Item 1. Business
Item
1. Business
Company
Information
We
were incorporated under the laws of the State of Delaware in February 1994 as Spatializer Audio Laboratories, Inc., which was a shell
company immediately prior to the completion of a “reverse merger” transaction on May 26, 2015, whereby Ameri100 Acquisition,
Inc., a Delaware corporation and newly created, wholly owned subsidiary, was merged with and into Ameri and Partners Inc. (“Ameri
and Partners”), a Delaware corporation (the “2015 Merger”). As a result of the 2015 Merger, Ameri and Partners became
Ameri’s wholly owned subsidiary with Ameri and Partners’ former stockholders acquiring a majority of the outstanding shares
of Ameri common stock. The 2015 Merger was consummated under Delaware law pursuant to an Agreement of Merger and Plan of Reorganization,
dated as of May 26, 2015 (the “2015 Merger Agreement”), and in connection with the 2015 Merger, Ameri changed its name to
AMERI Holdings, Inc. Ameri did business under the brand name “Ameri100”. Ameri, along with its eleven operating subsidiaries,
provided SAP cloud, digital and enterprise services to clients worldwide.
The
Ameri business ceased to be part of the Company on December 30, 2020, pursuant to the Spin-Off. On December 30, 2020, we completed the
Offer and changed our name to “Enveric Biosciences, Inc.” Our principal corporate office is located at Enveric Biosciences,
Inc., 4851 Tamiami Trail N, Suite 200, telephone (239) 302-1707. Our internet address is https://www.enveric.com/, and the information
included in, or linked to our website is not part of this prospectus. We have included our website address in this prospectus solely
as a textual reference.
Business
Overview
We
are an early-development-stage biosciences company with an initial focus on developing innovative, evidence-based prescription
products and combination therapies containing cannabinoids to address unmet needs in cancer care. We seek to improve the lives
of patients suffering from cancer, initially by developing palliative and supportive care products for people suffering from certain
side effects of cancer and cancer treatment such as pain or skin irritation. We currently intend to offer such palliative and
supportive care products in the United States, following approval through established regulatory pathways.
We
are also aiming to advance a pipeline of novel cannabinoid combination therapies for hard-to-treat cancers, including glioblastoma multiforme
(GBM) and several other indications which are currently being researched.
We
intend to bring together leading oncology clinicians, researchers, academic and industry partners so as to develop both external proprietary
products and a robust internal pipeline of product candidates aimed at improving quality of life and outcomes for cancer patients. We
intend to evaluate options to out-license its proprietary technology as it moves along the regulatory pathway and evaluates the building
of a small, targeted selling organization and will potentially utilize a hybrid approach based on the product indication and the market
opportunity.
In
developing our product candidates, we intend to focus on cannabinoids derived from hemp, other botanical sources, and synthetic materials
containing no tetrahydrocannabinol (THC) in order to comply with U.S. federal regulations. Of the potential cannabinoids to be used in
therapeutic formulations, THC, which is responsible for the psychoactive properties of marijuana, can result in undesirable mood effects.
Cannabidiol (CBD) and cannabigerol (CBG), on the other hand, are not psychotropic and are therefore more attractive candidates for translation
into therapeutic practice. In the future, we may utilize cannabinoids that are derived from cannabis plants, which may contain THC; however,
we only intend to do so in jurisdictions where THC is legal. These product candidates will then be studied through a typical Food and
Drug Administration (“FDA”) drug approval process.
Strengths
We
believe that we offer the following key distinguishing characteristics:
●
Unique
Dedication to Prescription Cancer Supportive Care . We believe that we are one of the only companies currently developing evidence-based
prescription-only therapies containing cannabinoids that are exclusively focused on the unique unmet needs of cancer patients. We
intend to develop such therapies by conforming its product candidates to GMP and obtaining FDA approval for such product candidates.
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●
Patient-Centric
Product Development . We are focusing on a patient-centric approach to our product development that will uniquely position us
to meet the needs of oncology patients.
●
First
Mover Advantage . We believe we are among the first companies working towards creating a leading brand utilizing cannabinoids
in oncology supportive care. We seek to build upon our first mover advantage and expertise in cannabinoid research to accelerate
the discovery, development, and commercialization of therapies for persons affected by cancer that are safe, effective, and trusted
by patients and physicians globally.
●
Collaboration
with Global Research Partner . We enjoy an exclusive license with our global cannabinoid research partner, Tikun Olam. We hold
exclusive global rights to Tikun Olam’s proprietary treatment database and cannabinoid derivatives for the development of oncology-focused
pharmaceutical products. We intend to leverage Tikun Olam’s large-scale human datasets and expand upon Tikun Olam’s existing
research by conducting new studies.
●
Sophisticated
Leadership Team and Scientific Advisors . We have a world-class leadership team with extensive regulated pharmaceutical industry
backgrounds and deep expertise in oncology, skin and wound care, and clinical research. In addition, we closely collaborate with
a broad network of leading physicians and scientists at major institutions.
●
Always
Seeking Growth and Enhancement Opportunities . We have identified a pathway to business growth and shareholder value creation
based on our planned development programs and eventually plan to leverage the credibility of that expertise into broader offerings.
We will continue to expand our opportunities to add assets that are complementary or accretive to our plans to serve patients through
acquisition and in-licensing.
Go-to
Market Strategy and Business Approach
We
have a two-step go-to-market strategy:
●
Skincare
Product Candidates : Develop product candidates that target skincare-related ailments common among cancer patients, such as radiodermatitis,
chemotherapy-induced neuropathy, pruritus, rashes, and dry skin.
●
Combination
Therapy : Advance novel cannabinoid combination therapies for persons with cancer, starting with programs in glioblastoma multiforme
(GBM).
We
believe that our existing approach to development, and a future ongoing emphasis on data collection, will differentiate us from our peers
and improve the quality of care we are able to provide.
Product
Candidates
Our
pipeline of product candidates and key ongoing development programs are shown in the tables below:
Product
Candidate
Targeted
Indications
Partner(s)
Status
Expected
Next Steps
Cannabinoid-Infused
Topical Product
Oncology-
related skincare conditions (e.g., radiodermatitis)
U.S.-Based
Center of Excellence
Research
& Development / Discovery
IND
submission; Exploratory Phase 1/2 trial
Cannabinoid
+ Chemotherapy Combination Therapy
Oral
synthetic CBD extract given alone or in combination with clomiphene, concurrently with dose-dense Temolozomide chemotherapy
Glioblastoma
Multiforme
Recurrent
or progressive
Dr.
Tali Siegal,
Rabin
Medical Center, Davidoff Institute of Oncology
Research
& Development / Discovery
Exploratory
Phase 1/2 trial
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Additional
Potential Development Programs
Potential
Target Indications
Cannabinoid
+ Chemotherapy Combination Therapy
Clomiphene
in combination with CBD in patients with selected locally advanced or metastatic breast cancer treated with standard adjuvant chemotherapy
regimens
Breast
Cancer
Market
Opportunity
Prevalence
According
to the U.S. Department of Health and Human Services, based on 2013-2015 data, approximately 38% of men and women will be diagnosed with
cancer at some point during their lifetime. In 2015, there were an estimated 15,112,098 people living with cancer in the U.S. The number
of new cases of cancer was 439 per 100,000 men and women per year.
Despite
widespread demand, the pharmaceutical market lacks products that address the unique supportive care needs of cancer patients. However,
we believe that research suggests that cannabis, as a palliative treatment for cancer patients, appears to be a well-tolerated option
to help patients cope with malignancy-related symptoms. For example, researchers from the Soroka Medical Center in Beersheba, Israel
analyzed data gathered at Tikun Olam’s central clinic from cancer patients to whom medical cannabis was given for palliative-care
purposes between March 2015 and February 2017 (Schleiderab, European Journal of Internal Medicine, 2018). The primary symptoms prior
to treatment reported among the patients to whom medical cannabis was given during the relevant timeframe were sleep problems (78.4%),
pain (77.7%), weakness (72.7%), nausea (64.6%), and lack of appetite (48.9%). Approximately 51% of the applicable patients reported an
8 out of 10 on the pain scale. Of the relevant patient population, 17% were given Tikun Olam’s cannabidiol-dominant strain “Avidekel,”
and after six months, 95.9% of patients reported improvement in their condition. Note, however, that these are anecdotal reports, which
may or may not be indicative of the results that we may see from clinical studies conducted pursuant to an IND.
According
to a separate survey of 237 oncologists, 80% of these oncologists discussed medical cannabinoids with patients where nearly half recommended
them clinically (Braun IM, J Clin Oncol, 2018). The same survey found that 67% of the oncologists viewed cannabinoids as a helpful adjunct
to standard pain management strategies, and 65% viewed cannabinoids as equally or more effective than standard treatments for anorexia
and cachexia.
