
+Added: We have not yet sold our CELsignia tests and cannot be certain
+Added: of the actual price we may be able to charge.
+Added: The availability and price of our competitors’ products could limit the demand and
+Added: the price we are able to charge.
+Added: We may not achieve our business plan if acceptance is inhibited by price competition, if pharmaceutical
+Added: companies refuse to pay our expected prices for CELsignia tests in clinical trials, if physicians are reluctant to switch from other
+Added: diagnostic tests to our CELsignia tests or if physicians switch to other new products or choose to reserve our CELsignia tests for use
+Added: in limited circumstances.
+Added: Furthermore, reductions in the reimbursement rate of third-party payors have occurred and may occur in the
+Added: Each of these factors could cause our selling price to be substantially lower than expected, and we may fail to generate revenue
+Added: or become profitable.
+Added: insurance coverage and reimbursement status of new diagnostic products is uncertain.
+Added: Failure to obtain or maintain adequate coverage
+Added: and reimbursement for CELsignia tests could limit our ability to market those CELsignia tests and decrease our ability to generate revenue.
+Added: availability and extent of reimbursement by governmental and private payors is essential for most patients to be able to afford expensive
+Added: diagnostic tests and treatments.
+Added: Sales of any of our potential CELsignia tests will depend substantially, both in the United States and
+Added: internationally, on the extent to which the costs of our CELsignia tests will be paid by health maintenance, managed care, and similar
+Added: healthcare management organizations, or reimbursed by government health administration authorities, private health coverage insurers
+Added: and other third-party payors.
+Added: Reimbursement by a payor may depend on a number of factors, including a payor’s determination that
+Added: the CELsignia tests are neither experimental nor investigational, appropriate for the specific patient, cost-effective, supported by
+Added: peer-reviewed publications, and included in clinical practice guidelines.
+Added: reimbursement is not available, or is available only to a limited amount, we may not be able to successfully commercialize our CELsignia
+Added: tests at expected levels, or potentially at all.
+Added: Even if coverage is provided, the approved reimbursement amount may not be high enough
+Added: to allow us to establish or maintain pricing sufficient to realize a sufficient return on our research and development investment.
+Added: is significant uncertainty related to the insurance coverage and reimbursement of newly approved diagnostic products.
+Added: In the United States,
+Added: the principal decisions about reimbursement for new diagnostic products and services are typically made by CMS.
+Added: CMS decides whether and
+Added: to what extent a new product or service will be covered and reimbursed under Medicare.
+Added: Private payors tend to follow CMS to a substantial
+Added: As such, a significant portion of our potential revenue depends on CMS approving coverage and reimbursement of our CELsignia
+Added: the United States, international operations are generally subject to extensive governmental price controls and other market regulations,
+Added: and we believe the increasing emphasis on cost-containment initiatives in Europe, Canada and other countries has and will continue to
+Added: put pressure on the pricing and usage of diagnostic tests such as our potential CELsignia tests.
+Added: In many countries, particularly the
+Added: countries of the European Union, the prices of medical products are subject to varying price control mechanisms as part of national health
+Added: In these countries, pricing negotiations with governmental authorities can take considerable time.
+Added: To obtain reimbursement or
+Added: pricing approval in some countries, we may be required to demonstrate the cost-effectiveness of our CELsignia tests relative to other
+Added: available diagnostic tests.
+Added: The prices of products under such systems may be substantially lower than in the United States.
+Added: Other countries
+Added: allow companies to fix their own prices for products but monitor and control company profits.
+Added: Additional foreign price controls or other
+Added: changes in pricing regulation could restrict the amount that we are able to charge for our CELsignia tests.
+Added: Accordingly, in markets outside
+Added: the United States, the reimbursement for our potential CELsignia tests may be reduced compared with the United States and may be insufficient
+Added: to generate commercially reasonable revenue and profit.
+Added: increasing efforts by governmental and third-party payors, in the United States and internationally, to cap or reduce healthcare costs
+Added: may cause such organizations to limit both coverage and level of reimbursement for new products approved and, as a result, they may not
+Added: cover or provide adequate payment for our potential CELsignia tests.
+Added: The downward pressure on healthcare costs in general, particularly
+Added: prescription drugs and surgical procedures and other treatments, has become very intense.
+Added: We expect to experience pricing pressures in
+Added: connection with the sale of any CELsignia tests due to the trend toward managed healthcare, the increasing influence of health maintenance
+Added: organizations and additional legislative changes.
+Added: may encounter difficulties in commercializing and marketing our CELsignia products, including in hiring and retaining a qualified sales
+Added: order to commercialize any CELsignia test, we must build marketing, sales, managerial and other non-technical capabilities or make arrangements
+Added: with third parties to perform these services, and we may not be successful in doing so.
+Added: For each CELsignia test we develop, we intend
+Added: to pursue development agreements with the pharmaceutical companies that provide matching targeted therapies.
+Added: Once we have completed the
+Added: analytical validation of a CELsignia test, we plan to target KOLs to build product awareness.
+Added: Once we have clinical validation data available,
+Added: we expect to expand our sales and marketing efforts to target the broader market and coordinate our go-to-market activities with those
+Added: of our partner pharmaceutical companies.
+Added: These activities will be expensive and time consuming and will require significant attention
+Added: of our executive officers to manage.
+Added: In particular, there is intense competition for qualified sales personnel and our inability to hire
+Added: or retain an adequate number of sales representatives could limit our ability to maintain or expand our business and increase sales.
+Added: Furthermore, there is no guarantee that any new drug indications will require our CELsignia tests as a companion diagnostic or that any
+Added: pharmaceutical company will effectively coordinate sales and marketing activities with us.
+Added: Any failure or delay in these activities,
+Added: including if we are unable to develop our marketing and sales networks or if our sales personnel do not perform as expected, would adversely
+Added: impact the commercialization our CELsignia platform, and our business, financial condition, results of operations and prospects may be
+Added: materially and adversely affected.
