Item 1A. Risk Factors
Item 1a. Risk Factors
Summary of Risk Factors
Below is a summary of the
principal factors that make an investment in our common stock speculative or risky. This summary does not address all of the risks that
we face. Additional discussion of the risks summarized in this risk factor summary, and other risks that we face, can be found below under
the heading “Risk Factors” and should be carefully considered, together with other information in this Form 10-K and our other
filings with the SEC, before making an investment decision regarding our common stock.
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We will require additional capital to finance our operations to continue as a going concern, which may not be available to us on acceptable terms, if at all. As a result, we may not complete the development and commercialization of our product candidates or develop new product candidates and have substantial doubt about our ability to continue as a going concern.
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Our ability to successfully engage with, and satisfactorily respond to, requests for information from the FDA in the future.
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We have incurred losses since inception and anticipate that we will continue to incur losses for the foreseeable future. We are not currently profitable, and we may never achieve or sustain profitability.
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We will require additional capital to fund our operations and if we fail to obtain necessary financing, we will not be able to complete the development and commercialization of our product candidates.
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We are significantly dependent on the success of our DN-TNF product platform and Natural Killer Cell Priming Platform (INKmune), CORDStrom, and our product candidates based on these platforms.
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We need to attract and retain highly skilled personnel; we may be unable to effectively manage growth with our limited resources.
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We depend upon our senior management and key consultants and their loss or unavailability could put us at a competitive disadvantage.
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The biotechnology and immunotherapy industries are characterized by rapid technological developments and a high degree of competition. We may be unable to compete with more substantial enterprises.
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We can provide no assurance that our clinical product candidates will obtain regulatory approval or that the results of clinical studies will be favorable.
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Drug discovery and development is a complex, time-consuming and expensive process with a high rate of failure.
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We may face legal claims; legal disputes are expensive, and we may not be able to afford the costs.
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We can provide no assurance of the successful and timely development of new products.
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We must comply with significant government regulations.
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We rely upon patents to protect our technology. We may be unable to protect our intellectual property rights.
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The price of our common stock may be volatile.
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The market prices for our common stock may be adversely impacted by future events.
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A limited public trading market may cause volatility in the price of our common stock.
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Our Rights Agreement contains anti-takeover provisions that could discourage, delay or prevent a change in control, which may cause our stock price to decline.
You should carefully consider
the risks described below as well as other information provided to you in this document, including information in the section of this
document entitled “Information Regarding Forward Looking Statements.” If any of the following risks actually occur, the Company’s
business, financial condition or results of operations could be materially adversely affected, the value of the Company’s Common
Stock could decline, and you may lose all or part of your investment.
RISKS RELATED TO OUR BUSINESS
There is doubt about our ability to continue
as a going concern.
As of December 31, 2024, the
Company had an accumulated deficit of $163,104,000. Losses have principally occurred as a result of the substantial resources required
for research and development of the Company’s product candidates which included the general and administrative expenses associated
with its organization and product development as well as the lack of sources of revenues until such time as the Company’s products
are commercialized. These factors raise substantial doubt about the Company’s ability to continue as a going concern for the 12
months from the issuance date of these financial statements. These financial statements do not include any adjustments to reflect the
possible future effect on the recoverability and classification of assets or the amounts and classifications of liabilities that may result
from the outcome of these uncertainties. Management intends to pursue additional funding and implement its strategic plan to allow the
opportunity for the Company to continue as a going concern, however, there cannot be any assurance that we will be successful in doing
so. The opinion of our independent registered public accounts on our audited financial statements for the year ended December 31, 2024,
contains an explanatory paragraph regarding substantial doubt about our ability to continue as a going concern.
There is no assurance that
we will be successful in raising the additional funds needed to fund our business plan. If we are not able to raise sufficient capital
in the near future, our continued operations will be in jeopardy and we may be forced to cease operations and sell or otherwise transfer
all or substantially all of our remaining assets.
We face intense competition in the markets
targeted by our lead product candidates. Many of our competitors have substantially greater resources than we do, and we expect that all
of our product candidates under development will face intense competition from existing or future drugs.
We expect that our product
candidates under development, if approved, will face intense competition from existing and future drugs marketed by large companies. These
competitors may successfully market products that compete with our products, successfully identify drug candidates or develop products
earlier than we do, or develop products that are more effective, have fewer side effects or cost less than our products, if any.
Additionally, if a competitor
receives FDA approval before we do for a drug that is similar to one of our product candidates, FDA approval for our product candidate
may be precluded or delayed due to periods of non-patent exclusivity and/or the listing with the FDA by the competitor of patents covering
its newly-approved drug product. Periods of non-patent exclusivity for new versions of existing drugs such as our current product candidates
can extend up to three and one-half years. See the section entitled “Government Regulation.”
These competitive factors
could require us to conduct substantial new research and development activities to establish new product targets, which would be costly
and time-consuming. These activities would adversely affect our ability to commercialize products and achieve revenue and profits.
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Competition and technological change may
make our product candidates and technologies less attractive or obsolete.
We compete with established
pharmaceutical and biotechnology companies that are pursuing other forms of treatment for the same indications we are pursuing and that
have greater financial and other resources. Other companies may succeed in developing products earlier than us, obtaining FDA approval
for products more rapidly, or developing products that are more effective than our product candidates. Research and development by others
may render our technology or product candidates obsolete or noncompetitive or result in treatments or cures superior to any therapy we
develop. We face competition from companies that internally develop competing technology or acquire competing technology from universities
and other research institutions. As these companies develop their technologies, they may develop competitive positions that may prevent,
make futile, or limit our product commercialization efforts, which would result in a decrease in the revenue we would be able to derive
from the sale of any products.
There can be no assurance
that any of our product candidates will be accepted by the marketplace as readily as these or other competing treatments. Furthermore,
if our competitors’ products are approved before ours, it could be more difficult for us to obtain approval from the FDA. Even if
our products are successfully developed and approved for use by all governing regulatory bodies, there can be no assurance that physicians
and patients will accept our product(s) as a treatment of choice.
Furthermore, the pharmaceutical
research industry is diverse, complex, and rapidly changing. By its nature, the business risks associated therewith are numerous and significant.
The effects of competition, intellectual property disputes, market acceptance, and FDA regulations preclude us from forecasting revenues
or income with certainty or even confidence.
We
have incurred losses since inception and anticipate that we will continue to incur losses for the foreseeable future. We are not currently
profitable, and we may never achieve or sustain profitability.
We were formed in September
2015 and have only a limited operating history and have incurred losses since our formation. We continue to incur significant development
and other expenses related to our ongoing operations. As a result, we are not and have never been profitable and have incurred losses
in each period since our inception, resulting in substantial doubt in our ability to continue as a going concern. We reported a net loss
of $42.1 million and $30.0 million for the years ended December 31, 2024 and 2023, respectively. As of December 31, 2024 and 2023, we
had cash and cash equivalents of $20.9 million and $35.8 million, respectively.
We expect to continue to incur significant losses for the foreseeable
future, and we expect these losses to increase as we continue our research and development of, and seek regulatory approvals for, our
product candidates and now that we are no longer an emerging growth company, as defined in Section 2(a) of the Securities Act of 1933,
as amended. As a public company, we are subject to the reporting requirements of the Exchange Act, the Sarbanes-Oxley Act and the Dodd-Frank
Act, as well as rules adopted, and to be adopted, by the SEC and The Nasdaq Stock Market LLC. We also expect that compliance with the
auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act and increased disclosure requirements will increase our legal
and financial compliance costs. The size of our future net losses will depend, in part, on the rate of future growth of our expenses and
our ability to generate revenues, if any. The costs of advancing product candidates into each clinical phase tend to increase substantially
over the duration of the clinical development process. Therefore, the total costs to advance any of our product candidates to marketing
approval in even a single jurisdiction will be substantial. Because of the numerous risks and uncertainties associated with pharmaceutical
product development, we are unable to accurately predict the timing or amount of increased expenses or when, or if, we will be able to
begin generating revenue from the commercialization of any products or achieve or maintain profitability.
The costs of advancing product
candidates into each clinical phase tend to increase substantially over the duration of the clinical development process. Therefore, the
total costs to advance any of our product candidates to marketing approval in even a single jurisdiction will be substantial. Because
of the numerous risks and uncertainties associated with pharmaceutical product development, we are unable to accurately predict the timing
or amount of increased expenses or when, or if, we will be able to begin generating revenue from the commercialization of any products
or achieve or maintain profitability.
Furthermore,
our ability to successfully develop, commercialize and license any product candidates and generate product revenue is subject to substantial
additional risks and uncertainties. As a result, we expect to continue to incur net losses and negative cash flows for the foreseeable
future. These net losses and negative cash flows have had, and will continue to have, an adverse effect on our stockholders’ equity
and working capital. The amount of our future net losses will depend, in part, on the rate of future growth of our expenses and our ability
to generate revenues. If we are unable to develop and commercialize one or more product candidates, either alone or through collaborations,
or if revenues from any product that receives marketing approval are insufficient, we will not achieve profitability. Even if we do achieve
profitability, we may not be able to sustain profitability or meet outside expectations for our profitability. If we are unable to achieve
or sustain profitability or to meet outside expectations for our profitability, the value of our common stock will be materially and adversely
affected.
Even if we are able to commercialize any
product candidate that we develop, the product may become subject to unfavorable pricing regulations, third-party payor reimbursement
practices or healthcare reform initiatives that could harm our business.
The commercial success of
our product candidates will depend substantially, both domestically and abroad, on the extent to which the costs of our product candidates
will be paid by health maintenance, managed care, pharmacy benefit and similar healthcare management organizations, or reimbursed by government
health administration authorities (such as Medicare and Medicaid), private health coverage insurers and other third-party payors. If reimbursement
is not available, or is available only to limited levels, we may not be able to successfully commercialize our product candidates. Even
if coverage is provided, the approved reimbursement amount may not be high enough to allow us to establish and maintain pricing sufficient
to realize a meaningful return on our investment.
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There is significant uncertainty
related to third-party payor coverage and reimbursement of newly approved drugs. Marketing approvals, pricing and reimbursement for new
drug products vary widely from country to country. Some countries require approval of the sale price of a drug before it can be marketed.
In many countries, the pricing review period begins after marketing or product licensing approval is granted. In some non-U.S. markets,
prescription pharmaceutical pricing remains subject to continuing governmental control even after initial approval is granted. As a result,
we might obtain marketing approval for a product in a particular country, but then be subject to price regulations that delay commercial
launch of the product, possibly for lengthy time periods, which may negatively impact the revenues we are able to generate from the sale
of the product in that country. Adverse pricing limitations may hinder our ability to recoup our investment in one or more product candidates,
even if our product candidates obtain marketing approval.
