UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K
☒ ANNUAL
REPORT PURSUANT TO SECTION 13 OR 15(d)
OF
THE SECURITIES EXCHANGE ACT OF 1934
For
the fiscal year ended December 31, 2020
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 001-12830
Lineage
Cell Therapeutics, Inc.
(Exact
name of registrant as specified in its charter)
California
94-3127919
(State
or other jurisdiction of
incorporation or organization)
(I.R.S.
Employer
Identification No.)
2173
Salk Avenue , Suite 200
Carlsbad ,
California 92008
(Address
of principal executive offices) (Zip Code)
Registrant’s
telephone number, including area code (442) 287-8990
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
LCTX
NYSE
American
Securities
registered pursuant to Section 12(g) of the Act:
None
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐
No ☒
Indicate
by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐
No ☒
Indicate
by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange
Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports),
and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate
by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant
to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that
the registrant was required to submit such files). Yes ☒ No ☐
Indicate
by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting
company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,”
“smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large
accelerated filer ☐
Accelerated
filer ☐
Non-accelerated
filer ☒
Smaller
reporting company ☒
Emerging
growth company ☐
If
an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for
complying with any new or revised financial accounting standards provided 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. ☐
Indicate
by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act): Yes ☐ No ☒
As
of June 30, 2020, the last business day of the registrant’s most recently completed second fiscal quarter, the aggregate
market value of the registrant’s voting and non-voting common equity held by non-affiliates of the registrant was approximately
$ 93.9 million.
The
number of common shares outstanding as of March 5, 2021 was 161,637,890 .
Lineage
Cell Therapeutics, Inc.
Table
of Contents
Page
Number
Part
I.
Item
1
Business
3
Item
1A
Risk
Factors
26
Item
1B
Unresolved
Staff Comments
53
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
Selected
Financial Data
55
Item
7
Management’s
Discussion and Analysis of Financial Condition and Results of Operations
56
Item
7A
Quantitative
and Qualitative Disclosures about Market Risk
65
Item
8
Financial
Statements and Supplementary Data
66
Item
9
Changes
in and Disagreements with Accountants on Accounting and Financial Disclosure
109
Item
9A
Controls
and Procedures
109
Item
9B
Other
Information
109
Part
III.
Item
10
Directors,
Executive Officers, and Corporate Governance
110
Item
11
Executive
Compensation
113
Item
12
Security
Ownership of Certain Beneficial Owners and Management, and Related Stockholder Matters
119
Item
13
Certain
Relationships and Related Transactions, and Director Independence
122
Item
14
Principal
Accounting Fees and Services
123
Part
IV.
Item
15
Exhibits,
Financial Statement Schedules
124
Item
16
Form
10-K Summary
126
Signatures
127
PART
I
FORWARD-LOOKING
STATEMENTS
This
Annual Report on Form 10-K (this “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 (the “Exchange
Act”), that involve substantial risks and uncertainties. The forward-looking statements are contained principally in Part
I, Item 1. “Business,” Part I, Item 1A. “Risk Factors,” and Part II, Item 7. “Management’s
Discussion and Analysis of Financial Condition and Results of Operations,” but are also contained elsewhere in this Report.
In some cases, you can identify forward-looking statements by the words “may,” “might,” “will,”
“could,” “would,” “should,” “expect,” “intend,” “plan,”
“objective,” “anticipate,” “believe,” “estimate,” “predict,” “project,”
“potential,” “continue” and “ongoing,” or the negative of these terms, or other comparable
terminology intended to identify statements about the future. These statements involve known and unknown risks, uncertainties
and other factors that may cause our actual results, levels of activity, performance or achievements to be materially different
from the information expressed or implied by these forward-looking statements. Although we believe that we have a reasonable basis
for each forward-looking statement contained in this Report, we caution you that these statements are based on a combination of
facts and factors currently known by us and our expectations of the future, about which we cannot be certain. Forward-looking
statements include statements about:
●
our
plans to research, develop and commercialize our product candidates;
●
the
initiation, progress, success, cost and timing of our clinical trials and product development activities;
●
the
therapeutic potential of our product candidates, and the disease indications for which we intend to develop our product candidates;
●
our
ability and timing to advance our product candidates into, and to successfully initiate, conduct, enroll and complete, clinical
trials;
●
our
ability to manufacture our product candidates for clinical development and, if approved, for commercialization, and the timing
and costs of such manufacture;
●
the
performance of third parties in connection with the development and manufacture of our product candidates, including third
parties conducting our clinical trials as well as third-party suppliers and manufacturers;
●
the
potential of our cell therapy platform, and our plans to apply our platform to research, develop and commercialize our product
candidates;
●
our
ability to obtain funding for our operations, including funding necessary to initiate and complete clinical trials of our
product candidates;
●
the
size and growth of the potential markets for our product candidates and our ability to serve those markets;
●
the
potential scope and value of our intellectual property rights;
●
our
ability, and the ability of our licensors, to obtain, maintain, defend and enforce intellectual property rights protecting
our product candidates, and our ability to develop and commercialize our product candidates without infringing the proprietary
rights of third parties;
●
our
ability to recruit and retain key personnel;
●
the
effects of the COVID-19 pandemic on our operations; and
●
other
risks and uncertainties, including those described under Part I, Item 1A. Risk Factors of this Report.
1
You
should refer to “Item 1A. Risk Factors” in this 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. As a result of these factors,
we cannot assure you that the forward-looking statements in this Report will prove to be accurate. Furthermore, if our forward-looking
statements prove to be inaccurate, the inaccuracy may be material. In light of the significant uncertainties in these forward-looking
statements, you should not regard these statements as a representation or warranty by us or any other person that we will achieve
our objectives and plans in any specified time frame, or at all. The forward-looking statements in this Report represent our views
as of the date of this Report. We anticipate that subsequent events and developments may cause our views to change. However, while
we may elect to update these forward-looking statements at some point in the future, we undertake no obligation to publicly update
any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by law.
You should, therefore, not rely on these forward-looking statements as representing our views as of any date subsequent to the
date of this Report.
You
should read this Report and the documents that we reference in this Report completely and with the understanding that our actual
future results may be materially different from what we expect. We qualify all of our forward-looking statements by these cautionary
statements.
This
Report also contains market data, industry forecasts and other data made by independent parties and by us relating to market size
and growth and other data about our industry. This data involves a number of assumptions and limitations, and you are cautioned
not to give undue weight to such estimates. In addition, projections, assumptions and estimates of our future performance and
the future performance of the markets in which we operate are necessarily subject to a high degree of uncertainty and risk.
All
brand names or trademarks appearing in this Report are the property of their respective owners. Solely for convenience, the trademarks
and trade names in this Report are referred to without the symbols ® and TM , but such references should
not be construed as any indication that their respective owners will not assert, to the fullest extent under applicable law, their
rights thereto.
Unless
the context requires otherwise, references in this report to “Lineage,” “we,” “us,” and “our”
refer to Lineage Cell Therapeutics, Inc. and its consolidated subsidiaries.
RISK
FACTOR SUMMARY
Below
is a summary of the material factors that make an investment in our stock speculative or risky. This summary does not address
all of the risks that we face. Additional discussion of the risks summarized in this risk factor summary, and other risks that
we face, can be found below under the heading “Risk Factors” in Item 1A of Part I of this Report and should be carefully
considered, together with other information in this Report and our other filings with the Securities and Exchange Commission before
making investment decisions regarding our common shares.
●
We
have incurred operating losses since inception, and we do not know if or when we will attain profitability.
●
We
will continue to spend a substantial amount of our capital on research and development, but we might not succeed in developing
products and technologies that are useful in medicine.
●
The
amount and pace of research and development work that we can do or sponsor, and our ability to commence and complete clinical
trials required to obtain regulatory approval to market our therapeutic and medical device products, depends upon the amount
of funds we have.
●
We
will need to issue additional equity or debt securities in order to raise additional capital needed to pay our operating expenses.
●
We
may be subject, directly or indirectly, to federal and state healthcare fraud and abuse laws, including anti-kickback and
false claims laws, transparency laws, and health information privacy and security laws. If we are unable to comply, or have
not fully complied, with such laws, we could face substantial penalties.
●
If
we do not receive regulatory approvals, we will not be permitted to sell our therapeutic and medical device products.
2
●
Government-imposed
bans or restrictions and religious, moral, and ethical concerns about the use of hES cells could prevent us from developing
and successfully marketing stem cell products.
●
We
expect that the commercial opportunity for some of our products may depend on our ability to obtain reimbursement and continued
coverage from various payors, including government entities and insurance companies.
●
Clinical
studies are costly, time consuming and are subject to risks that could delay or prevent commercialization of our current or
future product candidates.
●
Clinical
and preclinical drug development involves a lengthy and expensive process with an uncertain outcome. The results of early
preclinical trials and clinical trials of our product candidates are not necessarily predictive of future results. Our product
candidates may not have favorable results in later clinical trials, if any, or receive regulatory approval on a timely basis,
if at all.
●
Interim,
topline and preliminary data from our clinical trials that we announce or publish from time to time may change as more patient
data become available and are subject to audit and verification procedures that could result in material changes in the final
data.
●
Our
intellectual property may be insufficient to protect our products.
●
If
we are unable to obtain and enforce patents and to protect our trade secrets, others could use our technology to compete with
us, which could limit opportunities for us to generate revenues by licensing our technology and selling products.
●
We
may become dependent on possible future collaborations to develop and commercialize many of our product candidates and to
provide the regulatory compliance, sales, marketing and distribution capabilities required for the success of our business.
●
Because
we are engaged in the development of pharmaceutical and stem cell therapy products, the price of our common shares may rise
and fall rapidly.
●
Current
economic and stock market conditions may adversely affect the price of our common shares.
ITEM
1.
BUSINESS
Overview
We
are a clinical-stage biotechnology company developing novel cell therapies for unmet medical needs. Our focus is to develop therapies
for degenerative retinal diseases, neurological conditions associated with demyelination, and aiding the body in detecting and
combating cancer. Specifically, Lineage is testing therapies to treat dry age-related macular degeneration, spinal cord injuries,
and non-small cell lung cancer. Our programs are based on our proprietary cell-based therapy platform and associated development
and manufacturing capabilities. From this platform, we develop and manufacture specialized, terminally or functionally differentiated
human cells from established and well-characterized pluripotent cell lines. These differentiated cells are transplanted into a
patient either to replace or support cells that are dysfunctional or absent due to degenerative disease or traumatic injury, or
are administered as a means of helping the body mount an effective immune response to cancer.
Product
Candidates & Other Programs
We
have three allogeneic, or “off-the-shelf,” cell therapy programs in clinical development:
●
OpRegen ® ,
a retinal pigment epithelium (“RPE”) cell replacement therapy currently in a Phase 1/2a multicenter clinical trial
for the treatment of advanced dry age-related macular degeneration (“AMD”) with geographic atrophy (“GA”).
There currently are no therapies approved by the U.S. Food and Drug Administration (“FDA”) for dry AMD, which
accounts for approximately 85-90% of all AMD cases and is the leading cause of blindness in people over the age of 60.
3
●
OPC1 ,
an oligodendrocyte progenitor cell therapy currently in the long-term follow-up portion of a Phase 1/2a multicenter clinical
trial for acute spinal cord injuries (“SCI”). This clinical trial has been partially funded by the California
Institute for Regenerative Medicine.
●
VAC2 ,
an allogeneic cancer immunotherapy of antigen-presenting dendritic cells currently in a Phase 1 clinical trial in non-small
cell lung cancer. This clinical trial is being funded and conducted by Cancer Research UK, the world’s largest independent
cancer research charity.
In
addition to seeking to create value for shareholders by developing product candidates and other technologies through our clinical
development programs, we also seek to create value from our technologies through partnering and strategic transactions. We founded
two companies that later became publicly traded companies: OncoCyte Corporation (“OncoCyte”) and AgeX Therapeutics,
Inc. (“AgeX”).
During
the year ended December 31, 2020, we received approximately $12.6 million in gross proceeds in connection with our sale of shares
of OncoCyte and AgeX. In August 2020, we also received $24.6 million from Juvenescence Limited (“Juvenescence”),
representing principal and accrued interest under a promissory note we received in connection with our sale of AgeX shares to
Juvenescence in August 2018.
We
no longer hold any common stock in AgeX. The value of our OncoCyte holdings as of March 5, 2021, was approximately $4.2
million, based on the closing price of its common stock on that date. In this Report, see Part I, Item 1A, “Risk Factors—Risks
Related to Our Business Operations and Capital Requirements—The value of our investments in public companies fluctuates
based on their respective stock prices and could be negatively affected by poor business performance.”
Though
our principal focus is on advancing our three cell therapy programs currently in clinical development, we may seek to create additional
value through corporate transactions, as we have in the past, or by initiating new programs using our protocols or with new protocols
and cell lines.
Corporate
Information
Lineage
is incorporated in the State of California. Our common shares trade on the NYSE American and the Tel Aviv Stock Exchange under
the symbol “LCTX.” Our principal executive offices are at 2173 Salk Avenue, Suite 200, Carlsbad, CA 92008, and our
phone number at that address is (442) 287-8990. Our website address is www.lineagecell.com. The information on, or that can be
accessed through our website is not part of this Report. Lineage routinely uses its website as a means of disclosing material
non-public information and for complying with its disclosure obligations under Regulation FD. We also make available, free of
charge through our website, our most recent annual report on Form 10-K, quarterly reports on Form 10-Q, current reports on Form
8-K and any amendments to those reports as soon as reasonably practicable after the reports are electronically filed with or furnished
to the Securities and Exchange Commission.
2020
Highlights
We
achieved numerous strategic accomplishments during 2020, including advancing clinical trials and product development in several
key programs.
●
In
May 2020, we announced the early exercise of our option with Cancer Research UK to bring the VAC immuno-oncology platform
in-house.
●
In
June 2020, we announced the first known finding of retinal tissue restoration in a patient who received an RPE cell
transplant.
●
In
October 2020, we reported encouraging preliminary Phase 1 clinical study results with VAC2 for the treatment of non-small
cell lung cancer with high levels of antigen-specific immunogenicity observed.
●
In
November 2020, we completed enrollment in a 24 patient Phase 1/2a clinical study of OpRegen for the treatment of dry AMD with
GA with encouraging preliminary signs of tolerability and efficacy.
●
In
December 2020, we announced that we had been able to make significant manufacturing improvements to our OPC1 acute SCI program,
including better controlled processes, enhanced purity, potency, and scale, and to the development of a “ready-to-inject”
formulation, substantially decreasing logistical burden at the point of care and enabling use at a much larger number of treatment
centers.
4
Business
Strategy
Our
goal is to become a leading cell therapy company by developing allogeneic, or “off-the-shelf,” treatments that are
comprised of differentiated cells derived from pluripotent cell lines, which have been directed to become specific cell types
and use those cells as treatments to restore diseased or diminished functions, such as impaired vision, loss of movement and sensation,
or to increase immune response to tumors. Significant near-term activities that underlie our business strategy include:
●
Presenting
new and accumulated OpRegen data from the ongoing Phase 1/2a clinical study on two occasions during the first and second quarters
of 2021;
●
Completing
VAC2 patient enrollment in the ongoing Phase 1 clinical study for the treatment of non-small cell lung cancer by the end of
the first half of 2021;
●
Evaluating
delivery improvements for our OPC1 program, which combined with our “ready-to-inject” formulation, will enable
access to a greater number of clinical sites, currently ongoing and throughout 2021;
●
Meeting
with the FDA to discuss further development of the OPC1 program, including a late-stage clinical study, during the second
half of 2021;
●
Evaluating
opportunities for new VAC product candidates based on manufacturing improvements and product improvements, including newly
discovered tumor antigens/neoantigens, throughout 2021; and
●
Evaluating
partnership opportunities and expansion of existing external collaborations and identification of new collaborations for OpRegen,
OPC1 and VAC2, currently ongoing and throughout 2021.
Cell
Therapy Technology
We
believe we are a leader in pluripotent, cell-based asset development based on directed lineage derivation protocols and whole
cell manufacturing capabilities. Pluripotent cells, which are widely published as capable of becoming any human cell type, have
potential applications in many areas of medicine with large unmet patient needs, including certain age-related degenerative diseases
and degenerative conditions for which there presently are no cures. We currently are focused on developing pluripotent cells into
RPE cells, oligodendrocyte progenitor cells and dendritic cells.
Pluripotent
Stem Cells
5
Unlike
pharmaceuticals that require a narrowly defined molecular target, cellular therapies are often aimed at regenerating or replacing
the entire affected cell or tissue and therefore, may have broader or more suitable applicability than many traditional pharmaceutical
products. Small molecules and biologic therapies that require systemic delivery into the body often have unexpected results, or
side effects, that can limit their usefulness. When cell replacement is locally administered, particularly to anatomical compartments,
systemic side effects are usually not the primary concern. The risk profile of cell therapy more closely resembles that of transplant
medicine, focused more on whether the transplanted cells are rejected by the body and whether the cells function as expected.
We currently are using our pluripotent stem cells as starting material from which we derive three separate and specific cell types,
each of which are product candidates currently in clinical testing.
We
maintain an innovative cell therapy manufacturing facility in the Bio Park on the campus of the Hadassah University Hospital in
Jerusalem, Israel. The facility includes process development laboratories and a state-of-the-art, cGMP manufacturing facility.
It is designed and equipped to enable simultaneous cGMP processes and to produce a range of cell therapy products for human use
in clinical trials as well as developing scale suitable for commercial launch. All cGMP manufacturing processes, including cell
banks and product manufacturing for our cell therapy product candidates, are conducted in this facility.
Cell
Therapy Product Candidates
OpRegen
OpRegen
is our lead ophthalmic product candidate (currently in a Phase 1/2a clinical trial) for the treatment of advanced dry AMD with
GA. AMD is a gradual, progressive, deterioration of the macula, the small sensitive area in the center of the retina that provides
clear, high definition central vision. AMD affects over 30 million people worldwide and approximately 1.6 million people are diagnosed
annually in the United States. It is a leading cause of vision loss in people over the age of 65 in the developed world. As the
area of atrophy begins to include the fovea (the center of the macula), patients lose their central vision, making facial recognition,
reading and driving difficult or impossible, and often resulting in legal blindness. The exact cause of dry AMD is unknown, but
is thought to result from multiple factors, such as genetics, age and environmental effects. There are two clinical presentations
of AMD, the dry form and the wet form, or neovascular form (growth of abnormal new blood vessels). Dry AMD typically advances
slowly toward GA in which RPE cells and photoreceptors deteriorate over time. RPE cells support and nourish the retina by metabolizing
waste by-products and producing a number of components useful for photoreceptor health and function. If the metabolic waste products
accumulate, lesions known as drusen are generated. Approximately 85-90% of AMD patients suffer from dry AMD, for which there is
no FDA-approved medical therapies. Dry AMD may also lead to wet AMD, a condition for which there are several FDA-approved treatments
administered locally to inhibit the growth of new blood vessels, but these treatments are not effective nor approved for the treatment
of dry AMD. Physicians often recommend a healthy diet, exercise and/or nutritional supplements for dry AMD, but nutritional supplements
have shown limited efficacy in delaying the onset of more progressive disease in longer-term studies. The schematics below show
a representation of the process of drusen formation and the goal of cell replacement therapy.
6
Dry
AMD involves the loss of retina cells, creating an area of geographic atrophy (GA), which causes impaired vision and blindness
We
believe one of the most promising approaches to treat dry AMD is to replace the layer of damaged RPE cells with new, healthy and
functional RPE cells manufactured from a well-characterized cell line. OpRegen is a cell replacement therapy derived from our
pluripotent cell technology in which our proprietary directed-differentiation methods convert pluripotent stem cells into nearly
pure populations of RPE cells. Using this method, OpRegen is grown free of any animal products and consists of human RPE cells
with high yield and purity that can be transplanted directly into the patient’s eye, where the patient’s own RPE cells
are missing or dysfunctional. The OpRegen therapeutic approach is designed to replace damaged or lost RPE cells with the goal
of slowing disease progression to preserve and/or restore visual function.
OpRegen
is an injection of RPE cells delivered to the retina, to replace lost retinal cells and preserve or restore vision
Preclinical
studies in the Royal College of Surgeons (RCS) rat model have shown that following a single subretinal injection, OpRegen
as a suspension of cells rapidly organized into their natural monolayer structure and survived until the end of the study, which
we believe is critical to the potential success of OpRegen in humans. Additionally, rats receiving OpRegen had objective evidence
of improved optomotor tracking, indicating functional visual improvement compared to control animals.
OpRegen
is intended to be an allogeneic, or “off-the-shelf,” product provided to retinal surgeons in an “easy-to-use”
form for transplantation. We believe OpRegen could have a lasting benefit from a single administration, or once every several
years. This approach differs from other investigational drugs for Dry AMD and approved agents currently marketed for wet AMD,
such as Ranibizumab (Lucentis ® ) and Aflibercept (Eylea ® ), that require multiple, frequent intravitreal
injections into the eye.
7
The
patients in our ongoing Phase 1/2a clinical trial are 50 years of age or older, whose dry AMD has advanced to the GA stage, with
absence of additional concomitant ocular disorders. The eye in which the disease has progressed the most is treated, while their
other eye serves as a measure of disease progression. Following injection, the patients are followed for 12 months at specified
intervals to evaluate the safety and tolerability of OpRegen.
Following
the initial 12-month period, patients are evaluated at longer intervals for up to an additional five years following administration.
A secondary objective of the clinical trial is to examine the ability of transplanted OpRegen to engraft, survive, and modulate
disease progression in the patients. In addition to thorough characterization of visual function, several vision tests are used
to quantify stabilization or improvements in visual function. We also perform anatomical evaluation imaging to assess the restoration
of the structure of the retina.
Interim
data from the first 12 subjects in Cohorts 1-3 have been encouraging and suggest that OpRegen RPE cells are generally well-tolerated
when administered by subretinal injection in these legally blind patients with large areas of GA that have encompassed the foveal
area. The surgical procedures were generally well-tolerated, with spectral domain optical coherence tomography (SD-OCT) images
showing absorption of the subretinal fluid in the bleb less than 48 hours after surgery and healing of the site of retinal penetration
by the cannula within a few weeks. Initial findings using a variety of imaging modalities suggest presence of cells in the subretinal
space, an observation consistent with, and supported by, the data from preclinical studies of OpRegen. Findings on clinical examination
by different imaging modalities show potential improvements in retinal structure, which could precede visual functional improvements.
Though it is not definitively known at this time whether these changes represent engraftment and survival of the transplanted
cells, data from the preclinical animal studies suggest this is the most likely scenario.
Importantly,
in this safety-focused aspect of the trial, no unexpected ocular adverse events have been observed and those events expected to
occur based on the procedures involved in OpRegen administration, such as vitrectomy, have been predominately mild in severity.
The majority of these subjects had pre-existing epiretinal membranes (ERMs) at the time of trial enrollment and in most cases,
experienced new or worsening ERMs following the surgical procedure, which is believed to be partially attributable to the route
of administration via pars plana vitrectomy (PPV) and retinotomy. The majority were mild to moderate in severity, though two patients
with severe ERM were successfully treated via a routine surgical procedure. These subjects are being monitored during trial follow-up.
One instance of retinal detachment occurred in a patient who was legally blind prior to treatment. The event was not assigned
as related to treatment, procedure or to the combination. The patient continued for a period of time in the trial following successful
surgical repair but has since withdrawn due to other unrelated health issues. The independent data safety monitoring board approved
moving to Cohort 4 based on the safety data from the Cohorts 1-3. Cohort 4 incorporates an additional variety of objective and
subjective assessments to look for signs of potential efficacy as well as potential anatomical changes indicative of OpRegen cell
function following implantation.
As
described above, many of the adverse events (AEs) observed in subretinal procedures are likely related to the delivery technique
utilized during the surgery. As previously described, in January 2019, we announced an exclusive partnership with Orbit Biomedical
(now Gyroscope Therapeutics, Ltd.) to assess its FDA-cleared Orbit Subretinal Delivery System (SDS), a single-use vitrectomy-free
delivery device designed to deliver products to the subretinal space for the administration of OpRegen within the ongoing clinical
trial. The device allows for access to the subretinal space via a sclerotomy and suprachoroidal approach, which means that there
are no openings created into the vitreous chamber. This could eliminate the possibilities of new or worsening epiretinal membranes
and exacerbation or generation of a cataract, both known issues with the older standard method of delivery. We believe that the
use of this device could significantly decrease the number of adverse events and improve retention and dose control of OpRegen
in our clinical trials.
We
completed enrollment in Cohorts 1-3 (12 patients) in the middle of 2018 and as previously reported, OpRegen was well tolerated
with no unexpected systemic serious adverse events (SAEs) or ocular AEs. Importantly, there were several patients that exhibited
improved retinal structure, reduction in drusen, alterations in the pattern of GA progression and indications of long-term survival
of the OpRegen cells. We began enrollment of Cohort 4 (targeted for an additional 12 patients) shortly thereafter and treated
three patients via the traditional route of administration. In 2019, we amended our clinical protocol to incorporate the Orbit
SDS and our new thaw and inject formulation into our Phase 1/2a clinical trial. In February 2020, we announced that after reviewing
promising preliminary data from the ongoing OpRegen Phase 1/2a clinical trial, our independent data safety monitoring board removed
the protocol-mandated treatment stagger. The COVID pandemic slowed the rate of patient accrual but study enrollment was completed
on November 10, 2020, with the treatment of the twelfth Cohort 4 patient, seven via the Orbit SDS and five via PPV/retinotomy.
Five different surgeons at four centers successfully delivered OpRegen using the Orbit SDS and there were no unexpected AEs. Encouraging
structural and clinical changes in these better vision patients, including better visual acuity and increased reading speed, are
being followed and updates will be provided at major medical meetings or as findings merit.
8
In
June 2020, we were able to report the first known example of retinal restoration following OpRegen administration in a
Cohort 4 patient who was treated via the PPV/retinotomy route, with the findings confirmed by several independent reviewers. It
is hypothesized that photoreceptor cells in the transition areas at the boundary of the GA are dysfunctional and dying, but not
completely lost. The addition of new RPE cells may restore the microenvironment in surrounding tissue and contribute to the possibility
of restoring function to existing cells that otherwise, if left untreated, would inevitably progress to further expansion of the
atrophic region. Specifically, in this patient, the area of GA assessed at nine months following OpRegen treatment was
approximately 25% smaller than the patient’s pre-treatment baseline. As reported in November at the 2020 American Academy
of Ophthalmology (AAO) Annual Meeting, this patient continues to show signs of a smaller area of GA and improved visual acuity.
This unprecedented finding supports the view that dry AMD is not an irreversible, degenerative condition and that some portion
of diseased retinal tissue may be recoverable in atrophic end-stage disease patients.
With
enrollment complete, patients are being followed for safety and efficacy as per protocol. We plan to present OpRegen data to the
FDA in the third quarter of 2021 for discussion about a subsequent, comparative clinical trial.
OPC1
OPC1
is our lead product candidate for the treatment of acute spinal cord injury (“SCI”). SCI occurs when the spinal cord
is subjected to a severe crush or contusion injury, such as that caused by a car or motorcycle accident and typically results
in severe functional impairment, including limb paralysis, aberrant pain signaling, and loss of bladder and sexual function. There
are approximately 18,000 new spinal cord injuries annually in the U.S. (NSCIC SCI Facts and Figures at a Glance (2019)), and there
are currently no FDA-approved drugs specifically for the treatment of SCI, although methylprednisolone, a corticosteroid generally
used as an anti-inflammatory drug, is sometimes prescribed on an off-label basis to reduce acute inflammation in the injured spinal
cord immediately after injury. It is believed that to effect substantial benefit in treating this complex injury, multiple mechanisms
of action are required, such as introduction of biologics that preserve surviving neurons and stimulate new nerve axon outgrowth,
suppression of lesion formation at the injury site, generation of new blood vessels to repair the ischemic damage from injury,
and myelination of the demyelinated and newly formed nerve axons. A key therapeutic target in SCI is replacement of oligodendrocytes
that are selectively lost at the injury site. As the sole source of the insulating protein myelin in the brain and spinal cord,
oligodendrocytes wrap around nerve axons and allow conduction of electrical impulses throughout the central nervous system (“CNS”).
OPC1
is an oligodendrocyte progenitor cell therapy derived from our pluripotent cell technology under Current Good Manufacturing Practice
(“cGMP”) conditions using a directed differentiation method. These cells are stored frozen until ready for use and
prepared for direct administration into the injured spinal cord. Based on preclinical studies, when OPC1 is transplanted into
the injured spinal cord, the cells undergo further maturation to generate a replacement population of oligodendrocytes at the
injury site that are capable of remyelinating denuded and newly formed nerve axons. Prior to their maturation, the transplanted
oligodendrocyte progenitor cells stimulate additional reparative processes, including promotion of neuron survival and nerve axon
outgrowth, and induction of blood vessel formation in and around the injury site. In addition, OPC1 cells rapidly migrate from
the injection point to the injury site where they generate a supportive tissue matrix and suppress cavitation. Cavitation is a
destructive process that occurs within the spinal cord following SCI, and typically results in permanent loss of motor and sensory
function. A patient with cavitation can develop a condition known as syringomyelia, which results in additional neurological and
functional damage to the patient and can result in chronic pain. Based on the multiple reparative properties associated with OPC1,
we believe this candidate cell therapy product is ideally suited to treat neurological conditions such as SCI and other demyelination
and demyelination disorders of the CNS.
Under
a grant for clinical development, the development of OPC1 has been supported by $14.3 million in funds from the California Institute
for Regenerative Medicine (“CIRM”), from 2014 through the date of this Report. We intend to apply for additional grants
from CIRM for the program’s continued development.
9
Prior
to its acquisition, Asterias tested OPC1 in two clinical trials: a five patient Phase 1 safety trial and a 25-patient Phase 1/2a
dose escalation trial, which we call the SCiStar trial. The SCiStar trial was an open-label, single-arm trial testing three sequential
escalating doses of OPC1 administered at up to 20 million OPC1 cells with subacute, C-4 to C-7, motor complete (AIS-A or AIS-B)
cervical SCI. These individuals have essentially lost all movement below their injury site and experience severe paralysis of
the upper and lower limbs. AIS-A patients have lost all motor and sensory function below their injury site, while AIS-B patients
have lost all motor function but may retain some minimal sensory function below their injury site. OPC1 was administered 21 to
42 days post-injury. Patients continue to be followed by neurological exams and imaging procedures to assess the safety and activity
of the product. Enrollment was completed in December 2017 and consisted of five cohorts:
Cohort
Injury
Type; OPC1 Dose
#
of Patients
Cohort
1
AIS-A;
2 million OPC1 cells (low dose for safety evaluation)
3
Cohort
2
AIS-A;
10 million OPC1 cells
6
Cohort
3
AIS-A;
20 million OPC1 cells*
6
Cohort
4
AIS-B;
10 million OPC1 cells
6
Cohort
5
AIS-B;
20 million OPC1 cells*
4
*
One patient from Cohort 3 and one patient from Cohort 5 were administered 10 million cells.
In
January 2019, top-line 12-month data from the SCiStar trial were announced by Asterias, which included the following key findings:
●
Positive
Safety Profile . Magnetic resonance imaging (“MRI”) scans at 12 months post-injection of OPC1 showed no evidence
of adverse changes in any of the 25 patients.
●
Cell
Engraftment . All three patients in Cohort 1 and 21 of the 22 patients in Cohorts 2-5 had MRI scans at 12 months consistent
with the formation of a tissue matrix at the injury site, which is encouraging evidence that OPC1 cells had engrafted at the
injury site and helped to prevent cavitation.
●
Improved
Motor Function . At 12 months, 21 of the 22 patients who were administered either 10 million or 20 million cells of OPC1
(Cohorts 2-5) recovered at least one motor level on at least one side, and seven of the 22 patients recovered two or
more motor levels on at least one side. Motor level recovery was based on the upper extremity motor score (“UEMS”),
as measured by the International Standards for Neurological Classification of Spinal Cord Injury (“ISNCSCI”).
None of these patients saw decreased motor function following administration of OPC1, and patients consistently retained the
motor function recovery seen through six months or saw further motor function recovery from six to 12 months.
In
November 2019, we provided an update on the SCiStar trial that highlighted, among other things:
●
Positive
Safety Profile . For the 21 SCiStar trial patients who had follow-up visits at 24 months post-injection of OPC1, MRI scans
showed no evidence of adverse changes, and none of the patients had a decline in their motor function from their 12-month
follow-up visit. There were no unexpected serious adverse events to date in any of these patients.
●
Improved
Motor Function . All 3 Cohort 1 patients continued to be stable 2-4 years out post treatment. At 24 months, five
of the six Cohort 2 patients recovered at least two motor levels on at least one side, and one Cohort 2 patient
recovered three motor levels, which has been maintained through that patient’s 36-month follow-up visit. Motor level
recovery was based on the UEMS as measured by the ISNCSCI.
In
November 2020, the formal Clinical Study Report for the SCiStar study with the above supporting data was submitted to the FDA.
The
FDA designated OPC1 as a Regenerative Medicine Advanced Therapy (“RMAT”), for the treatment of acute SCI and granted
it Orphan Drug Designation, which includes the ability for increased interfacing with the FDA during clinical development, and
a pathway to possible market exclusivity.
10
In
2019, we transferred all cGMP manufacturing processes, including the establishment of cell banks and the OPC1 process development
and manufacturing for clinical studies, to our cell therapy manufacturing facility in Jerusalem, Israel. Improvements to the manufacturing
process were completed in 2020 and include enhancements to the production process to ensure robust, controlled reproducible and
commercially viable scale, and purity of OPC1. We also developed a thaw and inject formulation of OPC1 to facilitate logistics
and handling at the point of care with the elimination of the dose preparation at the clinical site. An information amendment
describing the new process, an improved analytical plan, and a proposed comparability plan has been filed with FDA. A meeting
with the FDA is planned during the second half of 2021 to discuss our manufacturing improvements and the further development
of OPC1 in SCI to best set the program up for success moving forward. Concurrently, we have announced a new partnership for the
introduction of a novel delivery device for OPC1. Preliminary assessment of prototypes revealed promising compatibility with OPC1
product while simplifying the surgical procedure by providing surgeons with an instrument that is small, simple to use and would
not require stopping the patient’s ventilator to perform the injection, allowing far more flexibility for accurate delivery
to the injury site. We intend to complete development activities in the first half of 2021, then discuss with FDA the introduction
of the new delivery device in our IND if supported by the collected data. We continue work to expand our partnerships with SCI
advocacy and support organizations to support their mission to accelerate stem cell treatments to patients with unmet medical
needs and fast-track the development of the most promising stem cell technologies.
VAC2
VAC2
is our lead product candidate for the treatment of cancer. Cancer afflicts millions worldwide and is one of the largest unmet
clinical needs with current treatment options providing limited efficacy and a wide range of debilitating side effects. To provide
a more effective and targeted treatment, we are developing VAC2 as an allogeneic, or non-patient specific, cancer vaccine candidate
designed to stimulate patient immune responses to an antigen hTERT, which is commonly expressed in cancerous cells but not in
normal adult cells. VAC2, is produced by our pluripotent cell technology using a directed differentiation method, and is comprised
of a population of mature dendritic cells to which the hTERT antigen was introduced. As the most potent type of antigen presenting
cell in the body, dendritic cells instruct our body’s immune system to attack and eliminate harmful pathogens and unwanted
cells. To target cancerous cells, VAC2 is engineered to express the tumor-selective antigen telomerase, which is found in over
85% of all cancers. The tumor antigen is loaded exogenously into the dendritic cells. The VAC1 autologous program,
which preceded VAC2, serves as an effective and encouraging proof of concept behind our approach to dendritic cell vaccines
targeting telomerase, which is the backbone of the VAC2 program.
Using
pluripotent cells as the starting material for VAC2 production adds several additional advantages to this therapeutic candidate.
Compared to technologies that rely on the use of a patient’s own blood, our pluripotent cell technology provides a scalable
system for production of a large number of vaccine doses in a single lot, lower manufacturing costs, greater product consistency,
and more notably, off-the-shelf availability to provide broader and immediate access to patients. In addition, we believe that
as an allogeneic therapy, VAC2 has the potential to stimulate a more robust immune response through an adjuvant effect resulting
from the partial immune mismatch between the VAC2 cells and patients receiving the therapy. We believe that VAC2 can be used as
a platform technology that can be modified to carry any antigen, including patient-specific tumor neo-antigens.
In
September 2014, Asterias initiated clinical development of VAC2 by entering into a Clinical Trial and Option Agreement (the “CRUK
Agreement”) with Cancer Research UK (“CRUK”) and Cancer Research Technology Limited (“CRT”), a wholly
owned subsidiary of CRUK, under which CRUK agreed to fund Phase 1 clinical development of VAC2 in non-small cell lung cancer.