Patient
Interest
Research
also shows that most cancer patients have a strong interest in learning about cannabinoids during treatment. According to the Washington
State Survey of Cancer Patients, 74% of surveyed patients wanted information from cancer care providers (Pergam SA, Cancer, 2017). The
same survey found that 66% of patients had used cannabis in the past, 24% used in the last year, and 21% used in the last month.
Moreover,
cancer patients tend to be heavy cannabis users. A survey of active cannabis users who have cancer (Pergam SA, Cancer, 2017) found that
74% used cannabis at least once a week, 56% used cannabis at least daily, and 31% used cannabis multiple times a day. Active users consumed
cannabis primarily for physical symptoms such as pain and nausea or for psychological reasons such as coping with stress, depression,
and sleep difficulty.
Lack
of Research
In
a 2017 report, the National Academy of Sciences noted that, although cannabis has both therapeutic value and public health risks, there
is a systemic lack of research aimed at properly evaluating cannabis-based therapies. The National Academy of Sciences offered recommendations
that included developing standards and benchmarks to guide cannabis research, addressing research gaps to evaluate the short- and long-term
health effects of cannabis use, improving surveillance capacity to ensure that sufficient data is available, and addressing regulatory
barriers to cannabis research and proposing strategies for supporting a comprehensive cannabis research agenda.
Critically,
only 30% of oncologists felt sufficiently informed to make recommendations regarding medical cannabis, suggesting a large unmet opportunity
to educate oncologists and provide research that supports the safety and efficacy of Enveric product candidates. Among the oncologists
who discussed medical cannabis with patients, 78% said that patients were the ones to express interest on most occasions.
Potential
for Premium Pricing
We
plan to conduct extensive clinical research in an effort to establish the safety of its prospective product candidates in cancer patients,
and, eventually, help to identify and/or develop cannabinoid medicines intended to reduce various unwanted side effects that commonly
affect cancer patients, target specific patient sequelae ( e.g. , cancer pain, anxiety, or nausea), and target specific side effects
to the skin as a result of radiation and chemotherapy treatments.
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We
believe that prescription only medicines containing cannabinoids (including product with hemp-based ingredients) will carry a price premium.
Upon obtaining FDA approval for our product candidates, we are striving to distinguish ourselves from a rising tide of cannabis industry
participants by:
●
Creating
product candidates specific to the side effects of cancer and cancer treatment, with a novel focus on skincare.
●
Employing
evidence-based best practices specific to cancer patients.
●
Generating
clinical research to support the safety and effectiveness of its product candidates in cancer patients.
●
Leveraging
FDA approval, as most over-the-counter (“OTC”) products sold are not FDA approved.
We
believe these will be an important differentiator for people with cancer and oncologists who are faced with high patient demand and in
still relatively novel, unproven field of medical cannabis. Accordingly, we anticipate eventually being able to charge a premium for
those of our prospective product candidates that are successfully commercialized. Further, more than one-third of cancer patients who
used medical cannabis were new users (K. Martell, Curr Oncol, 2018), suggesting the potential to establish strong brand loyalty from
cancer patients and oncologists.
Conditions
Currently Targeted by Enveric
Radiodermatitis
and Other Skin Conditions
Radiation
therapy is considered an essential component of cancer treatment, with nearly 50% of cancer patients undergoing radiation therapy at
some point during the course of their treatments. Radiodermatitis, or radiation-induced skin injury, is one of the most common adverse
effects of radiation therapy. Of those receiving radiation therapy, approximately 90% experience some form of radiodermatitis.
Dry
skin is another common adverse side effect of certain cancer therapies. For example, a recent study of patients being treated with chemotherapy
for breast cancer found that 57.9% of the patients reported dry skin. Rashes are the most common side effect from targeted cancer therapies
with some treatments. The incidence of rash varies based on the type of cancer and drug used. For instance, skin rash occurs in up to
90% of patients treated with Erbitux, while other drugs may only affect half of patients. Pruritus (itchy skin) is a common adverse side
effect of cancer therapies; a recent survey of 379 cancer survivors reported that 36% experienced pruritus during treatment.
To
address the unique skincare needs of persons with cancer, we are seeking to formulate a cannabinoid-based ointment or other topical drug
product for skincare conditions, such as radiodermatitis (among other conditions, as applicable).
Current
Standard of Care
The
current standard of care for radiodermatitis consists of a combination of preventative routines and symptomatic management based on dermatitis
grade. Preventative skin care routines generally involve keeping the area clean and dry while avoiding skin irritants and unnecessary
friction or skin stress (Salvo, Curr Onvol, 2010; Wong, Supp Care Canc, 2013). Applying lanolin-free moisturizer 2-3 times a day throughout
the duration of treatment is also recommended, with some evidence suggesting that topical corticosteroids used after radiotherapy sessions
may provide some benefit as well (Salvo, Curr Onvol, 2010; Wong, Supp Care Canc, 2013).
Despite
the use of these interventions, up to 85% of individuals will experience a moderate to severe skin reaction during their disease course
(Salvo, Curr Oncol, 2010). This highlights the need for better preventative strategies to reduce the incidence and severity of skin toxicity.
The incomplete success of therapies to date likely relates to the multiple toxic mechanisms of radiation, including direct DNA toxicity,
oxidative stress, and both acute and chronic inflammatory reactions. Therapies that can address multiple aspects of radiation toxicity
on the cellular level are likely to have the most success as prophylaxis and treatment for these patients.
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Our
Current Development Plans
We
intend to develop products that address unmet medical needs in palliative and supportive care for cancer patients. The first product
will address radiodermatitis and will enter into clinical trials after an IND submission has been filed. We then intend to seek FDA approval
via the new-drug-application (NDA 505(b)(1)) pathway.
Glioblastoma
Multiforme (GBM)
Glioblastoma
multiforme (GBM) is a highly aggressive and almost universally fatal disease. Even with the most extensive surgical resections and the
most aggressive radiation and chemotherapy regimens, median overall survival is as low as 15- to 19-months (Stupp, NEJM, 2005). This
is likely due, in part, to an intrinsic propensity for treatment resistance and, as a result, the essentially unavoidable event of tumor
recurrence. The current prognosis for most patients necessitates significant advances in the standard of care to improve both overall
survival and patient quality of life.
We
believe that CBD has the potential to influence many of the key pathways involved in GBM pathogenesis, from tumor stemness and proliferation
to angiogenesis and local invasion. GBM tumors express CB2 receptors, through which CBD and other cannabinoids are thought to exert their
anti-cancer efforts (Ellert-Miklaszewska, Adv Exp Med Biol, 2013). The prospect of CBD used in combination with other pharmacologic interventions
holds promise for the treatment of GBM. The development of clinical trials to evaluate the efficacy of CBD combination therapies may
represent an important step towards improving the clinical outcomes in a population of patients with few other effective therapeutic
options.
According
to a study by Kenyon in 2018, seven out of seven patients with GBM experienced a positive clinical response, although four ultimately
succumbed to the disease. CBD was hypothesized to be able to reduce the growth and survival of GBM cell lines by disrupting the normal
function of the cell, or cell cycle arrest, and the induction of programmed cell death, or apoptosis (Marcu, Mol Cancer Ther, 2010).
Cannabinoids have been shown to promote cancer cell death through the overproduction of a lipid subset, called ceramides, as accumulation
of ceramides in GBM cells may prevent the cell from functioning normally. Additionally, the generation of unstable oxygen molecules,
or reactive oxygen species, can damage nearby molecules and trigger cell death (Dumitru, Front Mol Neurosci, 2018).
Enveric’s
Prospective Product Candidates
We
plan to evaluate a novel combination of CBD and an existing chemotherapeutic agent for treating GBM. We intend to use, as part of the
study, a patent pending formulation developed by a partnership of three Israeli universities led by the Weizmann Institute, and now owned
by Enveric.
Our
proposed clinical cancer study plan consists of a Phase 1/2 study in Israel of oral synthetic CBD extract, given alone or in combination
with clomiphene concurrently with dose-dense temolozomide chemotherapy for patients with recurrent or progressive GBM, designed as an
open label, two-arm, randomized prospective study. An initial dose limiting toxicity (DLT) cohort will be investigated in a phase 1 study
in order to rule out any toxicity related to the combination. If successful, recruitment would continue, and then 40 patients would be
randomized into two arms, with 20 patients in each arm: (i) synthetic CBD extract plus clomiphene and temolozomide, and (ii) synthetic
CBD extract plus temolozomide. The primary endpoints would be progression free survival. The progression of the disease would be determined
from a Response Assessment in Neuro-Oncology (RANO) and a tumor assessment based on MRI scans. Safety parameters would include serious
adverse events and other adverse events as reported by the patients and caregivers.