We are subject to various government regulations.
The manufacture and sale of
human therapeutic products in the U.S. and foreign jurisdictions are governed by a variety of statutes and regulations. These laws require
approval of manufacturing facilities, controlled research and testing of products and government review and approval of a submission containing
manufacturing, preclinical and clinical data in order to obtain marketing approval based on establishing the safety and efficacy of the
product for each use sought, including adherence to current cGMP during production and storage, and control of marketing activities, including
advertising and labeling.
The products we are currently
developing will require significant development, preclinical and clinical testing and investment of substantial funds prior to its commercialization.
The process of obtaining required approvals can be costly and time-consuming, and there can be no assurance that we develop successfully
this product or any future products, or that this product or any future products we develop will prove to be safe and effective in clinical
trials or receive applicable regulatory approvals. Potential investors and shareholders should be aware of the risks, problems, delays,
expenses and difficulties which we may encounter in view of the extensive regulatory environment which controls our business.
If we are unable to keep up with rapid technological
changes in our field or compete effectively, we will be unable to operate profitably.
We are engaged in a rapidly
changing field. Other products and therapies that will compete directly with the products that we are seeking to develop and market currently
exist or are being developed. Competition from fully integrated pharmaceutical companies and more established biotechnology companies
is intense and is expected to increase. Most of these companies have significantly greater financial resources and expertise in discovery
and development, manufacturing, preclinical and clinical testing, obtaining regulatory approvals and marketing than us. Smaller companies
may also prove to be significant competitors, particularly through collaborative arrangements with large pharmaceutical and established
biopharmaceutical or biotechnology companies. Many of these competitors have significant products that have been approved or are in development
and operate large, well-funded discovery and development programs. Academic institutions, governmental agencies and other public and private
research organizations also conduct research, seek patent protection and establish collaborative arrangements for therapeutic products
and clinical development and marketing. These companies and institutions compete with us in recruiting and retaining highly qualified
scientific and management personnel. In addition to the above factors, we will face competition based on product efficacy and safety,
the timing and scope of regulatory approvals, availability of supply, marketing and sales capability, reimbursement coverage, price and
patent position. There is no assurance that our competitors will not develop more effective or more affordable products, or achieve earlier
patent protection or product commercialization, than our own.
Other companies may succeed
in developing products earlier than ourselves, obtaining FDA and European Medicines Agency (“EMA”) approvals for such products
more rapidly than we will, or in developing products that are more effective than products we propose to develop. While we will seek to
expand our technological capabilities in order to remain competitive, there can be no assurance that research and development by others
will not render our technology or products obsolete or non-competitive or result in treatments or cures superior to any therapy we develop,
or that any therapy we develop will be preferred to any existing or newly developed technologies.
We may request priority review for our product
candidate in the future. The FDA may not grant priority review for our product candidate. Moreover, even if the FDA designates such product
for priority review, that designation may not lead to a faster regulatory review or approval process and, in any event, would not assure
FDA approval.
We may be eligible for priority
review designation for our product candidate if the FDA determines such product candidate offers major advances in treatment or provides
a treatment where no adequate therapy exists. A priority review designation means that the goal for the FDA is to take action on an application
in six months, rather than the standard review period of ten months. The FDA has broad discretion with respect to whether or not to grant
priority review status to a product candidate, so even if we believe a particular product candidate is eligible for such designation or
status, the FDA may decide not to grant it. Thus, while the FDA has granted priority review to other oncology disease products, our product
candidate, should we determine to seek priority review, may not receive similar designation. Moreover, even if our product candidate is
designated for priority review, such a designation does not necessarily mean a faster regulatory review process or necessarily confer
any advantage with respect to approval compared to conventional FDA procedures. Receiving priority review from the FDA does not guarantee
approval within an accelerated timeline or thereafter.
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We believe we may in some instances be able
to secure approval from the FDA or comparable non-U.S. regulatory authorities to use accelerated development pathways. If we are unable
to obtain such approval, we may be required to conduct additional preclinical studies or clinical trials beyond those that we contemplate,
which could increase the expense of obtaining, and delay the receipt of, necessary marketing approvals.
We anticipate that we may
seek an accelerated approval pathway for our product candidates. Under the accelerated approval provisions in the Federal Food, Drug,
and Cosmetic Act, or FDCA, and the FDA’s implementing regulations, the FDA may grant accelerated approval to a product designed
to treat a serious or life-threatening condition that provides meaningful therapeutic benefit over available therapies upon a determination
that the product has an effect on a surrogate endpoint or intermediate clinical endpoint that is reasonably likely to predict clinical
benefit. The FDA considers a clinical benefit to be a positive therapeutic effect that is clinically meaningful in the context of a given
disease, such as irreversible morbidity or mortality. For the purposes of accelerated approval, a surrogate endpoint is a marker, such
as a laboratory measurement, radiographic image, physical sign, or other measure that is thought to predict clinical benefit, but is not
itself a measure of clinical benefit. An intermediate clinical endpoint is a clinical endpoint that can be measured earlier than an effect
on irreversible morbidity or mortality that is reasonably likely to predict an effect on irreversible morbidity or mortality or other
clinical benefit. The accelerated approval pathway may be used in cases in which the advantage of a new drug over available therapy may
not be a direct therapeutic advantage but is a clinically important improvement from a patient and public health perspective. If granted,
accelerated approval is usually contingent on the sponsor’s agreement to conduct, in a diligent manner, additional post-approval
confirmatory studies to verify and describe the drug’s clinical benefit. If such post-approval studies fail to confirm the drug’s
clinical benefit, the FDA may withdraw its approval of the drug.
Prior to seeking such accelerated
approval, we will seek feedback from the FDA and will otherwise evaluate our ability to seek and receive such accelerated approval. There
can be no assurance that after our evaluation of the feedback and other factors we will decide to pursue or submit a New Drug Application,
or NDA, for accelerated approval or any other form of expedited development, review or approval. Similarly, there can be no assurance
that after subsequent FDA feedback we will continue to pursue or apply for accelerated approval or any other form of expedited development,
review or approval, even if we initially decide to do so. Furthermore, if we decide to submit an application for accelerated approval
or under another expedited regulatory designation (e.g., breakthrough therapy designation), there can be no assurance that such submission
or application will be accepted or that any expedited development, review or approval will be granted on a timely basis, or at all. The
FDA or other non-U.S. authorities could also require us to conduct further studies prior to considering our application or granting approval
of any type. A failure to obtain accelerated approval or any other form of expedited development, review or approval for our product candidate
would result in a longer time period to commercialization of such product candidate, could increase the cost of development of such product
candidate and could harm our competitive position in the marketplace.
Clinical drug development involves a lengthy
and expensive process with an uncertain outcome. We may incur additional costs or experience delays in completing, or ultimately be unable
to complete the development and commercialization of our product candidate.
Our product candidates are
in early clinical development. Therefore, the risk of failure of our product candidates is high. It is impossible to predict when or if
our product candidates will prove effective or safe in humans or will receive regulatory approval. Before obtaining marketing approval
from regulatory authorities for the sale of any product candidate, we must complete preclinical development and then conduct extensive
clinical trials to demonstrate the safety and efficacy of our product candidate in humans. Clinical testing is expensive, difficult to
design and implement, can take many years to complete and is uncertain as to outcome. A failure of one or more clinical trials can occur
at any stage of testing. The clinical development of our product candidates is susceptible to the risk of failure inherent at any stage
of drug development, including failure to demonstrate efficacy in a clinical trial or across a broad population of patients, the occurrence
of severe or medically or commercially unacceptable adverse events, failure to comply with protocols or applicable regulatory requirements
and determination by the FDA or any comparable non-U.S. regulatory authority that a drug product is not safe or effective for its intended
uses. It is possible that even if our product candidate has a beneficial effect, that effect will not be detected during clinical evaluation
as a result of one or more of a variety of factors, including the size, duration, design, measurements, conduct or analysis of our clinical
trials. Conversely, as a result of the same factors, our clinical trials may indicate an apparent positive effect of a product candidate
that is greater than the actual positive effect, if any. Similarly, in our clinical trials we may fail to detect toxicity of, or intolerability
caused by our product candidates, or mistakenly believe that our product candidates are toxic or not well tolerated when that is not in
fact the case.
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Success in early development
does not mean that later development will be successful because, for example, drug candidates in later-stage clinical trials may fail
to demonstrate sufficient safety and efficacy despite having progressed through initial clinical trials.
The design of a clinical trial
can determine whether its results will support approval of a product; however, flaws in the design of a clinical trial may not become
apparent until the clinical trial is well advanced or completed. In addition, preclinical and clinical data are often susceptible to varying
interpretations and analyses. Many companies that believed their product candidates performed satisfactorily in preclinical studies and
clinical trials have nonetheless failed to obtain marketing approval for the product candidates. Even if we believe that the results of
clinical trials for our product candidate warrant marketing approval, the FDA or comparable non-U.S. regulatory authorities may disagree
and may not grant marketing approval of our product candidate.
In some instances, there can
be significant variability in safety or efficacy results between different clinical trials of the same product candidate due to numerous
factors, including changes in trial procedures set forth in protocols, differences in the size and type of the patient populations, changes
in and adherence to the clinical trial protocols and the rate of dropout among clinical trial participants. Any clinical trials that we
may conduct may not demonstrate the efficacy and safety necessary to obtain regulatory approval to market our product candidate.
The results of
preclinical studies and early-stage clinical trials may not be predictive of future results. Initial success in clinical trials may not
be indicative of results obtained when these trials are completed or in later-stage trials.
The results of preclinical
studies may not be predictive of the results of clinical trials, and the results of any early-stage clinical trials we commence may not
be predictive of the results of the later-stage clinical trials. In addition, initial success in clinical trials may not be indicative
of results obtained when such trials are completed. In particular, the small number of patients in our planned early clinical trials may
make the results of these trials less predictive of the outcome of later clinical trials. For example, even if successful, the results
of our initial clinical trials for XPro may not be predictive of the results of further clinical trials of this drug candidate or any
of our other drug candidates. Moreover, preclinical and clinical data often are susceptible to varying interpretations and analyses, and
many companies that have believed their drug candidates performed satisfactorily in preclinical studies and clinical trials nonetheless
have failed to obtain marketing approval of their products. Our future clinical trials may not ultimately be successful or support further
clinical development of any of our drug candidates. There is a high failure rate for drug candidates proceeding through clinical trials.