CRUK is responsible, at its own cost, for manufacturing clinical grade VAC2 and for carrying out the Phase 1 clinical trial of
VAC2. Patient enrollment began in June 2018 and six patients have now completed dosing in the initial aspect of the trial.
In
May 2020, Lineage and its wholly owned subsidiary Asterias entered into a Second Amendment to Clinical Trial and Option Agreement
(the “CTOA Amendment”) with CRUK and CRT, which amends the Clinical Trial and Option Agreement entered into between
Asterias, CRUK and CRT dated September 8, 2014, as amended September 8, 2014. Pursuant to the CTOA Amendment, Lineage assumed
all obligations of Asterias and exercised early its option to acquire data generated in the Phase 1 clinical trial of VAC2 in
non-small cell lung cancer being conducted by CRUK. CRUK will continue conducting the VAC2 study.
11
Lineage
and CRT effectuated the option by simultaneously entering into a license agreement (the “License Agreement”) pursuant
to which Lineage agreed to pay the previously agreed signature fee of £1,250,000 (approximately $1.6 million). In consideration
of Lineage’s agreement to exercise the option prior to completion of the study, the parties agreed to defer the signature
fee as follows: £500,000 in September 2020, £500,000 in January 2021 and £250,000 in April 2021. For the primary
licensed product for the first indication, the License Agreement provides for milestone fees of up to £8,000,000 based upon
initiation of a Phase 3 clinical trial and the filing for regulatory approval and up to £22,500,000 in sales-based milestones
payments. Additional milestone fees and sales-based milestone payments would be payable for other products or indications, and
mid-single-digit royalty payments are payable on sales of commercial products.
We
completed the transfer of all cGMP manufacturing processes, including the establishment of cell banks and the VAC2 process development
and manufacturing for clinical studies, to our cell therapy manufacturing facility in Jerusalem, Israel. In 2021, we will focus
on updating and optimizing the manufacturing process for VAC to ensure reliable supply for future clinical studies and possible
commercial development. An improved VAC manufacturing process will be the subject of a key interaction with FDA in the future
to introduce VAC in an IND.
The
allogeneic VAC2 program was preceded by the autologous VAC1 program which isolated dendritic cells from a patient’s own
blood, modified those cells to stimulate immune responses to telomerase and then administered those cells back to the patient
as a therapeutic modality. VAC1 was studied for the treatment of acute myeloid leukemia, the most common form of acute leukemia
in adults. A Phase 2 clinical trial of VAC1 demonstrated that it successfully manufactured and released in 24 out of the 33 patients
enrolled in the trial. Twenty-one patients received VAC1 in the trial, including 19 in clinical remission and two in early relapse.
VAC1 was found to have a favorable safety and tolerability profile. Asterias performed follow-up data collection on the 19 patients
treated while in complete remission to determine the long-term effects of the VAC1 administration on remission duration and disease-free
survival.
VAC1
utilized an autologous approach where the cellular vaccine needs to be created specifically for each patient. This results in
a longer time prior to administration of therapy as compared to the allogeneic approach of the VAC2 program, which is disadvantageous
in advanced cancer patients given the rapidity of disease progression. The VAC1 autologous program which preceded VAC2 serves
as an effective and encouraging proof of concept behind our approach to dendritic cell vaccines targeting telomerase, which is
the backbone of the VAC2 program.
Research
Programs
Vision
restoration
In
2017, we expanded our ophthalmology portfolio by acquiring exclusive global rights to technology that allows the generation of
three-dimensional human retinal tissue derived from human pluripotent cells. This tissue contains all the cell types and layers
of the human retina and has shown evidence of functional integration in proof of concept animal models for advanced retinal degeneration.
The technology is being developed to potentially treat or prevent a variety of retinal degenerative diseases and injuries. In
2017, the National Institutes of Health (“NIH”) awarded us a grant of up to $1.6 million to further develop this innovative,
next generation vision restoration program for retinal diseases and injuries, which severely impact the quality of life for millions
of people who have limited treatment options. In 2019, we received an additional grant of $0.7 million to continue work on this
program. We completed work under this grant in 2020 and submitted final reports to the NIH.
In
2020, the Israeli Innovation Authority approved a budgeted grant of approximately $0.6 million for us to manufacture novel
retinal implants aimed to treat patients with severe retinal impairment such as retinitis pigmentosa. We are eligible for 60%
reimbursement of our costs under this grant. This program allows us to combine our knowledge in manufacturing RPE cells and
photoreceptors with 3D printing technology.
Demyelination
OPC1
exhibits multiple reparative properties that may have broad applicability to neurological injury and disease, particularly as
a treatment for demyelination. Past research efforts investigated the potential development of OPC1 as a candidate treatment for
certain forms of ischemic stroke and multiple sclerosis (“MS”), two severely debilitating conditions for which demyelination
is a central component to their pathology.
12
To
develop OPC1 as a treatment for MS, initial proof-of-concept efficacy data has been demonstrated in collaboration with Yale University
using a non-human primate model of MS. Results of this study showed OPC1 engraftment that was associated with substantial remyelination
of the lesioned primate spinal cord up to five months post-treatment. Subsequently, we initiated a collaboration with University
of California Irvine to assess OPC1 efficacy in additional mouse models of MS that better recapitulate the autoimmune components
of the disease. Preliminary results indicated that in addition to OPC1’s capacity to remyelinate the lesioned spinal cord,
the cells may also help stimulate proliferation of a distinct class of immune cells known as regulatory T cells that can help
reduce or eliminate autoimmunity.
For
ischemic stroke, initial proof-of-concept efficacy data for OPC1 has been demonstrated in a collaborative study with the University
of California Los Angeles using a mouse model of white matter ischemic stroke. Results of this study demonstrated that within
the stroke injury site, OPC1 cells engrafted, reduced lesion formation and inflammation, and increased myelination, culminating
in improved functional recovery. A second preclinical study was completed in collaboration with the University of South Florida
to test two different doses of OPC1 in a rat model of ischemic subcortical and white matter stroke. Results from this study demonstrated
the ability of OPC1 to impact the restoration of motor function in a rat model of white matter stroke. Further, histological assessments
showed a treatment-associated reduction in stroke lesion size, including in the white matter, as well as reduced inflammation
and sustained OPC1 engraftment in the injured brain.
While
we are not actively pursuing OPC1 for MS and ischemic stroke at this time, we may use the results of these studies to seek additional
funding and guide further preclinical development of OPC1 for these or other conditions of demyelination.
Products
for Other Indications
We
also have rights to intellectual property applicable to other indications such as for producing cardiomyocytes, pancreatic islet
cells, hepatocytes, chondrocytes, osteoblasts and other cell types for which development of new therapies represent significant
commercial opportunities. We may elect to pursue these or other programs at any time.
Other
Products
We
also have rights to HyStem, a patented biomaterial that mimics naturally occurring extracellular matrix, the structural network
of molecules surrounding cells in organs and tissues essential to cellular function and tissue structure. HyStem may be useful
as a scaffold for cell replacement and retention. We sold HyStem-related assets and licensed the applicable technology in late
2019, but retained the rights for other uses, including for Renevia, our facial aesthetics product, which received a Conformité
Européenne (CE) Mark in September 2019.
Investments
and subsidiaries:
The
following tables show the companies in which we have a direct or indirect ownership, their respective principal fields of business,
our percentage ownership as of March 5, 2021, and the country where their principal business is located:
Investments:
Company
Field of Business
Lineage
Ownership
Country
OncoCyte Corporation (1)
Cancer diagnostics
~1 %
USA
Hadasit Bio-Holdings
Ltd. (1)
Owns a portfolio of R&D based companies
<2 %
Israel
13
Significant
subsidiaries:
Company
Field of Business
Lineage Ownership
Country
Cell Cure Neurosciences Ltd.
Development and manufacturing of Lineage’s cell replacement platform technology
99 % (2)
Israel
Asterias
Biotherapeutics, Inc. (3)
Cell based therapeutics to treat neurological conditions
100 %
USA
ES Cell International
Pte. Ltd (4)
Research and clinical grade cell lines
100 %
Singapore
OrthoCyte Corporation (4)(5)
Research in orthopedic diseases and injuries
99.8 %
USA
(1)
These
are publicly traded companies. See Notes to Consolidated Financial Statements: Note 4. Equity Method of Accounting for Common
Stock of OncoCyte, at Fair Value.
(2)
Includes
shares owned by Lineage and ES Cell International Pte. Ltd. (“ESI”).
(3)
Asterias
was acquired by Lineage in March 2019. See Notes to Consolidated Financial Statements: Note 3. Asterias Merger.
(4)
The
operating activities and fields of business listed under these subsidiaries are conducted primarily by Lineage as the parent
company.
(5)
OrthoCyte
Corporation (“OrthoCyte”) adopted a stock option plan under which it may issue up to 4,000,000 shares of its common
stock to officers, directors, employees, and consultants of OrthoCyte and Lineage employees, including officers. As of December
31, 2020, no options to purchase OrthoCyte common stock were outstanding.
Patents
and Trade Secrets
We
seek to protect and rely on our proprietary cell-based therapy platform and associated development and manufacturing capabilities
and derived product candidates through a variety of methods, including seeking and maintaining patents intended to cover our products
and compositions, their methods of use and processes for their manufacture, our platform technologies and any other inventions
that are commercially important to the development of our business. We also rely on contractual obligations with employees and
third parties to protect our proprietary rights. For example, in addition to protecting our proprietary rights with patents, we
rely on unpatented trade secrets, improvements, know-how and innovation, and we take steps necessary to protect these rights,
including through confidentiality agreements with our corporate partners, employees, consultants and vendors. We have sought,
and intend to continue to seek, appropriate patent protection for important and strategic components of our proprietary technologies
by filing patent applications in the U.S. and internationally. We may also file additional patent applications, when appropriate,
to cover improvements on our clinical products, clinical product candidates, and related technologies. There are no assurances
that any of our intellectual property rights will guarantee complete or adequate protection or market exclusivity for our products
and product candidates. We also enter into collaborative and other similar arrangements with third parties, such as license agreements,
to in-license and/or out-license intellectual property rights. Our financial success will be dependent, in part, on our ability
to obtain rights to commercially valuable patents, to protect and enforce our intellectual property rights and to operate without
infringing any intellectual property rights of others. From time to time, we assess our patents and pending applications covering
our products and product candidates. If we determine that any patents or patent applications no longer provide adequate or necessary
protection, we may transfer or abandon such patents and patent applications to avoid incurring unnecessary costs.
We
own or license, directly or through our subsidiaries, several patent families that include hundreds of U.S. and international
patents and patent applications. We cannot be certain that issued patents will be enforceable or provide adequate protection or
that pending applications will result in issued patents.
OpRegen
We
and our subsidiary, Cell Cure, have rights to issued U.S. and international patents and pending patent applications covering OpRegen.
The issued patents have expiration dates ranging from 2028 to 2036. The pending applications if issued, will have estimated expiration
dates ranging from 2028 to 2041. These U.S. and international issued patents and pending applications also include those in-licensed
from Hadasit Medical Research Services and Development Ltd. (“Hadasit”), the commercial arm and a wholly owned subsidiary
of Hadassah Medical Organization. We also solely own pending U.S. and Patent Cooperation Treaty (“PCT”) patent applications
relating to cryopreserving the cell population and then shipping it to the clinical trial site so the cells can be immediately
thawed and delivered to the patient without further processing. The U.S. patent applications, and any filed international patent
applications based on the PCT applications, if issued, will have estimated expiration dates in 2038.
14
Cell
Cure was a party to two pending opposition proceedings in the European Patent Office (“EPO”) involving EP Patent Numbers
2147094 (issued 08-Oct-2014) and 2554661 (issued 19-Nov-2014), both entitled, “Stem Cell-Derived Retinal Pigment Epithelial
Cells”. The oral proceedings took place on March 16, 2017 and March 17, 2017, respectively. Both patents were upheld by
the EPO and the patents issued as amended during the opposition proceedings. Both patents cover OpRegen until 2028.
OPC1
We
have numerous U.S. and international issued patents and pending patent applications that are relevant to neural cells, such as
oligodendrocyte progenitor cells, including patent families acquired from Geron Corporation (“Geron”) that are directed
to the differentiation of pluripotent stem cells, including human embryonic stem (“hES”) cells, into various neural
cell types, as well as various culture and purification methods. These U.S. and international issued patents and pending patent
applications also include those in-licensed from the Regents of the University of California. Additionally, there are four patent
families with pending patent applications owned by us directed to improved methods of producing oligodendrocyte progenitor cells,
oligodendrocyte progenitor cell compositions and methods of treatment of spinal cord injury using oligodendrocyte progenitor cells.
There is also a patent family directed to improved methods of producing oligodendrocyte progenitor cells, oligodendrocyte progenitor
cell compositions and methods for the treatment of stroke using oligodendrocyte progenitor cells which is jointly owned with the
Regents of the University of California. The expiration dates of the patents and pending patent applications acquired from Geron
and in-licensed from the Regents of the University of California range from 2023 to 2036. The estimated expiration dates of the
four patent families with pending applications owned by us range from 2036 to 2040. The commercial success of OPC1 depends, in
part, upon our ability to exclude competition for this product with the existing patent portfolio, regulatory exclusivity, undisclosed
know-how and/or trade secrets, or a combination of these barriers to entry.
VAC1
and VAC2
We
have numerous U.S. and international issued patents and pending patent applications that are relevant to dendritic cells, including
patent families acquired from Geron or in-licensed from third parties that are directed to the differentiation of pluripotent
stem cells, including hES cells, into hematopoietic progenitor cells and immature and mature dendritic cells. In addition, these
patent rights include a patent family with claims directed to immunogenic compositions comprising antigen-presenting dendritic
cells and methods of eliciting an anti-telomerase immune response in a subject by administering to the subject such compositions.
The expiration dates of the patents, and the estimated expiration dates of the pending applications, acquired from Geron or in-licensed
to us range from 2022 to 2041. The commercial success of VAC1 and VAC2 products depends, in part, upon our ability to exclude
competition in these products with this patent portfolio, regulatory exclusivity, undisclosed know-how and/or trade secrets, or
a combination of these barriers to entry.
Other
Patents and Patent Applications
We
have U.S. and international issued patents and pending patent applications related to producing cardiomyocytes, pancreatic islet
cells, hepatocytes, chondrocytes and osteoblasts. The expiration dates of these patents and pending patent applications range
from 2020 to 2032. In addition, we have U.S. and international issued patents and pending patent applications related to suspension
cultures and feeder-free cultures for culturing and proliferating pluripotent stem cells. The expiration dates for these patents
and pending patent applications range from 2021 to 2026.
We
also have U.S. and international issued patents and pending applications covering Renevia, include those in-licensed from the
University of Utah Research Foundation (“UURF”) having expiration dates ranging from 2023 to 2027, and a pending patent
application in Europe having an estimated expiration date of 2024. We also solely own pending U.S. and European patent applications
filed in 2018 that, if issued, will have estimated expiration dates in 2038.
15
General
Risks Related to Obtaining and Enforcing Patent Protection
Because
patent applications are confidential until a patent is issued, we may not know if our competitors have filed patent applications
for technology covered by our pending applications or if we were the first to invent or first to file an application directed
toward the technology that is the subject of our patent applications. Competitors may have filed patent applications or received
patents and may obtain additional patents and proprietary rights that block or compete with our products. In addition, if competitors
file patent applications covering our technology, we may have to participate in interference/derivation proceedings or litigation
to determine the right to a patent. Litigation and interference/derivation proceedings are unpredictable and expensive, such that,
even if we are ultimately successful, our results of operations may be adversely affected by such events. Accordingly, there is
a risk that any patent applications that we file and any patents that we hold or later obtain could be challenged by third parties
and be declared invalid in view of third party patent applications and/or patents. Litigation, interferences, oppositions, inter
partes reviews or other proceedings are, have been and may in the future be necessary in some instances to determine the validity
and scope of certain of our proprietary rights, and in other instances to determine the validity, scope or non-infringement of
certain patent rights claimed by third parties to be pertinent to the manufacture, use or sale of our products. We may also face
challenges to our patent and regulatory protections covering our products by third parties, including manufacturers of generics
and biosimilars that may choose to launch or attempt to launch their products before the expiration of our patent or regulatory
exclusivity. Litigation, interference, oppositions, inter partes reviews, administrative challenges or other similar types of
proceedings are unpredictable and may be protracted, expensive and distracting to management. The outcome of such proceedings
could adversely affect the validity and scope of our patent or other proprietary rights, hinder our ability to manufacture and
market our products, require us to seek a license for the infringed product or technology or result in the assessment of significant
monetary damages against us that may exceed any amounts that we may accrue on our financial statements as a reserve for contingent
liabilities. An adverse determination in a judicial or administrative proceeding or a failure to obtain necessary licenses could
prevent us from manufacturing or selling our products. Furthermore, payments under any licenses that we are able to obtain would
reduce our profits derived from the covered products and services.
The
enforcement of patent rights often requires litigation against third-party infringers, and such litigation can be costly to pursue.
Even if we succeed in having new patents issued or in defending any challenge to issued patents, there is no assurance that our
patents will be comprehensive enough to provide us with meaningful patent protection against our competitors.
Employees
As
of December 31, 2020, we had 55 employees, of which 20 were Lineage employees and 35 were employees of Cell Cure in Israel and
of which 49 were employed on a full-time basis and six were employed on a part-time basis. Ten employees hold Ph.D.
degrees in one or more fields of science. None of our employees are covered by a collective bargaining agreement.
Manufacturing
We
maintain an innovative cell therapy manufacturing facility in the Bio Park on the campus of the Hadassah University Hospital in
Jerusalem, Israel. The facility includes process development laboratories and a state-of-the-art, cGMP manufacturing facility.
It is designed and equipped to enable simultaneous cGMP processes and to produce a range of cell therapy products for human use
in clinical trials as well as at a scale suitable for commercial launch. All cGMP manufacturing processes, including cell banks
and product manufacturing for our cell therapy product candidates are conducted in this facility.
We
obtain key components required for the manufacture of our cell therapy product candidates from third-party manufacturers and suppliers,
which include, in some instances, sole source manufacturers and suppliers. We do not currently have long-term commitments or supply
agreements in place to obtain certain key components used in the manufacture of our cell therapy product candidates.
Licensed
Technology and Product Development Agreements
Lineage
has obtained the right to use technology that we believe has great potential in our product development efforts, and that may
be useful to other companies that are engaged in the research and development of products for human therapeutic and diagnostic
use.
16
Second
Amendment to Clinical Trial and Option Agreement and License Agreement with Cancer Research UK
On
May 6, 2020, Lineage and its wholly owned subsidiary Asterias entered into a Second Amendment to Clinical Trial and Option Agreement
(the “CTOA Amendment”) with Cancer Research UK (“CRUK”) and Cancer Research Technology Limited (“CRT”),
which amends the Clinical Trial and Option Agreement entered into between Asterias, CRUK and CRT dated September 8, 2014, as amended
September 8, 2014. Pursuant to the CTOA Amendment, Lineage assumed all obligations of Asterias and exercised early its option
to acquire data generated in the Phase 1 clinical trial of VAC2 in non-small cell lung cancer being conducted by CRUK. CRUK is
continuing to conduct the VAC2 study.
Lineage
and CRT effectuated the option by simultaneously entering into a license agreement (the “CRT License Agreement”) pursuant
to which Lineage agreed to pay the previously agreed signature fee of £1,250,000 (approximately $1.6 million). In consideration
of Lineage’s agreement to exercise the option prior to completion of the study, the parties agreed to defer the signature
fee as follows: £500,000 in September 2020, £500,000 in January 2021 and £250,000 in April 2021. For the primary
licensed product for the first indication, the CRT License Agreement provides for milestone fees of up to £8,000,000 based
upon initiation of a Phase 3 clinical trial and the filing for regulatory approval and up to £22,500,000 in sales-based
milestones payments. Additional milestone fees and sales-based milestone payments would be payable for other products or indications,
and mid-single-digit royalty payments are payable on sales of commercial products.
Either
party may terminate the CRT License Agreement for the uncured material breach of the other party. CRT may terminate the CRT License
Agreement in the case of Lineage’s insolvency or if Lineage ceases all development and commercialization of all products
under the CRT License Agreement.
Hadasit
Research and License Agreement
In
June 2017, Cell Cure entered into a Second Amended and Restated License Agreement with Hadasit (the “Hadasit License Agreement”).
Pursuant to the Hadasit License Agreement, Hadasit granted Cell Cure an exclusive, worldwide, royalty-bearing license (with the
right to grant sublicenses) in its intellectual property portfolio of U.S. and international issued patents and pending patent
applications relevant to materials and technology related to human stem cell derived photoreceptor cells and RPE cells, to use,
commercialize and exploit any part thereof, in any manner whatsoever in the fields of the development and exploitation of: (i)
human stem cell derived photoreceptor cells, solely for use in cell therapy for the diagnosis, amelioration, prevention and treatment
of eye disorders; and (ii) human stem cell derived RPE cells, solely for use in cell therapy for the diagnosis, amelioration,
prevention and treatment of eye disorders. This intellectual property licensed includes patents and pending applications having
expiration dates, and estimated expiration dates, respectively, ranging from 2025 to 2028. Cell Cure and Hadasit also jointly
own U.S. and international issued patents and patent applications directed to methods of selecting RPE cells, which patents and
patent applications will expire in 2033.
Pursuant
to the Hadasit License Agreement, Cell Cure paid a small one-time lump sum payment for reimbursement of intellectual property
related expenses and will pay a royalty in the mid-single digits of net sales from sales of licensed intellectual property by
any invoicing entity and a royalty of 21.5% on sublicensing receipts. In addition, Cell Cure will pay Hadasit an annual minimal
non-refundable royalty, which will become due and payable the first January 1 following the completion of services to Cell Cure
by a research laboratory.
Cell
Cure agreed to pay Hadasit non-refundable milestone payments upon the recruitment of the first patient for the first Phase 2b
clinical trial, upon the enrollment of the first patient in the first Phase 3 clinical trials, upon delivery of the report for
the first Phase 3 clinical trials, upon the receipt of an NDA or marketing approval in the EU, whichever is the first to occur,
and upon the first commercial sale in the United States or EU, whichever is the first to occur. Such milestones, in the aggregate,
may be up to $3.5 million. As of December 31, 2020, Cell Cure had not accrued any of these milestone payments.
The
Hadasit License Agreement terminates upon the expiration of Cell Cure’s obligation to pay royalties for all licensed products,
unless earlier terminated. In addition, the Hadasit License Agreement may be terminated by (i) Hadasit if, among other reasons,
Cell Cure fails to continue the clinical development of the licensed intellectual property or fails to take actions to commercialize
or sell the licensed intellectual property over any consecutive 12-month period, and (ii) by either party for: (a) a material
breach which remains uncured following a cure period; or (b) the granting of a winding-up order in respect of the other party,
or upon an order being granted against the other party for the appointment of a receiver or a liquidator in respect of a substantial
portion of such other party’s assets. The Hadasit License Agreement also contains customary indemnification obligations
of Cell Cure.
17
License
Agreement with University of California
We
are party to an exclusive license agreement with The Regents of the University of California dated February 20, 2003 (the “UC
License Agreement”) for U.S. and international issued patents and pending patent applications covering a method for directing
the differentiation of pluripotent cells to glial-restricted progenitor cells that generate pure populations of oligodendrocytes
for remyelination and treatment of spinal cord injury. Under the UC License Agreement, we have an exclusive worldwide license
under such patents, including the right to grant sublicenses, to create products for biological research, drug screening, and
human therapy using the licensed patents. These issued patents and pending applications have expiration dates ranging from 2023
to 2024.
Under
the UC License Agreement, we will pay the university a royalty of 1% from sales of products that are covered by the licensed patent
rights, and a minimum annual royalty of $5,000 starting in the year in which the first sale of a product covered by any licensed
patent rights occurs and continuing for the life of the applicable patent right under the agreement. Under certain conditions,
we will pay the university 7.5% of any proceeds, excluding debt financing and equity investments, and certain reimbursements,
that we receive from sublicensees.
The
UC License Agreement terminates on the expiration of the last-to-expire of the university’s issued licensed patents. If
no further patents covered by the UC License Agreement are issued, it will terminate in 2024. The university may terminate the
UC License Agreement if we breach it, and we can terminate with 60 days’ notice.
WARF
Agreements
We
have rights to certain U.S and international issued patents, pending patent applications and stem cell lines with the Wisconsin
Alumni Research Foundation (“WARF”) under a Commercial License and Option Agreement entered into between Lineage and
WARF in January 2008 and a Non-Exclusive License Agreement entered into between Asterias and WARF in October 2013 (collectively,
the “WARF Agreements”).
Under
the WARF Agreements, we have a worldwide non-exclusive license under certain WARF patents and WARF-owned primate (including human)
stem cell lines covered by such patents for use in internal research, and to make, use and sell products that are used as research
tools and products that are discovered or developed through our internal research using such patents and stem cells. We paid upfront
license fees and have agreed to additional payments upon the attainment of specified clinical development milestones, royalties
on sales of commercialized products, and, subject to certain exclusions, a percentage of any payments that we may receive from
any sublicenses that we may grant to use the licensed patents or stem cell lines.
The
WARF Agreements will terminate with respect to licensed patents upon the expiration of the last licensed patent to expire and
with respect to licensed cell lines until terminated by a party. We may terminate the WARF Agreements at any time with prior written
notice, and WARF may terminate the WARF Agreements upon a breach. We have agreed to indemnify WARF and certain other designated
affiliated entities from liability arising out of or relating to the death or injury of any person or damage to property due to
the sale, marketing, use or manufacture of products that are covered by the licensed patents, licensed stem cell lines or inventions
or materials developed or derived from the licensed patents or stem cell lines.
Royalty
Agreement with Geron
In
connection with Asterias’s acquisition of Geron’s stem cell assets, in October 2013, we entered into a royalty agreement
with Geron (the “Royalty Agreement”) pursuant to which we agreed to pay Geron a 4% royalty on net sales (as defined
in the Royalty Agreement) by us or any of our affiliates or sales agents of any products that we develop and commercialize that
are covered by the patents Geron contributed to us. In the case of sales of such products by a person other than us or one of
our affiliates or sales agents, we will be required to pay Geron 50% of all royalties and cash payments received by us or by our
affiliate in respect of a product sale. Royalty payments will be subject to proration in the event that a product covered by a
patent acquired from Geron is sold in combination with another product that is not covered by a patent acquired from Geron. The
Royalty Agreement will terminate at the expiration or termination date of the last issued patent contributed by Geron under the
Royalty Agreement. We estimate that the latest patent expiration date will be in 2032.
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Government
Regulation
Government
authorities at the federal, state and local level, and in other countries, extensively regulate among other things, the development,
testing, manufacture, quality, approval, safety, efficacy, distribution, labeling, packaging, storage, record keeping, marketing,
import/export and promotion of drugs, biologics, and medical devices. Authorities also heavily regulate many of these activities
for human cells, tissues, and cellular and tissue-based products (“HCT/Ps”).
FDA
and Foreign Regulation of Therapeutic Products
The
FDA and foreign regulatory authorities will regulate our proposed products as drugs, biologics or medical devices, depending upon
such factors as the use to which the product will be put, the chemical composition, and the interaction of the product with the
human body. In the United States, the FDA regulates drugs and biologics under the Federal Food, Drug and Cosmetic Act (“FDCA”),
the Public Health Service Act (“PHSA”), and implementing regulations. In addition, establishments that manufacture
human cells, tissues, and HCT/Ps are subject to additional registration and listing requirements, including current good tissue
practice regulations. Certain cell therapy proposed products will be reviewed by the FDA staff in its Center for Biologics Evaluation
and Research Office of Cellular, Tissue and Gene Therapies.
Our
domestic human drug and biologic products will be subject to rigorous FDA review and approval procedures. After testing in animals
to evaluate the potential efficacy and safety of the product candidate, an investigational new drug (“IND”) submission
must be made to the FDA to obtain authorization for human testing. Extensive clinical testing, which is generally done in three
phases, must then be undertaken to demonstrate optimal use, safety, and efficacy of each product in humans. Each clinical trial
is conducted under the auspices of an independent Institutional Review Board (“IRB”). The IRB will consider, among
other things, ethical factors, the safety of human subjects, and the possible liability of the institution.
Phase
1 clinical trials are conducted in a small number of healthy volunteers or volunteers with the target disease or condition to
assess safety. Phase 2 clinical trials are conducted with groups of patients afflicted with the target disease or condition in
order to determine preliminary efficacy, optimal dosages and expanded evidence of safety. In some cases, an initial trial is conducted
in diseased patients to assess both preliminary efficacy and preliminary safety, in which case it is referred to as a Phase 1/2
clinical trial. Phase 3 clinical trials are large-scale, multi-center, comparative trials and are conducted with patients afflicted
with the target disease or condition in order to provide enough data to demonstrate the efficacy and safety required by the FDA.
The FDA closely monitors the progress of each of the three phases of clinical testing and may, at its discretion, re-evaluate,
alter, suspend or terminate the clinical trial based upon the data which have been accumulated to that point and its assessment
of the risk/benefit ratio to the intended patient population. All adverse events must be reported to the FDA. Monitoring of all
aspects of the trial to minimize risks is a continuing process.
No
action can be taken to market any therapeutic product in the U.S. until an appropriate New Drug Application (“NDA”)
or Biologics License Application (“BLA”) has been approved by the FDA. Submission of the application is not a guarantee
that the FDA will find it complete and accept it for filing. If an application is accepted for filing, following the FDA’s
review, the FDA may grant marketing approval, request additional information or deny the application by way of a Complete Response
Letter if it determines that the application does not provide an adequate basis for approval. FDA regulations also restrict the
export of therapeutic products for clinical use prior to FDA approval. Before approving a BLA, the FDA will inspect the facilities
at which the product is manufactured. The FDA will not approve the product unless it determines that the manufacturing processes
and facilities are in compliance with cGMP requirements and adequate to assure consistent production of the product within required
specifications including gene therapy products (“GTPs”) to the extent applicable. These are FDA regulations and guidance
documents that govern the methods used in, and the facilities and controls used for, the manufacture of HCT/Ps. The primary intent
of the GTP requirements is to ensure that cell and tissue-based products are manufactured in a manner designed to prevent the
introduction, transmission and spread of communicable disease. FDA regulations also require HCT/P establishments to register and
list their HCT/Ps with the FDA and, when applicable, to evaluate donors through screening and testing. Additionally, before approving
a BLA, the FDA will typically inspect one or more clinical sites to assure that the clinical trials were conducted in compliance
with IND trial requirements and GCP requirements. To maintain compliance with CGMPs, GTPs, and GCPs, an applicant must incur significant
expenditure of time, money and effort in the areas of training, record keeping, production, and quality control.
19
To
date, the FDA has not granted marketing approval to any pluripotent stem-based therapeutic products and it is possible that the
FDA or foreign regulatory agencies may subject our product candidates to additional or more stringent review than drugs or biologics
derived from other technologies.
The
FDA offers several programs to expedite development of products that treat serious or life-threatening illnesses and that provide
meaningful therapeutic benefits to patients over existing treatments. A drug is eligible for designation as an RMAT if: the drug
is a regenerative medicine therapy, which is defined as a cell therapy, therapeutic tissue engineering product, human cell and
tissue product or any combination product using such therapies or products, except for those regulated solely under certain other
sections; the drug is intended to treat, modify, reverse or cure a serious or life-threatening disease or condition; and preliminary
clinical evidence indicates that the drug has the potential to address unmet medical needs for such disease or condition. Some
of our current and future products may be eligible for RMAT designation.
Under
the Orphan Drug Act, the FDA may grant orphan designation to a drug or biologic intended to treat a rare disease or condition,
which is a disease or condition that affects fewer than 200,000 individuals in the United States, or if it affects more than 200,000
individuals in the United States, there is no reasonable expectation that the cost of developing and making available a drug or
biologic for this type of disease or condition will be recovered from sales in the United States for that drug or biologic. Orphan
drug designation must be requested before submitting a BLA. 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. The orphan drug designation does not
convey any advantage in, or shorten the duration of, the regulatory review or approval process.
If
a product that has orphan drug designation subsequently receives the first FDA approval for the disease for which it has such
designation, the product is entitled to orphan drug exclusivity, which means that the FDA may not approve any other applications,
including a full BLA, to market the same biologic for the same indication for seven years, except in limited circumstances, such
as a showing of clinical superiority to the product with orphan drug exclusivity. Orphan drug exclusivity does not prevent 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
application 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, 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 quantities of the product to meet the needs of patients with the rare disease or condition.
Combination
Products
If
we develop any products that are used with medical devices, they may be considered combination products, which are defined by
the FDA to include products comprised of two or more regulated components or parts such as a biologic and a device. For example,
our HyStem hydrogel products may be used to administer one or more pluripotent stem cell-based therapy products. When regulated
independently, biologics and devices each have their own regulatory requirements. However, the regulatory requirements for a combination
product comprised of a biologic administered with a delivery device can be more complex, because in addition to the individual
regulatory requirements for each component, additional combination product regulatory requirements may apply. The Office of Combination
Products at the FDA coordinates the review of such products and determines the primary mode of action of a combination product.
The definition and regulatory requirements for combination products may differ significantly among countries in which we may seek
approval of our product candidates.
FDA
Regulation of Manufacturing
The
FDA regulates the manufacturing process of pharmaceutical products, human tissue and cell products, and medical devices, requiring
that they be produced in compliance with cGMP. See “Manufacturing.” The FDA regulates and inspects equipment, facilities,
laboratories and processes used in the manufacturing and testing of products prior to providing approval to market products. If
after receiving approval from the FDA, a material change is made to manufacturing equipment or to the location or manufacturing
process, additional regulatory review may be required. The FDA also conducts regular, periodic visits to re-inspect the equipment,
facilities, laboratories and processes of manufacturers following an initial approval. If, as a result of those inspections, the
FDA determines that equipment, facilities, laboratories or processes do not comply with applicable FDA regulations and conditions
of product approval, the FDA may seek civil, criminal or administrative sanctions and/or remedies against the manufacturer, including
suspension of manufacturing operations. Issues pertaining to manufacturing equipment, facilities or processes may also delay the
approval of new products undergoing FDA review.
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FDA
Regulation of Advertising and Product Promotion
The
FDA also regulates the content of advertisements used to market pharmaceutical and biologic products. Claims made in advertisements
concerning the safety and efficacy of a product, or any advantages of a product over another product, must be supported by clinical
data filed as part of an NDA, a BLA, or an amendment to an NDA or a BLA, and must be
consistent with the FDA-approved labeling and dosage information for that product.
Pharmaceutical
and biologic products may be promoted only for the approved indications in accordance with the approved label. The FDA and other
agencies actively enforce the laws and regulations prohibiting the promotion of off-label uses, and a company that is found to
have improperly promoted off-label may be subject to significant liability. However, physicians may, in their independent medical
judgment, prescribe legally available products for off-label uses. The FDA does not regulate the behavior of physicians in their
choice of treatments but the FDA does restrict manufacturer’s communications on the subject of off-label use of their products.
Foreign
Regulation
Sales
of pharmaceutical products outside the U.S. are subject to foreign regulatory requirements that vary widely from country to country.
Even if FDA approval has been obtained, approval of a product by comparable regulatory authorities of foreign countries must be
obtained prior to the commencement of marketing the product in those countries. The time required to obtain such approval may
be longer or shorter than that required for FDA approval.
Federal
Funding and State Regulations
Effective
July 7, 2009, the National Institutes of Health (“NIH”) adopted guidelines on the use of hES cells in federally funded
research. The central focus of the guidelines is to assure that hES cells used in federally funded research are derived from human
embryos that were created for reproductive purposes, are no longer needed for this purpose, and are voluntarily donated for research
purposes with the informed written consent of the donors. hES cells that were not derived in compliance with the guidelines, are
not eligible for use in federally funded research.
The
state of California has adopted legislation and regulations that require institutions that conduct stem cell research to notify,
and in certain cases obtain approval from, a Stem Cell Research Oversight Committee (“SCRO Committee”) before conducting
the research. Under certain California regulations, all hES cell lines used in our research must be acceptably derived. California
regulations further require certain records to be maintained with respect to stem cell research and the materials used. Lineage
programs that involve the use of stem cells have been reviewed by a SCRO Committee to confirm compliance with federal and state
guidelines.
The
hES cell lines that we use are all on the NIH registry of lines that have been reviewed and meet standards for federal funding
grants. All of our research programs utilize stem cells from established and well-characterized cell lines and which are capable
of self-renewal and expansion through normal cellular division (mitosis). Our research programs do not require new tissue or cells
from donors of any kind.