As
of the date of annual report, all pre-clinical studies, and the draft clinical study protocol related to our clinical cancer program,
have been completed. Dr. Tali Siegal has been selected as the primary investigator, and the protocol is currently under review by the
hospital’s internal review board (IRB). The Israeli Ministry of Health, Center for Cannabis (Yakar) has given preliminary approval,
and Enveric is currently awaiting its primary approval.
Neuropathy
We
intend to conduct a clinical study to validate the efficacy of topical cream or oral medication infused with high-potency CBD and/or
CBG to help prevent and treat the painful discomfort of chemotherapy-induced neuropathy.
Additional
Potential Development Projects
Supportive
Care Product Candidates
In
the future, we may also develop additional prescription medicines that are derived from natural sources that are targeted to major cancer
treatment side effects, including other skin conditions, cancer-related distress, chemotherapy-induced nausea and vomiting (CINV), lack
of appetite, pain, and insomnia.
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For
many patients, the concept of palliative care often carries a negative connotation, conjuring ideas and fears of the end of life. However,
the purpose of palliative care is to improve the patient experience and reduce suffering in all areas of life, including physical, emotional,
psychological, and spiritual well-being. In fact, incorporating palliative care into cancer management has the potential to not only
improve quality of life, but may also prolong survival (Temei, NEJM, 2010; Ferrell, J Clin Oncol, 2017). We avoid the negative connotations
of palliative care by using the term “supportive care”.
The
physical ailments experienced by cancer patients vary widely based on the individual, the type and stage of cancer, and the choice of
therapy. Three of the most common and perhaps most debilitating complaints addressed by palliative care are chronic pain, chemotherapy-induced
nausea and vomiting, and severe body wasting (Reeve, JNCI, 2014). Although efforts have been made to ameliorate these symptoms, many
patients do not achieve adequate relief. The need for new therapeutics to improve these debilitating symptoms has gained increasing attention
in recent years.
Combination
Therapies
We
seek to advance novel treatment for cancer based on a combination of cannabidiol (CBD) and chemotherapeutic agents, including clomiphene,
an anti-estrogen binding site (AEBS) inhibitor, which can regulate cell growth, with a potential for activity in multiple cancer cell
lines, including breast cancer, pancreatic cancer, and acute myeloid leukemia.
Preclinical
data suggests that combination therapies may improve the activity of certain chemotherapies or dendritic cell-based cancer immunotherapies,
potentially enabling more potent or longer-lasting therapeutic effects. In multiple in vitro and in vivo models of solid
tumors and blood cancers, CBD has been shown to reduce tumor size, potential for invasion and metastasis, and development of new tumor-associated
blood vessels. In combination with CBD, clomiphene has been shown to reduce cell viability and increase rates of programmed cell death
in certain cancer cell lines, while also inhibiting tumor growth in vivo .
Because
cancer cells contain largely the same proteins and other targets as the healthy cells in the body, there are few cancer-specific druggable
targets; chemotherapies often simply target all rapidly proliferating cells in the body. While chemotherapy can be successful in suppressing
tumors, there are many side effects associated with use; side effects may increase with higher doses. The ability to provide the same
or greater therapeutic effect with a smaller overall dose of the chemotherapeutic agent may minimize the risk and severity of side effects
in subjects and allow for the treatment of certain patients with weakened immune systems.
Cannabinoid
Combination with AEBS Inhibitors
The
use of cannabis in cancer management has traditionally been relegated to symptomatic management, including as an analgesic, anti-emetic,
and appetite stimulant. However, more recently, mounting evidence has suggested a therapeutic, anti-tumor effect of certain naturally
occurring cannabinoids. Specifically, CBD has been shown to reduce tumor size, the potential for invasion and metastasis, and development
of new tumor-associated blood vessels in multiple in vitro and in vivo models of solid tumors and blood cancers (Ladin, Front Pharmacol,
2016; Massi, Br J Pharmacol, 2013).
There
is also evidence to suggest that CBD used in combination with traditional chemotherapies and a certain class of compounds, the cholesterol
epoxide hydrolase (ChEH) / antiestrogen binding site (AEBS) inhibitors, may be more efficacious than CBD alone (Scott, Int J Oncol, 2017).
AEBS regulates cholesterol metabolism and, consequently, cell growth (Payre, Mol Cancer Ther, 2008).
Two
AEBS inhibitors that we believe may be especially promising are clomiphene citrate and DPPE. Clomiphene is an estrogen modulator typically
used to treat infertility. However, in combination with CBD, clomiphene was recently shown to synergistically reduce cell viability and
increase rates of programmed cell death in certain cancer cell lines, while also inhibiting tumor growth in vivo (WO2017072773A1).
DPPE, on the other hand, is a tamoxifen derivative that is thought to sensitize cancer cells to the activities of chemotherapies. As
a tumor grows and mutates, cancer cells can become resistant to therapies in several ways – tumors can overexpress efflux pumps
that remove certain agents from the cell or can upregulate enzymes that metabolize and inactivate chemotherapies. DPPE was shown to potentiate
the toxicity of multiple chemotherapeutic drugs by both mechanisms (Georges, Biochemical Pharm, 2014; Brandes, Cancer Chemother Pharmacol,
2000).
Cannabinoid
Combination with Immunotherapies
Dendritic
cells (DCs) process antigen material and present it on the cell surface to the T-cells of the immune system. A range of cancer immunotherapies
involving DCs have been used to generate tumor-specific immune responses that have had variable success in clinical trials.
CBD
may cause DCs to increase their production of IL-12 p70, an interleukin-12 (IL-12) family cytokine that may heighten the immune system’s
response against certain cancers. IL-12 is closely linked to the activity of the immune system and is produced by DCs. IL-12 can bring
T-cells and natural killer cells out of dormancy so that a heightened immune response against tumors is possible. By aiding in the generation
of CD4+ (T helper cells), IL-12 also can also elicit a longer lasting and amplified anti-tumor response.
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Injected
IL-12 has presented challenges in terms of its toxicity and dosage control and there is a need for generating heightened levels of IL-12,
particularly in immunocompromised patients. Preclinical research suggests that CBD may induce DCs to increase their production of IL-12
p70.
Intellectual
Property
We
are a party to certain license agreements as described below, and going forward it intends to both develop intellectual property and
license intellectual property from pharmaceutical and biotechnology companies and research institutions which would cover research stage
and clinical stage assets to build a pipeline of product candidates.
Tikun
Olam In-License
We
hold limited rights to several plant patent applications as an in-licensee of Tikun Olam.
Tikun
Olam employs evidence-based medicine and other best practices, and its products have been studied in numerous medical trials. Tikun Olam’s
patient databases include 12,000+ persons treated across a variety of conditions, with a primary focus on cancer care.
We
hold limited rights to use the data included in the Tikun Olam patient database.
Diverse
Biotech, Inc. In-License
We
hold limited rights to patent applications owned by Diverse Biotech, Inc. for the use of cannabinoids with five existing, standard-of-care
drugs via Diverse Biotech’s patent pending conjugate drug delivery platform. Our rights extend to all fields of use. We plan to
engage in targeted research and development to apply such conjugates to alleviate the side effects that cancer patients experience, with
the goal of achieving novel therapeutic outcomes for patients.
The
Diverse Biotech, Inc. patent application portfolio includes two patent applications licensed to us. Those two patent applications disclose
conjugate chemistry that combines cannabinoids with existing drugs in conjugate form that we believe will provide differentiation in
use and efficacy from combination therapy of drugs and cannabinoids.
Our
Patents and Patent Applications
We
own full rights to several families of patent applications covering the use of CBD in combination with current cancer treatments, both
broadly, as well as for specific cancer types, including the following:
●
Combination
Therapy (WO2017072773 and national phase filings in the U.S. and other countries/regions) : Combinations of compositions comprising
CBD and a therapeutic pharmaceutical cancer agents (ChEH/AEBS inhibitors, naphthoquinone or derivatives) for the treatment of cancer.
●
Combination
Therapy (EP 18165731.3 and WO2019/193112 and national patent filings in the U.S. and other countries/regions): Relates to regimes
of drug administration and drug combinations that include a cannabinoid for use in the treatment of breast cancer, including triple-negative
breast cancer.
●
Cannabinoids
in Combination with Chemotherapy (WO2021/028646): Relates to regimes of drug administration and cannabinoid administration for
treatment of bladder, brain and spinal cord, colorectal, head and neck, lung, lymphoma, neuroendocrine, oesophageal, ovarian, pancreatic
and prostate cancer.
Exclusive
Supply Agreement
On
February 22, 2021, we entered into an exclusive supply agreement (the “Development and Clinical Supply Agreement”)
with PureForm Global, Inc. (“PureForm”), a biotechnology company focused on the research, development and commercialization
of synthesized CBD and other cannabinoids not derived from hemp or cannabis, for use in development and commercialization of products
for cancer supportive/palliative care associated with radiodermatitis, chemotherapy induced peripheral neuropathy, and glioblastoma.