+Added: face significant competition from other diagnostic companies and our operating results will suffer if we fail to compete effectively.
+Added: diagnostic testing industry is intensely competitive.
+Added: We have competitors both in the United States and abroad, including universities
+Added: and other research institutions and providers of diagnostics that focus on developing genomic or proteomic analyses of a patient’s
+Added: diseased cells or theranostic tests to predict specific patient responses to a drug therapy.
+Added: Many of our competitors have substantially
+Added: greater financial, technical and other resources, such as larger research and development staff and well-established marketing and sales
+Added: Our competitors may succeed in developing, acquiring or licensing, on an exclusive basis, products or services that are more
+Added: effective or less costly than the CELsignia tests that we are currently developing or that we may develop.
+Added: In addition, established medical
+Added: technology, biotechnology and/or pharmaceutical companies may invest heavily to accelerate discovery and development of diagnostic tests
+Added: that could make our CELsignia tests less competitive.
+Added: ability to compete successfully will depend largely on our ability to:
+Added: and develop CELsignia tests for cancer sub-types that are superior to other products in the
+Added: ● demonstrate
+Added: compelling advantages in the efficacy and convenience of our CELsignia tests on a cost competitive
+Added: qualified scientific, product development and commercial personnel;
+Added: and maintain patent and other proprietary protection as necessary for our CELsignia platform;
+Added: required U.S.
+Added: and international regulatory approvals;
+Added: ● successfully
+Added: collaborate with research institutions and pharmaceutical companies in the discovery, development
+Added: and commercialization of our current and future CELsignia tests;
+Added: ● successfully
+Added: expand our operations and build a sales force to support commercialization.
+Added: our sole laboratory facility becomes inoperable, we will be unable to perform our tests and our business will be harmed.
+Added: do not have redundant laboratory facilities.
+Added: We perform all of our diagnostic services in our laboratory located in Minneapolis, Minnesota.
+Added: Our facility and the equipment we use to perform our tests would be costly to replace and could require substantial lead time to repair
+Added: The facility may be harmed or rendered inoperable by physical damage from fire, floods, tornadoes, power loss, telecommunications
+Added: failures, break-ins and similar events, which may render it difficult or impossible for us to perform our tests for some period of time.
+Added: The inability to perform our tests may result in the loss of customers or harm our reputation, and we may be unable to regain those customers
+Added: in the future.
+Added: Although we possess insurance for damage to our property and the disruption of our business, this insurance may not be
+Added: sufficient to cover all of our potential losses and may not continue to be available to us on acceptable terms, or at all.
+Added: order to rely on a third party to perform our tests, we could only use another facility with established state licensure and CLIA accreditation
+Added: under the scope of which our potential CELsignia tests could be performed following validation and other required procedures.
+Added: assure you that we would be able to find another CLIA-certified facility willing to adopt CELsignia tests and comply with the required
+Added: procedures, or that this laboratory would be willing to perform the tests for us on commercially reasonable terms.
+Added: instrument or reagent suppliers may fail to meet our quality requirements for the items we purchase or fail to provide a continuous supply
+Added: of the items we utilize to perform our CELsignia tests.
+Added: utilize highly specialized reagents and instruments to perform our CELsignia tests.
+Added: We may be unable to find suitable replacement reagents
+Added: and instruments on a timely basis, if at all.
+Added: Interruption in the supply of these items or degradation in their quality could delay analytical
+Added: and clinical studies, and/or render us unable to deliver CELsignia tests.
+Added: This would interrupt sales and adversely affect our business,
+Added: results of operations and financial condition.
+Added: issues or price increases by our shipping carriers could adversely affect our business, results of operations and financial condition,
+Added: and harm our reputation and ability to provide our CELsignia tests on a timely basis.
+Added: reliable shipping is essential to our operations.
+Added: Should our shipping carrier encounter delivery performance issues such as loss, damage
+Added: or destruction of a sample, such occurrences may damage our reputation and lead to decreased demand for our services and increased cost
+Added: and expense to our business.
+Added: In addition, any significant increase in shipping rates could adversely affect our operating margins and
+Added: results of operations.
+Added: Similarly, strikes, severe weather, natural disasters or other service interruptions by delivery services we use
+Added: would adversely affect our ability to receive and process patient samples on a timely basis.
+Added: There are only a few providers of overnight
+Added: nationwide transport services, and there can be no assurance that we will be able to maintain arrangements with providers on acceptable
+Added: terms, if at all.
+Added: CELsignia tests represent a novel approach to companion diagnostics, which could result in heightened regulatory scrutiny, delays in
+Added: clinical development, or delays in our ability to commercialize any products.
+Added: unique and proprietary CELsignia technology is the first cancer diagnostic platform we are aware of that can detect the underlying signaling
+Added: dysfunction driving a patient’s cancer.
+Added: Because this is a novel approach to companion diagnostics, there can be no assurance as
+Added: to the length of a clinical trial period, the number of patients the FDA or another applicable regulatory authority will require to be
+Added: enrolled in the trials in order to establish the safety and efficacy of our CELsignia tests and the companion drugs, or that the data
+Added: generated in these trials will be acceptable to the FDA or another applicable regulatory authority to support marketing approval of new
+Added: indications for the companion drugs.
+Added: This could delay or prohibit our clinical trials and/or commercialization of our CELsignia tests.
+Added: the FDA were to begin regulating our tests, we could incur substantial costs and delays associated with trying to obtain premarket clearance
+Added: LDTs are not currently subject to FDA regulation, although reagents, instruments, software or components provided by third parties and
+Added: used to perform LDTs may be subject to regulation.
+Added: We believe that the CELsignia tests are LDTs, which is a term that describes tests
+Added: that are designed and performed within a single laboratory.