Health
Insurance Portability and Accountability Act and Other Health Information Privacy and Security Laws
The
Health Insurance Portability and Accountability Act (“HIPAA”), as amended by the Health Information Technology for
Economic and Clinical Health Act (“HITECH”), and their respective implementing regulations impose obligations on “covered
entities,” including certain healthcare providers, health plans, and healthcare clearinghouses, as well as their respective
“business associates” that create, receive, maintain or transmit individually identifiable health information for
or on behalf of a covered entity, and their subcontractors that use, disclose, access, or otherwise process individually identifiable
protected health information, with respect to protecting the privacy, security, and transmission of protected health information.
HIPAA also regulates standardization of data content, codes and formats used in health care transactions and standardization of
identifiers for covered health plans and providers. Penalties for violations of HIPAA regulations include civil and criminal penalties.
Additionally, HITECH created four new tiers of civil monetary penalties, amended HIPAA to make civil and criminal penalties directly
applicable to business associates, and gave state attorneys general new authority to file civil actions for damages or injunctions
in U.S. federal courts to enforce HIPAA and seek attorneys’ fees and costs associated with pursuing federal civil actions.
In addition, certain state and foreign laws also govern the privacy and security of health information in some circumstances,
many of which differ from each other in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.
21
Federal
and State Fraud and Abuse Laws
A
variety of federal and state laws prohibit fraud and abuse. These laws are interpreted broadly and enforced aggressively by various
state and federal agencies, including the Centers for Medicare & Medicaid Services (“CMS”), the Department of
Justice, the Office of Inspector General for HHS, and various state agencies. In addition, the Medicare and Medicaid programs
increasingly use a variety of contractors to review claims data and to identify improper payments as well as fraud and abuse.
These contractors include Recovery Audit Contractors, Medicaid Integrity Contractors and Zone Program Integrity Contractors. In
addition, CMS conducts Comprehensive Error Rate Testing audits, the purpose of which is to detect improper Medicare payments.
Any overpayments identified must be repaid unless a favorable decision is obtained on appeal. In some cases, these overpayments
can be used as the basis for an extrapolation, by which the error rate is applied to a larger universe of claims, and which can
result in even higher repayments.
The
federal Anti-Kickback Statute prohibits, among other things, knowingly and willfully offering, paying, soliciting, receiving,
or providing remuneration, directly or indirectly, to induce or in return for either the referral of an individual, or the furnishing,
recommending, or arranging for the purchase, lease or order of any health care item or service reimbursable, in whole or in part,
under a federal health care program. The definition of “remuneration” has been broadly interpreted to include anything
of value, including gifts, discounts, credit arrangements, payments of cash, ownership interests and providing anything at less
than its fair market value. Recognizing that the federal Anti- Kickback Statute is broad and may prohibit certain common activities
within the health care industry, the Office of Inspector General for HHS has issued a series of statutory exceptions and regulatory
“safe harbors.” However, these exceptions and safe harbors are drawn narrowly and require strict compliance in order
to offer protection from prosecution under the federal Anti-Kickback Statute. Although full compliance with these provisions ensures
against prosecution under the federal Anti-Kickback Statute, the failure of a transaction or arrangement to fit within a specific
safe harbor does not necessarily mean that the transaction or arrangement is illegal or that prosecution under the federal Anti-Kickback
Statute will be pursued. However, conduct and business arrangements that do not fully satisfy all requirements of an applicable
safe harbor may result in increased scrutiny by government enforcement authorities and would be evaluated on a case-by-case basis
based on a cumulative review of their facts and circumstances. Additionally, the Patient Protection and Affordable Care Act, as
amended by the Health Care and Education Reconciliation Act (collectively, the “ACA”) codified case law 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
federal civil and criminal false claims laws, including the federal False Claims Act, which can be enforced by private citizens
on behalf of the government, through civil whistleblower or qui tam actions, and civil monetary penalty laws, which prohibit,
among other things, individuals or entities from knowingly presenting, or causing to be presented, claims for payment from Medicare,
Medicaid, or other third-party payors that are false or fraudulent. Pharmaceutical and other health care companies have been prosecuted
under these laws for alleged off-label promotion of drugs, purportedly concealing price concessions in the pricing information
submitted to the government for government price reporting purposes, and allegedly providing free product to customers with the
expectation that the customers would bill federal healthcare programs for the product. As a result of a modification made by the
Fraud Enforcement and Recovery Act of 2009, a claim includes “any request or demand” for money or property presented
to the U.S. government. In addition, manufacturers can be held liable under the federal False Claims Act even when they do not
submit claims directly to government payors if they are deemed to “cause” the submission of false or fraudulent claims.
HIPAA
also created new federal crimes, including health care fraud and false statements relating to health care matters. The health
care fraud statute prohibits knowingly and willfully executing a scheme to defraud any health care benefit program, including
private third-party payers. The false statements statute prohibits 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 health care 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.
22
The
federal Physician Payments Sunshine Act which require certain manufacturers of drugs, devices, biologics and medical supplies
for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program (with certain exceptions)
to report annually to CMS information related to payments or other transfers of value made to physicians (defined to include doctors,
dentists, optometrists, podiatrists, and chiropractors) and teaching hospitals, as well as ownership and investment interests
held by physicians and their immediate family members. Beginning in 2022, applicable manufacturers will also be required to report
information regarding payments and other transfers of value provided during the previous year to physician assistants, nurse practitioners,
clinical nurse specialists, certified nurse anesthetists and anesthesiologist assistants, and certified nurse-midwives.
Many
states have laws similar to the federal laws described above and the state laws may be broader in scope and may apply regardless
of payor, such as state anti-kickback and false claims laws that may apply to sales or marketing arrangements and claims involving
healthcare items or services reimbursed by non-governmental third party payors, including private insurers, or that apply regardless
of payor, state laws that require pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance
guidelines and the relevant compliance guidance promulgated by the federal government, state and local laws that require drug
manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers
or marketing expenditures, state laws that require the reporting of information related to drug pricing, and state and local laws
requiring the registration of pharmaceutical sales representatives.
Additionally,
the U.S. Foreign Corrupt Practices Act (“FCPA”) prohibits U.S. corporations and their representatives from offering,
promising, authorizing or making payments to any foreign government official, government staff member, political party or political
candidate in an attempt to obtain or retain business abroad. The scope of the FCPA includes interactions with certain healthcare
professionals in many countries. Other countries have enacted similar anti-corruption laws and/or regulations.
If
our operations are found to be in violation of any of the laws described above, or any other governmental regulations that apply
to us, we may be subject significant civil, criminal and administrative penalties, including sanctions, damages, disgorgement,
monetary fines, possible exclusion from participation in Medicare, Medicaid and other federal healthcare programs, imprisonment,
integrity oversight and reporting obligations, contractual damages, reputational harm, diminished profits and future earnings,
and curtailment or restructuring of our operations.
Coverage
and Reimbursement
Patients
generally rely on third-party payors to reimburse part or all of the costs associated with medical products. Accordingly, market
acceptance of medical products can depend on the extent to which third-party coverage and reimbursement is available from government
health administration authorities, private healthcare insurers and other healthcare funding organizations. No uniform policy for
coverage and reimbursement exists in the United States, and coverage and reimbursement can differ significantly from payor to
payor. Decisions regarding whether to cover any of our product candidates, if approved, the extent of coverage and amount of reimbursement
to be provided are made on a plan-by-plan basis. Third-party payors often rely upon Medicare coverage policy and payment limitations
in setting their own reimbursement rates, but also have their own methods and approval process apart from Medicare determinations.
As a result, the coverage determination process is often a time-consuming and costly process that will require us to provide scientific
and clinical support for the use of our product candidates to each payor separately, with no assurance that coverage and adequate
reimbursement will be applied consistently or obtained in the first instance. Pharmaceutical companies may be required to provide
specified rebates or discounts on the products it sells to certain government funded programs, including Medicare and Medicaid,
and those rebates or discounts have increased over time. The ACA increased many of these mandatory discounts and rebates required
and imposed a new branded prescription pharmaceutical manufacturers and importers fee payable each year by certain pharmaceutical
companies and manufacturers.
Outside
of the United States, the proposed pricing for a drug must be approved before it may be lawfully marketed. The requirements governing
drug pricing vary widely from country to country. For example, the EU provides options for its member states to restrict the range
of medicinal products for which their national health insurance systems provide reimbursement and to control the prices of medicinal
products for human use. A member state may approve a specific price for the medicinal product, or it may instead adopt a system
of direct or indirect controls on the profitability of the company placing the medicinal product on the market. Historically,
products launched in the EU do not follow price structures of the United States and generally tend to be significantly lower.
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Healthcare
Reform
The
United States and some foreign jurisdictions are considering or have enacted a number of reform proposals to change the healthcare
system. There is significant interest in promoting changes in healthcare systems with the stated goals of containing healthcare
costs, improving quality or expanding access. In the United States, the pharmaceutical industry has been a particular focus of
these efforts and has been significantly affected by federal and state legislative initiatives, including those designed to limit
the pricing, coverage, and reimbursement of pharmaceutical and biopharmaceutical products, especially under government-funded
health care programs, and increased governmental control of drug pricing.
In
March 2010, the ACA was signed into law, which substantially changed the way healthcare is financed by both governmental and private
insurers in the United States, and significantly affected the pharmaceutical industry. The ACA contains a number of provisions
of particular import to the pharmaceutical and biotechnology industries, including, but not limited to, those governing enrollment
in federal healthcare programs, 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, and annual fees based on pharmaceutical
companies’ share of sales to federal health care programs. Since its enactment, there have been judicial, Congressional,
and executive branch challenges to certain aspects of the ACA, and we expect there will be additional challenges and amendments
to the ACA in the future. For example, the 2020 federal spending package permanently eliminated, effective January 1, 2020, the
ACA-mandated “Cadillac” tax on high-cost employer-sponsored health coverage and medical device tax and, effective
January 1, 2021, also eliminated the health insurer tax. In addition, legislation enacted in 2017, informally known as the Tax
Cuts and Jobs Act (the “2017 Tax Act”), among other things, removes penalties for not complying with ACA’s
individual mandate to carry health insurance. Since the enactment of the 2017 Tax Act, there have been additional amendments to
certain provisions of the ACA. On December 14, 2018, a U.S. District Court Judge in the Northern District of Texas, ruled that
the individual mandate is a critical and inseverable feature of the ACA, and therefore, because it was repealed as part of the
2017 Tax Act, the remaining provisions of the ACA are invalid as well. Additionally, on December 18, 2019, the U.S. Court of Appeals
for the 5th Circuit upheld the District Court ruling that the individual mandate was unconstitutional and remanded the case back
to the District Court to determine whether the remaining provisions of the ACA are invalid as well. The U.S. Supreme Court is
currently reviewing the case, although it is unknown when or how the Supreme Court will rule. Accordingly, it is unclear how this
decision, future decisions, subsequent appeals, if any, and other efforts to repeal and replace the ACA will impact the ACA.
Moreover,
there has recently been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed
products, which has resulted in several Congressional inquiries and proposed and enacted federal and state legislation designed
to, among other things, bring more transparency to product pricing, review the relationship between pricing and manufacturer patient
programs, and reform government program reimbursement methodologies for drug products. At the federal level, the Trump administration’s
budget proposal for fiscal year 2021 includes a $135 billion allowance to support legislative proposals seeking to reduce drug
prices, increase competition, lower out-of-pocket drug costs for patients, and increase patient access to lower-cost generic and
biosimilar drugs. Further, the Trump administration released a “Blueprint”, or plan, to lower drug prices and reduce
out of pocket costs of drugs that contains additional proposals to increase drug manufacturer competition, increase the negotiating
power of certain federal healthcare programs, incentivize manufacturers to lower the list price of their products, and reduce
the out of pocket costs of drug products paid by consumers. The likelihood of implementation of any of these, or the other Trump
administration reform initiatives is uncertain, particularly in light of the new presidential administration. At the state level,
legislatures have increasingly passed legislation and implemented regulations designed to control pharmaceutical product pricing,
including price or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure
and transparency measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing. Further,
it is possible that additional governmental action is taken in response to the COVID-19 pandemic.
24
Major
Customers and Sources of Revenues
Major
Sources of Revenues
The
following table shows our major sources of revenues, as a percentage of total revenues, that were recognized during the years
ended December 31, 2020 and 2019:
Year Ended December 31,
Sources of Revenues
2020
2019
NIH grant income
21.2 %
17.5 %
IIA grant income (Cell Cure Neurosciences Ltd, Israel)
36.5 %
40.5 %
Royalties from product sales and licenses fees
42.3 %
34.7 %
Sale of research products
- %
7.3 %
Geographic
Area
Year Ended December 31,
2020
2019
United States
$ 1,160
$ 2,092
Foreign (1)
666
1,423
Total revenues
$ 1,826
$ 3,515
(1)
Foreign revenues are primarily generated from grants in Israel.
Marketing
Therapeutic
Products and Medical Devices
Because
our planned therapeutic products and medical devices are still in the research and development stage, we will not initially need
to have our own marketing personnel. If we or our subsidiaries are successful in developing marketable therapeutic products and
medical devices, we will need to build our own marketing and distribution capability for those products, which would require the
investment of significant financial and management resources, or we and our subsidiaries will need to find collaborative marketing
partners, independent sales representatives, or wholesale distributors for the commercial sale of those products.
If
we market products through arrangements with third parties, we may pay sales commissions to sales representatives or we may sell
or consign products to distributors at wholesale prices. This means that our gross profit from product sales may be less than
would be the case if we were to sell our products directly to end users at retail prices through our own sales force. On the other
hand, selling to distributors or through independent sales representatives would allow us to avoid the cost of hiring and training
our own sales employees. There can be no assurance we will be able to negotiate distribution or sales agreements with third parties
on favorable terms to justify our investment in our products or achieve sufficient revenues to support our operations.
Competition
We
face substantial competition in all fields of business in which we engage. That competition is likely to intensify as new products
and technologies reach the market. Superior new products are likely to sell for higher prices and generate higher profit margins
if acceptance by the medical community is achieved. Those companies that are successful at being the first to introduce new products
and technologies to the market may gain significant economic advantages over their competitors in the establishment of a customer
base and track record for the performance of their products and technologies. Such companies will also benefit from revenues from
sales that could be used to strengthen their research and development, production, and marketing resources. Companies engaged
in the medical products industry face the risk of obsolescence of their products and technologies as more advanced or cost-effective
products and technologies are developed by competitors. As the industry matures, companies will compete based upon the performance
and cost-effectiveness of their products. Specific efforts in the development of treatments for dry AMD include, but are not limited
to, neuroprotection, reducing by-product accumulation, and suppressing inflammation. Specific approaches include small molecules,
antibodies, and cell therapies. Some of these efforts have reached clinical development and at least one approach, complement
inhibition, is currently in a Phase 3 clinical trial. We believe that replacing the entire cell rather than attempts to fix one
aberrant pathway or signal confer a greater probability of success for individuals suffering with dry AMD.
25
Products
for Regenerative Medicine
The
cell therapy industry is characterized by rapidly evolving technology and intense competition. Our competitors include major multinational
pharmaceutical companies, specialty biotechnology companies, and chemical and medical products companies operating in the fields
of regenerative medicine, cell therapy, tissue engineering, and tissue regeneration. Many of these companies are well established
and possess technical, research and development, financial, and sales and marketing resources significantly greater than ours.
In addition, certain smaller biotech companies have formed strategic collaborations, partnerships, and other types of joint ventures
with larger, well-established industry competitors that afford the smaller companies’ potential research and development
as well as commercialization advantages. Academic institutions, governmental agencies, and other public and private research organizations
are also conducting and financing research activities, which may produce products directly competitive to those we are developing.
We
believe that some of our competitors are trying to develop pluripotent cells and human embryonic progenitor cell-based technologies
and products that may compete with our stem cell products based on efficacy, safety, cost, and intellectual property positions.
Ocata Therapeutics, Inc. (“Ocata”), which was acquired by a subsidiary of Astellas Pharma Inc. for approximately $379
million in 2016, and Retinal Patch Technologies Inc. have conducted clinical trials of hES cell products designed to treat dry
AMD. If their products are proven to be safe and effective, they may reach the market ahead of OpRegen.
We
may also face competition from companies that have filed patent applications relating to the propagation and differentiation of
stem cells. Those companies include Ocata, which in 2015 had certain U.S. patents issue with claims directed to methods of producing
RPE cells and isolating and purifying such cells. We may be required to seek licenses from these competitors in order to commercialize
certain products proposed by us, and such licenses may not be granted.
ITEM
1A.
RISK
FACTORS
Our
business is subject to various risks, including those described below. You should consider the following risk factors, together
with all of the other information included in this report, which could materially adversely affect our proposed operations, our
business prospects, and financial condition, and the value of an investment in our business. There may be other factors that are
not mentioned here or of which we are not presently aware that could also affect our business operations and prospects.
Risks
Related to Our Business Operations and Capital Requirements
We
have incurred operating losses since inception, and we do not know if or when we will attain profitability.
Our
total operating losses for the fiscal years ended December 31, 2020 and 2019 were $26.4 million and $38.9 million, respectively,
and we had an accumulated deficit of $294.1 million as of December 31, 2020. Since inception, we have incurred significant operating
losses and have funded our operations primarily through sales of our equity securities and the equity securities of former subsidiaries,
receipt of research grants, royalties on product sales, license revenues, sales of research products, and revenues from subscription
fees and advertising revenue from database products of a former subsidiary. Substantially all of our losses have resulted from
expenses incurred in connection with our research and development programs and from general and administrative costs associated
with our operations. All of our product candidates will require substantial additional development time and resources before we
would be able to apply for or receive regulatory approvals. We expect to continue to incur losses for the foreseeable future,
and we anticipate these losses will increase substantially as we continue our development of, seek regulatory approval for and
potentially commercialize any of our product candidates and seek to identify, assess, acquire, in-license or develop additional
product candidates.
To
become and remain profitable, we must succeed in developing and eventually commercializing products that generate significant
revenue. This will require us to be successful in a range of challenging activities, including completing clinical trials and
preclinical trials of our product candidates, obtaining regulatory approval for these product candidates and manufacturing, marketing
and selling any products for which we may obtain regulatory approval. In addition, we are attempting to develop new medical products
and technology. We may never succeed in these activities and, even if we do, may never generate revenues that are significant
enough to achieve profitability.
26
We
will continue to spend a substantial amount of our capital on research and development, but we might not succeed in developing
products and technologies that are useful in medicine.
We
are attempting to develop new medical products and technology. These new products and technologies might not prove to be safe
and efficacious in the human medical applications for which they are being developed. Our research and development activities
are costly, time consuming, and their results are uncertain. We incurred research and development expenses amounting to approximately
$12.3 million and $17.9 million during the fiscal years ended December 31, 2020 and 2019, respectively. If we successfully
develop a new technology or product, refinement of the new technology or product and definition of the practical applications
and limitations of the technology or product may take years and require large sums of money. Clinical trials of new therapeutic
products, particularly those products that are regulated as biologics, drugs, or devices, are very expensive and take years to
complete. We may not have the financial resources to fund clinical trials on our own and we may have to enter into licensing or
collaborative arrangements with others. Any such arrangements may be dilutive to our ownership or economic interest in the products
we develop, and we might have to accept royalty payments on product sales rather than receiving the gross revenues from product
sales. In addition, we may discontinue one or more of the research or product development programs. Our product and technology
development programs may be delayed or discontinued should adequate funding on acceptable terms not be available.
The
amount and pace of research and development work that we can do or sponsor, and our ability to commence and complete clinical
trials required to obtain regulatory approval to market our therapeutic and medical device products, depends upon the amount of
funds we have.
At
December 31, 2020, we had $41.6 million of cash, cash equivalents and marketable equity securities. There can be no assurance
that we will be able to raise additional funds on favorable terms or at all, or that any funds raised will be sufficient to permit
us to develop and market our products and technology, if and when approved. Our ability to raise additional funds may be adversely
impacted by deteriorating global economic conditions and the disruptions to and volatility in the credit and financial markets
in the United States and worldwide resulting from the ongoing COVID-19 pandemic. Unless we are able to generate sufficient revenue
or raise additional funds when needed, it is likely that we will be unable to continue our planned activities, even if we make
progress in our research and development projects. We may have to postpone or limit the pace of our research and development work
and planned clinical trials of our product candidates unless our cash resources increase through a growth in revenues, royalties,
license fees, equity financings or borrowings.
We
will need to issue additional equity or debt securities in order to raise additional capital needed to pay our operating expenses.
We
expect to continue to incur substantial research and product development expenses and will need to raise additional capital to
pay operating expenses until we are able to generate sufficient revenues from product sales, royalties and license fees. Our ability
to raise additional equity or debt capital will depend, not only on progress made in developing new products and technologies,
but also on access to capital and conditions in the capital markets. We believe that our cash, cash equivalents and marketable
securities as of December 31, 2020 will be sufficient to fund our planned operations for at least the next 12 months. We have
based these estimates on assumptions that may prove to be wrong, and we may use our capital resources sooner than we currently
expect. Our operating plans and other demands on our cash resources may change as a result of many factors currently unknown to
us, and we may need to seek additional funds sooner than planned. Any equity capital raise could result in the dilution of the
interests of shareholders or may otherwise limit our ability to finance further in the future, which may negatively impact our
business and operations. Any debt capital financing may involve covenants that restrict our operations, including limitations
on additional borrowing and on the use of our assets. If we raise capital through licensing arrangements, it may be necessary
to grant licenses on terms that are not favorable to us. There can be no assurance that we will be able to raise capital on favorable
terms, or at all, or at times and in amounts needed to successfully finance product development, clinical trials, and general
operations.
Lawsuits
have been filed and other lawsuits may be filed against Lineage and certain members of the Lineage and Asterias Biotherapeutics,
Inc. (“Asterias”) boards of directors relating to our acquisition of Asterias (the “Asterias Merger”).
An adverse ruling in any such lawsuit may result in additional payments and costs.
A
putative class action lawsuit alleging breach of fiduciary duties in connection with the Asterias Merger is pending in the Delaware
Chancery Court. As of December 31, 2020, the defendants are certain former members of Asterias’ board of directors and Lineage.
The complaint alleges that the merger process was conflicted, that the consideration was inadequate, and that the proxy statement
filed by Asterias was misleading. The complaint seeks, among other things, certification of a class, rescission of the merger
or monetary damages, and attorneys’ fees and costs.
27
The
defendants specifically deny all allegations in the litigation and intend to defend it vigorously. However, any adverse ruling
in this case could result in additional payments. Additional lawsuits arising out of or relating to the merger agreement and/or
the merger may be filed in the future.
Changes
in tax laws or regulations that are applied adversely to us or our customers may have a material adverse effect on our business,
cash flow, financial condition or results of operations.
New
income, sales, use or other tax laws, statutes, rules, regulations or ordinances could be enacted at any time, which could adversely
affect our business operations and financial performance. Further, existing tax laws, statutes, rules, regulations or ordinances
could be interpreted, changed, modified or applied adversely to us. For example, the 2017 Tax Act, enacted many significant changes
to the U.S. tax laws. Future guidance from the Internal Revenue Service and other tax authorities with respect to the 2017 Tax
Act may affect us, and certain aspects of the 2017 Tax Act could be repealed or modified in future legislation. For example, the
Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) and the Consolidated Appropriations Act, 2021
(CA) modified certain provisions of the 2017 Tax Act. In addition, it is uncertain if and to what extent various states will conform
to the 2017 Tax Act, the CARES Act, or any newly enacted federal tax legislation. Changes in corporate tax rates, the realization
of net deferred tax assets relating to our operations, the taxation of foreign earnings, and the deductibility of expenses under
the 2017 Tax Act or future reform legislation could have a material impact on the value of our deferred tax assets, could result
in significant one-time charges, and could increase our future U.S. tax expense.
Our
ability to use net operating losses and other tax attributes to offset future taxable income or taxes may be subject to limitations.
As
of December 31, 2020, we had net operating loss (“NOL”) carryforwards for U.S. federal and state tax purposes of approximately
$169.9 million and $118.6 million, respectively. Included in these amounts are NOLs acquired through the merger with Asterias
(see below). A portion of the federal and state NOL carryforwards will begin to expire, if not utilized, in varying amounts between
2027 and 2037. NOLs that expire unused will be unavailable to offset future income tax liabilities. Under federal income tax law,
federal NOLs incurred in tax years beginning after December 31, 2017, may be carried forward indefinitely, but the deductibility
of such NOLs in tax years beginning after December 31, 2020, is limited to 80% of taxable income. It is uncertain if and to what
extent various states that we may operate in will conform to the federal tax law. In addition, under Sections 382 and 383 of the
Internal Revenue Code of 1986, as amended (the “IRC”), and corresponding provisions of state law, if a corporation
undergoes an “ownership change,” which is generally defined as a greater than 50% change, by value, in its equity
ownership over a three-year period, the corporation’s ability to use its pre-change NOL carryforwards and other pre-change
tax attributes to offset its post-change income or taxes may be limited. We may experience ownership changes in the future as
a result of subsequent shifts in our stock ownership, some of which may be outside of our control. If an ownership change occurs
and our ability to use our NOL carryforwards is materially limited, it would harm our future operating results by effectively
increasing our future tax obligations. In addition, at the state level, there may be periods during which the use of net operating
loss carryforwards is suspended or otherwise limited, which could accelerate or permanently increase state taxes owed. For example,
in 2020 California enacted A.B. 85 which imposed limits on the usability of California state net operating losses and certain
tax credits in tax years beginning after 2019 and before 2023.
As
part of the merger with Asterias, we acquired various tax attribute carryforwards including federal and California NOLs of $52.8
million and $41.9 million, respectively, as well as California research and development credits of $2.4 million. As a result of
the merger, Asterias incurred an ownership change under Section 382 of the IRC, which places annual limits on the amount of these
NOLs that are available to offset income. Because of the annual limitation, the total amount of these NOLs is not immediately
available to offset future income. The California research and development credit of $2.4 million has no expiration date.
28
Taxing
authorities could reallocate our taxable income among our subsidiaries, which could increase our overall tax liability.
We
are organized in the United States, and currently have subsidiaries in Israel and Singapore. If we succeed in growing our business,
we expect to conduct increased operations through subsidiaries in various tax jurisdictions pursuant to transfer pricing arrangements
between us and our subsidiaries. If two or more affiliated companies are located in different countries, the tax laws or regulations
of each country generally will require that such arrangements be priced the same as those between unrelated companies dealing
at arm’s length and that appropriate documentation is maintained to support the value of such arrangements. Our transfer
pricing policies were formulated with the assistance of third-party experts. We are in the process of obtaining a formal transfer
pricing report. However, after we receive such report, we do not intend to amend our returns for prior years. Whether we obtain
a formal transfer pricing study with outside experts or not, our transfer pricing procedures will not be binding on applicable
tax authorities.
If
tax authorities in any of these countries were to successfully challenge our transfer prices as not reflecting arm’s length
transactions, they could require us to adjust our transfer prices and thereby reallocate our income to reflect these revised transfer
prices, which could result in a higher tax liability to us. In addition, if the country from which the income is reallocated does
not agree with the reallocation, both countries could tax the same income, resulting in double taxation. If tax authorities were
to allocate income to a higher tax jurisdiction, subject our income to double taxation or assess interest and penalties, it would
increase our tax liability, which could adversely affect our financial condition, results of operations and cash flows.
Our
business and operations could suffer in the event of system failures.
Despite
the implementation of security measures, our internal computer systems and those of our contractors and consultants are vulnerable
to damage from computer viruses, unauthorized access, natural disasters including earthquakes and tsunamis, terrorism, war, and
telecommunication and electrical failures. Such events could cause significant interruption of our operations and development
programs. For example, the loss of data for our product candidates could result in delays in our regulatory filings and development
efforts and significantly increase our costs. To the extent that any disruption or security breach was to result in a loss of
or damage to our data, or inappropriate disclosure of confidential or proprietary information, we could incur liability and the
development of our product candidates could be delayed.
In
addition, our product candidates are manufactured by starting with cells that are stored in a cryopreserved master cell bank.
While we believe we have adequate backup should any cell bank be lost in a catastrophic event, we or our third-party suppliers
and manufacturers could lose multiple cell banks, which would severely affect our manufacturing activities. We cannot assure you
that any stability or other issues relating to the manufacture of any of our product candidates or products will not occur in
the future. Any delay or interruption in the supply of clinical trial supplies could delay the completion of planned clinical
trials, increase the costs associated with maintaining clinical trial programs and, depending upon the period of delay, require
us to commence new clinical trials at additional expense or terminate clinical trials completely. Any adverse developments affecting
clinical or commercial manufacturing of our product candidates or products may result in shipment delays, inventory shortages,
lot failures, product withdrawals or recalls or other interruptions in the supply of our product candidates or products. Accordingly,
failures or difficulties faced at any level of our supply chain could adversely affect our business and delay or impede the development
and commercialization of any of our product candidates or products and could have an adverse effect on our business, prospects,
financial condition and results of operations.
Significant
disruptions of information technology systems or data security breaches could adversely affect our business.
We
are increasingly dependent on information technology systems and infrastructure to operate our business. In the ordinary course
of our business, we collect, store, process and transmit large amounts of confidential information, including intellectual property,
proprietary business information and personal information. It is critical that we do so in a secure manner to maintain the confidentiality,
integrity and availability of such information. We have also outsourced some of our operations (including parts of our information
technology infrastructure) to a number of third-party vendors who may have, or could gain, access to our confidential information.
In addition, many of those third parties, in turn, subcontract or outsource some of their responsibilities to third parties.
29
Our
information technology systems are large and complex and store large amounts of confidential information. The size and complexity
of these systems make them potentially vulnerable to service interruptions or to security breaches from inadvertent or intentional
actions by our employees, third party vendors and/or business partners, or from cyber-attacks by malicious third parties. Attacks
of this nature are increasing in frequency, persistence, sophistication and intensity, and are being conducted by sophisticated
and organized groups and individuals with a wide range of motives (including, but not limited to, industrial espionage) and expertise,
including organized criminal groups, “hacktivists,” nation states and others. In addition to the extraction of important
information, such attacks could include the deployment of harmful malware, ransomware, denial-of-service attacks, social engineering
and other means to affect service reliability and threaten the confidentiality, integrity and availability of our information.
Although the aggregate impact on our operations and financial condition has not been material to date, we have been the target
of events of this nature and expect them to continue.
Significant
disruptions of our, our third party vendors’ and/or business partners’ information technology systems or security
breaches could adversely affect our business operations and/or result in the loss, misappropriation, and/or unauthorized access,
use or disclosure of, or the prevention of access to, confidential information (including trade secrets or other intellectual
property, proprietary business information and personal information), and could result in financial, legal, business and reputational
harm to us. Any such event that leads to unauthorized access, use or disclosure of personal information, including personal information
regarding our patients or employees, could harm our reputation, compel us to comply with federal and/or state breach notification
laws and foreign law equivalents, subject us to mandatory corrective action, require us to verify the correctness of database
contents and otherwise subject us to liability under laws and regulations that protect the privacy and security of personal information,
which could disrupt our business, result in increased costs or loss of revenue, and/or result in significant legal and financial
exposure. In addition, security breaches and other inappropriate access can be difficult to detect, and any delay in identifying
them may further harm us. Moreover, the prevalent use of mobile devices to access confidential information increases the risk
of security breaches. While we have implemented security measures to protect our information technology systems and infrastructure,
there can be no assurance that such measures will prevent service interruptions or security breaches that could adversely affect
our business. In addition, failure to maintain effective internal accounting controls related to security breaches and cybersecurity
in general could impact our ability to produce timely and accurate financial statements and subject us to regulatory scrutiny.
Our
business could be adversely affected if we lose the services of the key personnel upon whom we depend or if we fail to attract
senior management and key scientific personnel.
We
believe that our continued success depends to a significant extent upon our efforts and ability to retain highly qualified personnel,
including our Chief Executive Officer, Brian Culley. All of our officers and other employees are at-will employees and may terminate
their employment with us at any time with no advance notice. The loss of the services of Mr. Culley or other members of our senior
management could have a material adverse effect on us. Further, the replacement of any of such individuals likely would involve
significant time and costs and may significantly delay or prevent the achievement of our business and clinical objectives and
would harm our business.
In
addition, we could experience difficulties attracting qualified employees in the future. For example, competition for qualified
personnel in the biotechnology and medical device field is intense due to the limited number of individuals who possess the skills
and experience required by our industry. We will need to hire additional personnel, including experienced sales representatives,
as we expand our clinical development and commercial activities. We may not be able to attract quality personnel on acceptable
terms, or at all. In addition, to the extent we hire personnel from competitors, we may be subject to allegations that they have
been improperly solicited or that they have divulged proprietary or other confidential information or that their former employers
own their research output.
The
value of our investments in public companies fluctuates based on their respective stock prices and could be negatively affected
by business, regulatory and other risks applicable to them.
As
of December 31, 2020, we had an equity investment in OncoCyte, a U.S. publicly traded company. As of December 31, 2020, the value
of our investment in OncoCyte was approximately $8.7 million based on its closing stock price as of that date. If OncoCyte were
to have delays in clinical trials or commercialization activities or otherwise realize the specific business, regulatory and other
risks applicable to them, the value of its common stock and the valuation of our investment could be negatively affected. If OncoCyte
were to fail and ultimately cease operations, we may lose the entire value of our investment. In addition, the value of our marketable
equity securities may be significantly and adversely impacted by deteriorating global economic conditions and the disruptions
to and volatility in the credit and financial markets in the United States and worldwide resulting from the ongoing COVID-19 pandemic.
30
Failure
of our internal control over financial reporting could harm our business and financial results.
Our
management is responsible for establishing and maintaining adequate internal control over financial reporting. Because of its
inherent limitations, internal control over financial reporting is not intended to provide absolute assurance that a misstatement
of our financial statements would be prevented or detected. Our growth and entry into new products, technologies and markets will
place significant additional pressure on our system of internal control over financial reporting. Any failure to maintain an effective
system of internal control over financial reporting could limit our ability to report our financial results accurately and timely
or to detect and prevent fraud. Operating our business through subsidiaries, some of which are located in foreign countries, also
adds to the complexity of our internal control over financial reporting and adds to the risk of a system failure, an undetected
improper use or expenditure of funds or other resources by a subsidiary, or a failure to properly report a transaction or financial
results of a subsidiary. We allocate certain expenses among Lineage itself and one or more of our subsidiaries, which creates
a risk that the allocations we make may not accurately reflect the benefit of an expenditure or use of financial or other resources
by Lineage as the parent company and the subsidiaries among which the allocations are made. An inaccurate allocation may impact
our consolidated financial results, particularly in the case of subsidiaries that we do not wholly own since our financial statements
include adjustments to reflect the minority ownership interests in our subsidiaries held by others.
If
we identify material weaknesses in our internal control over financial reporting, if we are unable to comply with the requirements
of Section 404 of the Sarbanes-Oxley Act in a timely manner or assert that our internal control over financial reporting is effective,
or if our independent registered public accounting firm is unable to express an opinion or expresses a qualified or adverse opinion
about the effectiveness of our internal control over financial reporting, investors may lose confidence in the accuracy and completeness
of our financial reports and the market price of our common shares could be negatively affected. In addition, we could become
subject to investigations by the NYSE American, the Securities and Exchange Commission, and other regulatory authorities, which
could require additional financial and management resources.
We
received a loan under the Paycheck Protection Program of the CARES Act, and all or a portion of the loan may not be forgivable.
In
April 2020, we received a loan for $523,305 from Axos Bank under the Paycheck Protection Program (“PPP”) contained
within the new CARES Act. The PPP loan has a term of two years, is unsecured, and is guaranteed by the U.S. Small Business Administration
(SBA). The loan carries a fixed interest rate of one percent per annum, with the first six months of interest deferred. Under
the CARES Act and Paycheck Protection Program Flexibility Act, we are eligible to apply for forgiveness of all loan proceeds used
to pay payroll costs, rent, utilities and other qualifying expenses during the 24-week period following receipt of the loan, provided
that we maintain our number of employees and compensation within certain parameters during such period. Not more than 40% of the
forgiven amount may be for non-payroll costs. If the conditions outlined in the PPP loan program are adhered to by us, all or
part of such loan could be forgiven. However, we cannot provide any assurance that any amount of the PPP loan will ultimately
be forgiven by the SBA. Any forgiven amounts will not be included in our taxable income. We applied for full forgiveness of the
PPP loan on September 30, 2020.
Risks
Related to Government Regulation
We
may be subject, directly or indirectly, to federal and state healthcare fraud and abuse laws, including anti-kickback and false
claims laws, transparency laws, and health information privacy and security laws. If we are unable to comply, or have not fully
complied, with such laws, we could face substantial penalties.
Our
current and future operations may be subject to various federal and state fraud and abuse laws, including, without limitation,
the federal Anti-Kickback Statute, the federal False Claims Act, and healthcare professional transparency laws and regulations.
These laws may impact, among other things, our research activities and our proposed sales, marketing, and education programs.
