UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-K
(Mark One)
☒ ANNUAL REPORT PURSUANT TO SECTION 13
OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31 , 2024
or
☐ TRANSITION REPORT PURSUANT TO SECTION
13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from __________________________
to __________________________
Commission file number 001-40804
PASITHEA THERAPEUTICS CORP.
(Exact name of registrant as specified in its charter)
Delaware 85-1591963
State or other jurisdiction of (I.R.S. Employer
incorporation or organization Identification No.)
1111 Lincoln Road , Suite 500
Miami Beach , Florida
33139
(Address of principal executive offices) (Zip Code)
Registrant’s telephone number, including
area code: (786) 977-3380
Securities registered pursuant to Section 12(b)
of the Act:
Title of each class Trading Symbol(s) Name of each exchange on which registered
Common Stock, par value $0.0001 per share KTTA The Nasdaq Capital Market
Warrants to purchase shares of Common Stock, par value $0.0001 per share KTTAW The Nasdaq Capital Market
Securities registered pursuant to Section 12(g)
of the Act: None
Indicate by check mark if the registrant is a
well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No ☒
Indicate by check mark if the registrant is not
required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No ☒
Indicate by check mark whether the registrant
(1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months
(or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements
for the past 90 days. Yes ☒ No ☐
Indicate by check mark whether the registrant
has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405
of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes
☒ No ☐
Indicate by check mark whether the registrant
is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company.
See the definitions of “large accelerated filer,” “accelerated filer” “smaller reporting company,”
and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer ☐ Accelerated filer ☐
Non-accelerated filer ☒ Smaller reporting company ☒
Emerging growth company ☒
If an emerging growth company, indicate by checkmark
if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards
provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant
has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial
reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or
issued its audit report. ☐
If securities are registered pursuant to Section
12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction
of an error to previously issued financial statements. ☐
Indicate by check mark whether any of those error
corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the registrant’s
executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐
Indicate by check mark whether the registrant
is a shell company (as defined in Rule 12b-2 of the Act). Yes ☐ No ☒
The aggregate market value of the common stock,
par value $0.0001 per share (“Common Stock”), held by non-affiliates of the registrant as of the last business day of the
registrant’s most recently completed second fiscal quarter (June 30, 2024) was $ 4.1 million.
As of March 20, 2025, there were 2,705,263 shares
of the registrant’s Common Stock outstanding.
DOCUMENTS INCORPORATED BY REFERENCE
None.
PASITHEA THERAPEUTICS CORP.
2024 FORM 10-K ANNUAL REPORT
TABLE OF CONTENTS
Page
PART I
ITEM 1. BUSINESS
1
ITEM 1A. RISK FACTORS
29
ITEM 1B. UNRESOLVED STAFF COMMENTS
54
ITEM 1C. CYBERSECURITY
54
ITEM 2. PROPERTIES
54
ITEM 3. LEGAL PROCEEDINGS
54
ITEM 4. MINE SAFETY DISCLOSURES
54
PART II
ITEM 5. MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES
55
ITEM 6. [RESERVED]
55
ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
55
ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
61
ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA
61
ITEM 9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE
61
ITEM 9A. CONTROLS AND PROCEDURES
61
ITEM 9B. OTHER INFORMATION
62
ITEM 9C. DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS
62
PART III
ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE
63
ITEM 11. EXECUTIVE COMPENSATION
70
ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS
78
ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE
81
ITEM 14. PRINCIPAL ACCOUNTANT FEES AND SERVICES
82
PART IV
ITEM 15. EXHIBIT AND FINANCIAL STATEMENT SCHEDULES
84
ITEM 16. FORM 10-K SUMMARY
85
SIGNATURES
86
i
CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
This annual report contains
forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities
Exchange Act of 1934, as amended. These statements are generally identified by the use of such words as “may,” “could,”
“should,” “would,” “believe,” “anticipate,” “forecast,” “estimate,”
“expect,” “intend,” “plan,” “continue,” “outlook,” “will,” “potential”
and similar statements of a future or forward-looking nature. These forward-looking statements speak only as of the date of filing this
annual report with the SEC and include, without limitation, statements about the following:
●
our lack of operating history;
●
the expectation that we will incur significant operating losses for the foreseeable future and will need significant additional capital;
●
the period over which we estimate our existing cash and cash equivalents will be sufficient to fund our future operating expenses and capital expenditure requirements;
●
our estimates regarding expenses, future revenue, capital requirements and needs for additional financing;
●
our plans to develop and commercialize our product candidates involves a lengthy and expensive process, with an uncertain outcome;
●
the initiation, enrollment, timing, progress, results, and cost of our research and development programs and our current and future preclinical studies and clinical trials, including statements regarding the timing of initiation and completion of studies or trials and related preparatory work, the period during which the results of the trials will become available;
●
the timing of interim data and final results from our clinical trials for PAS-004;
●
the potential safety and efficacy of our product candidates and the therapeutic implications of clinical and preclinical data;
●
potential impacts of increased trade tariffs, import quotas or other trade restrictions or measures taken by the United States and other countries, including the recent and potential changes in U.S. trade policies that may be made by the Trump presidential administration;
●
the timing and focus of our future preclinical studies and clinical trials, and the reporting of data from those studies and trials;
●
the size of the market opportunity for our future product candidates, including our estimates of the number of patients who suffer from the diseases we are targeting;
●
the success of competing therapies that are or may become available;
ii
●
the beneficial characteristics, safety, efficacy and therapeutic effects of our future product candidates;
●
our ability to obtain and maintain regulatory approval of our future product candidates;
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our plans relating to the further development of our future product candidates, including additional disease states or indications we may pursue;
●
existing regulations and regulatory developments in the United States and other jurisdictions;
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our dependence on third parties;
●
the need to hire additional personnel and our ability to attract and retain such personnel;
●
our plans and ability to obtain or protect intellectual property rights, including extensions of patent terms where available and our ability to avoid infringing the intellectual property rights of others;
●
our financial performance and sustaining an active trading market for our Common Stock and Warrants;
●
our ability to restructure our operations to comply with any potential future changes in government regulation; and
●
the impact of global economic and market conditions and political developments on our business, including, among others, rising inflation and capital market disruptions, economic sanctions, bank failures, regional conflicts around the world, and economic slowdowns or recessions that may result from such developments which could harm our research and development efforts as well as the value of our Common Stock and our ability to access capital markets.
Because forward-looking statements
are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified and some of which are beyond our control,
you should not rely on these forward-looking statements as predictions of future events. The events and circumstances reflected in our
forward-looking statements may not be achieved or occur and actual results could differ materially from those projected in the forward-looking
statements. You should refer to the “Risk Factors” section of this annual report for a discussion of important factors that
may cause our actual results to differ materially from those expressed or implied by our forward-looking statements. We operate in an
evolving environment and new risk factors and uncertainties may emerge from time to time. It is not possible for management to predict
all risk factors and uncertainties. As a result of these factors, we cannot assure you that the forward-looking statements in this annual
report will prove to be accurate. Except as required by applicable law, we do not plan to publicly update or revise any forward-looking
statements contained herein, whether as a result of any new information, future events, changed circumstances or otherwise. You should
review the factors and risks and other information we describe in the reports we will file from time to time with the SEC.
iii
EXPLANATORY NOTE
On December 28, 2023, our board of directors (“Board”)
approved a 1:20 reverse stock split (the “Reverse Stock Split”) of our outstanding shares of common stock, par value $0.0001
per share (“Common Stock”), which became effective on January 2, 2024. In connection with the Reverse Stock Split, there was
a corresponding reduction in the number of authorized shares of Common Stock to 100,000,000.
Unless otherwise noted, the
share and per share information in this Annual Report on Form 10-K reflects the Reverse Stock Split.
iv
PART I
ITEM 1. BUSINESS
Overview
We are a clinical-stage biotechnology
company focused on the discovery, research and development of innovative treatments for central nervous system (CNS) disorders and other
diseases, including RASopathies and certain cancers.
During the year ended December
31, 2023, we discontinued our support services to anti-depression clinics in the U.K. and related at-home services in New York, NY. In
addition, we discontinued our clinical operations in Los Angeles, CA and disposed of the related property. Accordingly, as of December
31, 2024, we currently have one reportable segment, “Therapeutics,” related to the research and development of our therapeutic
product candidates.
Our Therapeutic Pipeline
We are advancing a
pipeline of three therapeutic product candidates, with a focus on our lead product candidate, PAS-004, a next-generation macrocyclic
(as defined below) mitogen-activated protein kinase, or MEK inhibitor, that we believe may address the limitations and liabilities
associated with existing drugs with a similar mechanism of action. PAS-004 is a small molecule allosteric inhibitor of MEK 1 and 2
(“MEK 1/2”) for potential use in the treatment of a range of RASopathies, including neurofibromatosis type 1
(“NF1”), a number of MAPK pathway driven tumors, such as BRAFv600 and BRAF fusion tumors, among other indications
including ETS2 driven diseases, such as inflammatory bowel disease (“IBD”), primary sclerosing cholangitis and
ankylosing spondylitis.
MEK 1/2 are two of several
protein kinases involved in a signaling cascade, known as the mitogen-activated protein kinase, or MAPK pathway. The MAPK pathway
is an important pathway in cellular biology which has been a frequent target for drug discovery efforts. The MAPK pathway has been implicated
in a variety of diseases, as it functions to drive cell proliferation, differentiation, survival and a variety of other cellular functions
that, when abnormally upregulated, are critical for the formation and progression of tumors, fibrosis and other diseases. MEK inhibitors
block phosphorylation (activation) of extracellular signal-regulated kinases (“ERK”), which can lead to cell death and inhibition
of tumor growth.
Existing
MEK inhibitors approved by the U.S. Food and Drug Administration (the “FDA”) are marketed for a range of diseases, including
certain cancers and NF1-associated plexiform neurofibromas (“NF1-PN”), including selumitinib (Koselugo) for NF1-PN pediatric
patients and mirdametinib (Gomekli) for adult and pediatric NF1-PN patients. We believe that current MEK inhibitors have certain limitations,
including known toxicities. Unlike FDA-approved MEK inhibitors, PAS-004 features a macrocyclic structure, a characteristic that we believe
enhances potency, metabolic stability, and oral bioavailability. Macrocyclic molecules also provide structural rigidity, enabling stronger
binding with target receptors. PAS-004’s macrocyclic design was specifically developed to improve metabolic stability and optimize
its pharmacokinetic (PK) profile. The structure of PAS-004 is distinct from other earlier generation MEK inhibitors as
it maintains critical protein/ligand contacts but does not possess a primary alcohol or hydroxamate functionality, a known metabolic
liability in earlier generation MEK inhibitors. As described in greater detail below, PAS-004 offers a long half-life, a low peak (Cmax)
to trough (Cmin) drug concentration ratio, and stable steady-state drug levels over time. We believe that sustained suppression of the
MAPK pathway may result in improved efficacy, safety, and a broader therapeutic window compared to current FDA-approved MEK inhibitors
for NF1-PN, which have short half-lives and require twice-daily dosing. However, the ultimate safety and efficacy profile of PAS-004
will require clinical testing to be completed.
In December 2023, the FDA
cleared our Investigational New Drug application (the “IND”) for PAS-004 and we received a study may proceed letter for our
first-in-human Phase 1 multicenter, open-label trial of PAS-004 in patients with MAPK pathway-driven advanced tumors with a documented
RAS, NF1 or RAF mutation or patients who have failed BRAF/MEK inhibition (the “FIH Phase 1 Dose Escalation Study”). We are
currently conducting the FIH Phase 1 Dose Escalation Study at four clinical sites in the U.S. and three sites in Eastern Europe. The primary
objective of the FIH Phase 1 Dose Escalation Study is to assess the safety and tolerability of PAS-004 when administered as a single dose
(day 1) and as multiple doses (28-day treatment cycles). Secondary objectives are (I) to characterize the PK profile of PAS-004 when administered
as a single dose and as multiple doses, (ii) to evaluate the pharmacodynamics (“PD”) effect of PAS-004, (iii) to evaluate
the preliminary anticancer activity (efficacy) of PAS-004 per Response Evaluation Criteria in Solid Tumors (“RECIST”) 1.1
criteria, and (iv) to define the preliminary recommended Phase 2 dose(s) of PAS-004 in adults with MAPK pathway driven advanced solid
tumors.
1
On September 9, 2024, we announced
the successful completion of long-term chronic toxicology studies for PAS-004. On September 26, 2024, we announced safety, tolerability,
pharmacokinetic (PK) and preliminary efficacy data from the first two cohorts of patients in our FIH Phase 1 Dose Escalation Study. To
date, we have completed dosing of a total of 17 patients through cohort 4 (15 mg capsule), including cohort 4b (4 mg tablet) and are currently
dosing four patients in cohort 5 (22 mg capsule). We have observed no dose limiting toxicities (“DLTs”), rash or ocular toxicities
in any of the cohorts assessed to date, and all treatment related adverse events have been either Grade 1 or Grade 2, which support PAS-004’s
potential favorable safety and tolerability profile. Additionally, PAS-004 has demonstrated favorable PK properties, including a long
half-life of approximately 60 hours, a low peak to trough (Cmax to Cmin) ratio as compared to other FDA approved MEK inhibitors, and linear
pharmacokinetics.
PAS-004 has received orphan-drug
designation from the FDA for the treatment of NF1. Our clinical development plan for PAS-004 is to advance PAS-004 into a Phase 1/1b clinical
trial in adult NF1-PN patients followed by pediatric NF1-PN patients and ultimately complete registrational clinical trials in these patient
populations, as they represent the initial indication for which we plan to seek marketing approval for PAS-004.
Our remaining two programs,
PAS-003 and PAS-001, are in the earlier stages of development and are based on novel targets for the treatment of CNS disorders. PAS-003
is being developed for amyotrophic lateral sclerosis (ALS), while PAS-001 is targeted for schizophrenia.
Our
PAS-003 program aims to develop a proprietary humanized monoclonal antibody (“mAb”) with a mechanism-of-action targeting a 5 b 1
integrin for the treatment of ALS and potentially address other CNS disorders, such as Multiple Sclerosis (MS) and stroke. We believe
targeting a 5 b 1
integrin may have a beneficial impact on disease due to modulation of multiple cell types and mechanisms involved in neuroinflammation,
which occurs in ALS. We acquired PAS-003 in connection with our acquisition of Alpha-5 Integrin, LLC, a privately held biotechnology company,
in June 2022.
In November 2023, we announced
that we selected our PAS-003 lead development candidate, a humanized monoclonal antibody with optimal properties that targets α5β1
integrin for the treatment of both sporadic and familial ALS. PAS-003 is now ready for manufacturing and IND-enabling studies.
Our PAS-001 discovery program aims to develop a brain penetrant small
molecule targeting the complement component 4A (“C4A”) for the treatment of schizophrenia. Recent findings implicate C4A in
synaptic loss (fewer connections between nerve cells), which has been shown to occur in schizophrenia. In humans, structural variation
in the complement 4 gene (C4) is an important genetic risk factor for schizophrenia.
During the year ended December
31, 2023, we determined to cease further development of our PAS-002 program for multiple sclerosis (“MS”) due to several factors
including the significant capital, resources and time required to develop the program, and the current and projected availability of effective
treatment options for MS patients, among others.
Our Strategy
Our mission is to develop
innovative therapies to address areas of high unmet medical need, initially in RASopathies and CNS disorders. To achieve our mission,
we are executing a near-term strategy with the following key elements:
●
Complete our first-in-human clinical trial of PAS-004. In February 2024 we opened the first clinical site of our FIH Phase 1 Dose Escalation Study of PAS-004 in patients with MAPK pathway driven advanced solid tumors. The objective of the FIH Phase 1 Dose Escalation Study is to assess the safety, tolerability, PK, and PD of PAS-004 as well as to evaluate the preliminary anticancer activity (efficacy) of PAS-004 and to define the preliminary recommended Phase 2 dose. We have competed the first four dosing cohorts including cohort 4b (4 mg tablet) and are currently dosing patients in cohort 5. We expect to complete the trial in 2026.
●
Advance clinical development of PAS-004 for NF1-PN. Our primary focus is to advance the clinical development of PAS-004 for NF1-PN, the initial indication for which we plan to seek marketing approval. In the first half of 2025, we plan to initiate a Phase 1/1b clinical trial in adult patients with NF1 with symptomatic and inoperable, incompletely restricted or recurrent PNs. This Phase 1/1b trial will be conducted at clinical sites in Australia, South Korea and the U.S.
2
●
Expand utility of PAS-004 for other indications. Based on results from preclinical studies and current understanding of certain disorders, we believe that PAS-004 may have potential for the treatment of other diseases, such as NF1 cutaneous neurofibromas (“NF1-CN”), ALS, ETS2 gene driven diseases, (such as IBD, primary sclerosing cholangitis and ankylosing spondylitis), Noonan syndrome, LMNA cardiomyopathy and other MAPK-mutation driven cancers (such as BRAF V600 and BRAF fusion tumors). We plan to continue testing PAS-004 in various preclinical models to further demonstrate the potential utility of PAS-004 in some of these indications.
●
Expand formulation development for PAS-004. PAS-004 is currently being administered orally in capsule formulation in the ongoing FIH Phase 1 Dose Escalation Study in adult patients. During 2024, we completed the development of a tablet formulation of PAS-004, that we believe will be our commercial formulation for adult patients. We have tested a 4mg tablet formulation in a cohort of four patients in the FIH Phase 1 Dose Escalation Study and plan to use the tablet formulation for future clinical trials of PAS-004 in adult patients. We are currently evaluating additional formulations of PAS-004, such as a liquid formulation for the treatment of pediatric patients. Additionally, we may explore the development of a topical formulation for indications where topical treatment is beneficial, such as cutaneous neurofibromas.
●
Maximize the potential of our discovery product candidates with selective use of business development and commercial collaborations. To maximize the potential value of each of our discovery programs while optimizing our limited resources, we plan to pursue business development, non-dilutive funding, and collaborative opportunities. These efforts will support the continued preclinical and clinical development of our discovery product candidates. We plan to continue evaluating opportunities to work with partners that meaningfully enhance our capabilities with respect to the development and commercialization of our product candidates, which may entail the potential out-licensing of the development and commercialization of our product candidates to larger pharmaceutical organizations, including our lead product candidate PAS-004. Additionally, we plan to establish research collaborations for the continued preclinical and clinical development of our discovery programs. Further, we intend to commercialize our product candidates in key markets either alone or with partners in order to maximize the worldwide commercial potential of our programs.
Overview of Our Lead Program: PAS-004
MAPK Pathway Overview
Signaling pathways describe
a series of biological mechanisms in which a group of molecules work together to control a cell function. A cell receives signals from
its environment when a molecule binds to a specific receptor on or in the cell. This process may be repeated multiple times through the
entire signaling pathway until the last receptor is activated and the cell function is carried out. Abnormal activation of signaling pathways
may lead to diseases.
The MAPK pathway, which
relies upon the Ras/Raf/MEK/ERK signaling cascade, represents a central biological pathway in all human cells that is responsible for
regulating cellular transcription, proliferation and survival. The general structure of the pathway consists of Ras, a small GTPase, and
three downstream protein kinases, Raf, MEK and ERK. ERK 1 and 2 (“ERK 1/2”) are structurally similar protein-serine/threonine
kinases that regulate a variety of cellular processes including adhesion, migration, survival, differentiation, metabolism, proliferation,
transcription, cytoskeletal remodeling and cell cycle progression. MEK 1/2 catalyzes the phosphorylation of ERK 1/2, which is required
for enzyme activation. Phosphorylated ERK 1/2 moves to the nucleus, and in turn activates many transcription factors, regulates gene expression,
and controls various physiological processes, finally inducing cell repair or cell death.
In addition, at the level
of Ras, the pathway is negatively regulated by several proteins, including neurofibromin, the protein encoded by the NF1 gene.
Given its direct regulation of ERK, which directly controls downstream signaling through the MAPK pathway, MEK occupies a pivotal
position in this signaling cascade and represents a rational small-molecule therapeutic target for multiple diseases, including RASopathies
(such as NF1-PN), CNS indications (such as ALS), cardiomyopathies (such as LMNA cardiomyopathy) and oncology indications, where overactivation
of the MAPK pathway contributes to disease onset and/or progression.
Background of MEK Inhibitors
MAPK represents one of the
most highly targeted signaling pathways in drug development. Several allosteric inhibitors of MEK 1/2 are currently in clinical development
with five already approved by the FDA; three for various oncological indications, two for the treatment of children aged two and older
with NF1-PN, and one for the treatment of adults with NF1-PN. A limitation of current FDA approved MEK inhibitors are their high rates
of serious treatment-related adverse events, which may contribute to poor tolerability. These MEK inhibitors often require multiple doses
per day leading to high maximum concentrations (“Cmax”) potentially resulting in a higher rate of adverse events and discontinuations
in real world practice.
Our rationale in developing
PAS-004 is to address these shortcomings to potentially provide patients with better outcomes and improved safety.
3
RASopathies Overview
RASopathies are a clinically
defined group of genetic syndromes caused by germline mutations in genes that encode components or regulators of the MAPK pathway. These
disorders include neurofibromatosis type 1 (NF1), Noonan syndrome, capillary malformation–arteriovenous malformation syndrome, Costello
syndrome, cardio-facio-cutaneous syndrome, and Legius syndrome. Because of the common underlying MAPK pathway dysregulation amongst all
of these syndromes, RASopathies exhibit numerous overlapping phenotypic features, including CNS abnormalities. The MAPK pathway plays
an essential role in regulating various cell cycle functions, which are critical to normal human development. Therefore, we believe there
is a strong scientific rationale for targeting the MAPK pathway with small-molecule therapeutics to treat various RASopathies.
Neurofibromatosis type 1 (NF1) Overview
The initial indication we
plan to seek marketing approval for PAS-004 is the treatment of NF1-PN. NF1 is a RASopathy and part of a group of conditions known as
neurocutaneous disorders, conditions that affect the skin and the CNS. NF1 affects approximately one in 3,000 newborns throughout the
world, with approximately 100,000 patients living in U.S. with NF1.
NF1 arises from mutations
in the NF1 gene which encodes the tumor suppressor neurofibromin. Loss of NF1 function leads to loss of neurofibromin activity, leading
to Ras being locked in its active confirmation, which stimulates MEK, and then ERK activity.
NF1 is characterized by multiple
café au lait (light brown) skin spots and neurofibromas (small benign growths) on or under the skin, and/or freckling in the armpits
or groin. Individuals with NF1 may have other manifestations of the disorder, including cardiac malformations, cardiovascular disease,
vasculopathy, hypertension, vitamin D deficiency, brain malformations, and seizures. About 50% of people with NF1 also have learning disabilities.
Softening and curving of bones, and curvature of the spine (scoliosis) may occur in some patients with NF1. Occasionally, tumors
may develop in the brain, on cranial nerves, or on the spinal cord. NF1 is usually diagnosed during childhood.
Throughout their lifetime,
about 30% to 50% of NF1 patients progress to develop plexiform neurofibromas (“PNs”), which are tumors that grow in an infiltrative
pattern along the peripheral nerve sheath and can cause severe disfigurement, pain and functional impairment. In rare cases NF1-PN may
be fatal. NF1-PN are most often diagnosed within the first twenty years of life. These tumors are characterized by aggressive growth,
which is typically more rapid during childhood. While NF1-PN are initially benign, these tumors can undergo malignant transformation,
leading to malignant peripheral nerve sheath tumors (“MPNST”). NF1 patients have an 8% to 13% lifetime risk of developing
MPNST, a diagnosis that carries a 12-month survival rate of under 50%. In addition to MPNST, NF1 patients are at an increased risk of
developing other malignancies, including breast cancer and gliomas.
Until recently, the only treatment
option for NF1-PN was the surgical removal of the tumors. However, because NF1-PN arise from nerve cells and grow in an infiltrative pattern,
it is challenging to successfully resect tumors and surgery can lead to severe comorbidities, such as permanent nerve damage. Patients
that are ineligible for surgery or those who have had a recurrence post-surgery are often treated with a variety of off-label therapies.
Among these off-label therapies are various systemic treatments, such as chemotherapy and immunotherapy, which have not been shown to
consistently confer a clinical benefit. Given that NF1-PN is driven by dysregulation in the MAPK pathway, MEK inhibitors have emerged
as the only FDA approved therapy for the treatment of inoperable NF1-PNs.
4
Limitations of Current Standard of Care
Koselugo (selumetinib), a
MEK inhibitor, was approved by the FDA in 2020 for NF1 pediatric patients two years of age and older who have symptomatic, inoperable
PNs based on results from the SPRINT trial, a Phase 2 registrational study. In January 2025, results from a Phase 2 study of Koselugo
in adult patients with NF1-PNs was published in Nature Medicine. On February 11, 2025, Gomekli (mirdametinib) was approved by the FDA
for adult and pediatric patients aged 2 and older with NF1 who have symptomatic PNs not amenable to complete resection based on clinical
results from the RenNu Phase 2b clinical trial. In addition to Koselugo and Gomekli, we are aware of other MEK inhibitors in clinical
trials for this indication, as well as the off-label use of other drugs, such as bevacizumab, for the treatment of NF1.
We believe that Koselugo,
Gomekli and other earlier generation MEK inhibitors approved for indications other than NFI suffer from limitations, such as known toxicities,
high rates of drug discontinuation, limited efficacy and a dosing schedule that requires dosing twice a day. We believe that this creates
a significant market opportunity for a next-generation MEK inhibitor that addresses these shortcomings, has a PK and tolerability profile
suitable for long-term once-a-day or less dosing and that can arrest or reverse tumor growth.
Preclinical Profile and Mechanism of Action
of PAS-004
PAS-004 is a next-generation
MEK inhibitor that was rationally designed to have a macrocyclic structure by taking into consideration the metabolic liabilities of earlier
generation MEK inhibitors. The structure of PAS-004 is distinct from other earlier generation MEK inhibitors as
it maintains critical protein/ligand contacts but does not possess a primary alcohol or hydroxamate functionality, a known metabolic
liability in earlier generation MEK inhibitors. It is generally observed that macrocyclic scaffolds improve drug-like properties including
target binding, selectivity, and oral bioavailability.
PAS-004 has displayed promising
PK properties in IND-enabling toxicology studies of both rats and dogs. In these toxicology studies, PAS-004 has demonstrated a half-life
of 11.5 hours in rats and 52 hours in dogs.
Preclinical Studies Overview
In vitro Preclinical Studies of PAS-004
In a screen of 99 protein
kinases, a single high dose of PAS-004 (10 μM) was used to assess kinase inhibition specificity. This assay demonstrated that PAS-004
is a strong inhibitor of only the MEK 1 (~95%) and MEK 2 (>99%) kinases.
In an unpublished preclinical
study, the effects of PAS-004 were compared to selumetinib in tests for the ability to inhibit the growth of three NF1 mutant neurofibroma-derived
Schwann cell lines, the tumorigenic cell of origin for NF1-PN, and two human wild-type Schwann cell lines. Cells were treated for 48 hours
and all PAS-004 treated cell lines showed dose-dependent growth inhibition, with 60-80% growth inhibition in the three neurofibroma-derived
NF1 mutant cell lines and less than 20% inhibition of the wild-type cell lines tested. Growth inhibition with PAS-004 was greater than
the maximal growth inhibition seen with equivalent doses of selumetinib. In addition, the inhibition did not plateau at the highest doses
used in the study, compared to a plateau effect with selumetinib.
Additionally, PAS-004 was
compared to selumetinib in an in vitro potency assay. Western blots from this unpublished preclinical study showed that cells treated
with PAS-004 demonstrated greater reduction in ERK 1/2 phosphorylation as compared to cells treated with selumetinib.
We believe these in vitro
preclinical results support PAS-004’s favorable potency and dose-dependent inhibitory activity against cellular proliferation in
NF1 deficient Schwann cells, demonstrating a profile that appears similar to selumetinib, an FDA approved MEK inhibitor.
5
In vivo Preclinical Studies
In an unpublished preclinical
study, the effects of PAS-004 were assessed in the in vivo Colo-205 xenograft tumor model, a common mouse model used for preclinical
therapies. Results showed that PAS-004 dosed at 5 mg/kg once daily reduced tumor volume. The magnitude of tumor volume reduction was similar
to selumetinib dosed at 25mg/kg, twice daily, as published in Molecular Cancer Therapeutics in 2007.
In an unpublished preclinical
pilot study, PAS-004 was tested for tolerability and preliminary biological efficacy in a genetically engineered mouse model of NF1-PN.
These mice were engineered to develop plexiform neurofibromas that closely phenocopy the human tumors by four months of age with
100% penetrance. In this pilot study, selumetinib was administered in a parallel group, which served as a positive control. Both PAS-004
and selumetinib were administered as single-agents to six mice per group. PAS-004 was administered at 10 mg/kg once daily and selumetinib
was administered at the established maximum tolerated dose of 10 mg/kg, twice daily. Treatment began when the mice reached four months
of age and was continued for 12 weeks or until death. Mice were monitored for signs of toxicity, as well as survival. Results demonstrated
that both PAS-004 and selumetinib showed similar toxicity profiles and both PAS-004 (p=0.0123) and selumetinib (p=0.0048) significantly
reduced the tumor size compared to vehicle-treated mice based on statistical analysis using uncorrected Fisher’s least significant
difference.
We believe the results from
this preclinical pilot study illustrate that PAS-004 may be effective in reducing tumor burden of NF1-associated plexiform neurofibromas.
When administered at 10 mg/kg once daily, PAS-004 and selumetinib, which was dosed at 10mg/kg twice daily, demonstrated similar results.
We believe that the longer half-life of PAS-004, as compared to selumetinib, could potentially enhance efficacy by allowing more sustained
MEK/ERK signaling inhibition. Additionally, it may allow for longer dosing intervals, such as a once-daily regimen, compared to the twice-daily
dosing required for selumetinib.
Mutations in the LMNA gene,
which encodes nuclear lamins A and C, cause diseases affecting various organs, including the heart. Studies have found that the ERK 1/2
kinase branches of the MAPK signaling pathway were abnormally hyperactivated prior to the onset of significant cardiac impairment.
PAS-004 was studied in the
LMNA-cardiomyopathy Lmna H222P/H222P mouse model, a validated model of cardiomyopathy caused by LMNA mutations in humans. In
this study, male mice were orally administered placebo, PAS-004 at 3 mg/kg/day or PAS-004 at 6 mg/kg/day starting at 14 weeks of age when
symptoms of cardiomyopathy were present. Results of this preclinical study were published in Bioorganic & Medicinal Chemistry
in 2017 and are summarized as follows:
●
The effects of PAS-004 on phosphorylated ERK 1/2 were studied. Following six weeks of systemic administration, both doses of PAS-004 led to significant decreases in phosphorylated ERK 1/2 relative to total ERK 1/2 in the heart and liver when compared to placebo, whereas only the 6 mg/kg/day group produced a significant decrease in phosphorylated ERK 1/2 relative to total ERK 1/2 in quadricep muscles.
●
The effects of PAS-004 on echocardiographic parameters of the heart that correlate with left ventricular function were studied. Following six weeks of systemic administration, both doses of PAS-004 resulted in significant increases in left ventricular fractional shortening, the percentage the left ventricular diameter decreases with each contraction as compared to placebo.
●
The effects of PAS-004 on
cardiac fibrosis were studied. Following six weeks of systemic administration, both doses of PAS-004 resulted in significant
decreased fibrosis based on staining with Masson trichrome of fixed sections of left ventricles, when compared to placebo. Results
showed that treatment of PAS-004 lead to dose-dependent statistically significant decreases in fibrosis when compared to placebo, as
scored on a histologic scale of 0 to 4 by a pathologist blind to treatment group, when compared to placebo.
●
The effects of PAS-004 on survival were studied. Mice were followed until death or euthanasia. 23 mice treated with placebo had a median survival of 202 days, whereas median survival was 225 days for 17 mice treated with 3 mg/kg/day of PAS-004 and 225 days for 15 mice treated with 6 mg/kg/day of PAS-004. Results showed the median survival based on Kaplan-Meier plots of mice treated with both doses of PAS-004 were statistically significantly (P<0.05) longer than that for mice treated with placebo.
●
A preliminary analysis of potential tissue toxicity of PAS-004 was performed. Following six weeks of systemic administration, serum alkaline phosphatase activity, alanine aminotransferase activity and bilirubin concentration were measured to assess possible hepatic injury and liver function. Serum creatinine and blood urea nitrogen concentrations were also measured as indicators of renal function and serum amylase activity as a marker of pancreatic injury. Results showed that there were no statistically significant differences in any of these parameters between groups. A histopathological evaluation by a pathologist blind to treatment determined there were no consistent or specific abnormalities in liver, kidney or spleen of mice receiving either doses of PAS-004 and no alterations were observed that typically occur with drug toxicity.
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In unpublished preclinical in vivo studies, PAS-004 was tested
for anti-tumor efficacy in NRAS mutation cancer xenograft models. In the first study, PAS-004 exhibited dose-dependent anti-tumor efficacy
in the lung cancer NCI-H1299 cell-line-derived xenograft model. PAS-004 at dose levels of 10 mg/kg and 5 mg/kg, once daily, significantly
inhibited tumor growth as compared to vehicle control. The anti-tumor efficacy of PAS-004, when taken at equivalent doses, was shown to
be superior to that of binimetinib and selumetinib. In the second study, PAS-004 exhibited dose-dependent anti-tumor efficacy in the liver
cancer xHepG2 cell-line-derived xenograft model. PAS-004 at dose levels of 10 mg/kg and 5 mg/kg, once daily, produced significant antitumor
activities as compared to vehicle control. The anti-tumor efficacy of PAS-004, when taken at equivalent doses was shown to be similar
to that of binimetinib and superior to that of selumetinib.
PAS-004 has demonstrated dose-dependent
response in vivo across several preclinical cancer, LMNA cardiomyopathy and NF1-PN models.
Toxicology Studies
28-day toxicological studies
were performed in both rats and dogs under good laboratory practices (“GLP”) on PAS-004 by Wuxi AppTec (Suzhou) Co., Ltd.
and demonstrated a sufficient safety and toxicology profile of PAS-004 to support our IND with the FDA. Additionally, we have completed
repeat dose toxicity and toxicokinetic studies in Sprague Dawley rats of up to 26 weeks’ duration and in Beagle dogs up to 39 weeks’
duration with 14 or 28-day recovery periods to support chronic dosing of PAS-004.
Additional Indications: ETS2 Driven Diseases
A 2024 Nature publication
titled “A disease-associated gene desert directs macrophage inflammation through ETS2” demonstrated that the ETS2 gene is
a central regulator for multiple inflammatory functions in human macrophages and that ETS2 has a key pathogenic role in IBD. Further,
this publication identified that MEK inhibitors as a class are the strongest known ETS2 inhibitors, providing potent anti-inflammatory
activity and that MEK inhibition reduced inflammatory cytokine release to similar levels as infliximab, an anti-TNF antibody that is widely
used for the treatment of IBD. Blocking ETS2 signaling through MEK 1/2 inhibition was showed to affect multiple cytokines, including TNF
and IL-23, which are targets of existing therapies. Based on this publication, we have begun testing PAS-004 in pre-clinical models of
IBD.
Completion of GMP-Compliant
Manufacturing
In June 2023, we announced
the successful completion of manufacturing the GMP-compliant Phase 1 clinical supplies of the active pharmaceutical ingredient (“API”)
of our lead product candidate PAS-004. Utilizing this drug substance, we have manufactured the drug product in capsule form that we are
utilizing in our ongoing FIH Phase 1 Dose Escalation Study. In 2024, we completed a second batch of API and we have manufactured the drug
product in tablet formulation to support our upcoming Phase 1/1b clinical trial in adult NF1 patients.
Clinical Development Overview
In December 2023 we received
a study may proceed letter from the FDA for our IND and in February 2024 we opened the first clinical site of our first-in-human clinical
trial of PAS-004 in patients with MAPK pathway driven advanced solid tumors with a documented RAS, NF1 and RAF mutation or patients who
have failed BRAF/MEK inhibition. The FIH Phase 1 Dose Escalation Study is a multicenter open-label study designed to evaluate the safety,
tolerability, PK, PD, and preliminary efficacy of PAS-004 in cancer patients with MAPK pathway driven advanced solid tumors. Approximately
30 patients are being enrolled across four clinical sites in the U.S. and three clinical sites in Eastern Europe (Bulgaria and Romania).