A number of companies in the pharmaceutical and biotechnology industries have suffered significant setbacks in clinical development even
after achieving encouraging results in earlier studies. Any such setbacks in our clinical development could materially harm our business,
results of operations, financial condition and prospects.
Interim top-line
and preliminary data from our planned clinical trials that we announce or publish from time to time may change as more patient data become
available and are subject to audit and verification procedures that could result in material changes in the final data.
From time to time, we may
publish interim top-line or preliminary data from our planned clinical trials. Interim data from clinical trials that we may complete
are subject to the risk that one or more of the clinical outcomes may materially change as patient enrollment continues and more patient
data becomes available. Preliminary or top-line data also remain subject to audit and verification procedures that may result in the final
data being materially different from the preliminary data we previously published. As a result, interim and preliminary data should be
viewed with caution until the final data is available. Adverse differences between preliminary or interim data and final data could significantly
harm our reputation and business prospects.
If clinical trials of our product candidates
fail to demonstrate safety and efficacy to the satisfaction of the FDA and comparable non-U.S. regulators, we may incur additional costs
or experience delays in completing, or ultimately be unable to complete, the development and commercialization of our product candidates.
We are not permitted to commercialize,
market, promote or sell any product candidate in the United States without obtaining marketing approval from the FDA. Comparable non-U.S.
regulatory authorities, such as the EMA, impose similar restrictions. We may never receive such approvals. We must complete extensive
preclinical development and clinical trials to demonstrate the safety and efficacy of our product candidate in humans before we will be
able to obtain these approvals.
Clinical testing is expensive,
difficult to design and implement, can take many years to complete and is inherently uncertain as to outcome. We have not previously submitted
an NDA to the FDA or similar drug approval filings to comparable non-U.S. regulatory authorities for any product candidate.
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Any inability to successfully
complete preclinical and clinical development could result in additional costs to us and impair our ability to generate revenues from
product sales, regulatory and commercialization milestones and royalties. In addition, if (1) we are required to conduct additional clinical
trials or other testing of our product candidate beyond the trials and testing than we contemplate, (2) we are unable to successfully
complete clinical trials of our product candidate or other testing, (3) the results of these trials or tests are unfavorable, uncertain
or are only modestly favorable, or (4) there are unacceptable safety concerns associated with our product candidate, we, in addition to
incurring additional costs, may:
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be delayed in obtaining marketing approval for our product candidate;
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not obtain marketing approval at all;
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obtain approval for indications or patient populations that are not as broad as we intended or desired;
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obtain approval with labeling that includes significant use or distribution restrictions or significant safety warnings, including boxed warnings;
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be subject to additional post-marketing testing or other requirements; or
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be required to remove the product from the market after obtaining marketing approval.
If we experience any of a number of possible
unforeseen events in connection with clinical trials of any of our product candidates, potential marketing approval or commercialization
of that product candidate could be delayed or prevented.
We may experience numerous
unforeseen events during, or as a result of, clinical trials that could delay or prevent marketing approval of any of our product candidates,
including:
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clinical trials of our product candidate may produce unfavorable or inconclusive results;
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we may decide, or regulators may require us, to conduct additional clinical trials or abandon product development programs;
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the number of patients required for clinical trials of our product candidate may be larger than we anticipate, patient enrollment in these clinical trials may be slower than we anticipate, or participants may drop out of these clinical trials at a higher rate than we anticipate;
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data safety monitoring committees may recommend suspension, termination or a clinical hold for various reasons, including concerns about patient safety;
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regulators or institutional review boards, or IRBs, may suspend or terminate the trial or impose a clinical hold for various reasons, including noncompliance with regulatory requirements or concerns about patient safety;
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patients with serious, life-threatening diseases included in our clinical trials may die or suffer other adverse medical events for reasons that may not be related to our product candidate;
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participating patients may be subject to unacceptable health risks;
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patients may not complete clinical trials due to safety issues, side effects, or other reasons;
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changes in regulatory requirements and guidance may occur, which require us to amend clinical trial protocols to reflect these changes;
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our third-party contractors, including those manufacturing our product candidate or components or ingredients thereof or conducting clinical trials on our behalf, may fail to comply with regulatory requirements or meet their contractual obligations to us in a timely manner or at all;
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regulators or IRBs may not authorize us or our investigators to commence a clinical trial or conduct a clinical trial at a prospective trial site;
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we may experience delays in reaching or fail to reach agreement on acceptable clinical trial contracts or clinical trial protocols with prospective trial sites;
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patients who enroll in a clinical trial may misrepresent their eligibility to do so or may otherwise not comply with the clinical trial protocol, resulting in the need to drop the patients from the clinical trial, increase the needed enrollment size for the clinical trial or extend the clinical trial’s duration;
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we may have to suspend or terminate clinical trials of our product candidate for various reasons, including a finding that the participants are being exposed to unacceptable health risks, undesirable side effects or other unexpected characteristics of a product candidate;
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the FDA or comparable non-U.S. regulatory authorities may disagree with our clinical trial design or our interpretation of data from preclinical studies and clinical trials;
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the FDA or comparable non-U.S. regulatory authorities may fail to approve or subsequently find fault with the manufacturing processes or facilities of third-party manufacturers with which we enter into agreements for clinical and commercial supplies;
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the supply or quality of raw materials or manufactured product candidate or other materials necessary to conduct clinical trials of our product candidate may be insufficient, inadequate, delayed, or not available at an acceptable cost, or we may experience interruptions in supply; and
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the approval policies or regulations of the FDA or comparable non-U.S. regulatory authorities may significantly change in a manner rendering our clinical data insufficient to obtain marketing approval.
Product development costs
for us will increase if we experience delays in testing or pursuing marketing approvals and we may be required to obtain additional funds
to complete clinical trials and prepare for possible commercialization of our product candidates. We do not know whether any preclinical
tests or clinical trials will begin as planned, will need to be restructured or will be completed on schedule, or at all. Significant
preclinical or clinical trial delays also could shorten any periods during which we may have the exclusive right to commercialize our
product candidates or allow our competitors to bring products to market before we do and impair our ability to successfully commercialize
our product candidates and may harm our business and results of operations. In addition, many of the factors that cause, or lead to, clinical
trial delays may ultimately lead to the denial of marketing approval of our product candidates.
If we experience delays or difficulties
in the enrollment of patients in clinical trials, we may not achieve our clinical development on our anticipated timeline, or at all,
and our receipt of necessary regulatory approvals could be delayed or prevented.
We may not be able to initiate
or continue clinical trials for CORDStrom, INKmune our DN-TNF product platform or any other product candidate if we are unable to locate
and enroll a sufficient number of eligible patients to participate in clinical trials. Patient enrollment is a significant factor in the
timing of clinical trials, and is affected by many factors, including:
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the size and nature of the patient population;
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the severity of the disease under investigation;
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the proximity of patients to clinical sites;
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the eligibility criteria for the trial;
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the design of the clinical trial;
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efforts to facilitate timely enrollment;
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competing clinical trials; and
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clinicians’ and patients’ perceptions as to the potential advantages and risks of the drug being studied in relation to other available therapies, including any new drugs that may be approved for the indications we are investigating.
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Our inability to enroll a
sufficient number of patients for our clinical trials could result in significant delays or may require us to abandon one or more clinical
trials altogether. Enrollment delays in our clinical trials may result in increased development costs for our product candidates, delay
or halt the development of and approval processes for our product candidates and jeopardize our ability to achieve our clinical development
timeline and goals, including the dates by which we will commence, complete and receive results from clinical trials. Enrollment delays
may also delay or jeopardize our ability to commence sales and generate revenues from our product candidates. Any of the foregoing could
cause the value of the Company to decline and limit our ability to obtain additional financing, if needed.
We will need to obtain FDA approval of any
proposed product brand names, and any failure or delay associated with such approval may adversely impact our business.
A pharmaceutical product cannot
be marketed in the U.S. or other countries until we have completed rigorous and extensive regulatory review processes, including approval
of a brand name. Any brand names we intend to use for our product candidates will require approval from the FDA regardless of whether
we have secured a formal trademark registration from the U.S. Patent and Trademark Office, or the USPTO. The FDA typically conducts a
review of proposed product brand names, including an evaluation of potential for confusion with other product names. The FDA may also
object to a product brand name if it believes the name inappropriately implies medical claims. If the FDA objects to any of our proposed
product brand names, we may be required to adopt an alternative brand name for our product candidates. If we adopt an alternative brand
name, we will lose the benefit of our existing trademark applications for such product candidate and may be required to expend significant
additional resources in an effort to identify a suitable product brand name that would qualify under applicable trademark laws, not infringe
the existing rights of third parties and be acceptable to the FDA. We may be unable to build a successful brand identity for a new trademark
in a timely manner or at all, which would limit our ability to commercialize our product candidates.
37
We may fail to comply with regulatory requirements .
Our success will be dependent
upon our ability, and our collaborative partners’ abilities, to maintain compliance with regulatory requirements, including cGMP,
and safety reporting obligations. The failure to comply with applicable regulatory requirements can result in, among other things, fines,
injunctions, civil penalties, total or partial suspension of regulatory approvals, refusal to approve pending applications, recalls or
seizures of products, operating and production restrictions and criminal prosecutions.
Even if our product candidates receive marketing
approval, they may fail to achieve the degree of market acceptance by physicians, patients, third-party payors and others in the medical
community necessary for commercial success and the market opportunity for the product candidates may be smaller than we estimate.
We have never commercialized
a product. Even if CORDStrom, INKmune, our DN-TNF product platform (INB03 or XPro), or any other product candidate we develop is approved
by the appropriate regulatory authorities for marketing and sale, it may nonetheless fail to gain sufficient market acceptance by physicians,
patients, third-party payors and others in the medical community. For example, physicians are often reluctant to switch their patients
from existing therapies even when new and potentially more effective or convenient treatments enter the market. Further, patients often
acclimate to the therapy that they are currently taking and do not want to switch unless their physicians recommend switching products
or they are required to switch therapies due to lack of reimbursement for existing therapies.
Efforts to educate the medical
community and third-party payors on the benefits of our product candidate may require significant resources and may not be successful.
