Item 2. Management’s Discussion and Analysis
Item
2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The
following discussion and analysis of our unaudited condensed consolidated financial condition and results of operations should be read
together with our Annual Report on Form 10-K for the year ended December 31, 2024 (the “Form 10-K”), as filed with the Securities
and Exchange Commission (the “SEC”).
Unless
the context otherwise requires, (i) “we”, “us”, and “our”, and the “Company”, “Lucid”
and “Lucid Diagnostics” refer to Lucid Diagnostics Inc. and its subsidiaries LucidDx Labs Inc. (“LucidDx Labs”)
and CapNostics, LLC (“CapNostics”), (ii) “FDA” refers to the Food and Drug Administration, (iii) “510(k)”
refers to a premarket notification, submitted to the FDA by a manufacturer pursuant to § 510(k) of the Food, Drug and Cosmetic Act
and 21 CFR § 807 subpart E, (iv) “CLIA” refers to the Clinical Laboratory Improvement Amendments of 1988 and associated
regulations set forth in 42 CFR § 493, (v) “CE Mark” refers to a “Conformité Européenne” Mark,
a mark indicating that a product such as a medical device conforms to the essential requirements of the relevant European directive,
and (vi) “LDT” refers to a diagnostic test, defined by the FDA as “an IVD that is intended for clinical use and designed,
manufactured and used within a single laboratory,” which is generally subject only to self-certification of analytical validity
under the CMS CLIA program.
FORWARD-LOOKING
STATEMENTS
This
Quarterly Report on Form 10-Q (this “Form 10-Q”), including the discussion and analysis of our unaudited condensed consolidated
financial condition and results of operations, contains forward-looking statements that involve substantial risks and uncertainties.
All statements, other than statements of historical facts, contained in this Form 10-Q, including statements regarding our future results
of operations and financial position, business strategy and plans and objectives of management for future operations, are forward-looking
statements. The words “may,” “will,” “should,” “expects,” “plans,” “anticipates,”
“could,” “intends,” “target,” “projects,” “contemplates,” “believes,”
“estimates,” “predicts,” “potential” or “continue” or the negative of these terms or
other similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these
identifying words. Forward-looking statements are not guarantees of future performance and the Company’s actual results may differ
significantly from those expressed or implied in the forward-looking statements. Factors that might cause such differences include, but
are not limited to, those discussed in Item 1A of Part I of the Form 10-K under the heading “Risk Factors.”
Important
factors that may affect our actual results include:
● our
limited operating history;
● our
financial performance, including our ability to generate revenue;
● our
ability to obtain regulatory approval for the commercialization of our products;
● the
risk that the FDA will cease to exercise enforcement discretion with respect to LDTs, like
EsoGuard;
● the
ability of our products to achieve market acceptance;
● our
success in retaining or recruiting, or changes required in, our officers, key employees or
directors;
● our
potential ability to obtain additional financing when and if needed;
● our
ability to protect our intellectual property;
● our
ability to complete strategic acquisitions;
● our
ability to manage growth and integrate acquired operations;
● the
potential liquidity and trading of our securities;
● our
regulatory and operational risks;
● cybersecurity
risks;
● risks
related to the COVID-19 pandemic and other health-related emergencies;
● risks
related to our relationship with PAVmed; and
● our
estimates regarding expenses, future revenue, capital requirements and needs for additional
financing.
In
addition, our forward-looking statements do not reflect the potential impact of any future financings, acquisitions, mergers, dispositions,
joint ventures or investments we may make.
We
may not actually achieve the results, plans and/or objectives disclosed in our forward-looking statements, and the intended or
expected results, developments and/or other events disclosed in our forward-looking statements may not actually occur, and
accordingly you should not place undue reliance on our forward-looking statements. You should read this Quarterly Report on Form
10-Q and the documents we have filed as exhibits to this Form 10-Q and the Form 10-K completely and with the understanding our
actual future results may be materially different from what we expect. We do not assume any obligation to update any forward-looking
statements, whether as a result of new information, future events or otherwise, except as required by applicable law.