Patients are being enrolled into dosing cohorts under a modified 3+3 dose escalation study design. If the first three patients enrolled
into a dosing cohort reach the end of the first 28-day treatment cycle on day 35 without experiencing a DLT, following a review of safety,
PK, and PD data by the safety committee, enrollment into the next highest dosing cohort begins. If two or more of the first three patients
experience a DLT by day 35, dose-escalation will stop and cannot proceed at or above the current dose level. However, if one of the first
three patients enrolled into a dosing cohort experiences a DLT by day 35, an additional three patients will be enrolled into the dosing
cohort (six patients total). If only one of six patients experiences a DLT by day 35, following review of safety, PK and PD by the safety
committee, enrollment into the next highest dose level begin; however, if two or more of the six patients experience a DLT, dose escalation
will stop, and the prior dose level will be declared the maximum tolerated dose (“MTD”). Participants will sequentially receive
one of eight planned dose levels of PAS-004 in capsule formulation (2 mg, 4 mg, 8 mg, 15 mg, 22 mg, 30 mg, 37 mg and 45 mg) to be taken
orally. Additionally, we have completed a dosing cohort using a 4 mg tablet formulation of PAS-004. PAS-004 is administered a single dose
on day 1, followed by a 7-day observation period, before initiating continuous 28-day treatment cycles of PAS-004.
To date, we have dosed 17
patients through cohort 4, including cohort 4b (4 mg tablet). A total of 16 of these patients have completed dosing through the DLT period.
We are currently dosing four patients in cohort 5 (22 mg capsule).
7
To date, we have observed
no DLTs, rash or ocular toxicities in any of the cohorts assessed through cohort 4. Additionally, no patients have discontinued treatment
due to AEs. The AE profile of PAS-004 has been characterized by grade 1 and grade 2 treatment-related adverse events (“TRAEs”),
with the most frequently reported of these TRAEs being nausea, vomiting, and diarrhea. This data shows PAS-004 is observed to be well
tolerated and support PAS-004’s favorable safety and tolerability profile.
Interim PK results have demonstrated
a half-life of approximately 60 hours for PAS-004. Following multiple daily dosing, accumulation is consistent and suggests linear PK.
Exposure increases with an increase in dose and dose normalized exposure ranges overlap. At steady-state little fluctuations in drug concentrations
are observed with a ratio of Cmax to Cmin below 2. We believe PAS-004’s PK profile and longer half-life compared to other FDA approved
MEK inhibitors for the treatment of NF1-PN allows durable suppression of ERK phosphorylation, critical for clinical responses.
We plan to provide additional
interim data throughout 2025 and currently expect to complete the FIH Phase 1 Dose Escalation Study in 2026.
Phase 1/1b clinical trial
in adult patients with NF1-PN
Our clinical development plan
for PAS-004 is to initiate to a Phase 1/1b clinical trial in adult patients with NF1-PN followed by pediatric NF1-PN patients and ultimately
complete registrational clinical trials in these patient populations, which are the initial indications that we plan to seek marketing
approval of PAS-004 for.
We are preparing to launch
a Phase 1/1b open label study to assess the safety, tolerability, PK and PD of PAS-004, in adult participants with NF1 with symptomatic
and inoperable, incompletely resected, or recurrent PNs. The study will be conducted at up to five clinical sites in Australia, South
Korea and the U.S. The Company anticipates the first patient will be enrolled in April 2025.
8
The primary objective of the
study is to evaluate the safety and tolerability of PAS-004 when administered for one 28-day treatment cycle in adult NF1participants
with at least one and up to two additional target PNs that are symptomatic and inoperable, incompletely resected, or recurrent. Secondary
objectives are (i) to identify the recommended Part B dose (“RPBD”) or MTD of PAS-004, (ii) to characterize the PK and PD
profile of PAS-004, (iii) to evaluate the preliminary efficacy of PAS-004 on target PN volume, (iv) to evaluate the preliminary efficacy
of PAS-004 on the size and appearance, and associated symptoms of cutaneous neurofibromas (CNs), and (v) to evaluate the impact of PAS-004
on quality of life (“QOL”) and any physical symptoms attributed to the target PN. Experimental objectives are (i) to evaluate
the impact of PAS-004 on QOL and any physical symptoms attributed to CNs, (ii) to evaluate the impact of PAS-004 on pain and function
attributed to PNs, and (iii) to investigate PAS-004 effects on CN tumor cellular and molecular biology.
The trial will be conducted
in two parts. In Part A, following a screening period of up to 28 days, up to 24 eligible participants will be enrolled sequentially to
receive one of four planned dose levels of PAS-004 tablets in a modified 3+3 design. Part A will identify the recommended RPBD. During
Part B, up to 24 eligible participants will be enrolled in parallel to receive one of two planned dose levels of PAS-004 tablets. Participants
will be dosed at the RPBD level and at a dose level below the RPBD for up to six continuous 28-day treatment cycles. Part B will identify
the recommended phase 2 dose (RP2D).
Overview of Our Discovery Programs
PAS-003 Program
Amyotrophic Lateral Sclerosis Overview
ALS, or Lou Gehrig’s
disease, is a fatal, progressive motor neuron disease that targets nerve cells in the spinal cord and brain. ALS most commonly affects
people between the ages of 40 and 70, with an average age of 55 at the time of diagnosis. It affects as many as 30,000 patients in the
United States, with 5,000 new cases diagnosed each year.
While approximately 10% of
cases are hereditary, which is known as familial ALS, the large majority of cases (90-95%) are not, which is known as sporadic ALS. While
the pathogenesis of ALS is not fully understood, studies have shown that the disease is multifactorial, with several interlinked mechanisms,
such as neuroinflammation and neurodegeneration.
ALS often begins with muscle
twitching and/or weakness in a limb, however, as the disease progresses, ALS affects control of the muscles needed to move, speak, eat
and breathe. As a result, ALS patients develop extensive muscle wasting and atrophy leading to paralysis and ultimately death. The
life expectancy is low, with patients living on average three to five years after symptom onset, and the patient´s quality of life
is typically poor.
There are currently four FDA
approved medications to treat ALS and its symptoms. However, they have been shown to only have modest clinical efficacy. Therefore, despite
these therapies, the medical need for new treatments for ALS patients is very high.
Scientific
Background and Rationale for Targeting a 5 b 1
integrin for the treatment of ALS
Integrins are the principal
receptors used by animal cells to bind to the extracellular matrix as well as other cells. Integrins activate intracellular signaling
pathways and can cooperate with other conventional signaling receptors. Integrins are involved in a wide range of biological processes
including cell growth, migration, survival, and proliferation as well as cytokine activation and release. As a result, integrins play
a significant role in many physiological processes, including embryogenesis, organogenesis, and tissue development, but also in pathogenic
ones, including inflammation, infection, and allergic and neoplastic diseases.
Integrins
are composed by two non-covalently linked alpha and beta subunits. a 5 b 1
integrin, also known as the fibronectin receptor, is a heterodimer consisting of the a 5
and b 1 subunits. Integrins can
be broadly grouped based on ligand specificity. In this classification, integrin a 5 b 1
falls under RGD-recognizing integrins and is known to bind fibronectin, osteopontin, fibrillin, thrombospondin, among others. a 5 b 1
integrin has been shown to play a role in cancer, angiogenesis and in a variety of neurological disorders. a 5 b 1
integrin is a validated drug target supported by the clinical development of anti- a 5 b 1
mAbs by several pharmaceutical companies, including PDL Biopharma, Inc. jointly with Biogen Inc., and Pfizer, Inc., for the treatment
of cancer indications.
9
In
a 2018 Nature Neuroscience publication, scientists at the Steinman Laboratory at Stanford University, headed by our Chairman, Prof.
Lawrence Steinman, used mass cytometry to identify an upregulation of a 5 b 1
integrin (CD49e) on brain myeloid cells in the mutant SOD1-G93A mouse model of ALS and demonstrated that a 5 b 1
integrin is upregulated on microglia in the CNS as the disease progresses. Additional preclinical studies have shown that a 5 b 1
integrin is also elevated on macrophages in the periphery and suggest a role for mast cells which also express high level of a 5 b 1
integrin.
In August 2023, we announced
the publication of a study in the peer-reviewed journal Proceedings of the National Academy of Sciences (PNAS) that presented new
findings related to PAS-003 from an interdisciplinary collaboration of scientific teams from the Company, the Mayo Clinic, and Oregon
Health & Science University, combining results from human post-mortem tissues from ALS patients and tissue samples from the SOD1-G93A
mouse model of ALS (“SOD1-G93A”), the most phenotypically relevant preclinical model for ALS.
We have shown an upregulation of a 5 b 1
integrin in the human brain motor regions but not in sensory regions in ALS and that a 5 b 1
expression increases with disease progression in both mouse models of ALS and human ALS patients. Furthermore, we have shown that treatment
with a monoclonal antibody targeting a 5 b 1
leads to increased survival and improved motor function in SOD1-G93A mouse model of ALS.
We
believe these findings suggest that a 5 b 1
integrin in implicated in the pathophysiology of ALS and that targeting a 5 b 1
integrin may provide a treatment for ALS. We have repeated preclinical studies in over 250 animals, using the SOD1-G93A and TDP-43rNLS8
ALS models, and have consistently demonstrated that anti- a 5 b 1
mAb treatment improved motor function on behavioral testing and increased survival in SOD-G93A transgenic mice, as compared to an isotype
control.
We
believe these preclinical results demonstrate that targeting a 5 b 1
integrin has the potential to be a new therapy that could improve outcomes for all ALS patients. In November 2023, we announced that we
selected our PAS-003 lead development candidate, a humanized mAb with optimal properties that targets α5β1 integrin for the
treatment of both sporadic and familial ALS. PAS-003 is now ready for manufacturing and IND enabling studies.
PAS-001
Schizophrenia Overview
Schizophrenia is a chronic
and disabling psychiatric illness characterized by positive psychotic symptoms, such as delusions and hallucinations, negative symptoms,
such as social withdrawal and amotivation, and impairment in cognitive domains, including attention, working memory, verbal learning and
executive function. According to the World Health Organization (“WHO”) schizophrenia affects up to 24 million people in the
world. Schizophrenia has a low lifetime prevalence of about 1%, however the burden of the disease is substantial. Schizophrenia is a leading
cause of adult disease burden and has been ranked 12th in the top global causes of disability for the last decade, leading to substantial
healthcare and societal costs, with annual associated costs in the U.S. estimated to be more than $150 billion.
Current pharmacological treatments
for schizophrenia all act on dopamine D2 receptors. Although they are effective in reducing positive symptoms, they have little effect
on both cognitive and negative symptoms. Furthermore, up to 30% of patients show only partial benefit with antipsychotics and have treatment
resistant schizophrenia. This highlights the need for new therapeutic strategies.
Despite extensive research, the molecular etiology remains unknown.
The current dopamine hypothesis postulates that excessive striatal dopamine transmission and reduced frontal dopamine stimulation underlie
the pathophysiology of positive and negative symptoms, respectively. However, converging lines of genetic, epidemiological and clinical
evidence indicate that inflammatory pathways are also altered in schizophrenia. More recently, a leading hypothesis proposes that synaptic
terminal loss is central to the pathophysiology of schizophrenia, leading to impaired cortical function, and symptoms, including cognitive
impairments.
Scientific Background and Rationale for Targeting
C4A for the treatment of Schizophrenia
The complement system is a
group of proteins found in both the blood and the CNS. In the brain, the complement system plays in almost every aspect of normal brain
development, including neurogenesis, neuronal migration and synaptic refinement, and is now also recognized as a signaling cascade that
facilitate microglial removal of synapses. Microglia are phagocytes residing in the CNS. Unlike other phagocytes, which primarily function
in immunity, microglia are heavily involved in shaping and supporting brain tissue and are key modulators of neuronal development.
There are nine major complement proteins, labeled C1 through C9. Complement protein C4 is the only complement protein that has two different
isotypes encoded by two different genes: C4A and C4B.
According to the synaptic
pruning hypothesis, schizophrenia is thought to arise from a faulty pruning process and excessive synaptic elimination.
10
The largest genome-wide association
study (GWAS) in schizophrenia in 2014 identified 128 independent associations spanning 108 conservatively defined loci that meet genome-wide
significance. The most strongly associated GWAS locus is located in the extended Major Histocompatibility Complex (MHC) region on chromosome
6. This locus contains multiple copies of two closely related genes that codes for variants of C4: C4A and C4B. Their analyses revealed
that C4A copy numbers, as well as other structural variance leading to increased C4A mRNA expression, to a large degree explained schizophrenia
risk originating from this locus. This variant remains the strongest polygenic risk factor for schizophrenia identified to date, making
C4A the first gene linked to a specific mechanism underlying the disease. Importantly, schizophrenia risk was not influenced by copy numbers
of the closely related C4B gene.
Animal models of increased
C4A expression show reduced levels of synaptic proteins and increased phagocytosis of synaptic terminals by microglia. Moreover, preclinical
models showed C4A overexpression leads to reduced neurotransmission in prefrontal cortical neurons, reduced social interaction and impaired
memory, which mimic similar abnormalities seen in schizophrenia patients. Finally, excessive microglial synapse elimination has been observed
in schizophrenia patient-derived neural cultures. Post-mortem brain analyses showed that C4A is expressed at significantly higher levels
in people with schizophrenia than controls. C4A levels in cerebro-spinal fluid (“CSF”) have shown to be elevated in patients
with schizophrenia relative to matched controls and correlates with CSF measurements of synapse density. C4A levels have also been found
to be elevated in plasma in schizophrenia, and higher levels predict poorer outcomes in first episode patients.
Several other studies in scientific
journals have also reported increased complement gene expression, protein concentration, and overall activity in the serum or plasma of
schizophrenia cases compared to controls. Further, a 2020 study published in Brain, Behavior and Immunity , found that C4A was overexpressed
in the dorsolateral prefrontal cortex, parietal cortex, superior temporal gyrus and associative striatum of patients with schizophrenia
and that C4A expression was not altered in the peripheral tissues of schizophrenia patients. Further, the study found lifelong C4Aoverexpression
in the brain of schizophrenia patients. Taken together, this evidence has led to the hypothesis that C4A may play an important role in
the pathophysiology of schizophrenia.
We are currently developing
a brain-penetrant small molecule able to down regulate C4A, for the systemic treatment of schizophrenia. To our knowledge, no other company
is exploring this potentially important target. The initial development work and screening is currently being conducted by Evotec, utilizing
Evotec’s integrated research and development expertise and state-of-the-art structure-based drug design techniques. Our goal is
to continue screening and proceeding with early development of PAS-001 while seeking partnerships and/or collaborators to support further
development of the program including preclinical studies.
Acquisitions
Alpha-5 Integrin Therapeutics, LLC
On June 21, 2022, we entered
into a Membership Interest Purchase Agreement (the “Alpha-5 Agreement”) with PD Joint Holdings, LLC Series 2016-A and Prof.
Lawrence Steinman (the “Alpha-5 Sellers”), pursuant to which we purchased from the Alpha-5 Sellers all of the issued and outstanding
equity of Alpha-5 Integrin, LLC, a Delaware limited liability (“Alpha-5”). The Alpha-5 Sellers were the sole title and beneficial
owners of 100% of the equity interests of Alpha-5. In consideration of the equity of Alpha-5, the Alpha-5 Sellers received (i) an aggregate
of 163,044 shares (the “Alpha-5 Shares”) of our Common Stock, (ii) warrants to purchase 50,000 shares of our Common Stock
at an exercise price of $37.60 per share (the “Alpha-5 Warrants”), and (iii) contingent earn-out payments of an aggregate
of 2% to 4% of net sales generated from the sale of a drug currently in development by Alpha-5.
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Prof. Lawrence Steinman, one
of the Alpha-5 Sellers, is our Executive Chairman and Co-Founder, and as such is considered a related party. The terms of the Alpha-5
Agreement were approved by (i) the disinterested members of the audit committee (“Audit Committee”) of our board of directors
(the “Board”) and (ii) the disinterested members the Board, under the Company’s related party transaction
policy.
In connection with the Alpha-5
Agreement, each of the employees of Alpha-5 entered into employment agreements with the Company.
AlloMek Therapeutics, LLC
On
October 11, 2022, we entered into a Membership Interest Purchase Agreement, dated October 11, 2022 (the “AlloMek Agreement”),
by and among the Company, AlloMek Therapeutics, LLC, a Delaware limited liability company (the “AlloMek”), the persons listed
on Schedule 1.1 thereto (each individually a “AlloMek Seller” and collectively, “Sellers”), and Uday Khire, not
individually but in his capacity as the representative of Sellers (the “AlloMek Representative”), pursuant to which we purchased
all of the issued and outstanding equity of AlloMek. The AlloMek Sellers were the sole title and beneficial owners of 100% of the equity
interests of AlloMek. In consideration of the sale of the equity of AlloMek, the AlloMek Sellers received (i) an aggregate of 135,000
shares of our Common Stock, (ii) warrants to purchase an aggregate of 50,000 shares of our Common Stock (the “AlloMek Warrants”)
at an exercise price of $37.60 per share, which may be exercised on a cashless basis, for a period of five years commencing on the date
of issuance, (iii) a cash payment in the amount of $1.05 million, (iv) the right to certain milestone payments in an amount up to $5.0
million, and (v) the right to contingent earn-out payments ranging from 3% to 5% of net sales of the Drug currently in development (as
defined in the AlloMek Agreement) depending on the amount of such net sales in the applicable measurement period.
Pursuant
to the AlloMek Agreement, we are required to offer to sell the Drug (as defined in the AlloMek Agreement) and certain intellectual
property rights back to Sellers at a price set forth in the AlloMek Agreement within 30 days of the following two conditions being met:
(1) there is a Change of Control (as defined in the AlloMek Agreement) and (2) we fail to meet our obligations regarding development and
commercialization under the AlloMek Agreement, including by commencing a wind-up, a wind-down, a sale, liquidation or distribution of
all or substantially all of our assets, an assignment for the benefit of creditors, or a bankruptcy, or by exiting or announcing an intention
to exit the biotechnology business. The Sellers have one year from the date of notice of our repurchase offer to accept such offer.
Competition
The biotechnology and pharmaceutical
industries are characterized by rapidly evolving technologies, intense competition, and an emphasis on proprietary product candidates.
While we believe that our technology, development experience and scientific knowledge provide us with competitive advantages, we face
potential competition from many different sources, including major pharmaceutical, specialty pharmaceutical, and biotechnology companies,
academic institutions, governmental agencies and public and private research institutions. Any product candidates that we successfully
develop and commercialize will compete with existing therapies and new therapies that may become available in the future.
Many of our competitors may
have significantly greater financial resources and expertise in research and development, manufacturing, preclinical testing, conducting
clinical trials, obtaining regulatory approvals, and marketing approved products than we do. Mergers and acquisitions in the pharmaceutical
and biotechnology industries may result in even more resources being concentrated among a smaller number of our competitors. These competitors
also compete with us in recruiting and retaining qualified scientific and management personnel and establishing clinical trial sites and
patient registration for clinical trials, as well as in acquiring technologies complementary to, or necessary for, our programs. Smaller
or early-stage companies may also prove to be significant competitors, particularly through collaborative arrangements with large and
established companies. Moreover, potential competitors have or may have patents or other rights
that conflict with patents covering our technologies.
The key competitive factors
affecting the success of all our product candidates, if approved, are likely to be their efficacy, safety, side effects, convenience,
price, the level of generic competition, and the availability of reimbursement from government and other third-party payors.
Our commercial opportunity
could be reduced or eliminated if our competitors develop and commercialize products that are safer, more effective, have fewer or less
severe side effects, are more convenient, or are less expensive than any product candidates that we may develop. Our competitors also
may obtain FDA or other regulatory approval for their products more rapidly than we may obtain approval for ours, which could result in
our competitors establishing a strong market position before we are able to enter the market. In addition, our ability to compete may
be affected in many cases by insurers or other third-party payors seeking to encourage the use of generic products.
12
PAS-004
Companies with FDA approved
MEK inhibitors include: GSK plc, which received FDA approval for Mekinist (trametinib), that was subsequently sold to Novartis AG; Pfizer
Inc., which received FDA approval for Mektovi (binimetinib); Genentech, Inc., a member of the Roche Company, which received FDA approval
for Cotellic (cobimetinib); AstraZeneca PLC and Merck & Co., Inc., which received FDA approval for Koselugo (selumetinib); and
SpringWorks Therapeutics, Inc, which received FDA approval for Gomekli (mirdametinib).
Koselugo (selumetinib)
marketed by AstraZeneca PLC was the first FDA approved therapy for the treatment of pediatric NF1-PN patients, while Gomekli (mirdametinib)
marketed by SpringWorks Therapeutics, Inc was approved by the FDA in February 2025 for adult and pediatric patients aged 2 and older with
NF1 who have symptomatic PNs not amenable to complete resection. Mekinist, Mektovi, and Cotellic are approved for certain oncology indications.
We are aware that other companies
are, or may be, developing products for NF1-PN, including, but not limited to Array BioPharma Inc. (a subsidiary of Pfizer), Chia Tai
Tianqing Pharmaceutical Group Co., LTD, Healx Ltd., Infixion Bioscience, Inc., NFlection Therapeutics, Inc., Novartis International AG,
and Shanghai Fosun Pharmaceutical (Group) Co., Ltd., and Shanghai Kechow Pharma, Inc. We are also aware of several therapies, some of
which are generic, that are used off-label for the treatment of NF1-PN. These therapies include radiotherapy and various systemic treatments,
such as chemotherapy and immunotherapy.
There are other MEK inhibitors
in various stages of clinical trials for multiple indications, including various cancers and NF1-PN. Additionally, there are other FDA
approved small molecule therapeutics that target the MAPK signaling pathway.
Intellectual Property
Our ability to obtain, maintain
and enforce intellectual property protection for our products candidates, formulations, processes, methods and any other proprietary technologies,
preserve our trade secrets, and operate without infringing on the proprietary rights of other parties, both in the United States and in
other countries is fundamental to the long-term success of our business. Our policy is to actively seek to obtain, where appropriate,
the broadest intellectual property protection possible for our current product candidates and any future product candidates, proprietary
information and proprietary technology through a combination contractual arrangements and patents, both in the United States and abroad.
However, patent protection may not afford us with complete protection against competitors who seek to circumvent our patents.
We also depend upon the skills,
knowledge, experience and know-how of our management and research and development personnel, as well as that of our advisors, consultants
and other contractors. To help protect our proprietary know-how, which is not patentable, and for inventions for which patents may be
difficult to enforce, we currently rely and will in the future rely on trade secret protection and confidentiality agreements to protect
our interests. To this end, we require all of our employees, consultants, advisors and other contractors to enter into confidentiality
agreements that prohibit the disclosure of confidential information and, where applicable, require invention assignment agreements to
us of the ideas, developments, discoveries and inventions important to our business.
We generally control access
to our proprietary and confidential information through the use of internal controls that are subject to periodic review. Although we
take steps to protect our proprietary information and trade secrets, third parties may independently develop substantially equivalent
proprietary information and techniques or otherwise gain access to our trade secrets or disclose our technology. As a result, we may not
be able to meaningfully protect our trade secrets. For further discussion of the risks relating to intellectual property, see the section
titled “Risk Factors—Risks Related to Our Intellectual Property.”
Our patent portfolio includes
issued and pending applications worldwide for each of our programs.
13
PAS-004
For PAS-004, we have issued patents titled “Novel MEK inhibitors,
useful in the treatment of diseases” that have claims directed to composition of matter and methods of use, and includes granted
patents in the United States, Australia, Canada, China, Germany, Spain, France, Italy, Great Britain, India and Japan, that are expected
to expire in October of 2030 (without consideration of patent term adjustment (“PTA”) and patent term extension (“PTE”)).
We have a pending application directed to solid forms of PAS-004 including claims directed to polymorphic forms and methods of use and
a pending application directed to tablet formulations and uses thereof. We also have a pending application directed to stereoisomers of
PAS-004 that have claims directed to composition of matter and methods of use. Patents that may be issued in these families will have
a statutory expiration date of 2045 (without consideration of PTA and PTE).
PAS-003
For PAS-003, we have pending patent applications in two patent families.
The first patent family has claims directed to monoclonal antibodies. The second patent family has claims directed to humanized monoclonal
antibodies. Patents that may be issued worldwide in these families will have a statutory expiration date in May of 2042 to November
2043 (without consideration of PTA and PTE).
Grant Agreements
FightMND Grant
In
connection with the acquisition of Alpha-5, we legally assumed rights under a three-year grant agreement with FightMND, a not-for-profit
Australian charity, which was entered into by Alpha-5 on September 23, 2021. FightMND supports preclinical research, development and assessment
of therapeutics for Motor Neuron Disease/Amyotrophic Sclerosis. Under the grant agreement, we are entitled to reimbursements for costs
incurred up to $967,010 AUD for research related to a monoclonal antibody targeting a 5 b 1
integrin as a potential treatment for ALS. For the years ended December 31, 2024 and 2023, the Company recorded zero dollars of grant
income as a contra expense within research and development.
Manufacturing
We contract with third parties for the manufacture of our product candidates
for preclinical studies and clinical trials in accordance with the FDA’s cGMP regulations, and we intend to continue to do so in
the future. For PAS-004, we currently work with one contract manufacturing organization (“CMO”) for GMP materials, WuXi STA,
a subsidiary of WuXi AppTec (“Wuxi”) for the manufacture of PAS-004 drug substance and drug product for our clinical trials.
We do not own or operate and currently have no plans to establish any manufacturing facilities.
The manufacture of pharmaceuticals
is subject to extensive cGMP regulations, which impose various procedural and documentation requirements and govern all areas of record
keeping, production processes and controls, personnel and quality control. Replacement of any of our CMOs would require us to qualify
new manufacturers and negotiate and execute contractual agreements with them. If any of our supply or service agreements with our existing
CMOs are terminated, we may experience delays and additional expenses in the completion of the development of and obtaining regulatory
approval for our product candidates. To mitigate the risks above we utilize outside CMC consultants with pharmaceutical development and
manufacturing experience to assist with the management of the relationships with our CMO.
We believe that the use of
contract CMOs eliminates the need to directly invest in manufacturing facilities, equipment and additional staff.
14
As we further develop our product candidates, we expect to consider
secondary or back-up manufacturers for both active pharmaceutical ingredients and drug product manufacturing. To date, our CMO has met
the manufacturing requirements for our product candidates in a timely manner. We expect third-party manufacturers to be capable of providing
sufficient quantities of our product candidates to meet our current needs, but we have not assessed these capabilities beyond the supply
of clinical materials to date.
Although we believe that there are several potential alternative manufacturers
who could manufacture our product candidates, we may incur added costs and delays in identifying and qualifying any such replacement or
be unable to reach agreement with an alternative manufacturer. If we are unable to obtain sufficient quantities of our products candidates
or receive raw materials in a timely manner, we could be required to delay our ongoing clinical trials and seek alternative manufacturers,
which could be costly and time-consuming.
We currently engage CMOs on
a fee for services based on the needs of our current development plans.
Employees & Human Capital
As of December 31, 2024, we
had four full-time employees. None of our employees are represented by a labor union or covered by a collective bargaining agreement.
We believe that our future success will depend, in part, on our continued
ability to attract, hire and retain qualified personnel. In particular, we depend on the skills, experience and performance of our senior
management and research personnel. We compete for qualified personnel with other medical pharmaceutical and healthcare companies, as well
as universities and non-profit research institutions.
We
provide competitive compensation and benefits programs to help meet the needs of our employees. In addition to salaries, these programs
(which vary by country/region and employment classification) include incentive compensation plans, healthcare and insurance benefits,
retirement investments, paid time off, and family leave, among others. We also use targeted equity-based grants with vesting conditions
to facilitate retention of personnel, particularly for our key employees.
The success of our business is fundamentally connected to the well-being
of our people. Accordingly, we are committed to the health and safety of our employees.
We consider our relations
with our employees to be good.
Facilities
Our principal executive office
is located at 1111 Lincoln Road, Suite 500, Miami Beach, FL 33139. We rent approximately 300 square feet of space, which includes our
executive offices.
Our website is www.pasithea.com .
On our website, investors can obtain, free of charge, a copy of our Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, Current
Reports on Form 8-K, our Code of Conduct and Business Ethics, including disclosure related to any amendments or waivers thereto, other
reports and any amendments thereto filed or furnished pursuant to Section 13(a) or 15(d) of the Exchange Act of 1934, as amended, as soon
as reasonably practicable after we file such material electronically with, or furnish it to, the Securities and Exchange Commission, or
the SEC. None of the information posted on our website is incorporated by reference into this Annual Report. The SEC also maintains a
website at http://www.sec.gov that contains reports, proxy and information statements and other information regarding us and other companies
that file materials with the SEC electronically.
15
Government Regulation and Drug Approval
Government authorities in
the United States (including federal, state and local authorities) and in other countries, extensively regulate, among other things, the
manufacturing, research and clinical development, marketing, labeling and packaging, storage, distribution, post-approval monitoring and
reporting, advertising and promotion, pricing and export and import of pharmaceutical products, such as our future product candidates.
The process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, state, local and foreign statutes
and regulations require the expenditure of substantial time and financial resources. Moreover, failure to comply with applicable regulatory
requirements may result in, among other things, warning letters, clinical holds, civil or criminal penalties, recall or seizure of products,
injunction, disbarment, partial or total suspension of production or withdrawal of the product from the market. Any agency or judicial
enforcement action could have a material adverse effect on us.
U.S. Government Regulation
In the United States, the
FDA regulates pharmaceutical products under the Federal Food, Drug, and Cosmetic Act (“FDCA”) and implementing regulations
and other federal, state and local statutes and regulations. In the case of biologics, the section of the FDCA that governs the
approval of drugs via New Drug Applications (“NDAs”) does not apply to the approval of biologics. Rather, biologics, such
as monoclonal antibodies and gene therapy products, are approved for marketing under provisions of the Public Health Service Act (“PHSA”)
via a Biologics License Application (“BLA”). However, the application process and requirements for approval of BLAs are very
similar to those for NDAs. Drugs and biologics are also subject to other federal, state and local statutes and regulations. Accordingly,
we have and plan to continue to investigate our products through the IND framework and seek approval through the NDA and BLA pathways.
The process required by the FDA before our product candidates may be marketed in the United States generally involves the following:
●
submission to the FDA of an IND which must become effective before human clinical trials may begin and must be updated annually;
●
completion of extensive preclinical laboratory tests and preclinical animal studies, all performed in accordance with the FDA’s Good Laboratory Practice regulations;
●
performance of adequate and well-controlled human clinical trials to establish the safety and efficacy of the product candidate for each proposed indication in accordance with good clinical practice (“GCP”);
●
submission to the FDA of an NDA or BLA after completion of all pivotal clinical trials;
●
a determination by the FDA within 60 days of its receipt of an NDA or BLA to file the NDA or BLA for review;
●
satisfactory completion of an FDA pre-approval inspection of the manufacturing facilities at which the active pharmaceutical ingredient (“API”), and finished drug product are produced and tested to assess compliance with good manufacturing practices (“cGMP”) regulations; and
●
FDA review and approval of an NDA or BLA prior to any commercial marketing or sale of the drug in the United States.
An IND is a request for authorization
from the FDA to administer an investigational drug product to humans. The central focus of an IND submission is on the general investigational
plan and the protocol(s) for human studies. The IND also includes results of animal studies or other human studies, as appropriate, as
well as manufacturing information, analytical data and any available clinical data or literature to support the use of the investigational
new drug. An IND must become effective before human clinical trials may begin. An IND will automatically become effective 30 days after
receipt by the FDA, unless before that time the FDA raises concerns or questions related to the proposed clinical trials. In such a case,
the IND may be placed on clinical hold and the IND sponsor and the FDA must resolve any outstanding concerns or questions before clinical
trials can begin. Accordingly, submission of an IND may or may not result in the FDA allowing clinical trials to commence.
16
Clinical trials involve the
administration of the investigational drug to human subjects under the supervision of qualified investigators in accordance with GCP,
which include the requirement that all research subjects provide their informed consent for their participation in any clinical trial.
Clinical trials are conducted under protocols detailing, among other things, the objectives of the study, the parameters to be used in
monitoring safety, and the efficacy criteria to be evaluated. A protocol for each clinical trial and any subsequent protocol amendments
must be submitted to the FDA as part of the IND. Additionally, approval must also be obtained from each clinical trial site’s institutional
review board (“IRB”) before the trials may be initiated, and the IRB must monitor the study until completed. There are also
requirements governing the reporting of ongoing clinical trials and clinical trial results to public registries.
The clinical investigation
of a drug or biologic is generally divided into three phases. Although the phases are usually conducted sequentially, they may overlap
or be combined. The three phases of an investigation are as follows:
●
Phase I . Phase I includes the initial introduction of an investigational new drug into humans. Phase I clinical trials are typically closely monitored and may be conducted in patients with the target disease or condition or in healthy volunteers. These studies are designed to evaluate the safety, dosage tolerance, metabolism and pharmacologic actions of the investigational drug in humans, the side effects associated with increasing doses, and if possible, to gain early evidence on effectiveness. During Phase I clinical trials, sufficient information about the investigational drug’s pharmacokinetics and pharmacological effects may be obtained to permit the design of well-controlled and scientifically valid Phase II clinical trials. The total number of participants included in Phase I clinical trials varies but is generally in the range of 20 to 80.
●
Phase II . Phase II includes controlled clinical trials conducted to preliminarily or further evaluate the effectiveness of the investigational drug for a particular indication(s) in patients with the disease or condition under study, to determine dosage tolerance and optimal dosage, and to identify possible adverse side effects and safety risks associated with the drug. Phase II clinical trials are typically well-controlled, closely monitored, and conducted in a limited patient population, usually involving no more than several hundred participants.
●
Phase III . Phase III clinical trials are generally controlled clinical trials conducted in an expanded patient population generally at geographically dispersed clinical trial sites. They are performed after preliminary evidence suggesting effectiveness of the drug has been obtained, and are intended to further evaluate dosage, clinical effectiveness and safety, to establish the overall benefit-risk relationship of the investigational drug product, and to provide an adequate basis for product approval. Phase III clinical trials usually involve several hundred to several thousand participants.
A pivotal study is a
clinical study which adequately meets regulatory agency requirements for the evaluation of a drug candidate’s efficacy and
safety such that it can be used to justify the approval of the product. Generally, pivotal studies are also Phase III studies but
maybe Phase II studies if the trial design provides a well-controlled and reliable assessment of clinical benefit, particularly in
situations where there is an unmet medical need.
The FDA, the IRB or the clinical
trial sponsor may suspend or terminate a clinical trial at any time on various grounds, including a finding that the research subjects
are being exposed to an unacceptable health risk. Additionally, some clinical trials are overseen by an independent group of qualified
experts organized by the clinical trial sponsor, known as a data safety monitoring board or committee. This group provides authorization
for whether or not a trial may move forward at designated check points based on access to certain data from the study. We may also suspend
or terminate a clinical trial based on evolving business objectives and/or competitive climate.
Assuming successful completion
of all required testing in accordance with all applicable regulatory requirements, detailed investigational drug product information is
submitted to the FDA in the form of an NDA or BLA requesting approval to market the product for one or more indications. The application
includes all relevant data available from pertinent preclinical and clinical trials, including negative or ambiguous results as well as
positive findings, together with detailed information relating to the product’s chemistry, manufacturing, controls and proposed
labeling, among other things. Data can come from company-sponsored clinical trials intended to test the safety and effectiveness of the use of a product, or from a number of alternative sources, including studies initiated by investigators. To support marketing approval,
the data submitted must be sufficient in quality and quantity to establish the safety and effectiveness of the investigational drug product
to the satisfaction of the FDA.
17
Once the NDA or BLA submission
has been accepted for filing, within 60 days following submission, the FDA’s goal is to review applications for new molecular entities
within ten months of the filing date or, if the application relates to a serious or life-threatening indication and demonstrates the potential
to provide a significant improvement in safety or effectiveness over currently marketed therapies, six months from the filing date. The
review process is often significantly extended by FDA requests for additional information or clarification. The FDA may refer the application
to an advisory committee for review, evaluation and recommendation as to whether the application should be approved. The FDA is not bound
by the recommendation of an advisory committee, but it typically follows such recommendations.