If our product candidate is approved but does not achieve an adequate level of market acceptance, we may not generate significant revenues
and we may not become profitable. The degree of market acceptance of INmune or any other product candidate we develop, if approved for
commercial sale, will depend on a number of factors, including:
●
the efficacy and safety of the product;
●
the potential advantages of the product compared to alternative treatments;
●
the prevalence and severity of any side effects;
●
the clinical indications for which the product is approved;
●
whether the product is designated under physician treatment guidelines as a first-line therapy or as a second- or third-line therapy;
●
limitations or warnings, including distribution or use restrictions, contained in the product’s approved labeling;
●
our ability to offer the product for sale at competitive prices;
●
our ability to establish and maintain pricing sufficient to realize a meaningful return on our investment;
●
the product’s convenience and ease of administration compared to alternative treatments;
38
●
the willingness of the target patient population to try, and of physicians to prescribe, the product;
●
the strength of sales, marketing and distribution support;
●
the approval of other new products for the same indications;
●
changes in the standard of care for the targeted indications for the product;
●
the timing of market introduction of our approved products as well as competitive products and other therapies;
●
availability and amount of reimbursement from government payors, managed care plans and other third-party payors;
●
adverse publicity about the product or favorable publicity about competitive products; and
●
potential product liability claims.
The potential market opportunities
for our product candidate are difficult to estimate precisely. Our estimates of the potential market opportunities are predicated on many
assumptions, including industry knowledge and publications, third-party research reports and other surveys. While we believe that our
internal assumptions are reasonable, these assumptions involve the exercise of significant judgment on the part of our management, are
inherently uncertain and the reasonableness of these assumptions has not been assessed by an independent source. If any of the assumptions
prove to be inaccurate, the actual markets for our product candidate could be smaller than our estimates of the potential market opportunities.
Even if we obtain regulatory approvals for
CORDStrom, INKmune and/or any product from our DN-TNF platform those approvals and ongoing regulation of our products may limit how we
manufacture and market our products, which could prevent us from realizing the full benefit of our efforts.
If we obtain regulatory approvals,
CORDStrom, INKmune and/or the DN-TNF product platform, and the manufacturing facilities used for its production will be subject to continual
review, including periodic inspections, by the FDA and other United States and foreign regulatory authorities. In addition, regulatory
authorities may impose significant restrictions on the indicated uses or marketing of INKmune or other products that we may develop. These
and other factors may significantly restrict our ability to successfully commercialize INKmune.
We and many of our vendors
and suppliers will be required to comply with current Good Manufacturing Practices, or GMP, which include requirements relating to quality
control and quality assurance as well as to the corresponding maintenance of records and documentation. Furthermore, any manufacturing
facilities will need to be approved by regulatory agencies before these facilities can be used to manufacture, and they will also be subject
to additional regulatory inspections. Any material changes we may make to our manufacturing process may require approval by the FDA and
state or foreign regulatory authorities. Failure to comply with FDA or other applicable regulatory requirements may result in criminal
prosecution, civil penalties, recall or seizure of products, partial or total suspension of production or withdrawal of a product from
the market.
We must also report adverse
events that occur when our products are used. The discovery of previously unknown problems with CORDStrom, INKmune, the DN-TNF product
platform or manufacturing facilities used to manufacture CORDStrom, INKmune, or the DN-TNF product platform may result in restrictions
or sanctions on our products or manufacturing facilities, including withdrawal of our products from the market. Regulatory agencies may
also require us to reformulate our products, conduct additional clinical trials, make changes in the labeling of our product or obtain
re-approvals. This may cause our reputation in the marketplace to suffer or subject us to lawsuits, including class action suits.
39
If our product candidates receive marketing
approval and we, or others, later discover that the drug is less effective than previously believed or causes undesirable side effects
that were not previously identified, our ability to market the drugs could be compromised.
Clinical trials of our product
candidates will be conducted in carefully defined subsets of patients who have agreed to enter into clinical trials. Consequently, it
is possible that our clinical trials may indicate an apparent positive effect of a product candidate that is greater than the actual positive
effect, if any, or alternatively fail to identify undesirable side effects. If, following approval of our product candidate, we, or others,
discover that the drug is less effective than previously believed or causes undesirable side effects that were not previously identified,
any of the following adverse events could occur:
●
regulatory authorities may withdraw their approval of the drug or seize the drug;
●
we may be required to recall the drug or change the way the drug is administered;
●
additional restrictions may be imposed on the marketing of, or the manufacturing processes for, the particular drug;
●
we may be subject to fines, injunctions or the imposition of civil or criminal penalties;
●
regulatory authorities may require the addition of labeling statements, such as a “black box” warning or a contraindication;
●
we may be required to create a Medication Guide outlining the risks of the previously unidentified side effects for distribution to patients;
●
we could be sued and held liable for harm caused to patients;
●
the drug may become less competitive; and
●
our reputation may suffer.
Any of these events could
have a material and adverse effect on our operations and business.
Any product candidate for which we obtain
marketing approval, along with the manufacturing processes, qualification testing, post-approval clinical data, labeling and promotional
activities for such product, will be subject to continual and additional requirements of the FDA and other regulatory authorities.
These requirements include
submissions of safety and other post-marketing information, reports, registration and listing requirements, good manufacturing practices,
or GMP requirements relating to quality control, quality assurance and corresponding maintenance of records and documents, and recordkeeping.
Even if marketing approval of our product candidate is granted, the approval may be subject to limitations on the indicated uses for which
the product may be marketed or to conditions of approval or contain requirements for costly post-marketing testing and surveillance to
monitor the safety or efficacy of the product. The FDA closely regulates the post-approval marketing and promotion of pharmaceutical products
to ensure such products are marketed only for the approved indications and in accordance with the provisions of the approved labeling.
In addition, later discovery
of previously unknown problems with our products, manufacturing processes, or failure to comply with regulatory requirements, may lead
to various adverse results, including:
●
restrictions on such products, manufacturers or manufacturing processes;
●
restrictions on the labeling or marketing of a product;
●
restrictions on product distribution or use;
40
●
requirements to conduct post-marketing clinical trials;
●
requirements to institute a risk evaluation mitigation strategy, or REMS, to monitor safety of the product post-approval;
●
warning letters issued by the FDA or other regulatory authorities;
●
withdrawal of the products from the market;
●
refusal to approve pending applications or supplements to approved applications that we submit;
●
recall of products, fines, restitution or disgorgement of profits or revenue;
●
suspension, revocation or withdrawal of marketing approvals;
●
refusal to permit the import or export of our products; and
●
injunctions or the imposition of civil or criminal penalties.
We currently have no marketing and sales
organization and have no experience in marketing products. If we are unable to establish marketing and sales capabilities or enter into
agreements with third parties to market and sell our product candidates, we may not be able to generate product revenue.
We currently have no sales,
marketing or distribution capabilities and have no experience as a company in marketing products. If we develop internal sales, marketing
and distribution organization, this will require significant capital expenditures, management resources and time, and we would have to
compete with other pharmaceutical and biotechnology companies to recruit, hire, train and retain marketing and sales personnel.
If we are unable or decide
not to establish internal sales, marketing and distribution capabilities, we expect to pursue collaborative arrangements regarding the
sales, marketing and distribution of our products. However, we may not be able to establish or maintain such collaborative arrangements,
or if we are able to do so, their sales forces may not be successful in marketing our products. Any revenue we receive would depend upon
the efforts of such third parties, which may not be successful. We may have little or no control over the sales, marketing and distribution
efforts of such third parties and our revenue from product sales may be lower than if we had commercialized our product candidates ourselves.
We also face competition in our search for third parties to assist us with the sales, marketing and distribution efforts of our product
candidates. There can be no assurance that we will be able to develop internal sales, marketing distribution capabilities or establish
or maintain relationships with third-party collaborators to commercialize any product in the United States or overseas.
We face substantial competition from other
pharmaceutical and biotechnology companies and our operating results may suffer if we fail to compete effectively.
The development and commercialization
of new drug products is highly competitive. We expect that we will face significant competition from major pharmaceutical companies, specialty
pharmaceutical companies and biotechnology companies worldwide with respect to our DN-TNF product platform, INKmune and any other of our
product candidates that we may seek to develop or commercialize in the future. Specifically, due to the large unmet medical need, global
demographics and relatively attractive reimbursement dynamics, the oncology market is fiercely competitive and there are a number of large
pharmaceutical and biotechnology companies that currently market and sell products or are pursuing the development of product candidates
for the treatment of cancer. Our competitors may succeed in developing, acquiring or licensing technologies and drug products that are
more effective, have fewer or more tolerable side effects or are less costly than any product candidates that we are currently developing
or that we may develop, which could render our product candidates obsolete and noncompetitive.
41
We rely on key personnel and, if we are
unable to retain or motivate key personnel or hire qualified personnel, we may not be able to grow effectively.
We are dependent on certain
members of our management, the loss of services of one or more of whom could materially adversely affect us. In particular, our success
depends to a significant extent upon the continued services of Dr. Raymond J. Tesi, our President and CEO. Dr. Tesi has overseen INmune
Bio since inception and provides leadership for our growth and operations strategy as well as being an inventor of our patents. Although
we have entered into an employment agreement with Dr. Tesi, if he were to nevertheless terminate his employment with us, the loss of the
services of Dr. Tesi, would have a material adverse effect on our growth, revenues, and prospective business. We are also highly dependent
on the other principal members of our management and scientific team. We are not aware of any present intention of any of our key personnel
to leave our company or to retire. The loss of any of our key personnel, or the inability to attract and retain qualified personnel, may
significantly delay or prevent the achievement of our research, development or business objectives and could materially adversely affect
our business, financial condition and results of operations.
Our ability to manage growth
effectively will require us to continue to implement and improve our management systems and to recruit and train new employees. There
can be no assurance that we will be able to successfully attract and retain skilled and experienced personnel.
Product liability lawsuits against us could
divert our resources, cause us to incur substantial liabilities and limit commercialization of any products that we may develop.
We face an inherent risk of
product liability claims as a result of the clinical testing of our product candidate despite obtaining appropriate informed consent from
our clinical trial participants. We will face an even greater risk if we commercially sell any product that we may develop. For example,
we may be sued if any product we develop allegedly causes injury or is found to be otherwise unsuitable during clinical testing, manufacturing,
marketing or sale. Any such product liability claims may include allegations of defects in manufacturing, defects in design, a failure
to warn of dangers inherent in the product, negligence, strict liability or a breach of warranties. Claims could also be asserted under
state consumer protection acts. If we cannot successfully defend ourselves against product liability claims, we may incur substantial
liabilities or be required to limit commercialization of our product candidate. Regardless of the merits or eventual outcome, liability
claims may result in:
●
decreased demand for our product candidate or products that we may develop;
●
injury to our reputation and significant negative media attention;
●
withdrawal of clinical trial participants;
●
significant costs to defend resulting litigation;
●
substantial monetary awards to trial participants or patients;
●
loss of revenue;
●
reduced resources of our management to pursue our business strategy; and
●
the inability to commercialize any products that we may develop.