22
Overview
We
are a commercial-stage, cancer prevention medical diagnostics technology company focused on the millions of patients who are at risk
of developing esophageal precancer and cancer, specifically highly lethal esophageal adenocarcinoma (“EAC”).
We
believe that our flagship product, the EsoGuard Esophageal DNA Test, performed on samples collected with the EsoCheck Esophageal Cell
Collection Device, constitutes the first and only commercially available diagnostic test capable of serving as a widespread tool for
the early detection of esophageal precancer, including Barrett’s Esophagus (“BE”), in at-risk patients. Early detection
of esophageal precancer allows patients to undergo appropriate monitoring and treatment, as indicated by clinical practice guidelines,
in an effort to prevent progression to esophageal cancer.
EsoGuard
is a bisulfite-converted targeted next-generation sequencing (NGS) DNA assay performed on surface esophageal cells collected with EsoCheck.
It quantifies methylation at 31 sites on two genes, Vimentin (VIM) and Cyclin A1 (CCNA1). The assay has been evaluated in multiple studies,
demonstrating sensitivity of ~90% for detecting disease along the full esophageal precancer to cancer spectrum, with a negative predictive
value (NPV) of ~99%. Sensitivity and NPV remain very high even for detecting early precancer, which is unprecedented for a molecular
diagnostic test .
EsoCheck
is an FDA 510(k) and CE Mark cleared noninvasive swallowable balloon capsule catheter device capable of sampling surface esophageal
cells in a less than two minute office procedure. It consists of a vitamin pill-sized rigid plastic capsule tethered to a thin
silicone catheter from which a soft silicone balloon with textured ridges emerges to gently swab surface esophageal cells. When
vacuum suction is applied, the balloon and sampled cells are pulled into the capsule, protecting them from contamination and
dilution by cells outside of the targeted region during device withdrawal. We believe this proprietary Collect+Protect™
technology makes EsoCheck the only noninvasive esophageal cell collection device capable of such anatomically targeted and protected
sampling.
EsoGuard
and EsoCheck are based on patented technology licensed by Lucid from Case Western Reserve University (“CWRU”). EsoGuard and
EsoCheck have been developed to provide an accurate, non-invasive, patient-friendly test for the early detection of EAC and BE, including
dysplastic BE and related precursors to EAC in patients with gastroesophageal reflux disease (“GERD”), commonly known as
chronic heartburn, acid reflux, or just reflux.
Recent
Developments
Medicare
Coverage
In
November 2024, we submitted to MolDx our complete clinical evidence package in support of a request for reconsideration of the non-coverage
language in the LCD to secure Medicare coverage for EsoGuard. The EsoGuard clinical evidence package included six new peer-reviewed publications:
three clinical validation studies (two in the intended use population, one case control), two clinical utility studies, and one analytical
validation study. The current LCD provides clear coverage criteria consistent with the American College of Gastroenterology (ACG) guidelines
for esophageal precancer testing. The package was submitted as part of a request for reconsideration of the non-coverage language in
the LCD to secure Medicare coverage for EsoGuard.
As
part of the LCD reconsideration process, MolDX-participating Medicare Administrative Contractors are scheduled to convene a Contractor
Advisory Committee (CAC) Meeting regarding the LCD on September 4, 2025.
Clinical
Study Publications
In April 2025, the Company’s
fifth peer-reviewed clinical utility manuscript, “ Enhancing the Diagnostic Yield of EGD for Diagnosis of Barrett’s Esophagus
Through Methylated DNA Biomarker Triage ,” was published in Gastroenterology & Hepatology . This manuscript presents
clinical utility data from the ENVET-BE study, which is the second to assess the clinical utility of EsoGuard in a real-world screening
population. The ENVET-BE study analyzed 209 EsoGuard-positive patients who underwent biomarker triage and confirmatory EGD in the 2023
calendar year, to test the hypothesis that EGDs performed on patients who first triage positive on EsoGuard have higher diagnostic yield
than screening EGDs alone. The yield of screening EGDs was estimated by literature-established disease prevalence (10.6%). A 2.4-fold
increase in BE detection compared with the performance goal was observed for the full study population. In the cohort meeting American
College of Gastroenterology (ACG) criteria for BE screening, the diagnostic yield was increased by 2.7-fold.
