Item 1A. Risk Factors
ITEM 1A. RISK FACTORS
You should carefully consider the risks and
uncertainties described below and the other information in this Annual Report before making an investment in our securities. Our business,
financial condition, results of operations, or prospects could be materially and adversely affected if any of these risks occurs, and
as a result, the market price of our securities could decline and you could lose all or part of your investment. This Annual also contains
forward-looking statements that involve risks and uncertainties. See “Cautionary Statement Regarding Forward-Looking Statements.”
Our actual results could differ materially and adversely from those anticipated in these forward-looking statements as a result of certain
factors, including those set forth below.
Risks Related to Our Business, Technology
and Industry
We are a development clinical-stage company with limited operating
history and have incurred losses since our inception. We anticipate that our expenses will increase significantly, and we will continue
to incur increasing and significant losses for the foreseeable future.
We are a development clinical-stage biopharmaceutical
company with limited operating history. We have incurred losses in each year since BiomX Ltd.’s inception in 2015. As of
December 31, 2020, our accumulated deficit was $72.3 million, and we expect to incur increasingly significant losses for the foreseeable
future. Preclinical development and clinical trials and activities are costly. We have devoted, and will continue to devote for
the foreseeable future, substantially all of our resources to research and development and clinical trials for our product candidates.
We do not expect to generate any revenue from the commercial sales of our product candidates in the near term. For the years ended
December 31, 2020 and 2019, we had losses from operations of $30.3 million and $22.2 million, respectively. We anticipate that
our expenses will increase substantially if and as we:
●
continue to develop and conduct clinical trials
with respect to our lead product candidate, BX001, and other product candidates in our pipeline;
●
initiate and continue research, preclinical
and clinical development efforts for any future product candidates;
●
seek to discover and develop additional product
candidates and further expand our clinical product pipeline;
●
seek marketing and regulatory approvals for
any product candidates that successfully complete clinical trials;
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●
require the manufacture of larger quantities
of product candidates for clinical development and, potentially, commercialization;
●
maintain, expand and protect our intellectual
property portfolio;
●
expand our research and development infrastructure,
including hiring and retaining additional personnel, such as clinical, quality control and scientific personnel;
●
establish sales, marketing, distribution and
other commercial infrastructure in the future to commercialize products for which we obtain marketing approval, if any; and
●
add operational, financial and management information
systems and personnel, including personnel to support our product development and commercialization and help us comply with
our obligations as a subsidiary of a public company.
We will need to raise
additional capital in the future to support our operations.
As of December 31, 2020, we had cash, cash equivalents
and short-term deposits of $57.1 million, and we have had recurring losses from operations and negative operating cash flows since inception.
We will need to raise additional capital in the future to support our operations and product development activities. In the near term,
we expect to continue to fund our operations and other development activities relating to additional product candidates from the cash
held by us, governmental and other grants and through future equity financings. In connection with our efforts to raise additional capital,
we filed a shelf registration statement on Form S-3, which was declared effective by the SEC on December 11, 2020. In addition, on December
4, 2020, we entered into an Open Market Sale Agreement SM , or the Sale Agreement, with Jefferies LLC, or Jefferies, pursuant
to which we may issue and sell shares of our Common Stock having an aggregate offering price of up to $50,000,000 from time to time through
Jefferies and through March 25, 2021, we sold an aggregate of 610,820 shares of Common Stock pursuant to the Sale Agreement for aggregate
gross proceeds of $4,519,474. We may continue to sell shares under the Sale Agreement and otherwise to use our shelf registration statement
to raise additional funds from time to time. We may also seek funds through arrangements with collaborators or others that may require
us to relinquish rights to the product candidates that we might otherwise seek to develop or commercialize independently. If we enter
into a collaboration for one or more of our current or future product candidates at an earlier development stage, the terms of such a
collaboration will likely be less favorable than if we were to enter the collaboration in later stages or if we commercialized the product
independently. If we raise additional funds through equity offerings, the terms of these securities may include liquidation or other
preferences that adversely affect our stockholders’ rights or cause significant dilution to our stockholders. If we raise additional
capital through debt financing, it would be subject to fixed payment obligations and may be subject to covenants limiting or restricting
our ability to take specific actions, such as incurring additional debt, making capital expenditures, declaring dividends or acquiring
or licensing intellectual property rights.
If additional capital is not available
to us when needed or on acceptable terms, we may not be able to continue to operate our business pursuant to our business plan
and may be required to delay our clinical development. While we believe that our existing cash and cash equivalents, together
with our existing resources, will be sufficient to fund our planned operations until at least mid-2022, we cannot provide assurances
that our estimates are accurate, that our plans will not change or that changed circumstances will not result in the depletion
of our capital resources more rapidly than we currently anticipate.
Developing drugs and conducting clinical
trials is expensive. Our future funding requirements will depend on many factors, including:
●
the costs, timing and progress of our research
and development and clinical activities;
●
manufacturing costs associated with our targeted
bacteriophage, or phage, therapies strategy and other research and development activities;
●
the terms and timing of any collaborative, licensing,
acquisition or other arrangements that we may establish;
●
employee-related expenses, as well as external
costs such as fees paid to outside consultants;
●
the costs and timing of seeking regulatory approvals
and related to compliance with regulatory requirements; and
●
the costs of filing, prosecuting, defending
and enforcing any patent applications, claims, patents and other intellectual property rights.
Domestic and international equity and debt
markets have experienced and may continue to experience heightened volatility and turmoil based on domestic and international
economic conditions and concerns. In the event these economic conditions and concerns continue or worsen and the markets continue
to remain volatile, or a bear market, or recession, ensues in the U.S. stock market, and the impact recently seen associated with
the coronavirus outbreak, our operating results and liquidity could be affected adversely by those factors in many ways, including
making it more difficult for us to raise funds if necessary and our stock price may decline.
There can be no assurance that sufficient
funds will be available to us when required or on acceptable terms, if at all. Our inability to obtain additional funds could
have a material adverse effect on our business, financial condition and results of operations. Moreover, if we are unable to obtain
additional funds on a timely basis, there will be substantial doubt about our ability to continue as a going concern and increased
risk of insolvency and up to a total loss of investment by our stockholders.
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We are seeking to develop product candidates using phage
technology, an approach for which is difficult to predict the time and cost of development. To our knowledge, no bacteriophage
has thus far been approved as a drug in the United States or in the European Union.
We
are developing our product candidates with phage technology. We have not, nor to our knowledge has any other company, received
regulatory approval from the FDA, or equivalent foreign regulatory agencies for a product based on this approach. While in
vitro and in vivo studies have characterized the behavior of phage in cell cultures and animal models and there exists
a body of literature regarding the use of phage therapy in humans, the safety and efficacy of phage therapy in humans has not
been extensively studied in well-controlled modern clinical trials .
Most of the prior research on phage-based therapy was conducted in the former Soviet Union prior to and immediately after World
War II and lacked appropriate control group design or lacked control groups at all. Furthermore, the standard of care has changed
substantially during the ensuing decades since those studies were performed, diminishing the relevance of prior claims of improved
cure rates. Any product candidates that we develop may not demonstrate in patients the therapeutic properties ascribed to them
in laboratory and other preclinical studies, and they may interact with human biological systems in unforeseen, ineffective or
even harmful ways. We cannot be certain that our approach will lead to the development of approvable or marketable products. Furthermore,
the bacterial targets of phage may develop resistance to our product candidates over time, which we may or may not be able to
overcome with the development of new phage cocktails or we may not be able to construct a cocktail with sufficient coverage of
our target pathogen universe.
If our product candidates receive regulatory
approval but do not achieve an adequate level of acceptance by physicians, healthcare payors and patients, we may not generate
product revenue sufficient to attain profitability. Our success will depend upon physicians who specialize in the treatment of
diseases targeted by our product candidates that we pursue as drugs, prescribing potential treatments that involve the use of
our product candidates in lieu of, or in addition to, existing treatments with which they are more familiar and for which greater
clinical data may be available. Our success will also depend on consumer acceptance and adoption of our products that we commercialize.
Adverse events in preclinical studies and clinical trials of our product candidates or in clinical trials of others developing
similar products and the resulting publicity, as well as any other adverse events in the field of phage therapeutics, could result
in a decrease in demand for any product that we may develop. The degree of market acceptance of any approved products will depend
on a number of factors, including:
●
the effectiveness of the product;
●
the prevalence and severity of any side effects;
●
potential advantages or disadvantages over alternative
treatments;
●
relative convenience and ease of administration;
●
the strength of marketing and distribution support;
●
the price of the product, both in absolute terms
and relative to alternative treatments; and
●
sufficient third-party coverage or reimbursement.
Developing our product candidates on a
commercial scale will require substantial technical, financial and human resources. We and our third-party collaborators may experience
delays in developing manufacturing capabilities for our product candidates, and may not be able to do so at the scale required
to efficiently conduct the clinical trials required to obtain regulatory approval of those of our product candidates that require
it, or to manufacture commercial quantities of our products, if approved or otherwise permitted to be marketed.
We are considering marketing our lead candidate
product — BX001 — as a cosmetic, although this positioning also presents some challenges, as explained in this “Risk
Factors” section.
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Our product candidates must undergo clinical testing
which may fail to demonstrate the requisite safety and tolerability for cosmetics, safety and efficacy for drug products, or safety,
purity, and potency for biologics, and any of our product candidates could cause adverse effects, which would substantially delay
or prevent regulatory approval and/or commercialization.
Before we can obtain regulatory approval
for a product candidate or otherwise obtain evidence allowing us to market the product, we must undertake extensive preclinical
and clinical testing in humans to demonstrate safety and efficacy to the satisfaction of the FDA or other regulatory agencies.
Clinical trials of product candidates sufficient to obtain regulatory marketing approval or otherwise demonstrate safety prior
to marketing, are expensive and take years to complete, especially for our product candidate designed to treat CRC as the phage
will be genetically modified, which could make the conduct of clinical trials more complex. Furthermore, results from these clinical
trials may not show safety or efficacy of our product candidates sufficient to lead to approval, or to warrant further development.
For example, our approach is intended to design phage combinations, or cocktails, to target specific strains of pathogenic bacteria
in order to alter microbiome composition and confer potential therapeutic or cosmetic benefit to patients. However, there can
be no assurance that the eradication of the selected targets will result in a clinically meaningful effect on the underlying disease,
such as in cases where the pathology of the disease is not well-defined. In addition, the bacteria that we target may be associated
with the disease, but may not be causative or contributive to the pathology of the disease, or there may be other bacteria that
our product candidates do not target that are more meaningful drivers of the underlying disease. In addition, our product candidates
require the use of effective delivery vehicles to reach the target organ or tissue, and there can be no assurance that our intended
delivery systems will allow our product candidates to reach the desired locations in a patient. Safety must first be established
through preclinical testing and early clinical trials, before efficacy can be evaluated and established and thereby lead to FDA
or other regulatory agencies marketing approval. Our clinical trials may produce undesirable side effects or negative or inconclusive
results, and we may decide, or regulators may require us, to conduct additional clinical and/or preclinical testing or to abandon
programs.
The ongoing COVID-19 pandemic
has and may continue to adversely affect our business, including our clinical trials.
The COVID-19 pandemic has had and continues to have a significant impact,
both direct and indirect, on businesses and commerce, as worker shortages have occurred; supply chains have been disrupted; facilities
and production have been suspended; and demand for certain goods and services, such as medical services and supplies, has spiked, while
demand for other goods and services, such as travel, has fallen. In response to the spread of COVID-19, we temporarily had closed
our executive offices with our administrative employees continuing their work outside of our offices and may need to close them again
in the future. In addition, we have modified our business practices, including restricting employee travel, developing social distancing
plans for our employees and cancelling physical participation in meetings, events and conferences. As a result of the COVID-19 pandemic,
we have experienced and may continue to experience additional disruptions that could severely impact our business, preclinical studies
and clinical trials, including:
●
delays or difficulties in enrolling patients
in our clinical trials;
●
delays or difficulties in clinical site initiation,
including difficulties in recruiting clinical site investigators and clinical site staff;
●
diversion of healthcare resources away from
the conduct of clinical trials, including the diversion of hospitals serving as our clinical trial sites and hospital staff
supporting the conduct of our clinical trials;
●
interruption of key clinical trial activities,
such as clinical trial site data monitoring, due to limitations on travel imposed or recommended by federal or state governments,
in the U.S. and the government in Israel, employers and others or interruption of clinical trial subject visits and study
procedures (such as endoscopies that are deemed non-essential), which may impact the integrity of subject data and clinical
study endpoints;
●
interruption or delays in the operations of
the FDA or other regulatory authorities, which may impact review and approval timelines;
●
interruption of, or delays in receiving, supplies
of our product candidates from our contract manufacturing organizations due to staffing shortages, production slowdowns or
stoppages and disruptions in delivery systems;
●
limitations on employee resources that would
otherwise be focused on the conduct of our clinical trials, including because of sickness of employees or their families or
the desire of employees to avoid contact with large groups of people; and
●
interruptions or
delays to our sourced discovery and clinical activities.
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The pandemic and the resulting government actions have impacted
and may continue to adversely impact our planned and ongoing clinical trials. Clinical site initiation, including difficulties
in recruiting clinical site investigators and clinical site staff, and patient enrollment may be delayed due to prioritization
of hospital resources toward the COVID-19 pandemic. Some patients have not been willing and/or able to comply with clinical
trial protocols due to the COVID-19 pandemic, particularly if quarantines or other restrictions impede patient movement
or interrupt healthcare services. Similarly, our ability to recruit and retain patients and principal investigators and site staff
who, as healthcare providers, may have heightened exposure to COVID-19 has been impeded and may continue to remain impeded,
which would adversely impact our clinical trial operations. The diversion of healthcare resources away from the conduct of clinical
trials to focus on pandemic concerns, including the attention of physicians serving as our clinical trial investigators and hospitals
serving as our clinical trial sites, may significantly disrupt our research activities. As a result, the expected timeline for
data readouts of our clinical trials and certain regulatory filings will likely be negatively impacted, which would adversely affect
and delay our ability to obtain regulatory approvals for our product candidates, increase our operating expenses and have a material
adverse effect on our financial condition.
Furthermore, the response to the COVID-19 pandemic
may redirect resources with respect to regulatory matters and intellectual property matters in a way that would adversely impact
our ability to progress regulatory approvals and protect our intellectual property. In addition, we may face impediments to regulatory
meetings and approvals due to measures intended to limit in-person interactions. For example, the FDA postponed most
inspections of foreign manufacturing facilities and products and postponed routine surveillance inspections of domestic manufacturing
facilities. Comparable regulatory authorities in other jurisdictions may adopt similar restrictions or other policy measures in
response to the COVID-19 pandemic and provide guidance regarding the conduct of clinical trials. 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 to timely review and process our regulatory submissions, which
could have a material adverse effect on our business.
The COVID-19 pandemic continues
to evolve. The extent to which the outbreak impacts our business, preclinical studies and clinical trials will depend on future
developments, which are highly uncertain and cannot be predicted with confidence, such as the ultimate geographic spread of the
disease, the duration of the pandemic, travel restrictions and social distancing in the United States Canada, Europe, Israel and
other countries, business closures or business disruptions and the effectiveness of actions taken in the United States, Canada,
Europe, Israel and other countries to contain and treat the disease. As a result, the COVID-19 pandemic has had and
may continue to have a material adverse effect on our business, results of operations, financial condition and prospects and heighten
many of our known risks described or referenced in this “Risk Factors” section.
If we are not able to obtain, or if there are delays
in obtaining, required regulatory approvals for our product candidates for therapeutic indications, we will not be able to commercialize,
or will be delayed in commercializing, our product candidates, and our future ability to generate revenue will be materially impaired.
Our product candidates and the activities
associated with their development and commercialization for therapeutic indications, including their design, testing, manufacture,
safety, efficacy, recordkeeping, labeling, storage, approval, advertising, promotion, sale, distribution, import and export are
subject to regulation by the FDA and other regulatory agencies in the United States and by equivalent foreign regulatory authorities.
Before we can commercialize any of our product candidates for therapeutic indications, we must obtain marketing approval. We have
not received approval to market any of our product candidates from regulatory authorities in any jurisdiction, and it is possible
that none of our product candidates or any product candidates we may seek to develop in the future will ever obtain regulatory
approval.
39
The process of obtaining regulatory approvals
for therapeutic indications, both in the United States and in other countries, is expensive, may take many years if additional
clinical trials are required, and can vary substantially based upon a variety of factors, including the type, complexity and novelty
of the product candidates involved. Changes in marketing approval policies during the development period, changes in or the enactment
of additional statutes or regulations, or changes in regulatory review for each submitted IND, new drug application, or NDA, or
equivalent application types, may cause delays in the approval or rejection of an application. The FDA and equivalent foreign
regulatory authorities have substantial discretion in the approval process and may refuse to accept any application or may decide
that our data is insufficient for approval and require additional preclinical, clinical or other studies. Our product candidates
could be delayed in receiving, or fail to receive, regulatory approval for many reasons, including the following:
●
the FDA or equivalent foreign regulatory authorities
may disagree with the design, including study population, dose level, dose regimen, and bioanalytical assay methods, or implementation
of our clinical trials;
●
we may be unable to demonstrate to the satisfaction
of the FDA or equivalent foreign regulatory authorities that a drug candidate is safe and effective for its proposed indication
or a related companion diagnostic is suitable to identify appropriate patient populations;
●
the results of clinical trials may not meet
the level of statistical significance required by the FDA or equivalent foreign regulatory authorities for approval;
●
we may be unable to demonstrate that a drug
product candidate’s clinical and other benefits outweigh its safety risks;
●
the FDA or equivalent foreign regulatory authorities
may disagree with our interpretation of data from preclinical studies, non-IND human clinical studies or clinical trials;
●
the data collected from clinical trials of our
product candidates may not be sufficient to support the submission of an NDA or other submission or to obtain regulatory approval
in the United States or elsewhere;
●
the FDA or equivalent foreign regulatory authorities
may fail to approve the manufacturing processes or facilities of third-party manufacturers with which we contract for clinical
and commercial supplies; and
●
the approval policies or regulations of the
FDA or equivalent foreign regulatory authorities may significantly change in a manner rendering our clinical data insufficient
for approval.
Of the large number of drugs in development,
only a small percentage successfully complete the FDA or equivalent foreign regulatory approval processes and are commercialized.
The lengthy approval process as well as the unpredictability of future clinical trial results may result in us failing to obtain
regulatory approval to market its product candidates, which would significantly harm our business, results of operations and prospects.