In addition, we may be subject to patient privacy regulation by both the federal government and the states in which we conduct
our business. The laws that may affect our ability to operate include:
●
the
federal Anti-Kickback Statute, which prohibits, among other things, persons from knowingly and willfully soliciting, receiving,
offering or paying remuneration, directly or indirectly, to induce, or in return for, the purchase or recommendation of an
item or service reimbursable under a federal healthcare program, such as the Medicare and Medicaid programs;
31
●
federal
civil and criminal false claims laws, including the federal False Claims Act, and civil monetary penalty laws, which prohibit,
among other things, individuals or entities from knowingly presenting, or causing to be presented, claims for payment from
Medicare, Medicaid, or other third-party payors that are false or fraudulent;
●
the
federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), which created new federal criminal
statutes that prohibit, among other things, executing a scheme to defraud any healthcare benefit program and making false
statements relating to healthcare matters;
●
HIPAA,
as amended by the Health Information Technology for Economic and Clinical Health Act, (“HITECH”) and their implementing
regulations, which imposes certain requirements on covered entities,” including certain healthcare providers, health
plans, and healthcare clearinghouses, as well as their respective “business associates” that create, receive,
maintain or transmit individually identifiable health information for or on behalf of a covered entity, and their subcontractors
that use, disclose, access, or otherwise process individually identifiable protected health information, relating to the privacy,
security, and transmission of individually identifiable health information;
●
The
Physician Payments Sunshine Act which requires manufacturers of drugs, devices, biologics, and medical supplies to report
annually to CMS information related to payments and other transfers of value to physicians (defined to include doctors, dentists,
optometrists, podiatrists, and chiropractors) and teaching hospitals, and ownership and investment interests held by physicians
and other healthcare providers and their immediate family members and applicable group purchasing organizations, and, beginning
in 2020 will require applicable manufacturers to report information regarding payments and other transfers of value provided
during the previous year to physician assistants, nurse practitioners, clinical nurse specialists, certified nurse anesthetists
and anesthesiologist assistants, and certified nurse-midwives; and
●
state
law equivalents of each of the above federal laws, such as anti-kickback and false claims laws that may apply to items or
services reimbursed by any third-party payors, including commercial insurers, state laws that require pharmaceutical companies
to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant compliance guidance promulgated
by the federal government, or otherwise restrict payments that may be made to healthcare providers and other potential referral
sources; state laws that require drug manufacturers to report information related to payments and other transfers of value
to physicians and other healthcare providers, marketing expenditures, or drug pricing, state and local laws that require the
registration of pharmaceutical sales representatives, and state laws governing the privacy and security of health information
in certain circumstances, many of which differ from each other in significant ways and may not have the same effect, thus
complicating compliance efforts.
Because
of the breadth of these laws and the narrowness of the statutory exceptions and regulatory safe harbors available, it is possible
that some of our business activities could be subject to challenge under one or more of such laws. In addition, recent health
care reform legislation has strengthened these laws.
If
our operations are found to be in violation of any of the laws described above or any other governmental regulations that apply,
we may be subject to significant penalties, including administrative, civil and criminal penalties, damages, fines, disgorgement,
exclusion from participation in government health care programs, such as Medicare and Medicaid, integrity oversight and reporting
obligations, imprisonment, and the curtailment or restructuring of our operations, any of which could adversely affect our ability
to operate our business and our results of operations.
32
If
we do not receive regulatory approvals, we will not be permitted to sell our therapeutic and medical device products.
The
therapeutic and medical device products that we and our subsidiaries develop cannot be sold until the FDA and corresponding foreign
regulatory authorities approve the products for medical use. The need to obtain regulatory approval to market a new product means
that:
●
We
will have to conduct expensive and time-consuming clinical trials of new products. The full cost of conducting and completing
clinical trials necessary to obtain FDA and foreign regulatory approval of a new product cannot be presently determined but
could exceed our current financial resources.
●
Clinical
trials and the regulatory approval process for a pharmaceutical or cell-based product can take several years to complete.
As a result, we will incur the expense and delay inherent in seeking FDA and foreign regulatory approval of new products,
even if the results of clinical trials are favorable.
●
Data
obtained from preclinical and clinical studies is susceptible to varying interpretations and regulatory changes that could
delay, limit, or prevent regulatory agency approvals.
●
Because
the therapeutic products we are developing with pluripotent stem cell technology involve the application of new technologies
and approaches to medicine, the FDA or foreign regulatory agencies may subject those products to additional or more stringent
review than drugs or biologics derived from other technologies.
●
A
product that is approved may be subject to restrictions on use.
●
The
FDA can recall or withdraw approval of a product, if it deems necessary.
●
We
will face similar regulatory issues in foreign countries.
Government-imposed
bans or restrictions and religious, moral, and ethical concerns about the use of hES cells could prevent us from developing and
successfully marketing stem cell products.
Government-imposed
bans or restrictions on the use of embryos or hES cells in research and development in the United States and abroad could generally
constrain stem cell research, thereby limiting the market and demand for our products. During March 2009, President Obama lifted
certain restrictions on federal funding of research involving the use of hES cells, and in accordance with President Obama’s
Executive Order, the National Institutes of Health (“NIH”) has adopted guidelines for determining the eligibility
of hES cell lines for use in federally funded research. The central focus of the guidelines is to assure that hES cells used in
federally funded research were derived from human embryos that were created for reproductive purposes, were no longer needed for
this purpose, and were voluntarily donated for research purposes with the informed written consent of the donors. The hES cells
that were derived from embryos created for research purposes rather than reproductive purposes, and other hES cells that were
not derived in compliance with the guidelines, are not eligible for use in federally funded research. California law requires
that stem cell research be conducted under the oversight of a stem cell review oversight committee (“SCRO”). Many
kinds of stem cell research, including the derivation of new hES cell lines, may only be conducted in California with the prior
written approval of the SCRO. A SCRO could prohibit or impose restrictions on the research that we plan to do. The use of hES
cells may give rise to religious, moral, and ethical issues. These considerations could lead to more restrictive government regulations
or could generally constrain stem cell research, thereby limiting the market and demand for our products.
We
expect that the commercial opportunity for some of our products may depend on our ability to obtain reimbursement and continued
coverage from various payors, including government entities and insurance companies.
If
these third-party payors do not consider our products to be cost-effective compared to other therapies, they may not cover our
products as a benefit under their plans or, if they do, the level of payment may not be sufficient to allow us to sell our products
on a profitable basis.
33
For
example, in the United States, healthcare providers are reimbursed for covered services and products they deliver through Medicare,
Medicaid and other government healthcare programs, as well as through private payers. No uniform policy for coverage and reimbursement
exists in the United States, and coverage and reimbursement can differ significantly from payor to payor. Decisions regarding
whether to cover any of our product candidates, if approved, the extent of coverage and amount of reimbursement to be provided
are made on a plan-by-plan basis. Third-party payors often rely upon Medicare coverage policy and payment limitations in setting
their own reimbursement rates, but also have their own methods and approval process apart from Medicare determinations. As a result,
the coverage determination process is often a time-consuming and costly process that will require us to provide scientific and
clinical support for the use of our product candidates to each payor separately, with no assurance that coverage and adequate
reimbursement will be applied consistently or obtained in the first instance. We may be required to provide specified rebates
or discounts on the products we sell to certain government funded programs, including Medicare and Medicaid, and those rebates
or discounts have increased over time. The Patient Protection and Affordable Care Act, as amended by the Health Care and Education
Reconciliation Act (collectively, the “ACA”), enacted in 2010, increased many of the mandatory discounts and rebates
and imposed a new branded prescription pharmaceutical manufacturers and importers fee payable each year by certain manufacturers.
We
face similar issues outside of the United States. In some non-U.S. jurisdictions, the proposed pricing for a drug must be approved
before it may be lawfully marketed. The requirements governing drug pricing vary widely from country to country. For example,
the EU provides options for its member states to restrict the range of medicinal products for which their national health insurance
systems provide reimbursement and to control the prices of medicinal products for human use. A member state may approve a specific
price for the medicinal product, or it may instead adopt a system of direct or indirect controls on the profitability of the company
placing the medicinal product on the market. There can be no assurance that any country that has price controls or reimbursement
limitations for pharmaceutical products will allow favorable reimbursement and pricing arrangements for any of our products. Historically,
products launched in the EU do not follow price structures of the United States and generally tend to be significantly lower.
Disruptions
at the FDA and other government agencies caused by funding shortages or global health concerns could negatively impact our business.
The
ability of the FDA to review and approve proposed clinical trials or new product candidates can be affected by a variety of factors,
including, but not limited to, government budget and funding levels, ability to hire and retain key personnel and accept the payment
of user fees, statutory, regulatory, and policy changes, and other events that may otherwise affect the FDA’s ability to
perform routine functions. Average review times at the agency have fluctuated in recent years as a result. In addition, government
funding of other government agencies that fund research and development activities is subject to the political process, which
is inherently fluid and unpredictable.
Disruptions
at the FDA and other agencies may also slow the time necessary for new product candidates to be reviewed and/or approved by necessary
government agencies, which would adversely affect our business. For example, over the last several years, including for 35 days
beginning on December 22, 2018, the U.S. government has shut down several times and certain regulatory agencies, such as the FDA,
have had to furlough critical FDA employees and stop critical activities.
Separately,
in response to the global COVID-19 pandemic, in March 2020, the FDA announced its intention to postpone most foreign inspections
of manufacturing facilities and temporarily postponed routine surveillance inspections of domestic manufacturing facilities.
In July 2020 domestic inspections restarted only on a risk-based basis. Regulatory authorities outside the United States
may adopt similar restrictions or other policy measures in response to the COVID-19 pandemic. If a prolonged government shutdown
occurs, or if global health concerns continue to prevent the FDA or other regulatory authorities from conducting their regular
inspections, reviews, or other regulatory activities, it could significantly impact the ability of the FDA or other regulatory
authorities to timely review and process our regulatory submissions, which could have a material adverse effect on our business.
The
ACA and future changes to that law may adversely affect our business.
As
a result of the adoption of the ACA, in the United States, substantial changes have been made to the system for paying for healthcare
in the United States. Among the ACA’s provisions of importance to our industry are that it:
●
created
the branded prescription pharmaceutical manufacturers and importers annual fee;
●
increased
the statutory minimum rebates a manufacturer must pay under the Medicaid Drug Rebate Program, to 23.1% and 13% of the average
manufacturer price for most branded and generic drugs, respectively and capped the total rebate amount for innovator drugs
at 100% of the Average Manufacturer Price;
34
●
created
new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated for certain drugs
and biologics that are inhaled, infused, instilled, implanted or injected;
●
extended
manufacturers’ Medicaid rebate liability to covered drugs dispensed to individuals who are enrolled in Medicaid managed
care organizations;
●
expanded
eligibility criteria for Medicaid programs by, among other things, allowing states to offer Medicaid coverage to additional
individuals and by adding new mandatory eligibility categories for individuals with income at or below 133% of the federal
poverty level, thereby potentially increasing manufacturers’ Medicaid rebate liability;
●
expanded
the entities eligible for discounts under the Public Health program;
●
created
a new Patient-Centered Outcomes Research Institute to oversee, identify priorities in, and conduct comparative clinical effectiveness
research, along with funding for such research;
●
established
a Center for Medicare & Medicaid Innovation at the Centers for Medicare & Medicaid Services (“CMS”) to
test innovative payment and service delivery models to lower Medicare and Medicaid spending, potentially including prescription
drug spending; and
●
created
a licensure framework for follow on biologic products.
There
remain judicial and Congressional challenges to certain aspects of the ACA, as well as efforts by the Trump administration to
repeal or replace certain aspects of the ACA. Since January 2017, President Trump signed Executive Orders and other directives
designed to delay the implementation of certain provisions of the ACA. Concurrently, Congress has considered legislation that
would repeal or repeal and replace all or part of the ACA. While Congress has not passed comprehensive repeal legislation, it
has enacted laws that modify certain provisions of the ACA such as removing penalties, starting January 1, 2019, for not complying
with the ACA’s individual mandate to carry health insurance, and eliminating the implementation of certain ACA-mandated
fees. On December 14, 2018, a Texas U.S. District Court Judge ruled that the ACA is unconstitutional in its entirety because the
“individual mandate” was repealed by Congress as part of the 2017 Tax Act. Additionally, on December 18, 2019, the
U.S. Court of Appeals for the 5th Circuit upheld the District Court ruling that the individual mandate was unconstitutional and
remanded the case back to the District Court to determine whether the remaining provisions of the ACA are invalid as well. The
U.S. Supreme Court is currently reviewing the case, although it is uncertain when or how the Supreme Court will rule. It is unclear
how such litigation and other efforts to repeal and replace the ACA will impact the ACA and our business.
In
addition, other legislative changes have been proposed and adopted since the Affordable Care Act was enacted. For example, the
Budget Control Act of 2011, includes reductions to Medicare payments to providers of 2% per fiscal year, which went into effect
on April 1, 2013 and, due to subsequent legislative amendments to the statute, will remain in effect through 2030, with the exception
of a temporary suspension from May 1, 2020 through March 31, 2021, unless additional Congressional action is taken. On January
2, 2013, the American Taxpayer Relief Act of 2012 was signed into law, which, among other things, reduced Medicare payments to
several providers, including hospitals, and increased the statute of limitations period for the government to recover overpayments
to providers from three to five years.
35
Further,
there has been heightened governmental scrutiny in the United States of pharmaceutical pricing practices in light of the rising
cost of prescription drugs and biologics. Such scrutiny has resulted in several recent congressional inquiries and proposed and
enacted federal and state legislation designed to, among other things, bring more transparency to product pricing, review the
relationship between pricing and manufacturer patient programs, and reform government program reimbursement methodologies for
products. At the federal level, the Trump administration’s budget proposal for fiscal year 2021 includes a $135 billion
allowance to support legislative proposals seeking to reduce drug prices, increase competition, lower out-of-pocket drug costs
for patients, and increase patient access to lower-cost generic and biosimilar drugs. On March 10, 2020, the Trump administration
sent “principles” for drug pricing to Congress, calling for legislation that would, among other things, cap Medicare
Part D beneficiary out-of-pocket pharmacy expenses, provide an option to cap Medicare Part D beneficiary monthly out-of-pocket
expenses, and place limits on pharmaceutical price increases. In addition, the Trump administration previously released a “Blueprint”
to lower drug prices and reduce out of pocket costs of drugs that contained proposals to increase drug manufacturer competition,
increase the negotiating power of certain federal healthcare programs, incentivize manufacturers to lower the list price of their
products, and reduce the out-of-pocket costs of drug products paid by consumers. HHS has solicited feedback on some of these measures
and has implemented others under its existing authority. For example, in May 2019, CMS issued a final rule to allow Medicare Advantage
plans the option to use step therapy for Part B drugs beginning January 1, 2020. This final rule codified CMS’s policy change
that was effective January 1, 2019. Further, on November 20, 2020, HHS finalized a regulation removing safe harbor protection
for price reductions from pharmaceutical manufacturers to plan sponsors under Part D, either directly or through pharmacy benefit
managers, unless the price reduction is required by law. The rule also creates a new safe harbor for price reductions reflected
at the point-of-sale, as well as a safe harbor for certain fixed fee arrangements between pharmacy benefit managers and manufacturers.
The likelihood of implementation of any of the other Trump administration reform initiatives is uncertain, particularly in light
of the new presidential administration. On November 20, 2020, CMS issued an interim final rule implementing President Trump’s
Most Favored Nation executive order, which would tie Medicare Part B payments for certain physician-administered drugs to the
lowest price paid in other economically advanced countries, effective January 1, 2021. On December 28, 2020, the United States
District Court in Northern California issued a nationwide preliminary injunction against implementation of the interim final rule.
The likelihood of implementation of any of the other Trump administration reform initiatives is uncertain, particularly in light
of the new presidential administration. At the state level, legislatures have increasingly passed legislation and implemented
regulations designed to control pharmaceutical product pricing, including price or patient reimbursement constraints, discounts,
restrictions on certain product access and marketing cost disclosure and transparency measures, and, in some cases, designed to
encourage importation from other countries and bulk purchasing.
In
addition, it is possible that additional governmental action is taken to address the COVID-19 pandemic.
If
we fail to comply with the extensive legal and regulatory requirements affecting the health care industry, we could face increased
costs, penalties and a loss of business.
Our
activities, and the activities of our collaborators, distributors and other third-party providers, are subject to extensive government
regulation and oversight both in the U.S. and in foreign jurisdictions. The FDA and comparable agencies in other jurisdictions
will directly regulate many of our most critical business activities, including the conduct of preclinical and clinical studies,
product manufacturing, advertising and promotion, product distribution, adverse event reporting and product risk management. Our
interactions in the U.S. or abroad with physicians and other health care providers that may prescribe or purchase our products
are also subject to government regulation designed to prevent fraud and abuse in the sale and use of the products and place greater
restrictions on the marketing practices of health care companies. Health care companies are facing heightened scrutiny of their
relationships with health care providers from anti-corruption enforcement officials. In addition, health care companies have been
the target of lawsuits and investigations alleging violations of government regulation, including claims asserting submission
of incorrect pricing information, impermissible off-label promotion of pharmaceutical products, payments intended to influence
the referral of health care business, submission of false claims for government reimbursement, antitrust violations or violations
related to environmental matters. Risks relating to compliance with laws and regulations may be heightened as we bring products
to the market globally.
Regulations
governing the health care industry are subject to change, with possibly retroactive effect, including:
●
new
laws, regulations or judicial decisions, or new interpretations of existing laws, regulations or decisions, related to health
care availability, pricing or marketing practices, compliance with wage and hour laws and other employment practices, method
of delivery, payment for health care products and services, compliance with health information and data privacy and security
laws and regulations, tracking and reporting payments and other transfers of value made to physicians and teaching hospitals,
extensive anti-bribery and anti-corruption prohibitions, product serialization and labeling requirements and used product
take-back requirements;
●
changes
in the FDA and foreign regulatory approval processes that may delay or prevent the approval of new products and result in
lost market opportunity;
36
●
requirements
that provide for increased transparency of clinical trial results and quality data, such as the EMA’s clinical transparency
policy, which could impact our ability to protect trade secrets and competitively sensitive information contained in approval
applications or could be misinterpreted leading to reputational damage, misperception or legal action which could harm our business;
and
●
changes
in FDA and foreign regulations that may require additional safety monitoring, labeling changes, restrictions on product distribution
or use, or other measures after the introduction of our products to market, which could increase our costs of doing business,
adversely affect the future permitted uses of approved products, or otherwise adversely affect the market for our products.
Violations
of governmental regulation may be punishable by criminal and civil sanctions against us, including fines and civil monetary penalties
and exclusion from participation in government programs, including Medicare and Medicaid, as well as against executives overseeing
our business. In addition to penalties for violation of laws and regulations, we could be required to repay amounts we received
from government payors or pay additional rebates and interest if we are found to have miscalculated the pricing information we
have submitted to the government. We cannot ensure that our compliance controls, policies and procedures will in every instance
protect us from acts committed by our employees, collaborators, partners or third-party providers that would violate the laws
or regulations of the jurisdictions in which we operate. Whether or not we have complied with the law, an investigation into alleged
unlawful conduct could increase our expenses, damage our reputation, divert management time and attention and adversely affect
our business.
Even
if we receive approval for our products, we may be subject to extensive regulatory obligations in order to commercialize our products.
Even
after initial FDA or foreign regulatory agency approval has been obtained, further studies may be required to provide additional
data on safety or to gain approval for the use of a product as a treatment for clinical indications other than those initially
targeted. Use of a product during testing and after marketing could reveal side effects that could delay, impede, or prevent marketing
approval, result in a regulatory agency-ordered product recall, or in regulatory agency-imposed limitations on permissible uses
or in withdrawal of approval. For example, if the FDA or foreign regulatory agency becomes aware of new safety information after
approval of a product, it may require us to conduct further clinical trials to assess a known or potential serious risk and to
assure that the benefit of the product outweigh the risks. If we are required to conduct such a post-approval study, periodic
status reports must be submitted to the FDA or foreign regulatory agency. Failure to conduct such post-approval studies in a timely
manner may result in substantial civil or criminal penalties. Data resulting from these clinical trials may result in expansions
or restrictions to the labeled indications for which a product has already been approved. Any of these requirements or actions
may negatively impact our business or operations.
If
we are deemed to be an investment company, we may have to institute burdensome compliance requirements and our activities may
be restricted.
An
entity that, among other things, is or holds itself out as being engaged primarily, or proposes to engage primarily, in the business
of investing, reinvesting, owning, trading or holding certain types of securities would be deemed an investment company under
the Investment Company Act of 1940, as amended (the “1940 Act”). Based on the securities we hold, including our equity
ownership in publicly traded companies, we may not meet the requirements for an exemption promulgated under the 1940 Act. If we
are deemed to be an investment company under the 1940 Act, we would be subject to additional limitations on operating our business,
including limitations on the issuance of securities, which may make it difficult for us to raise capital.
Risks
Related to Our Clinical Development and Commercial Operations
Clinical
studies are costly, time consuming and are subject to risks that could delay or prevent commercialization of our current or future
product candidates.
We
cannot guarantee that any clinical studies will be conducted as planned or completed on schedule, if at all. A failure of one
or more clinical studies can occur at any stage of development. Events that may prevent successful or timely completion of clinical
development include but are not limited to:
●
inability
to generate satisfactory preclinical, toxicology, or other in vivo or in vitro data or diagnostics to support
the initiation or continuation of clinical studies necessary for product approval;
37
●
delays
in securing clinical investigators and agreeing on acceptable terms with contract research organizations (“CROs”)
and clinical trial sites, the terms of which can be subject to extensive negotiation and may vary significantly among CROs
and clinical trial sites;
●
delays
in obtaining required Institutional Review Board (“IRB”) approval at each clinical trial site;
●
failure
to obtain permission from regulatory authorities to conduct a clinical trial after review of an investigational new drug (“IND”)
or equivalent foreign application or amendment;
●
slower
than anticipated rates of patient recruitment and enrollment (including as a result of actual or threatened public health
emergencies and outbreaks of disease such as the current COVID-19 pandemic), failing to reach the targeted number of patients
due to competition for patients from other trials, or patients dropping out of our clinical studies once enrolled;
●
failure
by clinical sites or our CROs or other third parties to adhere to clinical trial requirements or report complete findings;
●
failure
to perform the clinical studies in accordance with the FDA’s good clinical practices requirements or applicable foreign
regulatory guidelines;
●
occurrence
of adverse events associated with our product candidates or with product candidates of third parties that may have characteristics
similar to or perceived to be similar to our product candidates;
●
negative
or inconclusive results from our clinical trials which may result in our deciding, or regulators requiring us, to conduct
additional clinical studies or to curtail or abandon development programs for a product candidate;
●
unforeseen
side effects, possibly resulting in the FDA or other regulatory authorities denying approval of our product candidates;
●
approval
and introduction of new therapies or changes in standards of practice or regulatory guidance that render our clinical trial
endpoints or the targeting of our proposed indications obsolete;
●
inability
to monitor patients adequately during or after treatment or problems with investigator or patient compliance with the trial
protocols;
●
inability
or unwillingness of medical investigators to follow our clinical protocols;
●
unavailability
of clinical trial supplies;
●
inability
to use clinical trial results from foreign jurisdictions to support U.S. regulatory approval;
●
changes
in regulatory requirements and guidance that require amending or submitting new clinical protocols;
●
the
cost of clinical studies of our product candidates; and
●
delays
in agreeing on acceptable terms with third-party manufacturers and the time for manufacture of sufficient quantities of our
product candidates for use in clinical studies.
Any
inability to successfully complete clinical development and obtain regulatory approval could result in additional costs to us
or impair our ability to generate revenue. Clinical trial delays could also shorten any periods during which our products have
patent protection and may allow competitors to develop and bring products to market before we do and may harm our business and
results of operations.
38
Clinical
and preclinical drug development involves a lengthy and expensive process with an uncertain outcome. The results of early preclinical
trials and clinical trials of our product candidates are not necessarily predictive of future results. Our product candidates
may not have favorable results in later clinical trials, if any, or receive regulatory approval on a timely basis, if at all.
Clinical
and preclinical drug development is expensive and can take many years to complete, and its outcome is inherently uncertain. Our
clinical trials may not be conducted as planned or completed on schedule, if at all, and failure can occur at any time during
the preclinical trial or clinical trial process. All of our product candidates will require substantial additional development,
and no assurances can be given that the development of any of our product candidates will ultimately be successful. Although we
may from time to time disclose results from preclinical testing or preliminary data or interim results from our clinical studies
of our product candidates, and earlier clinical studies, including clinical studies with similar product candidates, these are
not necessarily predictive of future results, including clinical trial results. The historical failure rate for product candidates
in our industry is high.
The
results of our current and future clinical trials may differ from results achieved in earlier preclinical and clinical studies
for a variety of reasons, including:
●
we
may not demonstrate the potency and efficacy benefits observed in previous studies;
●
our
efforts to improve, standardize and automate the manufacture of our product candidates, including OpRegen, OPC1 and VAC2,
and any resulting deviations in the manufacture of our product candidates, may adversely affect the safety, purity, potency
or efficacy of such product candidates;
●
differences
in trial design, including differences in size, eligibility criteria, and patient populations;
●
advancements
in the standard of care may affect our ability to demonstrate efficacy or achieve trial endpoints in our current or future
clinical trials;
●
safety
issues or adverse events in patients that enroll in our current or future clinical trials; and
●
results
in preclinical and clinical tests may not be repeated in subsequent tests or be predictive of future results.
In
particular, data presented from the Phase 1/2a open-label trial showed that both the surgical procedure and the OpRegen cells
were generally well tolerated, with no treatment-related systemic serious adverse events reported to date in the first nine patients.
The best corrected visual acuity of these patients remained relatively stable. In addition, the imaging of patients 8 and 9 suggested
early signs of structural improvement within the retina. However, we do not know how OpRegen will perform in future clinical trials.
It
is not uncommon to observe results in clinical trials that are unexpected based on preclinical trials and early clinical trials,
and many product candidates fail in clinical trials despite very promising early results. Moreover, preclinical and clinical data
may be susceptible to varying interpretations and analyses. A number of companies in the biotechnology industry have suffered
significant setbacks in clinical development even after achieving promising results in earlier studies.
Further,
as a result of the COVID-19 pandemic, if patients drop out of our clinical trials, miss scheduled doses or follow-up visits or
otherwise fail to follow clinical trial protocols, or if our clinical trials are otherwise disrupted due to COVID-19 or actions
taken to slow its spread, the integrity of data from our clinical trials may be compromised or not accepted by the FDA or other
regulatory authorities, which would represent a significant setback for the applicable program.
Even
if our current and planned clinical trials are successful, we will need to conduct additional clinical trials, which may include
registrational trials, trials in additional patient populations or under different treatment conditions, and trials using different
manufacturing protocols, processes, materials or facilities or under different manufacturing conditions, before we are able to
seek approvals for our product candidates from the FDA and regulatory authorities outside the United States to market and sell
these product candidates. Our failure to meet the requirements to support marketing approval for our product candidates in our
ongoing and future clinical trials would substantially harm our business and prospects. For the foregoing reasons, our ongoing
and planned clinical trials may not be successful, which could have a material adverse effect on our business, financial condition
and results of operations.
39
Interim,
topline and preliminary data from our clinical trials that we announce or publish from time to time may change as more patient
data become available and are subject to audit and verification procedures that could result in material changes in the final
data.
From
time to time, we may publicly disclose preliminary or topline data from our clinical trials, which is based on a preliminary analysis
of then-available data, and the results and related findings and conclusions are subject to change following a more comprehensive
review of the data related to the particular trial. We also make assumptions, estimations, calculations and conclusions as part
of our analyses of data, and we may not have received or had the opportunity to fully and carefully evaluate all data. As a result,
the topline results that we report may differ from future results of the same studies, or different conclusions or considerations
may qualify such results, once additional data have been received and fully evaluated. Topline data also remain subject to audit
and verification procedures that may result in the final data being materially different from the preliminary data we previously
published. As a result, topline data should be viewed with caution until the final data are available. From time to time, we may
also disclose interim data from our clinical trials. Interim data from clinical trials that we may complete are subject to the
risk that one or more of the clinical outcomes may materially change as patient enrollment continues and more patient data become
available. Adverse differences between preliminary or interim data and final data could significantly harm our business prospects.
Further,
others, including regulatory agencies, may not accept or agree with our assumptions, estimates, calculations, conclusions or analyses
or may interpret or weigh the importance of data differently, which could impact the value of the particular program, the approvability
or commercialization of the particular product candidate or product and our company in general. In addition, the information we
choose to publicly disclose regarding a particular trial is based on what is typically extensive information, and you or others
may not agree with what we determine is the material or otherwise appropriate information to include in our disclosure, and any
information we determine not to disclose may ultimately be deemed significant with respect to future decisions, conclusions, views,
activities or otherwise regarding a particular product candidate or our business. If the topline data that we report differ from
actual results, or if others, including regulatory authorities, disagree with the conclusions reached, our ability to obtain approval
for, and commercialize, our product candidates may be harmed, which could harm our business, operating results, prospects or financial
condition.
Because
we have multiple cell therapy programs in clinical development, we may expend our limited resources to pursue a particular product
candidate and fail to capitalize on product candidates that may be more profitable or for which there is a greater likelihood
of success.
We
have three cell therapy programs in clinical development. OpRegen is currently in a Phase 1/2a multicenter clinical trial for
the treatment of dry AMD, OPC-1 is currently in a Phase 1/2a clinical trial for acute spinal cord injuries, and VAC2 is in a Phase
1 clinical trial in non-small cell lung cancer. As a result of these and other future clinical trials for these product candidates
or any of our future product candidates may make our decision as to which product candidates to focus on more difficult and we
may forgo or delay pursuit of opportunities with other product candidates that could have had greater commercial potential or
likelihood of success.
Our
resource allocation decisions may cause us to fail to capitalize on viable commercial products or profitable market opportunities.
Our spending on current and future research and development programs and product candidates may not yield any commercially viable
products. If we do not accurately evaluate the commercial potential or target market for a particular product candidate, we may
relinquish valuable rights to that product candidate through future collaborations, licenses and other similar arrangements in
cases in which it would have been more advantageous for us to retain sole development and commercialization rights to such product
candidate.
Additionally,
we may pursue additional in-licenses or acquisitions of development-stage assets or programs, which entails additional risk to
us. Identifying, selecting and acquiring promising product candidates requires substantial technical, financial and human resources
expertise. Efforts to do so may not result in the actual acquisition or license of a particular product candidate, potentially
resulting in a diversion of our management’s time and the expenditure of our resources with no resulting benefit. For example,
if we are unable to identify programs that ultimately result in approved products, we may spend material amounts of our capital
and other resources evaluating, acquiring and developing products that ultimately do not provide a return on our investment.
40
The
commercial success of any of our current or future product candidates will depend upon the degree of market acceptance by physicians,
patients, third-party payors, other health care providers and others in the medical community.
Even
if a product candidate obtains regulatory approval, its commercial success will depend in part on physicians, patients, third-party
payors, other health care providers and others in the medical community accepting our product candidates as medically useful,
cost-effective, and safe. Any product we bring to the market may not gain market acceptance by such parties. The degree of market
acceptance of any of our products will depend on several factors, including without limitation:
●
the
efficacy of the product as demonstrated in clinical trials and potential advantages over competing treatments;
●
the
prevalence and severity of the disease and any side effects;
●
the
clinical indications for which approval is granted, including any limitations or warnings contained in a product’s approved
labeling;
●
the
convenience and ease of administration;
●
the
cost of treatment, particularly as additive to existing treatments;
●
the
willingness of the patients and physicians to accept and use these therapies;
●
the
marketing, sales and distribution support for the products;
●
the
publicity concerning our products or competing products and treatments; and
●
the
pricing and availability of coverage and adequate reimbursement by third-party payors and government authorities.
Even
if a product displays a favorable efficacy and safety profile upon approval, market acceptance of the product will be uncertain.
Efforts to educate the medical community and third-party payors on the benefits of the products may require significant investment
and resources and may never succeed. If our products fail to achieve an adequate level of acceptance by physicians, patients,
third-party payors, other health care providers and others in the medical community, we will not be able to generate sufficient
revenue to become or remain profitable.
If
the market opportunities for our product candidates are smaller than we believe and estimate they are, we may not meet our revenue
expectations and our business may suffer.
Our
projections of the number of potential users in the markets we are attempting to address are based on our beliefs and estimates.
Our estimates have been derived from a variety of sources, including market research and publications and scientific literature
estimating the total number of potential patients and currently approved or used therapies. Our estimates are also based on assumptions
regarding the potential size of the market assuming broad regulatory approval or potential usage by physicians beyond the approved
label. Any of our estimates may prove to be incorrect. The scope of approval and potential use of any product candidate may be
significantly narrower, and the number of patients may turn out to be lower than expected. Competitive products or approaches
may be approved or come into use and the potentially addressable patient population for each of our product candidates may be
limited or may not be amenable to treatment with our product candidates, and new patients may become increasingly difficult to
identify or gain access to, any which could adversely affect our results of operations and our business.
Sales
of the products we may develop will be adversely affected by the availability of competing products.
Our
products and product candidates will face substantial competition, whether through the development of safer and more effective
alternatives to our products, lower costs to administer than our products or other forms of competition such as more favorable
distribution, reimbursement and pricing or formulary and health care provider acceptance.
41
The
cell therapy industry is characterized by rapidly evolving technology and intense competition. Our competitors include major multinational
pharmaceutical companies, specialty biotechnology companies, and chemical and medical products companies operating in the fields
of regenerative medicine, cell therapy, tissue engineering, and tissue regeneration. Many of these companies are well established
and possess technical, research and development, financial, and sales and marketing resources significantly greater than ours.
In addition, certain smaller biotechnology companies have formed strategic collaborations, partnerships, and other types of joint
ventures with larger, well-established industry competitors that afford the smaller companies’ potential research and development
as well as commercialization advantages. Academic institutions, governmental agencies, and other public and private research organizations
are also conducting and financing research activities, which may produce products directly competitive to those we are developing.
We
believe that some of our competitors are trying to develop pluripotent cells and human embryonic progenitor cell (“hEPC”)
based technologies and products that may compete with our stem cell products based on efficacy, safety, cost, and intellectual
property positions. Ocata, which was acquired by a subsidiary of Astellas Pharma Inc., and Retinal Patch Technologies Inc. are
conducting clinical trials of hES cell products designed to treat age-related macular degeneration. If their products are proven
to be safe and effective, they may reach the market ahead of OpRegen.
We
may also face competition from companies that have filed patent applications relating to the propagation and differentiation of
stem cells. Those companies include Ocata, which in 2015 had certain U.S. patents issue with claims directed to methods of producing
RPE cells and isolating and purifying such cells. We may be required to seek licenses from these competitors in order to commercialize
certain products proposed by us, and such licenses may not be granted.
Competitive
products may make any products we develop obsolete or noncompetitive before we recover the expense of developing and commercializing
our product candidates. If we are unable to compete effectively, our opportunity to generate revenue from the sale of our products
we may develop, if approved, could be adversely affected.
We
will face risks related to our own manufacturing capabilities and those related to our reliance on third parties to manufacture
products, including those related to product acquisition costs, production delays, and supply shortages that could impair our
ability to complete the development and commercialization of our product candidates.
The
manufacture of medical products is complex and requires significant expertise and capital investment, including the development
of advanced manufacturing techniques and process controls. Although we have manufacturing capability through Cell Cure for OpRegen,
OPC1, and VAC2 in Israel, we will need greater manufacturing capacity if we are to successfully commercialize our products. Unless
we can raise the capital required to construct our own commercial scale manufacturing facilities and can develop the expertise
to manage and operate a manufacturing facility of our own, we may need to rely on third-party manufacturers to manufacture any
products we develop. There is no assurance that we will be able to identify manufacturers on acceptable terms or at all. Regardless
of whether we do our own manufacturing or rely on third parties to manufacture products for us, we will face risks related to
the manufacture of our products including these risks:
●
We
or any third-party manufacturers might not timely formulate and manufacture our products or produce the quantity and quality
required to meet our clinical and commercial needs, if any.
●
We
or any third-party manufacturers may not execute our manufacturing procedures appropriately.
●
Any
third-party manufacturers we engage may not perform as agreed or may not remain in the contract manufacturing business for
the time required to supply our clinical trials or to successfully produce, store and distribute our products on a commercial
scale.
●
We
or any third-party manufacturers will be subject to ongoing periodic unannounced inspection by the FDA and corresponding state
agencies to ensure strict compliance with current good manufacturing practices (“cGMP”), and other government
regulations and corresponding foreign standards. We will not have control over third-party manufacturers’ compliance
with applicable regulations and standards.