After the FDA evaluates the
NDA or BLA and conducts inspections of manufacturing facilities where the drug product and/or its active pharmaceutical ingredient will
be produced, it may issue an approval letter or a complete response letter. An approval letter authorizes commercial marketing of the
drug with specific prescribing information for specific indications. A complete response letter indicates that the review cycle of the
application is complete, and the application is not ready for approval. A complete response letter may require additional clinical data
and/or an additional pivotal Phase III clinical trial(s), and/or other significant, expensive and time-consuming requirements related
to clinical trials, preclinical studies or manufacturing. Even if such additional information is submitted, the FDA may ultimately decide
that the NDA or BLA does not satisfy the criteria for approval. The FDA could also approve the NDA or BLA with a risk evaluation and mitigation
strategy (REMS) to mitigate risks, which could include medication guides, physician communication plans, or elements to assure safe use,
such as restricted distribution methods, patient registries and other risk minimization tools. The FDA also may condition approval on,
among other things, changes to proposed labeling, development of adequate controls and specifications, or a commitment to conduct one
or more post-market studies or clinical trials. Such post-market testing may include Phase IV clinical trials and surveillance to further
assess and monitor the product’s safety and effectiveness after commercialization. Regulatory approval of oncology products often
requires that patients in clinical trials be followed for long periods to determine the overall survival benefit of the drug.
After regulatory approval
of a drug product is obtained, manufacturers are required to comply with a number of post-approval requirements. The holder of an approved
NDA or BLA must report, among other things, certain adverse reactions and production problems to the FDA, to provide updated safety and
efficacy information, and to comply with requirements concerning advertising and promotional labeling for the approved product. Also,
quality control and manufacturing procedures must continue to conform to cGMP after approval to ensure and preserve the long-term stability
of the drug product. The FDA periodically inspects manufacturing facilities to assess compliance with cGMP, which imposes extensive procedural,
substantive and record keeping requirements. In addition, changes to the manufacturing process are strictly regulated, and, depending
on the significance of the change, may require prior FDA approval before being implemented. FDA regulations also require investigation
and correction of any deviations from cGMP and impose reporting and documentation requirements upon us and any third-party manufacturers
that we may decide to use. Accordingly, manufacturers must continue to expend time, money and effort in the area of production and quality
control to maintain compliance with cGMP and other aspects of regulatory compliance.
We expect to rely on third
parties for the production of clinical and commercial quantities of our future product candidates. Future FDA and state inspections may
identify compliance issues at our facilities or at the facilities of our contract manufacturers that may disrupt production or distribution or require substantial resources to correct. In addition, discovery of previously unknown problems with a product or the failure to comply
with applicable requirements may result in restrictions on a product, manufacturer or holder of an approved NDA or BLA, including withdrawal
or recall of the product from the market or other voluntary, FDA-initiated or judicial action that could delay or prohibit further marketing.
Newly discovered or developed safety or effectiveness data may require changes to a product’s approved labeling, including the addition
of new warnings and contraindications, and also may require the implementation of other risk management measures. Also, new government
requirements, including those resulting from new legislation, may be established, or the FDA’s policies may change, which could
delay or prevent regulatory approval of our products under development.
18
Expedited Development and Review Programs
for Drugs
The FDA maintains several
programs intended to facilitate and expedite development and review of new drugs and biologics to address unmet medical needs in the treatment
of serious or life-threatening diseases or conditions. These programs include Fast Track designation, Breakthrough Therapy designation,
Priority Review and Accelerated Approval, and the purpose of these programs is to either expedite the development or review of important
new drugs to get them to patients more quickly than standard FDA review timelines typically permit.
A drug is eligible for Fast
Track designation if it is intended to treat a serious or life-threatening disease or condition and demonstrates the potential to address
unmet medical needs for such disease or condition. Fast Track designation provides increased opportunities for sponsor interactions with
the FDA during preclinical and clinical development, in addition to the potential for rolling review once a marketing application is filed.
Rolling review means that the agency may review portions of the marketing application before the sponsor submits the complete application.
In addition, a drug may be eligible for Breakthrough Therapy designation if it is intended to treat a serious or life-threatening disease
or condition and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over existing therapies
on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. Breakthrough
Therapy designation provides all the features of Fast Track designation in addition to intensive guidance on an efficient drug development
program, and FDA organizational commitment to expedited development, including involvement of senior managers and experienced review staff
in a cross-disciplinary review, where appropriate.
Any product submitted to the
FDA for approval, including a product with Fast Track or Breakthrough Therapy designation, may also be eligible for additional FDA programs
intended to expedite the review and approval process, including Priority Review designation and Accelerated Approval. A product is eligible
for Priority Review designation, once an NDA or a biologics license application, or BLA, is submitted, if the drug that is the subject
of the marketing application has the potential to provide a significant improvement in safety or effectiveness in the treatment, diagnosis
or prevention of a serious disease or condition. Under priority review, the FDA’s goal date to take action on the marketing application
is six months compared to ten months for a standard review. Products are eligible for Accelerated Approval if they can be shown to have
an effect on a surrogate endpoint that is reasonably likely to predict clinical benefit, or an effect on an intermediate clinical endpoint
that can be measured earlier than an effect on irreversible morbidity or mortality, which is reasonably likely to predict an effect on
irreversible morbidity or mortality or other clinical benefit, taking into account the severity, rarity, or prevalence of the condition
and the availability or lack of alternative treatments.
Accelerated Approval is usually
contingent on a sponsor’s agreement to conduct additional post-approval studies to verify and describe the product’s clinical
benefit. The FDA may withdraw approval of a drug, or an indication approved under Accelerated Approval if, for example, the confirmatory
trial fails to verify the predicted clinical benefit of the product. In addition, the FDA generally requires, as a condition for Accelerated
Approval, that all advertising and promotional materials intended for dissemination or publication within 120 days of marketing approval
be submitted to the agency for review during the pre-approval review period. After the 120-day period has passed, all advertising and
promotional materials must be submitted at least 30 days prior to the intended time of initial dissemination or publication.
Even if a product qualifies
for one or more of these programs, the FDA may later decide that the product no longer meets the conditions for qualification or the time
period for FDA review or approval may not be shortened. Furthermore, Fast Track designation, Breakthrough Therapy designation, Priority
Review and Accelerated Approval do not change the scientific or medical standards for approval or the quality of evidence necessary to
support approval, though they may expedite the development or review process.
19
Orphan Designation and Exclusivity
Under the Orphan Drug Act,
the FDA may grant orphan designation to a drug or biologic intended to treat a rare disease or condition, defined as a disease or condition
with a patient population of fewer than 200,000 individuals in the United States, or a patient population greater than 200,000 individuals
in the United States and when there is no reasonable expectation that the cost of developing and making available the drug or biologic
in the United States will be recovered from sales in the United States for that drug or biologic. Orphan drug designation must be requested
before submitting a BLA or NDA. After the FDA grants orphan drug designation, the generic identity of the therapeutic agent and its potential
orphan use are disclosed publicly by the FDA.
If a product that has orphan
drug designation subsequently receives the first FDA approval for a particular active ingredient for the disease for which it has such
designation, the product is entitled to orphan product marketing exclusivity, which means that the FDA may not approve any other applications,
including a full BLA, to market the same biologic for the same use or indication for seven years, except in limited circumstances, such
as a showing of clinical superiority to the product with orphan drug exclusivity or if FDA finds that the holder of the orphan drug exclusivity
has not shown that it can assure the availability of sufficient quantities of the orphan drug to meet the needs of patients with the disease
or condition for which the drug was designated. Orphan drug exclusivity does not prevent the FDA from approving a different drug or biologic
for the same disease or condition, or the same drug or biologic for a different disease or condition. Among the other benefits of orphan
drug designation are tax credits for certain research and a waiver of the BLA or NDA application user fee.
A designated orphan drug may
not receive orphan drug exclusivity if it is approved for a use that is broader than the indication for which it received orphan designation.
In addition, orphan drug exclusive marketing rights in the United States may be lost if the FDA later determines that the request for
designation was materially defective or, as noted above, if the second applicant demonstrates that its product is clinically superior
to the approved product with orphan exclusivity or the manufacturer of the approved product is unable to assure sufficient quantities
of the product to meet the needs of patients with the rare disease or condition.
The Rare Pediatric Disease Designation and Priority Review Voucher
Program
Under the FD&C Act, the
FDA incentivizes the development of drugs and biologics that meet the definition of a “rare pediatric disease,” defined to
mean a serious or life-threatening disease in which the serious or life-threatening manifestations primarily affect individuals aged from
birth to 18 years and the disease affects fewer than 200,000 individuals in the United States or affects more than 200,000 in the United
States and for which there is no reasonable expectation that the cost of developing and making such product for such disease or condition
will be received from sales in the United States. To be eligible for the incentives, a sponsor must first request and receive from FDA,
prior to or with an NDA or BLA submission, a rare pediatric disease designation. The FDA must deem the application eligible for priority
review (i.e., the product treats a serious condition and, if approved, would provide a significant improvement in safety or effectiveness).
If the rare pediatric product is approved, the sponsor may be eligible for a voucher that can be used to obtain a priority review for
a subsequent, different NDA or BLA for any use, pediatric or not. Rare pediatric disease designation does not guarantee that
a sponsor will receive a priority review voucher (PRV) upon approval of its NDA or BLA. If a PRV is received, it may be sold or transferred
an unlimited number of times. Under current law, PRVs can be granted only for products that receive rare disease designation by September
30, 2024, and that are approved by September 30, 2026.
U.S. Patent Term Restoration
Depending upon the timing,
duration, and specifics of the FDA approval of the use of our current and potential product candidates, some of our U.S. patents may be
eligible for limited patent term extension under the Drug Price Competition and Patent Term Restoration Act of 1984 (“Hatch-Waxman
Amendments”). The Hatch-Waxman Amendments permit a patent restoration term of up to five years as compensation for patent term lost
during product development and the FDA regulatory review process. However, patent term restoration cannot extend the remaining term of
a patent beyond a total of 14 years from the product’s approval date. The patent term restoration period is generally one-half the
time between the effective date of an IND and the submission date of an NDA or BLA plus the time between the submission date of a BLA
or NDA and the approval of that application. Only one patent applicable to an approved biological product is eligible for the extension
and the application for the extension must be submitted prior to the expiration of the patent. The U.S. Patent and Trademark Office, in
consultation with the FDA, reviews and approves the application for any patent term extension or restoration.
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Disclosure of Clinical Trial Information
Sponsors of clinical trials
of FDA-regulated drugs and biologics are required to register and disclose certain clinical trial information on the website www.clinicaltrials.gov.
Information related to the product, patient population, phase of investigation, trial sites and investigators, and other aspects of a
clinical trial are then made public as part of the registration. Sponsors are also obligated to disclose the results of their clinical
trials after completion. Disclosure of the results of clinical trials can be delayed in certain circumstances for up to two years after
the date of completion of the trial. Competitors may use this publicly available information to gain knowledge regarding the progress
of clinical development programs as well as clinical trial design.
Pediatric Information
Under the Pediatric Research
Equity Act (“PREA”), NDAs and BLAs must contain data to assess the safety and effectiveness of the product for the claimed
indications in all relevant pediatric subpopulations and to support dosing and administration for each pediatric subpopulation for which
the product is safe and effective. The FDA may grant full or partial waivers, or deferrals, for submission of data. Unless otherwise required
by regulation, PREA does not apply to any product with orphan product designation except a product with a new active ingredient that is
a molecularly targeted cancer product intended for the treatment of an adult cancer and directed at a molecular target determined by FDA
to be substantially relevant to the growth or progression of a pediatric cancer that is subject to an NDA or BLA submitted on or after
August 18, 2020.
The Best Pharmaceuticals for
Children Act (“BPCA”) provides a six-month extension of any non-patent exclusivity for a drug or biologic if certain conditions
are met. Conditions for exclusivity include the FDA’s determination that information relating to the use of a new drug or biologic
in the pediatric population may produce health benefits in that population, the FDA making a written request for pediatric studies, and
the applicant agreeing to perform, and reporting on, the requested studies within the statutory timeframe. Applications under the BPCA
are treated as priority applications, with all of the benefits that designation confers.
Post-Approval Requirements
Once an NDA or BLA is approved,
maintaining post-approval compliance with applicable federal, state, and local statutes and regulations requires the expenditure of substantial
time and financial resources. Manufacturers and other entities involved in the manufacture and distribution of approved products are required
to register establishments where the approved products are made with the FDA and certain state agencies and are subject to periodic
unannounced inspections by the FDA and certain state agencies for compliance with GMP and other laws. Rigorous and extensive FDA
regulation of products continues after approval, particularly with respect to GMP. We rely, and expect to continue to rely, on third parties
for the production and distribution of clinical and commercial quantities of any products that we may commercialize. Manufacturers of
our products are required to comply with applicable requirements in the GMP regulations, including quality control and quality assurance
and maintenance of records and documentation. Other post-approval requirements include reporting of GMP deviations that may affect the
identity, potency, purity and overall safety of a distributed product, record-keeping requirements, reporting of adverse effects, reporting
updated safety and efficacy information, and complying with electronic record and signature requirements. After an NDA or BLA is approved,
the product also may be subject to official lot release. As part of the manufacturing process, the manufacturer is required to perform
certain tests on each lot of the product before it is released for distribution. If the product is subject to official release by the
FDA, the manufacturer submits samples of each lot of product to the FDA together with a release protocol showing a summary of the history
of manufacture of the lot and the results of all of the manufacturer’s tests performed on the lot. The FDA also may perform certain
confirmatory tests on lots of some products before releasing the lots for distribution by the manufacturer. Accordingly, manufacturers
must continue to expend time, money, and effort in the area of production and quality control to maintain GMP compliance. Discovery of
problems with a product after approval may result in restrictions on a product, manufacturer, or holder of an approved BLA, including
withdrawal of the product from the market. In addition, changes to the manufacturing process or facility generally require prior FDA approval
before being implemented. Other types of changes to the approved product, such as adding new indications and additional labeling claims,
are also subject to further FDA review and approval.
We also must comply with the
FDA’s advertising and promotion requirements, such as those related to direct-to-consumer advertising, the prohibition on promoting
products for uses or in patient populations that are not described in the product’s approved labeling (known as “off-label
use”), industry-sponsored scientific and educational activities, and promotional activities involving the internet. Discovery of
previously unknown problems or the failure to comply with the applicable regulatory requirements may result in restrictions on the marketing
of a product or withdrawal of the product from the market as well as possible civil or criminal sanctions.
21
Hatch-Waxman Amendments and Exclusivity
Section 505 of the FDCA describes
three types of marketing applications that may be submitted to the FDA to request marketing authorization for a new drug. A Section 505(b)(1)
NDA is an application that contains full reports of investigations of safety and efficacy. A 505(b)(2) NDA is an application that contains
full reports of investigations of safety and efficacy but where at least some of the information required for approval comes from investigations
that were not conducted by or for the applicant and for which the applicant has not obtained a right of reference or use from the person
by or for whom the investigations were conducted. This regulatory pathway enables the applicant to rely, in part, on the FDA’s prior
findings of safety and efficacy for an existing product, or published literature, in support of its application. Section 505(j) establishes
an abbreviated approval process for a generic version of approved drug products through the submission of an ANDA. An ANDA provides for
marketing of a generic drug product that has the same active ingredients, dosage form, strength, route of administration, labeling, performance
characteristics and intended use, among other things, to a previously approved product. ANDAs are termed “abbreviated” because
they are generally not required to include preclinical (animal) and clinical (human) data to establish safety and efficacy. Instead, generic
applicants must scientifically demonstrate that their product is bioequivalent to, or performs in the same manner as, the innovator drug
through in vitro, in vivo or other testing. The generic version must deliver the same amount of active ingredients into a subject’s
bloodstream in the same amount of time as the innovator drug and can often be substituted by pharmacists under prescriptions written for
the reference listed drug. In seeking approval for a drug through an NDA, applicants are required to list with the FDA each patent with
claims that cover the applicant’s drug or a method of using the drug. Upon approval of a drug, each of the patents listed in the
application for the drug is then published in the Orange Book. Drugs listed in the Orange Book can, in turn, be cited by potential competitors
in support of approval of an ANDA or 505(b)(2) NDA.
Upon submission of an ANDA
or a 505(b)(2) NDA, an applicant must certify to the FDA that (1) no patent information on the drug product that is the subject of the
application has been submitted to the FDA; (2) such patent has expired; (3) the date on which such patent expires; or (4) such patent
is invalid or will not be infringed upon by the manufacture, use or sale of the drug product for which the application is submitted. Generally,
the ANDA or 505(b)(2) NDA cannot be approved until all listed patents have expired, except where the ANDA or 505(b)(2) NDA applicant challenges
a listed patent through the last type of certification, also known as a paragraph IV certification. If the applicant does not challenge
the listed patents or indicates that it is not seeking approval of a patented method of use, the ANDA or 505(b)(2) NDA application will
not be approved until all of the listed patents claiming the referenced product have expired.
If the ANDA or 505(b)(2) NDA
applicant has provided a Paragraph IV certification to the FDA, the applicant must send notice of the Paragraph IV certification to the
NDA and patent holders once the application has been accepted for filing by the FDA. The NDA and patent holders may then initiate a patent
infringement lawsuit in response to the notice of the paragraph IV certification. If the paragraph IV certification is challenged by an
NDA holder or the patent owner(s) asserts a patent challenge to the paragraph IV certification, the FDA may not approve that application
until the earlier of 30 months from the receipt of the notice of the paragraph IV certification, the expiration of the patent, when the
infringement case concerning each such patent was favorably decided in the applicant’s favor or settled, or such shorter or longer
period as may be ordered by a court. This prohibition is generally referred to as the 30-month stay. In instances where an ANDA or 505(b)(2)
NDA applicant files a paragraph IV certification, the NDA holder or patent owner(s) regularly take action to trigger the 30-month stay,
recognizing that the related patent litigation may take many months or years to resolve.
The FDA also cannot approve
an ANDA or 505(b)(2) application until all applicable non-patent exclusivities listed in the Orange Book for the branded reference drug
have expired. For example, a pharmaceutical manufacturer may obtain five years of non-patent exclusivity upon NDA approval of a new chemical
entity, or NCE, which is a drug containing an active moiety that has not been approved by FDA in any other NDA. An “active moiety”
is defined as the molecule responsible for the drug substance’s physiological or pharmacologic action. During that five-year exclusivity
period, the FDA cannot accept for filing (and therefore cannot approve) any ANDA seeking approval of a generic version of that drug or
any 505(b)(2) NDA that relies on the FDA’s approval of the drug, provided that that the FDA may accept an ANDA four years into the
NCE exclusivity period if the ANDA applicant also files a Paragraph IV certification.
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A drug, including one approved
under Section 505(b)(2), may obtain a three-year period of exclusivity for a particular condition of approval, or change to a marketed
product, such as a new formulation for a previously approved product, if one or more new clinical studies (other than bioavailability
or bioequivalence studies) was essential to the approval of the application and was conducted/sponsored by the applicant. Should this
occur, the FDA would be precluded from approving any ANDA or 505(b)(2) application for the protected modification until after that three-year
exclusivity period has run. However, unlike NCE exclusivity, the FDA can accept an application and begin the review process during the
exclusivity period.
Biosimilars and Exclusivity
The Biologics Price Competition
and Innovation Act of 2009 (“BPCIA”) created an abbreviated approval pathway for biological products shown to be highly
similar to, or interchangeable with, an FDA-licensed reference biological product. The FDA has issued several guidance documents outlining
an approach to review and approval of biosimilars.
Biosimilarity, which requires
that there be no clinically meaningful differences between the biological product and the reference product in terms of safety, purity,
and potency, can be shown through analytical studies, animal studies, and clinical study or studies. Interchangeability requires that
a product is biosimilar to the reference product and the product must demonstrate that it can be expected to produce the same clinical
results as the reference product in any given patient and, for products that are administered multiple times to an individual, the biologic
and the reference biologic may be alternated or switched after one has been previously administered without increasing safety risks or
risks of diminished efficacy relative to exclusive use of the reference biologic.
The BPCIA includes, among
other provisions:
●
A 12-year exclusivity period from the date of first licensure, or BLA approval, of the reference product, during which approval of a 351(k) application referencing that product may not be made effective;
●
A four-year exclusivity period from the date of first licensure of the reference product, during which a 351(k) application referencing that product may not be submitted; and
●
An exclusivity period for certain biological products that have been approved through the 351(k) pathway as interchangeable biosimilars.
The BPCIA also establishes
procedures for identifying and resolving patent disputes involving applications submitted under section 351(k) of the PHSA.
The BPCIA is complex and its
interpretation and implementation by the FDA remains unpredictable. In addition, government proposals have sought to reduce the 12-year
reference product exclusivity period. Other aspects of the BPCIA, some of which may impact the BPCIA exclusivity provisions, have also
been the subject of recent litigation. As a result, the ultimate effect, implementation, and meaning of the BPCIA is subject to uncertainty.
Failure to comply with the
applicable U.S. requirements after approval may subject an applicant or manufacturer to administrative or judicial civil or criminal sanctions
and adverse publicity. FDA sanctions could include refusal to approve pending applications, withdrawal of an approval, clinical hold,
warning or untitled letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions,
fines, refusals of government contracts, mandated corrective advertising or communications with doctors, debarment, restitution, disgorgement
of profits, or civil or criminal penalties.
Europe/Rest of World Government Regulation
In addition to regulations
in the United States, we may be subject to a variety of regulations in other jurisdictions governing, among other things, clinical trials
and any commercial sales and distribution of our future product candidates.
Whether or not we obtain FDA
approval for a product, we must obtain the requisite approvals from regulatory authorities in foreign countries prior to the commencement
of clinical trials or marketing of the product in those countries. Certain countries outside of the United States have a similar process
that requires the submission of a clinical trial application much like the IND prior to the commencement of human clinical trials. In
Europe, for example, a clinical trial application (“CTA”), must be submitted to each country’s national health authority
and an independent ethics committee, much like the FDA and IRB, respectively. Once the CTA is approved in accordance with a country’s
requirements, clinical trial development may proceed.
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Following the U.K.’s
exit from the European Union, a separate regulatory regime applies in the U.K. to clinical trials and licensing of medicines.
The requirements and process
governing the conduct of clinical trials, product licensing, pricing and reimbursement vary from country to country. In all cases, the
clinical trials are conducted in accordance with GCP and the applicable regulatory requirements and the ethical principles that have their
origin in the Declaration of Helsinki.
To obtain regulatory approval
of an investigational drug under EU regulatory systems, we must submit a marketing authorization application. The EMA is responsible for
the scientific evaluation of centralized MAA. Once granted by the European Commission, the centralized marketing authorization is valid
in all EU Member States, Iceland, Norway and Liechtenstein. The application used to file the NDA or BLA in the United States is similar
to that required in Europe, with the exception of, among other things, country-specific document requirements.
For other countries outside
of the EU, such as countries in Eastern Europe, Latin America or Asia, the requirements governing the conduct of clinical trials, product
licensing, pricing and reimbursement vary from country to country. In all cases, again, the clinical trials are conducted in accordance
with GCP and the applicable regulatory requirements and the ethical principles that have their origin in the Declaration of Helsinki.
If we fail to comply with
applicable foreign regulatory requirements, we may be subject to, among other things, fines, suspension or withdrawal of regulatory approvals,
product recalls, seizure of products, operating restrictions and criminal prosecution.
Authorization Procedures in the European Union
In all cases, the application
for marketing approval requires the completion of clinical trials. Clinical trials are currently regulated under Directive 2001/20/EC.
EU directives are not directly applicable in the Member States. They have to be transposed into national law. National law transposing
EU directives often varies to a great extent. However, in April 2014 a new regulation on clinical trials on medicinal products for human
use was adopted. Regulations are directly applicable in the Member States, so they generally lead to greater harmonization. Regulation
536/2014 (“CTR”), entered into force on in June 2014. The CTR will harmonize the assessment and supervision processes for
clinical trials throughout the EU via a Clinical Trials Information System, or CTIS, which will contain a centralized EU portal and database
for clinical trials. The exact timing of the Regulation’s application depends on confirmation of full functionality of CTIS through
an independent audit.
Medicines can be authorized
in the EU by using either the centralized authorization procedure or national authorization procedures.
●
Centralized Procedure (regulated in Regulation (EC) 726/2004). Under the Centralized Procedure a so-called Community Marketing Authorization is issued by the European Commission, based on the opinion of the Committee for Medicinal Products for Human Use of the European Medicines Agency (“EMA”). The Community Marketing Authorization is valid throughout the entire territory of the European Economic Area (“EEA”) (which includes the 27 Member States of the EU plus Norway, Liechtenstein and Iceland). The Centralized Procedure is mandatory for certain types of products, such as biotechnology medicinal products, orphan medicinal products, and medicinal products indicated for the treatment of AIDS, cancer, neurodegenerative disorders, diabetes, autoimmune and viral diseases. The Centralized Procedure is optional for products containing a new active substance not yet authorized in the EEA, or for products that constitute a significant therapeutic, scientific or technical innovation or which are in the interest of public health in the EU. For medicines that do not fall within these categories, an applicant has the option of submitting an application for a centralized marketing authorization to the EMA, as long as the medicine concerned is a significant therapeutic, scientific or technical innovation, or if its authorization would be in the interest of public health.
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●
Cooperative Authorization Procedures (regulated in Directive 2001/83/EC and implemented into Member States’ national law). There are also two other possible routes to authorize medicinal products in several countries, which are available for investigational drug products that fall outside the scope of the centralized procedure:
●
Decentralized Procedure. Using the Decentralized Procedure, an applicant may apply for simultaneous authorization in more than one EU country of medicinal products that have not yet been authorized in any EU country and that do not fall within the mandatory scope of the centralized procedure. Under the Decentralized Procedure the applicant chooses one country as Reference Member State. The regulatory authority of the Reference Member State will then be in charge of leading the assessment of the marketing authorization application.
●
Mutual Recognition Procedure. In the Mutual Recognition Procedure, a medicine is first authorized in one EU Member State, in accordance with the national procedures of that country. Following this, further marketing authorizations can be sought from other EU countries in a procedure whereby the countries concerned agree to recognize the validity of the original, national marketing authorization.
●
Furthermore, there is the option to obtain a national authorization in just one Member State.
In the EU, upon receiving
marketing authorization, new chemical entities generally receive eight years of data exclusivity and an additional two years of market
exclusivity. If granted, data exclusivity prevents regulatory authorities in the EU from referencing the innovator’s data to assess
a generic application. During the additional two-year period of market exclusivity, a generic marketing authorization can be submitted,
and the innovator’s data may be referenced, but no generic product can be marketed until the expiration of the market exclusivity.
However, there is no guarantee that a product will be considered by the EU’s regulatory authorities to be a new chemical entity,
and there is a risk that products may not qualify for data exclusivity.
U.K. Regulation
The Medicines and Healthcare
products Regulatory Agency (MHRA) is an executive agency of the Department of Health and Social Care in the U.K. which is responsible
for ensuring that medicines and medical devices work and are acceptably safe.
The MHRA has the following
roles:
●
Operate post-marketing surveillance - in particular the Yellow Card Scheme - for reporting, investigating and monitoring of adverse drug reactions to medicines and incidents with medical devices.
●
Assess and authorize medicinal products for sale and supply in the U.K.
●
Oversee the Notified Bodies that ensure medical device manufacturers comply with regulatory requirements before putting devices on the market.
●
Operate a quality surveillance system to sample and test medicines to address quality defects and to monitor the safety and quality of unlicensed products.
●
Investigate internet sales and potential counterfeiting of medicines and prosecute where necessary.
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●
Regulate clinical trials of medicines and medical devices.
●
Monitor and ensure compliance with statutory obligations relating to medicines and medical devices.
●
Promote safe use of medicines and devices.
In the United Kingdom and
following the United Kingdom’s exit from the European Union, EU medicines regulation has been adopted as standalone United Kingdom
legislation with some amendments to reflect procedural and other requirements with respect to marketing authorizations and other regulatory
provisions.
In order to market a medicinal
product in the United Kingdom, a license or marketing authorization must be obtained from the MHRA The United Kingdom legislation includes
multiple assessment routes for applications for medicinal products, including a 150-day national assessment or a rolling review application.
Further, and for a transitional period until December 31, 2022, the MHRA may rely on a decision taken by the European Commission on the
approval of a new marketing authorization in the centralized procedure. In addition, the MHRA has the power to have regard to marketing
authorizations approved in EU member states.
The United Kingdom has adopted
new legislation, the Medicines and Medical Devices Act 2021 and may make changes to the licensing or authorization of medicines in the
future. The separate UK authorization system, albeit with transitional recognition procedures in the UK, may lead to additional regulatory
costs. In addition, further regulatory costs will be incurred with respect to the lack of mutual recognition of batch testing and related
regulatory measures between the European Union and the United Kingdom.
The CQC is an executive non-departmental
public body of the Department of Health and Social Care of the U.K. It regulates and inspects health and social care services in England
and registration is required prior to the provision of health and care services. Further, certain drug and pharmaceutical licenses and
registrations may be required for the possession and/or supply of certain drugs.
The GPhC is the body responsible
for the independent regulation of the pharmacy profession within Great Britain (England, Scotland and Wales) regulation and enforcement
by, responsible for the regulation of pharmacists, pharmacy technicians and pharmacy premises.
Other Health Care Laws
We may also be subject to
healthcare regulation and enforcement by the US federal government and the states and foreign governments where we may market our product
candidates, if approved. The US laws include, without limitation, state and federal anti-kickback, fraud and abuse, false claims, physician
sunshine and privacy and security laws and regulations with corresponding laws in non-US countries.
The US federal Anti-Kickback
Statute prohibits, among other things, any person from knowingly and willfully offering, soliciting, receiving or providing remuneration,
directly or indirectly, to induce either the referral of an individual, for an item or service or the purchasing or ordering of a good
or service, for which payment may be made under federal healthcare programs such as the Medicare and Medicaid programs. The Anti-Kickback
Statute is subject to evolving interpretations. In the past, the government has enforced the Anti-Kickback Statute to reach large settlements
with healthcare companies based on sham consulting and other financial arrangements with physicians. A person or entity does not need
to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation. In addition, the government
may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false
or fraudulent claim for purposes of the federal False Claims Act. The majority of states also have anti-kickback laws which establish
similar prohibitions and, in some cases, may apply to items or services reimbursed by any third-party payor, including commercial insurers.
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Additionally, the US Civil
False Claims Act prohibits knowingly presenting or causing the presentation of a false, fictitious or fraudulent claim for payment to
the United States government. Actions under the False Claims Act may be brought by the Attorney General or as a qui tam action by a private
individual in the name of the government. Violations of the False Claims Act can result in very significant monetary penalties and treble
damages. The federal government is using the False Claims Act, and the accompanying threat of significant liability, in its investigation
and prosecution of pharmaceutical and biotechnology companies throughout the United States, for example, in connection with the promotion
of products for unapproved uses and other sales and marketing practices. The government has obtained multi-million and multi-billion-dollar
settlements under the False Claims Act in addition to individual criminal convictions under applicable criminal statutes. Given the significant
size of actual and potential settlements, it is expected that the government will continue to devote substantial resources to investigating
healthcare providers’ and manufacturers’ compliance with applicable fraud and abuse laws.
HIPAA also created new federal
criminal statutes that prohibit among other actions, knowingly and willfully executing, or attempting to execute, a scheme to defraud
any healthcare benefit program, including private third-party payors, knowingly and willfully embezzling or stealing from a healthcare
benefit program, willfully obstructing a criminal investigation of a healthcare offense, and knowingly and willfully falsifying, concealing
or covering up a material fact or making any materially false, fictitious or fraudulent statement in connection with the delivery of or
payment for healthcare benefits, items or services. Similar to the federal Anti-Kickback Statute, a person or entity does not need to
have actual knowledge of the statute or specific intent to violate it in order to have committed a violation.
There has also been a recent
trend of increased federal and state regulation of payments made to physicians and other healthcare providers. The Patient Protection
and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, (collectively, “the Affordable Care Act”),
among other things, imposed new reporting requirements on drug manufacturers for payments made by them to physicians and teaching hospitals,
as well as ownership and investment interests held by physicians and their immediate family members. Failure to submit timely, accurately
and completely the required information may result in civil monetary penalties of up to an aggregate of approximately $0.2 million per
year (or up to an aggregate of $1.2 million per year for “knowing failures”), for all payments, transfers of value or ownership
or investment interests that are not timely, accurately and completely reported in an annual submission. Drug manufacturers are required
to submit reports to the government by the 90th day of each calendar year. Certain states also mandate implementation of compliance programs,
impose restrictions on drug manufacturer marketing practices and/or require the tracking and reporting of marketing expenditures and pricing
information as well as gifts, compensation and other remuneration to physicians.
We may also be subject to
data privacy and security regulation by both the federal government and the states in which we conduct our business. HIPAA, as amended
by HITECH, and their respective implementing regulations, including the final omnibus rule published on January 25, 2013, imposes specified
requirements relating to the privacy, security and transmission of individually identifiable health information. Among other things, HITECH
makes HIPAA’s privacy and security standards directly applicable to “business associates,” defined as independent contractors
or agents of covered entities that create, receive, maintain or transmit protected health information in connection with providing a service
for or on behalf of a covered entity. HITECH also increased the civil and criminal penalties that may be imposed against covered entities,
business associates and possibly other persons, and gave state attorneys general new authority to file civil actions for damages or injunctions
in federal courts to enforce HIPAA and seek attorney’s fees and costs associated with pursuing such civil actions. In addition,
state laws govern the privacy and security of health information in certain circumstances, many of which differ from each other in significant
ways, thus complicating compliance efforts.
Coverage and Reimbursement
Sales of our product candidates, once approved, will depend, in part,
on the extent to which the costs of our products will be covered by third-party payors, such as government health programs, private health
insurers and managed care organizations. Third-party payors generally decide which drugs they will cover and establish certain reimbursement
levels for such drugs. In particular, in the United States, private health insurers and other third-party payors often provide reimbursement
for products and services based on the level at which the government (through the Medicare or Medicaid programs) provides reimbursement
for such treatments. Patients who are prescribed treatments for their conditions and providers performing the prescribed services generally
rely on third-party payors to reimburse all or part of the associated healthcare costs. Patients are unlikely to use our products unless
coverage is provided, and reimbursement is adequate to cover a significant portion of the cost of our products. Sales of our products
and product candidates, if approved, will therefore depend substantially on the extent to which the costs of products and our product
candidates will be paid by third-party payors. Additionally, the market for our products and future product candidates will depend significantly
on access to third-party payors’ formularies without prior authorization, step therapy, or other limitations such as approved lists
of treatments for which third-party payors provide coverage and reimbursement. Additionally, coverage and reimbursement for therapeutic
products can differ significantly from payor to payor. One third-party payor’s decision to cover a particular medical product or
service does not ensure that other payors will also provide coverage for the medical product or service or will provide coverage at an
adequate reimbursement rate. As a result, the coverage determination process will require us to provide scientific and clinical support
for the use of our products to each payor separately and will be a time-consuming process.
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In addition, the United States
government, state legislatures and foreign governments have continued implementing cost-containment programs, including price controls,
restrictions on coverage and reimbursement and requirements for substitution of generic products. Adoption of price controls and cost-containment
measures, and adoption of more restrictive policies in jurisdictions with existing controls and measures, could further limit our future
net revenue and results. Decreases in third-party reimbursement for our products and future product candidates or a decision by a third-party
payor to not cover our products or future product candidates could reduce physician usage of our products and future product candidates,
if approved, and have a material adverse effect on our sales, results of operations and financial condition.
Health Care Reform
In the United States and foreign
jurisdictions, there have been a number of legislative and regulatory changes to the healthcare system that could affect our future results
of operations. There have been and continue to be a number of initiatives at the United States federal and state levels that seek to reduce
healthcare costs.
In particular, in the United
States, the Affordable Care Act has had, and is expected to continue to have, a significant impact on the healthcare industry. The Affordable
Care Act was designed to expand coverage for the uninsured while at the same time containing overall healthcare costs. The Affordable
Care Act, among other things, addressed a new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program
are calculated for drugs that are inhaled, infused, instilled, implanted or injected, increased the minimum Medicaid rebates owed by manufacturers
under the Medicaid Drug Rebate Program and extended the rebate program to individuals enrolled in Medicaid managed care organizations,
established annual fees and taxes on manufacturers of certain branded prescription drugs, and established a new Medicare Part D coverage
gap discount program, in which manufacturers must agree to offer 50% point-of-sale discounts, which, through subsequent legislative amendments,
was increased to 70%, off negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a
condition for the manufacturer’s outpatient drugs to be covered under Medicare Part D. Substantial new provisions affecting compliance
were also enacted, which may require us to modify our business practices with healthcare providers and entities.