The FDA may also require a panel of experts,
referred to as an Advisory Committee, to deliberate on the adequacy of the safety and efficacy data to support approval for therapeutic
indications. The opinion of the Advisory Committee, although not binding, may have a significant impact on our ability to obtain
approval of any product candidates that we develop based on the completed clinical trials. In the European Union, the safety and
efficacy data of our product candidate for the treatment of CRC will be reviewed by the European Medicines Agency’s, or
the EMA’s, Committee for Advanced Therapies, or CAT, a group of experts in advanced therapy medicinal products. Our other
product candidates would be reviewed by CAT as well if the EMA were to consider that they also qualify as advanced therapy medicinal
products.
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Moreover, under PREA, in the United States, and the Paediatric
Regulation, in the European Union, the FDA or equivalent foreign regulatory authority could require mandatory testing in the pediatric
population. Applications for approval in the United States or in the European Union must contain data to assess the safety and
efficacy of the biologic for the claimed indications in all relevant pediatric subpopulations and to support dosing and administration
for each pediatric subpopulation for which the product is safe and effective. The FDA or equivalent foreign regulatory authority
may, in its discretion, grant full or partial waivers, or deferrals, for submission of data in pediatric subjects. If the FDA requires
data in pediatric patients, significantly more capital will have to be invested in order to conduct the mandatory pediatric clinical
trials and studies, but the approval of the medicinal products for the adult population should normally not be affected. If the
results of such pediatric studies are not positive, our product candidates will not be approved for children.
In addition, even if we were to obtain
approval, regulatory authorities may approve any of our product candidates for fewer or more limited therapeutic indications than
our requests, may include limitations for use or contraindications that limit the suitable patient population, may not approve
the price we intend to charge for our products, may grant approval contingent on the performance of costly post-marketing clinical
trials or may approve a product candidate with a label that does not include the labeling claims necessary or desirable for the
successful commercialization of that product candidate. Any of the foregoing scenarios could materially harm the commercial prospects
for our product candidates.
If we experience delays in obtaining approval
or if we fail to obtain approval of our product candidates, the commercial prospects for our product candidates may be harmed
and our future ability to generate revenues will be materially impaired.
Regulatory requirements for development of our product
candidates are uncertain and evolving. Changes in these laws or the current interpretation or application of these laws would
have a significant adverse impact on our ability to develop and commercialize our product candidates.
We intend to develop our lead product candidate, BX001 initially
as a cosmetic gel designed to improve the appearance of acne-prone skin. BX001 contains known cosmetic ingredients combined with
phage that are designed to help control the growth of C. acnes , and thereby help improve the appearance of acne-prone skin.
In the European Union, a product candidate
is considered to be a cosmetic if it is intended to and presented as protecting the skin, maintaining the skin in good condition
or improving the appearance of the skin, provided that it is not a medicinal product due to its composition. With regard to the
ingredients, in the European Union, the composition of a cosmetic may not be such that it has a significant effect on the body
through a pharmacological, immunological or metabolic mode of action. No test has been determined yet for the significance of
the effect. By contrast, a product candidate is a drug if it is intended to or presented as treating or preventing a disease or
restoring, correcting or modifying significantly physiological functions by a pharmacological, immunological or metabolic action.
However, in the European Union, medical or biocidal (i.e. antibacterial) claims may be made for cosmetics, provided that they
are ancillary to the cosmetic claims. As a result, we believe that we may develop BX001 as a cosmetic, including conducting non-IND
human clinical studies in order to evaluate safety, tolerability and biomarkers for non-drug applications.
Some countries also regulate other categories
of products that could be relevant such as biocides in the European Union.
Unlike medicinal products, cosmetic products are generally not
subject to premarket approval by regulatory agencies. However, they must not contain certain ingredients or concentrations of ingredients
and must be safe and properly labeled in relation to their cosmetic purpose. We remain unclear whether phage are authorized for
use in cosmetic products, in the United States, the European Union and other countries.
Moreover, the FDA or equivalent foreign
regulatory agencies may determine that BX001 is not governed by cosmetics regulations but by pharmaceutical regulations and, therefore
may classify BX001 as being ineligible for use in clinical studies without a regulatory approval. A determination that BX001 does
not meet the regulatory cosmetic requirements of the FDA or equivalent foreign regulatory agencies could cause a delay in the
commercialization of BX001, which may lead to reduced acceptance by the public or others. Any such determination could prevent
our reliance on existing regulatory frameworks to conduct non-IND human clinical studies for BX001 and could significantly increase
the cost of and delay the commercialization of BX001.
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Should we choose to continue to develop
and commercialize BX001 as a cosmetic and if the FDA or equivalent foreign regulatory agencies determine BX001 falls outside the
cosmetics regulations, the agency could ask us to withdraw BX001 from the market. In addition, if new safety issues are raised
by cosmetic clinical studies for BX001, then our ability to seek an IND to conduct clinical trials intended to lead toward approval
of the product as a drug, if pursued, could be adversely affected, for example the FDA or equivalent foreign regulatory agencies
could ask us to modify approved labeling for or withdraw BX001 from the market.
We have never generated any revenue from product sales
and may never be profitable or, if achieved, may not sustain profitability.
Our ability to generate meaningful revenue
and achieve profitability depends on our ability, and the ability of any third party with which we may partner, to successfully
complete the development of, and meet regulatory requirements, including (but not limited to) obtaining any necessary regulatory
approvals, to commercialize our product candidates. We do not currently meet regulatory requirements or have the required approvals
to market our product candidates and may never meet or receive them. We do not anticipate generating revenue from product sales
for the foreseeable future, if ever. If any of our product candidates fail in clinical trials or if any of our product candidates
do not meet regulatory requirements, including gaining regulatory approval when needed, or if any of our product candidates, if
marketed, fail to achieve market acceptance, we may never become profitable. Even if we achieve profitability in the future, we
may not be able to sustain profitability in subsequent periods. Our ability to generate future revenue from product sales depends
heavily on our success in:
●
completing research and preclinical and clinical
development of our product candidates;
●
seeking and obtaining regulatory and marketing
approvals for product candidates for which we complete clinical trials;
●
meeting regulatory requirements for marketing
the products;
●
developing a sustainable, scalable, reproducible
and transferable manufacturing process for our product candidates;
●
launching and commercializing product candidates
for which we obtain regulatory and marketing approval or are otherwise permitted to market, either by establishing a sales
force, marketing and distribution infrastructure or by collaborating with a partner;
●
obtaining market acceptance of any approved
products;
●
addressing any competing technological and market
developments;
●
implementing additional internal systems and
infrastructure, as needed;
●
identifying and validating new product candidates;
●
negotiating favorable terms in any collaboration,
licensing or other arrangements into which we may enter;
●
maintaining, protecting and expanding our portfolio
of intellectual property rights, including patents, trade secrets and know-how; and
●
attracting, hiring and retaining qualified personnel.
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Even if one or more of the product candidates
that we develop is approved for commercial sale or otherwise permitted for marketing, we anticipate incurring significant costs
associated with commercializing any approved product. Our expenses could increase beyond expectations if we are required by the
FDA, or the EMA, or other equivalent foreign regulatory agencies to perform clinical trials and other studies in addition to those
that we currently anticipate. Even if we are able to generate revenue from the sale of any approved products, we may not become
profitable and may need to obtain additional funding to continue operations. If we fail to become profitable, or if we are unable
to fund our continuing losses, our business, financial condition and results of operations may be materially adversely impacted.
Depending in part on how BX001 is marketed, it may be
classified as a cosmetic or a drug or as something else by the FDA and equivalent foreign regulatory agencies. There are fewer
requirements to market cosmetics in the United States; however, if we attempt to market as a cosmetic and the FDA disagrees with
its classification, we may be required to stop marketing the product to pursue approval as a drug and not market the product again
until we receive such approval, which we may not receive.
The FDA and equivalent foreign regulatory agencies regulate
products largely by their intended uses but may also consider the ingredients of the product. At the current time, such agencies
have not approved an NDA, or a BLA for a phage product. Products intended to beautify, moisturize, cleanse, or change one’s
appearance may be regulated as cosmetics. Products intended to diagnose, prevent, cure or mitigate a disease or condition are regulated
as drugs (or in some cases, as medical devices).
A premarket approval process is not required
for cosmetic products. Manufacturers of cosmetics must test for and assure that finished products and all ingredients are safe
prior to marketing them in the United States or the European Union, and claims may not be made that the product prevents, mitigates
or cures a condition or disease. Products that claim to treat acne are generally regulated as drugs in the United States and the
European Union. In the United States, drug products must either be approved through one of several FDA drug approval pathways
or, in the case of some over-the-counter, or OTC, drugs, meet the monograph criteria established by U.S. regulation. Similarly,
in the European Union, drugs must be approved by the national regulatory authority or the European Commission before being placed
on the national or European market.
If we market BX001 as a cosmetic, as we currently plan to, we
will not be able to promote the product for the treatment of acne, and our main claims would be limited to those that are consistent
with permitted cosmetic claims, to beautify, moisturize, cleanse or change the appearance of the skin such as “for beautiful,
bright skin” and similar claims. If we market the product as a cosmetic, it is possible that the FDA or equivalent foreign
regulatory agencies will disagree with us and find that the product should be marketed as a drug. Although the FDA or equivalent
foreign regulatory agencies have not affirmatively decided the regulatory status of phage, given that their function is antibacterial,
it is possible that such agencies will decide that products containing phage are drugs regardless of the claims presented on the
product or any other considerations. If the FDA evaluates BX001 and determines that the product is a drug and marketing it as a
cosmetic is a prohibited act under the FDCA, it may issue a Warning Letter and demand that we stop marketing the product unless
and until the product is approved as a drug. If the FDA issues a Warning Letter, it will be made available on the FDA’s website,
and we may suffer reputational damage. The same applies to the national competent authorities in the European Union. There is the
risk that if we go to market with BX001 as a cosmetic, potential competitors will bring the FDA’s or equivalent foreign regulatory
authorities’ attention to the marketing of BX001 as a cosmetic to encourage the FDA or equivalent foreign regulatory authorities
to take this very type of enforcement action against us.
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It is possible that the regulatory requirements or framework
will change by the time we are ready to market our product and these changes may eliminate the possibility of marketing BX001 as
a cosmetic. For example, the FDA could affirmatively determine that phage are to be regulated as drugs and are not permitted in
cosmetic products. If this were to occur, then BX001 would need to be approved as a drug in order to be marketed in the United
States and would need to be approved as an OTC drug rather than a prescription drug in order to be sold in products that are also
cosmetics. The same applies in the European Union.
Depending on the regulatory environment
and requirements at the time BX001 is ready for market, we may decide that pursuing a drug approval (either prescription or OTC)
is the better pathway to market, in which case, it will take longer to bring BX001 to market in the United States and in other
countries. And in this case, all other risks generally related to approval pathways would also be applicable to BX001.
Finally, even if we are permitted to market
BX001 as a cosmetic in one country, this does not guarantee that we will be permitted to market BX001 as a cosmetic in other countries.
Each country has its own distinct requirements for marketing products as cosmetics and BX001 would need to independently meet
each jurisdiction’s requirements.
We are seeking to develop product candidates to improve
the appearance of acne-prone skin and treat medical conditions related to the presence of certain bacteria. Our success is largely
dependent on a broad degree of market acceptance, and in the case of drug products, physician adoption and use, which are necessary
for commercial success.
Even if we obtain FDA or foreign regulatory
approvals for our drug product candidates, or BX001 is permitted to be marketed as a cosmetic, the commercial success of our product
candidates will depend on consumer acceptance and adoption of products that we commercialize. Adverse events in preclinical studies
and clinical trials of our product candidates or in clinical trials of others developing similar products and the resulting publicity
could result in a decrease in demand for any product that we may develop.
In addition, the commercial success of
our drug product candidates will depend significantly on their broad adoption and use by dermatologists, pediatricians and other
physicians for approved therapeutic indications, as well as any other indications for which we may seek approval. We cannot be
certain that our approach will lead to the development of approvable or marketable products.
Obtaining high titers for specific phage cocktails necessary
for our preclinical and clinical testing may be difficult and time-consuming.
Our product candidates are phage cocktails
that we have designed to meet specific characteristics. We and our contract manufacturers produce a cocktail of multiple phage
and it may be difficult or time-consuming to achieve high titers, or levels, of phage sufficient for our preclinical and clinical
testing. In some cases, it may require multiple product runs in order for us to obtain the amounts necessary for its clinical
testing. This may result in delays in our clinical trial timelines, and it may increase production costs and associated expenses.
Also, it may be difficult to reproduce the manufacturing process to the extent that more significant quantities are required as
our product candidates advance through the clinical development process.
Results from preclinical studies of our product candidates
may not be predictive of the results of clinical trials or later stage clinical development.
Preclinical studies of our product candidates,
such as BX001 and BX003, including studies in animal disease models in the case of BX003 and other studies, may not accurately
predict the safety of the product candidate such that further human clinical trials would be allowed to proceed. In particular,
promising preclinical testing suggesting the potential efficacy of prototype phage products may not predict the ability of these
products to address conditions in the human clinical settings. For example, while we have studied phage activity in vitro
and in vivo , in the case of BX003, these results may not be replicated when our phage cocktails are administered to human
subjects. Despite promising data in any preclinical studies, our phage technology may be found not to be efficacious when studied
in clinical trials.
44
To satisfy FDA or equivalent foreign regulatory
approval standards, we must demonstrate safety for any cosmetic product, and we must demonstrate in adequate and well controlled
clinical trials that our drug product candidates are safe and effective for their intended use. Success in preclinical testing
and early-stage clinical trials does not ensure that later clinical trials will be successful. Our initial results from preclinical
testing also may not be confirmed by later analysis or subsequent larger clinical trials. A number of companies in the pharmaceutical
industry have suffered significant setbacks in advanced clinical trials, even after obtaining promising results in earlier clinical
trials, and most product candidates that commence clinical trials are never approved for commercial sale.
For products that require regulatory approvals, we are
subject to significant regulatory approval requirements, which could delay, prevent or limit our ability to market our product
candidates.
Our research and development activities,
preclinical studies, clinical trials and the anticipated manufacturing and marketing of our drug product candidates are subject
to extensive regulation by the FDA and other regulatory agencies in the United States and by comparable authorities in Europe
and elsewhere. To satisfy FDA or equivalent foreign regulatory approval standards, we must demonstrate in adequate and well controlled
clinical trials that our drug product candidates are safe and effective for their intended use. The regulatory approval process
is expensive and time-consuming, and the timing of receipt of regulatory approval is difficult to predict. Given the uncertainties
around phage therapy, our product candidates could require a significantly longer time to gain regulatory approval than expected
or may never gain approval. This is especially so for the product candidate designed to treat CRC as the phage will be genetically
modified, which adds potential complexity to the process, particularly in the European Union. We cannot be certain that, even
after expending substantial time and financial resources, we will obtain regulatory approval for any of our product candidates.
A delay or denial of regulatory approval could delay or prevent our ability to generate product revenue and to achieve profitability.
The legal and regulatory status of phage
therapy remains unclear in many countries, including the European Union. Changes in regulatory approval policies during the development
period of any of our product candidates, changes in, or the enactment of, additional regulations or statutes, or changes in regulatory
review practices for a submitted product application may cause a delay in obtaining approval or result in the rejection of an
application for regulatory approval.
Regulatory approval, if obtained, may be
made subject to limitations on the indicated uses for which we may market a product, as well as the approved labeling for the
product. These limitations could adversely affect our potential product revenue. Regulatory approval may also be conditioned on
costly post-marketing follow-up studies. In addition, the labeling, packaging, adverse event reporting, storage, advertising,
promotion and recordkeeping related to the product will be subject to extensive ongoing regulatory requirements. Furthermore,
for any marketed product, our manufacturer and our manufacturing facilities will be subject to registration and listing requirements
and continual review and periodic inspections by the FDA or other regulatory authorities. Failure to comply with applicable regulatory
requirements may, among other things, result in fines, suspensions of regulatory approvals, product recalls, product seizures,
operating restrictions and criminal prosecution.
If we encounter difficulties enrolling patients in our
clinical trials, our clinical development activities could be delayed or otherwise adversely affected.
Completion of clinical trials depends,
among other things, on our ability to enroll a sufficient number of patients, which is a function of many factors, including:
●
the therapeutic endpoints chosen for evaluation;
●
the eligibility criteria defined in the protocol;
●
the perceived benefit of the product candidate
under study;
45
●
the size of the patient population required
for analysis of the clinical trial’s therapeutic endpoints;
●
our ability to recruit clinical trial investigators
and sites with the appropriate competencies and experience;
●
our ability to obtain and maintain patient consents;
and
●
competition for patients from clinical trials
for other treatments.
We may experience difficulties in enrolling
patients in our clinical trials, including due to the impacts of COVID-19, which could increase the costs or affect the timing
or outcome of these clinical trials. This is particularly true with respect to diseases with relatively small patient populations.
In addition, potential patients for our trials may not be adequately diagnosed or identified with the diseases that we are targeting
or may not meet the entry criteria for our studies.
We may not be able to initiate or continue
clinical trials if we are unable to locate a sufficient number of eligible patients to participate in the clinical trials required
by the FDA or equivalent foreign regulatory agencies. In addition, the process of finding and diagnosing patients may prove costly.
Our inability to enroll a sufficient number of patients for any of our clinical trials would result in significant delays or may
require us to abandon one or more clinical trials.
Delays in our clinical trials could result in us not
achieving anticipated developmental milestones when expected, increased costs and delays in our ability to obtain regulatory approval
for and commercialization of our product candidates.
Delays in our clinical trials could result
in us not meeting anticipated clinical milestones and could materially impact our product development costs and delay regulatory
approval of our product candidates. Planned clinical trials may not be commenced or completed on schedule, or at all.
Clinical trials can be delayed for a variety
of reasons, including:
●
delays in the development of manufacturing capabilities
for our product candidates to enable their consistent production at clinical trial scale;
●
failures in our internal manufacturing operations
that result in our inability to consistently and timely produce bacteriophages in sufficient quantities to support our clinical
trials;
●
the availability of financial resources to commence
and complete our planned clinical trials;
●
delays in reaching a consensus with clinical
investigators on study design;
●
delays in reaching a consensus with regulatory
agencies on trial design or in obtaining regulatory approval to commence a trial;
●
delays in obtaining clinical materials;
●
slower than expected patient recruitment for
participation in clinical trials;
●
regulatory constraints or injunctions (for example,
from supervisory authorities in case of noncompliance with cybersecurity and data privacy laws);
●
failure by clinical trial sites, other third
parties or us to adhere to clinical trial agreements;
●
delays in reaching agreement on acceptable clinical
trial agreement terms with prospective sites or obtaining IRB approval; and
●
adverse safety events experienced during our
clinical trials.