42
●
We
may not own, or may have to share, the intellectual property rights to any improvements made by our third-party manufacturers
in the manufacturing process for our product candidates.
●
We
may not obtain licenses for third-party intellectual property rights needed by manufacturers to produce our products.
●
Third-party
manufacturers could breach or terminate their agreements with us.
●
We
or third-party manufacturers may experience manufacturing difficulties as a result of resource constraints, labor disputes,
unstable political environments, natural disasters, public health crises such as pandemics and epidemics, political crises
such as terrorism, war, political insecurity or other conflict, or other events outside of our or our third-party manufacturers
control (including as a result of actual or threatened public health emergencies and outbreaks of disease such as the current
COVID-19 pandemic). This may result in business closures that affect us and our third-party manufacturers.
In
addition, we may rely on third parties to perform release testing on our product candidates prior to delivery to patients. If
these tests are not appropriately conducted and test data are not reliable, patients could be put at risk of serious harm which
could result in product liability suits.
If
we or any third-party manufacturers we may engage were to encounter any of these difficulties, our ability to provide our product
candidates to patients in clinical trials or to the medical market place would be jeopardized. Any delay or interruption in the
supply of clinical trial supplies could delay the completion of clinical trials, increase the costs associated with maintaining
clinical trial programs and, depending upon the period of delay, could require us to either commence new clinical trials at additional
expense or terminate clinical trials completely. Each risk could delay our clinical trials, any approval of our product candidates
by the FDA, or the commercialization of our product candidates, and could result in higher costs or deprive us of potential product
revenue.
Any
cell-based products that receive regulatory approval may be difficult and expensive to manufacture profitably.
Cell-based
products are among the more expensive biologic products to manufacture in accordance with cGMP. We do not yet have sufficient
information to reliably estimate the cost of commercially manufacturing any of our product candidates. Excessive manufacturing
costs could make our product candidates too expensive to compete in the medical market place with alternative products manufactured
by our competitors or might result in third party payors such as health insurers and Medicare, declining to cover our products
or setting reimbursement levels too low for us to earn a profit from the commercialization of one or more of our products.
We
may not secure a commercialization partner for Renevia.
In
September 2019, Renevia was granted a CE Mark and Class III classification with an intended use in adults as a resorbable matrix
for the delivery of autologous adipose tissue preparations to restore and/or augment facial volume after subcutaneous fat volume
loss for the treatment of facial lipoatrophy. The CE Mark provides us, or our authorized agent, the authority to market and distribute
Renevia throughout the European Union (“EU”) and in other countries that recognize the CE Mark.
However,
because we have no commercial infrastructure, we are seeking a commercialization partner in the EU. We can give no assurance that
we will secure a commercialization partner for Renevia or otherwise commercialize Renevia.
The
ongoing COVID-19 pandemic may adversely affect our operations, including the conduct of our clinical trials.
In
December 2019, a novel strain of coronavirus and the resulting illness known as COVID-19 emerged in Wuhan, China. The outbreak
has now spread to other countries and has been declared a pandemic by the World Health Organization.
43
The
COVID-19 pandemic has resulted in travel and other restrictions in order to reduce the spread of the disease, including a California
executive order and several other state and local orders across the country, which, among other things, direct individuals to
shelter at their places of residence, direct businesses and governmental agencies to cease non-essential operations at physical
locations, prohibit certain non-essential gatherings, and order cessation of non-essential travel. In response to these public
health directives and orders, we have implemented work-from-home policies for our employees. The effects of the executive order,
the shelter-in-place order and our work-from-home policies may negatively impact productivity, disrupt our business and delay
our clinical programs and timelines, the magnitude of which will depend, in part, on the length and severity of the restrictions
and other limitations on our ability to conduct our business in the ordinary course. These and similar, and perhaps more severe,
disruptions in our operations could negatively impact our business, operating results and financial condition.
As
COVID-19 continues to spread in the United States and Israel, we have experienced and may continue to experience disruptions that
could adversely affect our operations and clinical trials, including:
●
delays
or difficulties in enrolling, or conducting follow-up visits with, patients in our clinical trials, particularly patients
for our OpRegen Phase 1/2a clinical trial, who are older and who may be at higher risk of complications from COVID-19;
●
delays
or difficulties in clinical site initiation, including difficulties in recruiting clinical site investigators and staff;
●
diversion
of healthcare resources away from the conduct of clinical trials;
●
interruption
of key clinical trial activities, such as clinical trial site monitoring, due to limitations on travel;
●
limited
availability of our employees and the staff of our current clinical sites due to sickness or social distancing measures;
●
manufacturing
difficulties for us and our suppliers of raw materials caused by business closures;
●
delays
in clinical sites receiving the supplies and materials needed to conduct our clinical trials, including interruption in global
shipping that may affect the transport of clinical trial materials;
●
changes
in local regulations as part of a response to the COVID-19 outbreak which may require us to change the ways in which our clinical
trials are conducted, which may result in unexpected costs, or to discontinue the clinical trials altogether;
●
interruption
or delays in the operations of the FDA or other regulatory authorities, which may impact review and approval timelines;
●
risk
that participants enrolled in our clinical trials will acquire COVID-19 while the clinical trial is ongoing, which could impact
the results of the clinical trial, including by increasing the number of observed adverse events; and;
●
refusal
of the FDA to accept data from clinical trials in affected geographies;
These
and other disruptions in our operations and the global economy could negatively impact our business, operating results and financial
condition. The extent to which the COVID-19 pandemic affects our operations will depend on future developments, which are highly
uncertain and cannot be predicted with confidence, including the duration and severity of the pandemic, and the actions that may
be required to contain the COVID-19 pandemic or treat its impact.
Our
clinical trials have been, and may in the future be, affected by the COVID-19 pandemic. For example, the COVID-19 pandemic has
impacted patient enrollment in our OpRegen Phase 1/2a multicenter clinical trial and the VAC2 Phase 1 multicenter clinical trial.
In particular, some sites have paused enrollment to focus on, and direct resources to, the COVID-19 pandemic, while at other sites,
patients are choosing not to enroll or continue participating in the clinical trial as a result of the pandemic. We are unable
to predict with confidence the duration of such patient enrollment delays and difficulties. If patient enrollment is delayed for
an extended period of time, such clinical trials could be delayed or otherwise adversely affected. Our inability to enroll a sufficient
number of patients for any of our current or future clinical trials could result in significant delays or may require us to abandon
one or more clinical trials altogether. As a result, we may experience new or additional delays and difficulties in enrollment,
which would result in the delay of completion of such trials beyond our expected timelines.
44
Our
ongoing or planned clinical trials may also be impacted by interruptions or delays in the operations of the FDA and comparable
foreign regulatory agencies.
In
addition, quarantines, shelter-in-place and similar government orders, or the perception that such orders, shutdowns or other
restrictions on the conduct of business operations could occur, related to COVID-19 or other infectious diseases could impact
personnel at our CROs or third-party manufacturing facilities upon which we rely, or the availability or cost of materials, which
could disrupt the supply chain for our product candidates. To the extent our suppliers and service providers are unable to comply
with their obligations under our agreements with them or they are otherwise unable to deliver or are delayed in delivering goods
and services to us due to the COVID-19 pandemic, our ability to continue meeting clinical supply demand for our product candidates
or otherwise advancing development of our product candidates may become impaired.
The
spread of COVID-19 and actions taken to reduce its spread may also materially affect us economically. While the potential economic
impact brought by, and the duration of, the COVID-19 pandemic may be difficult to assess or predict, there could be a significant
disruption of global financial markets, reducing our ability to access capital, which could in the future negatively affect our
liquidity and financial position. In addition, the trading prices for other biotechnology companies have been highly volatile
as a result of the COVID-19 pandemic. As a result, we may face difficulties raising capital through sales of our common shares
or such sales may be on unfavorable terms.
COVID-19
and actions taken to reduce its spread continue to rapidly evolve. The extent to which COVID-19 may impede the development of
our product candidates, reduce the productivity of our employees, disrupt our supply chains, delay our clinical trials, reduce
our access to capital or limit our business development activities, will depend on future developments, which are highly uncertain
and cannot be predicted with confidence.
In
addition, to the extent the ongoing COVID-19 pandemic adversely affects our business and results of operations, it may also have
the effect of heightening many of the other risks and uncertainties described in this ‘‘Risk Factors’’
section.
The
withdrawal of the United Kingdom (the “U.K.”) from the EU, commonly referred to as “Brexit,” may adversely
impact our ability to obtain regulatory approvals of our product candidates in the EU, result in restrictions or imposition of
taxes and duties for importing our product candidates into the EU, and may require us to incur additional expenses in order to
develop, manufacture and commercialize our product candidates in the EU.
On
June 23, 2016, the U.K. held a referendum in which a majority of the eligible members of the electorate voted for the U.K. to
leave the EU. The U.K. formally left the EU on January 31, 2020, which is commonly referred to as Brexit, with a transition
period that ended December 31, 2020.
45
Since
a significant proportion of the regulatory framework in the U.K. applicable to our business and our product candidates is derived
from EU directives and regulations, Brexit and the new Trade and Cooperation Agreement between the European Union and the U.K.
that took provisional effect on January 1, 2021 could materially impact the regulatory regime with respect to the development,
manufacture, importation, approval and commercialization of our product candidates in the U.K. or the EU. For example, the
U.K. is no longer be covered by the centralized procedures for obtaining EU-wide marketing authorization from the European Medicines
Agency and a separate process for authorization of drug products, including our product candidates, will be required in the U.K.
It is currently unclear whether the Medicines & Healthcare products Regulatory Agency
in the U.K. is sufficiently prepared to handle the increased volume of marketing authorization applications that it is likely
to receive. Any delay in obtaining, or an inability to obtain, any marketing
approvals, as a result of Brexit or otherwise, would prevent us from commercializing our product candidates in the U.K. or the
EU and restrict our ability to generate revenue and achieve and sustain profitability. In addition, we may be required to pay
taxes or duties or be subjected to other hurdles in connection with the importation of our product candidates into the EU, or
we may incur expenses in establishing a manufacturing facility in the EU in order to circumvent such hurdles. If any of these
outcomes occur, we may be forced to restrict or delay efforts to seek regulatory approval in the U.K. or the EU for our product
candidates, or incur significant additional expenses to operate our business, which could significantly and materially harm or
delay our ability to generate revenues or achieve profitability of our business. Any further changes in international trade, tariff
and import/export regulations as a result of Brexit or otherwise may impose unexpected duty costs or other non-tariff barriers
on us. These developments, or the perception that any of them could occur, may significantly reduce global trade and, in particular,
trade between the affected nations and the U.K. It is also possible that Brexit may negatively affect our ability to attract and
retain employees, particularly those from the EU.
We
face potential product liability, and, if successful claims are brought against us, we may incur substantial liability and costs.
If the use or misuse of our products or product candidates harm patients or is perceived to harm patients even when such harm
is unrelated to our products or product candidates, our regulatory approvals could be revoked, suspended or otherwise negatively
affected, and we could be subject to costly and damaging product liability claims.
We
face the risk of incurring liabilities to clinical trial patients if they are injured as a result of their participation in our
clinical trials. In the event we commercialize Renevia in the EU or in other countries that recognize the CE Mark, we will also
face product liability risks associated with the use of Renevia by consumers. If any claims are made and if liability can be established,
the amount of any liability we or our affiliates may incur, could exceed any insurance coverage in effect, and the amount of the
liability could be material to our financial condition.
The
use or misuse of our product candidates in clinical trials and the sale of any products for which we obtain marketing approval,
including Renevia, exposes us to the risk of product liability claims. Product liability claims might be brought against us by
consumers, healthcare providers, pharmaceutical companies or others selling or otherwise coming into contact with our products.
There is a risk that our product candidates may induce adverse events. If we cannot successfully defend against product liability
claims, we could incur substantial liability and costs. In addition, regardless of merit or eventual outcome, product liability
claims may result in:
●
impairment
of our business reputation;
●
initiation
of investigations by regulators;
●
withdrawal
of clinical trial participants;
●
costs
due to related litigation;
●
distraction
of management’s attention from our primary business;
●
substantial
monetary awards to patients or other claimants;
●
the
inability to commercialize our product candidates;
●
product
recalls, withdrawals or labeling, marketing or promotional restrictions; and
●
decreased
demand for our product candidates, if approved for commercial sale.
46
We
believe our current product liability insurance coverage is appropriate in light of our clinical programs; however, we may not
be able to maintain insurance coverage at a reasonable cost or in sufficient amounts to protect us against losses due to liability.
If and when we obtain marketing approval for product candidates, we intend to increase our insurance coverage to include the sale
of commercial products; however, we may be unable to obtain product liability insurance on commercially reasonable terms or in
adequate amounts. Significant damages have been awarded in class action lawsuits based on drugs or medical treatments that had
unanticipated adverse effects. A successful product liability claim or series of claims brought against us could cause our stock
price to decline and, if the amount of damages exceeds our insurance coverage, could adversely affect our results of operations
and business.
Cell
Cure has received Israeli government grants for certain of its research and development activities. The terms of these grants
may require Cell Cure to seek approvals and to satisfy specified conditions to manufacture products and transfer or license grant-supported
technologies outside of Israel. In the context of such approvals, Cell Cure will be required to pay penalties in addition to the
repayment of the grants. Such grants are applied for on a yearly basis and may not be available or only partially granted in the
future, which would increase our costs.
Cell
Cure has received Israeli government grants for certain of its research and development activities. The terms of these grants
require prior approval and the satisfaction of specified conditions to manufacture products and transfer or license technologies
outside of Israel.
Under
the Encouragement of Research, Development and Technological Innovation in the Industry Law 5744-1984 (formerly known as the Law
for the Encouragement of Research and Development in Industry 5744-1984), and the regulations, guidelines, rules, procedures and
benefit tracks thereunder (collectively, the “Innovation Law”), annual research and development programs that meet
specified criteria and are approved by a committee of the Israel Innovation Authority (“IIA”) are eligible for grants.
The grants awarded are typically up to 50% of the project’s expenditures, as determined by the IIA committee and subject
to the benefit track under which the grant was awarded. A company that receives a grant from the IIA (a “Grant Recipient”),
is typically required to pay royalties to the IIA on income generated from products incorporating know-how developed using such
grants (including income derived from services associated with such products) or on all revenues of the Grant Recipient (depending
upon the terms of the approval letters issued by the IIA), until 100% of the U.S. dollar-linked grant plus annual LIBOR interest
is repaid. In general, the rate of such royalties varies between 3% to 5%.
The
obligation to pay royalties is contingent on actual revenues being generated from such products and services or actual revenues
being generated by the Grant Recipient in general (as the case may be). In the absence of such revenues, no payment of royalties
is required. It should be noted that the restrictions under the Innovation Law will continue to apply even after the repayment
of such royalties in full by the Grant Recipient including restrictions on the sale, transfer or licensing to a foreign entity
of know-how developed as part of the programs under which the grants were given.
The
terms of the grants under the Innovation Law also (generally) require that the products developed as part of the programs under
which the grants were given be manufactured in Israel and that the know-how developed thereunder may not be transferred outside
of Israel, unless prior written approval is received from the IIA (such approval is not required for the transfer of a portion
of the manufacturing capacity which does not exceed, in the aggregate, 10% of the portion declared to be manufactured outside
of Israel in the applications for funding (in which case only notification is required), and additional payments are required
to be made to IIA). It should be noted that this does not restrict the export of products that incorporate the funded know-how.
The
Innovation Law restricts the ability to transfer or license know-how funded by IIA outside of Israel. Transfer of IIA-funded know-how
outside of Israel requires prior approval and is subject to approval and payment of a redemption fee to the IIA calculated according
to the relevant formulas provided under the Innovation Law. A transfer or license for the purpose of the Innovation Law are generally
interpreted very broadly and include, inter alia, any actual sale or assignment of the IIA-funded know-how, any license to further
develop or otherwise exploit the IIA-funded know-how or the products resulting from such IIA-funded know-how or any other transaction,
which, in essence, constitutes a transfer of the IIA-funded know-how. Generally, a mere license solely to market or distribute
products resulting from the IIA-funded know-how would not be deemed a transfer or license for the purpose of the Innovation Law.
Part
of Cell Cure’s research and development efforts have been financed, partially, through grants that it has received from
the IIA and when we acquired our holdings in Cell Cure, we undertook in writing, vis-à-vis the IIA, to abide by, and to
ensure the abidance of Cell Cure to, the Innovation Law. We therefore must comply with the requirements of the Innovation Law
and related regulations. As of December 31, 2020, we received approximately $15.4 million of such grants.
47
The
restrictions under the Innovation Law may impair our ability to enter into agreements which involve IIA-funded products or know-how
without the approval of IIA. We cannot be certain that any approval of IIA will be obtained on terms that are acceptable to us,
or at all. We may not receive the required approvals should we wish to transfer or license IIA-funded know-how, manufacturing
and/or development outside of Israel in the future. Furthermore, in the event that we undertake a transaction involving the transfer
to a non-Israeli entity of know-how developed with IIA-funding pursuant to a merger or similar transaction, the consideration
available to our shareholders may be reduced by the amounts we are required to pay to the IIA. Any approval, if given, will generally
be subject to additional financial obligations. Failure to comply with the requirements under the Innovation Law may subject Cell
Cure to mandatory repayment of grants received by it (together with interest and penalties), as well as expose its directors and
management to criminal proceedings. In addition, the IIA may from time to time conduct royalty audits. Further grants may not
be approved or reduced in the future, which would increase our costs. IIA approval is not required for the marketing or distribution
of products resulting from the IIA-funded research or development in the ordinary course of business.
Our
international business exposes us to business, regulatory, political, operational, financial and economic risks associated with
doing business outside of the United States.
Cell
Cure is our 99% owned subsidiary located in Jerusalem, Israel. OpRegen is currently manufactured at Cell Cure and we anticipate
transitioning some or all of the manufacturing of OPC1 and VAC2 to Cell Cure as well. A portion of our OpRegen Phase 1/2a clinical
trial has been conducted at sites in Israel. Conducting operations internationally involves a number of risks, including:
●
difficulty
in staffing and managing foreign operations;
●
failure
by us to obtain the appropriate regulatory approvals;
●
logistics
and regulations associated with shipping drug product or patient samples, including infrastructure conditions and transportation
delays;
●
financial
risks, such as longer payment cycles and exposure to foreign currency exchange rate fluctuations;
●
political
and economic instability, including wars, terrorism, and political unrest, outbreak of disease, boycotts, curtailment of trade
and other business restrictions;
●
multiple,
conflicting and changing laws and regulations such as tax laws, export and import restrictions, employment laws, data and
privacy laws, regulatory requirements and other governmental approvals, permits and licenses; and
●
regulatory
and compliance risks that may fall within the purview of the U.S. Foreign Corrupt Practices Act, UK Bribery Act, anti-boycott
laws and other anti-corruption laws.
Any
of these factors could significantly harm our international operations and, consequently, our results of operations. In addition,
any failure to comply with applicable legal and regulatory obligations could impact us in a variety of ways that include, but
are not limited to, significant criminal, civil and administrative penalties, including imprisonment of individuals, fines and
penalties, denial of export privileges, seizure of shipments, and restrictions on certain business activities. Also, the failure
to comply with applicable legal and regulatory obligations could result in the disruption of our clinical trial activities.
Our
international operations could be affected by changes in laws, trade regulations, labor and employment regulations, and procedures
and actions affecting approval, production, pricing, reimbursement and marketing of tests, as well as by inter-governmental disputes.
Any of these changes could adversely affect our business.
Our
success internationally will depend, in part, on our ability to develop and implement policies and strategies that are effective
in anticipating and managing these and other risks in Israel. Failure to manage these and other risks may have a material adverse
effect on our operations in Israel and on our business as a whole.
48
Risks
Related to our Intellectual Property
Our
intellectual property may be insufficient to protect our products.
Our
patents and patent applications are directed to compositions of matter, formulations, methods of use and/or methods of manufacturing,
as appropriate. In addition to patenting our own technology and that of our subsidiaries, we have licensed patents and patent
applications for certain stem cell technology, hEPC, and hES cell lines, hydrogel technology and other technology from other companies.
The
patent positions of pharmaceutical and biotechnology companies, including ours, are generally uncertain and involve complex legal
and factual questions. Our business could be negatively affected by any of the following:
●
the
claims of any patents that are issued may not provide meaningful protection, may not provide a basis for commercially viable
products or may not provide us with any competitive advantages;
●
our
patents may be challenged by third parties;
●
others
may have patents that relate to our technology or business that may prevent us from marketing our product candidates unless
we are able to obtain a license to those patents;
●
the
pending patent applications to which we have rights may not result in issued patents;
●
our
patents may have terms that are inadequate to protect our competitive position on our products;
●
we
may not be successful in developing additional proprietary technologies that are patentable.
In
addition, others may independently develop similar or alternative technologies, duplicate any of our technologies and, if patents
are licensed or issued to us, design around the patented technologies licensed to or developed by us. As an example, Astellas’
patent portfolio with respect to the manufacture of its RPE products could adversely impact our rights to manufacture OpRegen.
Moreover, we could incur substantial costs in litigation if we have to defend ourselves in patent lawsuits brought by third parties
or if we initiate such lawsuits.
If
we are unable to obtain and enforce patents and to protect our trade secrets, others could use our technology to compete with
us, which could limit opportunities for us to generate revenues by licensing our technology and selling products.
Our
success will depend in part on our ability to obtain and enforce patents and maintain trade secrets in the United States and in
other countries. If we are unsuccessful at obtaining and enforcing patents, our competitors could use our technology and create
products that compete with our products, without paying license fees or royalties to us. The preparation, filing, and prosecution
of patent applications can be costly and time consuming. Our limited financial resources may not permit us to pursue patent protection
of all of our technology and products in all key markets. Even if we are able to obtain issued patents covering our technology
or products, we may have to incur substantial legal fees and other expenses to enforce our patent rights to protect our technology
and products from infringing uses. We may not have the financial resources to finance the litigation required to preserve our
patent and trade secret rights. Litigation, interferences, oppositions, inter partes reviews or other proceedings are, have been
and may in the future be necessary in some instances to determine the validity and scope of certain of our proprietary rights,
and in other instances to determine the validity, scope or non-infringement of certain patent rights claimed by third parties
to be pertinent to the manufacture, use or sale of our products. This means that patents owned or licensed by us may be lost if
the outcome of a proceeding is unfavorable to us.
There
is no certainty that our pending or future patent applications will result in the issuance of patents.
Our
success depends in part on our ability to obtain and defend patent and other intellectual property rights that are important to
the commercialization of our products and product candidates. The degree of patent protection that will be afforded to our products
and processes in the U.S. and in other important markets remains uncertain and is dependent upon the scope of protection decided
upon by the patent offices, courts, administrative bodies and lawmakers in these countries. We can provide no assurance that we
will successfully obtain or preserve patent protection for the technologies incorporated into our products and processes, or that
the protection obtained will be of sufficient breadth and degree to protect our commercial interests in all countries where we
conduct business. If we cannot prevent others from exploiting our inventions, we will not derive the benefit from them that we
currently expect. Furthermore, we can provide no assurance that our products will not infringe patents or other intellectual property
rights held by third parties.
49
In
Europe, there is uncertainty about the eligibility of hES cell subject matter for patent protection. The European Patent Convention
prohibits the granting of European patents for inventions that concern “uses of human embryos for industrial or commercial
purposes.” A recent decision at the Court of Justice of the European Union interpreted parthenogenetically produced hES
cells as patentable subject matter. Consequently, the European Patent Office now recognizes that human pluripotent stem cells
(including human ES cells) can be created without a destructive use of human embryos as of June 5, 2003, and patent applications
relating to hES cell subject matter with a filing and priority date after this date are no longer automatically excluded from
patentability under Article 53 (a) EPC and Rule 28(c) EPC.
Intellectual
property we may develop using grants received from governments are subject to rights maintained by those governments.
Research
and development we perform that is funded by grants from government, and any intellectual property that we create using those
grants, is subject to certain rights of the government entities to require that we license or grant rights to the intellectual
property developed using government funding in certain circumstances.
There
is no certainty that we will be able to obtain licenses to intellectual property rights owned by third parties.
There
are no assurances that any of our intellectual property rights will guarantee protection or market exclusivity for our products
and product candidates. In such cases, we may need to obtain enabling licenses from third parties to protect our products and
product candidates, try to secure market exclusivity or avoid infringing on the intellectual property rights of third parties.
If we are unable to fully protect our product candidates or achieve market exclusivity for our products and product candidates,
our financial success will be dependent, in part, on our ability to protect and enforce our intellectual property rights, to operate
without infringing upon the proprietary rights of others, or, when necessary, our ability to obtain enabling licenses.
If
we fail to meet our obligations under license agreements, we may lose our rights to key technologies on which our business depends.
Our
business depends on several critical technologies that are based in part on technology licensed from third parties. Those third-party
license agreements impose obligations on us, including payment obligations and obligations to pursue development of commercial
products under the licensed patents or technology. If a licensor believes that we have failed to meet our obligations under a
license agreement, the licensor could seek to limit or terminate our license rights, which could lead to costly and time-consuming
litigation and, potentially, a loss of the licensed rights. During the period of any such litigation, our ability to carry out
the development and commercialization of potential products, and our ability to raise any capital that we might then need, could
be significantly and negatively affected. If our license rights were restricted or ultimately lost, we would not be able to continue
to use the licensed technology in our business.
Risks
Related to our Dependence on Third Parties
We
may become dependent on possible future collaborations to develop and commercialize many of our product candidates and to provide
the regulatory compliance, sales, marketing and distribution capabilities required for the success of our business.
We
may enter into various kinds of collaborative research and development and product marketing agreements to develop and commercialize
our products. The expected future milestone payments and cost reimbursements from collaboration agreements could provide an important
source of financing for our research and development programs, thereby facilitating the application of our technology to the development
and commercialization of our products, but there are risks associated with entering into collaboration arrangements.
50
There
is a risk we could become dependent upon one or more collaborative arrangements. A collaborative arrangement upon which we might
depend might be terminated by our collaboration partner or a partner might determine not to actively pursue the development or
commercialization of our products. A collaboration partner also may not be precluded from independently pursuing competing products
and drug delivery approaches or technologies.
There
is a risk that a collaboration partner might fail to perform its obligations under the collaborative arrangements or may be slow
in performing its obligations. In addition, a collaboration partner may experience financial difficulties at any time that could
prevent it from having available funds to contribute to the collaboration. If a collaboration partner fails to conduct its product
development, commercialization, regulatory compliance, sales and marketing or distribution activities successfully and in a timely
manner, or if it terminates or materially modifies its agreements with us, the development and commercialization of one or more
product candidates could be delayed, curtailed or terminated because we may not have sufficient financial resources or capabilities
to continue such development and commercialization on our own.
We
do not have the ability to independently conduct clinical trials required to obtain regulatory approvals for our product candidates.
We
will need to rely on third parties, such as CROs, data management companies, contract clinical research associates, medical institutions,
clinical investigators and contract laboratories to conduct any clinical trials we may undertake for our product candidates. We
may also rely on third parties to assist with preclinical development of our product candidates. If we outsource clinical trials,
we may not directly control the timing, conduct and expense of our clinical trials. If we enlist third parties to conduct clinical
trials and they fail to perform their contractual duties or regulatory obligations or fail to meet expected deadlines, if they
need to be replaced or if the quality or accuracy of the data they obtain is compromised due to failing to adhere to our clinical
protocols or regulatory requirements or for other reasons, our preclinical development activities or clinical trials may be extended,
delayed, suspended or terminated, and we may not obtain regulatory approval for or successfully commercialize our product candidates.
In
addition, quarantines, shelter-in-place and similar government orders, or the perception that such orders, shutdowns or other
restrictions on the conduct of business operations could occur, related to COVID-19 or other infectious diseases could impact
personnel at these third parties, which could disrupt our clinical timelines, which could have a material adverse impact on our
business, prospects, financial condition and results of operations.
We
have relied on CIRM to fund past clinical trials of OPC1 and we do not know if they will provide additional funding for future
studies of OPC1.
We
received $14.3 million of funding from CIRM to support clinical development of OPC1. We intend to apply for additional
CIRM grants, if available; however, we cannot provide any assurance that such grants will be awarded. If we are unable to obtain
another CIRM grant, we will need to raise funds through other mechanisms to support future clinical studies of OPC1, which may
take additional time and effort. If capital is not immediately available, this may force us to amend, delay, or discontinue the
clinical trial and development work for OPC1 until funding is secured.
We
may need to rely on marketing partners or contract sales companies.
If
we are able to develop our product candidates and obtain necessary regulatory approvals, we may need to rely on marketing, selling
or distributing partners. If we do not partner for commercial services, we will depend on our ability to build our own marketing,
selling and distribution capabilities, which would require the investment of significant financial and management resources, or
we will need to find collaborative marketing partners, sales representatives or wholesale distributors for the commercial sale
of our products.
If
we market products through arrangements with third parties, we may pay sales commissions to sales representatives or we may sell
or consign products to distributors at wholesale prices. As a result, our gross profit from product sales may be lower than it
would be if we sold our products directly to end users at retail prices through our own sales force. There can be no assurance
we will be able to negotiate distribution or sales agreements with third parties on favorable terms to justify our investment
in our products or achieve sufficient revenues to support our operations.
51
Risks
Pertaining to Our Common Shares
Because
we are engaged in the development of pharmaceutical and stem cell therapy products, the price of our common shares may rise and
fall rapidly.
The
market price of our common shares, like that of the shares of many biotechnology companies, has been highly volatile. The price
of our common shares may rise rapidly in response to certain events, such as the commencement of clinical trials of an experimental
new therapy, even though the outcome of those trials and the likelihood of ultimate FDA approval of a therapeutic product remain
uncertain. Similarly, prices of our common shares may fall rapidly in response to certain events such as unfavorable results of
clinical trials or a delay or failure to obtain FDA approval. The failure of our earnings to meet analysts’ expectations
could result in a significant rapid decline in the market price of our common shares.
Current
economic and stock market conditions may adversely affect the price of our common shares.
The
stock market has been experiencing extreme price and volume fluctuations which have affected the market price of the equity securities
without regard to the operating performance of the issuing companies. Broad market fluctuations, as well as general economic,
political and other conditions (such as the recent coronavirus outbreak), may adversely affect the market price of our common
shares.
Because
we do not pay cash dividends, our common shares may not be a suitable investment for anyone who needs to earn dividend income.
We
do not pay cash dividends on our common shares. For the foreseeable future, we anticipate that any earnings generated in our business
will be used to finance the growth of our business and will not be paid out as dividends to holders of our common shares. This
means that our common shares may not be a suitable investment for anyone who needs to earn income from their investments.
Insiders
continue to have substantial influence over our company, which could limit your ability to influence the outcome of key transactions,
including a change of control.
Our
directors, executive officers and their affiliates, in the aggregate, owned approximately 27% of our outstanding common
shares as of December 31, 2020. As a result, these shareholders, if acting together, will be able to heavily influence or control
matters requiring approval by our shareholders, including the election of directors and the approval of mergers, acquisitions
or other extraordinary transactions. They may also have interests that differ from yours and may vote in a way with which you
disagree, and which may be averse to your interests. This concentration of ownership may have the effect of delaying, preventing
or deterring a change of control of our company, could deter certain public investors from purchasing our common shares and might
ultimately affect the market price of our common shares.
Our
business could be negatively affected as a result of actions of activist shareholders, and such activism could affect the trading
value of our securities.
Shareholders
may, from time to time, engage in proxy solicitations or advance stockholder proposals, or otherwise attempt to effect changes
and assert influence on our board of directors and management. Activist campaigns that contest or conflict with our strategic
direction or seek changes in the composition of our board of directors could have an adverse effect on our operating results and
financial condition. A proxy contest would require us to incur significant legal and advisory fees, proxy solicitation expenses
and administrative and associated costs and require significant time and attention by our board of directors and management, diverting
their attention from the pursuit of our business strategy. Any perceived uncertainties as to our future direction and control,
our ability to execute on our strategy, or changes to the composition of our board of directors or senior management team arising
from a proxy contest could lead to the perception of a change in the direction of our business or instability which may result
in the loss of potential business opportunities, make it more difficult to pursue our strategic initiatives, or limit our ability
to attract and retain qualified personnel and business partners, any of which could adversely affect our business and operating
results. If individuals are ultimately elected to our board of directors with a specific agenda, it may adversely affect our ability
to effectively implement our business strategy and create additional value for our stockholders. We may choose to initiate, or
may become subject to, litigation as a result of the proxy contest or matters arising from the proxy contest, which would serve
as a further distraction to our board of directors and management and would require us to incur significant additional costs.
In addition, actions such as those described above could cause significant fluctuations in our stock price based upon temporary
or speculative market perceptions or other factors that do not necessarily reflect the underlying fundamentals and prospects of
our business.
52
Securities
analysts may not initiate coverage or continue to cover our common shares, and this may have a negative impact on the market price
of our common shares.
The
trading market for our common shares depends, in part, on the research and reports that securities analysts publish about our
business and our common shares. We do not have any control over these analysts. There is no guarantee that securities analysts
will cover our common shares. If securities analysts do not cover our common shares, the lack of research coverage may adversely
affect the market price of those shares. If securities analysts do cover our common shares, they could issue reports or recommendations
that are unfavorable to the price of our common shares, and they could downgrade a previously favorable report or recommendation,
and in either case our share prices could decline as a result of the report. If one or more of these analysts does not initiate
coverage, ceases to cover our common shares or fails to publish regular reports on our business, we could lose visibility in the
financial markets, which could cause our share prices or trading volume to decline.
If
we or our subsidiaries issue additional common shares or preferred shares, investors in our common shares may experience dilution
of their ownership interests.
We
and our subsidiaries may issue additional common shares or other securities convertible into or exercisable for common shares
to raise additional capital or to hire or retain employees or consultants, or in connection with future acquisitions of companies
or licenses to technology or rights, or for other business purposes. The future issuance of additional securities may be dilutive
to our shareholders and may create downward pressure on the trading price of our common shares.
We
are currently authorized to issue an aggregate of 252,000,000 shares of capital stock consisting of 250,000,000 common shares
and 2,000,000 “blank check” preferred shares, which means we may issue, without stockholder approval, one or more
series of preferred stock having such designation, powers, privileges, preferences, including preferences over our common shares
respecting dividends and distributions, terms of redemption and relative participation, optional, or other rights, if any, of
the shares of each such series of preferred stock and any qualifications, limitations or restrictions thereof, as our board of
directors may determine. The terms of one or more series of preferred stock could dilute the voting power or reduce the value
of our common shares. Any preferred shares may also be convertible into common shares on terms that would be dilutive to holders
of common shares. Our subsidiaries may also issue their own preferred shares with a similar impact on our ownership of the subsidiaries.
As
of December 31, 2020, Lineage had 153,095,883 common shares outstanding, 16,214,547 common shares reserved for issuance upon the
exercise of outstanding options under our employee stock option plans, 92,700 common shares reserved for issuance upon the vesting
and settlement of restricted stock units under our equity incentive plan, and 1,089,900 common shares subject to warrants.
In
addition, in May 2020 we entered into a Controlled Equity Offering SM Sales Agreement (the “Sales Agreement”)
with Cantor Fitzgerald & Co., as sales agent (“Cantor Fitzgerald”), pursuant to which we may, but are not obligated
to, raise up to $25.0 million through the sale of common shares from time to time in at-the-market transactions under the Sales
Agreement. As of December 31, 2020, we made $5.1 million in sales under the Sales Agreement (which excludes $0.3 million
of cash in transit related to 2020 sales that settled in 2021).
The
operation of some of our subsidiaries has been financed in part through the sale of shares of capital stock and warrants to purchase
securities of those subsidiaries to private investors. Future sales of such securities by our subsidiaries could reduce our ownership
interest in the applicable subsidiary, and correspondingly dilute our shareholder’s ownership interests in our consolidated
enterprise. Certain of our subsidiaries also have their own stock option plans and the exercise of stock options or the sale of
restricted stock under those plans would also reduce our ownership interest in the applicable subsidiary, with a resulting dilutive
effect on the ownership interest of our shareholders in our consolidated enterprise.
ITEM
1B.
UNRESOLVED
STAFF COMMENTS
None.
53
ITEM
2.
PROPERTIES
General
In
general, we believe that our properties are well-maintained, adequate and suitable for their current requirements and for our
operations in the foreseeable future. See the Notes to Consolidated Financial Statements – Note 14. Commitments and
Contingencies included elsewhere in this Report.
Lineage
Facilities
Our
corporate headquarters comprise 8,841 square feet of rentable space in an office park in Carlsbad, California. We also sublease
2,432 square feet of space in Alameda, California.
Cell
Cure Facilities
Cell
Cure leases 728.5 square meters (approximately 7,842 square feet) of office and laboratory space in the Bio Park on the campus
of the Hadassah University Hospital in Jerusalem, Israel under a lease that expires on December 31, 2025. We have an option to
extend the term for an additional 5 years.