Although we plan to maintain
general liability insurance, this insurance may not fully cover potential liabilities that we may incur. The cost of any product liability
litigation or other proceeding, even if resolved in our favor, could be substantial. In addition, insurance coverage is becoming increasingly
expensive. If we are unable to obtain or maintain sufficient insurance coverage at an acceptable cost or to otherwise protect against
potential product liability claims, it could prevent or inhibit the development and commercial production and sale of our product candidate,
which could adversely affect our business, financial condition, results of operations and prospects.
42
We will need to increase the size and capabilities
of our organization, and we may experience difficulties in managing this growth.
To execute our business plan,
we will need to rapidly add other management, accounting, regulatory, manufacturing and scientific staff. We currently have 13 full-time
employees in the United States, 9 full-time employees in the United Kingdom and retain the services of additional personnel on an independent
contractor basis. We will need to attract, retain and motivate a significant number of new additional managerial, operational, sales,
marketing, financial, and other personnel, as well as highly skilled scientific and medical personnel, and to expand our capabilities
to successfully pursue our research, development, manufacturing and commercialization efforts and secure collaborations to market and
distribute our products. This growth may strain our existing managerial, operational, financial and other resources. We also intend to
add personnel in our research and development and manufacturing departments as we expand our clinical trial and research capabilities.
Any inability to attract and retain qualified employees to enable our planned growth and establish additional capabilities or our failure
to manage our growth effectively could delay or curtail our product development and commercialization efforts and harm our business.
We are subject to a multitude of manufacturing risks, any of which
could substantially increase our costs and limit supply of our drug candidates.
The process of manufacturing
our drug candidates is complex, highly regulated and subject to several risks. For example, the process of manufacturing our drug candidates
is extremely susceptible to product loss due to contamination, equipment failure or improper installation or operation of equipment, or
vendor or operator error. Even minor deviations from normal manufacturing processes for any of our drug candidates could result in reduced
production yields, product defects and other supply disruptions. If microbial, viral, or other contaminations are discovered in our drug
candidates or in the manufacturing facilities in which our drug candidates are made, such manufacturing facilities may need to be closed
for an extended period of time to investigate and remedy the contamination. In addition, the manufacturing facilities in which our drug
candidates are made could be adversely affected by equipment failures, labor shortages, natural disasters, epidemics, pandemics, power
failures and numerous other factors.
In addition, any adverse developments
affecting manufacturing operations of our drug candidates may result in shipment delays, inventory shortages, lot failures, withdrawals
or recalls, or other interruptions in the supply of our drug candidates. We also may need to take inventory write-offs and incur other
charges and expenses for drug candidates that fail to meet specifications, undertake costly remediation efforts, or seek costlier manufacturing
alternatives.
We and our contract manufacturers are subject to significant regulation
with respect to manufacturing our drug candidates. The manufacturing facilities on which we rely may not continue to meet regulatory requirements.
All entities involved in the
preparation of therapeutics for clinical trials or commercial sale, including our existing contract manufacturers for our drug candidates,
are subject to extensive regulation. Components of a finished therapeutic product approved for commercial sale or used in late-stage clinical
trials must be manufactured in accordance with cGMP. These regulations govern manufacturing processes and procedures and the implementation
and operation of quality systems to control and assure the quality of investigational products and products approved for sale. Poor control
of production processes can lead to the introduction of contaminants or to inadvertent changes in the properties or stability of our drug
candidates that may not be detectable in final product testing. We or our contract manufacturers must supply all necessary documentation
in support of an NDA or marketing authorization application, or MAA, on a timely basis and must adhere to GLP and cGMP regulations enforced
by the FDA, EMA or comparable foreign authorities through their facilities inspection program. Some of our contract manufacturers may
not have produced a commercially approved pharmaceutical product and therefore may not have obtained the requisite regulatory authority
approvals to do so. The facilities and quality systems of some or all of our third-party contractors must pass a pre-approval inspection
for compliance with the applicable regulations as a condition of regulatory approval of our drug candidates or any of our other potential
products. In addition, the regulatory authorities may, at any time, audit or inspect a manufacturing facility involved with the preparation
of our drug candidates or any of our other potential products or the associated quality systems for compliance with the regulations applicable
to the activities being conducted. Although we oversee the contract manufacturers, we cannot control the manufacturing process of, and
are completely dependent on, our contract manufacturing partners for compliance with the regulatory requirements. If these facilities
do not pass a pre-approval plant inspection, regulatory approval of the products may not be granted or may be substantially delayed until
any violations are corrected to the satisfaction of the regulatory authority, if ever.
43
The regulatory authorities
also may, at any time following approval of a product for sale, audit the manufacturing facilities of our third-party contractors. If
any such inspection or audit identifies a failure to comply with applicable regulations or if a violation of our product specifications
or applicable regulations occurs independent of such an inspection or audit, we or the relevant regulatory authority may require remedial
measures that may be costly or time consuming for us or a third party to implement, and that may include the temporary or permanent suspension
of a clinical trial or commercial sales or the temporary or permanent closure of a facility. Any such remedial measures imposed upon us
or third parties with whom we contract could materially harm our business, financial condition and results of operations.
If we or any of our third-party manufacturers fail
to maintain regulatory compliance, the FDA, EMA or comparable foreign authorities can impose regulatory sanctions including, among other
things, refusal to approve a pending application for a drug candidate, withdrawal of an approval, or suspension of production. As a result,
our business, financial condition and results of operations may be materially and adversely affected.
Additionally, if supply from one manufacturer is
interrupted, an alternative manufacturer would need to be qualified through an NDA supplement or MAA variation, or equivalent foreign
regulatory filing, which could result in further delay. The regulatory agencies may also require additional studies or trials if a new
manufacturer is relied upon for commercial production. Switching manufacturers may involve substantial costs and is likely to result in
a delay in our desired clinical and commercial timelines.
These factors could cause us to incur higher costs
and could cause the delay or termination of clinical trials, regulatory submissions, required approvals, or commercialization of our drug
candidates. Furthermore, if our suppliers fail to meet contractual requirements and we are unable to secure one or more replacement suppliers
capable of production at a substantially equivalent cost, our clinical trials may be delayed, or we could lose potential revenue.
If we or our third-party manufacturers use
hazardous and biological materials in a manner that causes injury or violates applicable law, we may be liable for damages.
Our research and development
activities involve the controlled use of potentially hazardous substances, including chemical and biological materials, by us and any
third-party manufacturers. We and such manufacturers will be subject to federal, state and local laws and regulations in the United States
governing the use, manufacture, storage, handling and disposal of medical and hazardous materials. Although we will seek to ensure that
our procedures for using, storing and disposing of these materials comply with legally prescribed standards, we cannot completely eliminate
the risk of contamination or injury resulting from medical or hazardous materials. As a result of any such contamination or injury, we
may incur liability or local, city, state or federal authorities may curtail the use of these materials and interrupt our business operations.
In the event of an accident, we could be held liable for damages or penalized with fines, and the liability could exceed our resources.
We do not have any insurance for liabilities arising from medical or hazardous materials. Compliance with applicable environmental laws
and regulations is expensive, and current or future environmental regulations may impair our research, development and production efforts,
which could harm our business, prospects, financial condition or results of operations.
We plan to rely on third parties to conduct
clinical trials for our product candidates. Any failure by a third party to meet its obligations with respect to the clinical development
of our product candidate may delay or impair our ability to obtain regulatory approval for our product candidates.
We plan to rely on contract
research organizations to conduct clinical trials relating to our product candidates. Our reliance on third parties to conduct clinical
trials could, depending on the actions of such third parties, jeopardize the validity of the clinical data generated and adversely affect
our ability to obtain marketing approval from the FDA or other applicable regulatory authorities.
Such clinical trial arrangements
will provide us with information rights with respect to the clinical data, including access to and the ability to use and reference the
data, including for our own regulatory filings, resulting from the clinical trials. If investigators or institutions breach their obligations
with respect to the clinical trials of our product candidate, or if the data proves to be inadequate, then our ability to design and conduct
any future clinical trials may be adversely affected.
44
Our reliance on these third
parties for research and development activities will reduce our control over these activities but will not relieve us of our responsibilities.
For example, we will design our clinical trials and will remain responsible for ensuring that each of our clinical trials is conducted
in accordance with the general investigational plan and protocols for the trial. Moreover, the FDA requires us to comply with standards,
commonly referred to as good clinical practices, or GCPs, for conducting, recording and reporting the results of clinical trials to assure
that data and reported results are credible and accurate and that the rights, integrity and confidentiality of trial participants are
protected. Our reliance on third parties that we do not control will not relieve us of these responsibilities and requirements. We also
are required to register ongoing clinical trials and post the results of completed clinical trials on a government-sponsored database,
ClinicalTrials.gov, within specified timeframes. Failure to do so can result in fines, adverse publicity and civil and criminal sanctions.
Furthermore, these third parties
may also have relationships with other entities, some of which may be our competitors. If these third parties do not successfully carry
out their contractual duties, meet expected deadlines or conduct our clinical trials in accordance with regulatory requirements or our
stated protocols, we will not be able to obtain, or may be delayed in obtaining, marketing approvals for our product candidate and will
not be able to, or may be delayed in our efforts to, successfully commercialize our product candidate.
We also expect to rely on
other third parties to store and distribute drug supplies for our clinical trials. Any performance failure on the part of our distributors
could delay clinical development or marketing approval of our product candidate or commercialization of our products, producing additional
losses and depriving us of potential product revenue.
Current and future legislation may increase
the difficulty and cost of commercializing our drug candidates and may affect the prices we may obtain if our drug candidates are approved
for commercialization.
In the U.S. and some foreign
jurisdictions, there have been a number of adopted and proposed legislative and regulatory changes regarding the healthcare system that
could prevent or delay regulatory approval of our drug candidates, restrict or regulate post-marketing activities and affect our ability
to profitably sell any of our drug candidates for which we obtain regulatory approval.
In the U.S., the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003, or the MMA, changed the way Medicare covers and pays for pharmaceutical
products. Cost reduction initiatives and other provisions of this legislation could limit the coverage and reimbursement rate that we
receive for any of our approved products. While the MMA only applies to drug benefits for Medicare beneficiaries, private payors often
follow Medicare coverage policy and payment limitations in setting their own reimbursement rates. Therefore, any reduction in reimbursement
that results from the MMA may result in a similar reduction in payments from private payors.