46
If we do not successfully commence or complete
our clinical trials on schedule, the price of our securities may decline. Significant preclinical or clinical trial delays could
shorten any periods during which we may have the exclusive right to commercialize our product candidates or allow our competitors
to bring products to market before we do, potentially impairing our ability to successfully commercialize our product candidates
and harming our business and results of operations.
Our current or future product candidates may cause adverse
effects that could halt their clinical development, prevent their approval or marketing, limit their commercial potential or result
in significant negative consequences.
Adverse effects could occur and cause us
or regulatory authorities to interrupt, delay or halt clinical trials and could result in a more restrictive label or the delay
or denial of marketing approval by the FDA or equivalent foreign regulatory agencies. Similarly, such adverse effects would prevent
marketing BX001 as a cosmetic. Results of our trials could reveal a high and unacceptable severity and prevalence of side effects
or unexpected characteristics.
If adverse effects arise in the development
of our product candidates, we, the FDA or equivalent foreign regulatory agencies, the IRBs or independent ethics committees at
the institutions in which our studies are conducted, or the Data Safety Monitoring Board could suspend or terminate our clinical
trials or the FDA or equivalent foreign regulatory agencies could deny approval of our product candidates for any or all targeted
indications. Adverse events in studies with BX001 as a cosmetic may lead us to stop our marketing.
We intend to continue to evaluate our product
candidates for safety and tolerability in the form of Phase 1 clinical trials. While our current and future product candidates
will undergo safety testing to the extent possible and, where applicable, under such conditions discussed with regulatory authorities,
not all adverse effects of drugs can be predicted or anticipated. Unforeseen adverse effects could arise either during clinical
development or, if such adverse effects are more rare, after our products have been approved by regulatory authorities and the
approved product has been marketed, resulting in the exposure of additional patients. For example, while we screen our phage in
attempts to minimize safety issues, there can be no assurance that we will eliminate the risk of the appearance of virulence genes,
antibiotic resistance genes, lysogenic genes, integrase genes, or other toxic genes in our phage, or of adverse reactions to our
phage in a patient’s immune system. So far, we have not demonstrated, and we cannot predict, if ongoing or future clinical
trials will demonstrate that any of our product candidates are safe in humans. Moreover, clinical trials of our product candidates
are conducted in carefully defined sets of patients who have agreed to enter into clinical trials. Consequently, it is possible
that our clinical trials may indicate an apparent positive effect of a product candidate that is greater than the actual positive
effect, if any, or alternatively fail to identify undesirable adverse effects.
Ultimately, some or all of our product
candidates may prove to be unsafe for human use. Moreover, we could be subject to significant liability if any volunteer or patient
suffers, or appears to suffer, adverse health effects as a result of participating in our clinical trials. Any of these events
could prevent us from achieving or maintaining market acceptance of our product candidates and could substantially increase commercialization
costs.
We have not completed composition development of our
product candidates.
The development of our product candidates requires that we isolate,
select, optimize and combine a number of phage that target the desired bacteria for that product candidate. The selection of phage
for any of our product candidates is based on a variety of factors, including, without limitation, the ability of the selected
phage, in combination, to successfully kill the targeted bacteria, the degree of cross-reactivity of the individual phage with
the same part of the bacterial targets, the ability of the combined phage to satisfy regulatory requirements, our ability to manufacture
sufficient quantities of the phage, intellectual property rights of third parties, and other factors. While we have selected initial
formulations of BX001 and BX003, there can be no assurance that these initial formulations will be the final formulations of these
product candidates for commercialization if approved. If we are unable to complete formulation development of our product candidates
in the time frame that we have anticipated, then our product development timelines, and the regulatory approval of our product
candidates, could be delayed.
47
We must continue to develop manufacturing processes for
our product candidates, and any delay in doing so, or our inability to do so, would result in delays in our clinical trials.
The manufacturing processes for our product
candidates, and the scale-up of such processes for clinical trials, may present challenges, and there can be no assurance that
we will be able to complete this work in a timely manner, if at all. Any delay in the development or scale-up of these manufacturing
processes could delay the start of clinical trials and harm our business. In order to scale-up our manufacturing capacity, we need
to either build additional internal manufacturing capacity, contract with one or more partners, or both. Our technology and the
production process for our equipment and tools are complex and we may encounter unexpected difficulties in manufacturing our product
candidates. For example, the manufacturing hosts that we use to produce our phage may contain one or more integrated phage in their
genomes that, if we are unable to remove, can present challenges in manufacturing of the produced phage. There is no assurance
that we will be able to continue to build manufacturing capacity internally or find one or more suitable partners, or both, to
meet the necessary volume and quality requirements. Manufacturing and product quality issues may arise as we increase the scale
of our production. Any delay or inability in establishing or expanding our manufacturing capacity could diminish our ability to
develop our product candidates.
In the third quarter of 2019, we established
our own current cGMP manufacturing facility at our headquarters in Ness Ziona, Israel and we have executed cGMP manufacturing
for our first in human clinical study (IBD project). Our facility undergoes ongoing inspections for compliance with cGMP regulations
before the respective product candidates are approved for use in clinical trials or commercialization. In the event this facility
does not receive a satisfactory cGMP inspection for the manufacture of our product candidates, we may need to fund additional
modifications to our manufacturing process, conduct additional validation studies or find alternative manufacturing facilities,
any of which would result in significant cost to us as well as a delay of up to several years in obtaining approval for such product
candidate.
The
manufacturing facility will be subjected to ongoing periodic inspection for compliance with European, FDA and cGMP regulations
as progress will be made in clinical phases. Compliance with these regulations and standards is complex and costly, and there
can be no assurance that we will be able to comply. Any failure to comply with applicable regulations could result in sanctions
being imposed (including fines, injunctions and civil penalties), failure of regulatory authorities to grant marketing approval
of our product candidates, delays, suspension or withdrawal of approvals, license revocation, seizures or recalls of product candidates
or products, operating restrictions and criminal prosecution.
If our competitors are able to develop and market products
that are more effective, safer or more affordable than ours, or obtain marketing approval before we do, our commercial opportunities
may be limited.
Competition in the biotechnology and pharmaceutical
industries is intense and continues to increase. Some companies that are larger and have significantly more resources than us
are aggressively pursuing development programs for indications that we are pursuing, including traditional therapies and therapies
with novel mechanisms of action. In addition, other companies are developing phage-based products for therapeutic and non-therapeutic
uses, and may elect to use their expertise in phage development and manufacturing to try to develop products that would compete
with our products.
We also face potential competition from
academic institutions, government agencies and private and public research institutions engaged in the discovery and development
of drugs and therapies. Many of our competitors have significantly greater financial resources and expertise in research and development,
preclinical testing, conducting clinical trials, obtaining regulatory approvals, manufacturing, sales and marketing than we do.
Smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative arrangements
with large and established pharmaceutical companies.
48
In the European Union, potential competition
also comes from medicinal preparations made by hospitals or pharmacists and administered without marketing authorizations, generally
referred to as “compounding.” In some member states, national authorities generally promote compounding in order to
reduce healthcare expenses.
Our competitors may succeed in developing
products that are more effective, have fewer side effects and are safer or more affordable than our product candidates, which
would render our product candidates less competitive or noncompetitive and would prevent the granting or maintenance of an orphan
designation. These competitors also compete with us to recruit and retain qualified scientific and management personnel, establish
clinical trial sites and patient registration for clinical trials, as well as to acquire technology and technology licenses complementary
to our programs or advantageous to our business. Moreover, competitors that are able to achieve patent protection, obtain regulatory
approvals and commence commercial sales of their products before we do, and competitors that have already done so may enjoy a
significant competitive advantage.
BX001 faces significant competition in the market.
The facial aesthetic market is highly competitive
and dynamic, and is characterized by rapid and substantial technological development and product innovations. If BX001 can be
marketed as a cosmetic, we may face significant competition from other facial aesthetic products. Due to less stringent regulatory
requirements, there are many more possibilities for marketing cosmetics in international markets than there are in the United
States. There are also fewer limitations on the claims that our competitors in international markets can make about the effectiveness
of their products and the manner in which they can market them. As a result, if we partner with other companies in these markets
and launch our products, we may face more competition in these markets than in the United States.
Legal requirements as well as ethical and social concerns
about synthetic biology and genetic engineering could limit or prevent the use of our technologies and limit our revenues.
Our technology may include the use of synthetic
biology and genetic engineering. In some countries, drugs made using genetically modified organisms may be subject to a more stringent
legal regime, which could prove to be complex and very challenging, especially for a small life sciences company. For example,
in the European Union, the rules on genetically modified organisms would apply in addition to the general rules on medicinal products
or cosmetic products. The rules on advanced therapy medicinal products may also apply.
Additionally, public perception about the
safety and environmental hazards of, and ethical concerns over, synthetic biology and genetic engineering could influence public
acceptance of our technologies, product candidates and processes. If we and our collaborators are not able to overcome the legal
challenges as well as the ethical and social concerns relating to synthetic biology and genetic engineering, our technologies,
product candidates and processes may not be accepted. These challenges and concerns could result in increased expenses, regulatory
scrutiny and increased regulation, trade restrictions on imports of our product candidates, delays or other impediments to our
programs or the public acceptance and commercialization of our products. We design and produce product candidates with characteristics
comparable or superior to those found in naturally occurring organisms or enzymes in a controlled laboratory; however, the release
of such organisms into uncontrolled environments could have unintended consequences. Any adverse effect resulting from such a
release could have a material adverse effect on our business, financial condition or results of operations, and we may have exposure
to liability for any resulting harm.
We may not be successful in our efforts to identify or
discover additional product candidates.
Although we intend to utilize our technology to evaluate other
therapeutic opportunities in addition to the product candidates that we are currently developing, we may fail to identify other
product candidates for clinical development for a number of reasons. For example, our research methodology may not be successful
in identifying potential product candidates, or those we identify may be shown to have harmful side effects or other characteristics
that make them unmarketable or unlikely to receive regulatory approval. In addition, we may not be able to identify phage that
eradicate the target bacteria, including due to sourcing difficulties such as lack of diversity, inability to obtain samples in
a timely manner or at all, or contamination in the samples. We may also encounter difficulties in designing phage cocktails that
meet the requirements of an investigational therapy, including due to the build-up of resistances in bacteria to our phage, the
range of host bacteria that are affected by our phage, the variety of activity on different bacteria growth states, issues with
toxicity in our phage, and the stability, robustness and ease of manufacturing of our product candidates. In addition, the designing
of synthetically engineered phage may fail to result in the development of phage with the desired characteristics or behaviors
that are suitable for use as viable therapies, or may result in phage that contain undesired features such as immunogenicity, toxicity
and other safety concerns.
49
A key part of our strategy is to utilize
our screening technology to identify product candidates to pursue in clinical development. If we fail to identify and develop
additional potential product candidates, we may be unable to grow our business and our results of operations could be materially
harmed. Such product candidates will require additional, time-consuming development efforts prior to commercial sale, including
preclinical studies, clinical trials and approval by the FDA and/or applicable foreign regulatory agencies. All product candidates
are prone to the risks of failure that are inherent in pharmaceutical product development.
We intend to rely on our new BOLT (BacteriOphage Lead
to Treatment) proprietary product platform to develop our phage therapies. Our competitive position could be materially harmed
if our competitors develop similar platforms and develop rival product candidates.
Our new BOLT platform enables us to rapidly
develop, manufacture and formulate phage therapy candidates targeting particular pathogenic bacteria and incorporates our experience
over the past six years with process refinement and implementation of technological advancements. For a given indication, the
platform will allow for the completion of a clinical proof of concept study in patients, meaning Phase 2 results, within approximately
12-18 months from project initiation; however in certain indications the length of clinical proof of concept may be longer depending
on the indication, identity of target bacteria, recruitment rate, cohort size and other factors. We are initially implementing
the ability to complete a clinical proof of concept study in patients within approximately 12-18 months from project initiation
in our cystic fibrosis and atopic dermatitis programs. Our BOLT platform is new and may not achieve the benefits we anticipate.
To the extent we utilize our resources to further develop our BOLT platform, we may become more dependent on its success.
We may expend our limited resources to pursue a particular
product candidate or indication and fail to capitalize on product candidates or indications that may be more profitable or for
which there is a greater likelihood of success.
Because we have limited financial and managerial
resources, we intend to focus on developing product candidates for specific indications that we identify as most likely to succeed,
in terms of both their potential for marketing approval and commercialization. As a result, we may forego or delay pursuit of
opportunities with other product candidates or for other indications that may prove to have greater commercial potential.
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 for specific indications may not yield any commercially viable product
candidates. 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 collaboration, licensing or other royalty arrangements in cases
in which it would have been more advantageous for us to retain sole development and commercialization rights to the product candidate.
50
There is a substantial risk of product liability claims
in our business. If we do not obtain sufficient liability insurance, a product liability claim could result in substantial liabilities
to us.
Our business exposes us to significant
potential product liability risks that are inherent in the development, manufacturing and marketing of human therapeutic products.
Regardless of merit or eventual outcome, product liability claims may result in:
●
delay or failure to complete our clinical trials;
●
withdrawal of clinical trial participants;
●
decreased demand for our product candidates;
●
injury to our reputation;
●
litigation costs;
●
substantial monetary awards against us; and
●
diversion of management or other resources from
key aspects of our operations.
If we succeed in marketing products, product
liability claims could result in an FDA or equivalent foreign regulatory agency investigation of the safety or efficacy of our
products, our manufacturing processes and facilities or our marketing programs. Such investigation could also potentially lead
to a recall of our products or more serious enforcement actions, or limitations on the indications, for which they may be used,
or suspension or withdrawal of approval.
We currently only have limited clinical
trials insurance policies that cover clinical trials in certain territories. We intend to expand our insurance coverage to include
the sale of commercial products if marketing approval is obtained for our product candidates or any other compound that we may
develop. However, insurance coverage is expensive, and we may not be able to maintain insurance coverage at a reasonable cost
or at all, and the insurance coverage that we have or obtain may not be adequate to cover potential claims or losses.
Our employees, independent contractors, consultants,
commercial partners and vendors may engage in misconduct or other improper activities, including noncompliance with regulatory
standards and requirements.
We are exposed to the risk of employee
fraud or other illegal activity by our employees, independent contractors, consultants, commercial partners and vendors. Misconduct
by these parties could include intentional, reckless and/or negligent conduct that fails to comply with the laws of the FDA and
other similar foreign regulatory bodies, provide true, complete and accurate information to the FDA and other similar foreign
regulatory bodies, comply with manufacturing standards we have established, comply with healthcare fraud and abuse laws in the
United States and similar foreign fraudulent misconduct laws or report financial information or data accurately or to disclose
unauthorized activities to us. If we obtain FDA approval of any of our product candidates and begin commercializing those products
in the United States, our potential exposure under such laws will increase significantly, and our costs associated with compliance
with such laws are also likely to increase. These laws may impact, among other things, our current activities with principal investigators
and research patients, as well as proposed and future sales, marketing and education programs.
The FDA and other equivalent foreign regulatory agencies
may implement additional regulations or restrictions on the development and commercialization of products which act on the microbiome,
which may be difficult to predict.
The FDA and equivalent foreign regulatory
agencies in other countries have each expressed interest in further regulating biotechnology products and product candidates,
such as those that act on the human microbiome. Agencies at both the federal and state level in the United States, as well as
the U.S. congressional committees and other governments or governing agencies, have also expressed interest in further regulating
the biotechnology industry. Such action may delay or prevent commercialization of some or all of our product candidates. Adverse
developments in non-IND human clinical studies or clinical trials of microbiome products conducted by others may cause the FDA
or other oversight bodies to change the requirements for approval of any of our product candidates. These regulatory review agencies
and committees and the new requirements or guidelines they promulgate may lengthen the regulatory review process, require us to
perform additional studies or trials, increase our development costs, lead to changes in regulatory positions and interpretations,
delay or prevent approval and commercialization of our product candidates or lead to significant post-approval limitations or
restrictions. As we advance our product candidates, we will be required to consult with these regulatory agencies and comply with
applicable requirements and guidelines. If we fail to do so, we may be required to delay or discontinue development of such product
candidates. These additional processes may result in a review and approval process that is longer than we otherwise would have
expected. Delays as a result of an increased or lengthier regulatory approval process or further restrictions on the development
of our product candidates can be costly and could negatively impact our ability to complete clinical trials and commercialize
our current and future product candidates in a timely manner if at all.
51
Exchange rate fluctuations between the U.S. Dollar, the
New Israeli Shekel, the Euro and other foreign currencies, may negatively affect our future revenues.
Our proceeds from sales of our securities
are generally received in U.S. Dollars. Our headquarters are located in Israel, where the majority of our general and administrative
expenses and research and development costs are incurred in the New Israeli Shekel, or NIS. Future expenses may be incurred in
foreign currencies such as the Euro or British Pound. As a result, our financial results may be affected by fluctuations in the
exchange rates of currencies in the countries. For example, during 2020, we witnessed a strengthening of the average exchange
rate of the NIS against the U.S. Dollar, which increased the U.S. Dollar value of Israeli expenses. If the NIS strengthens against
the U.S. Dollar, as it did in 2020, the U.S. Dollar value of our Israeli expenses, mainly personnel and facility-related, will
increase. We use foreign exchange contracts (mainly option and forward contracts) to hedge balance sheet items from currency exposure.
However, these foreign exchange contracts are not designated as hedging instruments for accounting purposes and they may not be
effective. Although exposure to currency fluctuations to date has not had a material adverse effect on our business, there can
be no assurance that fluctuations in the future will not have a material adverse effect on our operating results and financial
condition.
Our limited operating history may make it difficult to
evaluate the success of our business to date and to assess our future viability.
Since inception in 2015, BiomX Ltd. has
devoted substantially all of its resources to developing product candidates with phage technology through its preclinical programs,
building its intellectual property portfolio, developing a supply chain, planning its business, raising capital and providing
general and administrative support for these operations. We have not yet demonstrated our ability to successfully complete any
clinical study or other pivotal clinical trials, obtain regulatory approvals, manufacture a commercial-scale product, or arrange
for a third-party to do so on our behalf, or conduct sales and marketing activities necessary for successful product commercialization.
Consequently, any predictions made about our future success or viability may not be as accurate as they could be if we had a longer
operating history.
In addition, as an early-stage company,
we may encounter unforeseen expenses, difficulties, complications, delays and other known and unknown circumstances. As we advance
our product candidates, we will need to transition from a company with a research focus to a company capable of supporting clinical
development and, if successful, commercial activities. We may not be successful in such a transition.
We need to grow the size of our organization and may experience
difficulties in managing this growth.