+Added: As a result, we believe the CELsignia tests are not currently subject to
+Added: regulation by the FDA in accordance with the FDA’s current policy of exercising enforcement discretion regarding LDTs.
+Added: Historically,
+Added: the FDA has not required laboratories that furnish only LDTs to comply with the agency’s requirements for medical devices (e.g.,
+Added: establishment registration, device listing, quality systems regulations, premarket clearance or premarket approval, and post-market controls).
+Added: In mid-2014, the FDA published a draft Guidance Document describing a proposed approach for a regulatory framework for LDTs, but in late
+Added: 2016, the FDA indicated it did not intend to finalize the LDT Guidance Document at that time.
+Added: It is not clear when or if the FDA will
+Added: seek to alter the current LDT regulatory framework in the future.
+Added: We cannot provide any assurance that FDA regulation, including premarket
+Added: review, will not be required in the future for our tests, whether through additional guidance issued by the FDA, new enforcement policies
+Added: adopted by the FDA or new legislation enacted by Congress.
+Added: We cannot predict with certainty the timing or content of future legislation
+Added: enacted or guidance issued regarding LDTs, or how it will affect our business.
+Added: premarket review is required by the FDA at a future date or if we decide to voluntarily pursue FDA premarket review of our CELsignia
+Added: tests, there can be no assurance that our CELsignia tests or any tests we may develop in the future will be cleared or approved by the
+Added: FDA on a timely basis, if at all, nor can there be assurance that labeling claims will be consistent with our current claims or adequate
+Added: to support continued adoption of and reimbursement for our CELsignia tests.
+Added: If our CELsignia tests are allowed to remain on the market
+Added: but there is uncertainty in the marketplace about our tests, if they are labeled investigational by the FDA, or if labeling claims the
+Added: FDA allows us to make are more limited than we expect, reimbursement may be adversely affected and we may not be able to sell our CELsignia
+Added: Compliance with FDA regulations would increase the cost of conducting our business and subject us to heightened regulation and
+Added: scrutiny by the FDA and penalties for failure to comply with these requirements.
+Added: we fail to obtain required federal and state laboratory licenses, we could lose the ability to perform our tests.
+Added: laboratory tests, including our CELsignia tests, are regulated under CLIA.
+Added: CLIA is a federal law that regulates clinical laboratories
+Added: that perform testing on specimens derived from humans for the purpose of providing information for the diagnosis, prevention or treatment
+Added: CLIA regulations mandate specific standards for laboratories in the areas of personnel qualifications, administration, and
+Added: participation in proficiency testing, patient test management and quality assurance.
+Added: CLIA certification is also required in order for
+Added: us to be eligible to bill state and federal healthcare programs, as well as many private third-party payers, for any tests we launch.
+Added: We will also be required to maintain state licenses in certain states to conduct testing in our laboratories.
+Added: While we currently have
+Added: CLIA certification for our Minnesota laboratory, failure to maintain this certification would adversely affect our ability to launch
+Added: our CELsignia tests.
+Added: Risks Related to Intellectual Property
+Added: we are unable to obtain and maintain intellectual property protection for our CELsignia technology, or if the scope of the intellectual
+Added: property protection obtained is not sufficiently broad, our competitors could develop and commercialize technology and diagnostic tests
+Added: similar or identical to ours, and our ability to successfully commercialize our technology and diagnostic tests may be impaired.
+Added: ability to compete successfully will depend in part on our ability to obtain and enforce patent protection for our products, preserve
+Added: our trade secrets and operate without infringing the proprietary rights of third parties.
+Added: We have applied for patents that protect our
+Added: Our patent portfolio includes three issued U.S.
+Added: patents, five issued international patents, five pending U.S.
+Added: patent applications,
+Added: 23 pending non-U.S.
+Added: patent applications, one pending international PCT patent application, and numerous corresponding non-U.S.
+Added: applications.
+Added: Each patent and patent application covers methods of use.
+Added: However, we cannot assure you that our intellectual property
+Added: position will not be challenged or that all patents for which we have applied will be granted.
+Added: The validity and breadth of claims in
+Added: patents involve complex legal and factual questions and, therefore, may be highly uncertain.
+Added: Uncertainties and risks that we face include
+Added: the following:
+Added: pending or future patent applications may not result in the issuance of patents;
+Added: scope of any existing or future patent protection may not exclude competitors or provide
+Added: competitive advantages to us;
+Added: patents may not be held valid if subsequently challenged;
+Added: parties may claim that our products and designs infringe the proprietary rights of others,
+Added: and even if we are successful in defending our patents and proprietary rights, such litigation
+Added: may be costly;
+Added: parties may develop similar products, duplicate our products, or design around our patents.
+Added: patent prosecution process is expensive and time-consuming, and we may not be able to file, prosecute, maintain, enforce or license all
+Added: necessary or desirable patent applications at a reasonable cost or in a timely manner, or in all jurisdictions.
+Added: We may choose not to
+Added: seek patent protection for certain innovations and may choose not to pursue patent protection in certain jurisdictions, and under the
+Added: laws of certain jurisdictions, patents or other intellectual property rights may be unavailable or limited in scope.
+Added: It is also possible
+Added: that we will fail to identify patentable aspects of our discovery and nonclinical development output before it is too late to obtain
+Added: patent protection.
+Added: patent position of companies like ours is highly uncertain, involves complex legal and factual questions and has in recent years been
+Added: the subject of much litigation.
+Added: Patent and Trademark Office, or U.S.
+Added: PTO, has not established a consistent policy regarding
+Added: the breadth of claims that it will allow in medical technology patents.
+Added: In addition, the laws of foreign jurisdictions may not protect
+Added: our rights to the same extent as the laws of the United States.
+Added: For example, India and China do not allow patents for methods of treating
+Added: the human body.