Since its enactment, there have been judicial and Congressional challenges
to certain aspects of the Affordable Care Act. If a law is enacted, many if not all of the provisions of the ACA may no longer apply to
prescription drugs. While we are unable to predict what changes may ultimately be enacted, to the extent that future changes affect how
any future products are paid for and reimbursed by the government and private payers our business could be adversely impacted. In November
2020, Joseph Biden was elected President and, in January 2021, the Democratic Party obtained control of the Senate. As a result of these
electoral developments, it is unlikely that continued legislative efforts will be pursued to repeal ACA. Instead, it is possible that
legislation will be pursued to enhance or reform ACA. We are not able to state with certainty what the impact of potential legislation
will have on our business.
In addition, other legislative
changes have been proposed and adopted since the Affordable Care Act was enacted. Recently there has been heightened governmental scrutiny
over the manner in which manufacturers set prices for their marketed products, which has resulted in several Congressional inquiries and
proposed bills designed to, among other things, reform government program reimbursement methodologies. Individual states in the United
States have also become increasingly active in implementing regulations designed to control pharmaceutical product pricing, including
price or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and transparency
measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing. We expect that additional state
and federal healthcare reform measures will be adopted in the future, any of which could limit the amounts that federal and state governments
will pay for healthcare products and services, which could result in reduced demand for our future product candidates or additional pricing
pressures.
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ITEM 1A. RISK FACTORS
Our future operating results
could differ materially from the results described in this annual report due to the risks and uncertainties described below. You should
consider carefully the following information about risks in evaluating our business. If any of the following risks actually occur, our
business, financial condition, results of operations and future growth prospects would likely be materially and adversely affected. Additional
risks and uncertainties not presently known to us or that we currently deem immaterial also may impair our business operations in these
circumstances, the market price of our securities would likely decline. In addition, we cannot assure investors that our assumptions and
expectations will prove to be correct. Important factors could cause our actual results to differ materially from those indicated or implied
by forward-looking statements. See “Forward Looking Statements” for a discussion of some of the forward-looking statements
that are qualified by these risk factors. Factors that could cause or contribute to such differences include those factors discussed below.
Summary Risk Factors
The following summarizes key
risks and uncertainties that could materially adversely affect us. You should read this summary together with the more detailed description
of each risk factor contained below.
●
We are a clinical stage biopharmaceutical company with a limited operating history.
●
We have incurred a history of operating losses and expect to continue to incur substantial costs for the foreseeable future. We are not currently profitable, and we may never achieve or sustain profitability.
●
We will need to raise additional capital to complete the development and commercialization efforts for PAS-004 and our other product candidates. If we are unable to raise capital when needed, we could be forced to delay, reduce or terminate certain of our development programs or other operations.
●
A pandemic, epidemic, or outbreak of an infectious disease, could cause
a disruption to the development of our product candidates.
●
We are dependent primarily on the successful development and commercialization of our lead product candidate, PAS-004, which is not yet approved. Our business could be materially adversely affected if one or more of our key product candidates do not perform as well as expected and do not receive regulatory approval. We cannot give any assurance that we will receive regulatory approval for such a product candidate or any other product candidates which is necessary before any of our product candidates can be commercialized.
●
Even if we obtain regulatory approval for PAS-004, or any of our other product candidates, such approval may be limited, and we will be subject to stringent, ongoing government regulation The commercial success of our product candidates, if approved, depends partially upon attaining market acceptance by physicians, patients, third-party payors, and the medical community.
●
Our business is subject to extensive regulatory requirements, and our product candidates that obtain approval will be subject to ongoing and continued regulatory review, which may result in significant expense and limit our ability to commercialize such products.
●
We rely on third parties to conduct our clinical trials and our regulatory submissions for our product candidates, and those third parties may not perform satisfactorily, including failing to meet deadlines for the completion of such trials and/or regulatory submissions.
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●
We may rely on third parties to perform many essential services for any products that we commercialize, including distribution, customer service, accounts receivable management, cash collection and adverse event reporting. If these third parties fail to perform as expected or to comply with legal and regulatory requirements, our ability to commercialize PAS-004 or our other product candidates will be significantly impacted and we may be subject to regulatory sanctions.
●
We will need to further increase the size and complexity of our organization in the future, and we may experience difficulties in executing our growth strategy and managing any growth.
●
Our research and development is focused on discovering and developing product candidates which may not make it to the market.
●
We are increasingly dependent on information technology, and our systems and infrastructure face certain risks, including cybersecurity and data leakage risks.
●
If our intellectual property related to our products or product candidates is not adequate, we may not be able to compete effectively in our market.
●
An active trading market for our Common Stock or warrants to purchase shares of our Common Stock that were issued in our Initial Public Offering and are listed on Nasdaq (the “Warrants”) may not be sustained.
●
Impacts of increased trade tariffs, import quotas or other trade restrictions or measures taken by the United States and other countries, including the recent and potential changes in U.S. trade policies that may be made by the Trump presidential administration.
Risks Related to Our Financial Position and
Need for Additional Capital
We have a limited operating history and
have no products or services approved for commercial sale, which may make it difficult for you to evaluate our current business and predict
our future success and viability.
We have a limited operating
history upon which you can evaluate our business and prospects. We have no products or services approved for commercial sale and have
not generated any material revenue from product sales. To date, we have devoted substantially all of our resources and efforts to organizing
and staffing our company, business planning, and product candidate development. We have not yet demonstrated our ability to obtain marketing
approvals, manufacture a commercial-scale product or arrange for a third party to do so on our behalf, or conduct sales and marketing
activities necessary for successful product commercialization. As a result, it may be more difficult for you to accurately predict our
future success or viability than it could be if we had a longer operating history.
Accordingly, you should consider
our prospects in light of the costs, uncertainties, delays and difficulties frequently encountered by companies in the early stages of
development, especially preclinical stage pharmaceutical companies such as ours. Potential investors should carefully consider the risks
and uncertainties that a company with a limited operating history will face. In particular, potential investors should consider that we
cannot assure you that we will be able to, among other things:
●
successfully implement or execute our current business plan, and we cannot assure you that our business plan is sound;
●
successfully manufacture our clinical product candidates and establish commercial supply;
●
successfully complete the clinical trials necessary to obtain regulatory approval for the marketing of our product candidates;
●
secure market exclusivity and/or adequate intellectual property protection for our product candidates;
●
attract and retain an experienced management and advisory team;
●
secure acceptance of our product candidates in the medical community and with third-party payors and consumers;
●
raise sufficient funds in the capital markets or otherwise to effectuate our business plan; and
●
utilize the funds that we do have and/or raise in the future to efficiently execute our business strategy.
If we cannot successfully
execute any one of the foregoing, our business may fail and your investment will be adversely affected.
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We have a history of losses and may not
be able to achieve profitability going forward.
We are a clinical-stage biotechnology
company with a limited operating history and have incurred losses since our formation. We incurred net losses of approximately $13.9 million
and $16.0 million for the years ended December 31, 2024 and 2023, respectively. As of December 31, 2024, we had an accumulated deficit
of approximately $49.6 million. We have not commercialized any product candidates and have never generated revenue from the commercialization
of any product. To date, we have devoted most of our financial resources to research and development, including our preclinical work,
general and administrative expenses, as well as to intellectual property.
We expect to incur significant
additional operating losses for the next several years, at least, as we advance our product candidates through preclinical development,
complete clinical trials, seek regulatory approval and commercialization, if any our product candidates are approved. 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. Our expenses will also increase substantially if and as we:
●
establish a sales, marketing and distribution infrastructure to commercialize our drugs, if approved, and for any other product candidates for which we may obtain marketing approval;
●
maintain, expand and protect our intellectual property portfolio;
●
hire additional clinical, scientific and commercial personnel;
●
add operational, financial and management information systems and personnel, including personnel to support our product development and planned future commercialization efforts, as well as to support our transition to a public reporting company; and
●
acquire or in-license or invent other product candidates or technologies.
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 described under “Risks Related to Development, Clinical Testing, Manufacturing, Regulatory Approval
and Commercialization.” 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 and Warrants will be materially
and adversely affected.
We will require additional capital to fund
our operations, and if we fail to obtain necessary financing, we may not be able to complete the development and commercialization of
our drugs.
Our operations have consumed
substantial amounts of cash since inception. We expect to continue to spend substantial amounts to advance the clinical development of
and launch and commercialize our product candidates if we receive regulatory approval. We will require additional capital for the further
development and potential commercialization of our product candidates and may also need to raise additional funds sooner to pursue a more
accelerated development of our product candidates, if available to us. If we are unable to raise capital when needed or on attractive
terms, we could be forced to delay, reduce or eliminate our research and development programs or any future commercialization efforts.
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At December 31, 2024, we had
cash and cash equivalents of approximately $6.9 million. We have incurred continuing losses including a net loss of $13.9 million for
the year ended December 31, 2024. Our future funding requirements, both near and long-term, will depend on many factors, including, but
not limited to the:
●
initiation, progress, timing, costs and results of preclinical studies and clinical trials, including patient enrollment in such trials, for our product candidates or any other future product candidates;
●
clinical development plans we establish for our product candidates and any other future product candidates;
●
obligation to make royalty and non-royalty sublicense receipt payments to third-party licensors, if any, under our licensing agreements;
●
number and characteristics of product candidates that we discover or in-license and develop;
●
outcome, timing and cost of regulatory review by the FDA and comparable foreign regulatory authorities, including the potential for the FDA or comparable foreign regulatory authorities to require that we perform more studies than those that we currently expect;
●
costs of filing, prosecuting, defending and enforcing any patent claims and maintaining and enforcing other intellectual property rights;
●
effects of competing technological and market developments;
●
costs and timing of the implementation of commercial-scale manufacturing activities;
●
costs and timing of establishing sales, marketing and distribution capabilities for any product candidates for which we may receive regulatory approval;
●
cost associated with being a public company.
If we are unable to expand
our operations or otherwise capitalize on our business opportunities due to a lack of capital, our ability to become profitable will be
compromised.
Raising additional capital may cause dilution
to our stockholders, restrict our operations or require us to relinquish rights to our technologies or product candidates.
Until such time, if ever, as we can generate substantial revenue, we
may finance our cash needs through a combination of equity offerings, debt financings, marketing and distribution arrangements, collaborations,
strategic alliances and licensing arrangements, government or private party grants, or other sources. We do not currently have any committed
external source of funds. In addition, we may seek additional capital due to favorable market conditions or strategic considerations,
even if we believe that we have sufficient funds for our current or future operating plans.
On November 26, 2024, we entered into an At The Market Offering Agreement
(the “ATM Agreement”) with H.C. Wainwright & Co., LLC (“Wainwright”), as sales agent, pursuant to which
we may issue and sell, from time to time, through Wainwright, shares of our Common Stock, and pursuant to which Wainwright may sell our
Common Stock by any method permitted by law deemed to be an “at the market offering” as defined by Rule 415(a)(4) promulgated
under the Securities Act of 1933, as amended. We will pay Wainwright a commission of 3.0% of the aggregate gross proceeds from each sale
of Common Stock. As of December 31, 2024, we were authorized to offer and sell up to $2,076,000 of our Common Stock pursuant to the ATM
Agreement. During the three and twelve months ended December 31, 2024, we did not utilize the ATM Agreement, but any future sales of our
Common Stock under the ATM Agreement with Wainwright could be subject to business, economic or competitive uncertainties and contingencies,
many of which may be beyond our control, and which could cause actual results from the sale of our common stock to differ materially from
expectations.
To the extent that we raise
additional capital through the sale of equity or convertible debt securities, your ownership interest will be diluted, and the terms of
these securities may include liquidation or other preferences that adversely affect your rights as a common stockholder. Debt financing
and preferred equity financing, if available, may involve agreements that include covenants limiting or restricting our ability to take
specific actions, such as incurring additional debt, making capital expenditures or declaring dividends. If we raise additional funds
through collaborations, strategic alliances or marketing, distribution or licensing arrangements with third parties, we may be required
to relinquish valuable rights to our technologies, intellectual property, future revenue streams or product candidates or grant licenses
on terms that may not be favorable to us. If we are unable to raise additional funds through equity or debt financings when needed, we
may be required to delay, limit, reduce or terminate product candidate development or future commercialization efforts.
32
Changes in U.S. tax law may materially adversely
affect our financial condition, results of operations and cash flows.
On March 27, 2020, the Coronavirus
Aid, Relief, and Economic Security Act, or the CARES Act, was signed into law to address the COVID-19 crisis. The CARES Act is an approximately
$2 trillion emergency economic stimulus package that includes numerous U.S. federal income tax provisions, including the modification
of: (i) net operating loss rules (as discussed below), (ii) the alternative minimum tax refund and (iii) business interest
deduction limitations under Section 163(j) of the Internal Revenue Code of 1986, as amended, or the Code.
On December 22, 2017, President
Trump signed into law federal tax legislation commonly referred to as the TCJA (defined below), which also significantly changed the U.S.
federal income taxation of U.S. corporations. TCJA has been, and may continue to be, subject to amendments and technical corrections,
as well as interpretations and implementing regulations by the Treasury and Internal Revenue Service, or the IRS, any of which could lessen
or increase certain adverse impacts of TCJA.
The Tax Cuts and Jobs Act
(TCJA) (P.L. 115-97) modified the section 174 rules and beginning in 2022, taxpayers may no longer currently deduct R&D expenditures
but instead must amortize specified R&D expenditures ratably over five years (or 15 years for foreign expenditures).
On August 16, 2022, the Inflation
Reduction Act (IRA) was signed into law and, among other things, imposed a 1% U.S. federal excise tax on certain stock repurchases by
publicly traded companies. The 1% excise tax generally applies to any acquisition by the publicly traded company (or certain of its affiliates)
of stock of the publicly traded corporation in exchange for money or other property (other than stock of the company itself), subject
to a de minimis exception. Thus, the excise tax could apply to certain transactions that are not traditional stock repurchases.
Regulatory guidance under
the TCJA, the CARES Act, the IRA, and such additional legislation is and continues to be forthcoming.
While some of these U.S. federal
income tax changes may adversely affect us in one or more reporting periods and prospectively, other changes may be beneficial on a going-forward
basis. In addition, it is uncertain if and to what extent various states will conform to the TCJA, the CARES Act, and the IRA, and additional
tax legislation. We continue to work with our tax advisors and auditors to determine the full impact of the TCJA, the CARES Act, and the
IRA on us. We urge our investors to consult with their legal and tax advisors with respect to both TCJA and the CARES Act and the potential
tax consequences of investing in our Common Stock and Warrants.
Our ability to use our net operating losses
and other tax attributes may be limited.
As of December 31, 2024, we
had approximately $34.6 million of federal and $18.4 million of state net operating loss carryforwards (“NOLs”), available
to offset future taxable income. Under current law, our federal NOLs generated in taxable years beginning after December 31, 2017, may
be carried forward indefinitely, but the deductibility of such federal NOLs is limited to 80% of its taxable income annually for tax years
beginning after December 31, 2020. Under Sections 382 and 383 of the U.S. Internal Revenue Code of 1986, as amended, or the Code, a corporation
that undergoes an “ownership change,” generally defined as a greater than 50% change by value in its equity ownership over
a three-year period is subject to limitations on its ability to utilize its pre-change NOLs and other tax attributes such as research
tax credits to offset future taxable income. We have not performed an analysis to determine whether our past issuances of stock and other
changes in our stock ownership may have resulted in other ownership changes. If it is determined that we have in the past experienced
other ownership changes, or if we undergo one or more ownership changes as a result of future transactions in our stock, which may be
outside our control, then our ability to utilize NOLs and other pre-change tax attributes could be further limited by Sections 382 and
383 of the Code, and certain of our NOLs and other pre-change tax attributes may expire unused. As a result, if or when we earn net taxable
income, our ability to use our pre-change NOLs or other tax attributes to offset such taxable income or otherwise reduce any liability
for income taxes may be subject to limitations, which could adversely affect our future cash flows. Similar provisions of state tax law
may also apply to limit our use of accumulated state tax attributes.
Unfavorable global economic conditions and
adverse developments with respect to financial institutions and associated liquidity risk could adversely affect our business, financial
condition and stock price.
The global credit and financial markets are currently and have from
time-to-time experienced extreme volatility and disruptions, including severely diminished liquidity and credit availability, rising interest
and inflation rates, declines in consumer confidence, declines in economic growth, increases in unemployment rates and uncertainty about
economic stability. The financial markets and the global economy may also be adversely affected by the current or anticipated impact of
military conflict, including the ongoing conflict between Russia and Ukraine, the ongoing conflict between Israel and Hamas, terrorism
or other geopolitical events. Sanctions imposed by the United States and other countries in response to such conflicts, including the
one in Ukraine, may also adversely impact the financial markets and the global economy, and any economic countermeasures by the affected
countries or others could exacerbate market and economic instability.
33
Actual events involving limited
liquidity, defaults, non-performance or other adverse developments that affect financial institutions, transactional counterparties or
other companies in the financial services industry or the financial services industry generally, or concerns or rumors about any events
of these kinds or other similar risks, have in the past and may in the future lead to market-wide liquidity problems. Future adverse developments
with respect to specific financial institutions or the broader financial services industry may lead to market-wide liquidity shortages,
impair our ability to access near-term working capital needs, and create additional market and economic uncertainty. There can be no assurance
that future credit and financial market instability and a deterioration in confidence in economic conditions will not occur. Our general
business strategy may be adversely affected by any such economic downturn, liquidity shortages, volatile business environment or continued
unpredictable and unstable market conditions. If the equity and credit markets deteriorate, or if adverse developments are experienced
by financial institutions, it may cause short-term liquidity risk and make any necessary debt or equity financing more difficult, more
costly, more onerous with respect to financial and operating covenants and more dilutive. Failure to secure any necessary financing in
a timely manner and on favorable terms could have a material adverse effect on our growth strategy, financial performance and stock price
and could require us to delay or abandon clinical development plans. In addition, there is a risk that one or more of our current service
providers, financial institutions, manufacturers, and other partners may be adversely affected by the foregoing risks, which could directly
affect our ability to attain our operating goals on schedule and on budget.
In addition, any further deterioration
in the macroeconomic economy or financial services industry, could lead to losses or defaults by our suppliers, which in turn, could have
a material adverse effect on our current and/or projected business operations and results of operations and financial condition.
If our labor costs continue to rise, including
due to shortages, changes in certification requirements and/or higher than normal turnover rates in skilled clinical personnel; or currently
pending or future governmental laws, rules, regulations or initiatives impose additional requirements or limitations on our operations
or profitability; or, if we are unable to attract and retain key leadership talent, we may experience disruptions in our business operations
and increases in operating expenses, among other things, which could have a material adverse effect on our business, results of operations,
financial condition and cash flows.
We have incurred and expect
to continue to incur increased labor costs and experience staffing challenges. Furthermore, changes in certification requirements can
impact our ability to maintain sufficient staff levels, including to the extent our teammates are not able to meet new requirements, among
other things. In addition, if we experience a higher-than-normal turnover rate for our skilled clinical personnel, our operations and
treatment growth may be negatively impacted, which could adversely affect our business, results of operations, financial condition and
cash flows. We also face competition in attracting and retaining talent for key leadership positions. If we are unable to attract and
retain qualified individuals, we may experience disruptions in our business operations, including, without limitation, our ability to
achieve strategic goals, which could have a material adverse effect on our business, results of operations, financial condition and cash
flows.
Risks Related to Development, Clinical Testing,
Manufacturing, Regulatory Approval and Commercialization
Clinical trials are expensive, time-consuming
and difficult to design and implement, and involve an uncertain outcome.
Clinical testing is expensive
and can take many years to complete, and its outcome is inherently uncertain. Failure can occur at any time during the clinical trial
process. Because the results of preclinical studies and early clinical trials are not necessarily predictive of future results, our product
candidates may not have favorable results in later preclinical and clinical studies or receive regulatory approval. We may experience
delays in initiating and completing any clinical trials that we intend to conduct, and we do not know whether planned clinical trials
will begin on time, need to be redesigned, enroll patients on time or be completed on schedule, or at all. Clinical trials can be delayed
for a variety of reasons, including delays related to:
●
the FDA or comparable foreign regulatory authorities disagreeing as to the design or implementation of our clinical studies;
●
obtaining regulatory approval to commence a trial;
●
reaching an agreement on acceptable terms with prospective CROs, and clinical trial sites, the terms of which can be subject to extensive negotiation and may vary significantly among different CROs and trial sites;
34
●
obtaining Institutional Review Board (“IRB”), approval at each site, or Independent Ethics Committee (“IEC”), approval at sites outside the United States;
●
recruiting suitable patients to participate in a trial in a timely manner and in sufficient numbers;
●
having patients complete a trial or return for post-treatment follow-up;
●
imposition of a clinical hold by regulatory authorities, including as a result of unforeseen safety issues or side effects or failure of trial sites to adhere to regulatory requirements or follow trial protocols;
●
clinical sites deviating from trial protocol or dropping out of a trial;
●
addressing patient safety concerns that arise during the course of a trial;
●
adding a sufficient number of clinical trial sites; or
●
manufacturing sufficient quantities of product candidate for use in clinical trials.
We could also encounter delays
if a clinical trial is suspended or terminated by us, the IRBs or IECs of the institutions in which such trials are being conducted, the
Data Safety Monitoring Board (“DSMB”) for such trial or the FDA or other regulatory authorities. Such authorities may impose
such a suspension or termination due to a number of factors, including failure to conduct the clinical trial in accordance with regulatory
requirements or our clinical protocols, inspection of the clinical trial operations or trial site by the FDA or other regulatory authorities
resulting in the imposition of a clinical hold, unforeseen safety issues or adverse side effects, failure to demonstrate a benefit from
using a drug, changes in governmental regulations or administrative actions or lack of adequate funding to continue the clinical trial.
Furthermore, we rely on CROs and clinical trial sites to ensure the proper and timely conduct of our clinical trials and, while we have
agreements governing their committed activities, we have limited influence over their actual performance, as described in “Risks
Related to Our Dependence on Third Parties”.
Our industry
is subject to extensive regulatory obligations and policies that may be subject to change, including due to judicial challenges.
The U.S. pharmaceutical industry
is highly regulated and subject to frequent and substantial changes, including as a result of new judicial or governmental actions. Legislative
and regulatory agendas as they relate to the pharmaceutical industry are currently uncertain. Changes in the regulatory approval process,
or substantial reductions in the personnel who oversee that process, could affect our ability to obtain regulatory approval for our product
candidates or the timeline in which we can obtain that approval. We and/or our current and future third-party collaborators may rely
on government programs or agencies, such as the National Institutes for Health (“NIH”), as a source of grant funding for scientific
research relevant to our product candidates. Funding from government agencies such as the NIH can fluctuate and is subject to the political
process, which is often unpredictable. Reductions in NIH grants to us or our third-party collaborators may adversely impact our ability
to develop our existing product candidates and our ability to identify new product candidates. In addition, on June 28, 2024, the
U.S. Supreme Court issued an opinion holding that courts reviewing agency action pursuant to the Administrative Procedure Act “must
exercise their independent judgment” and “may not defer to an agency interpretation of the law simply because a statute is
ambiguous.” The decision could have a significant impact on how lower courts evaluate challenges to agency interpretations of law,
including those by the FDA and other agencies with significant oversight of the pharmaceutical industry. The new framework may increase
both the frequency of such challenges and their odds of success by eliminating one way in which the government previously prevailed in
such cases. As a result, significant regulatory policies could be subject to increased litigation and judicial scrutiny. We cannot predict
how other future federal or state legislative or administrative changes relating to healthcare reform or the pharmaceutical industry,
or the regulatory agencies that oversee the pharmaceutical industry, will affect our business.
Our choice of product candidates
and our development plans for our product candidates are subject to change based on a variety of factors,
some of which may be out of our control, and if we abandon development of a product candidate we may not be able to develop
or acquire a replacement product candidate.
We may determine to abandon
the development of one or more of our product candidates, or we may change the prioritization of the development of certain product candidates,
or we may select or acquire and prioritize the development of new product candidates. Our choice and prioritization of product candidates
for development will be influenced by a variety of factors, including but not limited to:
●
the amount of capital the amount of capital that we will have for our development programs and our projected costs for those programs;
●
competitors may develop alternatives that render our potential product candidates obsolete or less attractive;
●
product candidates may not be effective in treating their targeted indications;
35
●
product candidates may, on further study, be shown to have harmful side effects, toxicities or other characteristics that indicate that they are unlikely to be products that will receive marketing approval and/or achieve market acceptance;
●
our analysis of market demand and market prices for the products we plan to develop could lead us to conclude that market conditions are not favorable for receiving an adequate return on our investment in product development and commercialization;
●
a product candidate may not be capable of being produced in commercial quantities at an acceptable cost, or at all; or
●
The regulatory pathway for a potential product candidate is too complex and difficult to navigate successfully or economically.
Furthermore, given the nature
of our business, the biopharmaceutical industry in general and the uncertainty and costs associated with developing and commercializing
our product candidates within a complicated and costly regulatory environment, our goals, plans and assumptions with respect to our product
candidates may evolve or change. For example, we may not continue to emphasize, focus our research and development efforts on or direct
resources to certain of our product candidates, and we may shift our focus and resources to our other current or future product candidates.
Any such change in our business strategy could harm our business, cause uncertainty or confusion in the marketplace or harm the clinical
prospects of our product candidates.
The regulatory approval processes of the
FDA and comparable foreign authorities are lengthy, time consuming and inherently unpredictable, and if we are ultimately unable to obtain
regulatory approval for our product candidates, our business will be substantially harmed.
The time required to obtain approval by the FDA and comparable foreign
authorities is unpredictable but typically takes many years following the commencement of clinical trials and depends upon numerous factors,
including the substantial discretion of the regulatory authorities. In addition, approval policies, regulations or the type and amount
of clinical data necessary to gain regulatory approval may change during the course of a product candidate’s clinical development
and may vary among jurisdictions. We have not obtained regulatory approval for any product candidate, and it is possible that we will
never obtain regulatory approval for our product candidates. We are not permitted to market any of our product candidates in the United States
until we receive regulatory approval of an NDA from the FDA. Our product candidates could fail to receive regulatory approval for many
reasons, including the following:
●
we may be unable to demonstrate to the satisfaction of the FDA or comparable foreign regulatory authorities that a product candidate is safe and effective for its proposed indication;
●
serious and unexpected drug-related side effects experienced by participants in our clinical trials or by individuals using drugs similar to our product candidates, or other products containing the active ingredient in our product candidates;
●
negative or ambiguous results from our clinical trials or results that may not meet the level of statistical significance required by the FDA or comparable foreign regulatory authorities for approval;
●
we may be unable to demonstrate that a product candidate’s clinical and other benefits outweigh its safety risks;
●
the FDA or comparable foreign regulatory authorities may disagree with our interpretation of data from preclinical studies or clinical trials;
●
the data collected from clinical trials of our product candidates may not be acceptable or sufficient to support the submission of an NDA or other submission or to obtain regulatory approval in the United States or elsewhere, and we may be required to conduct additional clinical trials;
36
●
the FDA or comparable foreign authorities may disagree regarding the formulation, labeling and/or the specifications of our product candidates;
●
the FDA or comparable foreign regulatory authorities may fail to approve or find deficiencies with the manufacturing processes or facilities of third-party manufacturers with which we contract for clinical and commercial supplies; and
●
the approval policies or regulations of the FDA or comparable foreign regulatory authorities may significantly change in a manner rendering our clinical data insufficient for approval.
Prior to obtaining approval
to commercialize a product candidate in the United States or abroad, we must demonstrate with substantial evidence from well-controlled
clinical trials, and to the satisfaction of the FDA or foreign regulatory agencies, that such product candidates are safe and effective
for their intended uses. Results from preclinical studies and clinical trials can be interpreted in different ways. Even if we believe
the preclinical or clinical data for our product candidates are promising, such data may not be sufficient to support approval by the
FDA and other regulatory authorities, or we may decide to abandon the development or commercialization of a product
candidate altogether.
The FDA or any foreign regulatory
bodies can delay, limit or deny approval of our product candidates or require us to conduct additional preclinical or clinical testing
or abandon a program for many reasons, including:
●
the FDA or comparable foreign regulatory authorities may disagree with the design or implementation of our clinical trials;
●
the FDA or comparable foreign regulatory authorities may disagree with our safety interpretation of our product candidate;
●
the FDA or comparable foreign regulatory authorities may disagree with our efficacy interpretation of our product candidate;
●
the FDA or comparable foreign regulatory authorities may regard our CMC package as inadequate.
Of the large number of drugs
in development, only a small percentage successfully complete the regulatory approval processes and are commercialized. This lengthy approval
process, as well as the unpredictability of future clinical trial results, may result in our failing to obtain regulatory approval to
market our product candidates, which would significantly harm our business, results of operations and prospects.
In addition, the FDA or the
applicable foreign regulatory agency also may approve a product candidate for a more limited indication or patient population than we
originally requested, and the FDA or applicable foreign regulatory agency may approve a product candidate with a label that does not include
the labeling claims necessary or desirable for the successful commercialization of that product candidate. Any of the foregoing scenarios
could materially harm the commercial prospects for our product candidates.
Reductions in staffing and funding at FDA
and other federal agencies could cause delays in the development and approval of our products.
Under the Federal Food, Drug,
and Cosmetic Act, our products cannot be investigated in humans or marketed without approval from FDA. In addition, companies developing
new therapies routinely seek and receive guidance from FDA regarding their methods and plans for developing their products. We and companies
like us may also benefit from FDA-administered programs like orphan drug designation and expedited development pathways, e.g., breakthrough
designation. Any material reductions in the ability of FDA to perform these and other functions may delay the development and approval
of our product candidates. Recent actions by the Trump Administration have caused concern in the industry that this may occur. For example,
beginning on February 13, 2025, the Department of Health and Human Services began firing a large number of its probationary employees,
a category that includes new federal employees and employees recently promoted or transferred to new positions or agencies. Reports indicate
that 5,000 out of 80,000 employees have been terminated. Although we cannot be certain at this early stage, these terminations, if they
withstand legal challenges, may significantly delay and impede our interactions with FDA. Similar results may stem from the recent confirmed
resignations of some senior FDA employees with responsibility for regulation of drugs and biologics, as well as possible future layoffs
and resignations. There are also reports that the Trump Administration intends to request Congress to reduce FDA funding in upcoming budgets.
Such funding cuts may also delay the development and approval of our products.
Approval may be delayed or denied because
we cannot satisfy FDA’s Chemistry, Manufacturing and Control Requirements.
Formulation and manufacturing
of biologic products such as ours is complex and expensive. Our BLAs must include information about the chemistry and physical characteristics
of our products, and we must demonstrate that we have a reliable process for manufacturing the products in commercial quantities in accordance
with FDA’s current Good Manufacturing Practices (“cGMP”) requirements. The manufacturing process must consistently produce
quality batches of the biologic, and, among other things, the manufacturer must develop methods for testing the identity, strength, quality
and purity of the final product. In addition, appropriate packaging must be selected and tested, and stability studies must be conducted
to demonstrate the effectiveness of the packaging and that the compound does not undergo unacceptable deterioration over its shelf life.
If we are unable to successfully complete any of these complex steps, approval of our biologic may be delayed or denied.
37
We may encounter substantial delays in our
planned clinical trials or may not be able to conduct or complete our clinical trials on the timelines we expect, if at all.
Our planned clinical trials
are expected to be expensive, time consuming, and subject to uncertainty. We cannot guarantee that any clinical trials will be conducted
as planned or completed on schedule, if at all. We are currently conducting the FIH Phase 1 Dose Escalation Study at four clinical sites
in the U.S. and three sites in Eastern Europe. We cannot be sure that submission of an IND or, in the case of the European Medicines Agency
(the “EMA”), a clinical trial application (a “CTA”), will result in the FDA or EMA allowing future clinical trials
to begin in a timely manner, if at all. Moreover, even if additional trials begin, issues may arise that could suspend or terminate such
clinical trials. A failure of one or more clinical trials can occur at any stage of testing, and our future clinical trials may not be
successful. Events that may prevent successful or timely initiation or completion of clinical trials include:
●
inability to generate sufficient preclinical, toxicology, or other in vivo or in vitro data to support the initiation or continuation of clinical trials;
●
delays in confirming target engagement, patient selection or other relevant biomarkers to be utilized in preclinical and clinical product candidate development;
●
delays in reaching a consensus with regulatory agencies on study design;
●
delays in reaching agreement on acceptable terms with prospective contract research organizations (“CROs”) and clinical trial sites, the terms of which can be subject to extensive negotiation and may vary significantly among different CROs and clinical trial sites;
●
delays in identifying, recruiting and training suitable clinical investigators;
●
delays in obtaining required IRB approval at each clinical trial site;
●
imposition of a temporary or permanent clinical hold by regulatory agencies for a number of reasons, including, but not limited to, after review of an IND or amendment, CTA or amendment, or equivalent application or amendment; as a result of a new safety finding that presents unreasonable risk to clinical trial participants; a negative finding from an inspection of our clinical trial operations or study sites; developments in trials conducted by competitors that raise FDA or EMA concerns about risk to patients broadly; or if the FDA or EMA finds that the investigational protocol or plan is clearly deficient to meet its stated objectives;
●
delays or difficulties resulting from public health crises;
●
delays in identifying, recruiting and enrolling suitable patients to participate in our clinical trials, and delays caused by patients withdrawing from clinical trials or failing to return for post-treatment follow-up;
●
difficulty collaborating with patient groups and investigators;
●
failure by our CROs, other third parties, or us to adhere to clinical trial requirements;
●
failure to perform in accordance with the FDA’s or any other regulatory authority’s current good clinical practices, requirements, or applicable EMA or other regulatory guidelines in other countries;
●
occurrence of adverse events associated with a product candidate that are viewed to outweigh its potential benefits;
●
changes in regulatory requirements and guidance that require amending or submitting new clinical protocols;
●
changes in the standard of care on which a clinical development plan was based, which may require new or additional trials;
●
the cost of clinical trials of our product candidates being greater than we anticipate;
●
clinical trials of our product candidates producing negative or inconclusive
results, which may result in our deciding, or regulators requiring us, conducting additional clinical trials or abandoning product development
programs; and
●
delays in manufacturing, testing, releasing, validating, or importing/exporting sufficient stable quantities of our product candidates for use in clinical trials or the inability to do any of the foregoing.
38
Any inability to successfully initiate or complete
future clinical trials could result in additional costs to us or impair our ability to generate revenue. In addition, if we make manufacturing
or formulation changes to our product candidates, we may be required to or we may elect to conduct additional studies to bridge our modified
product candidates to earlier versions. Clinical trial delays could also shorten any periods during which our products have patent protection
and may allow our competitors to bring products to market before we do, which could impair our ability to successfully commercialize
our product candidates and may harm our business and results of operations.
We could also encounter delays
if a clinical trial is suspended or terminated by us, by the data safety monitoring board for such trial or by the FDA, EMA or any other
regulatory authority, or if the IRBs of the institutions in which such trials are being conducted suspend or terminate the participation
of their clinical investigators and sites subject to their review. Such authorities may suspend or terminate a clinical trial due to a
number of factors, including failure to conduct the clinical trial in accordance with regulatory requirements or our clinical protocols,
inspection of the clinical trial operations or trial site by the FDA, EMA or other regulatory authorities resulting in the imposition
of a clinical hold, unforeseen safety issues or adverse side effects, failure to demonstrate a benefit from using a product candidate,
changes in governmental regulations or administrative actions or lack of adequate funding to continue the clinical trial.
We may conduct certain of our clinical trials
for our product candidates outside of the U.S. which, among other risks, exposes us to the possibility that the FDA and other comparable
foreign regulatory authorities may not accept data from such trials, in which case our development plans will be delayed, which could
materially harm our business.
We may conduct clinical trials
outside of the United States. Where data from foreign clinical trials are intended to serve as the basis for marketing approval in the
U.S., the FDA will not approve the application on the basis of foreign data alone unless those data are applicable to the U.S. population
and U.S. medical practice. Therefore, later stage clinical trials designed to determine that our product candidates are safe and effective
for the purposes of FDA approval will be conducted in part in the U.S. For studies that are conducted only at sites outside of the U.S.
and not subject to an IND, the FDA requires the clinical trial to have been conducted in accordance with GCPs and the FDA must be able
to validate the data from the clinical trial through an on-site inspection if it deems such inspection necessary. For such studies not
subject to an IND, the FDA generally does not provide advance comment on the clinical protocols for the studies, and therefore there is
an additional potential risk that the FDA could determine that the study design or protocol for a non-U.S. clinical trial was inadequate,
which could require us to conduct additional clinical trials. There can be no assurance the FDA will accept data from clinical trials
conducted outside of the United States. If the FDA does not accept data from our clinical trials of our product candidates conducted outside
of the United States, it would likely result in the need for additional clinical trials, which would be costly and time consuming and
delay or permanently halt our development of our product candidates.