As our research, development, manufacturing
and commercialization plans and strategies develop as a public company, we need additional managerial, operational, sales, marketing,
financial and other personnel. Future growth would impose significant added responsibilities on members of management, including:
●
identifying, recruiting, compensating, integrating, maintaining and motivating additional employees;
●
managing our internal research and development efforts effectively, including identification of clinical candidates, scaling our manufacturing process and navigating the clinical and FDA review process for our product candidates; and
●
improving our operational, financial and management controls, reporting systems and procedures.
Our future financial performance and our
ability to commercialize our product candidates will depend, in part, on our ability to effectively manage any future growth, and
our management may also have to divert a disproportionate amount of our attention away from day-to-day activities in order to devote
a substantial amount of time to managing these growth activities.
If we are not able to effectively expand
our organization by hiring new employees and expanding our groups of consultants and contractors, we may not be able to successfully
implement the tasks necessary to further develop and commercialize our product candidates and, accordingly, may not achieve our
research, development and commercialization goals.
We are an “emerging growth company,” and we
cannot be certain that the reduced disclosure requirements applicable to “emerging growth companies” will not make
our Common Stock less attractive to investors.
We are an “emerging growth company,”
as defined in the Jumpstart Our Business Startups Act of 2012, or the JOBS Act. For so long as we remain an emerging growth company,
we intend to take advantage of certain exemptions from reporting requirements that are applicable to other public companies that
are not emerging growth companies, including, but not limited to, compliance with the auditor attestation requirements of Section
404(b) of the Sarbanes-Oxley Act of 2002, or the Sarbanes-Oxley Act, reduced disclosure obligations regarding executive compensation
in our periodic reports and proxy statements, and exemptions from the requirements of holding a nonbinding advisory vote on executive
compensation and stockholder approval of any golden parachute payments not previously approved. Further, under the JOBS Act, emerging
growth companies can delay adopting new or revised accounting standards issued subsequent to the enactment of the JOBS Act until
such time as those standards apply to private companies. We have irrevocably elected not to avail ourselves of this exemption from
new or revised accounting standards and, therefore, will be subject to the same new or revised accounting standards as other public
companies that are not emerging growth companies.
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We will remain an emerging growth company
until the earliest of (a) the last day of our fiscal year during which we have generated total annual gross revenue of at least
$1.07 billion; (b) the last day of our fiscal year following the fifth anniversary of the completion of our IPO; (c) the date on
which we have issued more than $1.0 billion in nonconvertible debt securities during the prior three-year period; or (d) the date
on which we are deemed to be a “large accelerated filer” under the Exchange Act.
Risks Related to Government Regulation
Breakthrough Therapy Designation or Fast Track Designation
by the FDA, even if granted for any of our product candidates developed for therapeutic indications, may not lead to a faster
development, regulatory review or approval process, and it does not increase the likelihood that any of our product candidates
will receive marketing approval in the United States.
In the United States, we may seek a Breakthrough
Therapy Designation for some of our product candidates, including BX003 or our cystic fibrosis product candidate under development.
A breakthrough therapy is defined as a therapy that is intended, alone or in combination with one or more other therapies, to
treat a serious or life-threatening disease or condition, and preliminary clinical evidence indicates that the therapy may demonstrate
substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment
effects observed early in clinical development. For therapies that have been designated as breakthrough therapies, interaction
and communication between the FDA and the sponsor of the trial can help to identify the most efficient path for clinical development
while minimizing the number of patients placed in ineffective control regimens. Therapies designated as breakthrough therapies
by the FDA may also be eligible for priority review and accelerated approval. Designation as a breakthrough therapy is within
the discretion of the FDA.
In the European Union, the PRIME (PRIority
MEdicines) status is similar to the Breakthrough Therapy Designation. The EMA has implemented the PRIME status to support the
development and accelerate the approval of complex, innovative medicinal products addressing an unmet medical need. The PRIME
status enables early dialogue with the relevant EMA scientific committees and, possibly, some payors and thus reinforces the EMA’s
scientific and regulatory support. The PRIME status, which is granted at the EMA’s discretion, focuses on medicinal products
the marketing authorization of which qualifies for accelerated assessment (medicinal products of major interest from a public
health perspective, in particular from a therapeutic innovation perspective).
Accordingly, even if we believe one of
our product candidates meets the criteria for designation as a breakthrough therapy or for PRIME status, the FDA or EMA, respectively,
may disagree and instead determine not to make such designation. In any event, the receipt of a Breakthrough Therapy Designation
or PRIME status for a product candidate may not actually result in a faster development process, review or approval compared to
therapies considered for approval under conventional procedures and does not assure ultimate approval. In addition, even if one
or more of our product candidates qualify as breakthrough therapies or is granted PRIME status, the FDA or EMA, respectively,
may later decide that such product candidates no longer meet the conditions for qualification or decide that the time period for
review or approval will not be shortened.
53
In the United States, we may seek Fast
Track Designation for some of our product candidates for therapeutic indications. If a therapy is intended for the treatment of
a serious or life-threatening condition and the therapy demonstrates the potential to address unmet medical needs for this condition,
the therapy sponsor may apply for Fast Track Designation. The FDA has broad discretion whether or not to grant this designation,
so even if we believe a particular product candidate is eligible for this designation; we cannot assure you that the FDA would
decide to grant it. Even if we receive Fast Track Designation, we may not experience a faster development process, review or approval
compared to conventional FDA procedures. The FDA may withdraw Fast Track Designation if we believe that the designation is no
longer supported by data from our clinical development program. Fast Track Designation alone does not guarantee qualification
for the FDA’s priority review procedures.
Other countries may have adopted schemes
designed to ensure an accelerated approval of drugs that are especially important for patients. For example, in the European Union,
the EMA may agree to an accelerated assessment (150 days instead of 210 days) for medicinal products of major interest from a
public health perspective, in particular from a therapeutic innovation perspective). Furthermore, competent regulatory authorities
may grant market authorizations “under exceptional circumstances,” in cases where all the required safety and efficacy
data have not been and will not be collected, to medicinal products designed for unmet needs or orphan medicinal products. Although
a marketing authorization under exceptional circumstances is definitive, the risk-benefit balance of the medicinal product must
be reviewed annually and the marketing authorization is withdrawn if it becomes negative. Moreover, under the centralized procedure,
the European Commission may grant “conditional marketing authorizations” in cases where all the required safety and
efficacy data are not yet available. The conditional marketing authorization is subject to conditions to be fulfilled for generating
the missing data or ensuring increased safety measures. It is valid for one year and has to be renewed annually until fulfillment
of all the conditions. If the conditions are not fulfilled within the timeframe set by the EMA, the marketing authorization ceases
to be renewed. As with Fast Track Designation, the competent regulatory authorities in the European Union have broad discretion
whether or not to grant such an accelerated assessment or approval and, even if such assessment or approval is granted, we may
not experience a faster development process, review or approval compared to conventional procedures.
We may seek a priority review designation for one or
more of our other product candidates for therapeutic indications, but we might not receive such designation, and even if we do,
such designation may not lead to a faster development or regulatory review or approval process.
If the FDA determines that a product candidate
offers a treatment for a serious condition and, if approved, the product would provide a significant improvement in safety or
effectiveness, the FDA may designate the product candidate for priority review. A priority review designation means that the goal
for the FDA to review an application is six months, rather than the standard review period of ten months. We may request priority
review for our product candidates. The FDA has broad discretion with respect to whether or not to grant priority review status
to a product candidate, so even if we believe a particular product candidate is eligible for such designation or status, the FDA
may decide not to grant it. Moreover, a priority review designation does not necessarily result in an expedited regulatory review
or approval process or necessarily confer any advantage with respect to approval compared to conventional FDA procedures. Receiving
priority review from the FDA does not guarantee approval within the six-month review cycle or at all.
54
We may fail to obtain and maintain orphan drug designations
from the FDA or equivalent foreign regulatory agencies for our current and future therapeutic product candidates, as applicable.
Our strategy may include filing for the orphan drug designation
where applicable for our product candidates for therapeutic indications. We currently believe that our product candidate under
development for cystic fibrosis patients may qualify for such a designation in the United States, the European Union, and
the other countries supporting the development and marketing of drugs for rare diseases.
In the United States, under the Orphan
Drug Act, the FDA may grant orphan drug designation to a drug or biologic intended to treat a rare disease or condition, which
is defined as one occurring in a patient population of fewer than 200,000 in the United States, or a patient population greater
than 200,000 in the United States where there is no reasonable expectation that the cost of developing the drug or biologic will
be recovered from sales in the United States. In the United States, the orphan drug designation entitles a party to financial
incentives, such as opportunities for grant funding toward clinical trial costs, tax advantages and user-fee waivers. In addition,
if a product that has the 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 an NDA, to market the same drug or 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 or where the original manufacturer is unable
to assure sufficient product quantity.
In addition, exclusive marketing rights
in the United States may be limited if we seek approval for an indication broader than the orphan-designated indication or may
be lost if the FDA later determines that the request for designation was materially defective, or if we are unable to assure sufficient
quantities of the product to meet the needs of patients with the orphan-designated disease or condition. Further, even if we obtain
orphan drug exclusivity for a product, that exclusivity may not effectively protect the product from competition because different
drugs with different active moieties may receive and be approved for the same condition, and only the first applicant to receive
approval will receive the benefits of marketing exclusivity. Even after an orphan-designated product is approved, the FDA can
subsequently approve a later drug with the same active moiety for the same condition if the FDA concludes that the later drug
is clinically superior if it is shown to be safer, more effective or makes a major contribution to patient care. Orphan drug designation
neither shortens the development time or regulatory review time of a drug nor gives the drug any advantage in the regulatory review
or approval process. In addition, while we may seek the orphan drug designation for our product candidates, we may never receive
such designation.
An orphan drug legal regime also exists
in the European Union. The EMA’s Committee for Orphan Medicinal Products, or COMP, gives opinions, and the European Commission
takes decisions, on the granting of the orphan drug designation to the development of products that are intended for the diagnosis,
prevention or treatment of (i) a life-threatening or chronically debilitating condition affecting not more than five in 10,000
persons in the European Economic Area (European Union plus Iceland, Liechtenstein and Norway); or (ii) a life-threatening, seriously
debilitating or serious and chronic condition when, without incentives, it is unlikely that sales of the drug in the European
Economic Area would be sufficient to justify the necessary investment in developing the drug or biological product. The granting
of the orphan designation requires that there is no satisfactory method of diagnosis, prevention or treatment, or, if such a method
exists, that the future medicine is to be of significant benefit to those affected by the condition. The test for that later condition
is stringent, because the future product must be compared with all existing therapies for the rare condition, including surgical
operations, already authorized medicinal products and compounded preparations (subject to certain conditions). At the time of
marketing authorization, the orphan designation is reviewed again by the COMP in view of the maintenance of the orphan status.
If the designation criteria are no longer met, the European Commission withdraws the orphan designation. Maintenance of the orphan
designation at the time of marketing authorization means that all the drugs/biologicals authorized since the granting of the designation
become relevant for determining the lack of satisfactory therapy or the significant benefit.
If obtained, the orphan drug designation
would entitle us to financial incentives, such as reductions of fees or fee waivers and 10 years of market exclusivity. Market
exclusivity precludes the EMA or the national competent authorities from validating a marketing authorization application, and
the European Commission or a national competent authority from granting a marketing authorization, for a same or similar drug/biological
and the same therapeutic indication. The 10-year period may be reduced to six years if the orphan designation criteria are no
longer met, including where it is shown that the product is not sufficiently profitable to justify maintenance of market exclusivity.
The orphan exclusivity may also be lost vis-à-vis another drug/biological in cases where the manufacturer is unable to
assure sufficient quantity of the drug to meet patient needs or if that other product is proved to be clinically superior to the
approved orphan product. A drug/biological is clinically superior if it is safer, more effective or makes a major contribution
to patient care.
55
Even if we receive regulatory approval of any product
candidates for therapeutic indications, we will be subject to ongoing regulatory compliance obligations and continued regulatory
review, which may result in significant additional expense. Additionally, any of our product candidates, if approved, could be
subject to labeling and other restrictions and market withdrawal, and we may be subject to penalties if we fail to comply with
regulatory requirements or experience unanticipated problems with our product candidates.
If any of our product candidates is approved for therapeutic
indications, we will be subject to ongoing regulatory requirements for manufacturing, labeling, packaging, storage, distribution,
advertising, promotion, sampling, recordkeeping, export, import, conduct of post-marketing studies and submission of safety, efficacy
and other post-market information, including both federal and state requirements in the United States and requirements of equivalent
foreign regulatory agencies. In addition, we will be subject to continued compliance with cGMP and GCP requirements for any clinical
trials that we conduct post-approval.
Manufacturers and manufacturers’ facilities
are required to comply with extensive FDA and equivalent foreign regulatory agency requirements, including ensuring that quality
control and manufacturing procedures conform to cGMP regulations. As such, we and our contract manufacturers will be subject to
continual review and inspections to assess compliance with cGMP and adherence to commitments made in any NDA, other marketing applications
and previous responses to inspection observations. Accordingly, we and others with whom we work must continue to expend time, money,
and effort in all areas of regulatory compliance, including manufacturing, production and quality control.
The FDA or equivalent foreign regulatory
agencies have significant post-marketing authority, including, for example, the authority to require labeling changes based on
new safety information and to require post-marketing studies or clinical trials to evaluate serious safety risks related to the
use of a drug. Any regulatory approvals that we receive for our product candidates may be subject to limitations on the approved
indicated uses for which the product may be marketed or to the conditions of approval, or contain requirements for potentially
costly post-marketing testing, including Phase 4 clinical trials and surveillance to monitor the safety and efficacy of the product
candidate. The FDA or equivalent foreign regulatory agencies may also require a REMS program as a condition of approval of our
product candidates, which could entail requirements for long-term patient follow-up, a medication guide, physician communication
plans or additional elements to ensure safe use, such as restricted distribution methods, patient registries and other risk minimization
tools. In addition, if the FDA or an equivalent foreign regulatory agency approves our product candidates, we will have to comply
with requirements, including submissions of safety and other post-marketing information and reports and registration.
The FDA or equivalent foreign regulatory
agencies may impose consent decrees or withdraw approval if compliance with regulatory requirements and standards is not maintained
or if problems occur after the product reaches the market. Later discovery of previously unknown problems with our product candidates,
including adverse events of unanticipated severity or frequency, or with our third-party manufacturers or manufacturing processes,
or failure to comply with regulatory requirements may result in revisions to the approved labeling to add new safety information,
the imposition of post-market studies or clinical trials to assess new safety risks, or the imposition of distribution restrictions
or other restrictions under a REMS program. Other potential consequences include, among other things:
●
restrictions on the marketing or manufacturing of our products, withdrawal of products from the market, or voluntary or mandatory product recalls;
●
fines, warning or untitled enforcement letters, or holds on clinical trials;
●
refusal by the FDA or equivalent foreign regulatory agencies to approve pending applications or supplements to approved applications filed by us or the suspension or revocation of license approvals;
●
product seizure or detention or refusal to permit the import or export of our product candidates; and
●
injunctions or the imposition of civil or criminal penalties.
56
The
FDA or equivalent foreign regulatory agencies strictly regulate the marketing, labeling, advertising and promotion of drug products
that are placed on the market. Products may be promoted only for the approved indications and in accordance with the provisions
of the approved label or other regulatory marketing pathway. The FDA and equivalent foreign regulatory 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 uses may be subject to significant liability. The policies of the FDA or equivalent foreign regulatory agencies may
change, and additional government regulations may be enacted that could prevent, limit or delay regulatory approval of our product
candidates. If we are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies,
or if we are not able to maintain regulatory compliance, we may lose any marketing approval that we may have obtained, which would
adversely affect our business, prospects and the ability to achieve or sustain profitability.
The
policies of the FDA or equivalent foreign regulatory agencies may change, and additional government regulations may be enacted
that could prevent, limit or delay regulatory approval of our product candidates. We also cannot predict the likelihood, nature
or extent of government regulation that may arise from future legislation or administrative or executive action, either in the
United States or abroad. For example, certain policies of the current administration may impact our business and industry. Namely,
the current administration has taken several executive actions, including the issuance of a number of executive orders, that could
impose significant burdens on, or otherwise materially delay, the FDA’s ability to engage in routine regulatory and oversight
activities, such as implementing statutes through rulemaking, the issuance of guidance, and the review and approval of marketing
applications. It is difficult to predict how these executive actions, including any executive orders, will be implemented and
the extent to which they will impact the FDA’s ability to exercise its regulatory authority. If these executive actions
impose constraints on the FDA’s ability to engage in oversight and implementation activities in the normal course, our business
may be negatively impacted. In addition, if we are slow or unable to adapt to changes in existing requirements or the adoption
of new requirements or policies, or if we are not able to maintain regulatory compliance, we may lose any marketing approval that
we may have obtained, and we may not achieve or sustain profitability.
Noncompliance
by us or any future collaborator with regulatory requirements, including safety monitoring or pharmacovigilance requirements,
can also result in significant financial penalties.
We
may conduct clinical trials for our product candidates outside the United States, and the FDA may not accept data from such trials.
Although
the FDA may accept data from clinical trials conducted outside the United States, acceptance of such study data by the FDA is
subject to certain conditions. For example, the study must be well designed and conducted and performed by qualified investigators
in accordance with ethical principles. The study population must also adequately represent the United States population, and the
data must be applicable to the United States population and United States medical practice in ways that the FDA deems clinically
meaningful. Generally, the patient population for any clinical studies conducted outside of the United States must be representative
of the population for whom we intend to label the product in the United States. In addition, such studies would be subject to
the applicable local laws, and FDA acceptance of the data would be dependent upon its determination that the studies also complied
with all applicable United States laws and regulations. There can be no assurance the FDA will accept data from trials conducted
outside of the United States. If the FDA does not accept any such data, it would likely result in the need for additional trials,
which would be costly and time-consuming and may delay aspects of our business plan.
Any
products that we may develop may become subject to unfavorable pricing regulations, third-party reimbursement practices or healthcare
reform initiatives, which could make it difficult for us to sell any product candidates or therapies profitably.
The
regulations that govern pricing for new medical products vary widely from country to country. As a result, we might obtain regulatory
approval for a product in a particular country but then be subject to pricing regulations in that country that delay the commercial
launch of the product and negatively impact the revenue we are able to generate from the sale of the product in that country.
In addition, our ability to commercialize any approved products successfully will depend in part on the extent to which reimbursement
for these products will be available from government health administration authorities, private health insurers and other organizations.
Even if we succeed in bringing one or more therapeutic products to market, these products may not be considered cost-effective,
and the amount reimbursed for any products may be insufficient to allow us to sell them on a competitive basis. If the price we
are able to charge for therapeutic products is inadequate in light of our development and other costs, our future profitability
could be adversely affected.
Ongoing
health care legislative and regulatory reform measures may have a material adverse effect
on our business and results of operations.