On August 1, 2025, the American
Journal of Gastroenterology e-published (ahead of printing) the manuscript “Nonendoscopic Detection of Barrett’s Esophagus
in Patients Without GERD Symptoms.” This investigator-initiated pilot study evaluated EsoGuard in 120 patients without GERD
symptoms, but who met American Gastroenterological Association (AGA) BE screening criteria. Of 34 EsoGuard-positive patients, 27 underwent
EGD, confirming BE in 9 cases (PPV: 33%). Of 86 EsoGuard-negative patients, 22 volunteered for EGD, with zero BE cases (NPV: 100%). This
is the first study to assess EsoGuard in this expanded risk group and informed the design of a larger, ongoing NIH R01-funded study.
ATM
Facility
On
May 30, 2025, the Company entered into an “at-the-market offering” (“ATM”) for up to $25.0 million of its common
stock that may be offered and sold under a Controlled Equity Offering Agreement between the Company and Maxim Group LLC.
23
Recent
Developments - continued
April
2025 Confidentially Marketed Public Offering
On
April 11, 2025, the Company closed on the sale of 14,375,000 shares of its common stock at a price of $1.20 per share (the “April
2025 Offering”). The net proceeds of the April 2025 Offering, after deducting the estimated placement agent’s fees and other
expenses of $1.2 million, was approximately $16.1 million. The Company intends to use the net proceeds from the April 2025 Offering for
working capital and other general corporate purposes.
March
2025 Registered Direct Offering
On
March 5, 2025, the Company closed on the sale of 13,939,330 shares of its common stock at a price of $1.10 per share (the “Offering”).
The net proceeds of the Offering, after deducting the estimated placement agent’s fees and other expenses of $0.4 million, was
approximately $14.9 million. The Company intends to use the net proceeds from the Offering for working capital and other general corporate
purposes.
Russell 2000® and 3000® Indexes
On June 27, 2025, the Company was added to the
Russell 2000® Index and the Russell 3000® Index, following the 2025 annual reconstitution by FTSE Russell.
Hoag Comprehensive Esophageal Precancer Testing
Program Using EsoGuard
On June 18, 2025, the Company announced that
Hoag, a nationally recognized regional healthcare delivery network, launched a comprehensive, integrated esophageal precancer testing
program using the Company’s EsoGuard® Esophageal DNA Test. The Company will partner with Hoag to offer EsoGuard testing across
its digestive health, primary care, and concierge medicine programs.
NCCN
Clinical Practice Guidelines Update
In
March 2025, we announced that a recent update to the National Comprehensive Cancer Network® (NCCN) Clinical Practice Guidelines in
Oncology (NCCN Guidelines®) focused on Esophageal and Esophagogastric Junction Cancers (Version 1.2025) has added a new section on
BE screening. The NCCN Guidelines® now reference professional society guidelines on BE screening, including the most recent ACG clinical
guideline discussed above, which recommends non-endoscopic biomarker testing, such as EsoGuard performed on samples collected with EsoCheck,
as an acceptable alternative to invasive upper endoscopy to detect esophageal precancer.
Highmark
Reimbursement Approval
On
March 13, 2025, the Company announced that Highmark Blue Cross Blue Shield, an independent licensee of the Blue Cross and Blue
Shield Association, has issued a positive coverage policy for non-invasive screening of esophageal precancer and cancer in New York
state. The new policy, which became effective as of May 26, 2025, covers EsoGuard in patients who meet established criteria for
esophageal precancer testing consistent with professional society guidelines.