Pursuant to the Development and Clinical Supply Agreement, PureForm will be the exclusive provider of synthetic cannabidiol (“API”)
for Enveric’s development plans for cancer treatment and supportive care. Under the terms of the Development and Clinical
Supply Agreement, PureForm has granted Enveric the exclusive right to purchase API and related products for cancer treatment
and supporting care.
Research
& Development
In
view of the urgent need for new and more effective oncology drugs, we intend to combine innovative science and accelerated clinical development
to create and develop novel therapies using cannabinoid-based medications and similar compounds. Our past research and development efforts
were limited to investigative work surrounding cannabinoids, including creating and developing novel formulations, and evaluating potential
opportunities to license technologies from pharmaceutical companies and leading research institutions. Our principal research efforts
to date have been with Soroka Medical Center, MSKCC, Tikun Olam and St. George’s University of London.
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Clinical
Studies
We
are currently assembling a team of principal investigators with of clinical experience across multiple cancer types to be responsible
for the management, monitoring, and integrity of the clinical research. The following studies are being evaluated for potential advancement:
●
Radiodermatitis:
A Phase 1/2 evaluating a CBD-infused formulation for skin.
●
Recurrent
or Progressive Glioblastoma Multiforme: A Phase 1/2 study of oral CBD extract in combination with Clomiphene or oral CBD extract
alone given concurrently with dose-dense Temolozomide to patients with recurrent or progressive glioblastoma.
We
plan to submit INDs and, eventually, NDAs to seek FDA approval in connection with the Radiodermatitis and Recurrent or Progressive Glioblastoma
Multiforme product candidates. The selection, timing, duration, and design of any prospective studies are subject to approval and finalization.
Scientific
Advisory Board
We
have established a scientific advisory board and regularly seeks advice and input from these experienced clinical leaders on matters
related to its research and development programs. The members of our scientific advisory board consist of experts across a range of key
disciplines relevant to its programs. We intend to continue to leverage the broad expertise of its advisors by seeking their counsel
on important topics relating to its product development and clinical development programs.
Our
scientific advisors are not our employees and have commitments to, or consulting or advisory contracts with, other entities that may
limit their availability to us. In addition, its scientific advisors may have arrangements with other companies to assist those companies
in developing products or technologies that may compete with us. All of our scientific advisors are affiliated with other entities and
devote a limited portion of their time to us.
Enveric’s
current scientific advisors are set forth in the table below:
Name
Title
Specialization
Michael
J. Zelefsky, M.D. (Chair)
Vice
Chair, Department of Radiation Oncology, Chief, Brachytherapy Service, Memorial Sloan Kettering Cancer Center
Clinical
Research
Angus
Dagleish, M.D.
Professor,
St. George’s University of London
Oncology
Research
James
Perry, M.D.
Neuro-Oncologist,
Sunnybrook Research Institute; Professor, University of Toronto
Clinical
Research
Zvi
Vogel, Ph.D.
Professor,
Neurobiology, Weizmann Institute
Oncology
Research, Patent Contributor
Michael
J. Zelefsky, M.D. has served as a Scientific Advisor of Enveric since April 2019. Dr. Zelefsky, is a board-certified radiation
oncologist and co-leader of Memorial Sloan Kettering’s Genitourinary Disease Management Team, a multidisciplinary group
of physicians who work together to treat patients with urologic malignancies. Dr. Zelefsky is Chief of Memorial Sloan Kettering’s
Brachytherapy Service. The prostate brachytherapy program at Memorial Sloan Kettering, which Dr. Zelefsky helped develop and enhance
since joining the staff in 1990, is known for its depth of experience and cutting-edge approach in treating men with prostate
cancer. Dr. Zelefsky was instrumental in pioneering the use of IMRT (intensity-modulated radiation therapy, which is computer-guided
delivery of high doses of radiation directly to the tumor) and IGRT (image-guided radiotherapy, radiation beams targeted precisely
to the tumor) for treating men with prostate cancer. Dr. Zelefsky is Editor-in-Chief of Brachytherapy, a medical journal that
addresses all aspects of this sub-specialty, and Chairman of the National Patterns of Care Study for Genitourinary Cancers. He
is also a past president of the American Brachytherapy Society. For his work in this field, Dr. Zelefsky has been honored to receive
several awards including the Boyer Award for Excellence in Clinical research, the Outstanding Teaching Award in the Department
of Radiation Oncology at Memorial Sloan Kettering, the 2009 Henschke Medal (the highest award of the American Brachytherapy Society
for achievements in Brachytherapy), and the 2009 Emanuel Van Descheuren Award for Excellence in Translational Research.
Angus
Dalgleish, M.D. has served as a Scientific Advisor of Enveric since January 2019. Dr. Dalgleish, is an oncologist practicing
in the United Kingdom at St. George’s University of London. Dr. Dalgleish divides his time between clinical practice and
research, and also serves as an advisor to several biopharmaceutical companies. Dr. Dalgleish has been a Professor of Medical
Oncology at St. George’s University of London and Consultant Physician at St. George’s Hospital since 1991. He has
served as the President of the Clinical Immunology and Allergy Section of the Royal Society of Medicine and is a Fellow of The
Royal College of Physicians. Dr. Dalgleish studied Medicine at University College London, where he obtained an MBBS and a BSc
in Anatomy.
James
Perry, M.D. has served as a Scientific Advisor of Enveric since April 2019. Dr. James Perry is a neuro-oncologist at Sunnybrook’s
Odette Cancer Centre and Hurvitz Brain Sciences Program. Dr. Perry is also a Professor of medicine at the University of Toronto
and the central nervous system cancers lead at Cancer Care Ontario. Dr. Perry is a clinician-investigator interested in the design,
conduct and analysis of clinical trials testing innovative therapies for primary brain tumours. His research unit is focused on
outcomes research. He is the chair of the Canadian Brain Tumour Consortium (CBTC), a national not-for-profit investigator network.
Zvi
Vogel, Ph.D. has served as a Scientific Advisor of Enveric since February 2018. Professor Vogel is currently a Professor Emeritus
at the Weizmann Institute of science serving as the Head of the Adelson Center for the Biology of Addictive Diseases at Tel-Aviv
University. Professor Vogel previously served as the Chairman of the Department of Neurobiology at the Weizmann Institute. He
has published more than 170 scientific manuscripts. Professor Vogel earned a M.Sc in Biochemistry and a Ph.D. from the Weizmann
Institute of Science. He performed his post-doctorate studies at the National Institutes of Health (Bethesda, MD) in the Laboratory
of Marshall Nirenberg, a Nobel Prize winner.
Academic
and Industry Partners
We
have also established relationships with certain academic and industry partners, whom we believe have the potential to accelerate product
development, market entry, data collection, analysis and advancement of clinical trials.
Our
current academic and industry partners are set forth in the table below:
Name
Description
Tikun
Olam Ltd.
Tikun
Olam Ltd. brings proprietary products and data, clinical research experience, and access to resources in Israel.
St.
George’s University of London
St.
George’s University of London brings research capabilities and relevant domain expertise in cancer and cannabinoids.
The
Soroka Medical Cancer Center
The
Soroka Medical Cancer Center brings clinical research capabilities and extensive patient access.
13
Competition
The
biotechnology and pharmaceutical industries are characterized by rapidly advancing technologies, intense competition, and a strong
emphasis on proprietary products. While we believe that our scientific knowledge and technology and development experience
provide us with competitive advantages, we face potential competition from many different sources, including major pharmaceutical,
specialty pharmaceutical and biotechnology companies, academic institutions, governmental agencies, and public and private research
institutions. Any product candidates that we successfully develop and commercialize will compete with existing therapies and
new therapies that may become available in the future.
In
GBM, we believe that only one drug product (Epidiolex, developed by GW Pharmaceuticals) is a potential late-stage competitor.
Other than Epidiolex, we are aware of exploratory research into the effects of cannabinoid drug formulations. We are also aware
of discovery research within the pharmaceutical industry into synthetic agonists and antagonists of CB1 and CB2 receptors, as
well as companies that supply synthetic cannabinoids and cannabis extracts to researchers for pre-clinical and clinical investigation,
and various companies that cultivate cannabis plants with a view to supplying herbal cannabis or nonpharmaceutical cannabis-based
formulations to patients. These therapies have not been approved by the FDA. In addition, Lutris Pharma has a topical B-Raf
Inhibitor in Phase ½ studies that is intended to treat radiation dermatitis, which is also a potential competitor.