+Added: Publications of discoveries in the scientific literature often lag behind the actual discoveries, and patent applications
+Added: in the United States and other jurisdictions are typically not published until 18 months after filing, or in some cases not at all.
+Added: we cannot know with certainty whether we were the first to make the inventions claimed in our owned or licensed patents or pending patent
+Added: applications, or that we were the first to file for patent protection of such inventions.
+Added: As a result, the issuance, scope, validity,
+Added: enforceability and commercial value of our patent rights are highly uncertain.
+Added: Our pending and future patent applications may not result
+Added: in patents being issued that protect our technology or CELsignia tests, in whole or in part, or which effectively prevent others from
+Added: commercializing competitive technologies and diagnostic tests.
+Added: Changes in either the patent laws or interpretation of the patent laws
+Added: in the United States and other countries may diminish the value of our patents or narrow the scope of our patent protection.
+Added: we may be subject to a third-party pre-issuance submission of prior art to the U.S.
+Added: PTO or patent offices in foreign jurisdictions, or
+Added: become involved in opposition, derivation, reexamination, inter parties review, post-grant review or interference proceedings challenging
+Added: our patent rights or the patent rights of others.
+Added: An adverse determination in any such submission, proceeding or litigation could reduce
+Added: the scope of, or invalidate, our patent rights, allow third parties to commercialize our technology and compete directly with us, without
+Added: payment to us, or result in our inability to commercialize CELsignia platform without infringing third-party patent rights.
+Added: if the breadth or strength of protection provided by our patents and patent applications is threatened, it could dissuade companies from
+Added: collaborating with us to develop or commercialize current or future CELsignia tests.
+Added: if our owned patent applications issue as patents, they may not issue in a form that will provide us with any meaningful protection,
+Added: prevent competitors from competing with us or otherwise provide us with any competitive advantage.
+Added: Our competitors may be able to circumvent
+Added: our owned patents by developing similar or alternative technologies or products in a non-infringing manner.
+Added: issuance of a patent is not conclusive as to its inventorship, scope, validity or enforceability, and our owned patents may be challenged
+Added: in the courts or patent offices in the United States and abroad.
+Added: Such challenges may result in loss of exclusivity or freedom to operate
+Added: or in patent claims being narrowed, invalidated or held unenforceable, in whole or in part, which could limit our ability to stop others
+Added: from using or commercializing similar or identical technology and product candidates, or limit the duration of the patent protection
+Added: of our technology and potential diagnostic tests.
+Added: Given the amount of time required for the development, testing and regulatory review
+Added: of new diagnostic tests, patents protecting such tests might expire before or shortly after such candidates are commercialized.
+Added: result, our owned patent portfolio may not provide us with sufficient rights to exclude others from commercializing diagnostic tests
+Added: similar or identical to ours.
+Added: parties may initiate legal proceedings alleging that we are infringing their intellectual property rights, the outcome of which would
+Added: be uncertain and could have a material adverse effect on the success of our business.
+Added: commercial success of CELsignia tests depends upon our ability, and the ability of our collaborators, to develop, manufacture, market
+Added: and sell our CELsignia tests and use our proprietary technologies without infringing the proprietary rights of third parties.
+Added: considerable intellectual property litigation in the medical technology, biotechnology and pharmaceutical industries.
+Added: We may become party
+Added: to, or threatened with, future adversarial proceedings or litigation regarding intellectual property rights with respect to our CELsignia
+Added: platform, including interference or derivation proceedings before the U.S.
+Added: PTO and similar bodies in other jurisdictions.
+Added: Third parties
+Added: may assert infringement claims against us based on existing patents or patents that may be granted in the future.
+Added: we are found to infringe a third party’s intellectual property rights, we could be required to obtain a license from such third
+Added: party to continue developing and marketing our CELsignia platform and CELsignia tests.
+Added: However, we may not be able to obtain any required
+Added: license on commercially reasonable terms or at all.
+Added: Even if we were able to obtain a license, it could be non-exclusive, thereby giving
+Added: our competitors access to the same technologies licensed to us.
+Added: We could be forced, including by court order, to cease commercializing
+Added: the infringing technology or product.
+Added: In addition, we could be found liable for monetary damages, including treble damages and attorneys’
+Added: fees if we are found to have willfully infringed a patent.
+Added: A finding of infringement could prevent us from commercializing our CELsignia
+Added: platform or force us to cease some of our business operations, which could materially harm our business.
+Added: Claims that we have misappropriated
+Added: the confidential information or trade secrets of third parties could have a similar negative impact on our business.
+Added: we are not able to prevent disclosure of our trade secrets and other proprietary information, the value of our CELsignia platform could
+Added: be significantly diminished.
+Added: rely on trade secret protection to protect our interests in proprietary know-how and in processes for which patents are difficult to
+Added: obtain or enforce.
+Added: We may not be able to protect our trade secrets adequately.
+Added: We have a policy of requiring our consultants, advisors
+Added: and strategic partners to enter into confidentiality agreements and our employees to enter into invention, non-disclosure and non-compete
+Added: However, no assurance can be given that we have entered into appropriate agreements with all parties that have had access
+Added: to our trade secrets, know-how or other proprietary information.
+Added: There is also no assurance that such agreements will provide meaningful
+Added: protection of our trade secrets, know-how or other proprietary information in the event of any unauthorized use or disclosure of information.
+Added: Furthermore, we cannot provide assurance that any of our employees, consultants, contract personnel, or strategic partners, either accidentally
+Added: or through willful misconduct, will not cause serious damage to our programs and/or our strategy, for example by disclosing important
+Added: trade secrets, know-how or proprietary information to our competitors.
+Added: It is also possible that our trade secrets, know-how or other
+Added: proprietary information could be obtained by third parties as a result of breaches of our physical or electronic security systems.