Changes
in regulations, statutes or the interpretation of existing regulations could impact our business in the future by requiring, for
example, (i) changes to our manufacturing arrangements, (ii) additions or modifications to product labeling, (iii) the recall
or discontinuation of our products, or (iv) additional record-keeping requirements. If any such changes were to be imposed, they
could adversely affect the operation of our business.
57
In the United States, there have been and continue to be a number
of legislative initiatives to contain health care costs. For example, in March 2010, the ACA was passed, which substantially changed
the way health care is financed by both governmental and private insurers and significantly impacted the United States pharmaceutical
industry. The ACA, among other things, subjects biological products to potential competition by lower-cost biosimilars; addresses
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; increases the minimum Medicaid rebates owed by manufacturers under the Medicaid
Drug Rebate Program; and extends the rebate program to individuals enrolled in Medicaid managed care organizations. It also establishes
annual fees and taxes on manufacturers of certain branded prescription drugs and creates a new Medicare Part D coverage gap discount
program in which manufacturers must agree to offer 50% point of sale discounts off negotiated prices of applicable brand drugs
to eligible beneficiaries during their coverage gap period as a condition for the manufacturer’s outpatient drugs to be covered
under Medicare Part D.
Some
of the provisions of the ACA have yet to be fully implemented, while certain provisions have been subject to judicial and Congressional
challenges, as well as efforts by the Trump administration to repeal or replace certain aspects of the ACA.
These
laws and future state and federal health care reform measures may be adopted in the future, any of which may result in additional
reductions in Medicare and other health care funding and otherwise affect the prices we may obtain for any of our product candidates
for which we may obtain regulatory approval or the frequency with which any such product candidate is prescribed or used.
A
similar movement is observed in the European Union countries. Criteria for pricing and reimbursement, which vary from country
to country, are regularly amended and tightened in order to reduce the draw on the budget allocated to national health insurance
systems. Moreover, the system of reference pricing (the price in a country calculated on the basis of prices in other countries
with typically lower prices) leads to price reductions in countries that traditionally granted high prices.
Disruptions
at the FDA and other government agencies caused by funding shortages or global health concerns could hinder their ability to hire,
retain or deploy key leadership and other personnel, or otherwise prevent new or modified products from being developed, approved
or commercialized in a timely manner or at all, which could negatively impact our business.
The
ability of the FDA to review and or approve new products can be affected by a variety of factors, including government budget
and funding levels, statutory, regulatory, and policy changes, the FDA’s ability to hire and retain key personnel and accept
the payment of user fees, and other events that may otherwise affect the FDA’s ability to perform routine functions. Average
review times at the FDA 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 regulatory authorities may also slow the time necessary for new drugs and biologics to be reviewed
and/or approved by necessary regulatory authorities, 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
authorities, such as the FDA, have had to furlough critical FDA employees and stop critical activities.
Separately,
in response to the global pandemic of COVID-19, on March 10, 2020 the FDA announced its intention to postpone most foreign inspections
of manufacturing facilities and products through April 2020, and subsequently, on March 18, 2020, the FDA temporarily postponed
routine surveillance inspections of domestic manufacturing facilities. Subsequently, on July 10, 2020 the FDA announced its intention
to resume certain on-site inspections of domestic manufacturing facilities subject to a risk-based prioritization system. The
FDA intends to use this risk-based assessment system to identify the categories of regulatory activity that can occur within a
given geographic area, ranging from mission critical inspections to resumption of all regulatory activities. 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.
We are subject to certain U.S. and foreign anticorruption,
anti-money laundering, export control, sanctions and other trade laws and regulations. We can face serious consequences for violations.
Among other matters, U.S. and foreign anticorruption,
anti-money laundering, export control, sanctions and other trade laws and regulations, which are collectively referred to as Trade
Laws, prohibit companies and their employees, agents, clinical research organizations, legal counsel, accountants, consultants,
contractors and other partners from authorizing, promising, offering, providing, soliciting or receiving, directly or indirectly,
corrupt or improper payments or anything else of value to or from recipients in the public or private sector. Violations of Trade
Laws can result in substantial criminal fines and civil penalties, imprisonment, the loss of trade privileges, debarment, tax reassessments,
breach of contract and fraud litigation, reputational harm, and other consequences. We have direct or indirect interactions with
officials and employees of government agencies or government-affiliated hospitals, universities and other organizations. We also
expect our non-U.S. activities to increase over time. We plan to engage third parties for clinical trials and/or to obtain necessary
permits, licenses, patent registrations and other regulatory approvals, and we can be held liable for the corrupt or other illegal
activities of our personnel, agents or partners, even if we do not explicitly authorize or have prior knowledge of such activities.
58
Risks
Related to our Licensed and Co-Owned Intellectual Property
The
license agreements we maintain, including the Yeda 2015 License Agreement, with Yeda are important to our business. If we or the
other parties to our license agreements fail to adequately perform under the license agreements, or if we or they terminate the
license agreements, the development, testing, manufacture, production and sale of our phage-based therapeutic or cosmetic product
candidates would be delayed or terminated, and our business would be adversely affected.
The
Yeda 2015 License Agreement provides for an exclusive worldwide license to certain know-how and research information related to
the development, testing, manufacture, production and sale of microbiome-based therapeutic product candidates, including candidates
specified in the agreement, which are used in our phage discovery platform, as well as patents, research and other rights to phage
product candidates resulting from the work of the consultants identified in the agreement and further research that we funded.
The License Agreement terminates upon the later of the expiration of the last of the patents covered under the License Agreement
and the expiry of a continuous 15-year period during which there has not been a first commercial sale of any product in any country.
Yeda may also terminate the agreement if we fail to observe certain diligence and development requirements and milestones as described
in the License Agreement. we or Yeda may terminate the agreement for the material uncured breach of the other party after a notice
period or the other party’s winding up, bankruptcy, insolvency, dissolution or other similar discontinuation of business.
Upon termination of the agreement, other than due to the passage of time, we are required to grant to Yeda a nonexclusive, irrevocable,
perpetual, fully paid-up, sublicensable, worldwide license in respect of our rights in know-how and research results as described
in the Yeda 2015 License Agreement, provided that, if Yeda subsequently grants a license to a third party that utilizes our rights,
we are entitled to share in the net proceeds actually received by Yeda arising out of that license, subject to a cap based on
the development expenses that we incur in connection with the License Agreement. For more information on the License Agreement,
see “ Business—Material Agreements—License Agreements—License Agreement with Yeda. ”
We
also maintain additional license agreements:
●
with Keio and JSR, pursuant
to which we were granted an exclusive, royalty-bearing, worldwide, perpetual sublicense by JSR to certain patent rights related
to our IBD program. Specifically, these patent rights relate to bacterial targets that have been observed to be related to IBD
and the phage that were observed to eradicate these bacterial targets; and
●
with Keio and JSR, pursuant
to which we were granted an exclusive, royalty-bearing, worldwide, perpetual sublicense by JSR to certain patent rights related
to PSC program. Specifically, these patent rights relate to bacterial targets that have been observed to be related to PSC and
the phage that were observed to eradicate these bacterial targets.
Termination
of the license agreements could cause significant delays in our product and commercialization efforts that could prevent us from
commercializing our product candidates, including our microbiome-based therapeutic product candidates, without first expanding
our internal capabilities or entering into other agreements with third parties. Any alternative collaboration or license could
also be on less favorable terms to us.
We
are highly dependent on intellectual property licensed from third parties, and termination or limitation of any of these licenses
could result in the loss of significant rights and materially harm our business.
We
currently rely on licenses from third-party collaborators for certain aspects of our technology and for certain of our existing
programs. In particular, we received exclusive, royalty-bearing licenses to certain patents held by third parties, including Yeda,
Keio and JSR. Our license agreement with Yeda provide license to certain know-how and research information related to the development,
testing, manufacture, production and sale of microbiome-based therapeutic product candidates that are used in our phage discovery
platform, as well as patents, research and other rights to phage product candidates resulting from the work of the consultants
identified in the agreement and further research that we funded. Our license agreements with Keio and JSR provide licenses to
patents related to, among other things, IBD and PSC programs. Pursuant to these license agreements, we are required to pay annual
license fees, as well as a contingent consideration comprised of milestone and royalty payments, which depend on the achievement
of future milestones and potential revenue from products.
If
we fail to comply with our obligations under our license agreements, including payment terms, our licensors may have the right
to terminate our license agreements, in which event we may not be able to develop, manufacture, market or sell the products covered
by those license agreements. We may also face other penalties under our license agreements if we do not meet our contractual obligations.
Such an occurrence could materially adversely affect the value of our products being developed under any such license agreements.
Termination of one or more of our license agreements, or reduction or elimination of our rights under these license agreements,
may result in us having to negotiate new or reinstated license agreements, which may not be available to us on equally favorable
terms, or at all, which may mean we are unable to commercialize the affected product candidates.
In
the future, we may rely upon additional licenses to certain patent rights and proprietary technology from third parties that are
important or necessary to the development of our product candidates and proprietary product platform. Patent rights that we in-license
in the future may be subject to a reservation of rights by one or more third parties. As a result, any such third party may have
certain rights to such intellectual property.
59
In
addition, subject to the terms of any such license agreements, we may not have the right to control the preparation, filing, prosecution
and maintenance, and we may not have the right to control the enforcement and defense, of patents and patent applications covering
the technology that we license from third parties. We cannot be certain that our in-licensed patent applications (and any patents
issuing therefrom) that are controlled by our licensors will be prepared, filed, prosecuted, maintained, enforced and defended
in a manner consistent with the best interests of our business. If our licensors fail to prosecute, maintain, enforce and defend
such patents rights, or lose rights to those patent applications (or any patents issuing therefrom), the rights we have licensed
may be reduced or eliminated, our right to develop and commercialize any of our product candidates and proprietary product platform
technology that are subject of such licensed rights could be adversely affected, and we may not be able to prevent competitors
from making, using and selling competing products. Moreover, we cannot be certain that such activities by our potential future
licensors will be conducted in compliance with applicable laws and regulations or will result in valid and enforceable patents
or other intellectual property rights. In addition, even where we may have the right to control the prosecution of patents and
patent applications that we may license to and from third parties, we may still be adversely affected or prejudiced by actions
or inactions of our potential future licensees, licensors and their counsel that took place prior to the date of assumption of
control over patent prosecution.
The
patent position of biopharmaceutical companies, including ours and our licensors’, is generally uncertain and involves complex
legal and factual considerations and, therefore, validity and enforceability cannot be predicted with certainty. Our licensed
and co-owned intellectual property may be challenged, deemed unenforceable, invalidated or circumvented. We and our licensors
will be able to protect our intellectual property rights from unauthorized use by third parties only to the extent that these
rights (and the products and services they cover) are protected by valid and enforceable patents, copyrights or trademarks, or
are effectively maintained as trade secrets.
Any
patents obtained by our licensors or us, may be challenged by re-examination or otherwise invalidated or eventually found unenforceable.
Both the patent application process and the process of managing patent disputes can be time consuming and expensive. If we or
one of our licensors were to initiate legal proceedings against a third party to enforce a patent relating to one of our products,
the defendant in such litigation could counterclaim that the asserted patents are invalid and/or unenforceable. In patent litigation
in the U.S., defendant counterclaims alleging invalidity or unenforceability are common, as are validity challenges by the defendant
against the subject patent or related patents before the USPTO. Grounds for a validity challenge could be an alleged failure to
meet any of several statutory patentability requirements, including lack of novelty, obviousness, non-enablement, failure to meet
the written description requirement, indefiniteness, and/or failure to claim patentable subject matter. Grounds for an unenforceability
assertion could be an allegation that someone connected to prosecution of the patent/s at issue intentionally withheld material
information from the USPTO or made a misleading statement during prosecution. Additional grounds for an unenforceability assertion
include an allegation of misuse or anticompetitive use of patent rights, and an allegation of incorrect inventorship with deceptive
intent. Third parties may also raise similar claims before the USPTO, even outside the context of litigation. The outcome of any
assertion of invalidity and/or unenforceability is unpredictable. If a defendant or third party were to prevail on a legal assertion
of invalidity and/or unenforceability, We and our licensors would lose at least part, and perhaps all, of the claims of the challenged
patent/s. Such a loss of patent protection could have a material adverse impact on our business.
We
are dependent on patents and proprietary technology. If we fail to adequately protect this intellectual property or if we otherwise
do not have exclusivity for the marketing of our products, our ability to commercialize products could suffer.
Our
commercial success will depend in part on our ability to obtain and maintain patent protection sufficient to prevent others from
marketing our product candidates, as well as to defend and enforce these patents against infringement and to operate without infringing
the proprietary rights of others. Protection of our product candidates from unauthorized use by third parties will depend on having
valid and enforceable patents that cover our product candidates or their manufacture or use or on having effective trade secret
protection. If our patent applications do not result in issued patents or if our patents are found to be invalid, we will lose
the ability to exclude others from making, using or selling the inventions claimed therein. We have a limited number of patents
and pending patent applications.
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The
patent positions of biotechnology companies can be uncertain and involve complex legal and factual questions. This is due to inconsistent
application of policies and changes in policy relating to the examination and enforcement of biotechnology patents to date on
a global scale. The laws of some countries may not protect intellectual property rights to the same extent as the laws of countries
having well-established patent systems, and those countries may lack adequate rules and procedures for defending our intellectual
property rights. Also, changes in either patent laws or in the interpretations of patent laws may diminish the value of our intellectual
property. We are not able to guarantee that all of our patent applications will result in the issuance of patents, and we cannot
predict the breadth of claims that may be allowed in our patent applications or in the patent applications we may license from
others.
Central
provisions of The Leahy-Smith America Invents Act, or the America Invents Act, went into effect on September 16, 2012 and on March
16, 2013. The America Invents Act includes a number of significant changes to U.S. patent law. These changes include provisions
that affect the way patent applications are being filed, prosecuted and litigated. For example, the America Invents Act enacted
proceedings involving post-issuance patent review procedures, such as inter partes review, or IPR, and post-grant review, that
allow third parties to challenge the validity of an issued patent in front of the USPTO Patent Trial and Appeal Board. Each proceeding
has different eligibility criteria and different patentability challenges that can be raised. IPRs permit any person (except a
party who has been litigating the patent for more than a year) to challenge the validity of the patent on the grounds that it
was anticipated or made obvious by prior art. Patents covering pharmaceutical products have been subject to attack in IPRs from
generic drug companies and from hedge funds. If it is within nine months of the issuance of the challenged patent, a third party
can petition the USPTO for post-grant review, which can be based on any invalidity grounds and is not limited to prior art patents
or printed publications.
In
post-issuance proceedings, USPTO rules and regulations generally tend to favor patent challengers over patent owners. For example,
unlike in district court litigation, claims challenged in post-issuance proceedings are given their broadest reasonable meaning,
which increases the chance a claim might be invalidated by prior art or lack support in the patent specification. As another example,
unlike in district court litigation, there is no presumption of validity for an issued patent, and thus a challenger’s burden
to prove invalidity is by a preponderance of the evidence, as opposed to the heightened clear and convincing evidence standard.
As a result of these rules and others, statistics released by the USPTO show a high percentage of claims being invalidated in
post-issuance proceedings. Moreover, with few exceptions, there is no standing requirement to petition the USPTO for inter partes
review or post-grant review. In other words, companies that have not been charged with infringement or that lack commercial interest
in the patented subject matter can still petition the USPTO for review of an issued patent. Thus, even where we have issued patents,
our rights under those patents may be challenged and ultimately not provide us with sufficient protection against competitive
products or processes.
The
degree of future protection for our proprietary rights is uncertain, because legal means afford only limited protection and may
not adequately protect our rights or permit us to gain or keep our competitive advantage. For example:
●
we might not be the
first to file patent applications for our inventions;
●
others may independently
develop similar or alternative product candidates to any of our product candidates that fall outside the scope of our patents;
●
our pending patent applications may not result
in issued patents;
●
our issued patents may not provide a basis for
commercially viable products or may not provide us with any competitive advantages or may be challenged by third parties;
●
others may design around our patent claims to
produce competitive products that fall outside the scope of our patents;
●
we may not develop additional patentable proprietary
technology related to our product candidates; and
●
we are dependent upon the diligence of our appointed
agents in national jurisdictions, acting for and on our behalf, which control the prosecution of pending domestic and foreign
patent applications and maintain granted domestic and foreign patents.
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An
issued patent does not guarantee us the right to practice the patented technology or commercialize the patented product. Third
parties may have blocking patents that could be used to prevent us from commercializing our patented products and practicing our
patented technology. Our issued patents and those that may be issued in the future may be challenged, invalidated or circumvented,
which could limit our ability to prevent competitors from marketing the same or related product candidates or could limit the
length of the term of patent protection of our product candidates. Moreover, because of the extensive time required for development,
testing and regulatory review of a potential product, it is possible that, before any of our product candidates can be commercialized,
any related patent may expire or remain in force for only a short period following commercialization, thereby reducing any advantage
of the patent. Patent term extensions may not be available for these patents.
Our
rights to develop and commercialize our product candidates and proprietary product platform may be subject, in part, to the terms
and conditions of current and future licenses granted to us by others.
Some
of our licensed rights could provide us with freedom to operate for aspects of our products and services. We may need to obtain
additional licenses from others to advance our research, development and commercialization activities.
Disputes
may arise between us and our licensors regarding intellectual property subject to a license agreement, including:
●
the scope of rights granted under the license
agreement and other interpretation-related issues;
●
whether, and the extent to which, our products,
services, technology and processes infringe on the intellectual property of the licensor that is not subject to the license
agreement;
●
our right to sublicense patent and other rights
to third parties under collaborative development relationships;
●
our diligence obligations under the license
agreement and what activities satisfy those diligence obligations;
●
the inventorship and ownership of inventions
and know-how resulting from the joint creation or use of intellectual property by our licensors and us and our collaborators;
and
●
the priority of invention of patented technology.
If
we do not prevail in such disputes, we may lose any or all of our rights under such license agreements.
In
addition, the agreements under which we currently license intellectual property or technology from third parties are complex,
and certain provisions in such agreements may be susceptible to multiple interpretations. The resolution of any contract interpretation
disagreement that may arise could narrow what we believe to be the scope of our rights to the relevant intellectual property or
technology or could increase what we believe to be our financial or other obligations under the relevant agreement, either of
which could have a material adverse effect on our business, financial condition, results of operations and prospects. Moreover,
if disputes over intellectual property that we have licensed prevent or impair our ability to maintain our current licensing arrangements
on commercially acceptable terms, we may be unable to successfully develop and commercialize any affected products or services,
which could have a material adverse effect on our business, financial conditions, results of operations and prospects.