In March 2010, the Patient
Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, collectively the PPACA, was
enacted. The PPACA was intended to broaden access to health insurance, reduce or constrain the growth of healthcare spending, enhance
remedies against healthcare fraud and abuse, add new transparency requirements for healthcare and health insurance industries, impose
new taxes and fees on the health industry and impose additional health policy reforms. The PPACA increased manufacturers’ rebate
liability under the Medicaid Drug Rebate Program by increasing the minimum rebate amount for both branded and generic drugs and revised
the definition of “average manufacturer price,” or AMP, which may also increase the amount of Medicaid drug rebates manufacturers
are required to pay to states. The legislation also expanded Medicaid drug rebates and created an alternative rebate formula for certain
new formulations of certain existing products that is intended to increase the rebates due on those drugs. The Centers for Medicare &
Medicaid Services, or CMS, which administers the Medicaid Drug Rebate Program, also has proposed to expand Medicaid rebates to the utilization
that occurs in the territories of the U.S., such as Puerto Rico and the Virgin Islands. Further, beginning in 2011, the PPACA imposed
a significant annual fee on companies that manufacture or import branded prescription drug products and required manufacturers to provide
a discount, equal to 70% off, effective as of 2019, the negotiated price of prescriptions filled by beneficiaries in the Medicare Part
D coverage gap, referred to as the “donut hole.” Legislative and regulatory proposals have been introduced at both the state
and federal level to expand post-approval requirements and restrict sales and promotional activities for pharmaceutical products.
45
Moreover, payment methodologies
may be subject to changes in healthcare legislation and regulatory initiatives. For example, CMS may develop new payment and delivery
models, such as bundled payment models. In addition, recently there has been heightened governmental scrutiny over the manner in which
manufacturers set prices for their marketed products, which has resulted in several U.S. Congressional inquiries and proposed and enacted
federal and state legislation designed to, among other things, bring more transparency to drug pricing, reduce the cost of prescription
drugs under government payor programs, and review the relationship between pricing and manufacturer patient programs. We also expect that
additional U.S. federal healthcare reform measures will be adopted in the future, any of which could limit the amounts that the U.S. federal
government will pay for healthcare products and services, which could result in reduced demand for our drug candidates, if approved for
commercialization.
In Europe, the United Kingdom
withdrew from the European Union on January 31, 2020, and entered into a transition period that expired on December 31, 2020. A significant
portion of the previous regulatory framework in the United Kingdom was derived from the regulations of the European Union. In 2021, the
United Kingdom’s Medicines and Healthcare products Regulatory Agency, or MHRA, and the European Medicines Agency, or EMA, released
guidance explaining the new regulatory framework. We cannot predict the consequences or impact that the new regulatory framework will
have on our future operations, if any, in these jurisdictions.
In addition, on August 16,
2022, President Biden signed into law the Inflation Reduction Act of 2022, which, among other things, includes policies that are designed
to have a direct impact on drug prices and reduce drug spending by the federal government, which shall take effect in 2023. Under the
Inflation Reduction Act, Congress authorized Medicare beginning in 2026 to negotiate lower prices for certain costly single-source drug
and biologic products that do not have competing generics or biosimilars. This provision is limited in terms of the number of pharmaceuticals
whose prices can be negotiated in any given year and it only applies to drug products that have been approved for at least 9 years and
biologics that have been licensed for 13 years. Drugs and biologics that have been approved for a single rare disease or condition are
categorically excluded from price negotiation. Further, the new legislation provides that if pharmaceutical companies raise prices in
Medicare faster than the rate of inflation, they must pay rebates back to the government for the difference. The new law also caps Medicare
out-of-pocket drug costs at an estimated $4,000 a year in 2024 and, thereafter beginning in 2025, at $2,000 a year.
Government regulations could impact
our ability to price our products
U.S. and international governmental
regulations that mandate price controls or limitations on patient access to our drugs under development, create coverage criteria or establish
prices paid by government entities or programs for our potential products could impact our business, and our future results could be adversely
affected by changes in such regulations or policies. In addition to the recent expansion of price controls in the U.S. in the IRA, the
adoption of restrictive coverage policies and price controls in new jurisdictions, more restrictive controls in existing jurisdictions
or the failure to obtain or maintain timely or adequate coverage and pricing could also adversely impact future revenue. We expect pricing
pressures and other cost containment measures for drugs and vaccines will continue globally.
In the U.S., pharmaceutical
product pricing is subject to government and public scrutiny and calls for reform, and many of our products are subject to increasing
pricing pressures as a result. We expect to see continued focus by the U.S. Congress and the Biden Administration on regulating pricing
and access to medicine. For example, in August 2022, the drug pricing provisions of the IRA were signed into law, which, among other things,
require manufacturers of certain drugs to engage in price negotiations with Medicare which will permit the CMS to set a maximum fair price
for selected drugs, impose rebates under Medicare Part B and Medicare Part D to penalize price increases that outpace inflation, and replace
the Part D coverage gap discount program with a new discounting program. The drug pricing provisions of the IRA began to be implemented
in 2022 and implementation efforts are expected to continue over the next several years. In August 2023, the Biden Administration unveiled
the first round of medicines subject to the Medicare Drug Pricing Negotiation Program. Health plans may also require rebates in addition
to the maximum fair price for preferred placement on a Medicare plan formulary. The Medicare Drug Price Negotiation Program is currently
subject to legal challenges and therefore, the outcome of the 340B Program remains uncertain.
46
Payors may promote generic
drugs and biosimilars more aggressively to generate savings and attempt to stimulate additional price competition. In addition, we expect
that consolidation and integration among pharmacy chains, wholesalers and PBMs will increase pricing pressures in the industry. Some states
have implemented, and others are considering, patient access constraints or cost cutting under state regulated programs including the
Medicaid program. State legislatures also have continued to focus on addressing drug costs, generally by increasing price transparency
or attempting to limit drug price increases for state regulated insurance. Measures to regulate prices or payment for pharmaceutical products,
including legislation on drug importation, such as Florida’s drug importation program which was recently approved by the FDA, could
adversely affect our business.
We may encounter similar regulatory
and legislative issues in other countries in which we may operate. In certain markets, such as in EU member states, the U.K., Japan, China,
Canada and South Korea, governments have significant power as large single payors to regulate prices, access criteria, or impose other
means of cost control, particularly as a result of recent global financing pressures.
Deterioration in general economic conditions
in the United States, Canada and globally, including the effect of prolonged periods of inflation on our suppliers, third-party
service providers and potential partners, could harm our business and results of operations.
Our business and results of
operations could be adversely affected by changes in national or global economic conditions. These conditions include but are not limited
to inflation, rising interest rates, availability of capital markets, energy availability and costs, the negative impacts caused
by pandemics and public health crises, negative impacts resulting from the military conflict between Russia and the Ukraine, and the effects
of governmental initiatives to manage economic conditions. Impacts of such conditions could be passed on to our business in the form of
higher costs for labor and materials, higher investigator fees, possible reductions in pharmaceutical industry-wide spending on research
and development and acquisitions and higher costs of capital.
Public health threats could have an
adverse effect on our operations and financial results.
Public health threats, such
as the novel coronavirus (COVID-19), influenza and other highly communicable diseases or viruses could adversely impact our operations
and disrupt our ongoing or planned research and development activities. We cannot presently predict the scope and severity of any potential
future business shutdowns or disruptions, but if we or any of the third parties with whom we engage, including the suppliers, clinical
trial sites, regulators and other third parties with whom we conduct business, were to experience shutdowns or other business disruptions,
our ability to conduct our business in the manner and on the timelines presently planned could be materially and negatively impacted.
We are exposed to risks related to currency
exchange rates.
We conduct a significant portion
of our operations outside of the United States. Because our financial statements are presented in U.S. dollars, changes in currency exchange
rates have had and could have in the future a significant effect on our operating results when our operating results are translated into
U.S. dollars.
Our employees,
principal investigators, consultants and commercial partners may engage in misconduct or other improper activities, including noncompliance
with regulatory standards and requirements and insider trading, which could cause significant liability for us and harm our reputation.
We are exposed to the risk
of fraud or other misconduct by our employees, principal investigators, consultants and collaborators, including intentional failures
to comply with FDA or Office of Inspector General regulations or similar regulations of comparable non-U.S. regulatory authorities, provide
accurate information to the FDA or comparable non-U.S. regulatory authorities, comply with manufacturing standards we have established,
comply with federal and state healthcare fraud and abuse laws and regulations and similar laws and regulations established and enforced
by comparable non-U.S. regulatory authorities, report financial information or data accurately or disclose unauthorized activities to
us. Misconduct by these parties could also involve the improper use of information obtained in the course of clinical trials, which could
result in regulatory sanctions and serious harm to our reputation. It is not always possible to identify and deter misconduct, and the
precautions we take to detect and prevent this activity may not be effective in controlling unknown or unmanaged risks or losses or in
protecting us from governmental investigations or other actions or lawsuits stemming from a failure to be in compliance with such laws,
standards or regulations. Such actions could have a significant impact on our business and results of operations, including the imposition
of significant fines or other sanctions.
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A cybersecurity incident and other technological
disruptions could negatively affect our business and our relationships with customers.
We use technology in substantially
all aspects of our business operations. The widespread use of technology, including mobile devices, cloud computing, and the internet,
gives rise to cybersecurity risks, including security breach, espionage, system disruption, theft and inadvertent release of information.
Our business involves the storage and transmission of numerous classes of sensitive and/or confidential information and intellectual property,
including information relating to suppliers, private information about employees, and financial and strategic information about us and
our business partners. If we fail to effectively assess and identify cybersecurity risks associated with the use of technology in our
business operations, we may become increasingly vulnerable to such risks. Additionally, while we have implemented measures to prevent
security breaches and cyber incidents, our preventative measures and incident response efforts may not be entirely effective. The theft,
destruction, loss, misappropriation, or release of sensitive and/or confidential information or intellectual property, or interference
with our information technology systems or the technology systems of third parties on which we rely, could result in business disruption,
negative publicity, brand damage, violation of privacy laws, loss of customers, potential liability and competitive disadvantage.
Use of social media platforms presents
new risks.