Patients
suffering from GBM in the U.S. are treated with a variety of FDA-approved products, including, but not limited to, Bevacizumab, Carmustine
Implant, Lomustine, and Temozolomide. Our potential competitors regarding the GBM product candidate include pharmaceutical and biopharmaceutical
companies such as Pfizer, Genentech, Arbor Pharmaceuticals, Next Source Pharmaceuticals, and Merck, among others, depending on when the
candidate is approved for commercialization, if ever (and what, if any, new therapies are approved in the interim). Such competitors
may have significantly greater financial resources and expertise in research and development, manufacturing, preclinical testing, conducting
clinical trials, obtaining regulatory approvals, and marketing approved medicines than we do. These competitors also compete with us
in recruiting and retaining qualified scientific and management personnel and establishing clinical trial sites and patient registration
for clinical trials, as well as in acquiring technologies complementary to, or necessary for, our programs.
With
respect to CBD, a number of nonapproved and non-standardized CBD preparations derived from crude herbal cannabis have been made
available in limited quantities by producers of “medical marijuana” in the U.S. We do not believe prescription cannabinoids
are the same as distributing or legalizing crude herbal cannabis, or preparations derived from crude herbal cannabis, and therefore
we do not believe they are competitive with, crude herbal cannabis. We believe that only a cannabinoid medication, one that is
standardized in composition, formulation and dose, administered by means of an appropriate delivery system, and tested in properly
controlled pre-clinical and clinical studies, can meet the standards of regulatory authorities around the world, including those
of the FDA. We also believe that these regulatory processes provide important protections for patients, and that any cannabinoid
medication must be subjected to, and satisfy, such rigorous scrutiny.
Our
commercial opportunities could be reduced or eliminated if its competitors develop and commercialize medicines that are safer, more effective,
have fewer or less severe side effects, are more convenient or are less expensive than any product candidates that we may develop. Our
competitors also may obtain approval from the FDA or other regulatory agencies for their medicines more rapidly than us, which could
result in our competitors establishing a strong market position before we are able to enter the market.
Government
Regulation and Product Approvals
Pharmaceutical
companies are subject to extensive regulation by the federal government, principally by the FDA under the Federal Food, Drug and Cosmetic
Act, or the FDCA, and, to a lesser extent, by state and local governments. Before our prescription products may be marketed in the U.S.,
they must be approved by the FDA for commercial distribution. Certain OTC products must comply with applicable FDA regulations, known
as OTC Monographs, in order to be marketed, but do not have the benefit of FDA review and approval before marketing. We are also subject
to regulation under federal, state and local laws, including requirements regarding occupational safety, laboratory practices, environmental
protection and hazardous substance control, and may be subject to other present and future local, state, federal and foreign regulations.
We cannot predict the extent to which we may be affected by legislative and other regulatory developments concerning our products and
the healthcare industry in general.
The
FDCA and other federal and state statutes and regulations govern the testing, manufacture, quality control, export and import, labeling,
storage, record keeping, approval, pricing, advertising, promotion, sale and distribution of pharmaceutical products. Noncompliance with
applicable requirements both before and after approval, can subject us, our third party manufacturers and other collaborative partners
to administrative and judicial sanctions, such as, among other things, warning letters, fines and other monetary payments, recall or
seizure of products, criminal proceedings, suspension or withdrawal of regulatory approvals, interruption or cessation of clinical trials,
total or partial suspension of production or distribution, injunctions, limitations on or the limitation of claims we can make for our
products, and refusal of the government to enter into supply contracts for distribution directly by governmental agencies, or delay in
approving or refusal to approve new drug applications. The FDA also has the authority to revoke or withhold approvals of new drug applications.
14
FDA
approval is required before any “new drug,” can be marketed. Our products are new drugs and require prior FDA approval. Such
approval must be based on extensive information and data submitted in a NDA, including, but not limited to, adequate and well controlled
laboratory and clinical investigations to demonstrate the safety and effectiveness of the drug product for its intended use(s) as well
as the manufacturing suitability of the product. In addition to providing required safety and effectiveness data for FDA approval, a
drug manufacturer’s practices and procedures must comply with current Good Manufacturing Practices (“cGMPs”), which
apply to manufacturing, receiving, holding and shipping, and include, among other things, demonstration of product purity, consistent
manufacturing and quality and at least six months of data supporting product expiration dating based on clinical registration batches.
Accordingly, manufacturers must continue to expend time, money and effort in all applicable areas relating to quality assurance and regulatory
compliance, including production and quality control to comply with cGMPs. Failure to so comply risks delays in approval of drug products
and possible FDA enforcement actions, such as an injunction against shipment of products, the seizure of non-complying products, criminal
prosecution and/or any of the other possible consequences described above. We are subject to periodic inspection by the FDA and the Drug
Enforcement Administration (“DEA”), which inspections may or may not be announced in advance.
FDA
New Drug Approval Process
In
the U.S., pharmaceutical products are subject to extensive regulation by the FDA. The Federal Food, Drug, and Cosmetic Act, or the FDCA,
and other federal and state statutes and regulations, govern, among other things, the research, development, testing, manufacture, storage,
recordkeeping, approval, labeling, promotion and marketing, distribution, post-approval monitoring and reporting, sampling, and import
and export of pharmaceutical products. Failure to comply with applicable U.S. requirements may subject a company to a variety of administrative
or judicial sanctions, such as imposition of clinical holds, FDA refusal to approve pending new drug applications (“NDA”),
warning letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions, fines, refusals
of government contracts, restitution, disgorgement, civil penalties and criminal prosecution.
Pharmaceutical
product development in the U.S. typically involves pre-clinical laboratory and animal tests and the submission to the FDA of an Investigational
New Drug applications (“IND”), which must become effective before clinical testing may commence. For commercial approval,
the sponsor must submit adequate tests by all methods reasonably applicable to show that the drug is safe for use under the conditions
prescribed, recommended or suggested in the proposed labeling. The sponsor must also submit substantial evidence, generally consisting
of adequate, well-controlled clinical trials to establish that the drug will have the effect it purports or is represented to have under
the conditions of use prescribed, recommended or suggested in the proposed labeling. In certain cases, the FDA may determine that a drug
is effective based on one clinical study plus confirmatory evidence. Satisfaction of FDA pre-market approval requirements typically takes
many years and the actual time required may vary substantially based upon the type, complexity and novelty of the product or disease.
Pre-clinical
tests include laboratory evaluation of product chemistry, formulation and toxicity, as well as animal trials to assess the characteristics
and potential safety and efficacy of the product. The conduct of the pre-clinical tests must comply with federal regulations and requirements,
including the FDA’s good laboratory practices regulations and the U.S. Department of Agriculture’s (USDA’s) regulations
implementing the Animal Welfare Act. The results of pre-clinical testing are submitted to the FDA as part of an IND along with other
information, including information about product chemistry, manufacturing and controls, and a proposed clinical trial protocol. Long-term
pre-clinical tests, such as animal tests of reproductive toxicity and carcinogenicity, may continue after the IND is submitted.
A
30-day waiting period after the submission of each IND is required prior to the commencement of clinical testing in humans. If the FDA
has not imposed a clinical hold on the IND or otherwise commented or questioned the IND within this 30-day period, the clinical trial
proposed in the IND may begin.
Clinical
trials involve the administration of the investigational new drug to healthy volunteers or patients under the supervision of a qualified
investigator. Clinical trials must be conducted: (i) in compliance with federal regulations, (ii) in compliance with GCP, an international
standard meant to protect the rights and health of patients and to define the roles of clinical trial sponsors, administrators and monitors,
and (iii) under protocols detailing the objectives of the trial, the parameters to be used in monitoring safety and the effectiveness
criteria to be evaluated. Each protocol involving testing on U.S. patients and subsequent protocol amendments must be submitted to the
FDA as part of the IND.
The
FDA may order the temporary, or permanent, discontinuation of a clinical trial at any time or impose other sanctions if it believes that
the clinical trial either is not being conducted in accordance with FDA requirements or presents an unacceptable risk to the clinical
trial patients. The trial protocol and informed consent information for patients in clinical trials must also be submitted to an institutional
review board, or IRB, for approval. An IRB may also require the clinical trial at the site to be halted, either temporarily or permanently,
for failure to comply with the IRB’s requirements or may impose other conditions.
15
Clinical
trials to support NDAs for marketing approval are typically conducted in three sequential phases, but the phases may overlap. In general,
in Phase 1, the initial introduction of the drug into healthy human subjects or patients, the drug is tested to assess metabolism, pharmacokinetics,
pharmacological actions, side effects associated with increasing doses and, if possible, early evidence on effectiveness. Phase 2 usually
involves trials in a limited patient population to determine the effectiveness of the drug for a particular indication, dosage tolerance
and optimum dosage, and to identify common adverse effects and safety risks. If a compound demonstrates evidence of effectiveness and
an acceptable safety profile in Phase 2 evaluations, Phase 3 trials are undertaken to obtain the additional information about clinical
efficacy and safety in a larger number of patients, typically at geographically dispersed clinical trial sites, to permit the FDA to
evaluate the overall benefit-risk relationship of the drug and to provide adequate information for the labeling of the drug. In most
cases, the FDA requires two adequate and well-controlled Phase 3 clinical trials to demonstrate the efficacy of the drug. The FDA may,
however, determine that a drug is effective based on one clinical study plus confirmatory evidence. Only a small percentage of investigational
drugs complete all three phases and obtain marketing approval. In some cases, the FDA may require post-market studies, known as Phase
4 studies, to be conducted as a condition of approval in order to gather additional information on the drug’s effect in various
populations and any side effects associated with long-term use. Depending on the risks posed by the drugs, other post-market requirements
may be imposed.