Absent
the license agreements, we may infringe patents subject to those agreements, and, if the license agreements are terminated, we
may be subject to litigation by the licensor. Litigation could result in substantial costs to us and distract our management.
If we do not prevail, we may be required to pay damages, including treble damages, attorneys’ fees, costs and expenses and
royalties. We may also be enjoined from selling our products or services, which could adversely affect our ability to offer products
or services, our ability to continue operations, and our financial condition.
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If
we infringe the rights of third parties, we could be prevented from selling products, forced to pay damages and/or royalties,
and forced to defend against litigation.
We
do not believe that the products we are currently developing infringe upon the rights of any third parties or are infringed upon
by third parties. However, there can be no assurance that our technology will not be found in the future to infringe upon the
rights of others or be infringed upon by others. Moreover, patent applications are in some cases maintained in secrecy until patents
are issued. The publication of discoveries in the scientific or patent literature frequently occurs much later than the date on
which the underlying discoveries were made and patent applications were filed. Because patents can take many years to issue, there
may be currently pending applications of which we are unaware that may later result in issued patents that our products or product
candidates infringe. For example, pending patent applications may exist that provide support or can be amended to provide support
for a claim that results in an issued patent that is infringed by one or more of our products. In such a case, others may assert
infringement claims against us, and should we be found to infringe these patents or impermissibly use their intellectual property,
we might be forced to pay damages, potentially including treble damages, if we are found to have willfully infringed on such third
parties’ patent rights.
In
addition to any damages we might have to pay, we may also be required to obtain licenses from the holders of this intellectual
property, enter into royalty agreements, or redesign our products so as not to use this intellectual property. Each of these penalties
may prove to be uneconomical or otherwise impossible. We may fail to obtain any such licenses or intellectual property rights
on commercially reasonable terms. Even if we are able to obtain a license, it may be non-exclusive, thereby giving our competitors
access to the same licensed technologies. In that event, we may be required to spend significant time and resources to develop
or license replacement technologies. If we are unable to do so, we may be unable to develop or commercialize the affected products,
which could materially harm our business. Conversely, we may not be able to pursue claims against third parties that infringe
on our licensed or co-owned technology. Thus, our licensed and co-owned technology may not provide adequate protection against
competitors.
The
pharmaceutical industry is characterized by extensive litigation regarding patents and other intellectual property rights. Moreover,
the cost to us of any litigation or other proceeding relating to our licensed and/or co-owned intellectual property rights, even
if resolved in our favor, could be substantial. Any such litigation would divert our management efforts, and we may not have sufficient
resources to bring any such action to a successful conclusion. Uncertainties resulting from the initiation and continuation of
any litigation could limit our ability to continue operations.
Additionally,
because our pipeline may involve additional development candidates that could require the use of proprietary rights held by third
parties, the growth of our business could depend in part on our ability to acquire, in-license or use these proprietary rights.
In addition, our development candidates may require specific formulations to work effectively and efficiently and these rights
may be held by others. We may be unable to acquire or in-license any compositions, methods of use, processes or other third-party
intellectual property rights from third parties that we identify. The licensing and acquisition of third-party intellectual property
rights is a competitive area, and a number of more established companies are also pursuing strategies to license or acquire third-party
intellectual property rights that we may consider attractive. These established companies may have a competitive advantage over
us due to their size, cash resources, and greater clinical development and commercialization capabilities.
For
example, we sometimes collaborate with U.S. and foreign academic institutions to accelerate our preclinical research or development
under written agreements with these institutions. Typically, these institutions provide us with an option to negotiate a license
to any of the institution’s rights in technology resulting from the collaboration. Regardless of such right of first negotiation
for intellectual property, we may be unable to negotiate a license within the specified time frame or under terms that are acceptable
to us. If we are unable to do so, the institution may offer the intellectual property rights to other parties, potentially blocking
our ability to pursue our program.
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In
addition, companies that perceive us to be a competitor may be unwilling to assign or license rights to us. We also may be unable
to license or acquire third-party intellectual property rights on terms that would allow us to make an appropriate return on our
investment. If we are unable to successfully obtain rights to require third-party intellectual property rights, our business,
financial condition and prospects for growth could suffer.
We
may not be successful in obtaining, through acquisitions, in-licenses or otherwise, necessary rights to our product candidates,
proprietary product platform technologies or other technologies.
We currently have rights to certain intellectual property, through
licenses from third parties, to develop our product candidates and proprietary product platform technologies. Some healthcare companies
and academic institutions are competing with us in the field of microbiome therapies and may have patents and/or have filed and are likely
filing patent applications potentially relevant to our business. In order to avoid infringing these third-party patents, we may find it
necessary or prudent to obtain licenses to such patents from such third-party intellectual property holders. We may also require licenses
from third parties for certain technologies that we may be evaluating for use with our current or future product candidates. However,
we may be unable to secure such licenses or otherwise acquire or in-license any compositions, methods of use, processes or other intellectual
property rights from third parties that we identify as necessary for our current or future product candidates and our proprietary product
platform at a reasonable cost or on reasonable terms, if at all. The licensing or acquisition of third-party intellectual property rights
is a competitive area, and several more established companies may pursue strategies to license or acquire third-party intellectual property
rights that we may consider attractive or necessary. These established companies may have a competitive advantage over us due to their
size, capital resources and greater clinical development and commercialization capabilities. In addition, companies that perceive us to
be a competitor may be unwilling to assign or license rights to us. We also may be unable to license or acquire third-party intellectual
property rights on terms that would allow us to make an appropriate return on our investment or at all.
In
the event that we try to obtain rights to required third-party intellectual property rights and is ultimately unsuccessful, we
may be required to expend significant time and resources to redesign our technology, product candidates or the methods for manufacturing
them or to develop or license replacement technology, all of which may not be feasible on a technical or commercial basis. If
we are unable to do so, we may be unable to develop or commercialize the affected product candidates or continue to utilize our
existing proprietary product platform technology, which could significantly harm our business, financial condition, results of
operations and prospects.
We
rely on our proprietary product platform to identify microbiome therapies. Our competitive position could be materially harmed
if our competitors develop a similar platform and develop rival product candidates.
We
rely on know-how, inventions and other proprietary information to strengthen our competitive position. We consider know-how to
be our primary intellectual property with respect to our proprietary product platform. Our clinical trials allow us to collect
clinical data, which we use as a feedback loop to make improvements to our proprietary product platform. In particular, we anticipate
that, with respect to this proprietary product platform, this data may over time be disseminated within the industry through independent
development, the publication of journal articles describing the method and the movement of skilled personnel.
We
cannot rule out that our competitors may have or obtain the knowledge necessary to analyze and characterize similar data to our
known data for the purpose of identifying and developing products that could compete with any of our product candidates. Our competitors
may also have significantly greater financial, product development, technical and human resources access to date. Further, our
competitors may have significantly greater experience in using translational science methods to identify and develop product candidates.
We
may not be able to prohibit our competitors from using technology or methods that are the same as or similar to our proprietary
product platform to develop their own product candidates. If our competitors develop associated therapies, our ability to develop
and market a promising product or product candidate may diminish substantially, which could have a material adverse effect on
our business, financial condition, prospects and results of operations.
64
We
rely on trade secrets and other forms of non-patent intellectual property protection. If we are unable to protect our trade secrets,
other companies may be able to compete more effectively against us.
We
rely on trade secrets to protect certain aspects of our technology, including our proprietary processes for manufacturing and
purifying bacteriophages. Trade secrets are difficult to protect, especially in the pharmaceutical industry, where much of the
information about a product must be made public during the regulatory approval process. Although we use reasonable efforts to
protect our trade secrets, our employees, consultants, contractors, outside scientific collaborators and other advisors may unintentionally
or willfully disclose our information to competitors. Enforcing a claim that a third party illegally obtained and is using our
trade secret information is expensive and time-consuming, and the outcome is unpredictable. In addition, courts outside the United
States may be less willing to or may not protect trade secrets. Moreover, our competitors may independently develop equivalent
knowledge, methods and know-how.
If
we are sued for infringing intellectual property rights of third parties or if we are forced to engage in an interference proceeding,
it will be costly and time-consuming, and an unfavorable outcome in that litigation or interference would have a material adverse
effect on our business.
Our
ability to commercialize our product candidates depends on our ability to develop, manufacture, market and sell our product candidates
without infringing the proprietary rights of third parties. Numerous U.S. and foreign patents and patent applications, which are
owned by third parties, exist in the general field of anti-infective products or in fields that otherwise may relate to our product
candidates. If we are shown to infringe, we could be enjoined from the use or sale of the claimed invention if we are unable to
prove that the patent is invalid. In addition, because patent applications can take many years to issue, there may be currently
pending patent applications, unknown to us, that may later result in issued patents that our product candidates may infringe or
that may trigger an interference proceeding regarding one of our owned or licensed patents or applications. There could also be
existing patents of which we are not aware that our product candidates may inadvertently infringe or that may become involved
in an interference proceeding.
The
biotechnology and pharmaceutical industries are characterized by the existence of a large number of patents and frequent litigation
based on allegations of patent infringement. For so long as our product candidates are in clinical trials, we believe our clinical
activities fall within the scope of the exemptions provided by 35 U.S.C. Section 271(e) in the United States, which exempts from
patent infringement liability activities reasonably related to the development and submission of information to the FDA. As our
clinical investigational drug product candidates progress toward commercialization, the possibility of a patent infringement claim
against us increases. While we attempt to ensure that our active clinical investigational drugs and the methods we employ to manufacture
them, as well as the methods for their use we intend to promote, do not infringe other parties’ patents and other proprietary
rights, we cannot be certain they do not, and competitors or other parties may assert that we infringe their proprietary rights
in any event.
We
may be exposed to future litigation based on claims that our product candidates, the methods we employ to manufacture them or
the uses for which we intend to promote them infringe the intellectual property rights of others. Our ability to manufacture and
commercialize our product candidates may depend on our ability to demonstrate that the manufacturing processes we employ and the
use of our product candidates do not infringe third-party patents. If third-party patents were found to cover our product candidates
or their use or manufacture, we could be required to pay damages or be enjoined and therefore unable to commercialize our product
candidates, unless we obtained a license. A license may not be available to us on acceptable terms, if at all.
We
may become subject to claims for remuneration or royalties for assigned service invention rights by our employees, which could
result in litigation and adversely affect our business.
A
significant portion of our intellectual property has been developed by our employees in the course of their employment for us.
Under the Israeli Patent Law, 5727-1967, or the Patent Law, inventions conceived by an employee during the term and as part of
the scope of his or her employment with a company are regarded as “service inventions,” which belong to the employer,
absent a specific agreement between the employee and employer giving the employee service invention rights. The Patent Law also
provides that, if there is no such agreement between an employer and an employee, the Israeli Compensation and Royalties Committee,
or the Committee, a body constituted under the Patent Law, shall determine whether the employee is entitled to remuneration for
his or her inventions. We generally enter into assignment of invention agreements with our employees pursuant to which such individuals
assign to us all rights to any inventions created in the scope of their employment or engagement with us. Although our employees
have agreed to assign to our service invention rights, we may face claims demanding remuneration in consideration for assigned
inventions. As a consequence of such claims, we could be required to pay additional remuneration or royalties to our current or
former employees or be forced to litigate such claims, which could negatively affect our business.
65
Risks
Related to Our Reliance on Third Parties
We
rely, and continue to rely, on third parties to conduct our clinical trials, and those third parties may not perform satisfactorily,
including failing to meet deadlines for the completion of such trials.
We
continue to rely on third parties, such as contract research organizations, or CROs, and clinical investigators, to conduct and
manage our clinical trials.
Our
reliance on these third parties for research and development activities will reduce our control over these activities but does
not relieve us of our responsibilities. For example, we remain responsible for ensuring that each of our clinical trials is conducted
in accordance with the general investigational plan and protocols for the trial. Moreover, the FDA requires us to comply with
GCPs for conducting, recording and reporting the results of clinical trials to assure that data and reported results are credible
and accurate and that the rights, safety and welfare of trial participants are protected. Other countries’ regulatory agencies
also have requirements for clinical trials with which we must comply. We are also required to register ongoing clinical trials
and post the results of completed clinical trials in a government-sponsored database, clinicaltrials.gov, within specified time
frames. Failure to do so can result in fines, adverse publicity, and civil and criminal sanctions.
Furthermore,
these third parties may also have relationships with other entities, some of which may be our competitors. If these third parties
do not successfully carry out their contractual duties, do not meet expected deadlines, experience work stoppages, terminate their
agreements with us or need to be replaced, or do not conduct our clinical trials in accordance with regulatory requirements or
our stated protocols, we may need to enter into new arrangements with alternative third parties, which could be difficult, costly
or impossible, and our clinical trials may be extended, delayed, terminated or need to be repeated. If any of the foregoing occurs,
we may not be able to obtain, or may be delayed in obtaining, marketing approvals for our product candidates and may not be able
to, or may be delayed in our efforts to, successfully commercialize our product candidates.
We
also rely on other third parties to store and distribute drug supplies for our clinical trials. Any performance failure on the
part of our distributors could delay clinical development or marketing approval of our product candidates or commercialization
of our products, producing additional losses and depriving us of potential product revenue.
Third-party
relationships are important to our business. If we are unable to maintain our collaborations or enter into new relationships,
or if these relationships are not successful, our business could be adversely affected.
We
have limited capabilities for product development and do not yet have any capability for sales, marketing or distribution. Accordingly,
we enter into relationships with other companies and academic institutions to provide us with important technology, and we may
receive additional technology and funding under these and other collaborations in the future. The relationships we enter into
may pose a number of risks, including the following:
●
third parties have, and future third-party collaborators
may have, significant discretion in determining the efforts and resources that they will apply;
●
current and future third parties may not perform
their obligations as expected;
●
current and future third parties may not pursue
development and commercialization of any product candidates that achieve regulatory approval or may elect not to continue
or renew development or commercialization programs based on clinical trial results, changes in the third parties’ strategic
focus or available funding, or external factors, such as a strategic transaction that may divert resources or create competing
priorities;
66
●
third parties may delay clinical trials, provide
insufficient funding for a clinical trial program, stop a clinical trial or abandon a product candidate, repeat or conduct
new clinical trials or require a new formulation of a product candidate for clinical testing;
●
current and future third parties could independently
develop, or develop with third parties, products that compete directly or indirectly with our products and product candidates
if the third parties believe that the competitive products are more likely to be successfully developed or can be commercialized
under terms that are more economically attractive than ours;
●
product candidates discovered in collaboration
with us may be viewed by our current or future third parties as competitive with their own product candidates or products,
which may cause such third parties to cease to devote resources to the commercialization of our product candidates;
●
current and future third parties may fail to
comply with applicable regulatory requirements regarding the development, manufacture, distribution or marketing of a product
candidate or product;
●
current and future third parties with marketing
and distribution rights to one or more of our product candidates that achieve regulatory approval may not commit sufficient
resources to the marketing and distribution of such product or products;
●
disagreements with current or future third parties,
including disagreements over proprietary rights, contract interpretation or the preferred course of development, might cause
delays or terminations of the research, development or commercialization of product candidates, might lead to additional responsibilities
for us with respect to product candidates, or might result in litigation or arbitration, any of which would be time-consuming
and expensive;
●
current and future third parties may not properly
maintain or defend our intellectual property rights or may use our proprietary information in such a way as to invite litigation
that could jeopardize or invalidate our intellectual property or proprietary information or expose us to potential litigation;
●
current and future third parties may infringe
the intellectual property rights of others, which may expose us to litigation and potential liability;
●
current and future third parties may infringe
regulatory frameworks (such as but not limited to cybersecurity and/or privacy frameworks), which may expose us to litigation
and potential liability or require or lead us to terminate relationships with them;
●
if a current or future third party is involved
in a business combination, the collaborator might deemphasize or terminate the development or commercialization of any product
candidate licensed to it by us; and
●
current and future relationships may be terminated
by the collaborator, and, if terminated, we could be required to raise additional capital to pursue further development or
commercialization of the applicable product candidates.
If
our relationships do not result in the successful discovery, development and commercialization of products or if one of our third-party
collaborators terminates its agreement with us, we may not receive any future research funding or milestone or royalty payments
under the collaboration. If we do not receive the funding we expect under these agreements, our development of our technology
and product candidates could be delayed, and we may need additional resources to develop product candidates and our technology.
Additionally, if any of our current or future third-party collaborators terminates its agreement with us, we may find it more
difficult to attract new collaborators, and our reputation in the business and financial communities could be adversely affected.
67
Relationships
are complex and time-consuming to negotiate and document. In addition, there have been a significant number of recent business
combinations among large pharmaceutical companies that have resulted in a reduced number of potential future collaborators. We
face significant competition in seeking appropriate collaborators. Our ability to reach a definitive agreement for a collaboration
will depend, among other things, upon our assessment of a collaborator’s resources and expertise, the terms and conditions
of a proposed collaboration and a proposed collaborator’s evaluation of a number of factors.
We
may not be successful in maintaining or establishing collaborations, which could adversely affect our ability to develop and,
if required regulatory approvals are obtained, commercialize our product candidates.
In
the future, in order to advance our clinical development, or in connection with any potential out-licensing of product candidates
or technologies, we may seek to enter into collaboration agreements. In addition, we may consider entering into collaboration
arrangements with medical technology, pharmaceutical or biotechnology companies and/or seek to establish strategic relationships
with marketing partners for the development, sale, marketing and/or distribution of our product candidates within or outside of
the United States. If we are unable to reach agreements with potential collaborators, then we may fail to meet our business objectives
for the affected product candidates or programs. Collaboration arrangements are complex and time-consuming to negotiate, document
and implement, and we may not be successful in our efforts, if any, to establish and implement collaborations or other alternative
arrangements. The terms of any collaboration or other arrangements that we establish may not be favorable to us, and the success
of any such collaboration will depend heavily on the efforts and activities of our collaborators. Moreover, our collaboration
agreement could be terminated or not renewed by a third party at a time that is costly or damaging to us. Any failure to engage
successful collaborators could cause delays in our product development and/or commercialization efforts, which could harm our
financial condition and operational results.
Risks
Related to Our Operations in Israel
68
The
Israeli government grants we have received for research and development expenditures restrict our ability to manufacture products
and transfer technology outside of Israel and requires us to satisfy specified conditions. If we fail to satisfy these conditions,
we may be required to refund grants previously received, together with interest and penalties.
Our
research and development efforts have been financed, in part, through the grants that we have received from the Israeli Innovation
Authority, or the IIA.. We, therefore, must comply with the requirements of the Israel Encouragement of Research and Development
in Industries, or the Research Law. For the years ended December 31, 2020 and 2019, we recorded grants totaling $0.5 million,
$0.3 million, from the IIA, respectively. The grants represented 2.4% and 2.3% of our gross research and development expenditures
for the years ended December 31, 2020 and 2019, respectively.