Conducting clinical trials
outside the United States also exposes us to additional risks including risks associated with:
● additional foreign regulatory requirements;
● foreign exchange fluctuations;
● compliance with foreign manufacturing, customs,
shipment and storage requirements;
● cultural differences in medical practice and
clinical research; and
● diminished protection of intellectual property
in some countries.
By extension, clinical trials
that are predominantly conducted in the U.S. or primarily based on feedback from the FDA may not result in sufficiently diverse patient
populations to warrant approval in other countries (for example, Japan) or those other comparable foreign regulatory authorities may have
differences of opinion on appropriateness of trial design or differences in interpretation of some data. In those situations, approvals
in other countries outside the U.S. may be delayed or never approved, which would materially detract from the commercial success of any
impacted product candidates.
Our preclinical programs may experience
delays or may never advance to clinical trials, which would adversely affect our ability to obtain regulatory approvals or commercialize
these programs on a timely basis or at all.
In order to obtain FDA or other regulatory authority approval to market
a new biological product we must demonstrate proof of safety, purity, and potency, and efficacy in humans. To meet these requirements,
we will have to conduct adequate and well-controlled clinical trials. Before we can commence clinical trials for a product candidate,
we must complete extensive preclinical testing and studies that support our planned INDs in the United States. We cannot be certain
of the timely completion or outcome of our preclinical testing and studies and cannot predict if the FDA will accept our proposed clinical
programs or if the outcome of our preclinical testing and studies will ultimately support the further development of our programs. As
a result, we cannot be sure that we will be able to submit INDs or similar applications for our preclinical programs on the timelines
we expect, if at all, and we cannot be sure that submission of INDs or similar applications will result in the FDA or other regulatory
authorities allowing clinical trials to begin.
Conducting preclinical testing
is a lengthy, time-consuming and expensive process. The length of time may vary substantially according to the type, complexity and novelty
of the program, and often can be several years or more per program. Any delays in preclinical testing and studies conducted by us or potential
future partners may cause us to incur additional operating expenses. The commencement and rate of completion of preclinical studies and
clinical trials for a product candidate may be delayed by many factors, including, for example:
●
inability to generate sufficient preclinical or other in vivo or in vitro data to support the initiation of clinical trials;
39
●
delays in reaching a consensus with regulatory agencies on study design; and
●
the FDA not allowing us to rely on previous findings of safety and efficacy for other similar but approved products and published scientific literature.
Moreover, because standards
for pre-clinical assessment are evolving and may change rapidly, even if we reach an agreement with the FDA on a pre-IND proposal, the
FDA may not accept the IND submission as presented, in which case patient enrollment would be placed on partial or complete hold and
treatment of enrolled patients could be discontinued while the product candidate is re-evaluated. Even if clinical trials do begin for
our preclinical programs, our clinical trials or development efforts may not be successful.
We may attempt to secure approval from the
FDA or comparable foreign regulatory authorities through an expedited review program, and if we are unable to do so, then we could face
increased expense to obtain, and delays in the receipt of necessary marketing approvals.
We may in the future seek
approval for one or more of our future product candidates under one of the FDA’s expedited review programs for serious conditions.
These programs are available to sponsors of therapies that address an unmet medical need to treat a serious condition. The qualifying
criteria and requirements vary for each expedited program. Prior to seeking review under one of these expedited programs for any of our
future product candidates, we intend to seek feedback from the FDA and will otherwise evaluate our ability to seek and receive marketing
approval through an expedited review program.
There can be no assurance
that, after our evaluation of the FDA’s feedback and other factors, we will decide to pursue one or more of these expedited review
programs. Similarly, there can be no assurance that after subsequent FDA feedback we will continue to pursue one or more of these expedited
programs, even if we initially decide to do so. Furthermore, FDA could decide not to grant our request to use one or more of the expedited
review programs for a product candidate, even if the FDA’s initial feedback is that the product candidate would qualify for such
program(s). Moreover, FDA can decide to stop reviewing a product candidate under one or more of these expedited review programs if, for
example, the conditions that warranted expedited review no longer apply to that product candidate.
Some of these expedited programs
(e.g., accelerated approval) also require post-marketing clinical trials to be completed and, if any such required trial fails, the FDA
could withdraw the approval of the product. If one of our future product candidates does not qualify for any expedited review program,
then this could result in a longer time period to approval and commercialization of such product candidate, could increase the cost of
development of such product candidate, and could harm our competitive position in the marketplace.
We may seek Orphan Drug Designation for
our product candidates, and we may be unsuccessful or may be unable to maintain the benefits associated with Orphan Drug Designation,
including the potential for market exclusivity.
We have received Orphan Drug
Designation for our PAS-004 product candidate for the treatment of NF1. Regulatory authorities in some jurisdictions, including the
United States and Europe, may designate drugs for relatively small patient populations as orphan drugs. Under the Orphan Drug Act, the
FDA may designate a drug as an orphan drug if it is a drug intended to treat a rare disease or condition, which is generally defined as
a patient population of fewer than 200,000 individuals annually in the United States, or a patient population greater than 200,000 in
the United States where there is no reasonable expectation that the cost of developing the drug will be recovered from sales in the United
States. In the United States, Orphan Drug Designation may entitle a party to financial incentives such as grant funding towards clinical
trial costs, tax advantages and user-fee waivers.
Similarly, in Europe, the
European Commission grants Orphan Drug Designation after receiving the opinion of the EMA Committee for Orphan Medicinal Products on an
Orphan Drug Designation application. Orphan Drug Designation is intended to promote the development of drugs that are intended for the
diagnosis, prevention or treatment of life-threatening or chronically debilitating conditions affecting not more than 5 in 10,000 persons
in Europe and for which no satisfactory method of diagnosis, prevention, or treatment has been authorized (or the product would be a significant
benefit to those affected). Additionally, designation is granted for drugs intended for the diagnosis, prevention, or treatment of a life-threatening,
seriously debilitating or serious and chronic condition and when, without incentives, it is unlikely that sales of the drug in Europe
would be sufficient to justify the necessary investment in developing the drug. In Europe, Orphan Drug Designation may entitle a party
to a number of incentives, such as protocol assistance and scientific advice specifically for designated orphan medicines, and potential
fee reductions depending on the status of the sponsor.
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Generally, if a drug with
an Orphan Drug Designation subsequently receives the first marketing approval for the indication for which it has such designation, the
drug is entitled to a period of marketing exclusivity, which precludes the EMA or the FDA from approving another marketing application
for the same drug and indication for that time period, except in limited circumstances. The applicable period is seven years in the United
States and ten years in Europe. The European exclusivity period can be reduced to six years if a drug no longer meets the criteria for
Orphan Drug Designation or if the drug is sufficiently profitable such that market exclusivity is no longer justified.
Even if we obtain orphan drug
exclusivity for our product candidates, that exclusivity may not effectively protect those product candidates from competition because
different therapies can be approved for the same condition and the same therapies can be approved for different conditions but used off-label.
Even after an orphan drug is approved, the FDA can subsequently approve another drug for the same condition if the FDA concludes that
the later drug is clinically superior in that it is shown to be safer, more effective or makes a major contribution to patient care. In
addition, a designated orphan drug may not receive orphan drug exclusivity if it is approved for a use that is broader than the indication
for which it received orphan designation. Moreover, orphan drug exclusive marketing rights in the United States may be lost if the FDA
later determines that the request for designation was materially defective or if the manufacturer is unable to assure sufficient quantity
of the drug to meet the needs of patients with the rare disease or condition. Orphan Drug Designation neither shortens the development
time or regulatory review time of a drug nor gives the drug any advantage in the regulatory review or approval process. While we may seek
Orphan Drug Designation for applicable indications for our product candidates, we may never receive such designations. Even if we do receive
such designations, there is no guarantee that we will enjoy the benefits of those designations.
We may not identify or discover other product
candidates and may fail to capitalize on programs or product candidates that may present a greater commercial opportunity or for which
there is a greater likelihood of success.
Our business depends upon our ability to identify, develop and commercialize
product candidates. A key element of our strategy is to discover and develop additional product candidates based upon our Treg Modalities.
We are seeking to do so through our internal research programs and may also explore strategic collaborations for the discovery of new
product candidates. Research programs to identify product candidates require substantial technical, financial and human resources, whether
or not any product candidates are ultimately identified. In addition, targets for different neurodegenerative and autoimmune diseases
may require changes to our cell manufacturing platform, which may slow down development or make it impossible to manufacture our product
candidates. Our research programs may initially show promise in identifying potential product candidates, yet fail to yield product candidates
for clinical development for many reasons, including the following:
●
the research methodology or technology modality used may not be successful in identifying potential product candidates;
●
competitors may develop alternatives that render our product candidates obsolete or less attractive;
●
we may choose to cease development if we determine that clinical results do not show promise;
●
product candidates we develop may nevertheless be covered by third-party patents or other exclusive rights;
●
a product candidate may be shown to have harmful side effects or other characteristics that indicate it is unlikely to be effective or otherwise does not meet applicable regulatory criteria; and
●
a product candidate may not be accepted as safe and effective by patients, the medical community or third-party payors.
Because we have limited resources, we must choose to pursue and fund
the development of specific types of treatment, and we may forego or delay the pursuit of opportunities with certain programs or product
candidates or for indications that later prove to have greater commercial potential. Our estimates regarding the potential market for
our product candidates could be inaccurate, and if we do not accurately evaluate the commercial potential for a particular product candidate,
we may relinquish valuable rights to that product candidate through strategic collaboration, licensing or other arrangements in cases
in which it would have been more advantageous for us to retain sole development and commercialization rights to such product candidate.
Alternatively, we may allocate internal resources to a product candidate in a therapeutic area in which it would have been more advantageous
to enter into a partnering arrangement.
If any of these events occur,
we may be forced to abandon or delay our development efforts with respect to a particular product candidate or fail to develop a potentially
successful product candidate.
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If any of our product candidates are approved
for marketing and commercialization and we have not developed or secured third-party marketing, sales and distribution capabilities, we
will be unable to successfully commercialize such products and may not be able to generate product revenue.
We currently have no sales,
marketing or distribution organizational experience or capabilities. We will need to develop internal sales, marketing and distribution
capabilities to commercialize any product candidate that gains FDA or other regulatory authority approval, which would be expensive and
time-consuming, or enter into partnerships with third parties to perform these services. If we decide to market any approved products
directly, we will need to commit significant financial and managerial resources to develop a marketing and sales force with technical
expertise and supporting distribution, administration and compliance capabilities. If we rely on third parties to market products or decide
to co-promote products with partners, we will need to establish and maintain marketing and distribution arrangements with third parties,
and there can be no assurance that we will be able to enter into such arrangements on acceptable terms or at all.
We will face significant competition
in seeking appropriate strategic partners and the negotiation process is time-consuming and complex. Whether we reach a definitive agreement
for other collaborations will depend, among other things, upon our assessment of the collaborator’s resources and expertise, the
terms and conditions of the proposed collaboration and the proposed collaborator’s evaluation of a number of factors. Those factors
may include the design or results of clinical trials, the progress of our clinical trials, the likelihood of approval by the FDA or similar
regulatory authorities outside the United States, the potential market for the subject product candidate, the costs and complexities of
manufacturing and delivering such product candidate to patients, the potential of competing products, the existence of uncertainty with
respect to our ownership of technology, which can exist if there is a challenge to such ownership without regard to the merits of the
challenge and industry and market conditions generally. The collaborator may also consider alternative product candidates or technologies
for similar indications that may be available to collaborate on and whether such a collaboration could be more attractive than the one
with us for our product candidate. Further, we may not be successful in our efforts to establish a strategic partnership or other alternative
arrangements for future product candidates because they may be deemed to be at too early of a stage of development for collaborative effort
and third parties may not view them as having the requisite potential to demonstrate safety and efficacy. Any delays in entering into
new collaborations or strategic partnership agreements related to any product candidate we develop could delay the development and commercialization
of our product candidates, which would harm our business prospects, financial condition, and results of operations.
The FDA and other regulatory agencies actively
enforce the laws and regulations prohibiting pre-approval promotion and the promotion of off-label uses.
The FDA prohibits the pre-approval
promotion of drugs as safe and effective for the purposes for which they are under investigation. Similarly, the FDA prohibits the promotion
of approved drugs for new or unapproved indications. If the FDA finds that we have engaged in pre-approval promotion of our future product
candidates, or if any of our future product candidates are approved and we are found to have improperly promoted off-label uses of those
products, we may become subject to significant liability. The FDA and other regulatory agencies strictly regulate the promotional claims
that may be made about prescription products, such as our future product candidates, if approved. In particular, an approved product may
not be promoted for uses that are not approved by the FDA or such other regulatory agencies as reflected in the product’s approved
labeling. If we receive marketing approval for a product candidate, physicians may nevertheless prescribe it to their patients in a manner
that is inconsistent with the approved label, which is within their purview as part of their practice of medicine. If we are found to
have promoted such off-label uses, however, we may become subject to significant liability. The U.S. federal government has levied large
civil and criminal fines against companies for alleged improper promotion of off-label use and has enjoined several companies from engaging
in off-label promotion. The FDA has also requested that companies enter into consent decrees or permanent injunctions under which specified
promotional conduct is changed or curtailed. The FDA may also issue a public warning letter or untitled letter to the company. If we cannot
successfully manage the promotion of our future approved products, we could become subject to significant liability, which would materially
adversely affect our business and financial condition.
42
Our business activities may be subject to
the U.S. Foreign Corrupt Practices Act, or the FCPA, and similar anti-bribery and anti-corruption laws of other countries in which we
operate, as well as U.S. and certain foreign export controls, trade sanctions, and import laws and regulations. Compliance with these
legal requirements could limit our ability to compete in foreign markets and subject us to liability if we violate them.
If we further expand our operations
outside of the United States, we must dedicate additional resources to comply with numerous laws and regulations in each jurisdiction
in which we plan to operate. Our business activities may be subject to the FCPA and similar anti-bribery or anti-corruption laws, regulations
or rules of other countries in which we operate. The FCPA generally prohibits companies and their employees and third-party intermediaries
from offering, promising, giving or authorizing the provision of anything of value, either directly or indirectly, to a non-U.S. government
official in order to influence official action or otherwise obtain or retain business. The FCPA also requires public companies to make
and keep books and records that accurately and fairly reflect the transactions of the corporation and to devise and maintain an adequate
system of internal accounting controls. Our business is heavily regulated and therefore involves significant interaction with public officials,
including officials of non-U.S. governments. Additionally, in many other countries, hospitals owned and operated by the government, and
doctors and other hospital employees would be considered foreign officials under the FCPA. Recently the Securities and Exchange Commission
(“SEC”) and Department of Justice (“DOJ”) have increased their FCPA enforcement activities with respect to biotechnology
and pharmaceutical companies. There is no certainty that all of our employees, agents or contractors, or those of our affiliates, will
comply with all applicable laws and regulations, particularly given the high level of complexity of these laws. Violations of these laws
and regulations could result in fines, criminal sanctions against us, our officers or our employees, disgorgement, and other sanctions
and remedial measures, and prohibitions on the conduct of our business. Any such violations could include prohibitions on our ability
to offer our products in one or more countries and could materially damage our reputation, our brand, our international activities, our
ability to attract and retain employees and our business, prospects, operating results and financial condition.
In addition, our products
and technology may be subject to U.S. and foreign export controls, trade sanctions and import laws and regulations. Governmental regulation
of the import or export of our products and technology, or our failure to obtain any required import or export authorization for our products,
when applicable, could harm our international sales and adversely affect our revenue. Compliance with applicable regulatory requirements
regarding the export of our products may create delays in the introduction of our products in international markets or, in some cases,
prevent the export of our products to some countries altogether. Furthermore, U.S. export control laws and economic sanctions prohibit
the shipment of certain products and services to countries, governments, and persons targeted by U.S. sanctions. If we fail to comply
with export and import regulations and such economic sanctions, penalties could be imposed, including fines and/or denial of certain export
privileges. Moreover, any new export or import restrictions, new legislation or shifting approaches in the enforcement or scope of existing
regulations, or in the countries, persons, or products targeted by such regulations, could result in decreased use of our products by,
or in our decreased ability to export our products to existing or potential customers with international operations. Any decreased use
of our products or limitation on our ability to export or sell access to our products would likely adversely affect our business.
Our business involves the use of hazardous
materials and we and our third-party manufacturers and suppliers must comply with environmental laws and regulations, which can be expensive
and restrict how we do business.
Our research and development activities and our third-party manufacturers
and suppliers’ activities involve the controlled storage, use and disposal of hazardous materials owned by us. We and our manufacturers
and suppliers are subject to laws and regulations governing the use, manufacture, storage, handling and disposal of these hazardous materials.
In some cases, these hazardous materials and various wastes resulting from their use are stored at our manufacturers’ facilities
pending their use and disposal.
We cannot eliminate the risk of contamination, which could cause an
interruption of our research and development efforts and business operations, environmental damage resulting in costly clean-up and liabilities
under applicable laws and regulations governing the use, storage, handling and disposal of these materials and specified waste products.
Although we believe that the safety procedures utilized by our third-party manufacturers and suppliers for handling and disposing these
materials generally comply with the standards prescribed by these laws and regulations, we cannot guarantee that this is the case or eliminate
the risk of accidental contamination or injury from these materials. In such an event, we may be held liable for any resulting damage
and such liability could exceed our resources and state or federal or other applicable authorities may curtail our use of certain materials
and/or interrupt our business operations. Furthermore, environmental laws and regulations are complex, change frequently and have tended
to become more stringent over time. We cannot predict the impact of such changes and cannot be certain of our future compliance. We do
not currently carry biological or hazardous waste insurance coverage. Any contamination by such hazardous materials could therefore materially
adversely affect our business, financial condition, results of operations and growth prospects.
43
Disruptions in the global economy and supply
chains may have a material adverse effect on our business, financial condition and results of operations.
The disruptions to the global economy which began in 2020 have impeded
global supply chains, resulting in longer lead times and also increased critical component costs and freight expenses. We have taken and
may have to take steps to minimize the impact of these disruptions on lead times and increased costs by working closely with our suppliers
and other third parties on whom we rely for the conduct of our business. Despite the actions we may have to undertake to minimize the
impacts from disruptions to the global economy, there can be no assurances that unforeseen future events in the global supply chain will
not have a material adverse effect on our business, financial condition and results of operations.
Furthermore, inflation can
adversely affect us by increasing the costs of clinical trials, the research and development of our product candidates, as well as administration
and other costs of doing business. We may experience increases in the prices of labor and other costs of doing business. In an inflationary
environment, cost increases may outpace our expectations, causing us to use our cash and other liquid assets faster than forecasted. If
this happens, we may need to raise additional capital to fund our operations, which may not be available in sufficient amounts or on reasonable
terms, if at all, sooner than expected.
Pursuant to the AlloMek Agreement, the Sellers
have a right to repurchase certain assets and specified intellectual property from us in the event of a change of control and if we fail
to meet certain obligations regarding development and commercialization.
Pursuant to the AlloMek Agreement,
the Sellers have a right to repurchase certain specified assets and intellectual property that we purchased from the Sellers pursuant
to the AlloMek Agreement. This right is triggered if (1) we undergo a change of control, and (2) if we fail to meet our obligations regarding
the development and commercialization of PAS-004 (formerly CIP-137401) (the “Drug”), including actions such as winding up,
liquidating, or exiting the biotechnology business. If these conditions are met, we must offer to sell the Drug and all related intellectual
property back to the Sellers at a specified price. The exercise of this repurchase right could result in the loss of key assets upon which
a substantial portion of our business and strategy is based.
Risks Related to Our Dependence on Third Parties
We rely completely
on third parties, including WuXi, to supply drug substance and manufacture drug product for our clinical trials and preclinical studies.
We intend to rely on other third parties to produce commercial supplies of product candidates, and our dependence on third parties could
adversely impact our business.
We are completely dependent
on third-party suppliers of the drug substance and drug product for our product candidates. If third-party suppliers do not supply sufficient
quantities of materials to us on a timely basis and in accordance with applicable specifications and other regulatory requirements, there
could be a significant interruption of our supplies, which would adversely affect clinical development and commercialization. Furthermore,
if any of our contract manufacturers cannot successfully manufacture material that conforms to our specifications within regulatory requirements,
we will not be able to secure and/or maintain regulatory approval, if any, for our product candidates.
We currently only use one
CMO, Wuxi, for the production of PAS-004 drug substance and we utilize the same manufacturer for the production of drug product for our
clinical trials. The termination of this relationship would result in a disruption to our product development and our business may be
harmed.
We also rely on our contract
manufacturers to purchase from third-party suppliers the materials necessary to produce our product candidates for our anticipated clinical
trials. We do not have any control over the process or timing of the acquisition of raw materials by our contract manufacturers. Moreover,
we currently do not have agreements in place for the commercial production of these raw materials. Any significant delay in the supply
of a product candidate or the raw material components thereof for an ongoing clinical trial, including as a result of public health crises,
such as the COVID-19 pandemic or the conflict between Russia and Ukraine and the conflict between Israel and Hamas, increased U.S. trade
tariffs and trade disputes with other countries and any resulting trade wars could considerably delay completion of that clinical trial,
product candidate testing, and potential regulatory approval of that product candidate.
We do not expect to have the
resources or capacity to commercially manufacture any of our proposed product candidates if approved and will likely continue to be dependent
on third-party manufacturers. Our dependence on third parties to manufacture and supply clinical trial materials and any approved product
candidates may adversely affect our ability to develop and commercialize our product candidates on a timely basis.
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If, for any reason, our CMOs are unable or unwilling to perform, we
may not be able to terminate our agreements with them, and we may not be able to locate alternative manufacturers or formulators
or enter into favorable agreements with them and we cannot be certain that any such third parties will have the manufacturing capacity
to meet future requirements. If these manufacturers or any alternate manufacturer of finished drug product experiences any significant
difficulties in its respective manufacturing processes for our ingredients or finished products or should cease doing business with us,
we could experience significant interruptions in the supply of any of our product candidates or may not be able to create a supply of
our product candidates at all. Our inability to coordinate the efforts of our third-party manufacturing partner(s), or the lack of capacity
available at our third-party manufacturing partner(s), could impair our ability to supply any of our product candidates at the required
levels. Because of the significant regulatory requirements that we would need to satisfy in order to qualify a new bulk or finished product
manufacturer, if we face these or other difficulties with our current manufacturing partner(s), we could experience significant interruptions
in the supply of any of our product candidates if we decide to transfer the manufacture of any of our product candidates to one or more alternative manufacturers in
an effort to deal with the difficulties.
Any manufacturing problem
or the loss of a contract manufacturer, including Wuxi, could be disruptive to our operations and delay development of our product candidates.
Additionally, we rely on third parties to supply the raw materials needed to manufacture our potential products. Any reliance on suppliers
may involve several risks, including a potential inability to obtain critical materials and reduced control over production costs, delivery
schedules, reliability and quality. Any unanticipated disruption to a future contract manufacturer caused by problems at suppliers could
delay shipment of any of our product candidates and, if approved, products.
In addition, we currently rely on foreign CROs and CMOs, including WuXi,
and will likely continue to rely on foreign CROs and CMOs in the future. There has been increased governmental focus in the United States
on the role of Chinese companies in the life sciences industry. This focus has included U.S. legislative proposals, such as the proposed
BIOSECURE Act, which has been passed by the U.S. House of Representatives and is pending before the U.S. Senate. If enacted, the BIOSECURE
Act would, among other things, prohibit U.S. federal agencies from entering into or renewing any contract with any entity that uses biotechnology
equipment or services produced or provided by a “biotechnology company of concern” to perform that contract with the government.
Although the proposed Act has not been enacted and thus is subject to change through the legislative process, a version of the BIOSECURE
Act passed by the U.S. House of Representatives defines a “biotechnology company of concern” to include WuXi Biologics and
WuXi AppTec. If adopted, the BIOSECURE Act could cause us to seek to exit some or all of our arrangements with WuXi (or any other China-based
service provider determined to be “biotechnology companies of concern”) and accelerate the transition of these services to
alternative companies or continue to engage redundant suppliers for the U.S. market. Additionally, the legislation could adversely impact
WuXi’s operations or financial position which, in turn, could impact its ability to perform under our agreements with it. Our reliance
on Chinese-based contract research organizations, such as WuXi, may also cause us to face additional risks due to geopolitical tensions
between the U.S. and China and related legal and regulatory restrictions and requirements, including measures directly affecting WuXi.
In addition, these entities
or materials sourced from these entities may be subject to other U.S. legislation, sanctions, investigations, regulations trade restrictions
tariffs, regulatory actions, or ex-U.S. legislation, regulatory actions or requirements that could increase the cost or reduce the supply
of material available to us, delay or prevent the procurement or supply of such material, delay or impact the availability of our product
candidates, delay or impact clinical trials, availability of commercial supply or have an adverse effect on our ability to secure significant
commitments from governments to purchase our potential therapies. Any of the foregoing outcomes could adversely affect our financial condition
and business prospects.
Furthermore, the biopharmaceutical
industry in China is strictly regulated by the Chinese government. Changes to Chinese regulations or government policies affecting biopharmaceutical
companies are unpredictable and may have a material adverse effect on our collaborators in China which could have an adverse effect on
our business, financial condition, results of operations and prospects. Evolving changes in China’s public health, economic, political,
and social conditions and the uncertainty around China’s relationship with other governments, such as the United States and the
UK, could also negatively impact our ability to manufacture our product candidates for our planned clinical trials or have an adverse
effect on our ability to secure government funding, which could adversely affect our financial condition and cause us to delay our clinical
development programs.
We have in the
past relied and expect to continue to rely on third-party CROs and other third parties to conduct and oversee our research programs, preclinical
studies, planned clinical trials and other aspects of product development. If these third parties do not meet our requirements or otherwise
operate as required, we may not be able to satisfy our contractual obligations or obtain regulatory approval for, or commercialize, our
product candidates when expected or at all.
We have in the past relied and expect to continue to rely on third-party
CROs to conduct and oversee our research programs, preclinical studies, clinical trials and other aspects of product development. We will
also rely upon various medical institutions, clinical investigators and contract laboratories to conduct our trials in accordance with
our clinical protocols and all applicable regulatory requirements, including the FDA’s regulations and GCPs, which are an international
standard meant to protect the rights and health of patients and to define the roles of clinical trial sponsors, administrators and monitors,
and state regulations governing the handling, storage, security and recordkeeping for drug and biologic products. These CROs and other
third parties will play a significant role in the conduct of these trials and the subsequent collection and analysis of data from our
planned clinical trials. We will rely heavily on these parties for the execution of our clinical trials and preclinical studies, and control
only certain aspects of their activities. We and our CROs and other third-party contractors are required to comply with GCP, GLP, and
GACP requirements, which are regulations and guidelines enforced by the FDA and comparable foreign regulatory authorities for products
in clinical development. Regulatory authorities enforce these GCP, GLP and GACP requirements through periodic inspections of trial sponsors,
principal investigators and trial sites. If we or any of these third parties fail to comply with applicable GCP, GLP and GACP requirements,
the clinical data generated in our clinical trials may be deemed unreliable and the FDA or other regulatory authority may require us to
perform additional clinical trials before approving our or our partners’ marketing applications. We cannot assure you that upon
inspection by a given regulatory authority, such regulatory authority will determine whether any of our clinical or preclinical trials
complies with applicable GCP and GLP requirements. In addition, our clinical trials must generally be conducted with product produced
under cGMP regulations. Our failure to comply with these regulations and policies may require us to repeat clinical trials, which would
delay the regulatory approval process.
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Our CROs are not our
employees, and we do not control whether or not they devote sufficient time and resources to our preclinical or clinical trials. Our CROs
may also have relationships with other commercial entities, including our competitors, for whom they may also be conducting clinical trials,
or other drug development activities, which could harm our competitive position. We face the risk of potential unauthorized disclosure
or misappropriation of our intellectual property by CROs, which may reduce our trade secret protection and allow our potential competitors
to access and exploit our proprietary technology. If our CROs do not successfully carry out their contractual duties or obligations, fail
to meet expected deadlines, or if the quality or accuracy of the clinical data they obtain is compromised due to the failure to adhere
to our clinical protocols or regulatory requirements or for any other reason, our clinical trials may be extended, delayed or terminated,
and we may not be able to obtain regulatory approval for, or successfully commercialize any product candidate that we develop. As a result,
our financial results and the commercial prospects for any product candidate that we may develop would be harmed, our costs could increase,
and our ability to generate revenue could be delayed.
If any of our CROs or clinical trial sites terminate their involvement
in one of our preclinical studies or clinical trials for any reason, we may not be able to enter into arrangements with alternative CROs
or clinical trial sites or do so on commercially reasonable terms. In addition, if our relationship with clinical trial sites is terminated,
we may experience the loss of follow-up information on patients unless we are able to transfer the care of those patients to another qualified
clinical trial site. In addition, principal investigators for our clinical trials may serve as scientific advisors or consultants to us
from time to time and could receive cash or equity compensation in connection with such services. If these relationships and any related
compensation result in perceived or actual conflicts of interest, the integrity of the data generated at the applicable clinical trial
site may be questioned by the FDA.
We also rely on research institutions
to conduct our research programs, preclinical studies and planned clinical trials. Our reliance upon research institutions, including
hospitals and clinics, provides us with less control over the timing and cost of clinical trials and the ability to recruit subjects.
If we are unable to reach agreement with suitable research institutions on acceptable terms, or if any resulting agreement is terminated,
we may be unable to quickly replace the research institution with another qualified institution on acceptable terms. Even if we do replace
the institution, we may incur additional costs to conduct the trial at the new institution. We may not be able to secure and maintain
suitable research institutions to conduct our clinical trials.
If we enter into collaborations with third
parties to develop or commercialize our product candidates, our prospects with respect to those product candidates will depend in significant
part on the success of those collaborations.
If we enter into future collaboration
with third parties, we could face the following risks:
●
collaborators have significant discretion in determining the efforts and resources that they will apply to these collaborations;
●
collaborators could independently develop, or develop with third parties, products that compete directly or indirectly with our products or product candidates;
●
collaborators may not properly enforce, maintain or defend our intellectual property rights or may use our proprietary information in a way that gives rise to actual or threatened litigation that could jeopardize or invalidate our intellectual property or proprietary information or expose us to potential litigation, or other intellectual property proceedings;
46
●
disputes may arise between a collaborator and us that cause the delay or termination of the research, development or commercialization of the product candidate, or that result in costly litigation or arbitration that diverts management attention and resources;
●
if a present or future collaborator of ours were to be involved in a business combination, the continued pursuit and emphasis on our product development or commercialization program under such collaboration could be delayed, diminished or terminated; and
●
collaboration agreements may restrict our right to independently pursue new product candidates.
If conflicts arise between
our collaborators and us, our collaborators may act in a manner adverse to us and could limit our ability to implement our strategies.
Future collaborators may develop, either alone or with others, products in related fields that are competitive with the products or potential
products that are the subject of these collaborations. Competing products, either developed by the collaborators or to which the collaborators
have rights, may result in the withdrawal of support for our product candidates. Our collaborators may preclude us from entering into
collaborations with their competitors, fail to obtain timely regulatory approvals, terminate their agreements with us prematurely or fail
to devote sufficient resources to the development and commercialization of products. Any of these developments could harm our product
development efforts.
As a result, if we enter into additional collaboration agreements and
strategic partnerships or license our intellectual property, products or businesses, we may not be able to realize the benefit of such
transactions if we are unable to successfully integrate them with our existing operations, which could delay our timelines or otherwise
adversely affect our business. We also cannot be certain that, following a strategic transaction or license, we will achieve the revenue
or specific net income that justifies such a transaction.
Changes in U.S. and international trade
policies, particularly with respect to China, may adversely impact our business and operating results.
The U.S. government has recently made statements and taken certain
actions that may lead to potential changes to U.S. and international trade policies, including imposing several rounds of tariffs and
export control restrictions affecting certain products manufactured in China. In March 2018, the first Trump administration announced
the imposition of tariffs on steel and aluminum entering the United States and in June 2018, the first Trump administration announced
further tariffs targeting goods imported from China. Recently both China and the United States have each imposed tariffs indicating the
potential for further trade barriers, including the U.S. Commerce Department adding numerous Chinese entities to its “unverified
list,” which requires U.S. exporters to go through more procedures before exporting goods to such entities. Furthermore, following
the change of administrations, the second Trump administration announced plans to implement or increase tariffs, particularly on products
manufactured in China, Canada and Mexico. Any retaliatory tariffs from Mexico are expected to be imposed on U.S. goods. It is unknown
whether and to what extent new tariffs, export controls, or other new laws or regulations will be adopted, or the effect that any such
actions would have on us or our industry.
Further, our primary manufacturer
and supplier, WuXi, is located in China and the subject of increased U.S. government scrutiny. Trade tensions and conflicts between the
United States and China have been escalating in recent years and, as such, we are exposed to the possibility of product supply disruption
and increased costs and expenses in the event of changes to the laws, rules, regulations and policies of the governments of the United
States or China, or due to geopolitical unrest and unstable economic conditions. Certain Chinese biotechnology companies may become subject
to trade restrictions, sanctions, other regulatory requirements or proposed legislation by the U.S. government, which could restrict or
even prohibit our ability to work with such entities, thereby potentially disrupting their supply of material to us. If these bills become
law, or similar laws are passed, they would have the potential to severely restrict the ability of companies to contract with certain
Chinese biotechnology companies of concern without losing the ability to contract with, or otherwise received funding from, the U.S. government.
Such disruptions could have adverse effects on the development of our product candidates and our business operations.
Any unfavorable government policies on international trade, such as export controls, capital controls or
tariffs, may increase the cost of manufacturing our product candidates and platform materials, affect the demand for our drug products
(if and once approved), the competitive position of our product candidates, and import or export of raw materials and finished product
candidate used in our and our collaborators’ preclinical studies and clinical trials, particularly with respect to any product candidates
and materials that we import from China, including pursuant to our manufacturing service arrangements with WuXi. If any new tariffs, export
controls, legislation and/or regulations are implemented, or if existing trade agreements are renegotiated or, in particular, if either
the U.S. or Chinese government takes retaliatory trade actions due to the recent trade tension, such changes could have an adverse effect
on our business, financial condition and results of operations.
47
Risks Related to Our Securities
The price of our Common Stock and Warrants
may be volatile, and you could lose all or part of your investment.
The market price of our Common
Stock and Warrants are highly volatile and for the year ended December 31, 2024, the market price of our Common Stock ranged from $2.54
to $8.75 per share and the market price of our Warrants ranged from less than $0.01 to $0.05. The recent fluctuations in our trading price
and future trading in our Common Stock and Warrants may be subject to wide fluctuations in response to a variety of factors, including
the following:
●
the timing and results of preclinical studies and clinical trials of our future product candidates or those of our competitors;
●
the success of competitive products or announcements by potential competitors of their product development efforts;
●
regulatory actions with respect to our or our competitors’ product candidates or products;
●
actual or anticipated changes in our growth rate relative to our competitors;
●
regulatory or legal developments in the United States and other countries;
●
developments or disputes concerning patent applications, issued patents or other proprietary rights;
●
the recruitment or departure of key personnel;
●
announcements by us or our competitors of significant acquisitions, strategic collaborations, joint ventures, or capital commitments;
●
actual or anticipated changes in estimates as to financial results, development timelines or recommendations by securities analysts;
●
fluctuations in the valuation of companies perceived by investors to be comparable to us;
●
market conditions in the pharmaceutical and biotechnology sector;
●
changes in the structure of healthcare payment systems;
●
price and volume fluctuations attributable to inconsistent trading volume levels of our securities;
●
announcement or expectation of additional financing efforts;
●
sales of our Common Stock and Warrants by us, our insiders or our other stockholders;
●
expiration of market stand-off or lock-up agreements; and
●
general economic, industry and market conditions.
These and other market and industry factors may cause the market price
and demand for our Common Stock and Warrants to fluctuate substantially, regardless of our actual operating performance, which may limit
or prevent investors from readily selling their shares of Common Stock or Warrants and may otherwise negatively affect the liquidity of
our Common Stock and Warrants. In addition, the stock market in general, and Nasdaq Capital Markets and emerging growth companies in particular,
have experienced extreme price and volume fluctuations that have often been unrelated or disproportionate to the operating performance
of these companies. In the past, when the market price of a security has been volatile, holders of that security have instituted securities
class action litigation against the company that issued the security. If any of our stockholders brought a lawsuit against us, we could
incur substantial costs by defending the lawsuit. Such a lawsuit could also divert the time and attention of our management.
48
We could be negatively affected as a result
of the actions of activists or hostile shareholders.