We believe that our potential
patient population is active on social media. Social media practices in the pharmaceutical and biotechnology industries are evolving,
which creates uncertainty and risk of noncompliance with regulations applicable to our business. For example, patients may use social
media platforms to comment on the effectiveness of, or adverse experiences with, a product candidate, which could result in reporting
obligations. In addition, there is a risk of inappropriate disclosure of sensitive information or negative or inaccurate posts or comments
about us or our product candidates on any social networking website. In addition, our employees or third parties with whom we contract,
such as our CROs or CMOs, may knowingly or inadvertently make use of social media in a manner that may give rise to liability, lead to
the loss of trade secrets or other intellectual property or result in public exposure of personal information of our employees, clinical
trial patients, customers and others or information regarding our product candidates or clinical trials. Any of these events could have
a material adverse effect on our business, prospects, operating results and financial condition and could adversely affect the price of
our common shares.
Risks Related to our Intellectual Property
We depend on obtaining certain patents and
protecting our proprietary rights.
Our success will depend, in
part, on our ability to obtain patents, maintain trade secret protection and operate without infringing on the proprietary rights of third
parties or having third parties circumvent our rights. We have filed and are actively pursuing a patent application for our product candidates.
The patent positions of biotechnology, biopharmaceutical and pharmaceutical companies can be highly uncertain and involve complex legal
and factual questions. Thus, there can be no assurance that our patent application will result in the issuance of a patent, that we will
develop additional proprietary products that are patentable, that any patents issued to us will provide us with any competitive advantages
or will not be challenged by any third parties, that the patents of others will not impede our ability to do business or that third parties
will not be able to circumvent our patents. Furthermore, there can be no assurance that others will not independently develop similar
products, duplicate any of our products not under patent protection, or, if patents are issued to us, design around the patented products
we developed or will develop.
We may be required to obtain
licenses from third parties to avoid infringing patents or other proprietary rights. No assurance can be given that any licenses required
under any such patents or proprietary rights would be made available, if at all, on terms we find acceptable. If we do not obtain such
licenses, we could encounter delays in the introduction of products or could find that the development, manufacture or sale of products
requiring such licenses could be prohibited.
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A number of pharmaceutical,
biopharmaceutical and biotechnology companies and research and academic institutions have developed technologies, filed patent applications
or received patents on various technologies that may be related to or affect our business. Some of these technologies, applications or
patents may conflict with our technologies or patent applications. Such conflict could limit the scope of the patents, if any, that we
may be able to obtain or result in the denial of our patent applications. In addition, if patents that cover our activities are issued
to other companies, there can be no assurance that we would be able to obtain licenses to these patents at a reasonable cost or be able
to develop or obtain alternative technology. If we do not obtain such licenses, we could encounter delays in the introduction of products,
or could find that the development, manufacture or sale of products requiring such licenses could be prohibited. In addition, we could
incur substantial costs in defending ourselves in suits brought against us on patents it might infringe or in filing suits against others
to have such patents declared invalid.
Much of our know-how and technology
may not be patentable. To protect our rights, we plan to require employees, consultants, advisors and collaborators to enter into confidentiality
agreements. There can be no assurance, however, that these agreements will provide meaningful protection for our trade secrets, know-how
or other proprietary information in the event of any unauthorized use or disclosure. Further, our business may be adversely affected by
competitors who independently develop competing technologies, especially if we obtain no, or only narrow, patent protection.
If we fail to protect our intellectual property
rights, our ability to pursue the development of our technologies and products would be negatively affected.
Our success will depend, in
part, on our ability to obtain patents and maintain adequate protection of our technologies and products. If we do not adequately protect
our intellectual property, competitors may be able to use our technologies to produce and market drugs in direct competition with us and
erode our competitive advantage. Some foreign countries lack rules and methods for defending intellectual property rights and do not protect
proprietary rights to the same extent as the United States. Many companies have had difficulty protecting their proprietary rights in
these foreign countries. We may not be able to prevent misappropriation of our proprietary rights.
We have received, and are
currently seeking, patent protection for numerous compounds and methods of treating diseases. However, the patent process is subject to
numerous risks and uncertainties, and there can be no assurance that we will be successful in protecting our products by obtaining and
defending patents. These risks and uncertainties include the following: patents that may be issued or licensed may be challenged, invalidated,
or circumvented, or otherwise may not provide any competitive advantage; our competitors, many of which have substantially greater resources
than us and many of which have made significant investments in competing technologies, may seek, or may already have obtained, patents
that will limit, interfere with, or eliminate our ability to make, use, and sell our potential products either in the United States or
in international markets; there may be significant pressure on the United States government and other international governmental bodies
to limit the scope of patent protection both inside and outside the United States for treatments that prove successful as a matter of
public policy regarding worldwide health concerns; countries other than the United States may have less restrictive patent laws than those
upheld by United States courts, allowing foreign competitors the ability to exploit these laws to create, develop, and market competing
products.
Moreover, any patents issued
to us may not provide us with meaningful protection, or others may challenge, circumvent or narrow our patents. Third parties may also
independently develop products similar to our products, duplicate our unpatented products or design around any patents on products we
develop. Additionally, extensive time is required for development, testing and regulatory review of a potential product. While extensions
of patent term due to regulatory delays may be available, it is possible that, before any of our product candidates can be commercialized,
any related patent, even with an extension, may expire or remain in force for only a short period following commercialization, thereby
reducing any advantages of the patent.
In addition, the United States
Patent and Trademark Office (the “USPTO”) and patent offices in other jurisdictions have often required that patent applications
concerning pharmaceutical and/or biotechnology-related inventions be limited or narrowed substantially to cover only the specific innovations
exemplified in the patent application, thereby limiting the scope of protection against competitive challenges. Thus, even if we or our
licensors are able to obtain patents, the patents may be substantially narrower than anticipated.
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Our success depends on patent
applications that are licensed exclusively to us and other patents to which we may obtain assignment or licenses. We may not be aware,
however, of all patents, published applications or published literature that may affect our business either by blocking our ability to
commercialize our product candidates, by preventing the patentability of our product candidates to us or our licensors, or by covering
the same or similar technologies that may invalidate our patents, limit the scope of our future patent claims or adversely affect our
ability to market our product candidates.
In addition to patents, we
rely on a combination of trade secrets, confidentiality, nondisclosure and other contractual provisions, and security measures to protect
our confidential and proprietary information. These measures may not adequately protect our trade secrets or other proprietary information.
If they do not adequately protect our rights, third parties could use our technology, and we could lose any competitive advantage we may
have. In addition, others may independently develop similar proprietary information or techniques or otherwise gain access to our trade
secrets, which could impair any competitive advantage we may have.
Patent protection and other
intellectual property protection is crucial to the success of our business and prospects, and there is a substantial risk that such protections
will prove inadequate.
By working with research collaborators
patent rights may be jointly owned by different parties.
Certain
of our licensors may have relied on third-party consultants or collaborators such that our licensors are not the sole and exclusive owners
of the patents we in-licensed. If other third parties have ownership rights to our in-licensed patents, the license granted to us for
such jointly owned patents may not be valid. Absent an agreement, each joint owner can independently sell, license, or otherwise exploit
the jointly owned patent without the approval of the other joint owner(s) and without having to account to each other for their revenues.
Without the cooperation of all joint owners, none can grant an exclusive license to a third party. Further, a jointly owned patent cannot
be enforced unless all of the owners join in the lawsuit. If a co-owner refuses to participate, the lawsuit cannot proceed. Certain of
our in-licensed patents from Xencor show joint ownership between Xencor and a third party. Xencor provided representations and warrants
as to its ability to grant the rights provided in the license. In addition, Xencor is required to indemnify us as to any breach of its
representations, warranties and covenants made in the agreement.
Further,
our rights to current or future in-licensed patents and patent applications may be dependent, in part, on inter-institutional or other
operating agreements between the joint owners of such in-licensed patents and patent applications. If one or more of such joint owners
breaches such inter-institutional or operating agreements, our rights to such in-licensed patents and patent applications may be adversely
affected. Any of these events could have a material adverse effect on our competitive position, business, financial conditions, results
of operations, and prospects.
Intellectual property discovered through
government funded programs may be subject to federal regulations such as “march-in” rights, certain reporting requirements
and a preference for U.S.-based companies. Compliance with such regulations may limit our exclusive rights and limit our ability to contract
with non-U.S. manufacturers.
Certain
in-licensed patents (i.e. those from the University of Pittsburgh) were supported through the use of U.S. government funding. Pursuant
to the Bayh-Dole Act of 1980, the U.S. government has certain rights in inventions developed with government funding. These U.S. government
rights include a non-exclusive, non-transferable, irrevocable worldwide license to use inventions for any governmental purpose. In addition,
the U.S. government has the right, under certain limited circumstances, to require us to grant exclusive, partially exclusive, or non-exclusive
licenses to any of these inventions to a third party if it determines that: (1) adequate steps have not been taken to commercialize the
invention; (2) government action is necessary to meet public health or safety needs; or (3) government action is necessary to meet requirements
for public use under federal regulations (also referred to as march-in rights). If the U.S. government exercised its march-in rights in
our current or future intellectual property rights that are generated through the use of U.S. government funding or grants, we could be
forced to license or sublicense intellectual property developed by us or that we license on terms unfavorable to us, and there can be
no assurance that we would receive compensation from the U.S. government for the exercise of such rights. The U.S. government also has
the right to take title to these inventions if the grant recipient fails to disclose the invention to the government or fails to file
an application to register the intellectual property within specified time limits. Intellectual property generated under a government
funded program is also subject to certain reporting requirements, compliance with which may require us to expend substantial resources.
In addition, the U.S. government requires that any products embodying any of these inventions or produced through the use of any of these
inventions be manufactured substantially in the United States. This preference for U.S. industry may be waived by the federal agency that
provided the funding if the owner or assignee of the intellectual property can show that reasonable but unsuccessful efforts have been
made to grant licenses on similar terms to potential licensees that would be likely to manufacture substantially in the United States
or that under the circumstances domestic manufacture is not commercially feasible. This preference for U.S. industry may limit our ability
to contract with non-U.S. product manufacturers for products covered by such intellectual property.
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We license our patents from others. If such
owners do not properly maintain or enforce the intellectual property underlying such licenses, our competitive position and business prospects
could be harmed. Our licensors may also seek to terminate our license.