After
completion of the required clinical testing, an NDA is prepared and submitted to the FDA. The FDA approval of the NDA is required before
marketing of the product may begin in the U.S. The NDA must include the results of all pre-clinical, clinical, and other testing and
a compilation of data relating to the product’s pharmacology, chemistry, manufacture, and controls. The cost of preparing and submitting
an NDA is substantial. Under federal law, the submission of most NDAs is additionally subject to a substantial application user fee.
The
FDA has 60 days from its receipt of an NDA to determine whether the application will be accepted for filing based on the agency’s
threshold determination that it is sufficiently complete to permit substantive review. Once the submission is accepted for filing, the
FDA begins an in-depth review. Under the statute and implementing regulations, the FDA has 180 days (the initial review cycle) from the
date of filing to issue either an approval letter or a complete response letter, unless the review period is adjusted by mutual agreement
between the FDA and the applicant or as a result of the applicant submitting a major amendment. In practice, the performance goals established
pursuant to the Prescription Drug User Fee Act have effectively extended the initial review cycle beyond 180 days. The FDA’s current
performance goals call for the FDA to complete review of 90 percent of standard (non-priority) NDAs within 10 months of receipt and within
six months for priority NDAs, but two additional months are added to standard and priority NDAs for a new molecular entity (NME).
The
FDA may also refer applications for novel drug products, or drug products that present difficult questions of safety or efficacy, to
an advisory committee, which is typically a panel that includes clinicians and other experts, for review, evaluation and a recommendation
as to whether the application should be approved. The FDA is not bound by the recommendation of an advisory committee, but it generally
follows such recommendations. Before approving an NDA, the FDA will typically inspect one or more clinical sites to assure compliance
with GCP. Additionally, the FDA will inspect the facility or the facilities at which the drug is manufactured. The FDA will not approve
the product unless compliance with current GMP is satisfactory and the NDA contains data that provide substantial evidence that the drug
is safe and effective in the indication studied.
After
the FDA evaluates the NDA and the manufacturing facilities, it issues either an approval letter or a complete response letter. A complete
response letter generally outlines the deficiencies in the submission and may require substantial additional testing, or information,
in order for the FDA to reconsider the application. If, or when, those deficiencies have been addressed to the FDA’s satisfaction
in a resubmission of the NDA, the FDA will issue an approval letter. The FDA has committed to reviewing 90 percent of resubmissions within
two to six months depending on the type of information included.
An
approval letter authorizes commercial marketing of the drug with specific prescribing information for specific indications. As a condition
of NDA approval, the FDA may require a risk evaluation and mitigation strategy, or REMS, to help ensure that the benefits of the drug
outweigh the potential risks. REMS can include medication guides, communication plans for health care professionals, and elements to
assure safe use, or ETASU. ETASU can include, but are not limited to, special training or certification for prescribing or dispensing,
dispensing only under certain circumstances, special monitoring, and the use of patient registries. The requirement for a REMS can materially
affect the potential market and profitability of the drug. Moreover, product approval may require substantial post-approval testing and
surveillance to monitor the drug’s safety or efficacy. Once granted, product approvals may be withdrawn if compliance with regulatory
standards is not maintained or problems are identified following initial marketing.
Disclosure
of Clinical Trial Information
Sponsors
of clinical trials of certain FDA-regulated products, including prescription drugs, are required to register and disclose certain clinical
trial information on a public website maintained by the U.S. National Institutes of Health. Information related to the product, patient
population, phase of investigation, study sites and investigator, and other aspects of the clinical trial is made public as part of the
registration. Sponsors are also obligated to disclose the results of these trials after completion. Disclosure of the results of these
trials can be delayed for up to two years if the sponsor certifies that it is seeking approval of an unapproved product or that it will
file an application for approval of a new indication for an approved product within one year. Competitors may use this publicly available
information to gain knowledge regarding the design and progress of our development programs.
16
Special
Protocol Assessment
A
company may reach an agreement with the FDA under the Special Protocol Assessment, or “SPA”, process as to the required design
and size of clinical trials intended to form the primary basis of an efficacy claim. According to its performance goals, the FDA is supposed
to evaluate the protocol within 45 days of the request to assess whether the proposed trial is adequate, and that evaluation may result
in discussions and a request for additional information. A SPA request must be made before the proposed trial begins, and all open issues
must be resolved before the trial begins. If a written agreement is reached, it will be documented and made part of the administrative
record. Under the FDCA and FDA guidance implementing the statutory requirement, an SPA is generally binding upon the FDA except in limited
circumstances, such as if the FDA identifies a substantial scientific issue essential to determining safety or efficacy after the study
begins, public health concerns emerge that were unrecognized at the time of the protocol assessment, the sponsor and the FDA agree to
the change in writing, or if the study sponsor fails to follow the protocol that was agreed upon with the FDA.
Advertising
and Promotion
Pre-approval
promotion of investigational drug candidates is prohibited by the FDA. Therefore, sponsors must ensure that any pre-approval communications
disseminated about its drug candidates do not state or imply that such candidates have been proven safe or effective for the applicable
use(s) or that they have been approved for commercialization in the United States. Further, once an NDA for a given candidate is approved,
if ever, the product will be subject to certain post-approval requirements. For instance, the FDA closely regulates the post-approval
marketing and promotion of drugs.
Drugs
may be marketed only for the approved indications and in accordance with the provisions of the approved labeling. Changes to some of
the conditions established in an approved application, including changes in indications, labeling, or manufacturing processes or facilities,
require submission and FDA approval of a new NDA or NDA supplement before the change can be implemented. An NDA supplement for a new
indication typically requires clinical data similar to that in the original application, and the FDA uses the same procedures and actions
in reviewing NDA supplements as it does in reviewing NDAs.
Adverse
Event Reporting and GMP Compliance
Adverse
event reporting and submission of periodic reports is required following FDA approval of an NDA. The FDA also may require post-marketing
testing, known as Phase 4 testing, may require under a REMS special communication regarding the safety of the drug or heightened surveillance
to monitor the effects of an approved product, or the FDA may place conditions on an approval that could restrict the distribution or
use of the product. In addition, quality-control, drug manufacture, packaging, and labeling procedures must continue to conform to GMP,
after approval. Drug manufacturers and certain of their subcontractors are required to register their establishments with the FDA and
certain state agencies. Registration with the FDA subjects entities to periodic unannounced inspections by the FDA, during which the
agency inspects manufacturing facilities to assess compliance with GMP. Accordingly, manufacturers must continue to expend time, money
and effort in the areas of production and quality control to maintain compliance with GMP. Regulatory authorities may withdraw product
approvals or request product recalls if a company fails to comply with regulatory standards, if it encounters problems following initial
marketing or if previously unrecognized problems are subsequently discovered.
Pediatric
Exclusivity and Pediatric Use
The
Best Pharmaceuticals for Children Act, or “BPCA”, provides NDA holders a six-month period of exclusivity attached to any
other exclusivity listed with the FDA — patent or non-patent — for a drug, if certain conditions
are met. Conditions for pediatric exclusivity include a determination by the FDA that information relating to the use of a new drug in
the pediatric population may produce health benefits in that population; a written request by the FDA for pediatric studies; and agreement
by the applicant to perform the requested studies and the submission to the FDA, completion of the studies in accordance with the written
request, and the acceptance by the FDA, of the reports of the requested studies within the statutory time frame. Applications under the
BPCA are treated as priority applications.
In
addition, under the Pediatric Research Equity Act, or “PREA”, NDAs or supplements to NDAs must contain data to assess the
safety and effectiveness of the drug for the claimed indications in all relevant pediatric subpopulations and to support dosing and administration
for each pediatric subpopulation for which the drug is safe and effective, unless the sponsor has received a deferral or waiver from
the FDA. Unless otherwise required by regulation, PREA does not apply to any drug for an indication for which orphan designation has
been granted. The sponsor or the FDA may request a deferral of pediatric studies for some or all of the pediatric subpopulations. A deferral
may be granted for several reasons, including a finding that the drug is ready for approval for use in adults before pediatric studies
are complete or that additional safety or effectiveness data need to be collected before the pediatric studies begin. Under PREA, the
FDA must send a noncompliance letter requesting a response within 45 days to any sponsor that fails to submit the required assessment,
keep a deferral current or fails to submit a request for approval of a pediatric formulation.