+Added: disclosure of confidential data into the public domain or to third parties could allow our competitors to learn our trade secrets and
+Added: use the information in competition against us.
+Added: In addition, others may independently discover our trade secrets and proprietary information.
+Added: Any action to enforce our rights is likely to be time consuming and expensive, and may ultimately be unsuccessful, or may result in a
+Added: remedy that is not commercially valuable.
+Added: These risks are accentuated in foreign countries where laws or law enforcement practices may
+Added: not protect proprietary rights as fully as in the United States.
+Added: Any unauthorized disclosure of our trade secrets or proprietary information
+Added: could harm our competitive position.
+Added: Risks Related to Government Regulation for Our Business
+Added: to comply with the HIPAA security and privacy regulations may increase our operational costs.
+Added: portion of the data that we obtain and handle for or on behalf of our clients is considered protected health information, or PHI, subject
+Added: Under HIPAA and our contractual agreements with our HIPAA-covered entity health plan customers, we are considered a “business
+Added: associate” to those customers, and are required to maintain the privacy and security of PHI in accordance with HIPAA and the terms
+Added: of our business associate agreements with our clients, including by implementing HIPAA-required administrative, technical and physical
+Added: We are also required to maintain similar business associate agreements with our subcontractors that have access to PHI of
+Added: our customers in rendering services to us or on our behalf.
+Added: We will incur significant costs to establish and maintain these safeguards
+Added: and, if additional safeguards are required to comply with HIPAA regulations or our clients’ requirements, our costs could increase
+Added: further, which would negatively affect our operating results.
+Added: Furthermore, we cannot guarantee that such safeguards have been and will
+Added: continue to be adequate under applicable laws.
+Added: If we have failed, or fail in the future, to maintain adequate safeguards, or we or our
+Added: agents or subcontractors use or disclose PHI in a manner prohibited or not permitted by HIPAA, our subcontractor business associate agreements,
+Added: or our business associate agreements with our customers, or if the privacy or security of PHI that we obtain and handle is otherwise
+Added: compromised, we could be subject to significant liabilities and consequences.
+Added: will also need to expend a considerable amount of resources complying with other federal, state and foreign laws and regulations.
+Added: we are unable to comply or have not complied with such laws, we could face substantial penalties or other adverse actions.
+Added: operations are subject, directly or indirectly, to other federal, state and foreign laws and regulations that are complex and their application
+Added: to our specific products, services and relationships may not be clear and may be applied to our business in ways that we do not anticipate.
+Added: Compliance with laws and regulations will require us to expend considerable resources implementing internal policies and procedures for
+Added: compliance and ongoing monitoring and will require significant attention of our management team.
+Added: This will be challenging as an early-stage
+Added: company with limited financial resources and human capital.
+Added: These laws include, for example:
+Added: XI of the Social Security Act, commonly referred to as the federal Anti-Kickback Statute,
+Added: which prohibits the knowing and willful offer, payment, solicitation or receipt of remuneration,
+Added: directly or indirectly, in cash or in kind, in return for or to reward the referral of patients
+Added: or arranging for the referral of patients, or in return for the recommendation, arrangement,
+Added: purchase, lease or order of items or services that are covered, in whole or in part, by a
+Added: federal healthcare program such as Medicare or Medicaid;
+Added: civil False Claims Act, that forbids the knowing submission or “causing the submission”
+Added: of false or fraudulent information or the failure to disclose information in connection with
+Added: the submission and payment of claims for reimbursement to Medicare, Medicaid, federal healthcare
+Added: programs or private health plans;
+Added: federal Physician Self-referral Law, commonly known as the Stark Law, which prohibits physicians
+Added: from referring Medicare or Medicaid patients to providers of “designated health services”
+Added: with whom the physician or a member of the physician’s immediate family has an ownership
+Added: interest or compensation arrangement, unless a statutory or regulatory exception applies,
+Added: and similar state equivalents that may apply regardless of payor;
+Added: Foreign Corrupt Practices Act of 1977, as amended, or FCPA, the U.S.
+Added: domestic bribery
+Added: statute contained in 18 U.S.C.
+Added: § 201, the U.S.
+Added: Travel Act, and the USA PATRIOT Act,
+Added: which among other things, prohibit companies and their employees, agents, third-party intermediaries,
+Added: joint venture partners and collaborators from authorizing, promising, offering, or providing,
+Added: directly or indirectly, improper payments or benefits to recipients in the public or private
+Added: states and foreign governments have adopted similar laws and regulations.
+Added: Violations of law could subject us to civil or criminal penalties,
+Added: monetary fines, disgorgement, individual imprisonment, contractual damages, reputational harm, diminished profits and future earnings
+Added: and curtailment of our operations.
+Added: We could also be required to change or terminate some portions of operations or business or could
+Added: be disqualified from providing services to healthcare providers doing business with government programs.
+Added: Related to Our Reliance on Third Parties
+Added: will rely on third parties to conduct certain aspects of our preclinical studies and clinical trials.
+Added: If these third parties do not successfully
+Added: carry out their contractual duties, meet expected deadlines or comply with regulatory requirements, we may not be able to obtain regulatory
+Added: approval for, or commercialize, any potential product candidates.
+Added: will depend upon third parties to conduct certain aspects of our preclinical studies and depend on third parties, including independent
+Added: investigators, to conduct our clinical trials, under agreements with universities, medical institutions, contract research organizations,
+Added: or CROs, strategic partners and others.
+Added: We expect to negotiate budgets and contracts with such third parties, which may result in delays
+Added: to our development timelines and increased costs.
+Added: continue to build our infrastructure and hire personnel necessary to execute our operational plans.
+Added: We will rely especially heavily on
+Added: third parties over the course of our clinical trials, and, as a result, may have limited control over the clinical investigators and
+Added: limited visibility into their day-to-day activities, including with respect to their compliance with the approved clinical protocol.