In
January 2018, Cell Cure entered into another lease for an additional 934 square meters (approximately 10,054 square feet) of office
space in the same facility in Jerusalem, Israel under a lease that expires on December 31, 2025, with two options to extend the
lease for 5 years each. The term of this lease commenced on April 1, 2018 and includes a leasehold improvement construction allowance
of up to NIS 4,000,000 (approximately up to $1.1 million) from the landlord. The leasehold improvements were substantially completed
by December 31, 2018 and the construction allowance was fully utilized.
ITEM
3.
LEGAL
PROCEEDINGS
From
time to time, we are subject to legal proceedings and claims in the ordinary course of business. While management presently believes
that the ultimate outcome of these proceedings, individually and in the aggregate, will not materially harm our financial position,
cash flows, or overall trends in results of operations, legal proceedings are subject to inherent uncertainties, and unfavorable
rulings or outcomes could occur that have individually or in aggregate, a material adverse effect on our business, financial condition
or operating results. Except as described below, we are not currently subject to any pending material litigation, other than ordinary
routine litigation incidental to our business, as described above.
On
February 19, 2019, a putative shareholder class action lawsuit was filed (captioned Lampe v. Asterias Biotherapeutics, Inc.
et al ., Case No. RG19007391) in the Superior Court of the State of California, County of Alameda challenging the Asterias
Merger. On March 1, 2019, Asterias made certain amendments and supplements to its public disclosures regarding the Asterias Merger
(the “Supplemental Disclosures”). On May 3, 2019, an amended class action complaint (the “Amended Complaint”)
was filed. The Amended Complaint named Lineage, Patrick Merger Sub, Inc., the Asterias board of directors, one member of Lineage’s
board of directors, and certain stockholders of both Lineage and Asterias. The action was brought by two purported stockholders
of Asterias, on behalf of a putative class of Asterias stockholders, and asserted breach of fiduciary duty and aiding and abetting
claims under Delaware law. The Amended Complaint alleged, among other things, that the process leading up to the Asterias Merger
was conflicted and inadequate, and that the proxy statement filed by Asterias with the Commission omitted certain material information,
which allegedly rendered the information disclosed materially misleading. The Amended Complaint sought, among other things, that
a class be certified, the recovery of monetary damages, and attorneys’ fees and costs.
On
June 3, 2019, defendants filed demurrers to the Amended Complaint. On August 13, 2019, the parties submitted a stipulation to
the court seeking dismissal of the action with prejudice as to the named Plaintiffs and without prejudice as to the unnamed putative
class members, and disclosing to the court the parties’ agreement to resolve, for $200,000, Plaintiffs’ claim for
an award of attorneys’ fees and expenses in connection with the purported benefit conferred on Asterias stockholders by
the Supplemental Disclosures. The court granted the stipulation and dismissed the action August 14, 2019. Lineage continues to
believe that the claims and allegations in the action lack merit, but believed that it was in Lineage’s shareholders’
best interest for the action to be dismissed and to resolve the fee claim in a timely manner without additional costly litigation
expenses.
On
October 14, 2019, another putative class action lawsuit was filed challenging the Asterias Merger. This action (captioned Ross
v. Lineage Cell Therapeutics, Inc., et al. , C.A. No. 2019-0822) was filed in Delaware Chancery Court and names Lineage, the
Asterias board of directors, one member of Lineage’s board of directors, and certain stockholders of both Lineage and Asterias
as defendants. The action was brought by a purported stockholder of Asterias, on behalf of a putative class of Asterias stockholders,
and asserts breach of fiduciary duty and aiding and abetting claims under Delaware law. The complaint alleges, among other things,
that the process leading up to the Asterias Merger was conflicted, that the Asterias Merger consideration was inadequate, and
that the proxy statement filed by Asterias with the Commission omitted certain material information, which allegedly rendered
the information disclosed materially misleading. The complaint seeks, among other things, that a class be certified, the recovery
of monetary damages, and attorneys’ fees and costs. On December 20, 2019, the defendants moved to dismiss the complaint.
On February 10, 2020, the plaintiff filed an opposition. Defendants filed their replies on March 13, 2020. On June 23, 2020, a
hearing on the motions to dismiss occurred. On September 21, 2020, the Chancery Court denied the motion to dismiss as to Lineage
and certain members of the Asterias board of directors, and it granted the motion to dismiss as to all other defendants. On October
30, 2020, the remaining defendants filed an answer to the complaint.
Lineage
believes the allegations in the action lack merit and intends to vigorously defend the claims asserted. It is impossible at this
time to assess whether the outcome of this proceeding will have a material adverse effect on Lineage’s consolidated results
of operations, cash flows or financial position. Therefore, in accordance with ASC 450, Contingencies, Lineage has not
recorded any accrual for a contingent liability associated with this legal proceeding based on its belief that a liability, while
possible, is not probable nor estimable, and any range of potential contingent liability amounts cannot be reasonably estimated
at this time. Lineage records legal expenses as incurred.
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 shares trade on the NYSE American and on the Tel Aviv Stock Exchange under the ticker symbol LCTX.
Holders
As
of March 1, 2021, there were 384 record holders of our common shares. The number of beneficial owners is substantially
greater than the number of record holders because a large portion of our common shares is held of record through brokerage firms
in “street name.”
Dividend
Policy
We
have not paid dividends on our common shares. We currently intend to retain any earnings for use in the operations of our business.
We, therefore, do not anticipate paying cash dividends on our common shares in the foreseeable future.
Recent
Sales of Unregistered Securities
Except
as previously reported in our quarterly reports on Form 10-Q and current reports on Form 8-K filed with the Securities and Exchange
Commission, during the year ended December 31, 2020, there were no unregistered sales of equity securities by us during
the year ended December 31, 2020.
ITEM
6.
SELECTED
FINANCIAL DATA
We
are a smaller reporting company as defined by Rule 12b-2 of the Securities Exchange Act of 1934, as amended. Accordingly, we are
not required to provide the information required by this item in this Report.
55
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 two-year period ended December 31, 2020, 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, 2020 as compared to the year ended December 31, 2019. This discussion should be read in conjunction with our consolidated
financial statements and related notes included elsewhere in this Report. 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
a number of forward-looking statements, all of which are based on our current expectations and could be affected by the uncertainties
and risks described throughout this Report, particularly in “Item 1A. Risk Factors.”
Overview
We
are a clinical-stage biotechnology company developing novel cell therapies for unmet medical needs. Our focus is to develop therapies
for degenerative retinal diseases, neurological conditions associated with demyelination, and aiding the body in detecting and
combating cancer. Specifically, we are testing therapies to treat dry age-related macular degeneration (“AMD”), spinal
cord injuries, and non-small cell lung cancer. Our programs are based on our proprietary cell-based therapy platform and associated
development and manufacturing capabilities. From this platform, we develop and manufacture specialized, terminally or functionally differentiated human cells from established and well-characterized pluripotent cell lines. These differentiated
cells are developed either to replace or support cells that are dysfunctional or absent due to degenerative disease or traumatic
injury, or are administered as a means of helping the body mount an effective immune response to cancer.
We
have three allogeneic, or “off-the-shelf,” cell therapy programs in clinical development:
●
OpRegen ® ,
a retinal pigment epithelium cell replacement therapy currently in a Phase 1/2a multicenter clinical trial for the treatment
of advanced dry AMD with geographic atrophy. There currently are no therapies approved by the U.S. Food and Drug Administration
(“FDA”) for dry AMD, which accounts for approximately 85-90% of all AMD cases and is the leading cause of blindness
in people over the age of 60.
●
OPC1 ,
an oligodendrocyte progenitor cell therapy currently in a Phase 1/2a multicenter clinical trial for acute spinal cord injuries.
This clinical trial has been partially funded by the California Institute for Regenerative Medicine.
●
VAC2 ,
an allogeneic cancer immunotherapy of antigen-presenting dendritic cells currently in a Phase 1 clinical trial in non-small
cell lung cancer. This clinical trial is being funded and conducted by Cancer Research UK, the world’s largest independent
cancer research charity.
Lineage
completed its merger (the “Asterias Merger”) with Asterias Biotherapeutics, Inc. (“Asterias”) on March
8, 2019, which incorporated OPC1 and VAC2 into its cell therapy product portfolio.
In
addition to seeking to create value for shareholders by developing product candidates and other technologies through our clinical
development programs, we also seek to create value from our technologies through partnering and strategic transactions. We founded
two companies that later became publicly traded companies: OncoCyte Corporation (“OncoCyte”) and AgeX Therapeutics,
Inc. (“AgeX”).
During
the year ended December 31, 2020, we received approximately $12.6 million in gross proceeds in connection with our sale of shares
of OncoCyte and AgeX. In August 2020, we also received $24.6 million from Juvenescence Limited (“Juvenescence”), representing
principal and accrued interest under a promissory note we received in connection with our sale of AgeX shares to Juvenescence in
August 2018.
We
no longer hold any common stock in AgeX. The value of our OncoCyte holdings as of March 5, 2021, was approximately $4.2
million, based on the closing price of its common stock on that date. In this Report, see Part I, Item 1A, “Risk Factors—Risks
Related to Our Business Operations and Capital Requirements—The value of our investments in public companies fluctuates
based on their respective stock prices and could be negatively affected by poor business performance.”
56
Though
our principal focus is on advancing our three cell therapy programs in clinical development, we may seek to create additional
value through corporate transactions, as we have in the past.
Critical
Accounting Policies
The
preparation of consolidated financial statements in conformity with accounting principles generally accepted in the United States
(“GAAP”) requires management to make estimates and assumptions that affect the reported amounts in our consolidated
financial statements and related notes. Our significant accounting policies are described in Note 2 to our consolidated financial
statements included elsewhere in this Report. We have identified below our critical accounting policies and estimates that we
believe require the greatest amount of judgment. On an ongoing basis, we evaluate estimates which are subject to significant judgment,
including those related to going concern assessment of our consolidated financial statements, useful lives associated with long-lived
assets, including evaluation of asset impairment, allowances for uncollectible accounts and financing receivables, v aluing
shares owned in nonconsolidated companies using the equity method of accounting, loss contingencies, deferred income taxes
and tax reserves, including valuation allowances related to deferred income taxes, and assumptions used to value stock-based awards,
debt or other equity instruments. Actual results could differ materially from those estimates. On an ongoing basis, we evaluate
our estimates compared to historical experience and trends which form the basis for making judgments about the carrying value
of assets and liabilities. To the extent that there are material differences between our estimates and our actual results, our
future financial statement presentation, financial condition, results of operations and cash flows will be affected.
We
believe the assumptions and estimates associated with the following have the greatest potential impact on our consolidated financial
statements.
Business
Combinations – We account for business combinations, such as the Asterias Merger, in accordance with Accounting Standards
Codification (“ASC”) Topic 805, Business Combinations , which requires the purchase price to be measured at
fair value. When the purchase consideration consists entirely of our common shares, we calculate the purchase price by determining
the fair value, as of the acquisition date, of shares issued in connection with the closing of the acquisition. We recognize estimated
fair values of the tangible assets and intangible assets acquired, including in-process research and development (“IPR&D”),
and liabilities assumed as of the acquisition date, and we record as goodwill any amount of the fair value of the tangible and
intangible assets acquired and liabilities assumed in excess of the purchase price.
Goodwill
and IPR&D – Goodwill is calculated as the difference between the acquisition date fair value of the consideration
transferred and the values assigned to the assets acquired and liabilities assumed. Goodwill is not amortized but is tested for
impairment at least annually, or more frequently if circumstances indicate potential impairment. IPR&D assets are indefinite-lived
intangible assets until the completion or abandonment of the associated research and development (“R&D”) efforts.
Once the R&D efforts are completed or abandoned, the IPR&D will either be amortized over the asset life as a finite-lived
intangible asset or be impaired, respectively, in accordance with ASC 350, Intangibles – Goodwill and Other . In accordance
with ASC 350, goodwill and acquired IPR&D are determined to have indefinite lives and, therefore, are not amortized. Instead,
they are tested for impairment at least annually and between annual tests if we become aware of an event or a change in circumstances
that would indicate the asset may be impaired.
Leases
– We account for leases in accordance with ASC 842, Leases . We determine if an arrangement is a lease at inception.
Leases are classified as either financing or operating, with classification affecting the pattern of expense recognition in the
consolidated statements of operations. Under the available practical expedients for the adoption of ASC 842, we account for the
lease and non-lease components as a single lease component. We recognize right-of-use (“ROU”) assets and lease liabilities
for leases with terms greater than twelve months in the consolidated balance sheet. ROU assets represent our right to use an underlying
asset during the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating
lease ROU assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease
term. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available
at commencement date in determining the present value of lease payments. We use the implicit rate when readily determinable. The
operating lease ROU asset also includes any lease payments made and excludes lease incentives. Our lease terms may include options
to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for lease payments
is recognized on a straight-line basis over the lease term. Operating leases are included as right-of-use assets in property and
equipment, and ROU lease liabilities, current and long-term, in the consolidated balance sheets. Financing leases are included
in property and equipment, and in financing lease liabilities, current and long-term, in the consolidated balance sheets. We disclose
the amortization of our ROU assets and operating lease payments as a net amount, “Amortization of ROU assets”, on
the consolidated statement of cash flows.
57
Going
concern assessment – In accordance with Accounting Standards Update (“ASU”) 2014-15, Presentation of
Financial Statements – Going Concern , we assess going concern uncertainty in our consolidated financial statements to
determine if we have sufficient cash and cash equivalents on hand and working capital to operate for a period of at least one
year from the date our consolidated financial statements are issued or are available to be issued, which is referred to as the
“look-forward period” as defined by ASU No. 2014-15. As part of this assessment, based on conditions that are known
and reasonably knowable to us, we will consider various scenarios, forecasts, projections, and estimates, and we will make certain
key assumptions, including the timing and nature of projected cash expenditures or programs, and our ability to delay or curtail
those expenditures or programs, if necessary, among other factors. Based on this assessment, as necessary or applicable, we make
certain assumptions concerning our ability to curtail or delay research and development programs and expenditures to the extent
we deem probable those implementations can be achieved and we have the proper authority to execute them within the look-forward
period in accordance with ASU 2014-15.
Marketable
Equity Securities – We account for our shares in OncoCyte and HBL (and previously AgeX) as marketable equity securities
in accordance with ASC 320-10-25, Investments – Debt and Equity Securities , as amended by Accounting Standards Update
(“ASU”) 2016-01, Financial Instruments–Overall: Recognition and Measurement of Financial Assets and Financial
Liabilities, further discussed below .
OncoCyte
and AgeX shares have readily determinable fair values quoted on the NYSE American under trading symbols “OCX” and
“AGE”. The HBL shares have a readily determinable fair value quoted on the Tel Aviv Stock Exchange (“TASE”)
under trading symbol “HDST” where share prices are denominated in New Israeli Shekels (NIS).
Prior
to September 11, 2019, we accounted for our OncoCyte shares held at fair value, using the equity method of accounting. On September
11, 2019, Lineage’s ownership percentage decreased from 24% to 16% when it sold 4.0 million shares of OncoCyte common stock.
Accordingly, as the ownership percentage was reduced to less than 20%, we are no longer considered to exercise significant influence
over OncoCyte and are now accounting for our OncoCyte holdings as marketable equity securities. Prior to the Asterias Merger completed
on March 8, 2019, we accounted for our Asterias shares held at fair value, using the equity method of accounting.
Royalties
from product sales and license fees – Lineage’s performance obligations in agreements with certain customers is
to provide a license to allow customers to make, import and sell company licensed products or methods for preclinical studies
and commercial use. Customers pay a combination of a license issue fee paid up front and a sales-based royalty, if any, in some
cases with yearly minimums. The transaction price is deemed to be the license issue fee stated in the contract. The license offered
by Lineage is a functional license with significant standalone functionality and provides customers with the right to use Lineage’s
intellectual property. This allows Lineage to recognize revenue on the license issue fee at a point in time at the beginning of
the contract, which is when the customer begins to have use of the license. Variable consideration related to sales-based royalties
is recognized only when (or as) the later of one or more of the following events occur: (i) a sale or usage occurs; or (ii) the
performance obligation to which some, or all, of the sales-based or usage-based royalty that has been allocated and has been satisfied
or partially satisfied. Due to the contract termination clauses, Lineage does not expect to receive all of the minimum royalty
payments throughout the term of the agreements. Therefore, Lineage fully constrains recognition of the minimum royalty payments
as revenues until its customers are obligated to pay, which is generally within 60 days prior to the beginning of each year the
minimum royalty payments are due.
Grant
revenues – In applying the provisions of Topic 606, Lineage has determined that government grants are out of the scope
of Topic 606 because the government entities do not meet the definition of a “customer”, as defined by Topic 606,
as there is not considered to be a transfer of control of good or services to the government entities funding the grant. Lineage
has, and will continue to, account for grants received to perform research and development services in accordance with ASC 730-20,
Research and Development Arrangements , which requires an assessment, at the inception of the grant, of whether the grant
is a liability or a contract to perform research and development services for others. If Lineage or a subsidiary receiving the
grant is obligated to repay the grant funds to the grantor regardless of the outcome of the research and development activities,
then Lineage is required to estimate and recognize that liability. Alternatively, if Lineage or a subsidiary receiving the grant
is not required to repay, or if it is required to repay the grant funds only if the research and development activities are successful,
then the grant agreement is accounted for as a contract to perform research and development services for others, in which case,
grant revenue is recognized when the related research and development expenses are incurred.
58
Deferred
grant revenues represent grant funds received from the governmental funding agencies for which the allowable expenses have not
yet been incurred as of the balance sheet date reported.
Long-lived
intangible assets – Long-lived intangible assets, consisting primarily of acquired patents, patent applications, and
licenses to use certain patents are stated at acquired cost, less accumulated amortization. Amortization expense is computed using
the straight-line method over the estimated useful lives of the assets, generally over five to ten years.
Impairment
of long-lived assets – Our long-lived assets, including long-lived intangible assets, are reviewed for impairment whenever
events or changes in circumstances indicate that the carrying amount of an asset may not be fully recoverable. If an impairment
indicator is present, we evaluate recoverability by a comparison of the carrying amount of the assets to future undiscounted net
cash flows expected to be generated by the assets. If the assets are impaired, the impairment recognized is measured by the amount
by which the carrying amount exceeds the estimated fair value of the assets.
Research
and development – Research and development expenses consist of costs incurred for company-sponsored, collaborative and
contracted research and development activities. These costs include direct and research-related overhead expenses including compensation
and related benefits, stock-based compensation, consulting fees, research and laboratory fees, rent of research facilities, amortization
of intangible assets, and license fees paid to third parties to acquire patents or licenses to use patents and other technology.
We expense research and development costs as incurred. Research and development expenses incurred and reimbursed by grants from
third parties approximate the grant income recognized in the consolidated statements of operations.
Stock-based
compensation – We follow accounting standards governing share-based payments, which require the measurement and recognition
of compensation expense for all share-based compensation awards made to directors and employees, including employee stock options,
based on estimated fair values. We utilize the Black-Scholes option pricing model. Our determination of fair value of share-based
payment awards on the date of grant using an option-pricing model is affected by our stock price as well as assumptions regarding
a number of complex and subjective variables. These variables include, but are not limited to, expected stock price volatility
over the term of the awards, and the expected term of options granted, which is derived using the simplified method, which is
an average of the contractual term of the option and its vesting period, as we do not have sufficient historical exercise data.
The risk-free rate is based on the U.S. Treasury yield in effect at the time of grant for zero coupon U.S. Treasury notes with
maturities similar to the expected term of the awards. Forfeitures are accounted for as they occur.
Although
the fair value of employee stock options is determined in accordance with FASB guidance, changes in the assumptions can materially
affect the estimated value and therefore the amount of compensation expense recognized in the consolidated financial statements.
In
management’s opinion, the existing valuation models may not provide an accurate measure of the fair value of employee stock
options because the option-pricing model value may not be indicative of the fair value that would be established in a willing
buyer/willing seller market transaction.
Income
taxes – We account for income taxes in accordance with ASC 740, Income Taxes , which prescribe the use of the
asset and liability method, whereby deferred tax asset or liability account balances are calculated at the balance sheet date
using current tax laws and rates in effect. Valuation allowances are established when necessary to reduce deferred tax assets
when it is more likely than not that a portion or all of the deferred tax assets will not be realized. ASC 740 guidance also prescribes
a recognition threshold and a measurement attribute for the financial statement recognition and measurement of tax positions taken
or expected to be taken in a tax return. For benefits to be recognized, a tax position must be more-likely-than-not sustainable
upon examination by taxing authorities. We file a U.S. federal income tax return as well as various state and foreign income tax
returns. Our judgments regarding future taxable income may change over time due to changes in market conditions, changes in tax
laws, tax planning strategies or other factors. If our assumptions, and consequently the estimates, change in the future with
respect to our own deferred tax assets and liabilities, the valuation allowance may be increased or decreased, which may have
a material impact on our consolidated financial statements. We
recognize accrued interest and penalties related to unrecognized tax benefits, if any, as income tax expense, however, no amounts
were accrued for the payment of interest and penalties as of December 31, 2020 and 2019.
59
Principles
of consolidation – Our consolidated financial statements include the accounts of our wholly owned and majority-owned
subsidiaries. All material intercompany accounts and transactions have been eliminated in consolidation. The consolidated financial
statements are presented in accordance with accounting principles generally accepted in the U.S. and with the accounting and reporting
requirements of SEC Regulation S-X.
Results
of Operations
Comparison
of Years Ended December 31, 2020 and 2019
Revenues
The
following table shows our revenues for the years ended December 31, 2020 and 2019 (amounts in thousands except percentages).
Year Ended December 31,
$ Increase/
% Increase/
2020
2019
(Decrease)
(Decrease)
Grant revenues
$ 1,053
$ 2,037
$ (984 )
(48 %)
Royalties from product sales and license fees
773
1,221
(448 )
(37 %)
Sale of research products and services
-
257
(257 )
(100 %)
Total revenues
1,826
3,515
(1,689 )
(48 %)
Cost of sales
(385 )
(412 )
(27 )
(7 %)
Gross profit
$ 1,441
$ 3,103
$ (1,662 )
(54 %)
Total
revenues for the year ended December 31, 2020 were $1.8 million compared to $3.5 million for the year ended December 31, 2019.
The decrease of $1.7 million is primarily due to a $1.0 million decrease in grant revenue,
a $0.4 million decrease in royalties from product sales and license fees and a $0.3 million decrease in the sale of research products
and services due to the cessation of such sales .
Grant
revenues are generated primarily by our subsidiary Cell Cure Neurosciences Ltd (“Cell Cure”) from the Israel Innovation
Authority (“IIA”) for the development of OpRegen® and our bio retina program, and from a Small Business
Innovation Research grant from the National Institutes of Health for our vision restoration program (the “NIH grant”).
The decreases in our grant revenues for the year ended December 31, 2020 as compared to the year ended December 31, 2019, were
primarily due to less grant-related activities. Grant revenues generated by Cell Cure from the IIA for the development of OpRegen
and our bio retina program (commencing in 2020) amounted to $0.7 million and $1.4 million for the years ended December
31, 2020 and 2019, respectively, and grant revenues generated by the NIH grant amounted to $0.4 million and $0.6 million for the
years ended December 31, 2020 and 2019, respectively.
Royalties
from product sales and license fees are generated from non-exclusive license agreements with multiple third parties. A majority
of our royalties from product sales and license fees for the year ended December 31, 2020 are related to technologies that were
acquired in the Asterias Merger. The decrease of $0.4 million for the year ended December 31, 2020 compared to the year ended
December 31, 2019 was primarily related to the impact from a $0.6 million upfront, non-refundable payment for a new license agreement
with a third party for the use of certain patents related to the culture of undifferentiated pluripotent stem cells in suspension
that was recorded in 2019.
Operating
Expenses
The
following table shows our operating expenses for the years ended December 31, 2020 and 2019 (amounts in thousands, except percentages).
Year Ended December 31,
$
%
2020
2019
Decrease
Decrease
Research and development expenses
$ 12,317
$ 17,948
$ (5,631 )
(31 %)
General and administrative expenses
15,571 (1)
24,031 (2)
(8,460 )
(35 %)
(1)
Includes
$0.7 million of acquisition related costs for the Asterias Merger.
(2)
Includes
$5.1 million of acquisition related costs for the Asterias Merger.
60
Research
and development expenses
Research
and development expenses consist of costs incurred for company-sponsored, collaborative and contracted research and development
activities. These costs include direct and research-related overhead expenses including compensation and related benefits, stock-based
compensation, consulting fees, research and laboratory fees, rent of research facilities, amortization of intangible assets, and
license fees paid to third parties to acquire patents or licenses to use patents and other technology. We expense research and
development costs as incurred. Research and development expenses incurred and reimbursed by grants from third parties approximate
the grant income recognized in the consolidated statements of operations.
The
following table shows the amount of our total research and development expenses allocated to our primary research and development
projects for the periods presented (amounts in thousands, except percentages).
Year
Ended December 31,
(unaudited)
Amount
Percent of Total
Program
2020
2019
2020
2019
OpRegen ®
and other ophthalmic applications
$ 5,569
$ 12,069
45 %
67 %
OPC1
3,958
4,488
32 %
25 %
VAC platform
2,472
322
20 %
2 %
Renevia and all other
318
1,069
3 %
6 %
Total research and development expenses
$ 12,317
$ 17,948
100 %
100 %
Research
and development expenses for the year ended December 31, 2020 were $12.3 million as compared to $17.9 million for the year
ended December 31, 2019. The decrease of $5.6
million is mainly attributable to the following:
●
a
decrease of $6.5 million in OpRegen and other ophthalmic application expenses, attributable primarily to a decrease in manufacturing
activities in 2020 as compared to 2019,
●
a
decrease of $0.5 million in OPC1 related expenses, primarily related to return of unspent project funds of approximately
$0.8 million from a former Asterias service provider,
●
a
decrease of $0.8 million in Renevia and other related expenses as Renevia received a CE Mark in September 2019 and we are
spending less on research activities as we are actively looking for a commercialization partner in Europe, offset by
●
an
increase of $2.2 million in VAC program expenses, primarily related to the accrual of the signature fee of £1.25 million
($1.6 million) to Cancer Research UK.
General
and administrative expenses
General
and administrative expenses include employee and director compensation allocated to general and administrative expenses, consulting
fees other than those paid for science-related consulting, facilities and equipment rent and maintenance related expenses, insurance
costs allocated to general and administrative expenses, costs of patent applications, prosecution and maintenance, stock
exchange-related costs, depreciation expense, marketing costs, board fees, legal and accounting costs, and other miscellaneous
expenses which are allocated to general and administrative expense.
General
and administrative expenses for the year ended December 31, 2020 were $15.6 million as compared to $24.0 million for the year
ended December 31, 2019. The total net decrease
of $8.4 million was primarily attributable to a $5.5 million reduction in Asterias Merger related expenses, a $2.1 million reduction
in compensation costs as a result of headcount reductions in 2019, a $0.9 million reduction in accounting expenses, a $0.5
million reduction in rent and utilities, a $0.3 million reduction in travel expenses, a $0.3 million reduction in office and information
technology related expenses and a $0.2 million reduction in consulting expenses, offset by a $0.9 million increase related to
the cessation of shared services reimbursements and a $0.5 million increase in legal and patent expenses.
61
Other
income and expenses, net
The
following table shows the amount of other income, net, during the year ended December 31, 2020 and 2019 (in thousands):
Year Ended December 31,
2020
2019
Other income, net
Interest income, net
$ 1,039
$ 1,685
Gain on sale of marketable equity securities
4,560
2,421
Unrealized loss on marketable equity securities
(3,782 )
(2,898 )
Gain on sale of equity method investment in OncoCyte
-
546
Unrealized gain on equity method investment in OncoCyte at fair value
-
8,001
Unrealized gain on equity method investment in Asterias at fair value
-
6,744
Unrealized (loss) gain on warrant liability
(174 )
611
Other income, net
2,880
2,532
Total other income, net
$ 4,523
$ 19,642
Interest
income and expense, net – During the years ended December 31, 2020 and 2019, we earned $1.0 million and $1.5 million
of interest income, respectively, from our promissory note with Juvenescence Limited (“Juvenescence”).
Gain
on equity method investment in Asterias – Prior to the closing of the Asterias Merger on March 8, 2019, we owned 21.7
million shares of common stock of Asterias, which we accounted for at fair value using the equity method of accounting. The fair
value of our Asterias shares was approximately $20.2 million as of March 8, 2019, the closing date of the Asterias Merger, based
on $0.93 per share, which was calculated by multiplying: (i) $1.31, the closing price of our common shares on such date; by (ii)
the merger exchange ratio of 0.71. The fair value of our Asterias shares was approximately $13.5 million as of December 31, 2018,
based on the closing price of Asterias common stock of $0.62 per share on such date. Accordingly, we recorded an unrealized gain
of $6.7 million for the year ended December 31, 2019, representing the change in fair value of Asterias common stock from December
31, 2018 to March 8, 2019.
Gain
(loss) on investment in OncoCyte – Prior to September 11, 2019, we elected to account for our shares of OncoCyte common
stock at fair value using the equity method of accounting. We sold 2.25 million shares of OncoCyte common stock for net proceeds
of $4.2 million in July 2019. Accordingly, our ownership in OncoCyte was reduced from 28% to 24%. We sold an additional 4.0 million
shares of OncoCyte common stock for net proceeds of $6.5 million on September 11, 2019. Our ownership in OncoCyte was further
reduced to 16% at this time. Effective September 11, 2019, we began accounting for our shares of OncoCyte common stock as marketable
equity securities.
As
of December 31, 2019, we had 8.4 million shares of OncoCyte common stock. These shares had a fair value of $19.0 million, based
on the closing price of OncoCyte common stock of $2.25 per share on December 31, 2019.
As
of December 31, 2020, we owned 3.6 million shares of OncoCyte common stock. These shares had a fair value of $8.7 million, based
on the closing price of OncoCyte common stock of $2.39 per share on December 31, 2020,
For
the year ended December 31, 2020, we recorded a realized gain of $3.1 million due to sales of OncoCyte shares in the period. In
the same period, we also recorded an unrealized loss of $2.5 million related to our OncoCyte shares. The unrealized loss is comprised
of $3.7 million related to the difference between the book cost basis of OncoCyte shares sold in the period versus the applicable
prior month’s ending OncoCyte stock price, which is offset by $1.2 million related to the shares remaining at December 31,
2020 and the increase in OncoCyte’s stock price from $2.25 at December 31, 2019 to $2.39 at December 31, 2020. For the year
ended December 31, 2019, we recorded a realized gain of $0.5 million due to sales of OncoCyte shares in the period. We
also recorded an unrealized gain of $8.8 million due to the increase in OncoCyte’s stock price from $1.38 per share at December
31, 2018 to $2.25 per share at December 31, 2019. $8.0 million of the unrealized gain was recorded as an unrealized gain on an
equity method investment as it was prior to September 11, 2019; the remaining $0.8 million was recorded as an unrealized gain
on marketable equity securities.
62
All
share prices are determined based on the closing price of OncoCyte common stock on the NYSE American on the applicable dates,
or the last day of trading of the applicable quarter, if the last day of a quarter fell on a weekend.
We
expect our other income and expenses, net, to continue to fluctuate each reporting period based on the changes in the market price
of our OncoCyte shares, which could significantly impact our net income or loss reported in our condensed consolidated statements
of operations for each period.
Marketable
equity securities – We account for the shares we held in Hadasit Bio-Holdings (“HBL”) and AgeX as marketable
equity securities, carried at fair market value on our consolidated balance sheets.
For
the year ended December 31, 2020, we recorded realized gains of $0.8 million and $0.6 million due to sales of AgeX shares and
HBL shares, respectively, in the period.
For
the year ended December 31, 2020, we recorded unrealized losses of $1.3 million related to our AgeX shares. $0.5 million of the
unrealized loss was related to the difference between the book cost basis of AgeX shares sold in the period versus the applicable
prior month’s ending AgeX share price and an additional $0.8 million was related to mark to mark adjustments throughout
the year on the remaining shares of AgeX at each applicable period.
Other
income and expenses, net – Other income and expenses, net, in 2020 and 2019 consist primarily of net foreign currency
transaction gains and losses recognized by Cell Cure and ESI, and changes in the fair value of the Cell Cure liability classified
warrants. Foreign currency transaction gains and losses for the periods presented are principally related to the remeasurement
of the U.S. dollar denominated notes payable by Cell Cure to Lineage.
Income
Taxes
The
market value of the shares of OncoCyte common stock we hold creates a deferred tax liability (the “OncoCyte DTL”)
based on the closing prices of the shares, less our tax basis in the shares. The OncoCyte DTL is a source of future taxable income
to us, as prescribed by ASC 740-10-30-17, that will more likely than not result in the realization of our deferred tax assets
to the extent of the OncoCyte DTL. The OncoCyte DTL is determined based on the closing prices of the OncoCyte shares as of December
31, 2020. Due to the inherent unpredictability of future prices of those shares, we cannot reliably estimate or project the OncoCyte
DTL on an annual basis. Therefore, the OncoCyte DTL is determined based on the actual closing prices on the last stock market
trading day of the applicable accounting period, and the related impacts to the valuation allowance and deferred tax asset changes,
and are recorded in the accounting period in which they occur.
In
connection with the Asterias Merger, a deferred tax liability of $10.8 million (the “Asterias DTL”) was recorded as
part of the acquisition accounting (see Note 3). The Asterias DTL is related to fair value adjustments for the assets and liabilities
acquired in the Asterias Merger, principally consisting of IPR&D. This estimate of deferred taxes was determined based on
the excess of the estimated fair values of the acquired assets and liabilities over the tax basis of the assets and liabilities
acquired. The statutory tax rate was applied, as appropriate, to the adjustment based on the jurisdiction in which the adjustment
is expected to occur. Because the IPR&D (prior to completion or abandonment of the R&D) is considered an indefinite-lived
asset for accounting purposes, the fair value of the IPR&D on the acquisition date creates a deferred income tax liability
in accordance with ASC 740. The Asterias DTL is computed using the fair value of the IPR&D assets on the acquisition date
multiplied by Lineage’s respective federal and state income tax rates. While the Asterias DTL would reverse on impairment
or sale or commencement of amortization of the related intangible assets, those events are not anticipated under ASC 740 for purposes
of predicting reversal of a temporary difference to support the realization of deferred tax assets, except for certain deferred
tax assets and credit carryforwards that are also indefinite in nature as of the Asterias Merger date, which may be considered
for reversal under ASC 740 as further discussed below.
A
valuation allowance is provided when it is more likely than not that some portion of the deferred tax assets will not be realized.
Lineage established a full valuation allowance as of December 31, 2018 due to the uncertainty of realizing future tax benefits
from its net operating loss carryforwards and other deferred tax assets, including foreign net operating losses generated by its
subsidiaries. During the year ended December 31, 2019, a portion of the valuation allowance was released as it relates to Lineage’s
indefinite lived assets that can be used against the indefinite lived liabilities. The amount of the valuation allowance released
was $7.4 million; as new indefinite lived deferred tax assets are generated, we will continue to book provision benefits until
the deferred tax liability position is exhausted, barring any new developments.
63
For
the year ended December 31, 2020, Lineage recorded a $1.2 million deferred tax benefit for income taxes.
We
expect that deferred income tax expense or benefit we record each reporting period, if any, will vary depending on the change
in the closing stock prices of OncoCyte shares from period to period and the related changes in those deferred tax liabilities
and our deferred tax assets and other credits, including changes in the valuation allowance, for each period.
See
Note 3 to our consolidated financial statements included elsewhere in this Report for a description of the Asterias Merger that
was completed on March 8, 2019. We have concluded that an ownership change did occur after the Asterias Merger, and the acquired
operating loss carryforwards are subject to limitation under Section 382 of the Internal Revenue Service Code; Lineage will only
be able to utilize $52.8 million of these operating loss carryforwards.
Liquidity
and Capital Resources
At
December 31, 2020, we had $41.6 million of cash, cash equivalents and marketable equity securities on hand, which includes our
investments in OncoCyte and HBL. We may use our marketable equity securities for liquidity, as necessary, and as market conditions
allow. The market value may not represent the amount that could be realized in a sale of investment shares due to various market
and regulatory factors, including trading volume or market depth factors and volume and manner of sale restrictions under Federal
securities laws, prevailing market conditions and prices at the time of any sale, and subsequent sales of securities by the entities.
In addition, the value of our marketable equity securities may be significantly and adversely impacted by deteriorating global
economic conditions and the recent disruptions to and volatility in the credit and financial markets in the United States and
worldwide resulting from the ongoing COVID-19 pandemic.