Under
the Research Law, we are required to manufacture the major portion of each of our products developed using these grants in the
State of Israel or otherwise ask for special approvals. We may not receive the required approvals for any proposed transfer of
manufacturing activities. Even if we receive approval to manufacture products developed with government grants outside of Israel,
the royalty rate may be increased, and we may be required to pay up to 300% of the grant amounts, plus interest, depending on
the manufacturing volume that is performed outside of Israel. This restriction may impair our ability to outsource manufacturing
or engage in our own manufacturing operations for those products or technology.
Additionally,
under the Research Law, we are prohibited from transferring, including by way of license, the IIA-financed technology and related
intellectual property rights and know-how outside of the State of Israel, except under limited circumstances and only with the
approval of the IIA Research Committee. We may not receive the required approvals for any proposed transfer, and, even if received,
we may be required to pay the IIA a portion, to be set by the IIA, in its discretion and taking into account the circumstances,
upon its approval of such transaction, of the consideration or milestone and royalty payments that we receive upon any sale or
out-licensing of such technology to a non-Israeli entity, up to 600% of the grant amounts plus interest.
These
restrictions may impair our ability to sell our technology assets or to perform or outsource manufacturing outside of Israel or
otherwise transfer our know-how outside of Israel and may require us to obtain the approval of the IIA for certain actions and
transactions and pay additional royalties and other amounts to the IIA. In addition, any change of control and any change of ownership
of our Common Stock that would make a non-Israeli citizen or resident an “interested party,” as defined in the Research
Law, requires prior written notice to the IIA, and our failure to comply with this requirement could, under certain circumstances,
result in criminal liability.
These
restrictions will continue to apply even after we have repaid the full amount of royalties on the grants.
Potential
political, economic and military instability in the State of Israel, where the majority of our senior management and our research
and development facilities are located, may adversely affect our results of operations.
Our headquarters and principal offices and most of our operations are
located in the State of Israel. In addition, all but one of our key employees and officers are residents of Israel. Accordingly, political,
economic and military conditions in Israel directly affect our business.
Any
hostilities involving Israel or the interruption or curtailment of trade between Israel and its present trading partners, or a
significant downturn in the economic or financial condition of Israel, could affect adversely our operations. Ongoing and revived
hostilities or other Israeli political or economic factors could harm our operations, product development and results of operations.
Although Israel has entered into various agreements
with Egypt, Jordan and the Palestinian Authority and with various states in the Persian Gulf, there has been a continuous unrest and
terrorist activity with varying levels of severity. In addition, Israel faces threats from more distant neighbors, in particular, Iran.
Our insurance policies do not cover us for the damages incurred in connection with these conflicts or for any resulting disruption in
our operations. The Israeli government, as a matter of law, provides coverage for the reinstatement value of direct damages that are
caused by terrorist attacks or acts of war; however, the government may cease providing such coverage or the coverage might not be enough
to cover potential damages. In the event that hostilities disrupt the ongoing operation of our facilities or the airports and seaports
on which we depend to import and export our supplies and products, our operations may be materially adversely affected.
In
addition, since the end of 2010, numerous acts of protest and civil unrest have taken place in several countries in the Middle
East and North Africa, many of which involved significant violence, including in Syria and Egypt that border with Israel. The
ultimate effect of these developments on the political and security situation in the Middle East and on Israel’s position
within the region is not clear at this time. Such instability may lead to deterioration in the political and trade relationships
that exist between the State of Israel and certain other countries.
69
Several
countries, principally in the Middle East, still restrict doing business with Israel and Israeli companies, and additional countries
may impose restrictions on doing business with Israel and Israeli companies, whether as a result of hostilities in the region
or otherwise. In addition, there have been increased efforts by activists to cause companies, research institutions and consumers
to boycott Israeli goods and cooperation with Israeli-related entities based on Israeli government policies. Such actions, particularly
if they become more widespread, may adversely impact our ability to cooperate with research institutions and collaborate with
other third parties. Any hostilities involving Israel, any interruption or curtailment of trade or scientific cooperation between
Israel and its present partners, or a significant downturn in the economic or financial condition of Israel could adversely affect
our business, financial condition and results of operations. We may also be targeted by cyber terrorists specifically because
we are an Israeli-related company.
Under
applicable employment laws, we may not be able to enforce covenants not to compete.
We
generally enter into noncompetition agreements with our employees. These agreements prohibit our employees, if they cease working
for us, from competing directly with us or working for our competitors or clients for a limited period. We may be unable to enforce
these agreements under the laws of the jurisdictions in which our employees work, and it may be difficult for us to restrict our
competitors from benefitting from the expertise our former employees or consultants developed while working for us. For example,
Israeli labor courts have required employers seeking to enforce noncompete undertakings of a former employee to demonstrate that
the competitive activities of the former employee will harm one of a limited number of material interests of the employer that
have been recognized by the courts, such as the protection of a company’s trade secrets or other intellectual property.
We have received, and may continue to receive, Israeli governmental
grants to assist in the funding of our research and development activities. If we lose our funding from these research and development
grants, we may encounter difficulties in the funding of future research and development projects and implementing technological improvements,
which would harm our operating results.
Through December 31, 2020, we had received an aggregate
of $2.7 million in the form of grants from the IIA. BiomX Ltd. was formed as an incubator company as part of the FutuRx incubator, and,
until 2017, the majority of our funding was from IIA grants and funding by the incubator, which is supported by the IIA. We continued
to apply for and receive IIA grants after we left the incubator. The requirements and restrictions for such grants are found in the Research
Law. Under the Research Law, royalties of 3% to 3.5% on the revenue derived from sales of products or services developed in whole or in
part using these IIA grants are payable to the Israeli government. We developed both of our platform technologies, at least in part, with
funds from these grants, and, accordingly, we would be obligated to pay these royalties on sales of any of our product candidates that
achieve regulatory approval. As long as the manufacturing of our product candidates takes place in Israel and no technology funded with
IIA grants is sold or out licensed to a non-Israeli entity, the maximum aggregate royalties paid generally would not exceed 100% of the
grants made to us, plus annual interest equal to the 12-month LIBOR rate applicable to dollar deposits, as published on the first business
day of each calendar year. As of December 31, 2020, the balance of the principal and interest in respect of our commitments for future
payments to the IIA totaled approximately $2.3 million. As part of funding our current and planned product development activities, we
have submitted follow-up grant applications for new grants.
These grants have funded some of our personnel,
development activities with subcontractors, and other research and development costs and expenses. However, if these awards are not funded
in their entirety or if new grants are not awarded in the future, due to, for example, IIA budget constraints or governmental policy decisions,
our ability to fund future research and development and implement technological improvements would be impaired, which would negatively
impact our ability to develop our product candidates.
Our
operations may be disrupted by the obligations of personnel to perform military service.
Some
of our employees based in Israel may be called upon to perform annual military reserve duty and, in emergency circumstances, could
be called to immediate and unlimited active duty. Our operations could be disrupted by the absence of a significant number of
our employees related to military service or the absence for extended periods of one or more of our executive officers or other
key employees. Such disruption could materially adversely affect our business and results of operations.
The
tax benefits that are available to us if and when we generate taxable income require us to meet various conditions and may be
prevented or reduced in the future, which could increase our costs and taxes.
If
and when we generate taxable income, we would be eligible for certain tax benefits provided to “Technologic Preferred Enterprise”
and/or “Preferred Enterprise” as defined under the Encouragement of Capital Investment Law -1959, or the “Law,
and its regulations, as amended and, accordingly, could be subject to a reduced corporate tax rate on its income that will meet
the provisions of the Law (ranging between 7.5%-16%). To the extent that we are not eligible to obtain such statuses, our Israeli
taxable income would be subject to regular Israeli corporate tax rates. The standard corporate tax rate for Israeli companies
is 23%. The benefits available to us in accordance to the Law and its regulations are subject to the fulfillment of conditions
stipulated in the Law and the regulations. Further, in the future, these tax benefits may be reduced or discontinued.
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It
may be difficult to enforce a U.S. judgment against us or our officers and directors in Israel or the United States or to assert
U.S. securities laws claims in Israel or serve process on our officers and directors.
Not
all of our directors or officers are residents of the United States, and most of their and our assets are located outside the
United States. Service of process upon us or our non-U.S. resident directors and officers may be difficult to obtain within the
United States. Israeli courts may refuse to hear a claim based on a violation of U.S. securities laws against us or our non-U.S.
officers and directors, because Israel may not be the most appropriate forum to bring such a claim. In addition, even if an Israeli
court agrees to hear a claim, it may determine that Israeli law, and not U.S. law, is applicable to the claim. If U.S. law is
found to be applicable, the content of applicable U.S. law must be proved as a fact, which can be a time-consuming and costly
process. Certain matters of procedure will also be governed by Israeli law. There is little binding case law in Israel addressing
the matters described above. Additionally, Israeli courts might not enforce judgments obtained in the United States against us
or our non-U.S. directors and executive officers, which may make it difficult to collect on judgments rendered against us or our
non-U.S. officers and directors.
Moreover,
an Israeli court will not enforce a non-Israeli judgment if it was given in a state whose laws do not provide for the enforcement
of judgments of Israeli courts (subject to exceptional cases), if its enforcement is likely to prejudice the sovereignty or security
of the State of Israel, if it was obtained by fraud or in the absence of due process, if it is at variance with another valid
judgment that was given in the same matter between the same parties, or if a suit in the same matter between the same parties
was pending before a court or tribunal in Israel at the time the foreign action was brought.
Risks
Related to Manufacturing and Supply
We
rely on third parties to manufacture our clinical supply of product candidates and we intend to rely on third parties to produce
and process our products, if approved.
We
currently rely on outside vendors to supply raw materials and other important components, such as lab equipment. We have not yet
caused any product candidates to be manufactured or processed on a commercial scale and may not be able to do so for any of our
product candidates. We will make changes as it works to optimize the manufacturing process for our product candidates, and we
cannot be sure that even minor changes in the process will result in therapies that are safe and effective.
The
facilities used to manufacture our product candidates must be approved by the FDA or equivalent foreign regulatory agencies pursuant
to inspections that will be conducted after we submit a marketing application to the FDA or equivalent foreign regulatory agency.
Additionally, any facilities used for the manufacture of product candidates commercialized for non-therapeutic uses will be subject
to inspection by the FDA and foreign regulatory agencies. We do not currently control all aspects of the manufacturing process
of, and are currently largely dependent on, our contract manufacturing partners for compliance with regulatory requirements, known
as cGMP requirements, for manufacture of our product candidates. If and when our manufacturing facility becomes operational, we
will be responsible for compliance with cGMP requirements. If we or our contract manufacturers cannot successfully manufacture
in conformance with our specifications and the strict regulatory requirements of the FDA or other regulatory authorities, we and
they will not be able to secure and/or maintain regulatory approval for their manufacturing facilities with respect to the manufacture
of our product candidates. In addition, we have no control over the ability of our contract manufacturers to maintain adequate
quality control, quality assurance and qualified personnel. If the FDA or an equivalent foreign regulatory agency does not approve
these facilities for the manufacture of our product candidates or if it withdraws any such approval in the future, we may need
to find alternative manufacturing facilities, which would significantly impact our ability to develop, obtain regulatory approval
for or market our product candidates, if approved.
We
have limited experience manufacturing our product candidates for purposes of clinical trials for therapeutic indications or for
non-therapeutic clinical studies or trials. We opened our own manufacturing facility at our headquarters in Ness Ziona, Israel
in the third quarter of 2019. We cannot assure you that we can manufacture our product candidates in compliance with regulations
at a cost or in quantities necessary to make them commercially viable.
Our
product candidates rely on the availability of specialty raw materials, which may not be available to us on acceptable terms or
at all.
Our
product candidates require certain specialty raw materials, some of which we obtain from small companies with limited resources
and experience to support a commercial product. These third-party suppliers may be ill-equipped to support our needs, especially
in non-routine circumstances like an FDA inspection or medical crisis, such as widespread contamination. We do not currently have
contracts in place with all of the suppliers that we may need at any point in time and, if needed, may not be able to contract
with them on acceptable terms or at all. Accordingly, we may experience delays in receiving key raw materials to support clinical
or commercial manufacturing.
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Risks
Related to Our Common Stock
A
significant number of shares of our Common Stock are subject to issuance upon exercise of outstanding warrants and options, which
upon such exercise may result in dilution to our security holders.
As of December 31, 2020, we had an aggregate of 10,265,418 warrants
outstanding to purchase an aggregate of up to 6,765,418 shares of Common Stock with a weighted average exercise price of $11.09, certain
of which are included in our outstanding units, certain of which were issued in private placements and certain of which are traded on
the NYSE American under the symbol “PHGE.WS,” or the Outstanding Warrants, in each case subject to adjustment. To the extent
such warrants are exercised, additional shares of our Common Stock will be issued, which will result in dilution to the then existing
holders of Common Stock and increase the number of shares eligible for resale in the public market. Sales of substantial numbers of such
shares in the public market could adversely affect the market price of our Common Stock.
In
addition, as of December 31, 2020, we had outstanding vested and unvested options to purchase 3,569,769 shares of our Common Stock.
To the extent any of these options are exercised, additional shares of Common Stock will be issued that will generally be eligible
for resale in the public market (subject to limitations under Rule 144 under the Securities Act with respect to shares held by
our affiliates), which will result in dilution to our security holders. We plan to grant additional options and warrants in the
future. The issuance of additional securities could also have an adverse effect on the market price of our Common Stock.
We
have never paid dividends on our Common Stock, and we do not anticipate paying any cash dividends on our Common Stock in the foreseeable
future.
We
have never declared or paid cash dividends on our Common Stock. We do not anticipate paying any cash dividends on our Common Stock
in the foreseeable future. We currently intend to retain all available funds and any future earnings to fund the development and
growth of our business. As a result, capital appreciation, if any, of our Common Stock will be our stockholders’ sole source
of gain for the foreseeable future.
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We
may be unable to maintain the listing of our securities in the future.
Our
Common Stock and certain of our warrants currently trade on the NYSE American and our Common Stock currently trades on the Tel
Aviv Stock Exchange. If our Common Stock or warrants are subsequently delisted, we could face significant material adverse consequences,
including:
●
a limited availability of market quotations
for our securities;
●
reduced liquidity with respect to our securities;
●
a determination that our shares are a “penny
stock,” which will require brokers trading in our securities to adhere to more stringent rules, possibly resulting in
a reduced level of trading activity in the secondary trading market for our securities;
●
a limited amount of news and analyst coverage
for the post-transaction company; and
●
a decreased ability to issue additional securities
or obtain additional financing in the future.
As a “smaller reporting company” we are permitted
to provide less disclosure than larger public companies, which may make our Common Stock less attractive to investors.
We are currently a “smaller reporting company,” as defined
by Rule 12b-2 of the Exchange Act. As a smaller reporting company, we are eligible to take advantage of certain exemptions from various
reporting requirements applicable to other public companies. Consequently, it may be more challenging for investors to analyze our results
of operations and financial prospects which may result in less investor confidence. Investors may find our Common Stock less attractive
as a result of our smaller reporting company status. If some investors find our Common Stock less attractive, there may be a less active
trading market for our Common Stock and our stock price may be more volatile.
General
Risk Factors
Our
success depends, in part, on our ability to retain key executives and to attract, retain and motivate qualified personnel.
We
are highly dependent on Jonathan Solomon, our chief executive officer, as well as the other principal members of our management,
scientific and clinical team. Although we have entered into employment agreements with our executive officers, each of them may
terminate their employment with us at any time. We do not maintain “key person” insurance for any of our executives
or other employees. The loss of the services of any of our executive officers, other key employees, and other scientific and medical
advisors, and our inability to find suitable replacements could result in delays in product development and harm our business.
Our
continued ability to attract, retain and motivate highly qualified management, clinical and scientific personnel and our ability
to develop and maintain important relationships with leading academic institutions, clinicians and scientists is critical to our
success. Competition for qualified personnel in the biotechnology field is intense, particularly in Israel where our headquarters
are located. We face competition for personnel from other biotechnology and pharmaceutical companies, universities, public and
private research institutions and other organizations. We also face competition from other more well-funded and well-established
businesses, and we may also be viewed as a riskier choice from a job stability perspective due to our relatively newer status
than longer existing biotech and pharmaceutical companies. We may not be able to attract and retain qualified personnel on acceptable
terms given the competition for such personnel. If we are unsuccessful in our retention, motivation and recruitment efforts, we
may be unable to execute our business strategy.
Failure
to comply with health and data protection laws and regulations could lead to claims, government enforcement actions (which could
include civil or criminal penalties), regulatory actions, private litigation and/or adverse publicity and could negatively affect
our operating results and business .
We
may be subject to federal, state and foreign data protection laws and regulations (i.e., laws and regulations that address privacy
and security). In the United States, numerous federal and state laws and regulations, including federal health information privacy
laws, state consumer privacy laws, state data breach notification laws, state health information privacy laws and federal and
state consumer protection laws (e.g., Section 5 of the Federal Trade Commission Act), that govern the collection, use, disclosure
and protection of health-related and other personal information could apply to our operations or the operations of our collaborators.
In addition, we may obtain health information from third parties (including research institutions from which we obtain clinical
trial data) that are subject to privacy and security requirements under the Health Insurance Portability and Accountability Act
of 1996, or HIPAA, as amended by the Health Information Technology for Economic and Clinical Health of 2009, or HITECH. Depending
on the facts and circumstances, we could be subject to criminal penalties if we knowingly obtain, use or disclose individually
identifiable health information maintained by a HIPAA-covered entity in a manner that is not authorized or permitted by HIPAA.
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Additional requirements may also be imposed by
international data protection laws. In this context, Regulation 2016/679 of the GDPR (in addition to many other international
data protection laws) may have an impact on our operations when we collect and/or process personal data of individuals located in the
European Union. The GDPR has applied since May 25, 2018 (replacing previously applicable data protection frameworks) and has an extraterritorial
reach. The GDPR allows members states to introduce specific requirements in relation to certain areas, including processing of special
categories of data, and we may face further restrictions and non-compliance risks under such national frameworks. We have not yet assessed
whether its activities might be caught by the GDPR.