Our business could be negatively
affected as a result of stockholder activism, which could cause us to incur significant expense, hinder execution of our business strategy,
and impact the trading value of our securities. Stockholder activism requires significant time and attention by management and the Board
of Directors, potentially interfering with our ability to execute our strategic plan. Stockholder activism could give rise to perceived
uncertainties as to our future direction, adversely affect our relationships with key executives and business partners, and make it more
difficult to attract and retain qualified personnel. Also, we may be required to incur significant legal fees and other expenses related
to activist stockholder matters. Any of these impacts could materially and adversely affect our business and operating results. Further,
the market price of our Common Stock could be subject to significant fluctuation or otherwise be adversely affected by stockholder activism.
Our Warrants may not have any value.
There
can be no assurance that the market price of our Common Stock will ever equal or exceed the exercise price of our outstanding Warrants.
In the event that our Common Stock price does not exceed the exercise price of the Warrants during the period when the Warrants are exercisable,
the Warrants may not have any value.
A Warrant does not entitle the holder to
any rights as common stockholders until the holder exercises the Warrant for a share of our Common Stock.
Until you acquire shares of our Common Stock upon exercise of your
Warrants, your Warrants will not provide you any rights as a common stockholder. Upon the exercise of your Warrants, you will be entitled
to exercise the rights of a common stockholder only as to matters for which the record date occurs after the exercise date.
If securities or industry analysts do not
publish research or reports, or if they publish adverse or misleading research or reports, regarding us, our business or our market, the
price and trading volume of our Common Stock and Warrants could decline.
The trading market for our
Common Stock and Warrants is influenced by the research and reports that securities or industry analysts publish about us, our business
or our market. We do not currently have and may never obtain research coverage by securities or industry analysts. If no or few securities
or industry analysts commence coverage of us, the stock price would be negatively impacted. In the event we obtain securities or industry
analyst coverage, if any of the analysts who cover us issue adverse or misleading research or reports regarding us, our business model,
our future intellectual property, our stock performance or our market, or if our operating results fail to meet the expectations of analysts,
the price of our Common Stock and Warrants would likely decline. If one or more of these analysts cease coverage of us or fail to publish
reports on us regularly, we could lose visibility in the financial markets, which in turn could cause the price of our Common Stock and
Warrants or trading volume to decline.
Our quarterly operating results may fluctuate
significantly or may fall below the expectations of investors or securities analysts, each of which may cause our stock price to fluctuate
or decline.
Our operating results are
subject to quarterly fluctuations. Our net loss and other operating results are affected by numerous factors, including:
●
variations in the level of expense related to the ongoing development of our future product candidates or future development programs;
●
results of clinical trials, or the addition or termination of clinical trials or funding support by us or potential future partners;
●
our execution of any collaboration, licensing or similar arrangements, and the timing of payments we may make or receive under potential future arrangements or the termination or modification of any such potential future arrangements;
●
any intellectual property infringement, misappropriation or violation lawsuit or opposition, interference or cancellation proceeding in which we may become involved;
49
●
additions and departures of key personnel;
●
strategic decisions by us or our competitors, such as acquisitions, divestitures, spin-offs, joint ventures, strategic investments or changes in business strategy;
●
if any of our future product candidates receive regulatory approval, the terms of such approval and market acceptance and demand for such approved products;
●
regulatory developments affecting our future product candidates, or those of our competitors; and
●
changes in general market and economic conditions.
If our quarterly operating
results fall below the expectations of investors or securities analysts, the price of our Common Stock and Warrants could decline substantially.
Furthermore, any quarterly fluctuations in our operating results may, in turn, cause the price of our Common Stock and Warrants to fluctuate
substantially. We believe that quarterly comparisons of our financial results are not necessarily meaningful and should not be relied
upon as an indication of our future performance.
If we fail to maintain an effective system
of internal control over financial reporting, we may not be able to accurately report our financial results or prevent fraud. As a result,
stockholders could lose confidence in our financial and other public reporting, which would harm our business and the trading price of
our Common Stock and Warrants.
Effective internal controls over financial reporting
are necessary for us to provide reliable financial reports and, together with adequate disclosure controls and procedures, are designed
to prevent fraud. Any failure to implement required new or improved controls, or difficulties encountered in their implementation could
cause us to fail to meet our reporting obligations. In addition, any testing by us conducted in connection with Section 404 of the Sarbanes-Oxley
Act, or any subsequent testing by our independent registered public accounting firm, may reveal deficiencies in our internal controls
over financial reporting that are deemed to be material weaknesses or that may require prospective or retroactive changes to our financial
statements or identify other areas for further attention or improvement. Inferior internal controls could also cause investors to lose
confidence in our reported financial information, which could have a negative effect on the trading price of our securities.
We are required to disclose changes made in our
internal controls and procedures on a quarterly basis and our management is required to assess the effectiveness of these controls annually.
However, for as long as we are an emerging growth company, our independent registered public accounting firm will not be required to attest
to the effectiveness of our internal controls over financial reporting pursuant to Section 404 of the Sarbanes-Oxley Act. We will remain
an “emerging growth company” until the earliest of (i) the last day of the fiscal year in which we have total annual gross
revenues of $1.235 billion or more; (ii) the last day of our fiscal year following the fifth anniversary of the date of our offering;
(iii) the date on which we have issued more than $1 billion in nonconvertible debt during the previous three years; or (iv) the date on
which we are deemed to be a large accelerated filer under the rules of the SEC. An independent assessment of the effectiveness of our
internal controls over financial reporting could detect problems that our management’s assessment might not. Undetected material
weaknesses in our internal controls over financial reporting could lead to restatements of our financial statements and require us to
incur the expense of remediation.
During the year ended December
31, 2023, we identified a material weakness in our financial reporting related to certain tax disclosures in Note 10 of our financial
statements. As of the date hereof, after designing and conducting procedures designed to remediate the material weakness, and testing
such procedures, we have concluded that these controls are operating effectively, and the prior material weakness has been remediated.
50
We are an “emerging growth company,”
and we cannot be certain if the reduced reporting requirements applicable to emerging growth companies will make our Common Stock and
Warrants less attractive to investors.
We are an “emerging
growth company,” as defined in the JOBS Act. For as long as we continue to be an emerging growth company, we intend to take advantage
of exemptions from various reporting requirements that are applicable to other public companies that are not emerging growth companies,
including:
●
being permitted to provide only two years of audited financial statements, in addition to any required unaudited interim financial statements, with correspondingly reduced “Management’s Discussion and Analysis of Financial Condition and Results of Operations” disclosure in this 10-K;
●
not being required to comply with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act;
●
not being required to comply with any requirement that may be adopted by the Public Company Accounting Oversight Board regarding mandatory audit firm rotation or a supplement to the auditor’s report providing additional information about the audit and the financial statements;
●
reduced disclosure obligations regarding executive compensation in this 10-K and our periodic reports and proxy statements; and
●
exemptions from the requirements of holding nonbinding advisory stockholder votes on executive compensation and stockholder approval of any golden parachute payments not previously approved.
We cannot predict if investors
will find our securities less attractive because we may rely on these exemptions. If some investors find our securities less attractive
as a result, there may be a less active trading market for our securities and the trading prices of our securities may be more volatile.
We will remain an emerging
growth company until the earliest to occur of: (1) the last day of the fiscal year in which we have more than $1.235 billion in annual
revenue; (2) the date we qualify as a “large accelerated filer,” with at least $700 million of equity securities held by non-affiliates;
(3) the date on which we have issued more than $1.0 billion in non-convertible debt securities during the prior three-year period; and
(4) the last day of the fiscal year ending after the fifth anniversary of our offering.
Pursuant to the JOBS Act,
as an emerging growth company, we have elected to use the extended transition period for complying with any new or revised financial accounting
standards to delay adopting new or revised accounting standards until such time as those standards apply to private companies.
The requirements of being a public company
may strain our resources, resulting in more litigation and divert management’s attention.
As a public company, we are
subject to the reporting requirements of the Exchange Act, the Sarbanes-Oxley Act, the Dodd-Frank Wall Street Reform and Consumer Protection
Act, or the Dodd-Frank Act, the listing requirements of Nasdaq and other applicable securities rules and regulations. Complying with these
rules and regulations increases legal and financial compliance costs, makes some activities more difficult, time consuming or costly and
increases demand on our systems and resources, including management. The Exchange Act requires, among other things, that we file annual,
quarterly and current reports with respect to our business and operating results. The Sarbanes-Oxley Act requires, among other things,
that we maintain effective disclosure controls and procedures and internal control over financial reporting. We are required to disclose
changes made in our internal control and procedures on a quarterly basis. In order to maintain and, if required, improve our disclosure
controls and procedures and internal control over financial reporting to meet this standard, significant resources and management oversight
may be required. As a result, management’s attention may be diverted from other business concerns, which could adversely affect
our business and operating results. We may also need to hire additional employees or engage outside consultants to comply with these requirements,
which will increase our costs and expenses.
51
In addition, changing laws,
regulations and standards relating to corporate governance and public disclosure are creating uncertainty for public companies, increasing
legal and financial compliance costs and making some activities more time consuming. These laws, regulations and standards are subject
to varying interpretations, in many cases due to their lack of specificity and, as a result, their application in practice may evolve
over time as new guidance is provided by regulatory and governing bodies. This could result in continuing uncertainty regarding compliance
matters and higher costs necessitated by ongoing revisions to disclosure and governance practices. We intend to invest resources to comply
with evolving laws, regulations and standards, and this investment may result in increased general and administrative expenses and a diversion
of management’s time and attention from revenue-generating activities to compliance activities. If our efforts to comply with new
laws, regulations and standards differ from the activities intended by regulatory or governing bodies due to ambiguities related to their
application and practice, regulatory authorities may initiate legal proceedings against us and our business may be adversely affected.
These new rules and regulations
may make it more expensive for us to obtain director and officer liability insurance and, in the future, we may be required to accept
reduced coverage or incur substantially higher costs to obtain coverage. These factors could also make it more difficult for us to attract
and retain qualified members of our Board, particularly to serve on our Audit Committee and compensation committee (“Compensation
Committee”), and qualified executive officers.
By disclosing information
in this 10-K and in future filings required of a public company, our business and financial condition will become more visible, which
we believe may result in threatened or actual litigation, including by competitors and other third parties. If those claims are successful,
our business could be seriously harmed. Even if the claims do not result in litigation or are resolved in our favor, the time and resources
needed to resolve them could divert our management’s resources and seriously harm our business.
We may be subject to securities litigation,
which is expensive and could divert management attention.
The market price of our Common
Stock and Warrants may be volatile and, in the past, companies that have experienced volatility in the market price of their stock have
been subject to securities class action litigation. We may be the target of this type of litigation in the future. Securities litigation
against us could result in substantial costs and divert our management’s attention from other business concerns, which could seriously
harm our business.
We do not currently intend to pay dividends
on our Common Stock and, consequently, your ability to achieve a return on your investment will depend on appreciation of the value of
our Common Stock.
We have never declared or
paid any cash dividends on our equity securities. We currently anticipate that we will retain future earnings for the development, operation
and expansion of our business and do not anticipate declaring or paying any cash dividends for the foreseeable future. Any return to stockholders
will therefore be limited to any appreciation in the value of our Common Stock, which is not certain.
Provisions in our Certificate of Incorporation
and Bylaws and Delaware law might discourage, delay or prevent a change in control of our company or changes in our management and, therefore,
depress the market price of our securities.
Our second amended and restated
certificate of incorporation (“Certificate of Incorporation”), and our amended and restated bylaws (“Bylaws”)
contain provisions that could depress the market price of our securities by acting to discourage, delay or prevent a change in control
of our Company or changes in our management that the stockholders of our Company may deem advantageous. These provisions, among other
things:
●
prohibit cumulative voting;
●
authorize our Board to amend the Bylaws;
●
provide that our Board be divided into three
classes of directors serving staggered three-year terms and removal of directors can only be for cause;
●
provide that our stockholders may only adopt,
amend, alter or repeal the Bylaws by the affirmative vote of the holders of at least sixty-six and two-thirds percent (66 2/3%) in voting
power of the outstanding shares of common stock;
●
eliminate the ability of our stockholders to act by written consent without a meeting, requiring all stockholder action to be taken at an annual or special meeting of stockholders;
●
establish advance notice requirements for nominations for election to our Board or for proposing matters that can be acted upon by stockholders at annual stockholder meetings; and
●
state that a stockholders meeting, special or annual, may be adjourned by the Board, the chairman of the meeting or, if directed to be voted on by the chairman of the meeting, by the Company’s stockholders present or represented at the meeting, although less than a quorum.
52
In addition, Section 203 of
the General Corporation Law of the State of Delaware, or the DGCL, prohibits a publicly-held Delaware corporation from engaging in a business
combination with an interested stockholder, generally a person which together with its affiliates owns, or within the last three years
has owned, 15% of our voting stock, for a period of three years after the date of the transaction in which the person became an interested
stockholder, unless the business combination is approved in a prescribed manner.
Any provision of our Certificate
of Incorporation, Bylaws or Delaware law that has the effect of delaying or preventing a change in control could limit the opportunity
for our stockholders to receive a premium for their shares of our capital stock and could also affect the price that some investors are
willing to pay for our securities.
Certain beneficial owners might have control
over us which could delay or prevent a change in corporate control or result in the entrenchment of management and/or the Board .
As of March 20, 2025, our
officers, directors and principal stockholders, beneficially own, in the aggregate, approximately 17.7% of our outstanding Common Stock.
Accordingly, these stockholders, if acting together, may have the ability to impact the outcome of matters submitted to our stockholders
for approval, including the election and removal of directors and any merger, consolidation, or sale of all or substantially all of our
assets. In addition, these persons may have the ability to influence the management and affairs of our Company. Accordingly, this concentration
of ownership may harm the market price of our securities by:
●
delaying, deferring, or preventing a change in control;
●
entrenching our management and/or the Board;
●
impeding a merger, consolidation, takeover, or other business combination involving us; or
●
discouraging a potential acquirer from making a tender offer or otherwise attempting to obtain control of us.
Exchange rate fluctuations may materially
affect our results of operations and financial conditions.
In light of the international
scope of our operations, fluctuations in exchange rates, particularly between the U.S. dollar, the British pound, the Euro, and the Australian
Dollar may adversely affect us. Although we are based in the United States, we currently have research and development operations through
our Australian subsidiary, Pasithea MacroMEK Pty Ltd. As a result, our business may be affected by fluctuations in foreign exchange rates,
which may have a significant impact on our results of operations and cash flows from period to period and the price of our Common Stock
and Warrants. Currently, we do not have any exchange rate hedging arrangements in place.
Failure to comply with The Nasdaq Capital
Market continued listing requirements may result in our Common Stock and/or Warrants being delisted from The Nasdaq Capital Market.
In the past, we have
received notices from Nasdaq’s Listing Qualifications Department indicating that we had not complied with certain of the Nasdaq
Capital Market’s continued listing standards. While we have regained compliance for each instance, there can be no assurance that
we will continue to maintain compliance with the Minimum Bid Price Requirement or maintain compliance with the other Nasdaq listing requirements.
If the price of our Common Stock were to again decline to a price whereby we are in violation of the Minimum Bid Price Requirement, the
market may perceive a decision to effect an additional reverse stock split as a negative indicator of our future prospects, and as a result,
the price of our Common Stock may fail to regain compliance with the Minimum Bid Price Requirement after any such additional reverse stock
split. A delisting could substantially decrease trading in our Common Stock and/or Warrants, adversely affect the market liquidity of
our Common Stock and/or Warrants as a result of the loss of market efficiencies associated with Nasdaq and the loss of federal preemption
of state securities laws, adversely affect our ability to obtain financing on acceptable terms, if at all, and may result in the potential
loss of confidence by investors, suppliers, customers and employees and fewer business development opportunities. Additionally, the market
price of our Common Stock and/or Warrants may decline further, and stockholders may lose some or all of their investment.
In the event of a delisting,
we anticipate that we would take actions to restore our compliance with the Nasdaq Capital Market or another national exchange’s
listing requirements, but we can provide no assurance that any such action taken by us would allow our common stock to remain listed on
the Nasdaq Capital Market, stabilize our market price, improve the liquidity of our Common Stock, prevent our Common Stock from dropping
below the Nasdaq Capital Market’s minimum bid price requirement, or prevent future non-compliance with the Nasdaq Capital Market
or another national exchange’s listing requirements.
53
ITEM 1B. UNRESOLVED STAFF COMMENTS
Not applicable.
ITEM 1C. CYBERSECURITY
Cybersecurity Risk Management and Strategy
We, like other companies in
our industry, face several cybersecurity risks in connection with our business. Our business strategy, results of operations, and financial
condition have not, to date, been affected by risks from cybersecurity threats. During the reporting period, we have not experienced any
material cyber incidents, nor have we experienced a series of immaterial incidents, which would require disclosure.
In the ordinary course of
our business, we may use, store and process sensitive of data. To effectively prevent, detect, and respond to cybersecurity threats,
we maintain a cyber risk management program, which is comprised of data segregation, physical, procedural, and technical safeguards along
with documented policies and procedures. By fully outsourcing our IT environment and placing it within expert third party software-as-a-service,
human resource, and clinical providers, our primary means of avoiding cyber risk is minimizing sensitive data within our enterprise.
The cyber risk management
program falls under the responsibility of our Chief Financial Officer (“CFO”) who manages the overall security through constant
communication and supervision of our third-party vendors. Under the guidance of our CFO who reports the Audit Committee, we
try to minimize our data footprint to keep our cyber risk low. We use technology-based tools that are designed to mitigate cybersecurity
risks and to bolster our employee-based cybersecurity programs.
We do not believe that there
are currently any known risks from cybersecurity threats that are reasonably likely to materially affect us or our business strategy,
results of operations or financial condition .
Governance; Board Oversight
Under the ultimate direction
of our CFO, with oversight from our board of directors, we maintain a security governance structure to evaluate and address cyber risk.
Our CFO regularly consults with our third-party IT consultant who has expertise in cybersecurity to develop strategies to assess, address
and align cybersecurity efforts with our business objectives and operational requirements.
The Audit Committee of our
Board provides direct oversight over cybersecurity risk, and provides updates to the Board of Directors regarding such oversight, when
and if appropriate. Our CFO provides periodic updates to the Audit Committee regarding cybersecurity matters including significant new
cybersecurity threats or incidents, when and if appropriate.
ITEM 2. PROPERTIES
We do not own any real property.
Our principal executive office
is located at 1111 Lincoln Road, Suite 500, Miami Beach, FL 33139. We rent approximately 300 square feet of space, which includes our
executive offices.
We believe that our facilities
are generally in good condition and suitable to operate our business. We also believe that, if required, suitable alternative or additional
space will be available to us on commercially reasonable terms.
ITEM 3. LEGAL PROCEEDINGS
None.
ITEM 4. MINE SAFETY DISCLOSURES
Not applicable.
54
PART II
ITEM 5. MARKET FOR REGISTRANT’S COMMON
EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES
Market information
Our Common Stock trades on
the Nasdaq Capital Market under the symbol “KTTA.”
Holders of Record
As of March 20, 2025, we had 39 holders
of record of our Common Stock. The actual number of holders of our Common Stock is greater than this number of record holders and includes
stockholders who are beneficial owners, but whose shares are held in street name by brokers or held by other nominees. This number of
holders of record also does not include stockholders whose shares may be held in trust by other entities.
Dividend Policy
We have never declared or
paid any dividends on our Common Stock. We currently intend to retain all available funds and any future earnings, if any, to fund the
development and expansion of our business, and we do not anticipate paying any cash dividends in the foreseeable future. Any future determination
to pay dividends will be made at the discretion of our Board.
ITEM 6. [Reserved]
[Reserved]
ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS
OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following Management’s
Discussion and Analysis of Financial Condition and Results of Operations is intended to provide information necessary to understand our
audited consolidated financial statements for the fiscal years ended December 31, 2024 and December 31, 2023 and highlight certain other
information which, in the opinion of management, will enhance a reader’s understanding of our financial condition, changes in financial
condition and results of operations. In particular, the discussion is intended to provide an analysis of significant trends and material
changes in our financial position and the operating results of our business during the year ended December 31, 2024, as compared to the
fiscal year ended December 31, 2023. This discussion should be read in conjunction with our consolidated financial statements for the
fiscal years ended December 31, 2024 and December 31, 2023 and related notes included elsewhere in this 10-K. These historical financial
statements may not be indicative of our future performance. This Management’s Discussion and Analysis of Financial Condition and
Results of Operations contains numerous forward-looking statements, all of which are based on our current expectations and could be affected
by the uncertainties and risks described throughout this filing, particularly in “Item 1A. Risk Factors.”
Throughout this report, the terms “our,” “we,”
“us,” and the “Company” refer to Pasithea Therapeutics Corp. and its subsidiaries, Pasithea Therapeutics Limited
(UK), Pasithea Therapeutics Portugal, Sociedade Unipessoal Lda, Pasithea Clinics Inc., Alpha-5 Integrin, LLC, AlloMek Therapeutics, LLC
and Pasithea MacroMEK Pty Ltd. Pasithea Therapeutics Limited (UK) is a private limited Company, registered in the United Kingdom (UK).
Pasithea Clinics Inc. is incorporated in Delaware, Pasithea Therapeutics Portugal, Sociedade Unipessoal Lda, a private limited Company,
registered in Portugal, and Alpha-5 Integrin, LLC and AlloMek Therapeutics, LLC, are both Delaware limited liability companies. Pasithea
MacroMEK Pty Ltd is registered in Australia.
55
Overview
We are a clinical-stage biotechnology
company focused on the discovery, research and development of innovative treatments for central nervous system (CNS) disorders and other
diseases, including RASopathies.
Our primary operations (the
“Therapeutics” segment) are focused on developing our lead product candidate, PAS-004, a next-generation macrocyclic mitogen-activated
protein kinase, or MEK inhibitor that we believe may address the limitations and liabilities associated with existing drugs targeting
a similar mechanism of action. In December 2023, the U.S. Food and Drug Administration (the “FDA”) cleared our Investigational
New Drug application (the “IND”) for PAS-004 and we received a study may proceed letter from the FDA for our Phase 1 multicenter,
open-label, dose escalation trial of PAS-004 in patients with MAPK pathway-driven advanced tumors with a documented RAS, NF1 or RAF mutation
or patients who have failed BRAF/MEK inhibition (the “FIH Phase 1 Dose Escalation Study”). We are currently conducting the
FIH Phase 1 Dose Escalation Study at four clinical sites in the United States and three additional sites in Eastern Europe. Our clinical
development plan for PAS-004 is to advance PAS-004 into a Phase 1/1b clinical trial in adult NF1-PN patients followed by pediatric NF1-PN
patients and ultimately complete registrational clinical trials in these patient populations, which are the initial indications that the
Company plans to seek marketing approval of PAS-004 for.
Additionally, we have two
programs that are in the discovery stage, which we believe address limitations in the treatment paradigm of the indications we plan
to address with these programs, which are currently amyotrophic lateral sclerosis (“ALS”) for PAS-003 and schizophrenia for
PAS-001. During the year ended December 31, 2023, we determined to cease further development of our PAS-002 program for multiple sclerosis
due to several factors including the significant capital, resources and time required to develop the program, and the current and projected
availability of effective treatment options for MS patients, among others.
During the year ended December
31, 2023, we also discontinued providing business support services to anti-depression clinics (the “Clinics” segment) in the
U.K. and in the United States, previously conducted through partnerships with healthcare providers. During the year ended December 31,
2023, the at home services in New York, NY as well as in the U.K were discontinued and the Company sold and disposed of the assets associated
with the Clinics operations in Los Angeles, CA. The lease associated with the related property in Los Angeles was assumed by the buyer
in the transaction.
Throughout this report, the
terms “our,” “we,” “us,” and the “Company” refer to Pasithea Therapeutics Corp. and its
subsidiaries, Pasithea Therapeutics Limited (U.K.), Pasithea Therapeutics Portugal, Sociedade Unipessoal Lda, Pasithea Clinics Inc., Alpha-5
Integrin, LLC (“Alpha-5”), AlloMek Therapeutics, LLC (“AlloMek”) and Pasithea MacroMEK Pty Ltd. Pasithea Therapeutics
Limited (U.K.), legally dissolved as of January 2, 2024 was a private limited Company, registered in the United Kingdom (U.K.). Pasithea
Therapeutics Portugal, Sociedade Unipessoal Lda is a private limited Company registered in Portugal. Pasithea Clinics Inc. is incorporated
in Delaware. Alpha-5 and AlloMek are both Delaware limited liability companies. Pasithea MacroMEK Pty Ltd is registered in Australia.
The operations of Pasithea Therapeutics Limited (U.K.), Pasithea Therapeutics Portugal, Sociedade Unipessoal Lda, and Pasithea Clinics
Inc. have been discontinued.
56
Impact of Inflation
We have recently experienced
higher costs across our business as a result of inflation, including higher costs related to employee compensation and outside services.
Although we anticipate a decline in the rate of inflation in 2025, we expect inflation to continue to have a negative impact throughout
2025, and it is uncertain whether we will be able to offset the impact of inflationary pressures in the near term.
Reverse Stock Split
On
December 28, 2023, we filed a Certificate of Amendment to our Amended and Restated Certificate of Incorporation reflecting a one-for-20
Reverse Stock Split of our issued and outstanding shares of Common Stock which became effective at 12:01 a.m. Eastern Time on January
2, 2024. As a result of the Reverse Stock Split, every 20 shares of Common Stock issued and outstanding
were converted into one share of Common Stock, with a corresponding reduction in the number of authorized shares of Common Stock from
495,000,000 to 100,000,000. The Reverse Stock Split affected all stockholders uniformly and did not alter any stockholder’s percentage
interest in the Company’s equity, except to the extent that the Reverse Stock Split resulted in some stockholders owning a fractional
share. No fractional shares were issued in connection with the Reverse Stock Split. Stockholders who were otherwise entitled to receive
a fractional share instead received a cash payment (without interest) equal to such fraction multiplied by the average of the closing
sales prices of Common Stock on The Nasdaq Capital Market for the five consecutive trading days immediately preceding the effective date
of the Reverse Stock Split (with such average closing sales prices adjusted to give effect to the Reverse Stock Split). All outstanding
securities entitling their holders to purchase shares of Common Stock or acquire shares of Common Stock, including stock options, convertible
debt and warrants, were adjusted as a result of the Reverse Stock Split, as required by the terms of those securities.
The
accompanying consolidated financial statements reflect the Reverse Stock Split. All share and per share information data herein that
relates to our Common Stock prior to the effective date has been retroactively restated to reflect the Reverse Stock Split.
Results of Operations
Years Ended December 31, 2024 and 2023
Our financial results for
the years ended December 31, 2024 and 2023 are summarized as follows:
For the Years Ended
December 31,
2024
2023
Change
% Change
Selling, general and administrative
$ 7,051,468
$ 7,878,596
$ (827,128 )
(10.5 )
Research and development
7,198,494
8,100,765
(902,271 )
(11.1 )
Loss from operations
(14,249,962 )
(15,979,361 )
1,729,399
(10.8 )
Other income, net
345,378
471,613
(126,235 )
(26.8 )
Net loss from continuing operations
(13,904,584 )
(15,507,748 )
1,603,164
(10.3 )
Net loss from discontinued operations, net of tax
-
(453,910 )
453,910
(100.0 )
Net loss
$ (13,904,584 )
$ (15,961,658 )
$ 2,057,074
(12.9 )
General and Administrative
General and administrative
expenses decreased by approximately $827,000, or 10.5%, for the year ended December 31, 2024 compared to the year ended December 31, 2023.
The decrease was primarily driven by (i) a decrease of $530,000 in professional fees, of which approximately $271,000 was related to public
company and corporate communications expenses, approximately $127,000 was related to business development, and approximately $132,000
was related to personnel, office expenses or other professional fees (ii) a decrease in legal fees of approximately $461,000, (iii) a
decrease in accounting fees of approximately $57,000, offset by (iv) an increase of approximately $147,000 in stock compensation expenses,
and (v) an increase of approximately $74,000 in consulting fees.
We expect general and administrative
expenses to decrease slightly in fiscal year 2025 as compared to fiscal year 2024 primarily due to reduced legal and public company and
corporate communications expenses.
57
Research and Development
Research and development expenses
for the years ended December 31, 2024 and 2023 relates to activities primarily focused on the development of PAS-004, PAS-003 and PAS-001.
Research and development expenses
decreased by approximately $903,000, or 11.1%, for the year ended December 31, 2024 compared to the year ended December 31, 2023. The
decrease was primarily due to (i) a decrease of approximately $2,019,000 of pre-clinical research related to our discovery programs, (ii)
a decrease of approximately $1,141,000 in manufacturing costs related to PAS-004 due to the bulk manufacturing of GMP materials to support
our clinical trials in fiscal year 2023, (iii) a decrease of approximately $167,000 in consulting fees, (iv) a decrease in compensation
and stock compensation expenses of approximately $200,000 in connection with the reduction in workforce related to the closure of our
research laboratory, offset by (v) an increase of approximately $2,624,000 in clinical research related to the ongoing FIH Phase 1 Dose
Escalation Study.
We expect research and development
expenses to increase in fiscal year 2025 as compared to fiscal year 2024 primarily due to (i) an increase in clinical research for PAS-004
related to the ongoing FIH Phase 1 Dose Escalation Study and the upcoming phase 1/1b clinical trial of PAS-004 in adult NF1-PN patients,
and (ii) an increase in manufacturing costs related to the drug supply for our clinical trials, offset by decreases in pre-clinical research
and the reduction in workforce related to the closure of our research laboratory.
Other Income, Net
For the year ended December 31, 2024, other income, net decreased by
approximately $126,000, or 26.8%, as compared to the year ended December 31, 2023. The decrease was primarily driven by a $126,000 increase
in the fair value of our warrant liabilities during the year ended December 31, 2024.
Discontinued Operations
During the year ended December
31, 2023, we discontinued our support services to anti-depression clinics in the U.K. and related at-home services in New York, NY. We
also discontinued our clinical operations in Los Angeles, CA and disposed of the related property. Accordingly, as of December 31, 2023,
all activity related to our discontinued subsidiaries is included in Net loss from discontinued operations, net of tax in the statements
of operations.
Working Capital
As of December 31,
2024
2023
Current assets
$ 7,368,315
$ 16,692,154
Current liabilities
1,119,871
2,634,040
Working capital
$ 6,248,444
$ 14,058,114
Working capital decreased
by $7.8 million between December 31, 2024 and December 31, 2023 due primarily to cash used to fund operations for the year ended December
31, 2024.
58
Liquidity and Capital Resources
Year Ended December 31,
2024
2023
Net loss
$
(13,904,584
)
$
(15,961,658
)
Net cash used in operating activities
$
(13,923,438
)
$
(12,814,133
)
Net cash provided by investing activities
-
75,199
Net cash provided by (used in) financing activities
4,517,634
(3,726,416
)
Effect of foreign currency translation
(2,519
)
(3,991
)
Net cash used in discontinued operations
-
(287,471
)
Decrease in cash and cash equivalents
$
(9,408,323
)
$
(16,756,812
)
Cash and cash equivalents
decreased by approximately $9.4 million for the year ended December 31, 2024 compared to a decrease of approximately $16.8 million for
the year ended December 31, 2023, which was primarily attributable to cash used to fund operations, partially offset by an increase of
approximately $4.5 million in net cash from financing activities from the private placement offering in September 2024.
Liquidity & Capital Resources Outlook
As of December 31, 2024, we
had approximately $6.9 million in operating bank accounts and money market funds, with working capital of approximately $6.2 million.
We are dependent on obtaining additional working capital funding from the sale of equity and/or debt securities in order to continue to
execute our development plans and continue operations. Subsequent to the consummation of the Initial Public Offering, our liquidity was
and continues to be satisfied through the net proceeds from the Initial Public Offering, the private placements we consummated in November
2021 and September 2024 and the receipt of cash upon the prior exercise of our outstanding warrants. Based on the foregoing, management
believes that we will not have sufficient working capital to meet our needs through twelve months from the issuance date of the financial
statements included in this annual report, without raising additional capital.
In September 2024, we entered
into a securities purchase agreement with an institutional investor for the issuance and sale in a private placement (the “September
2024 Private Placement”) of (i) pre-funded warrants to purchase up to 1,219,513 shares of our Common Stock, at an exercise price
of $0.001 per share, (ii) Series A warrants (the “Series A Warrants”) to purchase up to 1,219,513 shares of Common Stock,
at an exercise price of $3.85 per share, and (iii) Series B warrants (the “Series B Warrants” and together with the Series
A Warrants, the “September 2024 Warrants” ) to purchase up to 1,219,513 shares of Common Stock with an exercise price of $3.85
per share. The combined purchase price per Pre-Funded Warrant and accompanying September 2024 Warrants was $4.099. The net proceeds to
us from the Private Placement were approximately $4.5 million, after deducting placement agent fees and estimated offering expenses.
We are able to sell securities
on a shelf registration statement pursuant to the ATM Agreement with H.C. Wainwright & Co., LLC. Under current Securities and Exchange
Commission regulations, if at any time our public float is less than $75.0 million, and for so long as our public float remains less than
$75.0 million, the amount we can raise through primary public offerings of securities in any twelve-month period using shelf registration
statements is limited to an aggregate of one-third of our public float, which is referred to as the baby shelf rules. As of December 31,
2024, our calculated public float is below $75.0 million and we will be restricted from selling more than an aggregate of one-third of
our public float pursuant to a shelf registration statement in any twelve-month period, so long as the aggregate market value of our Common
Stock held by non-affiliates is less than $75.0 million.
Our primary use of cash is
to fund operating expenses, primarily general and administrative and research and development expenditures. Cash used to fund operating
expenses is impacted by the timing of when we pay these expenses, as reflected in the change in our outstanding accounts payable, accrued
expenses and prepaid expenses.
Because of the numerous risks
and uncertainties associated with research, development and commercialization of pharmaceutical products, we are unable to estimate the
exact amount of our operating capital requirements. Our future funding requirements will depend on many factors, including, but not limited
to:
●
the scope, timing, progress and results of discovery, preclinical development, laboratory testing and clinical trials for our product candidates;
●
the costs of manufacturing our product candidates for clinical trials and in preparation for marketing approval and commercialization;
●
the extent to which we enter into collaborations or other arrangements with third parties in order to further develop our product candidates;
●
the costs of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual property rights and defending intellectual property-related claims;
●
the costs and fees associated with the discovery, acquisition or in-license of additional product candidates or technologies;
●
expenses needed to attract and retain skilled personnel;
59
●
the costs required to scale up our clinical, regulatory and manufacturing capabilities;
●
the costs of future commercialization activities, if any, including establishing sales, marketing, manufacturing and distribution capabilities, for any of our product candidates for which we receive marketing approval; and
●
revenue, if any, received from commercial sales of our product candidates, should any of our product candidates receive marketing approval.
We will need significant additional
funds to meet operational needs and capital requirements for clinical trials, other research and development expenditures, and business
development activities. We currently have no credit facility or committed sources of capital. Because of the numerous risks and uncertainties
associated with the development and commercialization of our product candidates, we are unable to estimate the amounts of increased capital
outlays and operating expenditures associated with our current and anticipated clinical studies.
Contractual Obligations
See Note 12 – Commitments
and Contingencies in the Notes to the Consolidated Financial Statements in Item 8 of this Form 10-K for a summary of our contractual obligations.
Off-Balance Sheet Arrangements
We did not have any off-balance
sheet arrangements as defined in Item 303(a)(4)(ii) of Regulation S-K promulgated under the Exchange Act.
Critical Accounting Estimates
The preparation of financial
statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires the Company’s management
to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities
at the date of the financial statement and the reported amounts of revenues and expenses during the reporting period.
Making estimates requires
management to exercise significant judgment. It is at least reasonably possible that the estimate of the effect of a condition, situation
or set of circumstances that existed at the date of the financial statements, which management considered in formulating its estimate,
could change in the near term due to one or more future confirming events.
We believe that the following
critical accounting estimates are particularly subject to management’s judgment and could materially affect our financial condition
and results of operations:
●
Assumptions used in the Black-Scholes pricing model for valuation of stock option awards, such as expected volatility, risk-free interest rate, expected term and expected dividends.
●
Valuation of the liability for Representative Warrants, for which there is no active market, based on the relative fair value to the quoted market price of the Public Warrants, accounting for a small difference in the exercise price.