Since
inception, we have incurred significant operating losses and have funded our operations primarily through the issuance of equity
securities, the sale of common stock of our former subsidiaries, AgeX and OncoCyte, payments from research grants, royalties from
product sales and sales of research products and services. At December 31, 2020, we had an accumulated deficit of approximately
$294.1 million, working capital of $36.2 million and shareholders’ equity of $95.1 million. We evaluated the projected cash
flows for Lineage and our subsidiaries, and we believe that our $41.6 million in cash, cash equivalents and marketable equity
securities at December 31, 2020, provide sufficient cash, cash equivalents, and liquidity to carry out our current planned operations
through at least twelve months from the issuance date of our consolidated financial statements included elsewhere in this Report.
If we need near term working capital or liquidity to supplement our cash and cash equivalents for our operations, we may sell
some, or all, of our investments, as necessary.
On
March 8, 2019, the Asterias Merger closed and Asterias became our wholly owned subsidiary. We began consolidating Asterias’
operations and results with our operations and results beginning on March 8, 2019. As we integrated Asterias’ operations
into our own, we made extensive reductions in headcount and reduced non-clinical related spend, in each case, as compared to Asterias’
operations before the merger. We implemented significant cost savings initiatives and achieved reduced operational spend in 2020
compared to prior periods.
Our
projected cash flows are subject to various risks and uncertainties, and the unavailability or inadequacy of financing to meet
future capital needs could force us to modify, curtail, delay, or suspend some or all aspects of our current planned operations.
Our determination as to when we will seek new financing and the amount of financing that we will need will be based on our evaluation
of the progress we make in our research and development programs, any changes to the scope and focus of those programs, any changes
in grant funding for certain of those programs, and projection of future costs, revenues, and rates of expenditure. Our ability
to raise additional funds may be adversely impacted by deteriorating global economic conditions and the disruptions to and volatility
in the credit and financial markets in the United States and worldwide resulting from the ongoing COVID-19 pandemic. We may be
required to delay, postpone, or cancel our clinical trials or limit the number of clinical trial sites, unless we are able to
obtain adequate financing. We cannot assure that adequate financing will be available on favorable terms, if at all. Sales of
additional equity securities by us or our subsidiaries and affiliates could result in the dilution of the interests of our current
shareholders.
64
Cash
used in operating activities
Net
cash used in operating activities of $19.8 million for the year ended December 31, 2020 primarily reflects the loss from operations
of $26.4 million adjusted for the changes in assets and liabilities of $1.3 million. These items were offset primarily
by non-cash expenses of $2.2 million for stock-based compensation and $2.1 million of depreciation and amortization. The unrealized
gains on equity method investments and marketable securities, foreign currency remeasurement and deferred tax benefit are non-cash
items that had no effect on cash flows.
Net
cash used in operating activities of $31.9 million for the year ended December 31, 2019 primarily reflects the loss from operations
of $38.9 million adjusted for the changes in assets and liabilities of $2.1 million. These items were offset primarily by non-cash
expenses of $3.6 million for stock-based compensation and $3.1 million of depreciation and amortization. The unrealized gains
on equity method investments and marketable securities, foreign currency remeasurement and deferred tax benefit are non-cash items
that had no effect on cash flows.
Cash
used in investing activities
Cash
provided by investing activities of $13.0 million for the year ended December 31, 2020 was associated primarily with receipts
of $10.9 million from sales of a portion of our OncoCyte holdings, $1.3 million in sales of our AgeX holdings and $0.8 million
in sales of a portion of our HBL holdings.
Cash
provided by investing activities of $17.0 million for the year ended December 31, 2019 was associated primarily with receipts
of $10.7 million from sales of a portion of our OncoCyte holdings, $1.7 million in sales of a portion of our AgeX holdings and
$1.7 million in sales of a portion of our HBL holdings as well as the receipt of $3.1 million of cash that Asterias had on the
closing date of the Asterias Merger, offset by $0.4 million in purchases of equipment and other assets.
Cash
provided by financing activities
Cash
provided by financing activities of $29.9 million for the year ended December 31, 2020 was associated primarily with proceeds
of $24.6 million from payment of the Juvenescence promissory note, gross proceeds of $5.1 million from sales of our common
shares in at-the-market transactions under our Controlled Equity Offering SM Sales Agreement with Cantor Fitzgerald
& Co (which excludes $0.3 million of cash in transit related to 2020
sales that settled in 2021), and proceeds of $0.5 million from a Paycheck Protection Program (“PPP”) loan under the Coronavirus
Aid, Relief, and Economic Security Act, all offset by $0.4 million in financing costs.
Cash
provided by financing activities of $0.6 million for the year ended December 31, 2019 was associated primarily with $0.8 million
in landlord reimbursements for tenant improvements, offset by $0.1 million in common shares received and retired for employee
taxes paid.
Off-Balance
Sheet Arrangements
As
of December 31, 2020, we did not have any off-balance sheet arrangements, as defined under the rules of the Securities and Exchange
Commission.
ITEM
7A.
QUANTITATIVE
AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
Under
rules and regulations of the Securities and Exchange Commission, as a smaller reporting company, we are not required to provide
the information required by this item.
65
ITEM
8.
FINANCIAL
STATEMENTS AND SUPPLEMENTARY DATA
Index
to consolidated financial statements
Report of OUM & CO. LLP, Independent Registered Public Accounting Firm – Audit Opinion
67
Financial Statements:
Consolidated
Balance Sheets
69
Consolidated
Statements of Operations
70
Consolidated
Statements of Comprehensive Loss
71
Consolidated
Statements of Shareholders Equity
72
Consolidated
Statements of Cash Flows
73
See
accompanying notes to consolidated financial statements.
66
Report
of Independent Registered Public Accounting Firm
Shareholders
and Board of Directors
Lineage
Cell Therapeutics, Inc.
Carlsbad,
California
Opinion
on the Consolidated Financial Statements
We
have audited the consolidated balance sheets of Lineage Cell Therapeutics, Inc. and Subsidiaries (collectively, the “Company”)
as of December 31, 2020 and 2019, and the related consolidated statements of operations, comprehensive income (loss), changes
in shareholders’ equity, and cash flows for each of the two years in the period ended December 31, 2020, and the related
notes (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial
statements present fairly, in all material respects, the financial position of the Company at December 31, 2020 and 2019, and
the results of their operations and their cash flows for each of the two years in the period ended December 31, 2020 , in
conformity with accounting principles generally accepted in the United States of America.
Basis
for Opinion
These
consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an
opinion on the Company’s consolidated financial statements based on our audits. We are a public accounting firm registered
with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws
and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We
conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit
to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether
due to error or fraud.
Our
audits included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether
due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis,
evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the
accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the
consolidated financial statements. We believe that our audits provide a reasonable basis for our opinion.
Critical
Audit Matter
The
critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial statements
that was communicated or required to be communicated to the Audit Committee and that: (1) relates to accounts or disclosures that
are material to the consolidated financial statements; and (2) involved our especially challenging, subjective, or complex judgments.
The communication of a critical audit matter does not alter in any way our opinion on the consolidated financial statements, taken
as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit
matter or on the accounts or disclosures to which it relates.
67
Intangible
Assets Impairment Assessment - In-Process Research and Development
Description
of the Matter
As
described in Note 7 to the consolidated financial statements, the Company’s in-process research and development indefinite-lived
intangible assets had a balance of $46.5 million as of December 31, 2020.
Indefinite-lived
intangible assets are tested for impairment annually and when events or changes in circumstances indicate that the asset might
be impaired. As part of its indefinite-live intangible asset impairment assessment, management estimates the fair values of the
Company’s indefinite-lived intangible assets using an income approach that utilizes a discounted cash flow model or, where
appropriate, a market approach. The discounted cash flow model is dependent upon management’s estimates of future cash flows
and other factors such as estimates of (i) future operating performance, including future sales, long-term growth rates, operating
margins, discount rates, variations in the amount and timing of cash flows and the probability of achieving the estimated cash
flows, and (ii) future economic conditions.
Auditing
the Company’s impairment analysis of its indefinite-lived intangible assets is complex because of the significant judgment
and estimates used by management in developing the fair value measurement of in-process research and development intangible assets.
This in turn leads to significant audit effort and a high degree of auditor judgment and subjectivity in performing procedures
to evaluate management’s estimated cash flows, including significant assumptions related to future sales, long-term growth
rates, operating margins, discount rates, variations in the amount and timing of cash flows and the probability of achieving the
estimated cash flows, and future economic conditions in determining the fair value of each of the in-process research and development
intangible assets.
How
We Addressed the Matter in Our Audit
Addressing
the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the
consolidated financial statements. These procedures included, among others, obtaining an understanding of and evaluating management’s
process for identifying potential impairment events; evaluating the appropriateness of the cash flow model used in the impairment
testing process; testing the completeness, accuracy, and relevance of underlying data used in the model; and evaluating the reasonableness
of the significant assumptions used by management, including the future cash flow projections and discount rates. We evaluated
the reasonableness of management’s assumptions for future cash flow projections and discount rates in consideration of (i)
the current and past performance of the asset group, (ii) the consistency with external market and industry data, and (iii) whether
these assumptions were consistent with evidence obtained in other areas of the audit.
/s/
OUM & CO. LLP
San
Francisco, California
March
11, 2021
We
have served as the Company’s auditor since 2014.
68
LINEAGE
CELL THERAPEUTICS, INC. AND SUBSIDIARIES
CONSOLIDATED
BALANCE SHEETS
(IN
THOUSANDS)
December 31, 2020
December 31, 2019
ASSETS
CURRENT ASSETS
Cash and cash equivalents
$ 32,585
$ 9,497
Marketable equity securities
8,977
21,219
Promissory note from Juvenescence (Note 5)
-
23,616
Trade accounts and grants receivable, net
4
317
Receivables from affiliates, net
-
7
Prepaid expenses and other current assets
2,433
2,863
Total current assets
43,999
57,519
NONCURRENT ASSETS
Property and equipment, net (Notes 6 and 14)
5,630
8,175
Deposits and other long-term assets
616
864
Goodwill
10,672
10,672
Intangible assets, net
47,032
48,248
TOTAL ASSETS
$ 107,949
$ 125,478
LIABILITIES AND SHAREHOLDERS’ EQUITY
CURRENT LIABILITIES
Accounts payable and accrued liabilities
$ 6,813
$ 5,226
Financing lease and right-of-use liabilities, current portion (Note 14)
762
1,223
Deferred revenues
193
45
Liability classified warrants, current portion
1
-
Total current liabilities
7,769
6,494
LONG-TERM LIABILITIES
Deferred tax liability
2,076
3,315
Deferred revenues, net of current portion
-
200
Right-of-use lease liability, net of current portion (Note 14)
2,514
3,868
Financing lease, net of current portion
26
77
Liability classified warrants and other long-term
liabilities
437
277
TOTAL LIABILITIES
12,822
14,231
Commitments and contingencies (Note 14)
-
-
SHAREHOLDERS’ EQUITY
Preferred shares, no par value, authorized 2,000 shares; none issued and
outstanding as of December 31, 2020 and 2019, respectively
-
-
Common shares, no par value, authorized 250,000 shares; 153,096 and 149,804 shares issued and
outstanding as of December 31, 2020 and 2019, respectively
393,944
387,062
Accumulated other comprehensive loss
( 3,667 )
( 681 )
Accumulated deficit
( 294,078 )
( 273,422 )
Lineage Cell Therapeutics, Inc. shareholders’ equity
96,199
112,959
Noncontrolling interest (deficit)
( 1,072 )
( 1,712 )
Total shareholders’ equity
95,127
111,247
TOTAL LIABILITIES AND SHAREHOLDERS’ EQUITY
$ 107,949
$ 125,478
See
accompanying notes to the consolidated financial statements.
69
LINEAGE
CELL THERAPEUTICS, INC. AND SUBSIDIARIES
CONSOLIDATED
STATEMENTS OF OPERATIONS
(IN
THOUSANDS, EXCEPT PER SHARE DATA)
2020
2019
Year Ended December 31,
2020
2019
REVENUES:
Grant revenue
$ 1,053
$ 2,037
Royalties from product sales and license fees
773
1,221
Sale of research products and services
-
257
Total revenues
1,826
3,515
Cost of sales
( 385 )
( 412 )
Gross profit
1,441
3,103
OPERATING EXPENSES:
Research and development
12,317
17,948
General and administrative
15,571
24,031
Total operating expenses
27,888
41,979
Loss from operations
( 26,447 )
( 38,876 )
OTHER INCOME, NET:
Interest income, net
1,039
1,685
Gain on sale of marketable securities
4,560
2,421
Gain on sale of equity method investment in OncoCyte
-
546
Unrealized loss on marketable equity securities
( 3,782 )
( 2,898 )
Unrealized gain on equity method investment in OncoCyte at fair value
-
8,001
Unrealized gain on equity method investment in Asterias at fair value
-
6,744
Unrealized (loss) gain on warrant liability
( 174 )
611
Other income, net
2,880
2,532
Total other income, net
4,523
19,642
LOSS BEFORE INCOME TAXES
( 21,924 )
( 19,234 )
Income tax benefit
1,239
7,407
NET LOSS
( 20,685 )
( 11,827 )
Net loss attributable to noncontrolling interest
36
118
NET LOSS ATTRIBUTABLE TO LINEAGE
$ ( 20,649 )
$ ( 11,709 )
NET LOSS PER COMMON SHARE:
BASIC AND DILUTED
$ ( 0.14 )
$ ( 0.08 )
WEIGHTED AVERAGE NUMBER OF COMMON SHARES OUTSTANDING:
BASIC AND DILUTED
150,044
145,533
See
accompanying notes to the consolidated financial statements.
70
LINEAGE
CELL THERAPEUTICS, INC. AND SUBSIDIARIES
CONSOLIDATED
STATEMENTS OF COMPREHENSIVE LOSS
(IN
THOUSANDS)
2020
2019
Year Ended December 31,
2020
2019
NET LOSS
$ ( 20,685 )
$ ( 11,827 )
Other comprehensive loss, net of tax:
Foreign currency translation adjustments, net of tax
( 2,986 )
( 2,107 )
COMPREHENSIVE LOSS
( 23,671 )
( 13,934 )
Less: comprehensive loss attributable to noncontrolling
interest
36
118
COMPREHENSIVE LOSS ATTRIBUTABLE TO LINEAGE COMMON SHAREHOLDERS
$ ( 23,635 )
$ ( 13,816 )
See
accompanying notes to the consolidated financial statements.
71
LINEAGE
CELL THERAPEUTICS, INC. AND SUBSIDIARIES
CONSOLIDATED
STATEMENTS OF CHANGES IN SHAREHOLDERS’ EQUITY
(IN
THOUSANDS)
Number
of
Shares
Amount
Number
of
Shares
Amount
Accumulated
Deficit
Noncontrolling
Interest/(Deficit)
Other
Comprehensive
Income/(Loss)
Total
Shareholders’
Equity
Preferred
Shares
Common
Shares
Accumulated
Number
of
Shares
Amount
Number
of
Shares
Amount
Accumulated
Deficit
Noncontrolling
Interest/(Deficit)
Other
Comprehensive
Income/(Loss)
Total
Shareholders’
Equity
BALANCE AT DECEMBER 31, 2018
-
$ -
127,136
$ 354,270
$ ( 261,856 )
$ ( 1,594 )
$ 1,426
$ 92,246
Shares issued in connection with the Asterias Merger
-
-
24,696
32,352
-
-
-
32,352
Shares retired in connection with the Asterias Merger
-
-
( 2,622 )
( 3,435 )
-
-
-
( 3,435 )
Shares issued for settlement of Lineage Warrants
-
-
252
302
-
-
-
302
Shares issued upon vesting of restricted stock units, net of shares
retired to pay employees’ taxes
-
-
189
( 110 )
-
-
-
( 110 )
Shares issued for services
-
-
Stock-based compensation
-
-
-
3,501
-
-
-
3,501
Stock-based compensation for shares issued upon vesting of Asterias
restricted stock units attributable to post combination services
-
-
60
79
-
-
-
79
Shares issued through ATM
-
-
93
103
-
-
-
103
Adjustment upon adoption of leasing standard
-
-
-
-
143
-
-
143
Financing related fees
Dissolution of BioTime Asia
Hadasit non-cash warrant exercise
Foreign currency translation gain (loss)
-
-
-
-
-
-
( 2,107 )
( 2,107 )
NET LOSS
-
-
-
-
( 11,709 )
( 118 )
-
( 11,827 )
BALANCE AT DECEMBER 31, 2019
-
$ -
149,804
$ 387,062
$ ( 273,422 )
$ ( 1,712 )
$ ( 681 )
$ 111,247
BALANCE AT DECEMBER 31, 2019
-
$ -
149,804
$ 387,062
$ ( 273,422 )
$ ( 1,712 )
$ ( 681 )
$ 111,247
Shares issued through ATM
-
-
3,095
5,404
-
-
-
5,404
Shares issued upon vesting of restricted stock units, net of shares
retired to pay employees’ taxes
-
-
47
( 27 )
-
-
-
( 27 )
Shares issued for services
-
-
150
119
-
-
-
119
Stock-based compensation
-
-
-
2,227
-
-
-
2,227
Financing related fees
-
-
-
( 209 )
-
-
-
( 209 )
Dissolution of BioTime Asia
-
-
-
( 676 )
( 7 )
676
-
( 7 )
Hadasit non-cash warrant exercise
-
-
-
44
-
-
-
44
Foreign currency translation gain (loss)
-
-
-
-
-
-
( 2,986 )
( 2,986 )
NET LOSS
-
-
-
-
( 20,649 )
( 36 )
-
( 20,685 )
BALANCE AT DECEMBER 31, 2020
-
$ -
153,096
$ 393,944
$ ( 294,078 )
$ ( 1,072 )
$ ( 3,667 )
$ 95,127
See
accompanying notes to the consolidated financial statements.
72
LINEAGE
CELL THERAPEUTICS, INC. AND SUBSIDIARIES
CONSOLIDATED
STATEMENTS OF CASH FLOWS
(IN
THOUSANDS)
2020
2019
Year Ended December 31,
2020
2019
CASH FLOWS FROM OPERATING ACTIVITIES:
Net loss attributable to Lineage
$ ( 20,649 )
$ ( 11,709 )
Net loss attributable to noncontrolling interest
( 36 )
( 118 )
Adjustments to reconcile net loss attributable to Lineage to net cash used in operating activities:
Unrealized gain on equity method investment in OncoCyte at fair value
-
( 8,001 )
Unrealized gain on equity method investment in Asterias at fair value
-
( 6,744 )
Gain on sale of marketable equity securities
( 4,560 )
( 2,967 )
Unrealized loss on marketable equity securities
3,782
2,898
Income tax benefit
( 1,239 )
( 7,407 )
Depreciation expense, including amortization of leasehold improvements
823
1,002
Amortization of right-of-use assets
72
129
Amortization of intangible assets
1,216
1,998
Stock-based compensation
2,227
3,580
Common stock issued for services
119
-
Change in unrealized loss (gain) on warrant liability
174
( 611 )
Write-off of security deposit
150
-
Amortization of deferred license fee
( 200 )
-
Foreign currency remeasurement and other (gain) loss
( 2,957 )
( 2,367 )
(Gain) loss on sale of assets
( 20 )
273
Realized loss on warrant exercise
44
-
Dividend received
-
182
Changes in operating assets and liabilities:
Accounts and grants receivable, net
287
467
Accrued interest receivable
( 1,008 )
( 1,512 )
Receivables from affiliates, net of payables
7
2,105
Prepaid expenses and other current assets
1,575
( 260 )
Accounts payable and accrued liabilities
308
( 2,885 )
Deferred revenue and other liabilities
132
-
Net cash used in operating activities
( 19,753 )
( 31,947 )
CASH FLOWS FROM INVESTING ACTIVITIES:
Proceeds from sale of OncoCyte common shares
10,941
10,738
Proceeds from the sale of AgeX common shares
1,290
1,734
Proceeds from the sale of Hadasit common shares
830
1,743
Cash and cash equivalents acquired in the Asterias Merger
-
3,117
Purchase of property and equipment
( 64 )
( 440 )
Proceeds from sale of assets
23
82
Security deposit paid and other
18
( 17 )
Net cash provided by investing activities
13,038
16,957
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from payment of Juvenescence promissory note
24,624
-
Common shares received and retired for employee taxes paid
( 27 )
( 110 )
Proceeds from sale of subsidiary warrants
-
( 40 )
Proceeds from sale of common shares
5,127
103
Payments for offering costs
( 356 )
-
Repayment of financing lease liabilities
( 26 )
( 30 )
Proceeds from Paycheck Protection Program (“PPP”) Loan (Note
8)
523
-
Reimbursement from landlord on tenant improvements
-
764
Repayment of principal portion of promissory notes
-
( 70 )
Net cash provided by financing activities
29,865
617
Effect of exchange rate changes on cash, cash equivalents and restricted
cash
( 63 )
70
NET INCREASE (DECREASE) IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH
23,087
( 14,303 )
At beginning of year
10,096
24,399
At end of year
$ 33,183
$ 10,096
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION:
Cash paid during year for interest
$ 20
$ 28
SUPPLEMENTAL SCHEDULE OF NON-CASH FINANCING AND INVESTING ACTIVITIES:
Receivable from sale of common shares in at the market offering
$ 269
$ -
Receivable from sale of AgeX common shares
-
41
Issuance of common shares for the Asterias Merger (Note 3)
-
32,353
Assumption of liabilities in the Asterias Merger
-
982
Assumption of warrants in the Asterias Merger
-
867
Issuance of common shares for settlement of Lineage Warrants
-
332
See
accompanying notes to the consolidated financial statements.
73
LINEAGE
CELL THERAPEUTICS, INC.
NOTES
TO THE CONSOLIDATED FINANCIAL STATEMENTS
1.
Organization, Basis of Presentation and Liquidity
General
– Lineage Cell Therapeutics, Inc. (“Lineage”) is a clinical-stage biotechnology company developing novel
cell therapies for unmet medical needs. Lineage’s focus is to develop therapies for degenerative retinal diseases, neurological
conditions associated with demyelination, and aiding the body in detecting and combating cancer. Specifically, Lineage is testing
therapies to treat dry age-related macular degeneration, spinal cord injuries, and non-small cell lung cancer. Lineage’s
programs are based on its proprietary cell-based therapy platform and associated development and manufacturing capabilities. From
this platform, Lineage develops and manufactures specialized, terminally or functionally differentiated human cells
from its pluripotent and progenitor cell starting materials. These differentiated cells are transplanted into a patient either
to replace or support cells that are dysfunctional or absent due to degenerative disease or traumatic injury, or administered
as a means of helping the body mount an effective immune response to cancer.
Lineage
has three allogeneic, or “off-the-shelf,” cell therapy programs in clinical development:
●
OpRegen ® ,
a retinal pigment epithelium cell replacement therapy currently in a Phase 1/2a multicenter clinical trial for the treatment
of advanced dry age-related macular degeneration (“AMD”) with geographic atrophy. There currently are no therapies
approved by the U.S. Food and Drug Administration (“FDA”) for dry AMD, which accounts for approximately 85-90%
of all AMD cases and is the leading cause of blindness in people over the age of 60.
●
OPC1 ,
an oligodendrocyte progenitor cell therapy currently in a Phase 1/2a multicenter clinical trial for acute spinal cord injuries
(“SCI”). This clinical trial has been partially funded by the California Institute for Regenerative Medicine.
●
VAC2 ,
cancer immunotherapy of antigen-presenting dendritic cells currently in a Phase 1 clinical trial in non-small cell lung cancer.
This clinical trial is being funded and conducted by Cancer Research UK, the world’s largest independent cancer research
charity.
In
addition to seeking to create value for shareholders by developing product candidates and other technologies through our clinical
development programs, we also seek to create value from our technologies through partnering and strategic transactions. We founded
two companies that later became publicly traded companies: OncoCyte Corporation (“OncoCyte”) and AgeX Therapeutics,
Inc. (“AgeX”).
During
the year ended December 31, 2020, we received approximately $ 12.6 million in gross proceeds in connection with our sale of shares
of OncoCyte and AgeX. In August 2020, we also received $ 24.6 million from Juvenescence Limited (“Juvenescence”), representing
principal and accrued interest under a promissory note we received in connection with our sale of AgeX shares to Juvenescence in
August 2018.
We
no longer hold any common stock in AgeX. The value of our OncoCyte holdings as of March 5, 2021, was approximately $ 4.2
million, based on the closing price of its common stock on that date.
Though
our principal focus is on advancing our three cell therapy programs currently in clinical development, we may seek to create additional
value through corporate transactions, as we have in the past, or by initiating new programs using our protocols or with new protocols
and cell lines.
Asterias
Merger
On
November 7, 2018, Lineage, Asterias Biotherapeutics, Inc. (“Asterias”) and Patrick Merger Sub, Inc., a wholly owned
subsidiary of Lineage, entered into an Agreement and Plan of Merger (the “Merger Agreement”) whereby Lineage agreed
to acquire all of the outstanding common stock of Asterias in a stock-for-stock transaction (the “Asterias Merger”).
On
March 7, 2019, the shareholders of each of Lineage and Asterias approved the Merger Agreement. Prior to the Asterias Merger, Lineage
owned approximately 38 % of Asterias’ issued and outstanding common stock and accounted for Asterias as an equity method
investment.
74
On
March 8, 2019, the Asterias Merger closed with Asterias surviving as a wholly owned subsidiary of Lineage. The former stockholders
of Asterias (other than Lineage) received 0.71 common shares of Lineage for every share of Asterias common stock they owned. Lineage
issued 24,695,898 common shares, including 58,085 shares issued in respect of restricted stock units issued by Asterias that immediately
vested in connection with the closing of the Asterias Merger. The aggregate dollar value of such shares, based on the closing
price of Lineage common shares on March 8, 2019, was $ 32.4 million. Lineage also assumed warrants to purchase shares of Asterias
common stock.
The
Asterias Merger has been accounted for using the acquisition method of accounting in accordance with Accounting Standards Codification
(“ASC”) Topic 805, Business Combinations , which requires, among other things, that the assets and liabilities
assumed be recognized at their fair values as of the acquisition date.
See
Note 3 for a full discussion of the Asterias Merger.
Investment
in OncoCyte
Lineage
has significant equity holdings in OncoCyte, which Lineage founded and, in the past, was a majority-owned consolidated subsidiary
until February 17, 2017, when Lineage deconsolidated OncoCyte’s financial statements. OncoCyte is focused on developing
and commercializing laboratory-developed tests to serve unmet medical needs across the cancer care continuum. As of December 31,
2020, Lineage owned approximately 3.6 million shares of OncoCyte common stock, or 5.4 % of its outstanding shares (see Note 4).
Use
of estimates
The
preparation of consolidated financial statements in conformity with accounting principles generally accepted in the U.S. (“GAAP”)
requires 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 consolidated financial statements and the reported amounts of revenues
and expenses during the reporting period with consideration given to materiality. Significant estimates and assumptions which
are subject to significant judgment include those related to going concern assessment of consolidated financial statements, useful
lives associated with long-lived assets, including evaluation of asset impairment, allowances for uncollectible accounts receivables,
loss contingencies, deferred income taxes and tax reserves, including valuation allowances related to deferred income taxes, and
assumptions used to value stock-based awards, debt or other equity instruments. Actual results could differ materially from those
estimates.
Principles
of consolidation
Lineage’s
consolidated financial statements include the accounts of its subsidiaries. The following table reflects Lineage’s ownership,
directly or through one or more subsidiaries, of the outstanding shares of its operating subsidiaries as of December 31, 2020.
Schedule of Lineage's Ownership of Outstanding Shares of its Subsidiaries
Subsidiary
Field of Business
Lineage Ownership
Country
Asterias BioTherapeutics, Inc.
Cell therapy clinical development programs in spinal cord injury and oncology
100 %
USA
Cell Cure Neurosciences Ltd (“Cell Cure”)
Development and manufacturing of Lineage’s cell replacement platform technology
99 % (1)
Israel
ES Cell International Pte. Ltd. (“ESI”)
Stem cell products for research, including clinical grade cell lines produced under cGMP
100 %
Singapore
OrthoCyte Corporation (“OrthoCyte”)
Developing bone grafting products for orthopedic diseases and injuries
99.8 %
USA
(1)
Includes
shares owned by Lineage and ESI
All
material intercompany accounts and transactions have been eliminated in consolidation. As of December 31, 2020, Lineage consolidated
its direct and indirect wholly owned or majority-owned subsidiaries because Lineage has the ability to control their operating
and financial decisions and policies through its ownership, and the noncontrolling interest is reflected as a separate element
of shareholders’ equity on Lineage’s consolidated balance sheets.
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Liquidity
Since
inception, Lineage has incurred significant operating losses and has funded its operations primarily through sale of common stock
of AgeX and OncoCyte, both former subsidiaries, sale of common stock of Hadasit Bio-Holdings (“HBL”), receipt of research
grants, royalties from product sales, license revenues, sales of research products and issuance of equity securities.
On
May 1, 2020, Lineage entered into a Controlled Equity Offering SM Sales Agreement (the “Sales Agreement”)
with Cantor Fitzgerald & Co., as sales agent (“Cantor Fitzgerald”), pursuant to which Lineage may, but is not
obligated to, raise up to $ 25.0
million through the sale of common shares
(“ATM Shares”) from time to time in at-the-market transactions under the Sales Agreement. As of December 31, 2020,
Lineage raised $ 5.1
million in gross proceeds under
the Sales Agreement (which excludes $ 0.3 million in cash in transit related to 2020 sales that settled in 2021) and during
the first quarter through March 5, 2021, Lineage raised $ 19.9
million in gross proceeds under
the Sales Agreement (which includes $ 0.3 million in cash in transit related to 2020 sales that settled in 2021). On March
5, 2021, Lineage filed a prospectus supplement with the Securities and Exchange Commission (the “SEC”) in connection
with the offer and sale of an additional $ 25
million of ATM Shares.
At
December 31, 2020, Lineage had an accumulated deficit of approximately $ 294.1 million, working capital of $ 36.2 million and shareholders’
equity of $ 95.1 million. Lineage has evaluated its projected cash flows and believes that its $ 41.6 million of cash, cash equivalents
and marketable equity securities are sufficient to fund Lineage’s planned operations for at least the next twelve months
from the issuance date of the condensed consolidated financial statements included herein. If Lineage needs near term working
capital or liquidity to supplement its cash and cash equivalents for its operations, Lineage may sell some, or all, of its marketable
equity securities, as necessary.
On
March 8, 2019, Asterias became Lineage’s wholly owned subsidiary, and Lineage began consolidating Asterias’ operations
and results with its operations and results (see Note 3). Lineage has made extensive reductions in headcount and reduced non-clinical
related spend, in each case, as compared to Asterias’ operations before the Asterias Merger.
Lineage’s
projected cash flows are subject to various risks and uncertainties, and the unavailability or inadequacy of financing to meet
future capital needs could force Lineage to modify, curtail, delay, or suspend some or all aspects of its planned operations.
Lineage’s determination as to when it will seek new financing and the amount of financing that it will need will be based
on Lineage’s evaluation of the progress it makes in its research and development programs, any changes to the scope and
focus of those programs, any changes in grant funding for certain of those programs, and projection of future costs, revenues,
and rates of expenditure. Lineage’s ability to raise additional funds may be adversely impacted by deteriorating global
economic conditions and the disruptions to and volatility in the credit and financial markets in the United States and worldwide
resulting from the ongoing COVID-19 pandemic. Lineage may be required to delay, postpone, or cancel clinical trials or limit the
number of clinical trial sites, unless it is able to obtain adequate financing. In addition, Lineage has incurred significant
costs in connection with the acquisition of Asterias and with integrating its operations. Lineage may incur additional costs to
maintain employee morale and to retain key employees. Lineage cannot assure that adequate financing will be available on favorable
terms, if at all. Sales of additional equity securities by Lineage or its subsidiaries and affiliates could result in the dilution
of the interests of current shareholders.
2.
Summary of Significant Accounting Policies
Business
Combinations – Lineage accounts for business combinations, such as the Asterias Merger completed in March 2019, in accordance
with ASC Topic 805, which requires the purchase price to be measured at fair value. When the purchase consideration consists entirely
of Lineage common shares, Lineage calculates the purchase price by determining the fair value, as of the acquisition date, of
shares issued in connection with the closing of the acquisition. Lineage recognizes estimated fair values of the tangible assets
and intangible assets acquired, including in-process research and development (“IPR&D”), and liabilities assumed
as of the acquisition date, and records as goodwill any amount of the fair value of the tangible and intangible assets acquired
and liabilities assumed in excess of the purchase price.
Marketable
Equity Securities – Lineage accounts for the shares it holds in OncoCyte and HBL (and AgeX previously) as marketable
equity securities in accordance with ASC 320-10-25, Investments – Debt and Equity Securities , as amended by Accounting
Standards Update (“ASU”) 2016-01, Financial Instruments–Overall: Recognition and Measurement of Financial
Assets and Financial Liabilities, further discussed below .
76
The
OncoCyte and AgeX shares have readily determinable fair values quoted on the NYSE American under trading symbols “OCX”
and “AGE”. The HBL shares have a readily determinable fair value quoted on the Tel Aviv Stock Exchange (“TASE”)
under trading symbol “HDST” where share prices are denominated in New Israeli Shekels (NIS).
Prior
to September 11, 2019, Lineage accounted for its OncoCyte shares held at fair value, using the equity method of accounting. On
September 11, 2019, Lineage’s ownership percentage decreased from 24 % to 16 % when it sold 4.0 million shares of OncoCyte
common stock. Accordingly, as the ownership percentage was reduced to less than 20 % , Lineage is no longer considered to exercise
significant influence over OncoCyte and is now accounting for its OncoCyte holdings as marketable equity securities. Prior to
the Asterias Merger completed on March 8, 2019, Lineage accounted for its Asterias shares held at fair value, using the equity
method of accounting.
Revenue
Recognition – Lineage recognizes revenue in accordance with Financial Accounting Standards Board (“FASB”)
Accounting Standards Update (“ASU”) ASU 2014-09, Revenues from Contracts with Customers (Topic 606), and in
a manner that depicts the transfer of control of a product or a service to a customer and reflects the amount of the consideration
it is entitled to receive in exchange for such product or service. In doing so, Lineage follows a five-step approach: (i) identify
the contract with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price;
(iv) allocate the transaction price to the performance obligations; and (v) recognize revenue when (or as) the customer obtains
control of the product or service. Lineage considers the terms of a contract and all relevant facts and circumstances when applying
the revenue recognition standard. Lineage applies the revenue recognition standard, including the use of any practical expedients,
consistently to contracts with similar characteristics and in similar circumstances.
Lineage’s
largest source of revenue is currently related to government grants. In applying the provisions of ASU 2014-09, Lineage has determined
that government grants are out of the scope of ASU 2014-09 because the government entities do not meet the definition of a “customer,”
as defined by ASU 2014-09, as there is not considered to be a transfer of control of good or services to the government entities
funding the grant. Lineage has, and will continue to, account for grants received to perform research and development services
in accordance with ASC 730-20, Research and Development Arrangements , which requires an assessment, at the inception of
the grant, of whether the grant is a liability or a contract to perform research and development services for others. If Lineage
or a subsidiary receiving the grant is obligated to repay the grant funds to the grantor regardless of the outcome of the research
and development activities, then Lineage is required to estimate and recognize that liability. Alternatively, if Lineage or a
subsidiary receiving the grant is not required to repay, or if it is required to repay the grant funds only if the research and
development activities are successful, then the grant agreement is accounted for as a contract to perform research and development
services for others, in which case, grant revenue is recognized when the related research and development expenses are incurred
(see Note 14).
Deferred
grant revenues represent grant funds received from the governmental funding agencies for which the allowable expenses have not
yet been incurred as of the balance sheet date reported. As of December 31, 2020, deferred grant revenue was $ 193,000 .
Basic
and diluted net income (loss) per share attributable to common shareholders – Basic earnings per share is calculated
by dividing net income or loss attributable to Lineage common shareholders by the weighted average number of common shares outstanding,
net of unvested restricted stock or restricted stock units, subject to repurchase by Lineage, if any, during the period. Diluted
earnings per share is calculated by dividing the net income or loss attributable to Lineage common shareholders by the weighted
average number of common shares outstanding, adjusted for the effects of potentially dilutive common shares issuable under outstanding
stock options and warrants, using the treasury-stock method, convertible preferred stock, if any, using the if-converted method,
and treasury stock held by subsidiaries, if any.
For
the years ended December 31, 2020 and 2019, respectively, Lineage reported a net loss attributable to common shareholders, and
therefore, all potentially dilutive common shares were considered antidilutive for those periods.