CWRU
NIH Grant Related to EsoGuard and EsoCheck
On
February 27, 2025, the Company announced that principal investigators from Case Western Reserve University (CWRU) and University Hospitals
(UH), were awarded an $8 million National Institutes of Health (NIH) R01 grant to conduct a five-year clinical study designed to evaluate
esophageal precancer detection using EsoCheck and EsoGuard among at-risk individuals without symptoms of chronic gastroesophageal reflux
disease (GERD). The study, “A Clinical Trial of Cancer Prevention by Biomarker Based Detections of Barrett’s Esophagus and Its
Progression,” aims to evaluate the effectiveness of EsoCheck and EsoGuard in detecting esophageal precancer (Barrett’s Esophagus
or BE) to prevent esophageal cancer (EAC) within a non-GERD at-risk population. To accomplish this aim, 800 patients without GERD symptoms
who meet the American Gastroenterological Association’s (AGA) risk criteria for screening will be recruited across five participating
research centers: University Hospitals, University of Colorado, Johns Hopkins University, University of North Carolina, and Cleveland
Clinic.
24
Results
of Operations
Overview
Revenue
The
Company recognized revenue resulting from the delivery of patient EsoGuard test results when the Company considered the collection of
such consideration to be probable to the extent that it is unconstrained.
Cost
of revenue
Cost
of revenues recognized from the delivery of patient EsoGuard test results includes costs related to EsoCheck device usage, shipment of
test collection kits, royalties and the cost of services to process tests and provide results to physicians. We incur expenses for tests
in the period in which the activities occur, therefore, gross margin as a percentage of revenue may vary from quarter to quarter due
to costs being incurred in one period that relate to revenues recognized in a later period.
We
expect that the gross margin for our services will continue to fluctuate and be affected by EsoGuard test volume, our operating efficiencies,
patient compliance rates, payer mix, the levels of reimbursement, and payment patterns of payers and patients.
Sales
and marketing expenses
Sales
and marketing expenses consist primarily of salaries and related costs for employees engaged in sales, sales support and marketing activities,
as well as the portion of the MSA Fee (as defined in Note 5, Related Party Transactions , to our accompanying unaudited condensed
consolidated financial statements) allocated to sales and marketing expenses, which are principally costs related to PAVmed employees
who are performing services for the Company. We anticipate our sales and marketing expenses will increase in the future, to the extent
we expand our commercial sales and marketing operations as resources permit and insurance reimbursement coverage for our EsoGuard test
expands.
General
and administrative expenses
General
and administrative expenses consist primarily of professional fees for accounting, tax, audit and legal services (including those
fees incurred as a result of our being a public company), consulting fees, employees costs involved in third-party payor
reimbursement contract negotiations and consulting fees, expenses associated with obtaining and maintaining patents within our
intellectual property portfolio, and certain employee costs, along with the portion of the MSA Fee allocated to general and
administrative expenses.
We
anticipate our general and administrative expenses will increase in the future to the extent our business operations grow. Furthermore,
we anticipate continued expenses related to being a public company, including fees and expenses for audit, legal, regulatory, tax-related
services, insurance premiums and investor relations costs associated with maintaining compliance as a public company.
Research
and development expenses
Research
and development expenses are recognized in the period they are incurred and consist principally of internal and external expenses incurred
for the development of our technologies and conducting clinical trials, including:
● costs
associated with submission of regulatory filings;
● cost
of laboratory supplies and acquiring, developing, and manufacturing preclinical prototypes;
and
● the
portion of the MSA Fee allocated to research and development.
We
plan to incur research and development expenses for the foreseeable future as we continue the development of our existing products as
well as new innovations. Our research and development activities, including our clinical trials, are focused principally on facilitating
insurer reimbursement, encouraging physician adoption and developing product improvements or extending the utility of the lead products
in our pipeline, including EsoCheck and EsoGuard.
Other
Income and Expense, net
Other
income and expense, net, consists principally of changes in fair value of our convertible note and losses on extinguishment of debt upon
repayment of such convertible note.
Presentation
of Dollar Amounts
All
dollar amounts in this Management’s Discussion and Analysis of Financial Condition and Results of Operations are presented as dollars
in millions, except for share and per share amounts.
25
Results
of Operations - continued
The
three months ended June 30, 2025 as compared to the three months ended June 30, 2024
Revenue
In
the three months ended June 30, 2025, revenue was $1.2 million as compared to $1.0 million for the corresponding period in the prior
year. The $0.2 million increase principally relates to the increase in the consideration received for the performance of the EsoGuard
Esophageal DNA Tests.