+Added: Nevertheless, we are responsible for ensuring that each of our clinical trials is conducted in accordance with the applicable protocol,
+Added: legal and regulatory requirements and scientific standards, and our reliance on third parties does not relieve us of our regulatory responsibilities.
+Added: We and these third parties are required to comply with GCP requirements, which are regulations and guidelines enforced by the FDA and
+Added: comparable foreign regulatory authorities for product candidates in clinical development.
+Added: Regulatory authorities enforce these GCP requirements
+Added: through periodic inspections of clinical trial sponsors, clinical investigators and clinical trial sites.
+Added: If we or any of these third
+Added: parties fail to comply with applicable GCP requirements, the clinical data generated in our clinical trials may be deemed unreliable
+Added: and the FDA or comparable foreign regulatory authorities may require us to suspend or terminate these trials or perform additional preclinical
+Added: studies or clinical trials before approving our marketing applications.
+Added: We cannot be certain that, upon inspection, such regulatory authorities
+Added: will determine that any of our clinical trials comply with GCP requirements.
+Added: In addition, our clinical trials must be conducted with
+Added: product produced under cGMP requirements and may require a large number of patients.
+Added: failure or any failure by these third parties to comply with these regulations may require us to repeat clinical trials, which would
+Added: delay the regulatory approval process.
+Added: Moreover, our business may be adversely affected if any of these third parties violates federal
+Added: or state fraud and abuse or false claims laws and regulations or healthcare privacy and security laws.
+Added: third parties conducting aspects of our preclinical studies or our clinical trials will not be our employees and, except for remedies
+Added: that may be available to us under our agreements with such third parties, we cannot control whether or not they devote sufficient time
+Added: and resources to our preclinical studies and clinical programs.
+Added: These third parties may also have relationships with other commercial
+Added: entities, including our competitors, for whom they may also be conducting clinical trials or other product development activities, which
+Added: could affect their performance on our behalf.
+Added: If these third parties do not successfully carry out their contractual duties or obligations
+Added: or meet expected deadlines, if they need to be replaced or if the quality or accuracy of the preclinical or clinical data they obtain
+Added: is compromised due to the failure to adhere to our protocols or regulatory requirements or for other reasons, our development timelines,
+Added: including clinical development timelines, may be extended, delayed or terminated and we may not be able to complete development of, obtain
+Added: regulatory approval of or successfully commercialize our product candidates.
+Added: As a result, our financial results and the commercial prospects
+Added: for our product candidates would be harmed, our costs could increase and our ability to generate revenue could be delayed or precluded
+Added: pharmaceutical companies that we partner with may not be successful in receiving regulatory approval for drug indications or may not
+Added: commercialize their companion therapies for our expected companion diagnostic programs.
+Added: we intend to provide our pharmaceutical company partners with new patient populations for such partners’ existing or investigational
+Added: targeted therapies, there can be no assurances that such partners will be able to obtain regulatory approval for new indications to treat
+Added: these patient populations or otherwise be successful in commercializing these new therapies.
+Added: The pharmaceutical companies we partner
+Added: not meet clinical trial endpoint targets in evaluating efficacy of a targeted therapy in
+Added: the patient population;
+Added: encounter regulatory or production difficulties that could constrain the supply of the companion
+Added: have difficulties gaining acceptance of the use of the companion therapies in the clinical
+Added: not pursue commercialization of any companion therapies;
+Added: elect not to continue or renew commercialization programs based on changes in their strategic
+Added: focus or available funding, or external factors, such as an acquisition, that divert resources
+Added: or create competing priorities;
+Added: not commit sufficient resources to the marketing and distribution of such companion therapies;
+Added: terminate their relationship with us.
+Added: of these factors could adversely affect our commercialization strategy, business, results of operations and financial condition.
+Added: reliance on third parties to formulate and manufacture our drug product will expose us to a number of risks that may delay the development,
+Added: regulatory approval and commercialization of our drug product or result in higher product costs.
+Added: have no direct experience in drug formulation or manufacturing and do not intend to establish our own manufacturing facilities.
+Added: the resources and expertise to formulate or manufacture our own product candidates.
+Added: Instead, we will contract with one or more manufacturers
+Added: to manufacture, supply, store and distribute drug supplies for our clinical trials.
+Added: If our drug product receives FDA approval, we will
+Added: rely on one or more third-party contractors to manufacture our drugs.
+Added: Our anticipated future reliance on a limited number of third-party
+Added: manufacturers exposes us to risks that, among other things, we may be unable to identify manufacturers on acceptable terms or at all
+Added: because the number of potential manufacturers is limited and the FDA must approve any replacement contractor;
+Added: our third-party manufacturers
+Added: might be unable to formulate and manufacture our drugs in the volume and of the quality required to meet our clinical and/or commercial
+Added: needs, if any;
+Added: our future contract manufacturers may not perform as agreed or may not remain in the contract manufacturing business for
+Added: the time required to supply our clinical trials or to successfully produce, store and distribute our products;
+Added: and our contract manufacturers
+Added: may fail to comply with good manufacturing practice and other government regulations and corresponding foreign standards.
+Added: Each of these
+Added: risks could delay our clinical trials, the approval, if any, of our product candidates by the FDA, or the commercialization of our product
+Added: candidates or result in higher costs or deprive us of potential product revenues.
+Added: reform legislation could increase the uncertainties and costs surrounding the prosecution of our patent applications and the enforcement
+Added: or defense of our issued patents.
+Added: September 16, 2011, the Leahy-Smith America Invents Act, or the Leahy-Smith Act, was signed into law.
+Added: The Leahy-Smith Act includes a
+Added: number of significant changes to U.S.
+Added: These include provisions that affect the way patent applications are prosecuted and
+Added: may also affect patent litigation.