77
The
following common share equivalents were excluded from the computation of diluted net income (loss) per common share for the periods
presented because including them would have been antidilutive (in thousands):
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share
Years
Ended
December
31,
2020
2019
Stock options
16,215
15,060
Lineage Warrants (1)
(Note 3)
1,090
1,090
Restricted stock units
93
166
(1)
Although
the Lineage Warrants are classified as liabilities, these warrants are considered for dilutive earnings per share calculations
in accordance with ASC 260, Earnings Per Share , and determined to be anti-dilutive for the period presented.
Restricted
Cash – In accordance with ASU 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash , Lineage explains
the change during the year in the total of cash, cash equivalents and restricted cash, and includes restricted cash with
cash and cash equivalents when reconciling the beginning-of-year and end-of-year total amounts shown on the condensed
consolidated statements of cash flows.
Lineage
has several certificates of deposit as required under our facility leases and credit card program. Lineage is restricted from
using this cash for working capital purposes. At December 31, 2020, Lineage maintains $ 420,000 pursuant to the Cell Cure Leases,
$ 100,000 pursuant to its credit card program and $ 78,000 pursuant to the Alameda Lease. Amounts related to the Cell Cure Leases
and credit card program are recorded in deposits and other long-term assets and the amount related to the Alameda Lease is recorded
in prepaid expenses and other current assets, as this certificate of deposit is expected to be released within the first quarter
of 2021.
The
following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated
balance sheet dates that comprise the total of the same such amounts shown in the condensed consolidated statements of cash flows
for all periods presented herein (in thousands):
Schedule of Reconciliation of Cash, Cash Equivalents, and Restricted Cash
December
31,
2020
December
31,
2019
Cash and cash equivalents
$ 32,585
$ 9,497
Restricted cash included in deposits and other long-term assets (see Note 14)
520
599
Restricted cash included in prepaid expenses and other current assets
(see Note 14)
78
-
Total cash, cash equivalents, and restricted cash as shown in the condensed
consolidated statements of cash flows
$ 33,183
$ 10,096
Lease
accounting and impact of adoption of the new lease standard – On January 1, 2019, Lineage adopted ASU 2016-02, Leases
(Topic 842, “ASC 842”) and its subsequent amendments affecting Lineage: (i) ASU 2018-10, Codification Improvements
to Topic 842, Leases ; and (ii) ASU 2018-11, Leases (Topic 842): Targeted improvements, using the modified retrospective
method.
Lineage
management determines if an arrangement is a lease at inception. Leases are classified as either financing or operating, with
classification affecting the pattern of expense recognition in the consolidated statements of operations. When determining whether
a lease is a finance lease or an operating lease, ASC 842 does not specifically define criteria to determine “major part
of remaining economic life of the underlying asset” and “substantially all of the fair value of the underlying asset.”
For lease classification determination, Lineage continues to use: (i) greater than or equal to 75% to determine whether the lease
term is a major part of the remaining economic life of the underlying asset; and (ii) greater than or equal to 90% to determine
whether the present value of the sum of lease payments is substantially all of the fair value of the underlying asset. Under the
available practical expedients, Lineage accounts for the lease and non-lease components as a single lease component. Lineage recognizes
right-of-use (“ROU”) assets and lease liabilities for leases with terms greater than twelve months in the condensed
consolidated balance sheet.
78
ROU
assets represent Lineage’s right to use an underlying asset during the lease term and lease liabilities represent Lineage’s
obligation to make lease payments arising from the lease. Operating lease ROU assets and liabilities are recognized at commencement
date based on the present value of lease payments over the lease term. As most of Lineage’s leases do not provide an implicit
rate, Lineage uses its incremental borrowing rate based on the information available at commencement date in determining the present
value of lease payments. Lineage uses the implicit rate when readily determinable. The operating lease ROU asset also includes
any lease payments made and excludes lease incentives. Lineage’s lease terms may include options to extend or terminate
the lease when it is reasonably certain that Lineage will exercise that option. Lease expense for lease payments is recognized
on a straight-line basis over the lease term.
Operating
leases are included as right-of-use assets in property and equipment (see Note 6), and ROU lease liabilities, current and long-term,
in the condensed consolidated balance sheets. Financing leases are included in property and equipment, and in financing lease
liabilities, current and long-term, in Lineage’s condensed consolidated balance sheets.
In
connection with the adoption on ASC 842 on January 1, 2019, Lineage derecognized net book value of leasehold improvements and
corresponding lease liabilities of $ 1.9 million and $ 2.0 million, respectively, which was the carrying value of certain operating
leases as of December 31, 2018, included in property and equipment and lease liabilities, respectively, recorded pursuant to build
to suit lease accounting under the previous ASC 840 lease standard. The derecognition of these amounts from the superseded ASC
840 lease standard was offset by a cumulative effect adjustment of $ 0.1 million as a reduction of Lineage’s accumulated
deficit on January 1, 2019. These build to suit leases were primarily related to Lineage’s prior leases in Alameda, California
and Cell Cure’s leases in Jerusalem, Israel (See Note 14). ASC 842 requires build to suit leases recognized on Lineage’s
consolidated balance sheets as of December 31, 2018 to be derecognized upon the adoption of the new lease standard and be recognized
in accordance with the new standard on January 1, 2019.
The
adoption of ASC 842 had a material impact in Lineage’s consolidated balance sheets, with the most significant impact resulting
from the recognition of ROU assets and lease liabilities for operating leases with remaining terms greater than twelve months
on the adoption date. Lineage’s accounting for financing leases (previously referred to as “capital leases”)
remained substantially unchanged (see Note 14).
Goodwill
and IPR&D – Goodwill is calculated as the difference between the acquisition date fair value of the consideration
transferred and the values assigned to the assets acquired and liabilities assumed. Goodwill is not amortized but is tested for
impairment at least annually, or more frequently if circumstances indicate potential impairment. IPR&D assets are indefinite-lived
intangible assets until the completion or abandonment of the associated research and development (“R&D”) efforts.
Once the R&D efforts are completed or abandoned, the IPR&D will either be amortized over the asset life as a finite-lived
intangible asset or be impaired, respectively, in accordance with ASC 350, Intangibles – Goodwill and Other . In accordance
with ASC 350, goodwill and acquired IPR&D are determined to have indefinite lives and, therefore, are not amortized. Instead,
they are tested for impairment at least annually and between annual tests if Lineage becomes aware of an event or a change in
circumstances that would indicate the asset may be impaired.
Going
concern assessment – Lineage assesses going concern uncertainty for its consolidated financial statements to determine
if Lineage has sufficient cash and cash equivalents on hand and working capital to operate for a period of at least one year from
the date the consolidated financial statements are issued or are available to be issued, which is referred to as the “look-forward
period” as defined by FASB’s ASU No. 2014-15. As part of this assessment, based on conditions that are known and reasonably
knowable to Lineage, Lineage will consider various scenarios, forecasts, projections, and estimates, and Lineage will make certain
key assumptions, including the timing and nature of projected cash expenditures or programs, and its ability to delay or curtail
those expenditures or programs, if necessary, among other factors. Based on this assessment, as necessary or applicable, Lineage
makes certain assumptions concerning its ability to curtail or delay research and development programs and expenditures within
the look-forward period in accordance with ASU No. 2014-15.
79
Cash
and cash equivalents – Lineage considers all highly liquid investments purchased with an original maturity of three
months or less to be cash equivalents. As of December 31, 2020 and 2019, Lineage had $ 28.8 million and $ 6.6 million in money market
funds, respectively, considered to be cash equivalents.
Concentrations
of credit risk and significant sources of supply – Financial instruments that potentially subject Lineage to significant
concentrations of credit risk consist primarily of cash and cash equivalents. Lineage limits the amount of credit exposure of
cash balances by maintaining its accounts in high credit quality financial institutions. Cash equivalent deposits with financial
institutions may occasionally exceed the limits of insurance on bank deposits; however, Lineage has not experienced any losses
on such accounts.
Lineage
relies on single-source, third-party suppliers for a few key components of our product candidates. If these single-source, third-party
suppliers are unable to continue providing a key component, the initiation or progress of any clinical studies of its product
candidates may be impeded.
Property
and equipment, net – Property and equipment is stated at cost and is being depreciated using the straight-line method
over their estimated useful lives ranging from 3 to 10 years. Leasehold improvements are amortized over the shorter of the useful
life or the lease term. (See Note 6).
Long-lived
intangible assets – Long-lived intangible assets, consisting primarily of acquired patents, patent applications, and
licenses to use certain patents are stated at acquired cost, less accumulated amortization. Amortization expense is computed using
the straight-line method over the estimated useful lives of the assets, generally over 5 to 10 years.
Impairment
of long-lived assets – Long-lived assets, including long-lived intangible assets, are reviewed annually for impairment
and whenever events or changes in circumstances indicate that the carrying amount of an asset may not be fully recoverable. If
an impairment indicator is present, Lineage evaluates recoverability by a comparison of the carrying amount of the assets to future
undiscounted net cash flows expected to be generated by the assets. If the assets are impaired, the impairment recognized is measured
by the amount by which the carrying amount exceeds the estimated fair value of the assets.
Accounting
for warrants – Lineage determines the accounting classification of warrants that it or its subsidiaries issue, as either
liability or equity, by first assessing whether the warrants meet liability classification in accordance with ASC 480-10, Accounting
for Certain Financial Instruments with Characteristics of both Liabilities and Equity , and then in accordance with ASC 815-40,
Accounting for Derivative Financial Instruments Indexed to, and Potentially Settled in, a Company’s Own Stock . Under
ASC 480, warrants are considered liability classified if the warrants are mandatorily redeemable, obligate the issuer to settle
the warrants or the underlying shares by paying cash or other assets, or warrants that must or may require settlement by issuing
variable number of shares. If warrants do not meet liability classification under ASC 480-10, Lineage assesses the requirements
under ASC 815-40, which states that contracts that require or may require the issuer to settle the contract for cash are liabilities
recorded at fair value, irrespective of the likelihood of the transaction occurring that triggers the net cash settlement feature.
If the warrants do not require liability classification under ASC 815-40, in order to conclude equity classification, Lineage
assesses whether the warrants are indexed to its common stock or its subsidiary’s common stock, as applicable, and whether
the warrants are classified as equity under ASC 815-40 or other applicable GAAP. After all relevant assessments are made, Lineage
concludes whether the warrants are classified as liability or equity. Liability classified warrants are required to be accounted
for at fair value both on the date of issuance and on subsequent accounting period ending dates, with all changes in fair value
after the issuance date recorded in the consolidated statements of operations as a gain or loss. Equity classified warrants are
accounted for at fair value on the issuance date with no changes in fair value recognized subsequent to the issuance date. In
2017, Cell Cure issued certain liability classified warrants (see Note 11) and in 2019, Lineage assumed certain warrants
in connection with the closing of the Asterias Merger (see Note 3).
80
Transactions
with noncontrolling interests of subsidiaries - Lineage accounts for a change in ownership interests in its subsidiaries that
does not result in a change of control of the subsidiary by Lineage under the provisions of ASC 810-10-45-23,
Consolidation – Other Presentation Matters, which prescribes the accounting for changes in ownership interest
that do not result in a change in control of the subsidiary, as defined by GAAP, before and after the transaction . Under
this guidance, changes in a controlling shareholder’s ownership interest that do not result in a change of control, as defined
by GAAP, in the subsidiary are accounted for as equity transactions. Thus, if the controlling shareholder retains control, no
gain or loss is recognized in the statements of operations of the controlling shareholder. Similarly, the controlling shareholder
will not record any additional acquisition adjustments to reflect its subsequent purchases of additional shares in the subsidiary
if there is no change of control. Only a proportional and immediate transfer of carrying value between the controlling and the
noncontrolling shareholders occurs based on the respective ownership percentages.
Research
and development expenses - Research and development expenses consist of costs incurred for company-sponsored, collaborative
and contracted research and development activities. These costs include direct and research-related overhead expenses including
compensation and related benefits, stock-based compensation, consulting fees, research and laboratory fees, rent of research facilities,
amortization of intangible assets, and license fees paid to third parties to acquire patents or licenses to use patents and other
technology. Research and development are expensed as incurred. Research and development expenses incurred and reimbursed by grants
from third parties approximate the grant income recognized in the consolidated statements of operations.
General
and administrative expenses - General and administrative expenses consist of compensation and related benefits, including
stock-based compensation, for executive and corporate personnel; professional and consulting fees; and allocated overhead such
as facilities and equipment rent and maintenance, insurance costs allocated to general and administrative expenses, costs of patent
applications, prosecution and maintenance, stock exchange-related costs, depreciation expense, marketing costs, and other miscellaneous
expenses which are allocated to general and administrative expense.
Foreign
currency translation adjustments and other comprehensive income or loss - In countries in which Lineage operates where the
functional currency is other than the U.S. dollar, assets and liabilities are translated using published exchange rates in effect
at the consolidated balance sheet date. Revenues and expenses and cash flows are translated using an approximate weighted average
exchange rate for the period. Resulting foreign currency translation adjustments are recorded as other comprehensive income or
loss, net of tax, in the consolidated statements of comprehensive income or loss and included as a component of accumulated other
comprehensive income or loss on the consolidated balance sheets. Foreign currency translation adjustments are primarily attributable
to Cell Cure and ESI, Lineage’s consolidated foreign subsidiaries. For the years ended December 31, 2020 and 2019, comprehensive
loss includes foreign currency translation adjustments, net of tax, of $ 3.0 million and $ 2.1 million, respectively.
Foreign
currency transaction gains and losses - For transactions denominated in other than the functional currency of Lineage or its
subsidiaries, Lineage recognizes transaction gains and losses in the consolidated statements of operations and classifies the
gain or loss based on the nature of the item that generated it. The majority of Lineage’s foreign currency transaction gains
and losses are generated by Cell Cure’s intercompany debt due to Lineage, which are U.S. dollar-denominated, while Cell
Cure’s functional currency is the Israeli New Shekel (“ILS”). At each balance sheet date, Lineage remeasures
the intercompany debt using the current exchange rate at that date pursuant to ASC 830, Foreign Currency Matters. These
foreign currency remeasurement gains and losses are included in other income and expenses, net.
Income
taxes - Lineage accounts for income taxes in accordance with ASC 740, Income Taxes , which prescribe the use of the
asset and liability method, whereby deferred tax asset or liability account balances are calculated at the balance sheet date
using current tax laws and rates in effect. Valuation allowances are established when necessary to reduce deferred tax assets
when it is more likely than not that a portion or all of the deferred tax assets will not be realized. ASC 740 guidance also prescribes
a recognition threshold and a measurement attribute for the financial statement recognition and measurement of tax positions taken
or expected to be taken in a tax return. For benefits to be recognized, a tax position must be more-likely-than-not sustainable
upon examination by taxing authorities. Lineage files a U.S. federal income tax return as well as various state and foreign income
tax returns. Lineage’s judgments regarding future taxable income may change over time due to changes in market conditions,
changes in tax laws, tax planning strategies or other factors. If Lineage assumptions, and consequently the estimates, change
in the future with respect to Lineage’s own deferred tax assets and liabilities, the valuation allowance may be increased
or decreased, which may have a material impact on Lineage’s consolidated financial statements. Lineage recognizes accrued
interest and penalties related to unrecognized tax benefits, if any, as income tax expense; however, no amounts were accrued
for the payment of interest and penalties as of December 31, 2020 and 2019.
81
Stock-based
compensation - Lineage follows accounting standards governing share-based payments in accordance with ASC 718, Compensation
– Stock Compensation , which require the measurement and recognition of compensation expense for all share-based payment
awards made to directors and employees, including employee stock options, based on estimated fair values. Lineage utilizes the
Black-Scholes option pricing model for valuing share-based payment awards. Lineage’s determination of fair value of share-based
payment awards on the date of grant using that option-pricing model is affected by Lineage’s stock price as well as by assumptions
regarding a number of complex and subjective variables. These variables include, but are not limited to, expected stock price
volatility over the term of the awards, and the expected term of options granted, which is derived using the simplified method,
which is an average of the contractual term of the option and its vesting period, as we do not have sufficient historical exercise
data. The risk-free rate is based on the U.S. Treasury yield in effect at the time of grant for zero coupon U.S. Treasury notes
with maturities similar to the expected term of the awards. Forfeitures are accounted for as they occur.
Although
the fair value of employee stock options is determined in accordance with FASB guidance, changes in the assumptions can materially
affect the estimated value and therefore the amount of compensation expense recognized in the consolidated financial statements.
Royalties
from product sales and license fees - Lineage’s performance obligations in agreements with certain customers is to provide
a license to allow customers to make, import and sell company licensed products or methods for preclinical studies and commercial
use. Customers pay a combination of a license issue fee paid up front and a sales-based royalty, if any, in some cases with yearly
minimums. The transaction price is deemed to be the license issue fee stated in the contract. The license offered by Lineage is
a functional license with significant standalone functionality and provides customers with the right to use Lineage’s intellectual
property. This allows Lineage to recognize revenue on the license issue fee at a point in time at the beginning of the contract,
which is when the customer begins to have use of the license. Variable consideration related to sales-based royalties is recognized
only when (or as) the later of one or more of the following events occur: (a) a sale or usage occurs, or (b) the performance obligation
to which some, or all, of the sales-based or usage-based royalty that has been allocated and has been satisfied or partially satisfied.
Due to the contract termination clauses, Lineage does not expect to receive all of the minimum royalty payments throughout the
term of the agreements. Therefore, Lineage fully constrains recognition of the minimum royalty payments as revenues until its
customers are obligated to pay, which is generally within 60 days prior to the beginning of each year the minimum royalty payments
are due.
Grant
revenues - In applying the provisions of Topic 606, Lineage has determined that government grants are out of the scope of
Topic 606 because the government entities do not meet the definition of a “customer”, as defined by Topic 606, as
there is not considered to be a transfer of control of good or services to the government entities funding the grant. Lineage
has, and will continue to, account for grants received to perform research and development services in accordance with ASC 730-20,
Research and Development Arrangements , which requires an assessment, at the inception of the grant, of whether the grant
is a liability or a contract to perform research and development services for others. If Lineage or a subsidiary receiving the
grant is obligated to repay the grant funds to the grantor regardless of the outcome of the research and development activities,
then Lineage is required to estimate and recognize that liability. Alternatively, if Lineage or a subsidiary receiving the grant
is not required to repay, or if it is required to repay the grant funds only if the research and development activities are successful,
then the grant agreement is accounted for as a contract to perform research and development services for others, in which case,
grant revenue is recognized when the related research and development expenses are incurred.
Deferred
grant revenues represent grant funds received from the governmental funding agencies for which the allowable expenses have not
yet been incurred as of the balance sheet date reported.
Revenue
Recognition by Source and Geography - Revenues are recognized when control of the promised goods or services is transferred
to customers, or in the case of governmental entities funding a grant, when allowable expenses are incurred, in an amount that
reflects the consideration Lineage or a subsidiary, depending on which company has the customer or the grant, expects to be entitled
to in exchange for those goods or services.
82
The
following table presents Lineage’s consolidated revenues disaggregated by source (in thousands).
Schedule of Disaggregated Revenues
Year Ended December 31,
2020
2019
REVENUES:
Grant revenue
$ 1,053
$ 2,037
Royalties from product sales and license fees
773
1,221
Sale of research products and services
-
257
Total revenues
$ 1,826
$ 3,515
The
following table presents consolidated revenues, disaggregated by geography, based on the billing addresses of customers, or in
the case of grant revenues, based on where the governmental entities that fund the grant are located (in thousands).
Schedule of Revenues Disaggregated
by Geography
Year Ended December 31,
2020
2019
REVENUES:
United States
$ 1,160
$ 2,092
Foreign (1)
666
1,423
Total revenues
$ 1,826
$ 3,515
(1)
Foreign
revenues are primarily generated from grants in Israel.
Recently
Adopted Accounting Pronouncements
In
August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure
Requirements for Fair Value Measurement , which modifies certain disclosure requirements for reporting fair value measurements.
ASU 2018-13 is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019. Lineage
adopted this standard on January 1, 2020 and it did not have a significant impact on our consolidated financial statements.
Recently
Issued Accounting Pronouncements Not Yet Adopted - The following accounting standards, which are not yet effective, are presently
being evaluated by Lineage to determine the impact that they might have on its consolidated financial statements.
In
December 2019, the FASB issued ASU 2019-12, Simplifying the Accounting for Income Taxes . The ASU enhances and simplifies
various aspects of the income tax accounting guidance in ASC 740 and removes certain exceptions for recognizing deferred taxes
for investments, performing intraperiod allocation and calculating income taxes in interim periods. The ASU also adds guidance
to reduce complexity in certain areas, including recognizing deferred taxes for tax goodwill and allocating taxes to members of
a consolidated group. This ASU is effective for fiscal years beginning after December 15, 2020, and interim periods within those
fiscal years with early adoption permitted. Lineage adopted this standard as of January 1, 2021 and it is not expected to have
a material impact on the consolidated financial statements.
In
June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses
on Financial Instruments . ASU 2016-13 is intended to provide financial statement users with more decision-useful information
about the expected credit losses on financial instruments and other commitments and requires consideration of a broader range
of reasonable and supportable information to inform credit loss estimates. ASU 2016-13 is effective for Lineage beginning January
1, 2023. Lineage has not yet completed its assessment of the impact of the new standard on its consolidated financial statements.
3.
Asterias Merger
On
March 8, 2019, the Asterias Merger closed with Asterias surviving as a wholly owned subsidiary of Lineage. The former stockholders
of Asterias (other than Lineage) received 0.71 common shares of Lineage (the “Merger Consideration”) for every share
of Asterias common stock they owned (the “Merger Exchange Ratio”). Lineage issued 24,695,898 common shares, including
58,085 shares issued in respect of restricted stock units issued by Asterias that immediately vested in connection with the closing
of the Asterias Merger. The fair value of such shares, based on the closing price of Lineage common shares on March 8, 2019, was
$ 32.4 million.
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In
connection with the closing of the Asterias Merger, Lineage assumed outstanding warrants to purchase shares of Asterias common
stock, as further discussed below and in Note 11, and assumed sponsorship of the Asterias 2013 Equity Incentive Plan (see
Note 12). All stock options to purchase shares of Asterias common stock outstanding immediately prior to the closing of
the Asterias Merger were canceled at the closing for no consideration.
As
of December 31, 2019, the assets and liabilities of Asterias have been included in the consolidated balance sheet of Lineage.
The results of operations of Asterias from March 8, 2019 through December 31, 2019 have been included in the consolidated statement
of operations of Lineage for the year ended December 31, 2019.
Calculation
of the purchase price
The
calculation of the purchase price for the Asterias Merger and the Merger Consideration transferred on March 8, 2019 was as follows
(in thousands, except for share and per share amounts):
Schedule of Merger Consideration Transferred
Lineage
(38%
ownership
interest)
Shareholders
other
than
Lineage
(approximate
62%
ownership
interest)
Total
Outstanding Asterias common stock as of March 8, 2019
21,747,569
34,783,333 (1)
56,530,902 (1)
Exchange ratio
0.710
0.710
0.710
Lineage common shares issuable
15,440,774 (2)
24,695,898 (3)
40,136,672
Per share price of Lineage common shares as of March 8, 2019
$ 1.31
$ 1.31
$ 1.31
Purchase price (in $000s)
$ 20,227 (2)
$ 32,353
$ 52,580
(1)
Includes
81,810 shares of Asterias restricted stock unit awards that immediately vested on March 8, 2019 and converted into the right
to receive common shares of Lineage based on the Merger Exchange Ratio, resulting in 58,085 common shares of Lineage issued
on March 8, 2019 as part of the Merger Consideration. These restricted stock units were principally attributable to pre-combination
services and included as part of the purchase price in accordance with ASC 805. See Note 12 for Asterias restricted stock
units that vested on the closing of the Asterias Merger attributable to post-combination services that were recorded outside
of the purchase price as an immediate charge to stock-based compensation expense.
(2)
Estimated
fair value for Lineage’s previously held 38% ownership interest in Asterias common stock is part of the total purchase
price of Asterias for purposes of the purchase price allocation under ASC 805 and for Lineage’s adjustment of its 38 %
interest to fair value at the effective date of the Asterias Merger and immediately preceding the consolidation of Asterias’
results with Lineage. No actual common shares of Lineage were issued to Lineage in connection with the Asterias Merger.
(3)
Net
of a de minimis number of fractional shares which were paid in cash.
Purchase
price allocation
Lineage
allocated the acquisition consideration to tangible and identifiable intangible assets acquired and liabilities assumed based
on their estimated fair values as of the acquisition date. The fair value of the acquired tangible and identifiable intangible
assets were determined based on inputs that are unobservable and significant to the overall fair value measurement. It is also
based on estimates and assumptions made by management at the time of the acquisition. As such, this was classified as Level 3
fair value hierarchy measurements and disclosures.
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The
allocation of the purchase price in the table below is based on our estimates of the fair values of tangible and intangible assets
acquired, including IPR&D, and liabilities assumed as of the acquisition date, with the excess recorded as goodwill (in thousands).
As of December 31, 2019, Lineage had finalized its purchase price allocation.
Schedule of Identifiable Tangible and Intangible Assets Acquired and Liabilities Assumed
Assets acquired:
Cash and cash equivalents
$ 3,117
Prepaid expenses and other assets, current and noncurrent
660
Machinery and equipment
308
Long-lived intangible assets - royalty contracts
650
Acquired in-process research and development (“IPR&D”)
46,540
Total assets acquired
51,275
Liabilities assumed:
Accrued liabilities and accounts payable
982
Liability classified warrants
867
Deferred license revenue
200
Long-term deferred income tax liability
10,753
Total liabilities assumed
12,802
Net assets acquired, excluding goodwill (a)
38,473
Fair value of Lineage common shares held by Asterias (b)
3,435
Total purchase price (c)
52,580
Estimated goodwill (c-a-b)
$ 10,672
The
valuation of identifiable intangible assets and their estimated useful lives are as follows (in thousands, except for useful life):
Schedule of Valuation of Identifiable Intangible Assets and Their Estimated Useful Lives
Preliminary Estimated Asset
Fair Value
Useful
Life
(Years)
(in thousands, except for useful life)
In process research and development (“IPR&D”)
$ 46,540
n/a
Royalty contracts
650
5
$ 47,190
The
following is a discussion of the valuation methods used to determine the fair value of Asterias’ significant assets and
liabilities in connection with the Asterias Merger:
IPR&D
and Deferred Income Tax Liability - The fair value of identifiable acquired IPR&D intangible assets consisting of $ 31.7
million pertaining to the OPC1 program that is currently in a Phase 1/2a clinical trial for SCI, which has been partially funded
by the California Institute for Regenerative Medicine and $ 14.8 million pertaining to the VAC2 program, which is an allogeneic,
or “off-the-shelf,” cancer immunotherapy derived from pluripotent stem cells for which a clinical trial in non-small
cell lung cancer is being funded and sponsored by Cancer Research UK. The identification of these intangible assets are based
on consideration of historical experience and a market participant’s view further discussed below; collectively, OPC1 and
VAC2 are referred to as the “AST-Clinical Programs”. These intangible assets are valued primarily through the use
of a probability weighted discounted cash flow method under the income approach further discussed below. Lineage considered Asterias’
VAC1 program, which is an autologous, or patient-specific, cancer immunotherapy derived from the patient’s own cells, to
have de minimis value due to significant risks, substantial costs and limited opportunities.
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Lineage
determined that the estimated aggregate fair value of the AST-Clinical programs was $ 46.5 million as of the acquisition date using
a probability weighted discounted cash flow method for each respective program. This approach estimates the probability of the
AST-Clinical Programs achieving successful completion of remaining clinical trials and related approvals into the valuation technique.
To
calculate fair value of the AST-Clinical programs under the discounted cash flow method, Lineage used probability-weighted, projected
cash flows discounted at a rate considered appropriate given the significant inherent risks associated with cell therapy development
by clinical-stage companies. Cash flows were calculated based on estimated projections of revenues and expenses related to each
respective program. Cash flows were assumed to extend through a seven-year market exclusivity period for the OPC1 program from
the date of market launch. Revenues from commercialization of the AST-Clinical Programs were based on estimated market potential
for the indication of each program. The resultant cash flows were then discounted to present value using a weighted-average cost
of capital for companies with profiles substantially similar to that of Lineage, which Lineage believes represents the rate that
market participants would use to value the assets. Lineage compensated for the phase of development of the program by applying
a probability factor to its estimation of the expected future cash flows. The projected cash flows were based on significant assumptions,
including the indications in which Lineage will pursue development of the AST-Clinical programs, the time and resources needed
to complete the development and regulatory approval, estimates of revenue and operating profit related to the program considering
its stage of development, the life of the potential commercialized product, market penetration and competition, and risks associated
with achieving commercialization, including delay or failure to obtain regulatory approvals to conduct clinical studies, failure
of clinical studies, delay or failure to obtain required market clearances, and intellectual property litigation.
These
IPR&D assets are indefinite-lived intangible assets until the completion or abandonment of the associated research and development
(“R&D”) efforts. Once the R&D efforts are completed or abandoned, the IPR&D will either be amortized over
the asset life as a finite-lived intangible asset or be impaired, respectively, in accordance with ASC 350, Intangibles - Goodwill
and Other . In accordance with ASC 350, goodwill and acquired IPR&D are determined to have indefinite lives and, therefore,
are not amortized. Instead, they are tested for impairment at least annually and between annual tests if Lineage becomes aware
of an event or a change in circumstances that would indicate the asset may be impaired.
Because
the IPR&D (prior to completion or abandonment of the R&D) is considered an indefinite-lived asset for accounting purposes,
the fair value of the IPR&D on the acquisition date creates a deferred income tax liability (“DTL”) in accordance
with ASC 740, Income Taxes (see Note 13). This DTL is computed using the fair value of the IPR&D assets on the
acquisition date multiplied by Lineage’s federal and state income tax rates. While this DTL would reverse on impairment
or sale or commencement of amortization of the related intangible assets, those events are not anticipated under ASC 740 for purposes
of predicting reversal of a temporary difference to support the realization of deferred tax assets, except for certain deferred
tax assets and credit carryforwards that are also indefinite in nature as of the closing of the Asterias Merger, which may be
considered for reversal under ASC 740 as further discussed in Note 13.
Royalty
contracts – Asterias has certain royalty revenues for “research only use” culture media for preclinical
research applications under certain, specific patent families under contracts which preclude the customers to sell for commercial
use or for clinical trials. These royalty cash flows are generated under certain specific patent families which Asterias previously
acquired from Geron Corporation (“Geron”). Asterias pays Geron a royalty for all royalty revenues received from these
contracts. Because these patents are a subset of the clinical programs discussed above, are expected to continue to generate revenues
for Asterias and are not to be used in the OPC1 or the VAC2 programs, these patents are considered to be separate long-lived intangible
assets under ASC 805. These intangible assets are also valued primarily through the use of the discounted cash flow method under
the income approach, and will be amortized over their useful life, estimated to be 5 years. The discounted cash flow method estimated
the amount of net royalty income that can be expected under the contracts in future years. The amounts were based on observed
historical trends in the growth of these revenue streams, and were estimated to terminate in approximately five years, when the
key patents under these contracts will begin to expire. The resulting cash flows were discounted to the valuation date based on
a rate of return that recognizes a lower level of risk associated with these assets as compared to the AST-Clinical programs discussed
above.
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Deferred
license revenue – In September 2018, Asterias and Novo Nordisk A/S (“Novo Nordisk”) entered into an option
for Novo Nordisk or its designated U.S. affiliate to license, on a non-exclusive basis, certain intellectual property related
to culturing pluripotent stem cells, such as hES cells, in suspension. Under the terms of the option, Asterias received a one-time
upfront payment of $ 1.0 million, in exchange for a 24-month period option to negotiate a non-exclusive license during which time
Asterias has agreed to not grant any exclusive licenses inconsistent with the Novo Nordisk option. This option is considered a
performance obligation as it provides Novo Nordisk with a material right that it would not receive without entering into the contract.
For
business combination purposes under ASC 805, the fair value of this performance obligation to Lineage, from a market participant
perspective, is the estimated costs Lineage may incur, plus a normal profit margin for the level of effort required to perform
under the contract after the acquisition date, assuming Novo Nordisk exercised its option, including, but not limited to, negotiation
costs, legal fees, arbitration, if any, and other related costs. Management has estimated those costs, plus a normal profit margin,
to be approximately $ 200,000 in the purchase price allocation. This amount was originally recorded as deferred revenue and subsequently
recognized as revenue in September 2020 when Novo Nordisk did not exercise the option.
Liability
classified warrants – On May 13, 2016, in connection with a common stock offering, Asterias issued warrants to purchase
2,959,559 shares of Asterias common stock (the “Asterias Warrants”) with an exercise price of $ 4.37 per share that
expire in five years from the issuance date, or May 13, 2021 . As of the closing of the Asterias Merger, there were 2,813,159 Asterias
Warrants outstanding. The Asterias Warrants contain certain provisions in the event of a Fundamental Transaction, as defined in
the warrant agreement governing the Asterias Warrants (“Warrant Agreement”), that Asterias or any successor entity
will be required to purchase, at a holder’s option, exercisable at any time concurrently with or within thirty days after
the consummation of the fundamental transaction, the Asterias Warrants for cash in an amount equal to the calculated value of
the unexercised portion of such holder’s warrants, determined in accordance with the Black-Scholes option pricing model
with significant inputs as specified in the Warrant Agreement. The Asterias Merger was a Fundamental Transaction for purposes
of the Asterias Warrants.
The
fair value of the Asterias Warrants was determined by using Black-Scholes option pricing models which take into consideration
the probability of the Fundamental Transaction, which for purposes of the above valuation was assumed to be at 100 % and net cash
settlement occurring, using the contractual remaining term of the warrants. In applying these models, these inputs included key
assumptions including the per share closing price of Lineage common shares on March 8, 2019, volatility computed in accordance
with the provisions of the Warrant Agreement and, to a large extent, assumptions based on discussions with a majority of the holders
of the Asterias Warrants since the closing of the Asterias Merger to settle the Asterias Warrants in cash or in common shares
of Lineage. Based on such discussions, Lineage believes the fair value of the Asterias Warrants as of the closing of the Asterias
Merger is not subject to change significantly, however, to the extent any Asterias Warrants that were not settled in cash or in
Lineage common shares discussed below, were automatically converted to Lineage warrants 30 days after the closing of the Asterias
Merger. In April 2019, Asterias Warrants representing approximately $ 372,000 in fair value were settled: $ 332,000 in fair value
was settled in exchange for 251,835 common shares of Lineage, and $ 40,000 in fair value was settled in exchange for cash. The
Asterias Warrants settled in exchange for common shares of Lineage were held by Broadwood Partners, L.P., an Asterias and Lineage
shareholder. The Asterias Warrants settled in exchange for cash were held by other parties. The remaining Asterias Warrants (representing
approximately $ 495,000 in fair value as of March 31, 2019) were converted into warrants to purchase common shares of Lineage using
the Merger Exchange Ratio (the “Lineage Warrants”).
As
of December 31, 2020, the total number of common shares of Lineage subject to warrants that were assumed by Lineage in connection
with the Asterias Merger was 1,089,900 , with similar terms and conditions retained under the Lineage Warrants as per the original
Warrant Agreements. The Lineage Warrants have an exercise price of $ 6.15 per warrant share and expire on May 13, 2021 . Lineage
is accounting for the outstanding Lineage Warrants as a liability at fair value, with subsequent changes to the fair value of
the Lineage Warrants at each reporting period thereafter included in the consolidated statement of operations (see Note 11).
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Fair
value of Lineage common shares held by Asterias – As of March 8, 2019, Asterias held 2,621,811 common shares of Lineage
as marketable securities on its standalone financial statements. The fair value of those shares acquired by Lineage from Asterias
is determined based on the $ 1.31 per share closing price of Lineage common shares on March 8, 2019. Although treasury shares are
not considered an asset and were retired upon Lineage’s acquisition of Asterias, the fair value of those shares is a part
of the purchase price allocation shown in the tables above. These Lineage shares were retired at the completion of the Asterias
Merger.
Goodwill
– Goodwill is calculated as the difference between the acquisition date fair value of the consideration transferred
and the values assigned to the assets acquired and liabilities assumed. Goodwill is not amortized but is tested for impairment
at least annually, or more frequently if circumstances indicate potential impairment.
Depending
on the structure of a particular acquisition, goodwill and identifiable intangible assets may not be deductible for tax purposes.
Goodwill recorded in the Asterias Merger is not expected to be deductible for tax purposes (see Note 13).
During
the years ended December 31, 2020 and 2019, Lineage incurred $ 0.7 million and $ 5.1 million, respectively, in acquisition related
costs which were recorded in general and administrative expenses in the accompanying consolidated statements of operations.
Prior
to the Asterias Merger being consummated in March 2019, Lineage elected to account for its 21.7 million shares of Asterias common
stock at fair value using the equity method of accounting. The fair value of the Asterias shares was approximately $20.2 million
as of March 8, 2019, the closing date o
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