Cost
of revenue
In
the three months ended June 30, 2025, the cost of revenue remained relatively level at approximately $1.6 million, as compared to the corresponding
period in the prior year.
Sales
and marketing expenses
In
the three months ended June 30, 2025, sales and marketing costs were approximately $4.0 million as compared to $4.2 million for the
corresponding period in the prior year. The net decrease of $0.2 million was principally related to a decrease in compensation
costs.
General
and administrative expenses
In
the three months ended June 30, 2025, general and administrative costs were approximately $5.6 million as compared to $4.9 million for
the corresponding period in the prior year. The net increase of $0.7 million was principally related to:
● approximately
$0.4 million increase related to the amended MSA with PAVmed due to the growth and expansion
of our business and the services incurred through PAVmed; and
● approximately
$0.3 million increase in stock-based compensation related costs.
Research
and development expenses
In
the three months ended June 30, 2025, research and development costs were approximately $1.3 million, compared to $1.4 million for
the corresponding period in the prior year. The net decrease of $0.1 million was principally related to a decrease in development
costs, particularly in clinical trial activities and outside professional and consulting fees.
Amortization
of Acquired Intangible Assets
In
the three months ended June 30, 2025, the amortization of acquired intangible assets remained relatively level at approximately $0.1 million, as compared to the corresponding period in the prior year.
Other
Income and Expense
Change
in fair value of convertible debt
In
the three months ended June 30, 2025, the change in the fair value of our convertible notes was approximately $6.8 million of income,
related to the 2024 Senior Convertible Notes (as defined in Note 10, Debt , to our accompanying unaudited condensed consolidated
financial statements). The 2024 Senior Convertible Notes was initially measured at the notes’ issue-date estimated fair value and
is subsequently remeasured at estimated fair value as of each reporting period date.
26
Results
of Operations - continued
The
three months ended June 30, 2025 as compared to three months ended June 30, 2024 - continued
Loss
on Debt Extinguishment
The Company did not incur debt extinguishment
loss in the three months ended June 30, 2025.
In
the three months ended June 30, 2024, a debt extinguishment loss in the aggregate of approximately $0.5 million was recognized in connection
with our March 2023 Senior Convertible Note as discussed below.
● In
the three months ended June 30, 2024, approximately $1.1 million of principal repayments
along with approximately $0.2 million of interest expense thereon, were settled through the
issuance of 2,117,883 shares of common stock of the Company, with such shares having a fair
value of approximately $1.9 million (with such fair value measured as the quoted closing
price of the common stock of the Company on the respective conversion date). The conversions
resulted in a debt extinguishment loss of $0.5 million in the three months ended June 30,
2025.
See
Note 10 , Debt , to our accompanying unaudited condensed consolidated financial statements, for additional information with respect
to the 2024 Senior Convertible Notes.
The
six months ended June 30, 2025 as compared to six months ended June 30, 2024
Revenue
In
the six months ended June 30, 2025, revenue remained relatively level at $2.0 million, as compared to the corresponding period in the
prior year.
Cost
of revenue
In
the six months ended June 30, 2025, the cost of revenue was approximately $3.1 million as compared to $3.3 million for the corresponding
period in the prior year. The net decrease of $0.2 million was principally related to:
● approximately
$0.4 million decrease in the manufacturing costs associated with the EsoCheck devices and
EsoGuard Esophageal DNA Tests; and
● approximately
$0.2 million increase in compensation related costs.
Sales
and marketing expenses
In
the six months ended June 30, 2025, sales and marketing costs were approximately $8.1 million as compared to $8.4 million for the corresponding
period in the prior year. The net decrease of $0.3 million was principally related to:
● approximately
$0.2 million decrease in stock-based compensation; and
● approximately
$0.1 million decrease related to third-party facility related expenses.
General
and administrative expenses
In
the six months ended June 30, 2025, general and administrative costs were approximately $11.8 million as compared to $8.9 million for
the corresponding period in the prior year. The net increase of $2.9 million was principally related to:
● approximately
$1.6 million increase related to third-party professional fees, primarily due to financing related costs;
● approximately
$0.9 million increase related to the amended MSA with PAVmed due to the growth and expansion
of our business and the services incurred through PAVmed; and
● approximately
$0.4 million increase in stock-based compensation costs.