+Added: PTO recently developed new regulations and procedures to govern administration of the Leahy-Smith
+Added: Act, and many of the substantive changes to patent law associated with the Leahy-Smith Act, and in particular, the first to file provisions,
+Added: only became effective on March 16, 2013.
+Added: Accordingly, it is not clear what, if any, impact the Leahy-Smith Act will have on the operation
+Added: of our business.
+Added: However, the Leahy-Smith Act and its implementation could increase the uncertainties and costs surrounding the prosecution
+Added: of our patent applications and the enforcement or defense of our issued patents, all of which could have a material adverse effect on
+Added: our business and financial condition.
+Added: Depending on future actions by the U.S.
+Added: Congress, the federal courts, and the U.S.
+Added: PTO, the laws
+Added: and regulations governing patents could change in unpredictable ways that would weaken our ability to obtain new patents or to enforce
+Added: our existing patents and patents that we might obtain in the future.
+Added: In addition, there may be patent law reforms in foreign jurisdictions
+Added: that could increase the uncertainties and costs surrounding the prosecution of our patent applications and the enforcement or defense
+Added: of our issued patents in those foreign jurisdictions.
+Added: may be subject to claims by third parties asserting that our employees or we have misappropriated their intellectual property, or claiming
+Added: ownership of what we regard as our own intellectual property.
+Added: current and future employees may have been previously employed at universities or other biotechnology, diagnostic technology or pharmaceutical
+Added: companies, including our competitors or potential competitors and strategic partners.
+Added: Although we try to ensure that our employees do
+Added: not use the proprietary information or know-how of others in their work for us, we may be subject to claims that these employees or we
+Added: have used or disclosed intellectual property, including trade secrets or other proprietary information, of any such employee’s
+Added: former employer.
+Added: Litigation may be necessary to defend against these claims.
+Added: addition, while it is our policy to require our employees and contractors who may be involved in the development of intellectual property
+Added: to execute agreements assigning such intellectual property to us, we may be unsuccessful in executing such an agreement with each party
+Added: who in fact develops intellectual property that we regard as our own.
+Added: Our and their assignment agreements may not be self-executing or
+Added: may be breached, and we may be forced to bring claims against third parties, or defend claims they may bring against us, to determine
+Added: the ownership of what we regard as our intellectual property.
+Added: we fail in prosecuting or defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property
+Added: rights or personnel.
+Added: Even if we are successful in prosecuting or defending against such claims, litigation could result in substantial
+Added: costs and be a distraction to management.
+Added: lawsuits relating to infringement of intellectual property rights necessary to defend ourselves or enforce our rights will be costly
+Added: and time consuming and could be unsuccessful.
+Added: competition in our industry is intense, competitors may infringe or otherwise violate our issued patents, patents of our licensors or
+Added: other intellectual property.
+Added: To counter infringement or unauthorized use, we may be required to file infringement claims, which can be
+Added: expensive and time consuming, and could distract our technical and management personnel from their normal responsibilities.
+Added: we assert against perceived infringers could provoke these parties to assert counterclaims against us alleging that we infringe their
+Added: In addition, in a patent infringement proceeding, a court may decide that a patent of ours is invalid or unenforceable, in whole
+Added: or in part, construe the patent’s claims narrowly or refuse to stop the other party from using the technology at issue on the grounds
+Added: that our patents do not cover the technology in question.
+Added: An adverse result in any litigation proceeding could put one or more of our
+Added: patents at risk of being invalidated or interpreted narrowly.
+Added: We may also elect to enter into license agreements in order to settle patent
+Added: infringement claims or to resolve disputes prior to litigation, and any such license agreements may require us to pay royalties and other
+Added: fees that could be significant.
+Added: Furthermore, because of the substantial amount of discovery required in connection with intellectual
+Added: property litigation, there is a risk that some of our confidential information could be compromised by disclosure.
+Added: Relating to Our Common Stock
+Added: in our corporate charter documents and under Delaware law could make an acquisition of our company, which may be beneficial to our stockholders,
+Added: more difficult and may prevent attempts by our stockholders to replace or remove our current management.
+Added: in our certificate of incorporation and our bylaws may discourage, delay or prevent a merger, acquisition or other change in control
+Added: of our company that stockholders may consider favorable, including transactions in which you might otherwise receive a premium for your
+Added: These provisions could also limit the price that investors might be willing to pay in the future for shares of our common stock,
+Added: thereby depressing the market price of our common stock.
+Added: In addition, because our board of directors will be responsible for appointing
+Added: the members of our management team, these provisions may frustrate or prevent any attempts by our stockholders to replace or remove our
+Added: current management by making it more difficult for stockholders to replace members of our board of directors.
+Added: Among other things, these
+Added: the authorized number of our directors to be changed only by resolution of our board of directors;
+Added: the manner in which stockholders can remove directors from our board of directors;
+Added: advance notice requirements for stockholder proposals that can be acted on at stockholder
+Added: meetings and nominations to our board of directors;
+Added: that stockholder actions must be effected at a duly called stockholder meeting and prohibit
+Added: actions by our stockholders by written consent;
+Added: who may call stockholder meetings;
+Added: our board of directors to issue preferred stock without stockholder approval, which could
+Added: be used to institute a “poison pill” that would work to dilute the stock ownership
+Added: of a potential hostile acquirer, effectively preventing acquisitions that have not been approved
+Added: by our board of directors;
+Added: the approval of the holders of at least two-thirds of the votes that all our stockholders
+Added: would be entitled to cast to amend or repeal specified provisions of our certificate of incorporation
+Added: we are governed by the provisions of Section 203 of the Delaware General Corporation Law, which prohibits a person who owns in excess
+Added: of 15% of our outstanding voting stock from merging or combining with us for a period of three years after the date of the transaction
+Added: in which the person acquired in excess of 15% of our outstanding voting stock, unless the merger or combination is approved in a prescribed
+Added: of these provisions of our charter documents or Delaware law could, under certain circumstances, depress the market price of our common
+Added: price of our common stock may be volatile and fluctuate substantially, which could result in substantial losses for purchasers of our
+Added: common stock or could subject us to securities litigation.