Management also regularly
makes estimates related to the recoverability of long-lived assets; the fair values and useful lives of intangible assets acquired in
business combinations; the potential impairment of goodwill; and income taxes. The Company bases its estimates on historical experience
and on various assumptions that are believed to be reasonable, the results of which form the basis for the amounts recorded in the consolidated
financial statements. As appropriate, the Company obtains reports from third-party valuation experts to inform and support estimates related
to fair value measurements.
For additional information
on critical accounting estimates, see Note 2 to the consolidated Financial Statements, “Summary of Significant Accounting Policies
and New Accounting Standards,” in Part II, Item 8, of this Annual Report on Form 10-K.
60
New Accounting Standards
For discussion of new accounting
standards, see Note 2 to the consolidated Financial Statements, “Summary of Significant Accounting Policies and New Accounting Standards,”
in Part II, Item 8, of this Annual Report on Form 10-K.
ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES
ABOUT MARKET RISK
Not applicable.
ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA
The information called for by Item 8 is included
following the “Index to Financial Statements” on page F-1 contained in this Annual Report on Form 10-K.
ITEM 9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS
ON ACCOUNTING AND FINANCIAL DISCLOSURE
None.
ITEM 9A. CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls and Procedures
We maintain disclosure controls
and procedures (as that term is defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended, or the
Exchange Act), that are designed to ensure that information required to be disclosed in our reports under the Exchange Act is recorded,
processed, summarized and reported within the time periods specified in the SEC’s rules and forms, and that such information is
accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate,
to allow timely decisions regarding required disclosures. In designing disclosure controls and procedures, our management was required
to apply its judgment in evaluating the cost-benefit relationship of possible disclosure controls and procedures. The design of any disclosure
controls and procedures also is based in part upon certain assumptions about the likelihood of future events, and there can be no assurance
that any design will succeed in achieving its stated goals under all potential future conditions. Any controls and procedures, no matter
how well designed and operated, can provide only reasonable, not absolute, assurance of achieving the desired control objectives.
Under the supervision and
with the participation of our management, including our Chief Executive Officer and Chief Financial Officer, we are required to perform
an evaluation of our disclosure controls and procedures, as such term is defined in Rule 13a-15(e) under the Exchange Act, as of December
31, 2024.
Management has completed such an evaluation and has concluded that
our disclosure controls and procedures were effective to provide reasonable assurance that information required to be disclosed by us
in reports we file or submit under the Exchange Act is appropriate to allow timely decisions regarding required disclosures.
Management’s Annual Report on Internal
Control Over Financial Reporting
Our management, under the
supervision of the Chief Executive Officer and Chief Financial Officer, is responsible for establishing and maintaining adequate internal
control over financial reporting for our company. Internal control over financial reporting is defined in Rule 13a-15(f) or 15d-15(f)
promulgated under the Exchange Act as a process designed by, or under the supervision of, the Company’s principal executive and
principal financial officers and effected by the Board, management and other personnel, to provide reasonable assurance regarding the
reliability of financial reporting and the preparation of financial statements for external purposes in accordance with GAAP and includes
those policies and procedures that: (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect
the transactions and dispositions of the assets of the company; (ii) provide reasonable assurance that transactions are recorded as necessary
to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures
of our company are being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable
assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of our company’s assets that
could have a material effect on the financial statements.
61
Our management, with the participation
of our Chief Executive Officer and Chief Financial Officer, evaluated the effectiveness of our internal control over financial reporting
as of December 31, 2024. In making this evaluation, our management used the criteria set forth in the Internal Control - Integrated Framework
(2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission.
Based on this evaluation,
management concluded that our internal control over financial reporting was effective at a reasonable assurance level as of December 31,
2024 based on those criteria.
Remediation of Previously Identified Material
Weakness
A material
weakness is a deficiency, or a combination of deficiencies, in internal control over financial reporting, such that there is a reasonable
possibility that a material misstatement of the Company’s annual or interim financial statements will not be prevented or detected
on a timely basis.
As
previously disclosed in our Form 10-K for the year ended December 31, 2023, as filed on March 29, 2024, management in connection with
our independent auditors identified a material weakness in our controls related to the review of the annual income tax provision prepared
by a third-party firm during the audit process related to our fiscal year ended December 31, 2023. Specifically, we did not maintain effective
controls to sufficiently review the completeness and accuracy of the annual tax provision in Note 10 to our financial statements (the
“Tax Provision Disclosure”) included in our Form 10-K for the year ended December 31, 2023.
In
response to the material weakness, management, under the supervision and with the participation of the Company’s Chief Executive
Officer and Chief Financial Officer, initiated a reassessment of our processes and controls related to the Tax Provision Disclosure and
developed an action plan to remediate this matter, which included creating processes to ensure a thorough review of all materials and
schedules prepared by third parties with respect to the Tax Provision Disclosure and engaging a tax professional to prepare and review
any Tax Provision Disclosures.
Management
believes our updated controls have been operating for a sufficient period of time and we have concluded, through testing, that these controls
are operating effectively and that the material weakness identified above is remediated as of December 31, 2024.
Changes in Internal Control Over Financial
Reporting
Other than the changes to remediate the material weaknesses noted above,
there was no change in our internal control over financial reporting (as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act)
during the fiscal quarter ended December 31, 2024, that has materially affected, or is reasonably likely to materially affect,
our internal control over financial reporting.
This Annual Report on Form
10-K does not include an attestation report of our registered public accounting firm regarding internal control over financial reporting.
Management’s report was not subject to attestation by our registered public accounting firm pursuant to an exemption for nonaccelerated
filers and emerging growth companies from the internal control audit requirements of Section 404(b) of the Sarbanes-Oxley Act.
ITEM 9B. OTHER INFORMATION
(a)
None.
(b) During the fiscal quarter ended December 31, 2024, no director or “officer” (as defined in Rule 16a-1(f) under the Exchange Act) of the Company adopted or terminated any “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement,” as each term is defined in Item 408(c) of Regulation S-K.
ITEM 9C. DISCLOSURE REGARDING FOREIGN JURISDICTIONS
THAT PREVENT INSPECTIONS
Not applicable.
62
PART III
ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE
Executive Officers, Non-Executive Employees
and Directors
The following table sets forth
the name, age as of March 20, 2025, and current position of the individuals who serve as directors and executive officers of the Company.
The following also includes certain information regarding the individual experience, qualifications, attributes and skills of our directors
and executive officers as well as brief statements of those aspects of our directors’ backgrounds that led us to conclude that they
are qualified to serve as directors.
Name
Age
Position
Executive Officers
Dr. Tiago Reis Marques
48
Chief Executive Officer and Director
Daniel Schneiderman
47
Chief Financial Officer
Non-Employee
Directors
Prof. Lawrence Steinman
77
Executive Chairman and Co-Founder
Simon Dumesnil (1)(2)(3)
47
Director
Dr. Emer Leahy (1)(2)(3)
59
Director
Alfred Novak (1) (2)(3)
77
Director
(1) Member
of the Audit Committee.
(2) Member
of the Compensation Committee.
(3) Member
of the Nominating and Corporate Governance Committee.
Executive Officers
Each executive officer serves
at the discretion of our Board and holds office until his or her successor is duly elected and qualified or until his or her earlier resignation
or removal.
Dr. Tiago Reis Marques
(Chief Executive Officer and Director) has served as our Chief Executive Officer and member of our Board since August 2020. Dr. Marques
is also a senior clinical fellow at Imperial College London and a lecturer at the Institute of Psychiatry, Psychology and Neuroscience
(IoPPN) at King’s College London. The IoPPN is renowned globally, being ranked second in the world for psychology and psychiatry
by US News and Best Global Universities and is home to one of the largest centers for neuroscience research worldwide. Dr. Marques also
practices as a psychiatrist at Maudsley Hospital. His research is primarily focused on the mechanism of action of psychiatric medications
and novel treatment targets. During his career, he has obtained multiple awards for his research. Dr. Marques has authored or co-authored
over 100 scientific publications in peer-reviewed journals within the fields of psychiatry and neuroscience, has an h-index exceeding
45 and over 10,000 citations, and has co-authored international treatment guidelines and written book chapters, including the seminal,
“Neurobiology of Mental Illness.” We believe that Dr. Marques’s extensive medical and scientific background coupled
with his significant research and development achievements and clinical experience, makes him qualified to serve as our Chief Executive
Officer and a member of our Board.
Daniel Schneiderman (Chief
Financial Officer) is an experienced finance executive with over 24 years of experience in the areas of capital markets and finance
operations. Mr. Schneiderman has served as our Chief Financial Officer since October 11, 2022 and as a consultant to the Company from
July 1, 2022 through October 10, 2022. Prior to joining the Company, from January 2020 through February 2022 Mr. Schneiderman served as
Chief Financial Officer of First Wave BioPharma, Inc. (Nasdaq: FWBI), a clinical stage biopharmaceutical company specializing in the development
of targeted, non-systemic therapies for gastrointestinal (GI) diseases. Prior to joining First Wave, from November 2018 through December
2019, Mr. Schneiderman served as Chief Financial Officer of Biophytis SA, (ENXTPA: ALBPS; Nasdaq: BPTS) and its U.S. subsidiary, Biophytis,
Inc., a European-based, clinical-stage biotechnology company focused on the development of drug candidates for age-related diseases, with
a primary focus on neuromuscular diseases. From February 2012 through August 2018, Mr. Schneiderman served as Vice President of Finance,
Controller and Secretary of MetaStat, Inc. (OTCQB: MTST), a publicly traded biotechnology company with a focus on Rx/Dx precision medicine
solutions to treat patients with aggressive (metastatic) cancer. From 2008 through February 2012, Mr. Schneiderman was Vice President
of Investment Banking at Burnham Hill Partners LLC, a boutique investment bank providing capital raising, advisory and merchant banking
services primarily in the healthcare and biotechnology industries. From 2004 through 2008, Mr. Schneiderman served in various roles and
increasing responsibilities, including as Vice President of Investment Banking at Burnham Hill Partners, a division of Pali Capital, Inc.
Previously, Mr. Schneiderman worked at H.C. Wainwright & Co., Inc. in 2004 as an investment banking analyst. Mr. Schneiderman holds
a bachelor’s degree in economics from Tulane University.
63
Non-Employee Directors
Prof. Lawrence Steinman
has served on our Board since August 2020. Prior to joining Pasithea, he served on the Board of Centocor from 1989 to 1998, the Board
of Neurocine Biosciences from 1997 to 2005, the Board of Atreca from 2010 to 2019, the Board of BioAtla from 2016 to the present, and
the Board of Tolerion from 2013 to 2021. He is currently the George A. Zimmermann Endowed Chair in the Neurology Department at Stanford
University and previously served as the Chair of the Interdepartmental Program in Immunology at Stanford University Medical School from
2003 to 2011. He is an elected member of the National Academy of Medicine and the National Academy of Sciences. He also founded the Steinman
Laboratory at Stanford University, which is dedicated to understanding the pathogenesis of autoimmune diseases, particularly multiple
sclerosis and neuromyelitis optica. He received the Frederic Sasse Award from the Free University of Berlin in 1994, the Sen. Jacob Javits
Award from the U.S. Congress in 1988 and 2002, the John Dystel Prize in 2004 from the National MS Society in the U.S., the Charcot Prize
for Lifetime Achievement in Multiple Sclerosis Research in 2011 from the International Federation of MS Societies and the Anthony Cerami
Award in Translational Medicine by the Feinstein Institute of Molecular Medicine in 2015. He also received an honorary Ph.D. at the Hasselt
University in 2008 and from the University of Buenos Aires in 2022. He received his BA (physics) from Dartmouth College in 1968 and his
MD from Harvard University in 1973. He also completed a fellowship in chemical immunology at the Weizmann Institute (1974 - 1977) and
was an intern and resident at Stanford University Medical School (1973-1974; 1977-1980). We believe that Prof. Steinman is qualified to
serve on our Board due to his extensive background in medicine and his experience as a board member in the life sciences industry.
Simon Dumesnil has
served on our Board since April 2021. He is currently a Managing Partner and Director of Dunraven Capital Partners Limited, an investment
management advisory company incorporated in the U.K. that focuses on investments in Eastern European corporate distressed credits and
structured products. From 2013 to 2018, Mr. Dumesnil served as Managing Director and Head of the Structured Financing Group Americas at
UBS Securities LLC. In this role, he was responsible for managing the structured financing trading book in the USA and LATAM, overseeing
a portfolio of financing positions across various fixed income products including corporate syndicated and middle-market loans, corporate
bonds, real estate loans, and CMBS/RMBS/CLO/ABS, as well as LATAM Sovereign. Prior to this, Mr. Dumesnil was the Managing Director and
Co-Head of the Private-Side Structuring Group EMEA at UBS AG from 2010 to 2013. In these roles, he was responsible for arranging structured
solution transactions and acquisitions for the Financial Institutions Group (FIG) and Special Situation Group (SSG) and co-headed the
illiquid financing business. From 2009 to 2010, Mr. Dumesnil served as the Chief Investment Officer at Bluestone Capital Management, where
he managed investments in distressed assets across Europe. Between 2008 and 2009, Mr. Dumesnil was a Director at Lehman Brothers Holding
Inc., where he was responsible for restructuring and unwinding Lehman Brothers Special Financing Inc.’s derivative book post-bankruptcy.
From 2003 to 2008, Mr. Dumesnil was a Director at Lehman Brothers International (Europe). Mr. Dumesnil holds a Master of Science in Banking
and International Finance from Cass Business School and a Bachelor in Business and Administration from École des Hautes Études
Commerciales (HEC). Throughout his career, Mr. Dumesnil has advised on and underwritten corporate risk related to companies across various
industries and jurisdictions. He possesses extensive knowledge in corporate restructuring and capital structure optimization for companies
at different stages of their business life cycle. His experience as Chief Investment Officer during the launch and growth phases of a
financial services and technology company provides valuable insights for our Company. We believe that Mr. Dumesnil is qualified to serve
on our Board due to his extensive management and investment experience, as well as his expertise in corporate restructuring and capital
structure optimization.
64
Dr. Emer Leahy has
served on our Board since June 2021. Dr. Leahy received her Ph.D. in neuropharmacology from University College Dublin, Ireland in 1990,
and her MBA from Columbia University in 2000. She has been with PsychoGenics Inc., a preclinical CNS service company, since 1999 and is
currently serving as its chief executive officer and is responsible for compensation recommendations companywide. Prior to her appointment
as the chief executive officer, where she is responsible for compensation recommendations companywide. Prior to her appointment as chief
executive officer, she was the vice president of business development. Dr. Leahy is also the chief executive officer of PGI Drug Discovery
LLC, a company engaged in psychiatric drug discovery with five partnered clinical programs including one in Phase III. Additionally, Dr.
Leahy served as a member of both the compensation committee and the audit committee of Bright Minds Biosciences Inc. (NASDAQ: DRUG), a
biotech company, until April 2022. Since 2016, Dr. Leahy has served as a member of the board of directors of Intensity Therapeutics, Inc..
With more than 30 years of experience in drug discovery, clinical development and business development for pharmaceutical and biotechnology
companies, Dr. Leahy possesses extensive knowledge of technology assessment, licensing, mergers and acquisitions, and strategic planning.
She is also an Adjunct Associate Professor of Neuroscience at Mount Sinai School of Medicine. Dr. Leahy has also served on the Emerging
Companies Section Governing Board for the Board of the Biotechnology Industry Organization, the Business Review Board for the Alzheimer’s
Drug Discovery Foundation, and the Scientific Advisory Board of the International Rett Syndrome Foundation. She also currently serves
on the Board of PsychoGenics Inc, the Board of Intensity Therapeutics, and is the Chair of the Board of Trustees of BioNJ. We believe
that Dr. Leahy is qualified to serve on our Board due to her extensive pharmaceutical, biotechnology and business background, which provides
valuable insights and expertise to the Company.
Alfred Novak has been
a member of our Board since September 2022, bringing financial acumen and expertise in the pharmaceutical and medical device industries.
He has held leadership positions as a Chief Executive Officer and Chief Financial Officer of public and private companies and has served
on several boards of directors. Between October 2007 and June 2022, Mr. Novak served as a director, Audit Committee Chair, and Compensation
Committee member of LivaNova Plc (NASDAQ: LIVN) (and its predecessor company, Cyberonics, Inc.), a publicly held, medical device company.
Mr. Novak was actively involved in several acquisitions, disposals and start-up companies during his career. Mr. Novak has an MBA from
the Wharton School of the University of Pennsylvania with a concentration in Healthcare and Finance. He holds a BS from the United States
Merchant Marine Academy. We believe Mr. Novak is qualified to serve on our Board due to his extensive experience as a Chief Executive
Officer, in financial management, strategic planning, international operations, product development, regulatory process and commercialization
in the pharmaceutical and medical device industries.
Scientific Advisory Board
Luca Rastelli, Ph.D.
Dr. Rastelli is the Chief
Scientific Officer of Deepcure, an emerging biotech that uses AI-driven discovery to create better molecules and faster cures for every
disease-relevant protein target. Dr. Rastelli brings more than 25 years of oncology drug discovery and development experience, as well
as business development experience ranging from startups to large pharmaceutical companies. Most recently, Dr. Rastelli was Chief Scientific
Officer at Jubilant Therapeutics where he led all aspects of R&D for the company and was instrumental in bringing 2 compounds to the
clinic. Previously Dr. Rastelli was Chief Scientific Officer at Kleo Pharmaceuticals where he led the team that brough a CD38 targeting
compound based on Kleo’s novel ARM technology to the clinic for multiple myeloma. At BioXcel Therapeutics he was Vice President,
Oncology at where he helped bring the company to a successful IPO and he led a project focused on Neurofibromatosis type 2. Dr. Rastelli
has held multiple preclinical and clinical project leadership positions at Boston Scientifics, CuraGen, Sopherion and EMD Serono (Merck
Serono). Dr. Rastelli led the initial development of c-MET inhibitor TEPMETKO, approved for the treatment of METex14 positive NSCLC patients.
Dr. Rastelli was also part of the initial development of the immuno-oncology antibody BAVENCIO, a PDL-1 inhibitor approved for several
type of cancers. Dr. Rastelli received the American Brain Tumor Association’s 25th Anniversary Translational grant for his work on Medulloblastoma
tumors at the Department of Neuro-Oncology, MD Anderson Cancer Center. Dr. Rastelli is a named inventor on more than 10 issued patents
and holds a Ph.D. in Molecular Biology from the University of Geneva.
65
Rebecca Brown, M.D., Ph.D.
Dr. Rebecca Brown is a board-certified
adult neuro-oncologist who specializes in Neurofibromatosis (NF) and Schwannomatosis (SWN) genetic nerve tumor predisposition syndromes.
She earned her Ph.D. from The University of Texas at Austin (UT Austin) in Neuroscience studying the molecular genomics and behavioral
outcomes of endocrine-disrupting pollutants on females across multiple generations. Dr. Brown completed a post-doctoral fellowship at
the Center for Strategic and Innovative Technologies at UT Austin in human performance research and then earned her M.D. from UT Southwestern
in 2013. She completed her intern year at East Tennessee State University in 2014 and her neurology residency at Mount Sinai Hospital
in NYC in 2017. She specialized in neuro-oncology during a fellowship at Memorial Sloan Kettering Cancer Center (MSKCC) completed in 2019.
She worked as an instructor at MSKCC for 18 months prior to accepting a position as Assistant Professor and Director of the all-ages NF
and SWN Clinic at The Mount Sinai Health System in January 2021. In November 2024, Dr. Brown joined the University of Alabama (UAB) Department
of Neurology as an associate professor and is the Director of the adult NF and SWN clinic at UAB. Dr. Brown has experience on both sides
of the bench in NF laboratory research involving the RAS-RAF-MEK-ERK (MAPK) pathway, including genome editing, cell culture, xenografts,
and clinical trials. Her particular interest is in developing treatments for NF1-associated dermal tumors called cutaneous neurofibromas.
Daniel R. Weinberger, M.D.
Dr. Weinberger is Director
and CEO of the Lieber Institute for Brain Development at the Johns Hopkins Medical Center and Professor of Psychiatry, Neurology, Neuroscience
and Human Genetics at the Johns Hopkins School of Medicine. He was formally Director of the Genes, Cognition, and Psychosis Program of
the Intramural Research Program, National Institute of Mental Health, National Institutes of Health in Bethesda, Maryland. He attended
college at the Johns Hopkins University and medical school at the University of Pennsylvanian and did residencies in psychiatry at Harvard
Medical School and in neurology at George Washington University. He is board certified in both psychiatry and neurology. Dr. Weinberger’s
research has focused on brain and genetic mechanisms involved in the pathogenesis and treatment of neuropsychiatric disorders, especially
schizophrenia. He was instrumental in focusing research on the role of abnormal brain development as a risk factor for schizophrenia.
He has identified a number of specific neural and molecular mechanisms of genetic risk for schizophrenia, and genetic effects that account
for variation in specific human cognitive functions and in human temperament. His recent work has focused on genetic and epigenetic regulation
of expression in human brain of genes associated with developmental brain disorders. In 2003, Science magazine highlighted the
genetic research of his lab as the second biggest scientific breakthrough of the year, second to the origins of the cosmos. He is the
recipient of many honors and awards, including the Sarnat International Prize of the National Academy of Medicine, The International Neuroscience
Prize of the Gertrud Reemtsma Foundation of the Max Planck Society, the NIH Directors Award, The Roche-Nature Medicine Neuroscience Award,
The William K. Warren Medical Research Institute Award, the Adolf Meyer Prize of the American Psychiatric Association, the Foundation’s
Fund Prize from the American Psychiatric Association, and the Lieber Prize of the Brain and Behavior Research Foundation. He is past president
of the Society of Biological Psychiatry, past President of the American College of Neuropsychopharmacology and has been elected to the
National Academy of Medicine of the National Academy of Sciences.
66
Board Composition
Our Board currently consists of five members. Under our Bylaws, the
number of directors who shall constitute the Board shall equal not less than one or more than ten, as the Board may determine by resolution
from time to time.
Board Elections
In accordance with the terms
of our Certificate of Incorporation and Bylaws, our Board is divided into three classes; Class I, Class II and Class III,
with each class serving staggered three-year terms. Upon the expiration of the term of a class of directors, directors in that class will
be eligible to be elected for a new three-year term at the annual meeting of stockholders in the year in which their term expires. Our
directors are divided among the three classes as follows:
●
The Class I director is Dr. Emer Leahy; her term will expire at the 2027 Annual Meeting;
●
The Class II directors are Alfred Novak and Simon Dumesnil; their terms will expire at the 2025 Annual Meeting; and
●
The Class III directors are Dr. Tiago Reis Marques and Prof. Lawrence Steinman; their terms will expire at the 2026 Annual Meeting.
We expect that any additional
directorships resulting from an increase in the number of directors will be distributed among the three classes so that, as nearly as
possible, each class will consist of one-third of the total number of directors. The division of our Board into three classes
with staggered three-year terms may delay or prevent a change of our management or a change in control.
Our Certificate of Incorporation
and Bylaws provide that the authorized number of directors may be changed only by resolution of our Board. Our Certificate of Incorporation
and Bylaws also provide that our directors may be removed only for cause, and that any vacancy on our Board, including a vacancy resulting
from an enlargement of our Board, may be filled only by vote of a majority of our directors then in office, even if less than a quorum,
or by a sole remaining director.
Board Leadership Structure
The positions of our Chairman
of the Board and Chief Executive Officer are separated. Separating these positions allows our Chief Executive Officer to focus on our
day-to-day business, while allowing the Chairman of the Board to lead our Board in its fundamental role of providing advice to and independent
oversight of management. Our Board recognizes the time, effort and energy that the Chief Executive Officer must devote to his position
in the current business environment, as well as the commitment required to serve as our Chairman, particularly as our Board’s oversight
responsibilities continue to grow. Our Board also believes that this structure ensures a greater role for the independent directors in
the oversight of our Company and active participation of the independent directors in setting agendas and establishing priorities and
procedures for the work of our Board. Our Board believes its administration of its risk oversight function has not affected its leadership
structure.
Our corporate governance guidelines
provide that, if the Chairman of the Board is a member of management or does not otherwise qualify as independent, the independent directors
of the Board may elect a lead director. The lead director’s responsibilities include, but are not limited to: presiding over all
meetings of the Board at which the chairman is not present, including any executive sessions of the independent directors; approving Board
meeting schedules and agendas; and acting as the liaison between the independent directors and the Chief Executive Officer and Chairman
of the Board. Our corporate governance guidelines further provide the flexibility for our Board to modify our leadership structure in
the future as it deems appropriate.
67
Role of the Board in Risk Oversight
One of the key functions of our Board is informed oversight of our
risk management process. Our Board does not have a standing risk management committee but rather administers this oversight function directly
through our Board as a whole, as well as through various standing committees of our Board that address risks inherent in their respective
areas of oversight. In particular, our Board is responsible for monitoring and assessing strategic risk exposure and our Audit Committee
has the responsibility to consider and discuss our major financial risk exposures and the steps our management has taken to monitor and
control these exposures, including guidelines and policies to govern the process by which risk assessment and management is undertaken.
Our Audit Committee also monitors compliance with legal and regulatory requirements. Our nominating and corporate governance committee
(“Nominating and Corporate Governance Committee”) monitors the effectiveness of our corporate governance practices, including
whether they are successful in preventing illegal or improper liability-creating conduct. Our Compensation Committee assesses and monitors
whether any of our compensation policies and programs has the potential to encourage excessive risk-taking. While each committee is responsible
for evaluating certain risks and overseeing the management of such risks, our entire Board is regularly informed through committee reports
about such risks.
Board Committees
We currently have three committees
of the Board and have adopted charters for such committees: an Audit Committee, a Compensation Committee, and a Nominating and Corporate
Governance Committee. The composition and responsibilities of each committee are described below. Members serve on these committees until
their resignation or until otherwise determined by our Board. Each committee’s charter is available under the Corporate Governance
section of our website at www.pasithea.com . The reference to our website address does not constitute incorporation by reference
of the information contained at or available through our website, and you should not consider it to be a part of this 10-K.
Audit Committee . The Audit Committee’s responsibilities
include:
●
appointing, approving the compensation of, and assessing the independence of our registered public accounting firm;
●
overseeing the work of our registered public accounting firm, including through the receipt and consideration of reports from such firm;
●
reviewing and discussing with management and the registered public accounting firm our annual and quarterly financial statements and related disclosures;
●
coordinating our Board’s oversight of our internal control over financial reporting, disclosure controls and procedures and code of business conduct and ethics;
●
discussing our risk management policies;
●
meeting independently with our internal auditing staff, if any, registered public accounting firm and management;
●
reviewing and approving or ratifying any related person transactions; and
●
preparing the Audit Committee report required by SEC rules.
The members of our Audit Committee
are Simon Dumesnil (chairperson), Dr. Emer Leahy and Alfred Novak. All members of our Audit Committee meet the requirements for financial
literacy under the applicable rules and regulations of the SEC and Nasdaq. Our Board has determined that Simon Dumesnil is an audit committee
financial expert as defined under the applicable rules of the SEC and has the requisite financial sophistication as defined under the
applicable rules and regulations of Nasdaq. Under the rules of the SEC, members of the Audit Committee must also meet heightened independence
standards. Our Board has determined that Simon Dumesnil (chairperson), Dr. Emer Leahy and Alfred Novak are independent within the meaning
of the rules and regulations of Nasdaq and Rule 10A-3 under the Exchange Act.
The Audit Committee operates
under a written charter that satisfies the applicable standards of the SEC and Nasdaq.
68
Compensation Committee . The Compensation
Committee’s responsibilities include:
●
reviewing and approving, or recommending for approval by the Board, the compensation of our Chief Executive Officer and our other executive officers;
●
overseeing and administering our cash and equity incentive plans;
●
reviewing and making recommendations to our Board with respect to director’s
compensation;
●
reviewing and discussing annually with management our “Compensation Discussion and Analysis,” to the extent required; and
●
preparing the annual Compensation Committee report required by SEC rules, to the extent required.
The members of our Compensation
Committee are Dr. Emer Leahy (chairperson), Alfred Novak and Simon Dumesnil. Each of the members of our Compensation Committee is independent
under the applicable rules and regulations of Nasdaq and is a “non-employee director” as defined in Rule 16b-3 promulgated
under the Exchange Act. The Compensation Committee operates under a written charter that satisfies the applicable standards of the SEC
and Nasdaq.
Nominating and Corporate Governance Committee .
The Nominating and Corporate Governance Committee’s responsibilities include:
●
identifying individuals qualified to become Board members;
●
recommending to our Board the persons to be nominated for election as directors and to each Board committee;
●
developing and recommending to our Board corporate governance guidelines, and reviewing and recommending to our Board proposed changes to our corporate governance guidelines from time to time; and
●
overseeing a periodic evaluation of our Board.
The members of our Nominating
and Corporate Governance Committee are Alfred Novak (chairperson), Dr. Emer Leahy and Simon Dumesnil. Each of the members of our Nominating
and Corporate Governance Committee is an independent director under the applicable rules and regulations of Nasdaq relating to Nominating
and Corporate Governance Committee independence. The Nominating and Corporate Governance Committee operates under a written charter that
satisfies the applicable standards of the SEC and Nasdaq.
Director Independence
Our Board has determined that
Simon Dumesnil, Dr. Emer Leahy and Alfred Novak are all “independent” as that term is defined under the rules of The Nasdaq
Stock Market LLC. Our Board has determined that due to Dr. Tiago Reis Marques’ employment as an executive officer of the Company,
he currently has a relationship that would interfere with the exercise of independent judgment in carrying out the responsibilities of
a director, such that he is not “independent” as that term is defined under the rules of The Nasdaq Stock Market LLC, or the
Nasdaq rules. Our Board has also determined that beginning as of June 21, 2022, due to the Company’s transaction with Alpha-5,
Prof. Lawrence Steinman has a relationship that would interfere with the exercise of independent judgment in carrying out the responsibilities
of a director, such that he is not “independent” as that term is defined under the Nasdaq rules.
69
Compensation Committee Interlocks and Insider
Participation
No member of our Compensation
Committee is a current or former officer or employee. None of our executive officers served as a director or a member of a Compensation
Committee (or other committee serving an equivalent function) of any other entity, one of whose executive officers served as a director
or member of our Compensation Committee during the last completed fiscal year.
Corporate Code of Conduct and Ethics
Our Board has adopted a written
code of business conduct and ethics that applies to our directors, officers and employees, including our principal executive officer,
principal financial officer, principal accounting officer or controller, or persons performing similar functions. Copies of our corporate
code of conduct and ethics are available, without charge, upon request in writing to Pasithea Therapeutics Corp., 1111 Lincoln Road, Suite
500, Miami Beach, FL 33139, Attn: Secretary and are posted on the investor relations section of our website, which is located at www.pasithea.com .
The inclusion of our website address in this 10-K does not include or incorporate by reference the information on our website into this
10-K. We also intend to disclose any amendments to the Corporate Code of Conduct and Ethics, or any waivers of its requirements, on our
website.
Insider Trading Policies
We have adopted an insider trading policy that governs the purchase,
sale, and/or other transactions of our securities by our directors, officers and employees. A copy of our insider trading policy is filed
as Exhibit 19.1 to this Annual Report on Form 10-K for the fiscal year ended December 31, 2024. In addition, with regard to the Company’s
trading in its own securities, it is our policy to comply with the federal securities laws and the applicable exchange listing requirements
in all respects.
ITEM 11. EXECUTIVE COMPENSATION
As an emerging growth company
under the JOBS Act we have opted to comply with the executive compensation disclosure rules applicable to “smaller reporting companies,”
which require compensation disclosure for our principal executive officer and the two most highly compensated executive officers (other
than our principal executive officer) serving as executive officers at the end of our most recently completed fiscal year (collectively,
our “Named Executive Officers”). This section describes the executive compensation program in place for our Named Executive
Officers during the years ended December 31, 2024 and December 31, 2023, who are the individuals who served as our principal executive
officer and two most highly compensated executive officers.
This section discusses the
material components of the executive compensation program for our executive officers who are named in the “Summary Compensation
Table” below and the non-employee members of our Board.
Summary Compensation Table
Name and Principal Position
Year
Salary
($)
Bonus
($)
Stock Awards
($)
Option
Awards
($) (1)
All Other
Compensation
($)
Total
($)
Tiago
Reis Marques (2)
2024
450,000
-
22,241
167,818
-
640,059
Chief Executive Officer
2023
450,000
30,000
57,347
-
-
537,347
Daniel Schneiderman (3)
2024
330,000
-
-
100,223
-
430,223
Chief Financial Officer
2023
330,000
15,939
-
-
-
345,939
Graeme Currie (4)
2024
386,535
-
-
48,276
434,811
Chief Development Officer
2023
330,647
15,970
-
98,247
-
444,864
(1) In
accordance with SEC rules, the amounts in this column reflect the fair value on the grant date of the option awards granted to the named
executive, calculated in accordance with ASC Topic 718. Stock options were valued using the Black-Scholes model. The grant-date fair
value does not necessarily reflect the value of shares which may be received in the future with respect to these awards. The grant-date
fair value of the stock options in this column is a non-cash expense for the Company that reflects the fair value of the stock options
on the grant date and therefore does not affect our cash balance.
(2)
Dr. Marques has served as Director and Chief Executive Officer since August 2020. Total compensation for 2024 for Dr. Marques includes i) $22,241 for stock awards representing the grant date fair value of the issuance of 4,168 shares of common stock pursuant to the vesting of RSUs originally issued in December 2021 and ii) $167,818 for the issuance of stock options to purchase 26,669 shares of Common Stock in March 2024. Total compensation for 2023 for Dr. Marques includes $57,347 for stock awards representing the grant date fair value of the issuance of 5,832 shares of Common Stock pursuant to the vesting of RSUs originally issued in December 2021.
70
(3)
Mr. Schneiderman was hired as Chief Financial Officer of the Company on October 11, 2022. Total compensation for 2024 for Mr. Schneiderman includes $100,223 for the issuance of stock options to purchase 15,927 shares of Common Stock in March 2024.
(4) Dr. Currie resigned as Chief Development Officer effective as of November
15, 2024.
Employment Agreements with our Named Executive
Officers
Employment Agreement with Dr. Tiago Reis
Marques
On January 1, 2022, we entered
into an employment agreement with Dr. Marques. Under the terms of Dr. Marques’ employment agreement, he holds the position of Chief
Executive Officer and receives a base salary of $463,500 annually (effective April 1, 2025). In addition, Dr. Marques is eligible to receive
an annual bonus, with a target amount equal to seventy-five percent (75%) of Dr. Marques’ annual base salary. The actual amount
of each bonus will be determined by the sole discretion of our Compensation Committee and will be based upon both the Company’s
performance and Dr. Marques’ individual performance. Pursuant to the terms of his employment agreement, Dr. Marques is also eligible
to participate in all incentive and deferred compensation programs available to other executives or officers of the Company, and will
be eligible to participate in any employee benefit plans and equity plans that we may adopt, which plans may be amended by the Company
from time to time in its sole discretion.
Pursuant to Dr. Marques’
employment agreement, Dr. Marques was paid $100,000 as a sign on bonus. We also issued to Dr. Marques stock options to purchase 10,000
shares of Common Stock under our 2021 Incentive Plan, with one-third of the total shares vesting on the 12-month anniversary of the grant
date, and the remainder vesting in equal quarterly installments thereinafter. Further, we issued to Dr. Marques Restricted Stock Units
exercisable for 10,000 shares of Common Stock, with one-third of the total shares underlying the RSUs vesting upon the 12-month anniversary
of the grant date, with the remainder vesting in equal quarterly installments thereafter.
We may terminate Dr. Marques’
employment at any time with or without Cause (as that term is defined in Mr. Marques’ employment agreement) and with or without
advance notice to Dr. Marques, and Dr. Marques may terminate his employment at any time for any reason upon providing 90 days’ written
notice to the Company.
In the event we terminate Dr. Marques’ employment without Cause,
we will pay Dr. Marques the equivalent of 12 months of his base annual salary in effect as of the date of termination, subject to standard
payroll deductions and withholdings and Dr. Marques’ executing a release of claims against the Company. If we terminate Dr. Marques’
employment for any other reason, Dr. Marques will receive no compensation other than what he has earned at the time of the termination,
and he will not be entitled to any severance benefits.
Employment Agreement with Daniel Schneiderman
On October 11, 2022, we entered
into an employment agreement with Mr. Schneiderman. Under the terms of Mr. Schneiderman’ employment agreement, he holds the position
of Chief Financial Officer and receives a base salary of $339,900 annually (effective April 1, 2025). In addition, Mr. Schneiderman is
eligible to receive an annual bonus, with a target amount equal to thirty-five percent (35%) of Mr. Schneiderman’s annual base salary.