Research
and development expenses
In
the six months ended June 30, 2025, research and development costs were approximately $2.7 million, compared to $2.9 million for the
corresponding period in the prior year. The net decrease of $0.2 million was principally related to:
● approximately
$0.3 million increase related to the amended MSA with PAVmed due to the growth and expansion
of our business and the services incurred through PAVmed;
● approximately
$0.3 million decrease in development costs, particularly in clinical trial activities; and
● approximately
$0.2 million decrease in stock-based compensation.
27
Results
of Operations - continued
The
six months ended June 30, 2025 as compared to six months ended June 30, 2024 - continued
Amortization
of Acquired Intangible Assets
The
amortization of acquired intangible assets was approximately $0.2 million in the six months ended June 30, 2025, as compared to $0.5
million for the corresponding period in the prior year. The decrease of $0.3 million in the current period was due to certain acquired
intangible assets being fully amortized in February 2024.
Other
Income and Expense
Change
in fair value of convertible debt
In
the six months ended June 30, 2025 and 2024, the change in the fair value of our convertible note was approximately $7.6 million of expense
and $0.9 million of income, respectively, related to the 2024 Convertible Notes and the March 2023 Senior Convertible Note (as defined
in Note 10 , Debt , to our accompanying unaudited condensed consolidated financial statements). The 2024 Convertible Notes and March
2023 Senior Convertible Note were initially measured at their respective issue date estimated fair value and subsequently remeasured at estimated
fair value as of each reporting period date. The Company initially recognized a $0.8 million fair value remeasurement as a non-cash expense
on the issue date.
Loss
on Debt Extinguishment
The Company did not incur debt
extinguishment loss in the six months ended June 30, 2025.
In
the six months ended June 30, 2024, a debt extinguishment loss in the aggregate of approximately $0.7 million was recognized in connection
with our March 2023 Senior Convertible Note as discussed below.
● In
the six months ended June 30, 2024, approximately $1.2 million of principal repayments along with approximately $0.7 million of interest
expense thereon, were settled through the issuance of 2,661,181 shares of common stock of the Company, with such shares having a fair value
of approximately $2.5 million (with such fair value measured as the quoted closing price of the common stock of the Company on the respective
conversion date). The conversions resulted in a debt extinguishment loss of $0.7 million in the six months ended June 30, 2024.
See
Note 10 , Debt , to our accompanying unaudited condensed consolidated financial statements, for additional information with respect
to the 2024 Convertible Notes.
Deemed
Dividend on Series A and Series A-1 Convertible Preferred Stock Exchange Offer
The
fair value of the consideration given in the form of the issue of 31,790 shares of Series B Convertible Preferred Stock, with such fair
value recognized as the carrying value of such issued shares of Series B Convertible Preferred Stock, as compared to the carrying value
of the extinguished Series A and Series A-1 Convertible Preferred Stock (carrying value of $24.3 million), resulting in an excess of
fair value of $7.5 million recognized as a deemed dividend charged to accumulated deficit in the unaudited condensed consolidated balance
sheet on March 13, 2024, with such deemed dividend included as a component of net loss attributable to common stockholders, summarized
as follows:
Series B Convertible Preferred Stock Issuance and Series A/A-1 Exchange Offer ($ in
thousands)
March 13, 2024
Fair Value - 31,790 shares of Series B Preferred Stock issued in exchange for Series A and Series A-1 Preferred Stock
$ 31,790
Less: Carrying value related to Series A and Series A-1 Preferred Stock Exchanged for Series B Preferred Stock (of 24,295 shares)
(24,294 )
Deemed Dividend Charged to Accumulated Deficit
$ 7,496
28
Liquidity
and Capital Resources
Our
current operational activities are principally focused on the commercialization of EsoGuard. We are pursuing commercialization across
multiple sales channels, including: the communication to and education of medical practitioners and clinicians regarding EsoGuard; the
establishment of Lucid Test Centers for the collection of cell samples using EsoCheck; use of our mobile testing unit; ongoing #CheckYourFoodTube
testing days; and our direct contracting strategic initiative (including in the concierge medicine and employer markets sectors). Additionally,
we are developing expanded clinical evidence to support insurance reimbursement adoption by government and private insurers. Further,
as resources permit, the Company also intends to pursue development of other products and services.