We are a party to a number of licenses that give us rights to third-party
intellectual property that is necessary or useful to our business. To this end, we are dependent on our licenses with Xencor, Inc., Immune
Ventures, LLC, the University of Pittsburgh and GOSH. Our success will depend in part on the ability of our licensors to obtain, maintain
and enforce our licensed intellectual property. Our licensors may not successfully prosecute any applications for or maintain intellectual
property to which we have licenses, may determine not to pursue litigation against other companies that are infringing such intellectual
property, or may pursue such litigation less aggressively than we would. Without protection for the intellectual property we license,
other companies might be able to offer similar products for sale, which could adversely affect our competitive business position and harm
our business prospects. If we lose any of our right to use third-party intellectual property, it could adversely affect our ability to
commercialize our technologies, products or services, as well as harm our competitive business position and our business prospects.
We are dependent on our licensing agreement
with Xencor, and the termination of this agreement would harm our business.
On October 3, 2017, the Company
entered into a license agreement with Xencor, Inc., which has discovered and developed a proprietary biological molecule that inhibits
soluble tumor necrosis factor. Pursuant to the license agreement, Xencor granted the Company an exclusive worldwide, royalty-bearing license
in licensed patent rights, licensed know-how and licensed materials to make, develop, use, sell and import any pharmaceutical product
that comprises, contains, or incorporates Xencor’s proprietary protein known as XPro that inhibits soluble tumor necrosis factor
(or all modifications, formulations and variants of the licensed protein that specifically bind soluble tumor necrosis factor) alone or
in combination with one or more active ingredients, in any dosage or formulation. If we breach this Agreement, Xencor may be able to terminate
it, which would harm our business.
Our officers and Chairman of the Board own
the company that we license our INKmune patent from.
On October 29, 2015, we entered
into an exclusive license agreement with Immune Ventures, LLC (Immune Ventures). The license agreement relates to our natural killer program,
INKmune. Immune Ventures is owned by our RJ Tesi, our CEO and Chairman of the Board of Directors, David Moss, our Chief Financial Officer
and Treasurer and Mark Lowdell, our Chief Scientific Officer. Because our officers and directors also own Immune Ventures there may be
an inherent conflict of interest which could result in unanticipated actions that adversely affect us.
Changes in U.S. patent law could diminish
the value of patents in general, thereby impairing our ability to protect our products.
As is the case with other
biopharmaceutical companies, our success is heavily dependent on intellectual property, particularly patents. Obtaining and enforcing
patents in the biopharmaceutical industry involves both technological and legal complexity and is costly, time-consuming and inherently
uncertain. For example, on September 16, 2011, the Leahy-Smith America Invents Act, or the Leahy-Smith Act, was signed into law. The Leahy-Smith
Act included a number of significant changes to U.S. patent law, including provisions that affect the way patent applications will be
prosecuted and that may also affect patent litigation. In particular, under the Leahy-Smith Act, the United States transitioned in March
2013 to a “first to file” system in which the first inventor to file a patent application is typically entitled to the patent.
Third parties are allowed to submit prior art before the issuance of a patent by the USPTO, and may become involved in post-grant proceedings,
including opposition, derivation, reexamination, inter partes review or interference proceedings challenging our patent rights or the
patent rights of others. An adverse determination in any such submission, proceeding or litigation could reduce the scope or enforceability
of, or invalidate, our patent rights, which could adversely affect our competitive position.
In addition, the U.S. Supreme
Court has ruled on several patent cases in recent years, either narrowing the scope of patent protection available in certain circumstances
or weakening the rights of patent owners in certain situations. In addition to increasing uncertainty with regard to our ability to obtain
patents in the future, this combination of events has created uncertainty with respect to the value of patents, once obtained. Depending
on decisions by the U.S. Congress, the federal courts and the USPTO, the laws and regulations governing patents could change in unpredictable
ways that would weaken our ability to obtain new patents or to enforce patents that we might obtain in the future.
Similarly, changes in patent
law and regulations in other countries or jurisdictions or changes in the governmental bodies that enforce them or changes in how the
relevant governmental authority enforces patent laws or regulations may weaken our ability to obtain new patents or to enforce patents
that we have licensed or that we may obtain in the future. For example, the complexity and uncertainty of European patent laws have also
increased in recent years. In Europe, in June 2023, a new unitary patent system was introduced, which will significantly impact European
patents, including those granted before the introduction of the system. Under the unitary patent system, after a European patent is granted,
the patent proprietor can request unitary effect, thereby getting a European patent with unitary Effect, or a Unitary Patent. Each Unitary
Patent is subject to the jurisdiction of the Unitary Patent Court, or the UPC. As the UPC is a new court system, there is no precedent
for the court, increasing the uncertainty of any litigation. Patents granted before the implementation of the UPC will have the option
of opting out of the jurisdiction of the UPC and remaining as national patents in the UPC countries. Patents that remain under the jurisdiction
of the UPC may be potentially vulnerable to a single UPC-based revocation challenge that, if successful, could invalidate the patent in
all countries who are signatories to the UPC. We cannot predict with certainty the long-term effects of the new unitary patent system.
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Risks Related to our Common Stock
We do not intend to pay dividends for the
foreseeable future.
We have paid no dividends
on our common stock to date, and we do not anticipate paying any dividends to holders of our common stock in the foreseeable future. While
our future dividend policy will be based on the operating results and capital needs of the business, we anticipate that we will retain
any earnings to finance our future expansion and for the implementation of our business plan. As an investor, you should take note of
the fact that a lack of a dividend can further affect the market value of our common stock and could significantly affect the value of
any investment in our Company.
We are subject to the reporting requirements
of federal securities laws, which can be expensive and may divert resources from other projects, thus impairing our ability grow.
We are a public reporting
company and, accordingly, subject to the information and reporting requirements of the Exchange Act and other federal securities laws,
including compliance with the Sarbanes-Oxley Act of 2002 (the “Sarbanes-Oxley Act”). The costs of preparing and filing annual
and quarterly reports, proxy statements and other information with the SEC and furnishing audited reports to stockholders would cause
our expenses to be higher than they would be if we remained privately held.
It may be time consuming,
difficult and costly for us to develop and implement the internal controls and reporting procedures required by the Sarbanes-Oxley Act.
We may need to hire additional financial reporting, internal controls and other finance personnel in order to develop and implement appropriate
internal controls and reporting procedures.
Our stock price may be volatile.
The market price of our common
stock is likely to be highly volatile and could fluctuate widely in price in response to various factors, many of which are beyond our
control, including the following:
●
changes in our industry;
●
competitive pricing pressures;
●
our ability to obtain working capital financing;
●
additions or departures of key personnel;
●
limited “public float” in the hands of a small number of persons whose sales or lack of sales could result in positive or negative pricing pressure on the market price for our common stock;
●
sales of our common stock;
●
our ability to execute our business plan;
●
operating results that fall below expectations;
●
loss of any strategic relationship;
●
regulatory developments;
●
economic and other external factors;
●
period-to-period fluctuations in our financial results; and
●
inability to develop or acquire new or needed technology or products.
In addition, the securities
markets have from time-to-time experienced significant price and volume fluctuations that are unrelated to the operating performance of
particular companies. These market fluctuations may also materially and adversely affect the market price of our Common Stock.
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You may have difficulty trading and obtaining
quotations for our common stock.
Our securities are not actively
traded, and the bid and asked prices for our common stock may fluctuate widely. As a result, investors may find it difficult to dispose
of, or to obtain accurate quotations of the price of, our securities. This severely limits the liquidity of the common stock and would
likely reduce the market price of our common stock and hamper our ability to raise additional capital. There is a limited market for our
securities. Accordingly, investors may therefore bear the economic risk of an investment in our securities for an indefinite period of
time.
Additional stock offerings in the future
may dilute your percentage ownership of our company.
Given our plans and expectations
that we may need additional capital and personnel, we may need to issue additional shares of common stock or securities convertible or
exercisable for shares of common stock, including convertible preferred stock, convertible notes, stock options or warrants. The issuance
of additional securities in the future will dilute the percentage ownership of then current stockholders.
Our internal control over financial reporting may not
meet the standards required by Section 404 of the Sarbanes-Oxley Act, and failure to achieve and maintain effective internal control
over financial reporting in accordance with Section 404 of the Sarbanes-Oxley Act, could have a material adverse effect on our business
and share price.
Our management is currently required to report on the effectiveness of our internal control over financial
reporting. However, as a smaller reporting company and a non-accelerated filer, our independent registered public accounting firm will
not be required to attest to the effectiveness of our internal control over financial reporting pursuant to Section 404 for as long as
we are not deemed an “accelerated filer” or “large accelerated filer.” The rules governing the standards that
must be met for our management to assess our internal control over financial reporting are complex and require significant documentation,
testing and possible remediation.
In connection with
the implementation of the necessary procedures and practices related to internal control over financial reporting, we may identify deficiencies
or material weaknesses that we may not be able to remediate in time to meet the deadline imposed by the Sarbanes-Oxley Act for compliance
with the requirements of Section 404. In addition, we may encounter problems or delays in completing the implementation of any requested
improvements and receiving a favorable attestation in connection with the attestation provided by our independent registered public accounting
firm. Failure to achieve and maintain an effective internal control environment could have a material adverse effect on our business,
financial condition and results of operations and could limit our ability to report our financial results accurately and in a timely manner.
Anti-takeover provisions in our stockholder
rights plan could make a third-party acquisition of us difficult.
We have a stockholder rights
plan that may have the effect of discouraging unsolicited takeover proposals. Specifically, the rights issued under the stockholder rights
plan could cause significant dilution to a person or group that attempts to acquire us on terms not approved in advance by our board of
directors. The rights plan is not intended to prevent a takeover, and we believe it will enable all our stockholders to realize the full
potential value of their investment in the Company and protect the Company and its stockholders from efforts to obtain control of the
Company that are inconsistent with the best interests of the Company and its stockholders. The rights under the plan will expire on December
30, 2025, subject to a possible earlier expiration to the extent provided in the stockholder rights plan, unless extended.
Sales of our common
shares by our employees, including our executive officers, could cause the trading price of our common shares to fall or prevent it from
increasing for numerous reasons, and sales by such persons could be viewed negatively by other investors.
In accordance with the guidelines
specified under Rule 10b5-1 under the Exchange Act, as amended, equivalent legislation in applicable jurisdictions, and our policies regarding
equity transactions, a number of our employees, including executive officers, may adopt share trading plans pursuant to which they have
arranged to sell common shares from time to time in the future. Generally, sales of common shares, including sales under such plans, by
our executive officers and directors require public filings. Sales of our common shares by such persons could cause the price of our common
shares to fall or prevent it from increasing. If sales by employees, executive officers, or directors cause a substantial number of our
common shares to become available for purchase in the public market, the price of our common shares could fall or may not increase. Also,
sales by such personnel could be viewed negatively by holders and potential purchasers of our common shares.
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