Because
of the types of data we collect and process, which may involve health, biometric and genetic data, we may face high risks for
non-compliance with the GDPR rules (or local declinations of GDPR-rules across the different European Union Member States), as
these types of data are considered as special categories of data and are granted higher protection. The risks are further increased
considering the diverging approach in the European Union as to the rules, requirements and frameworks in relation to the processing
of personal data in clinical trials (in matters such as the choice of the legal basis for the processing of data, the possible
uses of the personal data collected, etc.) and the interplay with other relevant frameworks. The GDPR introduced stringent data
protection requirements in the European Union, as well as potential fines for noncompliant companies of up to the greater of €20
million or 4% of annual worldwide turnover. Supervisory authorities also have the ability to restrict our processing activities
if those are deemed not to be in compliance with the GDPR (or local declinations); this may significantly impact the way we conduct
our activities. The GDPR imposes numerous requirements for the collection, use and disclosure of personal data, including high
standards for consent to be valid, and specific information to be provided to individuals about how their personal data is used,
the obligation to notify regulators and (in some cases) to communicate to affected individuals of personal data breaches, extensive
new internal privacy governance requirements and obligations to allow individuals to exercise their strengthened privacy rights
(e.g., the right to access, correct and delete their personal data, to withdraw their consent, etc.), and obligations when contracting
with third parties such as service providers, CROs, etc. In addition, the GDPR includes restrictions on data transfers outside
the European Economic Area, or EEA. The actual mechanisms made available under GDPR to transfer such personal data have recently
received heightened regulatory and judicial scrutiny. If we cannot rely on existing mechanisms for transferring personal data
from the EEA, the United Kingdom, or other jurisdictions, we may be unable to transfer personal data in those regions. Further,
the United Kingdom’s vote in favor of exiting the European Union, often referred to as “Brexit,” has created
uncertainty as to whether or not the United Kingdom data protection legislation will depart from the GDPR and how data transfers
to and from the United Kingdom will be regulated.
Compliance
with U.S. and international data protection laws and regulations could require us to take on more onerous obligations in our contracts,
restrict our ability to collect, use and disclose data, or in some cases, impact our ability to operate in certain jurisdictions.
Such laws and regulations could limit our ability to use and share personal or other data, thereby increasing our costs and harming
our business and financial condition. Failure to comply with U.S. and international data protection laws and regulations could
result in claims, government enforcement actions (which could include civil or criminal penalties), regulatory actions, private
litigation and/or adverse publicity and could negatively affect our operating results and business. Moreover, clinical trial subjects
about whom we or our potential collaborators obtain information, as well as the providers who share this information with us,
may contractually limit our ability to use and disclose the information. Claims that we have violated individuals’ privacy
rights, failed to comply with data protection laws, or breached our contractual obligations, even if we are not found liable,
could be expensive and time consuming to defend and could result in adverse publicity that could harm our business. Finally, we
may be required to disclose personal data pursuant to demands from government agencies, from law enforcement agencies, and from
intelligence agencies. This disclosure may result in a failure or perceived failure by us to comply with data privacy laws, rules,
and regulations and could result in proceedings or actions against us in the same or other jurisdictions, and could have an adverse
impact on our reputation and brand.
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Our
relationships with healthcare providers, physicians and third-party payors will be subject to applicable anti-kickback, fraud
and abuse and other healthcare laws and regulations, which could expose us to criminal sanctions, civil penalties, contractual
damages, reputational harm and diminished profits and future earnings .
Healthcare
providers, physicians and third-party payors in the United States and elsewhere play a primary role in the recommendation and
prescription of pharmaceutical products. Arrangements with third-party payors and customers can expose pharmaceutical manufacturers
to broadly applicable fraud and abuse and other healthcare laws and regulations, including, without limitation, the federal Anti-Kickback
Statute and the federal False Claims Act, or FCA, and foreign equivalent legislation, which may constrain the business or financial
arrangements and relationships through which such companies sell, market and distribute pharmaceutical products. In particular,
the promotion, sales and marketing of healthcare items and services, as well as certain business arrangements in the healthcare
industry, are subject to extensive laws designed to prevent fraud, kickbacks, self-dealing and other abusive practices. These
laws and regulations may restrict or prohibit a wide range of pricing, discounting, marketing and promotion, structuring and commissions,
certain customer incentive programs and other business arrangements generally. Activities subject to these laws also involve the
improper use of information obtained in the course of patient recruitment for clinical trials. The applicable federal, state and
foreign healthcare laws and regulations laws that may affect our ability to operate include, but are not limited to:
●
the federal Anti-Kickback Statute, which prohibits,
among other things, knowingly and willfully soliciting, receiving, offering or paying any remuneration (including any kickback,
bribe or rebate), directly or indirectly, overtly or covertly, in cash or in kind, to induce, or in return for, either the
referral of an individual, or the purchase, lease, order or recommendation of any good, facility, item or service for which
payment may be made, in whole or in part, under a federal healthcare program, such as the Medicare and Medicaid programs.
A person or entity can be found guilty of violating the statute without actual knowledge of the statute or specific intent
to violate it. In addition, 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 FCA. The Anti-Kickback Statute has been interpreted to apply to
arrangements between pharmaceutical manufacturers on the one hand and prescribers, purchasers and formulary managers on the
other hand. There are a number of statutory exceptions and regulatory safe harbors protecting some common activities from
prosecution;
●
federal civil and criminal false claims laws
and civil monetary penalty laws, including the FCA, which prohibit, among other things, individuals or entities from knowingly
presenting, or causing to be presented, false or fraudulent claims for payment to, or approval by Medicare, Medicaid or other
federal healthcare programs, knowingly making, using or causing to be made or used a false record or statement material to
a false or fraudulent claim or an obligation to pay or transmit money to the federal government, or knowingly concealing or
knowingly and improperly avoiding or decreasing or concealing an obligation to pay money to the federal government. Manufacturers
can be held liable under the FCA even when they do not submit claims directly to government payors if they are deemed to “cause”
the submission of false or fraudulent claims. The FCA also permits a private individual acting as a “whistleblower”
to bring actions on behalf of the federal government alleging violations of the FCA and to share in any monetary recovery;
●
HIPAA, which created new federal criminal statutes
that prohibit knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program
or obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by,
or under the custody or control of, any healthcare benefit program, regardless of the payor (e.g., public or private) and
knowingly and willfully falsifying, concealing or covering up by any trick or device a material fact or making any materially
false statements in connection with the delivery of, or payment for, healthcare benefits, items or services relating to healthcare
matters. Similar to the federal Anti-Kickback Statute, a person or entity can be found guilty of violating HIPAA without actual
knowledge of the statute or specific intent to violate it;
●
HIPAA, as amended by HITECH and their respective
implementing regulations, which impose, among other things, requirements on certain covered healthcare providers, health plans
and healthcare clearinghouses, as well as their respective business associates that perform services for them that involve
the use, or disclosure of, individually identifiable health information relating to the privacy, security and transmission
of individually identifiable health information without appropriate authorization. HITECH also created 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 federal courts to enforce the federal
HIPAA laws and seek attorneys’ fees and costs associated with pursuing federal civil actions;
●
the federal Physician Payment Sunshine Act,
created under the Patient Protection and Affordable Care Act and its implementing regulations, which require manufacturers
of drugs, devices, biologicals 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 the United States Department of Health and Human
Services 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;
75
●
federal consumer protection and unfair competition
laws, which broadly regulate marketplace activities and activities that potentially harm consumers;
●
analogous state and foreign laws and regulations,
such as state anti-kickback and false claims laws, which may apply to sales or marketing arrangements and claims involving
healthcare items or services reimbursed by nongovernmental third-party payors, including private insurers, and may be broader
in scope than their federal equivalents; state and foreign 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; state and foreign 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; and state and foreign laws governing the privacy and security of health information in certain circumstances,
many of which differ from each other in significant ways and often are not preempted by HIPAA, thus complicating compliance
efforts; and
●
European Union and other foreign provisions.
The
distribution of pharmaceutical products is subject to additional requirements and regulations, including extensive recordkeeping,
licensing, storage, security requirements intended to prevent the unauthorized sale of pharmaceutical products and, in some foreign
countries, including the European Union countries, mandatory anti-counterfeit features.
The
scope and enforcement of each of these laws is uncertain and subject to rapid change in the current environment of healthcare
reform, especially in light of the lack of applicable precedent and regulations. Federal and state enforcement bodies have recently
increased their scrutiny of interactions between healthcare companies and healthcare providers, which has led to a number of investigations,
prosecutions, convictions and settlements in the healthcare industry. Ensuring business arrangements comply with applicable healthcare
laws, as well as responding to possible investigations by government authorities, can be time- and resource-consuming and can
divert a company’s attention from the business.
The
failure to comply with any of these laws or regulatory requirements could subject us to possible legal or regulatory action. Depending
on the circumstances, failure to meet applicable regulatory requirements can result in civil, criminal and administrative penalties,
damages, fines, disgorgement, individual imprisonment, possible exclusion from participation in federal and state funded healthcare
programs, contractual damages and the curtailment or restricting of our operations, as well as additional reporting obligations
and oversight if we become subject to a corporate integrity agreement or other agreement to resolve allegations of noncompliance
with these laws. Any action for violation of these laws, even if successfully defended, could cause a pharmaceutical manufacturer
to incur significant legal expenses and divert management’s attention from the operation of the business. Prohibitions or
restrictions on sales or withdrawal of future marketed products could materially affect business in an adverse way.
We
are subject to a code of business conduct and ethics, but it is not always possible to identify and deter employee misconduct,
and the precautions we take to detect and prevent inappropriate conduct may not be effective in controlling unknown or unmanaged
risks or losses or in protecting us from governmental investigations or other actions or lawsuits stemming from a failure to be
in compliance with such laws or regulations. Efforts to ensure that the our business arrangements will comply with applicable
healthcare laws may involve substantial costs. It is possible that governmental and enforcement authorities will conclude that
our business practices may not comply with current or future statutes, regulations or case law interpreting applicable fraud and
abuse or other healthcare laws and regulations. If any such actions are instituted against us, and we are not successful in defending
ourselves or asserting our rights, those actions could have a significant impact on our business, including the imposition of
civil, criminal and administrative penalties, damages, disgorgement, monetary fines, possible exclusion from participation in
Medicare, Medicaid and other federal healthcare programs, contractual damages, reputational harm, diminished profits and future
earnings, and curtailment of our operations, any of which could adversely affect our ability to operate our business and our results
of operations. In addition, the approval and commercialization of any of our product candidates outside the United States will
also likely subject us to foreign equivalents of the healthcare laws mentioned above, among other foreign laws.
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If
we engage in future acquisitions or strategic partnerships, this may increase our capital requirements, dilute our stockholders,
cause us to incur debt or assume contingent liabilities, and subject us to other risks.
We
may evaluate various acquisition opportunities and strategic partnerships, including licensing or acquiring complementary products,
intellectual property rights, technologies or businesses. Any potential acquisition or strategic partnership may entail numerous
risks, including:
●
increased operating expenses and cash requirements;
●
the assumption of additional indebtedness or
contingent liabilities;
●
the issuance of our equity securities;
●
assimilation of operations, intellectual property
and products of an acquired company, including difficulties associated with integrating new personnel;
●
the diversion of our management’s attention
from our existing product programs and initiatives in pursuing such a strategic merger or acquisition;
●
retention of key employees, the loss of key
personnel and uncertainties in our ability to maintain key business relationships;
●
risks and uncertainties associated with the
other party to such a transaction, including the prospects of that party and their existing products or product candidates
and marketing approvals; and
●
our inability to generate revenue from acquired
technology and/or products sufficient to meet our objectives in undertaking the acquisition or even to offset the associated
acquisition and maintenance costs.
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Our
business and operations might be adversely affected by security breaches, including any cybersecurity incidents .
We
depend on the efficient and uninterrupted operation of our computer and communications systems, and those of our consultants,
contractors and vendors, which we use for, among other things, sensitive company data, including our intellectual property, financial
data and other proprietary business information.
While
certain of our operations have business continuity and disaster recovery plans and other security measures intended to prevent
and minimize the impact of IT-related interruptions, our IT infrastructure and the IT infrastructure of our consultants, contractors
and vendors are vulnerable to damage from cyberattacks, computer viruses, unauthorized access, electrical failures and natural
disasters or other catastrophic events. We could experience failures in our information systems and computer servers, which could
result in an interruption of our normal business operations and require substantial expenditure of financial and administrative
resources to remedy. System failures, accidents or security breaches can cause interruptions in our operations and can result
in a material disruption of our targeted phage therapies, product candidates and other business operations. The loss of data from
completed or future studies or clinical trials could result in delays in our research, development or regulatory approval efforts
and significantly increase our costs to recover or reproduce the data. To the extent that any disruption or security breach were
to result in a loss of, or damage to, our data or applications, or inappropriate disclosure of confidential or proprietary information,
we could incur regulatory investigations and redresses, penalties and liabilities and the development of our product candidates
could be delayed or otherwise adversely affected.
Even
though we believe we carry commercially reasonable business interruption and liability insurance, we might suffer losses as a
result of business interruptions that exceed the coverage available under our insurance policies or for which we do not have coverage.
For example, we are not insured against terrorist attacks or cyberattacks. Any natural disaster or catastrophic event could have
a significant negative impact on our operations and financial results. Moreover, any such event could delay the development of
our product candidates.
In the ordinary course of our business, we collect and store sensitive
data, including intellectual property, clinical trial data, proprietary business information, personal data and personally identifiable
information of our clinical trial subjects and employees, in our data centers and on our networks. The secure processing, maintenance
and transmission of this information is critical to our operations. Attacks upon information technology systems are increasing in their
frequency, levels of persistence, sophistication and intensity, and are being conducted by sophisticated and organized groups and individuals
with a wide range of motives and expertise. As a result of the COVID-19 pandemic, we may also face increased cybersecurity risks due to
our reliance on internet technology and the number of our employees who are working remotely, which may create additional opportunities
for cybercriminals to exploit vulnerabilities. Because the techniques used to obtain unauthorized access to, or to sabotage, systems change
frequently and often are not recognized until launched against a target, we may be unable to anticipate these techniques or implement
adequate preventative measures. We may also experience security breaches that may remain undetected for an extended period. Despite our
security measures, our information technology and infrastructure may be vulnerable to attacks by hackers or internal bad actors, or breached
due to employee error, a technical vulnerability, malfeasance or other disruptions. We have experienced and expect to continue to experience
actual and attempted cyber-attacks of our IT networks, such as through phishing scams and ransomware. Although none of these actual or
attempted cyber-attacks has had a material adverse impact on our operations or financial condition, we cannot guarantee that any such
incidents will not have such an impact in the future.
We
incur significant costs operating as a public company.
As
a public company, we incur significant costs in connection with our directors and officers insurance, paying for service providers
such as legal and accounting as well as other expenses. We are subject to the reporting requirements of the Exchange Act, which
require, among other things, that we file with the SEC annual, quarterly and current reports with respect to our business and
financial condition. In addition, the Sarbanes-Oxley Act, as well as rules subsequently adopted by the SEC and the NYSE American
to implement provisions of the Sarbanes-Oxley Act, the Dodd-Frank Wall Street Reform and Consumer Protection Act, or the Dodd-Frank
Act, and the Public Company Accounting Oversight Board impose significant requirements on public companies, including requiring
the establishment and maintenance of effective disclosure and financial controls and changes in corporate governance practices.
These expenses will likely increase in the future, particularly after we cease to be an “emerging growth company”
if we are also no longer a “smaller reporting company” as a result of additional corporate governance and disclosure
requirements under the Sarbanes-Oxley Act, the Dodd-Frank Act, and SEC rules and regulations.
The
rules and regulations applicable to public companies result in us continuing to incur substantial legal and financial compliance
costs. These costs increase our net loss or decrease any net income and may require us to reduce costs in other areas of our business.
78
Sales
of a substantial number of shares of our Common Stock in the public market by our existing stockholders could cause our stock
price to decline.
Sales
of a substantial number of shares of our Common Stock in the public market or the perception that these sales might occur, could
depress the market price of our Common Stock and could impair our ability to raise capital through the sale of additional equity
securities. We are unable to predict the effect that sales may have on the prevailing market price of our Common Stock.
The
market price of our Common Stock and other securities may be volatile and fluctuate substantially, which could result in substantial
losses for purchasers of our common stock.
The
stock markets in general and the markets for biotechnology stocks have experienced extreme volatility. The market for the common
stock of smaller companies such as ours is characterized by significant price volatility when compared to the shares of larger,
more established companies that trade on a national securities exchange and have large public floats, and our share price is more
volatile than the shares of such larger, more established companies for the indefinite future.
In
addition to the factors discussed in this “Risk Factors” section, price declines in our Common Stock (and other securities)
could also result from general market and economic conditions and a variety of other factors, including:
●
adverse results or delays in our clinical trials;
●
adverse actions taken by regulatory agencies
with respect to our product candidates, clinical trials or the manufacturing processes of our product candidates;
●
announcements of technological innovations,
patents or new products by our competitors;
●
regulatory developments in the United States
and foreign countries;
●
any lawsuit involving us or our product candidates;
79
●
announcements concerning our competitors, or
the biotechnology or pharmaceutical industries in general;
●
developments concerning any strategic alliances
or acquisitions we may enter into;
●
actual or anticipated variations in our operating
results;
●
changes in recommendations by securities analysts
or lack of analyst coverage;
●
deviations in our operating results from the
estimates of analysts;
●
our inability, or the perception by investors
that we will be unable, to continue to meet all applicable requirements for continued listing of our Common Stock on the NYSE
American, and the possible delisting of our Common Stock;
●
sales of our Common Stock by our executive officers,
directors and principal stockholders or sales of substantial amounts of Common Stock; and
●
loss of any of our key scientific or management
personnel.
Additionally,
market prices for securities of biotechnology companies historically have been very volatile. The market for these securities
has from time to time experienced significant price and volume fluctuations for reasons unrelated to the operating performance
of any one company. Furthermore, our business may be adversely impacted by risks, or the public perception of the risks, related
to a pandemic or other health crisis, such as the COVID-19. A significant outbreak of contagious diseases could result in a widespread
health crisis that could adversely affect the economies and financial markets of many countries, resulting in an economic downturn.
In
the past, following periods of volatility in the market price of a particular company’s securities, litigation has often
been brought against that company. Any such lawsuit could consume resources and management time and attention, which could adversely
affect our business.
If
securities or industry analysts do not publish research or publish unfavorable research about our business, our stock price and
trading volume could decline.
The
trading market for our Common Stock will depend in part on the research and reports that securities or industry analysts publish
about us, our business, our market or our competitors. Securities and industry analysts do not currently, and may never, publish
research on us. If no securities or industry analysts commence coverage of our company, our stock price and trading volume could
be negatively impacted. If any of the analysts who may cover us change their recommendation regarding our stock adversely, provide
more favorable relative recommendations about our competitors or publishes inaccurate or unfavorable research about our business,
our stock price would likely decline. If any analyst who may cover us ceases coverage of us or fails to publish reports on us
regularly, demand for our stock could decrease, which could cause our stock price and trading volume to decline.
80
ITEM
1B. UNRESOLVED STAFF COMMENTS
Not
applicable.