Our
ability to generate revenue depends upon our ability to successfully advance the commercialization of EsoGuard, including significantly
expanding insurance reimbursement coverage. There are no assurances, however, we will be able to obtain an adequate level of financial resources required
for the long-term commercialization and development of our products and services.
We
are subject to all of the risks and uncertainties typically faced by medical device and diagnostic companies that devote substantially
all of their efforts to the commercialization of their initial products and services. We experienced a net loss of approximately $31.3 million and used approximately $23.0 million of cash
in operations during the six months ended June 30, 2025. Financing activities provided $31.9 million of cash during the six months ended June
30, 2025. We ended the quarter with cash on-hand of $31.1 million as of June 30, 2025. We expect to continue to experience recurring
losses and negative cash flow from operations, and will continue to fund our operations with debt and/or equity financing transactions,
which in accordance with management’s plans may include conversions of our existing debt to equity and refinancing our existing
debt obligations to extend the maturity date. The Company’s ability to continue operations 12 months beyond the issuance of the
financial statements will depend upon generating substantial revenue that is conditioned on obtaining positive third-party reimbursement
coverage for its EsoGuard Esophageal DNA Test from both government and private health insurance providers, increasing revenue through
contracting directly with self-insured employers, and upon raising additional capital through various potential sources including equity
and/or debt financings or refinancing existing debt obligations. These factors raise substantial doubt about the Company’s ability
to continue as a going concern within one year after the date the accompanying unaudited condensed consolidated financial statements
are issued.
29
Liquidity
and Capital Resources - continued
March
2025 Registered Direct Offering
On
March 5, 2025, the Company closed on the sale of 13,939,330 shares of its common stock at a price of $1.10 per share (the “Offering”).
The net proceeds of the Offering, after deducting the estimated placement agent’s fees and other expenses of $0.4 million, was
approximately $14.9 million. The Company intends to use the net proceeds from the Offering for working capital and other general corporate
purposes.
April
2025 Confidentially Marketed Public Offering
On
April 11, 2025, the Company closed on the sale of 14,375,000 shares of its common stock at a price of $1.20 per share (the “April
2025 Offering”). The net proceeds of the April 2025 Offering, after deducting the estimated placement agent’s fees and other
expenses of $1.1 million, was approximately $16.2 million. The Company intends to use the net proceeds from the April 2025 Offering for
working capital and other general corporate purposes.
ATM Facility
On May 30, 2025, the
Company entered into an “at-the-market offering” (“ATM”) for up to $25.0 million of its common stock that
may be offered and sold under a Controlled Equity Offering Agreement between the Company and Maxim Group LLC. In the six months
ended June 30, 2025, the Company sold 215,421 shares through its at-the-market equity facility for net proceeds of
approximately $0.3 million, after payment of 3% commissions.
Critical
Accounting Estimates
The
discussion and analysis of our financial condition and results of operations is based on our unaudited condensed consolidated financial
statements, which have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S.
GAAP”). The preparation of these unaudited condensed consolidated financial statements requires us to make estimates and assumptions
that affect the amounts reporting in our unaudited condensed consolidated financial statements and accompanying notes. On an ongoing
basis, we evaluate our estimates and judgements. In accordance with U.S. GAAP, we base our estimates on historical experience and on
various other factors that are believed to be appropriate under the circumstances. Actual results may differ from these estimates under
different assumptions or conditions. Our critical accounting estimates are as disclosed in the Company’s Annual Report on Form
10-K for the year ended December 31, 2024 as filed with the SEC on March 24, 2025. There have been no material changes to our critical
accounting estimates in the six months ended June 30, 2025.
Text extracted from the filing as submitted to EDGAR. Formatting, tables and exhibits are simplified for reading; the original document is authoritative for anything you rely on.