The actual amount of each bonus will be determined by the sole discretion of our Compensation Committee and will be based upon both the
Company’s performance and Mr. Schneiderman’s individual performance. Pursuant to the terms of his employment agreement, Mr.
Schneiderman is also eligible to participate in all incentive and deferred compensation programs available to other executives or officers
of the Company, and will be eligible to participate in any employee benefit plans and equity plans that we may adopt, which plans may
be amended by the Company from time to time in its sole discretion.
Pursuant to Mr. Schneiderman’s
employment agreement, Mr. Schneiderman was paid $30,000 as a sign on bonus. We also issued to Mr. Schneiderman stock options to purchase
15,000 shares of Common Stock under our 2021 Incentive Plan, with one-third of the total shares vesting on the one year anniversary of
the grant date, one-third of the total shares vesting on the two year anniversary of the grant date, and one-third of the total shares
vesting on the three year anniversary of the grant date.
We may terminate Mr. Schneiderman’s
employment at any time with or without Cause (as that term is defined in Mr. Schneiderman’s employment agreement) and with or without
advance notice to Mr. Schneiderman, and Mr. Schneiderman may terminate his employment at any time for any reason upon providing 60 days’
written notice to the Company.
In the event we terminate
Mr. Schneiderman’s employment without Cause, we will pay Mr. Schneiderman the equivalent of six months of his base annual salary
in effect as of the date of termination, subject to standard payroll deductions and withholdings and Mr. Schneiderman’s executing
a release of claims against the Company. His stock options will also accelerate and fully vest on his termination date. If we terminate
Mr. Schneiderman’s employment for any other reason, Mr. Schneiderman will receive no compensation other than what he has earned
at the time of the termination and he will not be entitled to any severance benefits.
71
Outstanding Equity Awards at Fiscal Year-End
The following table summarizes,
for each of our Named Executive Officers, the number of shares of our Common Stock underlying outstanding stock options held as of December
31, 2024:
Option Awards
Stock Awards
Name
Grant Date
Number of
Shares
Underlying
Unexercised
Options (#)
Exercisable
Number of
Shares
Underlying
Unexercised
Options (#)
Unexercisable
Option
Exercise
Price ($)
Option
Expiration
Date
Number of
Units of
Stock
That Have
Not Vested
Market
Value of
Units of
Stock That
Have Not
Vested
Tiago Reis Marques,
Chief Executive Officer
(1)
12/20/2021
10,000
-
$ 28.80
12/20/2031
-
$ -
(2)
03/1/24
11,669
15,000
$ 8.13
3/1/1934
-
$ -
Daniel Schneiderman,
Chief Financial Officer
(3)
10/11/2021
10,000
5,000
$ 25.20
10/11/2031
-
$ -
(4)
3/1/2024
5,927
10,000
$ 8.13
3/1/1934
-
$ -
Graeme Currie,
Chief Development Officer
(5)
2/24/2023
11,250
-
$ 9.82
2/24/1933
-
$ -
(6)
03/1/24
5,938
-
$ 8.13
3/1/1934
-
$ -
(1)
Under the terms of Dr. Marques’ Executive Employment Agreement, on December 20, 2021, he received (i) a grant of 10,000 stock options at an exercise price equal to the closing price of the Company’s Common Stock on the grant date and (ii) a grant of 10,000 restricted stock units (“RSUs”). Dr. Marques’ stock options and RSUs each vest over three years, with one-third vesting 12 months after the grant date, and the remainder vesting in equal tranches quarterly for two years thereafter.
(2)
Under the terms of the Company’s 2023 Incentive Plan, Dr. Marques
received a grant of 26,669 stock options at an exercise price equal to the closing price of the Company’s Common Stock on the grant
date. 11,669 shares vested immediately and 5,000 shares vested on February 28, 2025 and then 10,000 shares vest in equal quarterly tranches
for each of the two years thereinafter.
(3)
Under the terms of Mr. Schneiderman’s Executive Employment Agreement, on October 11, 2022, he received a grant of 15,000 stock options at an exercise price equal to the closing price of the Company’s Common Stock on the grant date. Mr. Schneiderman’s stock options each vest over three years, with one-third vesting one year after the grant date, one-third vesting two years after the grant date and the one-third vesting three years after the grant date.
(4)
Under the terms of the Company's 2023 Incentive Plan, Mr. Schneiderman
received a grant of 15,927 stock options at an exercise price equal to the closing price of the Company’s Common Stock on the grant
date. 5,927 shares vested immediately 3,334 shares vested on February 28, 2025 and 6,666 shares vest in equal quarterly tranches for each
of the two years thereinafter.
(5)
Under the terms of Dr. Currie’s Executive Employment
Agreement, on February 24, 2023, he received a grant of 15,000 stock options at an exercise price equal to the closing price of the
Company’s Common Stock on the grant date. 5,000 of Mr. Currie’s stock options vested on June 30, 2023 and the remaining
10,000 stock options were due to vest in equal quarterly tranches over each of the next two years. Upon Dr. Currie’s
resignation on November 15, 2024, 3,750 unvested stock options were cancelled, and the 11,250 vested stock options were cancelled 90
days following Dr. Currie’s termination date on February 13, 2025.
(6)
Under the terms of the Company's 2023 Incentive Plan, Dr. Currie received
a grant of 5,938 stock options at an exercise price equal to the closing price of the Company’s Common Stock on the grant date.
5,938 shares vested immediately. The 5,938 vested stock options were cancelled 90 days following Dr. Currie’s termination date on
February 13, 2025.
There were no option exercises by our Named Executive
Officers during our fiscal years ended December 31, 2024 or 2023.
Incentive Award Plans
2023 Incentive Plan
On October 6, 2023, our
Board adopted the Company’s 2023 Stock Incentive Plan (the “2023 Incentive Plan”), and our stockholders approved the
2023 Incentive Plan at our 2023 Annual Meeting. As of stockholder approval of the 2023 Incentive Plan, no new grants of awards were made
under the Pasithea Therapeutics Corp. 2021 Stock Incentive Plan (the “2021 Incentive Plan”) and all new grants of awards will
be made under the 2023 Incentive Plan. All unused shares of Common Stock reserved under our 2021 Incentive Plan and shares from outstanding
awards that are canceled or forfeited under the 2021 Incentive Plan will be rolled over for issuance under the 2023 Incentive Plan.
The following description
of the material terms of the 2023 Incentive Plan is intended to be a summary only. This summary is qualified in its entirety by the full
text of the 2023 Incentive Plan, a copy of which is filed as an exhibit to this Annual Report on Form 10-K and incorporated herein by
reference.
72
Administration. The
2023 Incentive Plan is administered by the Compensation Committee. However, the entire Board may act in lieu of the Compensation Committee
on any manner. The Compensation Committee has authority, in its discretion, to approve the persons to whom awards may be granted, to make
any combination of awards to participants, to accelerate the exercisability or vesting of an award and to determine the specific terms
and conditions of each award, subject to the provisions of the 2023 Incentive Plan. The Compensation Committee may also approve rules
and regulations for the administration of the 2023 Incentive Plan and amendments or modifications of outstanding awards (except that options
and Stock Appreciation Rights (“SARs”) cannot be repriced without shareholder approval). The Compensation Committee may delegate
authority to the Chief Executive Officer and/or other officers to grant awards to employees (other than themselves), subject to applicable
law and the 2023 Incentive Plan. No awards may be made under the 2023 Incentive Plan on or after the tenth anniversary of the date of
Board approval of this 2023 Incentive Plan (the “Expiration Date”), but the 2023 Incentive Plan will continue thereafter while
previously granted awards remain outstanding.
Eligibility. Persons
eligible to receive awards under the 2023 Incentive Plan are all employees, officers, directors, consultants, other advisors and other
individual service providers of our Company and our subsidiaries, who, in the opinion of the Compensation Committee, are in a position
to contribute to the success and growth of the Company, or any person who is determined by the Compensation Committee to be a prospective
employee, officer, director, consultant, advisor or other individual service provider of our Company or any subsidiary. Notwithstanding
the foregoing, only Company employees are eligible to receive ISO grants. As of October 12, 2023, the Company and its subsidiaries
had a total of eight employees, including three officers, and four non-employee directors. In accordance with our Bylaws, directors
who are serving the Company as employees and who receive compensation for their services as such, shall not be eligible to receive any
other compensation under the 2023 Incentive Plan for their services as directors of the Company. None of our subsidiaries have employees
and none of the officers and directors of our subsidiaries are eligible for awards under the 2023 Incentive Plan other than those who
are eligible as officers or directors of the Company. As of October 12, 2023, no person is eligible to participate as a result of
a determination by the Compensation Committee that that person is a prospective employee, officer, director, consultant, advisor or other
individual service provider of the Company or any subsidiary. As awards under the 2023 Incentive Plan are within the discretion of the
Compensation Committee, the Company cannot determine how many individuals in each of the categories described above will receive awards.
Shares Subject to the
2023 Incentive Plan. The Board has reserved for issuance under the 2023 Incentive Plan (i) 125,000 shares of Common
Stock, plus (ii) such number of unused shares of Common Stock reserved under the 2021 Incentive Plan as of the date of stockholder
approval of this 2023 Incentive Plan, which unused reserve shall be rolled in to the 2023 Incentive Plan (subsections (i) and (ii) together,
the “Share Reserve”). All such shares of Common Stock reserved for issuance under the 2023 Incentive Plan may, but need not,
be issued in respect of ISOs. In addition, shares of our Common Stock that relate to any outstanding grants or awards under the 2021 Incentive
Plan as of the date of stockholder approval of this 2023 Incentive Plan that are forfeited, cancelled or otherwise lapse in accordance
with applicable plan terms or are surrendered in payment of the exercise price and/or withholding taxes shall be rolled into the 2023
Incentive Plan and added to the Share Reserve (but not issued in respect of ISOs).
The number of shares of Common
Stock available for issuance under the 2023 Incentive Plan will automatically increase on January 1 st of each year
commencing with January 1, 2024 and on each January 1 st thereafter until the Expiration Date, in an amount equal
to three percent (3%) of the total number of shares of our Common Stock outstanding on the December 31 st of the preceding
calendar year, unless the Board takes action prior thereto to provide that there will not be an increase in the share reserve for such
year or that the increase in the share reserve for such year will be of a lesser number of shares of Common Stock than would otherwise
occur. None of the additional shares of Common Stock available for issuance pursuant to this paragraph shall be issued in respect of ISOs.
If any option or SAR granted
under the 2023 Incentive Plan terminates without having been exercised in full or if any award is forfeited, or if shares of Common Stock
are withheld to cover withholding taxes on options or other awards or applied to the payment of the exercise price of an option or purchase
price of an award, the number of shares of Common Stock as to which such option or award was forfeited, withheld or paid, will be available
for future grants under the 2023 Incentive Plan. Awards settled in cash will not count against the number of shares available for issuance
under the 2023 Incentive Plan.
The number of shares of Common
Stock authorized for issuance under the 2023 Incentive Plan and the foregoing share limitations are subject to customary adjustment for
stock splits, stock dividends or similar transactions.
73
Director Compensation. The
2023 Incentive Plan provides for an annual limit on non-employee director compensation of $500,000, increased to $750,000 in the
fiscal year of a non-employee director’s initial service as a non-employee member of the Board. This limit applies to
the sum of both equity grants that could be awarded to non-employee directors during a fiscal year (based on their value under ASC
Topic 718 on the grant date) and cash compensation, such as cash retainers and meeting fees earned during a fiscal year. Notwithstanding
the foregoing, the Board reserves the right to make an exception to these limits due to extraordinary circumstances without the participation
of the affected director receiving additional compensation.
Terms and Conditions
of Options. Options granted under the 2023 Incentive Plan may be either ISOs or “nonstatutory stock options”
that do not meet the requirements of Section 422 of the Code. The Compensation Committee will determine the exercise price of options
granted under the 2023 Incentive Plan. The exercise price of stock options may not be less than the fair market value per share of our
Common Stock on the date of grant (or 110% of fair market value in the case of ISOs granted to a ten-percent stockholder).
If on the date of grant the
Common Stock is listed on a stock exchange or is quoted on the automated quotation system of Nasdaq, the fair market value will generally
be the closing sale price on the date of grant (or the last trading day before the date of grant if no trades occurred on the date
of grant). If no such prices are available, the fair market value will be determined in good faith by the Compensation Committee based
on the reasonable application of a reasonable valuation method. On October 12, 2023, the closing sale price of a share of our Common
Stock on The Nasdaq Capital Market, adjusted for the Reverse Stock Split, was $8.668.
No option may be exercisable
for more than ten years (five years in the case of an ISO granted to a ten-percent stockholder) from the date of grant.
Options granted under the 2023 Incentive Plan will be exercisable at such time or times as the Compensation Committee prescribes at the
time of grant. Unless otherwise provided by the Compensation Committee, no option will provide for vesting or exercise earlier than one
year after the date of grant. No employee may receive ISOs that first become exercisable in any calendar year in an amount exceeding $100,000.
The Compensation Committee may, in its discretion, permit a holder of a nonstatutory option to exercise the option before it has otherwise
become exercisable, in which case the shares of our Common Stock issued to the recipient will continue to be subject to the vesting requirements
that applied to the option before exercise.
Generally, the option price
may be paid in cash or by certified check, bank draft or money order. The Compensation Committee may permit other methods of payment,
including (a) through delivery of shares of our Common Stock having a fair market value equal to the purchase price, (b) by
a full recourse, interest bearing promissory note having such terms as the Compensation Committee may permit, or (c) a combination
of these methods, as set forth in an award agreement or as otherwise determined by the Compensation Committee. The Compensation Committee
is authorized to establish a cashless exercise program and to permit the exercise price (or tax withholding obligations) to be satisfied
by reducing from the shares otherwise issuable upon exercise a number of shares having a fair market value equal to the exercise price.
No option may be transferred
other than by will or by the laws of descent and distribution, and during a recipient’s lifetime an option may be exercised only
by the recipient. However, the Compensation Committee may permit the holder of a nonstatutory option to transfer the award to immediate
family members or a family trust for estate planning purposes. The Compensation Committee will determine the extent to which a holder
of a stock option may exercise the option following termination of service with us.
Stock Appreciation Rights. The
Compensation Committee may grant SARs independent of or in connection with an option. The Compensation Committee will determine the other
terms applicable to SARs. Unless otherwise provided by the Compensation Committee, no SAR will provide for vesting or exercise earlier
than one year after the date of grant. The exercise price per share of a SAR will not be less than 100% of the fair market value of a
share of our Common Stock on the date of grant, as determined by the Compensation Committee. The maximum term of any SAR granted under
the 2023 Incentive Plan is ten years from the date of grant. Generally, each SAR will entitle a participant upon exercise to an amount
equal to:
●
the excess of the fair market value on the exercise date of one share of our Common Stock over the exercise price, multiplied by
●
the number of shares of Common Stock covered by the SAR.
Payment may be made in shares
of our Common Stock, in cash, or partly in Common Stock and partly in cash, all as determined by the Compensation Committee.
74
Restricted Stock and
Restricted Stock Units. The Compensation Committee may award restricted Common Stock and/or restricted stock units under
the 2023 Incentive Plan. Restricted stock awards consist of shares of Common Stock that are transferred to a participant subject to restrictions
that may result in forfeiture if specified conditions are not satisfied. Restricted stock units confer the right to receive shares of
our Common Stock, cash, or a combination of shares of Common Stock and cash, at a future date upon or following the attainment of certain
conditions specified by the Compensation Committee. The restrictions and conditions applicable to each award of restricted stock or restricted
stock units may include performance-based conditions. Unless otherwise provided by the Compensation Committee, no award of restricted
stock or restricted stock units will provide for vesting earlier than one year after the date of grant. Dividends or distributions with
respect to restricted stock may be paid to the holder of the shares as and when dividends are paid to stockholders or at the time that
the restricted stock vests, as determined by the Compensation Committee. If any dividends or distributions are paid in stock before the
restricted stock vests, they will be subject to the same restrictions. Dividend equivalent amounts may be deemed reinvested in additional
restricted stock units or paid with respect to restricted stock units either when cash dividends are paid to stockholders or when the
units vest. Unless the Compensation Committee determines otherwise, holders of restricted stock will have the right to vote on the shares.
Performance Shares and
Performance Units. The Compensation Committee may award performance shares and/or performance units under the 2023 Incentive
Plan to any eligible employee or other individual service provider other than a non-employee director of the Board. Performance shares
and performance units are awards, denominated in either shares of Common Stock or U.S. dollars, which are earned during a specified
performance period subject to the attainment of performance criteria, as established by the Compensation Committee. The Compensation Committee
will determine the restrictions and conditions applicable to each award of performance shares and performance units.
Incentive Bonus Awards. The
Compensation Committee may grant incentive bonus awards under the 2023 Incentive Plan from time to time. The terms of incentive bonus
awards will be set forth in award agreements. Each award agreement will have such terms and conditions as the Compensation Committee determines,
including performance goals and the amount of payment based on achievement of such goals. Incentive bonus awards are payable in cash and/or
shares of our Common Stock.
Other Stock-Based and Cash-Based Awards. The
Compensation Committee may award other types of equity-based or cash-based awards under the 2023 Incentive Plan, including the
grant or offer for sale of shares of our Common Stock that do not have vesting requirements and the right to receive one or more cash
payments subject to satisfaction of such conditions as the Compensation Committee may impose.
Effect of Certain Corporate
Transactions. The Compensation Committee may, at the time of the grant of an award provide for the effect of a Change in
Control (as defined in the 2023 Incentive Plan) on any award, including (i) accelerating or extending the time periods for exercising,
vesting in, or realizing gain from any award, (ii) eliminating or modifying the performance or other conditions of an award, or (iii) providing
for the cash settlement of an award for an equivalent cash value, as determined by the Compensation Committee. The Compensation Committee
may, in its discretion and without the need for the consent of any recipient of an award, also take one or more of the following actions
contingent upon the occurrence of a Change in Control: (a) cause any or all outstanding options and SARs to become immediately exercisable,
in whole or in part; (b) cause any other awards to become non-forfeitable, in whole or in part; (c) cancel any option
or SAR in exchange for a substitute option; (d) cancel any award of restricted stock, restricted stock units, performance shares
or performance units in exchange for a similar award of the capital stock of any successor corporation; (e) redeem any restricted
stock for cash and/or other substitute consideration with a value equal to the fair market value of an unrestricted share of our Common
Stock on the date of the change in control; (f) cancel any awards in exchange for cash and/or other property equal to the amount,
if any, that would have been attained upon the exercise of such award or realization of rights upon a change in control, but if the change
in control consideration with respect to any option or SAR does not exceed its exercise price, the option or SAR may be canceled without
payment of any consideration; or (g) take any other action the Compensation Committee deems necessary or appropriate to carry out
the terms of any definitive agreement controlling the terms and conditions of the Change in Control.
75
Clawback/Recoupment. Awards
granted under the 2023 Incentive Plan will be subject to the requirement that the awards be forfeited or amounts repaid to the Company
after they have been distributed to the participant (i) to the extent set forth in an award agreement or (ii) to the extent
covered by any clawback or recapture policy adopted by the Company from time to time, or any applicable laws that impose mandatory forfeiture
or recoupment, under circumstances set forth in such applicable laws.
Amendment, Termination. Our
Board may at any time amend, suspend or terminate the 2023 Incentive Plan for the purpose of satisfying the requirements of the Code,
or other applicable law or regulation or for any other legal purpose, provided that, without the consent of our stockholders, the Board
may not (i) increase the number of shares of Common Stock available under the 2023 Incentive Plan, (ii) change the group of
individuals eligible to receive awards, or (iii) extend the term of the 2023 Incentive Plan.
Indemnification Agreements
We have entered into indemnification
agreements with each of our directors and executive officers. These agreements, among other things, require us or will require us to indemnify
each director and executive officer to the fullest extent permitted by Delaware law, including indemnification of expenses such as attorneys’
fees, judgments, fines and settlement amounts incurred by the director or executive officer in any action or proceeding, including any
action or proceeding by or in right of us, arising out of the person’s services as a director or executive officer. For further
information, see “Description of Capital Stock-Limitations on Liability and Indemnification Matters.”
Policies and Procedures for Related Person
Transactions
Our Board has adopted a written
related person transaction policy, setting forth the policies and procedures for the review and approval or ratification of related person
transactions. This policy covers, with certain exceptions as set forth in Item 404 of Regulation S-K under the Securities Act, any transaction,
arrangement or relationship, or any series of similar transactions, arrangements or relationships, in which we were or are to be a participant,
where the amount involved will be the lesser of $120,000 or 1% of assets the average of our total assets at year-end for the last two
completed fiscal years, in any fiscal year and a related person had, has or will have a direct or indirect material interest, including
without limitation, purchases of goods or services by or from the related person or entities in which the related person has a material
interest, indebtedness, guarantees of indebtedness and employment by us of a related person. In reviewing and approving any such transactions,
our Audit Committee is tasked to consider all relevant facts and circumstances, including, but not limited to (i) whether the
transaction is on terms comparable to those that could be obtained in an arm’s length transaction with an unrelated party; (ii) the
extent of the related person’s interest in the transaction; (iii) the benefits to the Company; (iv) the impact on a director’s
independence in the event the related person is a director, an immediately family member of a director or an entity in which a director
is a partner, stockholder or executive officer; (v) the availability of other sources for comparable products or services;
(vi) the terms of the transaction; and (vii) the terms available to unrelated third parties.
All related-party transactions
may only be consummated if our Audit Committee has approved or ratified such transaction in accordance with the guidelines set forth in
the policy. Any member of the Audit Committee who is a related person with respect to a transaction under review will not be permitted
to participate in the deliberations or vote respecting approval or ratification of the transaction. However, such director may be counted
in determining the presence of a quorum at a meeting of the Audit Committee that considers the transaction.
Limitations on Liability and Indemnification
Matters
Our Certificate of Incorporation
limits our directors’ liability to the fullest extent permitted under Delaware law, which prohibits our Certificate of Incorporation
from limiting the liability of our directors for the following:
●
any breach of the director’s duty of loyalty to us or our stockholders;
●
acts or omissions not in good faith or that involve intentional misconduct or a knowing violation of law;
●
unlawful payment of dividends or unlawful stock repurchases or redemptions; or
●
any transaction from which the director derived an improper personal benefit.
If Delaware law is amended
to authorize corporate action further eliminating or limiting the personal liability of a director, then the liability of our directors
will be eliminated or limited to the fullest extent permitted by Delaware law, as so amended.
76
Our Bylaws provide that we
indemnify our directors and officers to the fullest extent permitted under Delaware law and that we shall have the power to indemnify
our employees and agents to the fullest extent permitted by law. Our Bylaws also permit us to secure insurance on behalf of any officer,
director, employee or other agent for any liability arising out of his or her actions in this capacity, regardless of whether we would
have the power to indemnify such person against such expense, liability or loss under the DGCL.
We have entered into indemnification
agreements with our directors and officers, in addition to indemnification provided for in our Bylaws. These agreements, among other things,
provide for indemnification of our directors and officers for expenses, including attorneys’ fees, judgments, fines and settlement
amounts incurred by such persons in any action or proceeding arising out of this person’s services as a director or officer or at
our request. We believe that these provisions in our Certificate of Incorporation and Bylaws and indemnification agreements are necessary
to attract and retain qualified persons as directors and executive officers.
The above description of the
limitation of liability and indemnification provisions of our Certificate of Incorporation, our Bylaws and our indemnification agreements
is not complete and is qualified in its entirety by reference to these documents, each of which is filed as an exhibit to this Annual
Report on Form 10-K.
The limitation of liability
and indemnification provisions in our Certificate of Incorporation and Bylaws may discourage stockholders from bringing a lawsuit against
our directors for breach of their fiduciary duties. They may also reduce the likelihood of derivative litigation against directors and
officers, even though an action, if successful, might benefit us and our stockholders. A stockholder’s investment may be harmed
to the extent we pay the costs of settlement and damage awards against directors and officers pursuant to these indemnification provisions.
Insofar as indemnification
for liabilities under the Securities Act may be permitted to directors, officers or persons controlling us pursuant to the foregoing provisions,
we have been informed that in the opinion of the SEC such indemnification is against public policy as expressed in the Securities Act
and is therefore unenforceable. There is no pending litigation or proceeding naming any of our directors or officers as to which indemnification
is being sought, nor are we aware of any pending or threatened litigation that may result in claims for indemnification by any director
or officer.
Director Compensation
The following table sets forth
for each non-employee director that served as a director during the year ended December 31, 2024 certain information concerning his or
her compensation for the year ended December 31, 2024:
Year Ended December 31, 2024
Name
Fees
Earned or
Paid in
Cash
($)
Stock
Awards
($)
Option Awards
($) (1)
Non-equity
Incentive
Plan
Compensation
($)
Nonqualified
Deferred
Compensation
Earnings
($)
All Other
Compensation
($)
Total
($) (2)
Professor Lawrence Steinman
(3)
250,000
-
47,195
-
-
-
297,195
Simon Dumesnil
(4)
60,000
-
47,195
-
-
-
107,195
Dr. Emer Leahy
(5)
60,000
-
47,195
-
-
-
107,195
Alfred Novak
(6)
60,000
-
31,463
-
-
-
91,463
(1)
In accordance with SEC
rules, the amounts in this column reflect the fair value on the grant date of the option awards granted to the named executive,
calculated in accordance with ASC Topic 718. Stock options were valued using the Black-Scholes model. The grant-date fair value does
not necessarily reflect the value of shares which may be received in the future with respect to these awards. The grant-date fair
value of the stock options in this column is a non-cash expense for the Company that reflects the fair value of the stock options on
the grant date and therefore does not affect our cash balance. The fair value of the stock options will likely vary from the actual
value the holder receives because the actual value depends on the number of options exercised and the market price of our Common
Stock on the date of exercise. For a discussion of the assumptions made in the valuation of the stock options, see Note 5
(Stockholders’ Equity) to our financial statements, which are included in this 10-K. The aggregate number of shares of Common
Stock underlying stock options outstanding as of December 31, 2024 held by each of Prof. Lawrence Steinman, Simon Dumesnil, Dr. Emer
Leahy and Alfred Novak was 12,500, 12,500, 12,500 and 10,000, respectively.
(2)
All directors receive reimbursement for reasonable out of pocket expenses in attending Board meetings and for participating in our business.
77
(3)
Under the terms of the Company’s 2023 Incentive Plan, Dr. Steinman received a grant of 7,500 stock options at an exercise price of $8.13 per share, equal to the closing price of the Company’s Common Stock on the grant date of March 1, 2024.
(4)
Under the terms of the Company’s 2023 Incentive Plan, Mr. Dumesnil received a grant of 7,500 stock options at an exercise price of $8.13 per share, equal to the closing price of the Company’s Common Stock on the grant date of March 1, 2024.
(5)
Under the terms of the Company’s 2023 Incentive Plan, Dr. Leahy received a grant of 7,500 stock options at an exercise price of $8.13 per share, equal to the closing price of the Company’s Common Stock on the grant date of March 1, 2024.
(6)
Under the terms of the
Company’s 2023 Incentive Plan, Mr. Novak received a grant of 5,000 stock options at an exercise price of $8.13 per share,
equal to the closing price of the Company’s Common Stock on the grant date of March 1, 2024. $10,000 of the fees earned for services rendered during fiscal year 2024 will be paid in fiscal year 2025.
Compensation Policy for Non-Employee Directors.
The material terms of the
non-employee director compensation program, as it is currently contemplated, are summarized below.
The non-employee director
compensation program provides for annual retainer fees and/or long-term equity awards for our non-employee directors. Each non-employee
director is eligible to receive an annual retainer of $50,000 plus an additional $10,000 for each Board committee that he or she chairs.
A non-employee director serving as Chairman of the Board is eligible to receive an additional annual retainer of $100,000. Additionally,
upon joining the Board, non-employee directors are eligible to receive stock options to purchase 5,000 shares of Common Stock, with 50%
of the shares subject to the options vesting after the first year of service and 50% vesting after the second year.
Compensation under our non-employee
director compensation policy is subject to the annual limits on non-employee director compensation set forth in the 2023 Incentive Plan,
as described above. Our Board or an authorized committee may modify the non-employee director compensation program from time to time in
the exercise of its business judgment, taking into account such factors, circumstances and considerations as it shall deem relevant from
time to time, subject to the annual limit on non-employee director compensation set forth in the 2023 Incentive Plan. As provided in the
2023 Incentive Plan, our Board or its authorized committee may make exceptions to this limit for individual non-employee directors in
extraordinary circumstances, as the Board or its authorized committee may determine in its discretion.
Consulting Agreement with Prof. Lawrence Steinman
The Steinman Consulting Agreement
memorializes the compensation arrangements pursuant to which Prof. Steinman has been compensated for his services to our Company, as previously
disclosed in our public filings. Pursuant to the Steinman Consulting Agreement, Prof. Steinman provides a variety of consulting and advisory
services relating principally to the clinical and commercial development of our product candidates, including our research and development
strategy through all phases of discovery and preclinical development, identifying potential partners for our pre-clinical assets, and
business development efforts related to our pre-clinical assets, among other things. Pursuant to the Steinman Consulting Agreement,
Prof. Steinman receives $25,000 per quarter for his services.
The Company’s Policies and Practices
Related to the Grant of Certain Equity Awards Close in Time to the Release of nonpublic Information.
We do not have any formal
policy that requires us to grant, or avoid granting, equity-based compensation to our executive officers at certain times. Consistent
with our annual compensation cycle, the Compensation, Corporate Governance and Nominating Committee has for several years granted annual
equity awards to its executive officers and directors at the start of the new fiscal year. The timing of any equity grants to executive
officers in connection with new hires, promotions, or other non-routine grants is tied to the event giving rise to the award (such as
an executive officer’s commencement of employment or promotion effective date). As a result, in all cases, the timing of grants
of equity awards, including stock options, occurs independent of the release of any material nonpublic information, and we do not time
the disclosure of material nonpublic information for the purpose of affecting the value of equity-based compensation.
No stock options were issued
to executive officers in fiscal year 2024 during any period beginning four business days before the filing of a periodic report or current
report disclosing material non-public information and ending one business day after the filing or furnishing of such report with the SEC.
ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL
OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS
Security Ownership of Certain Beneficial Holders and Management
The following table sets forth
information with respect to the beneficial ownership of our Common Stock as of March 20, 2025 by:
●
each of our Named Executive Officers;
●
each of our directors; and
●
all of our executive officers and directors as a group.
78
The number of shares beneficially
owned by each stockholder is determined in accordance with the rules issued by the SEC, and the information is not necessarily indicative
of beneficial ownership for any other purpose. Under these rules, beneficial ownership includes any shares as to which the individual
or entity has sole or shared voting power or investment power, which includes the power to dispose of or to direct the disposition of
such security. Except as indicated in the footnotes below, we believe, based on the information furnished to us, that the individuals
and entities named in the table below have sole voting and investment power with respect to all shares of Common Stock beneficially owned
by them, subject to any community property laws.
Percentage ownership of our
Common Stock is based on 2,705,263 shares of Common Stock outstanding as of March 20, 2025. In computing the number of shares beneficially
owned by an individual or entity and the percentage ownership of that person, shares of Common Stock subject to options, restricted units,
warrants or other rights held by such person that are currently exercisable or will become exercisable within 60 days of March 20, 2025
are considered outstanding, although these shares are not considered outstanding for purposes of computing the percentage ownership of
any other person.
To calculate a stockholder’s
percentage of beneficial ownership of Common Stock, we must include in the numerator and denominator those shares of Common Stock, as
well as those shares of Common Stock underlying options, warrants and convertible securities, that such stockholder is considered to beneficially
own. Shares of Common Stock, and Common Stock underlying options, warrants and convertible securities, held by other stockholders, however,
are disregarded in this calculation. Therefore, the denominator used in calculating beneficial ownership of each of the stockholders may
be different.
Unless otherwise indicated,
the address of each beneficial owner listed below is c/o Pasithea Therapeutics Corp., 1111 Lincoln Road, Suite 500, Miami Beach, FL 33139.
To our knowledge, there is no arrangement, including any pledge by any person of securities of the Company, the operation of which may
at a subsequent date result in a change in control of the Company.
Beneficial Ownership
Common Stock
Name of Beneficial Owner
Shares (1)
% (2)
5% or Greater Stockholders
PD Joint Holdings, LLC (3)
170,434
6.2 %
Armistice Capital, LLC (4)
133,787
4.9 %
Named Executive Officers and Directors:
Dr. Tiago Reis Marques (5)
67,170
2.5 %
Daniel Schneiderman (6)
19,261
* %
Prof. Lawrence Steinman (7)
83,858
3.1 %
Dr. Emer Leahy (8)
7,500
*
Simon Dumesnil (9)
10,000
*
Alfred Novak (10)
10,167
*
Dr. Graeme Currie (11)
-
*
All Directors and Officers as a group (6 persons) (12)
197,956
7.1 %
*
Less than 1%.
(1)
Beneficial ownership is determined in accordance with the rules of the SEC and generally includes voting or investment power with respect to securities. All entries exclude beneficial ownership of shares issuable pursuant to warrants, options or other derivative securities that have not vested or that are not otherwise exercisable as of the date hereof or which will not become vested or exercisable within 60 days.
(2)
Percentages are rounded to the nearest tenth of a percent. Percentages
are based on 2,705,263 shares of Common Stock outstanding as of March 20, 2025. Warrants, stock options or other derivative securities
that are presently exercisable or exercisable within 60 days are deemed to be beneficially owned by the person holding such securities
for the purpose of computing the percentage ownership of that person, but are not treated as outstanding for the purpose of computing
the percentage of any other person.
79
(3)
Consists of (i) 130,434 shares of Common Stock and (ii) 40,000 shares of Common Stock issuable upon the exercise of a warrant held directly by PD Joint Holdings, LLC Series 2016-A. All share information is based on information disclosed in a statement on Schedule 13G filed with the SEC on February 15, 2023 on behalf of Paul B. Manning, Bradford Manning, PD Joint Holdings, LLC, Series 2016-A, and Tiger Lily Capital, LLC. The business address for each person and entity named in this footnote is 200 Garrett Street, Suite S, Charlottesville, Virginia 22902.
(4)
All share information is based on information disclosed in a statement on Schedule 13G filed with the SEC on February 14, 2025, on behalf of Armistice Capital, LLC and Steven Boyd. The business address for each person and entity named in this footnote is 510 Madison Avenue, 7th Floor, New York, New York 10022.
(5)
Includes (i) 45,001 shares of Common Stock and (ii) 26,669 shares of
Common Stock issuable upon exercise of vested stock options. Excludes 10,000 unvested options.
(6)
Includes 19,261 shares of Common Stock issuable upon exercise of vested stock options. Excludes 11,666 unvested stock options.
(7)
Includes (i) 66,358 shares of Common Stock, (ii) 10,000 shares of Common Stock issuable upon exercise of warrants; and (iii) 7,500 shares of Common Stock issuable upon exercise of vested stock options. Excludes 5,000 unvested stock options
(8)
Includes 7,500 shares of Common Stock issuable upon exercise of vested stock options. Excludes 5,000 unvested stock options.
(9)
Includes (i) 2,500 shares of Common Stock and (ii) 7,500 shares of Common Stock issuable upon exercise of vested stock options. Excludes 5,000 unvested stock options.
(10)
Includes (i) 3,500 shares of Common Stock and (ii) 6,667 shares of Common Stock issuable upon exercise of vested stock options. Excludes 3,333 unvested stock options.
(11)
Dr. Currie resigned from his position as Chief Development Officer effective as of November 15, 2024. As of the date of his resignation, he held no shares of Common Stock and all vested stock options held by Dr. Currie have been cancelled as of March 20, 2025.
(12)
Excludes Dr. Graeme Currie.
Securities Authorized for Issuance Under Existing Equity Compensation
Plans
The following table summarizes
certain information regarding our equity compensation plans as of December 31, 2024, including our 2021 Incentive Plan and our 2023 Incentive
Plan. Upon the adoption by our stockholders of the 2023 Plan on December 19, 2023, all unused shares of Common Stock reserved under our
2021 Incentive Plan, and shares from outstanding awards that are canceled or forfeited under the 2021 Incentive Plan, are available for
issuance under the 2023 Incentive Plan:
Plan Category
Number of
Securities
to be Issued
Upon Exercise
of Outstanding
Options
Weighted-Average
Exercise
Price of
Outstanding
Options (2)
Number of
Securities
Remaining
Available for
Future Issuance
Under Equity
Comp
Text extracted from the filing as submitted to EDGAR. Formatting, tables and exhibits are simplified for reading; the original document is authoritative for anything you rely on.