+Added: stock price may be extremely volatile.
+Added: The stock market in general and the market for smaller medical technology companies in particular
+Added: have experienced extreme volatility that has often been unrelated to the operating performance of particular companies.
+Added: As a result of
+Added: this volatility, investors may not be able to sell our common stock at or above the price they paid for such stock.
+Added: The market price
+Added: for our common stock may be influenced by many factors, including:
+Added: success of competitive products or technologies;
+Added: of planned clinical trials of our CELsignia HER2 Pathway Activity Test, CELsignia Multi-Pathway
+Added: Activity Test or other CELsignia tests may develop in the future;
+Added: or legal developments in the United States and other countries;
+Added: ● developments
+Added: or disputes concerning patent applications, issued patents or other proprietary rights;
+Added: recruitment or departure of key personnel;
+Added: level of expenses related to any of our CELsignia tests or clinical development programs;
+Added: or anticipated changes in estimates as to financial results, development timelines or recommendations
+Added: by securities analysts;
+Added: results that fail to meet expectations of securities analysts that cover our company;
+Added: in our financial results or those of companies that are perceived to be similar to us;
+Added: in the structure of healthcare payment systems;
+Added: conditions in the pharmaceutical, biotechnology and medical technology sectors;
+Added: of our stock by us, our insiders and our other stockholders;
+Added: economic and market conditions;
+Added: other factors described in this “Risk Factors” section.
+Added: Additionally,
+Added: companies that have experienced volatility in the market price of their stock have been subject to an increased incidence of securities
+Added: class action litigation.
+Added: We may be the target of this type of litigation in the future.
+Added: Securities litigation against us could result
+Added: in substantial costs and divert our management’s attention from other business concerns, which could seriously harm our business.
+Added: securities or industry analysts do not publish research or reports about our business, or publish negative reports about our business,
+Added: our stock price and trading volume could decline.
+Added: trading market for our common stock depends in part on the research and reports that securities or industry analysts publish about us
+Added: or our business.
+Added: We do not have any control over these analysts.
+Added: There can be no assurance that analysts will cover us or provide favorable
+Added: If one or more of the analysts who cover us downgrade our stock or change their opinion of our stock, our stock price would
+Added: likely decline.
+Added: If one or more of these analysts cease coverage of our company or fail to regularly publish reports on us, we could lose
+Added: visibility in the financial markets, which could cause our stock price or trading volume to decline.
+Added: are an “emerging growth company,” and the reduced disclosure requirements applicable to emerging growth companies may make
+Added: our common stock less attractive to investors.
+Added: are an “emerging growth company,” as defined in the JOBS Act, and may remain an emerging growth company for up to five years.
+Added: For so long as we remain an emerging growth company, we are permitted and intend to rely on exemptions from certain disclosure requirements
+Added: that are applicable to other public companies that are not emerging growth companies.
+Added: These exemptions include:
+Added: permitted to provide only two years of audited financial statements, in addition to any required
+Added: unaudited interim financial statements, with correspondingly reduced “Management’s
+Added: Discussion and Analysis of Financial Condition and Results of Operations” disclosure;
+Added: being required to comply with the auditor attestation requirements in the assessment of our
+Added: internal control over financial reporting of Section 404(b) of the Sarbanes-Oxley Act;
+Added: being required to comply with any requirement that may be adopted by the Public Company Accounting
+Added: Oversight Board regarding mandatory audit firm rotation or a supplement to the auditor’s
+Added: report providing additional information about the audit and the financial statements;
+Added: disclosure obligations regarding executive compensation;
+Added: from the requirements of holding a nonbinding advisory vote on executive compensation and
+Added: stockholder approval of any golden parachute payments not previously approved.
+Added: have taken advantage of reduced reporting burdens in this report.
+Added: We cannot predict whether investors will find our common stock less
+Added: attractive if we rely on these exemptions.
+Added: If some investors find our common stock less attractive as a result, there may be a less active
+Added: trading market for our common stock and our stock price may be more volatile.
+Added: incur increased costs as a result of operating as a public company, and our management will be required to devote substantial time to
+Added: new compliance initiatives and corporate governance practices.
+Added: a public company, and particularly after we are no longer an emerging growth company, we will incur significant legal, accounting and
+Added: other expenses that we did not incur as a private company.
+Added: The Sarbanes-Oxley Act, the Dodd-Frank Wall Street Reform and Consumer Protection
+Added: Act, the continued listing requirements of The Nasdaq Stock Market and other applicable securities rules and regulations impose various
+Added: requirements on public companies, including establishment and maintenance of effective disclosure and financial controls and corporate
+Added: governance practices.
+Added: Our management and other personnel will need to devote a substantial amount of time to these compliance initiatives.
+Added: Moreover, these rules and regulations have increased our ongoing legal and financial compliance costs and will make some activities more
+Added: time-consuming and costly.
+Added: to Section 404 of the Sarbanes-Oxley Act, or Section 404, we are required to furnish a report by our management on our internal control
+Added: over financial reporting.
+Added: Depending upon our filer status, if we cease to be an emerging growth company, we could also be required to
+Added: include an attestation report on internal control over financial reporting issued by our independent registered public accounting firm
+Added: as required by Section 404(b).
+Added: While we, as of March 31, 2022, concluded that our internal control over financial reporting was effective,
+Added: we may need to dedicate additional internal resources and engage outside consultants to maintain compliance with Section 404 in the future.
+Added: Any material weaknesses that we may identify in the future could result in an adverse reaction in the financial markets due to a loss
+Added: of confidence in the reliability of our financial statements.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.