17
Controlled
Substances
The
federal Controlled Substances Act of 1970, or “CSA”, and its implementing regulations establish a “closed system”
of regulations for controlled substances. The CSA imposes registration, security, recordkeeping and reporting, storage, manufacturing,
distribution, importation and other requirements under the oversight of the DEA. The DEA is the federal agency responsible for regulating
controlled substances, and requires those individuals or entities that manufacture, import, export, distribute, research, or dispense
controlled substances to comply with the regulatory requirements in order to prevent the diversion of controlled substances to illicit
channels of commerce.
The
DEA categorizes controlled substances into one of five schedules — Schedule I, II, III, IV or V — with
varying qualifications for listing in each schedule. Schedule I substances by definition have a high potential for abuse, have no currently
accepted medical use in treatment in the U.S., and lack accepted safety for use under medical supervision. Marijuana is currently a Schedule
I controlled substance, which means that no preclinical or clinical studies of product candidates containing marijuana may be conducted
in the United States without the required DEA registration(s) and related approvals, as applicable. Pharmaceutical products having a
currently accepted medical use that are otherwise approved for marketing may be listed as Schedule II, III, IV or V substances, with
Schedule II substances presenting the highest potential for abuse and physical or psychological dependence, and Schedule V substances
presenting the lowest relative potential for abuse and dependence.
Facilities
that manufacture, distribute, import, or export any controlled substance must register annually with the DEA. The DEA registration is
specific to the particular location, activity(ies) and controlled substance schedule(s). For example, separate registrations are required
for importation and manufacturing activities, and each registration authorizes which schedules of controlled substances the registrant
may handle. However, certain coincidental activities are permitted without obtaining a separate DEA registration, such as distribution
of controlled substances by the manufacturer that produces them.
The
DEA inspects all manufacturing facilities to review security, recordkeeping, reporting, and handling prior to issuing a controlled substance
registration. The specific security requirements vary by the type of business activity and the schedule and quantity of controlled substances
handled. The most stringent requirements apply to manufacturers of Schedules I and Schedule II substances. Required security measures
commonly include background checks on employees and physical control of controlled substances through storage in approved vaults, safes
and cages, and through use of alarm systems and surveillance cameras. An application for a manufacturing registration as a bulk manufacturer
(not a dosage form manufacturer or a repacker/relabeler) for a Schedule I or II substance must be published in the Federal Register,
and is open for 60 days to permit interested persons to submit comments, objections or requests for a hearing. A copy of the notice of
the Federal Register publication is simultaneously forwarded by DEA to all those registered, or applicants for registration, as bulk
manufacturers of that substance. Once registered, manufacturing facilities must maintain records documenting the manufacture, receipt
and distribution of all controlled substances. Manufacturers must submit periodic reports to the DEA of the distribution of Schedules
I and II controlled substances, Schedule III narcotic substances, and other designated substances. Registrants must also report any controlled
substance thefts or significant losses, and must obtain authorization to destroy or dispose of controlled substances. As with applications
for registration as a bulk manufacturer, an application for an importer registration for a Schedule I or II substance must also be published
in the Federal Register, which remains open for 30 days for comments. Imports of Schedules I and II controlled substances for commercial
purposes are generally restricted to substances not already available from a domestic supplier or where there is not adequate competition
among domestic suppliers. In addition to an importer or exporter registration, importers and exporters must obtain a permit for every
import or export of a Schedules I and II substance or Schedules III, IV and V narcotic, and submit import or export declarations for
Schedules III, IV and V non-narcotics. In some cases, Schedule III non-narcotic substances may be subject to the import/export permit
requirement, if necessary to ensure that the U.S. complies with its obligations under international drug control treaties.
For
drugs manufactured in the U.S., the DEA establishes annually an aggregate quota for the amount of substances within Schedules I and II
that may be manufactured or produced in the U.S. based on the DEA’s estimate of the quantity needed to meet legitimate medical,
scientific, research and industrial needs. This limited aggregate amount of cannabis that the DEA allows to be produced in the U.S. each
year is allocated among individual companies, which, in turn, must annually apply to the DEA for individual manufacturing and procurement
quotas. The quotas apply equally to the manufacturing of the active pharmaceutical ingredient and production of dosage forms. The DEA
may adjust aggregate production quotas a few times per year, and individual manufacturing or procurement quotas from time to time during
the year, although the DEA has substantial discretion in whether or not to make such adjustments for individual companies.
The
states also maintain separate controlled substance laws and regulations, including licensing, recordkeeping, security, distribution,
and dispensing requirements. State Authorities, including Boards of Pharmacy, regulate use of controlled substances in each state. Failure
to maintain compliance with applicable requirements, particularly as manifested in the loss or diversion of controlled substances, can
result in enforcement action that could have a material adverse effect on our business, operations and financial condition. The DEA may
seek civil penalties, refuse to renew necessary registrations, or initiate proceedings to revoke those registrations. In certain circumstances,
violations could lead to criminal prosecution.
18
Europe/Rest
of World Government Regulation
In
addition to regulations in the U.S., we are and will be subject, either directly or through our distribution partners, to a variety of
regulations in other jurisdictions governing, among other things, clinical trials and any commercial sales (including pricing and reimbursement)
and distribution of our product candidates, if approved.
Whether
or not we obtain FDA approval for a product, it must obtain the requisite approvals from regulatory authorities in non-U.S. countries
prior to the commencement of clinical trials or marketing of the product in those countries.
In
the European Union, medicinal products are subject to extensive pre- and post-marketing regulation by regulatory authorities at both
the European Union and national levels. Additional rules also apply at the national level to the manufacture, import, export, storage,
distribution and sale of controlled substances. In many European Union member states the regulatory authority responsible for medicinal
products is also responsible for controlled substances. Responsibility is, however, split in some member states, such as the U.K. Generally,
any company manufacturing or distributing a medicinal product containing a controlled substance in the European Union will need to hold
a controlled substances license from the competent national authority and will be subject to specific record-keeping and security obligations.
Separate import or export certificates are required for each shipment into or out of the member state.
Clinical
Trials and Marketing Approval
Certain
countries outside of the U.S. have a process that requires the submission of a clinical trial application much like an IND prior to the
commencement of human clinical trials. In Europe, for example, a clinical trial application, or “CTA”, must be submitted
to the competent national health authority and to independent ethics committees in each country in which a company intends to conduct
clinical trials. Once the CTA is approved in accordance with a country’s requirements and a company has received favorable ethics
committee approval, clinical trial development may proceed in that country.
The
requirements and process governing the conduct of clinical trials, product licensing, pricing, and reimbursement vary from country to
country, even though there is already some degree of legal harmonization in the European Union member states resulting from the national
implementation of underlying European Union legislation. In all cases, the clinical trials must be conducted in accordance with the International
Conference on Harmonization, or “ICH”, guidelines on GCP and other applicable regulatory requirements.
To
obtain regulatory approval to place a drug on the market in European Union countries, Enveric must submit a marketing authorization application.
This application is similar to the NDA in the U.S., with the exception of, among other things, country-specific document requirements.
All application procedures require an application in the common technical document, or CTD, format, which includes the submission of
detailed information about the manufacturing and quality of the product, and nonclinical and clinical trial information. Drugs can be
authorized in the European Union by using (i) the centralized authorization procedure, (ii) the mutual recognition procedure, (iii) the
decentralized procedure, or (iv) national authorization procedures.
The
European Commission created the centralized procedure for the approval of human drugs to facilitate marketing authorizations that are
valid throughout the European Union and, by extension (after national implementing decisions) in Iceland, Liechtenstein and Norway, which,
together with the European Union. member states, comprise the European Economic Area, or “EEA”. Applicants file marketing
authorization applications with the EMA, where they are reviewed by a relevant scientific committee, in most cases the Committee for
Medicinal Products for Human Use (the “CHMP”). The EMA forwards CHMP opinions to the European Commission, which uses them
as the basis for deciding whether to grant a marketing authorization. This procedure results in a single marketing authorization granted
by the European Commission that is valid across the European Union, as well as in Iceland, Liechtenstein and Norway. The centralized
procedure is compulsory for human drugs that are: (i) derived from biotechnology processes, such as genetic engineering, (ii) contain
a new active substance indicated for the treatment of certain diseases, such as HIV/AIDS, cancer, diabetes, neurodegenerative diseases,
autoimmune and other immune dysfunctions and viral diseases, (iii) officially designated “orphan drugs” (drugs used for rare
human diseases), and (iv) advanced-therapy medicines, such as gene-therapy, somatic cell-therapy or tissue-engineered medicines. The
centralized procedure may at the voluntary request of the applicant also be used for human drugs that do not fall within the above-mentioned
categories if the CHMP agrees that the human drug (a) contains a new active substance not yet approved on November 20, 2005; (b) constitutes
a significant therapeutic, scientific or technical innovation, or (c) authorization under the centralized procedure is in the interests
of patients at the European Union level.
Under
the centralized procedure in the European Union, the maximum time frame for the evaluation of a marketing authorization application by
the EMA is 210 days (excluding clock stops, when additional written or oral information is to be provided by the applicant in response
to questions asked by the CHMP), with adoption of the actual marketing authorization by the European Commission thereafter.
Accelerated
evaluation might be granted by the CHMP in exceptional cases, when a medicinal product is expected to be of a major public health interest
from the point of view of therapeutic innovation, defined by three cumulative criteria: the seriousness of the disease to be treated;
the absence of an appropriate alternative therapeutic approach, and anticipation of exceptional high therapeutic benefit. In this circumstance,
EMA ensures that the evaluation for the opinion of the CHMP is completed within 150 days and the opinion issued thereafter.
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For
those medicinal products for which the centralized procedure is not available, the applicant must submit marketing authorization applications
to the national medicines regulators through one of three procedures: (i) the mutual recognition procedure (which must be used if the
product has already been authorized in at least one other European Union member state, and in which the European Union member states
are required to grant an authorization recognizing the existing authorization in the other European Union member state, unless they identify
a serious risk to public health), (ii) the decentralized procedure (in which applications are submitted simultaneously in two or more
European Union member states), or (iii) national authorization procedures (which results in a marketing authorization in a single European
Union member state).
Mutual
Recognition Procedure
The
mutual recognition procedure, or “MRP”, for the approval of human drugs is an alternative approach to facilitate individual
national marketing authorizations within the European Union. Basically, the MRP may be applied for all human drugs for which the centralized
procedure is not obligatory. The MRP is applicable to the majority of conventional medicinal products, and must be used if the product
has already been authorized in one or more member states.
The
characteristic of the MRP is that the procedure builds on an already-existing marketing authorization in a member state of the European
Union that is used as a reference in order to obtain marketing authorizations in other European Union member states. In the MRP, a marketing
authorization for a drug already exists in one or more member states of the European Union and subsequently marketing authorization applications
are made in other European Union member states by referring to the initial marketing authorization. The member state in which the marketing
authorization was first granted will then act as the reference member state. The member states where the marketing authorization is subsequently
applied for act as concerned member states. The concerned member states are required to grant an authorization recognizing the existing
authorization in the reference member state, unless they identify a serious risk to public health.
The
MRP is based on the principle of the mutual recognition by European Union member states of their respective national marketing authorizations.
Based on a marketing authorization in the reference member state, the applicant may apply for marketing authorizations in other member
states. In such case, the reference member state shall update its existing assessment report about the drug in 90 days. After the assessment
is completed, copies of the report are sent to all member states, together with the approved summary of product characteristics, labeling
and package leaflet. The concerned member states then have 90 days to recognize the decision of the reference member state and the summary
of product characteristics, labeling and package leaflet. National marketing authorizations shall be granted within 30 days after acknowledgement
of the agreement.
Should
any Member State refuse to recognize the marketing authorization by the reference member state, on the grounds of potential serious risk
to public health, the issue will be referred to a coordination group. Within a time frame of 60 days, member states shall, within the
coordination group, make all efforts to reach a consensus. If this fails, the procedure is submitted to an EMA scientific committee for
arbitration. The opinion of this EMA Committee is then forwarded to the European Commission, for the start of the decision-making process.
As in the centralized procedure, this process entails consulting various European Commission Directorates General and the Standing Committee
on Human Medicinal Products.
Data
Exclusivity
In
the European Union, marketing authorization applications for generic medicinal products do not need to include the results of pre-clinical
and clinical trials, but instead can refer to the data included in the marketing authorization of a reference product for which regulatory
data exclusivity has expired. If a marketing authorization is granted for a medicinal product containing a new active substance, that
product benefits from eight years of data exclusivity, during which generic marketing authorization applications referring to the data
of that product may not be accepted by the regulatory authorities, and a further two years of market exclusivity, during which such generic
products may not be placed on the market. The two-year period may be extended to three years if during the first eight years a new therapeutic
indication with significant clinical benefit over existing therapies is approved.
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Orphan
Medicinal Products
The
EMA’s Committee for Orphan Medicinal Products (“COMP”) may recommend orphan medicinal product designation to promote
the development of products that are intended for the diagnosis, prevention or treatment of life-threatening or chronically debilitating
conditions affecting not more than 5 in 10,000 persons in the European Union. Additionally, designation is granted for products intended
for the diagnosis, prevention or treatment of a life-threatening, seriously debilitating or serious and chronic condition and when, without
incentives, it is unlikely that sales of the product in the European Union would be sufficient to justify the necessary investment in
developing the medicinal product. The COMP may only recommend orphan medicinal product designation when the product in question offers
a significant clinical benefit over existing approved products for the relevant indication. Following a positive opinion by the COMP,
the European Commission adopts a decision granting orphan status. The COMP will reassess orphan status in parallel with EMA review of
a marketing authorization application and orphan status may be withdrawn at that stage if it no longer fulfills the orphan criteria (for
instance because in the meantime a new product was approved for the indication and no convincing data are available to demonstrate a
significant benefit over that product). Orphan medicinal product designation entitles a party to financial incentives such as reduction
of fees or fee waivers and ten years of market exclusivity is granted following marketing authorization. During this period, the competent
authorities may not accept or approve any similar medicinal product, unless it offers a significant clinical benefit. This period may
be reduced to six years if the orphan medicinal product designation criteria are no longer met, including where it is shown that the
product is sufficiently profitable not to justify maintenance of market exclusivity.
Pediatric
Development
In
the European Union, companies developing a new medicinal product must agree to a Pediatric Investigation Plan, or “PIP”,
with the EMA and must conduct pediatric clinical trials in accordance with that PIP unless a waiver applies, for example, because the
relevant disease or condition occurs only in adults. The marketing authorization application for the product must include the results
of pediatric clinical trials conducted in accordance with the PIP, unless a waiver applies, or a deferral has been granted, in which
case the pediatric clinical trials must be completed at a later date. Products that are granted a marketing authorization on the basis
of the pediatric clinical trials conducted in accordance with the PIP are eligible for a six-month extension of the protection under
a supplementary protection certificate (if the product covered by it qualifies for one at the time of approval). This pediatric reward
is subject to specific conditions and is not automatically available when data in compliance with the PIP are developed and submitted.
If
we fail to comply with applicable foreign regulatory requirements, it may be subject to, among other things, fines, suspension of clinical
trials, suspension or withdrawal of regulatory approvals, product recalls, seizure of products, operating restrictions and criminal prosecution.
In
addition, most countries are parties to the Single Convention on Narcotic Drugs 1961, which governs international trade and domestic
control of narcotic substances, including cannabis extracts. Countries may interpret and implement their treaty obligations in a way
that creates a legal obstacle to us obtaining marketing approval for our product candidates in those countries. These countries may not
be willing or able to amend or otherwise modify their laws and regulations to permit our product candidates to be marketed, or achieving
such amendments to the laws and regulations may take a prolonged period of time. In that case, we would be unable to market our product
candidates in those countries in the near future or perhaps at all.
Employees
We
continue to build on our leadership expertise. We employ two full-time and one part-time employee. We also work with scientific
advisors, consultants and service providers, mainly through academic institutions and contract research organizations.
We
have never had a work stoppage and none of its employees are covered by collective bargaining agreements or represented by a labor union.
We believe that we have good relationships with our employees.
Legal
Proceedings
From
time to time, we may be a party to litigation that arises in the ordinary course of its business. Other than as described below,
we do not have any pending litigation that, separately or in the aggregate, would, in the opinion of management, have a material
adverse effect on its results of operations, financial condition or cash flows.
On
January 21, 2021, we received a stockholder litigation demand letter from the law firm of Purcell Julie & Lefkowitz LLP,
on behalf of James Self, a purported stockholder of our Company. The letter demands that we (i) deem ineffective the December
30, 2020 amendment to its Amended and Restated Certificate of Incorporation in which we effected a reverse stock split due to
the manner in which non-votes by brokers were tabulated, (ii) seek appropriate relief for damages allegedly suffered by the
company and its stockholders or seek a valid stockholder approval of the amendment and reverse stock split, and (iii) adopt
adequate internal controls to prevent a recurrence of the alleged misconduct. We dispute that the amendment was ineffective
or that there were any inadequate internal controls related to the same. However, to eliminate any questions about the
amendment, we intend to seek to ratify the amendment at a special stockholders’ meeting pursuant to Section 204 of the
Delaware General Corporation Law. This special stockholders’ meeting is scheduled to occur on May 14, 2021.
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